Doctors who carry out cosmetic procedures
anywhere in the UK are being issued with new guidance to ensure patients are
treated safely and effectively.
The
guidance by the General Medical Council (GMC) sets out the obligations that
doctors owe their patients, including ethical considerations, knowledge, skills
and performance, safety and quality, and communications.
Meanwhile,
the Royal College of Surgeons is setting out new professional standards for
surgeons and is calling on the government to legislate to protect patients.
Industry Review
The new
standards follow a 2013 review of the cosmetic industry in England conducted by
Professor Sir Bruce Keogh, national medical director at NHS England. His report
found that there was almost no regulation of non-surgical interventions,
despite the fact that they can have major, permanent effects on people’s health
and wellbeing.
The new
GMC guidance comes into force from June, and covers surgical procedures, such
as breast augmentation, as well as non-surgical procedures, such as Botox
injections.
The
guidance says that doctors must:
·
Advertise and market services responsibly. Any advertising must be clear,
factual, and not use promotional tactics, such as 'two-for-one' offers to
encourage patients to make ill-considered decisions. It must not be aimed at
young people or children, and it also includes a ban on offering procedures as
prizes. Doctors must not allow others to misrepresent their services.
· Give
patients time for reflection. They must make sure patients have time to absorb
information about risks before going ahead with a procedure. Patients should
not feel rushed or pressured.
· Seek a
patient’s consent themselves. The doctor carrying out a cosmetic procedure is
responsible for discussing it with the patient, providing them with the
information and support they need, and for obtaining their consent. This
responsibility must not be delegated.
·
Consider the vulnerabilities and psychological needs of the patient and if
necessary seek expert assessment.
· Provide
continuity of care. The doctor must make sure patients know who to contact and
how their care will be managed if they experience any complications, and that
they have full details of any medicines or implants.
· Support
patient safety. Doctors must make full and accurate records of consultations,
using systems to identify and act on any patient safety concerns, and
contribute to programmes to monitor quality and outcomes, including registers
for devices such as breast implants.
Honest Advice
In a
statement, Professor Terence Stephenson, chair of the GMC, says: "Cosmetic
interventions should not be entered into lightly or without serious
considerations. Above all, patients considering whether to have such a
procedure need honest and straightforward advice which allows them to
understand the risks as well as the possible benefits.
"It
is a challenging area of medicine which deals with patients who can be
extremely vulnerable. Most doctors who practise in this area do so to a high
standard but we do sometimes come across poor practice, and it is important
that patients are protected from this and that doctors understand what is
expected from them.
"Our
new guidance is designed to help drive up standards in the cosmetic industry
and make sure all patients, and especially those who are most vulnerable, are
given the care, treatment and support they need."
Legislation
New
professional standards being published at the same time by the Royal College of
Surgeons (RCS) recommend similar practices. Mr Stephen Cannon, chair of the
cosmetic surgery interspeciality committee and vice president of the RCS says
in a statement: "Our message to surgeons and doctors working in the
cosmetic surgery industry is simple: if you are not working to the surgical
standards we have set out and published today, you should not be treating patients
at all.
"We,
and the regulators, will do everything within our powers to protect patients
and stop unscrupulous individuals from practising."
However,
the RCS wants to go even further towards stopping 'cowboys' from operating in
the industry. It is calling on the government to introduce legislation in the
next Queen's Speech next month to protect patients.
Mr Cannon
says: "Cosmetic surgery is a booming industry, but the law currently
allows any doctor - surgeon or otherwise - to perform cosmetic surgery in the
private sector. This can make it difficult for patients to identify an
experienced, highly trained surgeon from someone who should not be practising.
"To
correct this, we will launch a new system of certification later this year
which will help patients to find a certified surgeon, who has the appropriate
training, experience and insurance to carry out a procedure - such as a tummy
tuck or nose job.
"Giving
the professional regulator, the GMC, the power to annotate its register of
doctors, will give our certification system extra teeth and regulatory
backing."
Non-Medically Trained Providers
There remain
concerns that at present people such as beauticians with no medical training
can administer non-surgical treatments such as Botox injections, even though it
is a potent neurotoxin, and dermal fillers, which are completely unregulated.
Surgeons say that only trained doctors, nurses and dentists should be able to
provide non-surgical cosmetic treatments and urge the government to introduce
tougher laws.
SOURCES:
General
Medical Council (GMC).
Royal
College of Surgeons (RCS).
Peter
Russell
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