Following a motion at the British Association of Cosmetic Nurses (BACN) conference on November 7 and 8, members unanimously agreed to update its Code of Conduct to state that regulated healthcare professionals should not train or prescribe for beauty therapists or ‘lay people’ in the use of injectable treatments such as dermal fillers and botulinum toxin.
The motion has also been supported by the British College of Aesthetic Medicine (BCAM) and the Aesthetics Clinical Advisory Board. When Aesthetics exclusively shared the news on social media last month, the posts reached almost 10,000 people, garnering huge support amongst the medical aesthetic community.
Why now?
The BACN acknowledged that there has been a rise in complications as a result of beauty therapists offering aesthetic treatments, which has meant the public is exposed to an inability to be cared for medically by this group. In its statement, the BACN noted, ‘The public are often subject to ghosting, blocking and intimidation should they complain, and the medical professionals are increasingly required to pick up and help, often out of good will’.
The association continued, ‘Whilst the task of injecting a botulinum toxin or a dermal filler (implant) at its most basic level can be taught relatively easily, much wider knowledge and clinical acumen are required. The tick-box consultation method in medicine does not work if the answers to the questions are not clearly understood and acted upon. Our own patients may present with a medical condition or medications and our clinical judgement, scrutiny and reasoning will come into play when we consider and plan their treatment, and we may decide not to treat, or we may refer. A qualified nurse is furnished with competency in multiple clinical skillsets, judgement, critical thinking and evaluation’.
Considerations for nurses
The association asked its members to remember the principles of the Nursing and Midwifery Council (NMC) Code, which emphasises that nurses should act within patients’ best interest and be able to demonstrate competency for all they do, as well as the competency of those they delegate to. According to the NMC, delegation is defined as the transfer, to a competent individual, of the authority to perform a specific task in a specified situation.1 As such, the BACN stated, ‘One could postulate that those training someone else in healthcare is akin to delegating a task, and that those training others therefore must be responsible in ensuring that the training meets the NMC delegation requirements. The same applies to prescribing for others and the delegation of the administration of medicines’.
‘Nurses should act within patients’ best interest and be able to demonstrate competency for all they do, as well as the competency of those they delegate to’ NMC Code
The BACN also reiterated the NMC’s statement on remote prescribing, which reads, ‘All prescribers must take individual responsibility for their prescribing decisions and should recognise that there are certain areas of practice where remote prescribing is unlikely to be suitable, for example when prescribing medicines likely to be subject to misuse or abuse, or injectable cosmetic treatments’.
The association went on the emphasise that the training of a beauty therapist/lay person who has: no medical qualification, no clinical knowledge or acumen, no pathway or requirement to demonstrate competency, is not required to evidence or show accountability, cannot consult or consent adequately as the clinical knowledge is absent, cannot prescribe and therefore manage complications, is not part of a multi-disciplinary team and is not answerable or accountable for their actions, must surely conflict with the Code where maintaining patient safety is a priority. The statement concluded, ‘We have no doubt that the practice of teaching the unregulated beauty sector or lay people to administer injectable treatments is contrary to the NMC Code of Conduct’.
Moving forward
Following the successful motion, BACN Chair Sharon Bennett commented, “We are overwhelmed; we had a 100% unanimous vote on this and we know that the British College of Aesthetic Medicine is in support of us. It’s a step forward in demonstrating that we are professionals and these treatments should be in the hands of professionals, not lay people. We hope the public will recognise that this is the pathway to go down when considering aesthetic treatments.”
