The Last Word: Lone Working

By Frances Turner Traill / 21 Jun 2017

Aesthetic nurse prescriber Frances Turner Traill explains why she believes every aesthetic practitioner should have a ‘lone working policy’

There are many times and situations in which aesthetic practitioners may find themselves working alone. Some practitioners will solely run a practice, some will be working late after their colleagues have gone home, while others may be caught off guard when a colleague calls in sick. There is nothing wrong with working alone, as long as the right safeguards are in place. However, this is not a mandatory requirement and therefore, not every aesthetic practitioner has one.

In this article I shall be arguing why every practitioner should adopt a lone working policy, and why by not doing so, they are putting the safety of themselves and their patients at risk.

What is ‘lone working’ and why is this an issue?

The NHS defines lone working as, ‘Any situation in which someone works without a colleague nearby or when someone is working out of sight or earshot of another colleague.’1 This means that a member of staff doesn’t have to be completely alone in their clinic to be classed as a ‘lone worker’, they may just be in a treatment room with the door closed.

In my opinion, lone working is something that isn’t talked about enough. There isn’t much guidance for those setting up clinics on their own and some practitioners may not realise the importance of creating such a policy, and therefore, are practising without one. When you work under the umbrella of the NHS, this is all done for you. But when you go into your own aesthetic practice, you need to ensure that this is covered.

Is it essential to have a policy?

Although there is no legal prohibition on working alone, the Health and Safety at Work Act 1974 and the Management of Health and Safety at Work Regulations 1999, state that all employers have legal responsibilities to evaluate all risks to health and safety, and this includes the risks involved with lone working.2

For those of us working specifically in aesthetics, Part One of the Health Education England (HEE) report on non-surgical cosmetic interventions also specifies that to ensure that practitioners can deliver safe procedures, then they must understand the pitfalls of lone working.3 Having a policy in your clinic is the easiest and most efficient way of ensuring this.

Without a policy, you could be putting yourself and your patients at risk. If you want to operate a safe practice, you need provisions in place.

What should the policy include?

A lone working policy can help to encourage a strong safety ethos among employees and reduce the risk of potential legal disputes. According to guidance provided by Peoplesafe, a company which specialises in lone worker safety, the policy should reflect the hypothetical dangers that employees face when working alone and offer best-practice guidance.4

Public service union Unison advises that a lone working policy should include risks, key definitions, your organisational commitment, clearly-defined responsibilities, guidance on reporting incidents, plus any relevant support and contact details; fundamentally it should contain any guidance needed to protect you and your patients.2 If you have a lone working policy, then as soon as you find yourself working alone, the policy will kick in. Some of the key information that I believe should be contained in the policy is as follows:

Personal safety measures – Staff should take all reasonable precautions to ensure their own safety, as they would in any other circumstances. You must ensure that there is a robust system in place for opening and closing the clinic by someone who is working alone. Staff will ensure they have a mobile phone; they are responsible for checking that it is charged, in working order, and with sufficient credit remaining with the relevant provider, when opening or closing the clinic on their own.

Assessing Risks – On a periodic basis or when an incident occurs a risk assessment will be done by an experienced member of staff to establish if any process/procedural changes are required.

Planning – Staff should be fully briefed on the protocols to be followed should they find themselves at risk whilst working alone. Communication, checking-in and fall back arrangements must be in place to deal with known risks.

Security of premises – Staff working alone must ensure they are familiar with the exits and alarms within the clinic in the case of an emergency. There must be access to a telephone and first aid equipment for staff working alone. If there is any indication that the clinic has been broken into, a staff member must not enter alone, but must escalate the situation to the appropriate person and/or organisation.

Once this policy is in place, it should be integral in your staff training to ensure everyone knows the policy and are working in accordance to it.

The solution

We need to get the discussion going and raise awareness of the issue of lone working through peer groups, such as the British Association of Cosmetic Nurses (BACN) regional groups and the Aesthetic Complications Expert (ACE) group. One solution could be for aesthetic associations to create a standard lone working policy, which can be given out to members. In my opinion, it is essential to be part of a peer group or wider network so issues like this can be discussed.

District nurses in the NHS, who I have spoken to, have an electronic tag team system. This system has GPS tracking, so when they are on their own, somebody somewhere always knows where they are, and if they are not responding within a certain period, then an alert will be sent out. Some of these devices can detect if the worker has a fall, and then send out an alarm to a nominated person. We don’t do this in aesthetics but I think it is something we could adopt, cost-dependant.

If practitioners want to implement a lone working policy, but are still unsure where to turn, then they could look at hiring a business consultant, but be sure to make sure they have experience in creating such policies. They could also speak to fellow, experienced practitioners, who I’m sure would be happy to help.


In an unregulated specialty such as aesthetics, it is so important to protect yourself and your patients. Many of us work alone, so a risk assessment and a lone working policy will identify precautions that will keep you and your patients safe. Whilst we may practice alone sometimes, or all the time, we should not work in isolation, and instead, be part of wider network, such as the BACN or other aesthetic associations. 

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