Members of the British Association of Cosmetic Nurses (BACN) have voted unanimously to update its Code of Conduct on the training of beauty therapists.
Following a motion at the BACN conference on November 7 and 8, members agreed 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.
The BACN acknowledged that there has been a rise in complications as a result of beauty therapists offering such treatments, which has meant the public is exposed to an inability to be cared for medically by this group. It stated, ‘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 statement continued, ‘Whilst the task of injecting a botulinum toxin or a dermal filler (implant) at its most basic level can be taught relatively easily, a much wider knowledge and clinical acumen is 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’.
The association asked its members to remember the principles of the 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.
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’.
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’.
Following the successful motion, the BACN stated, ‘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. 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’.
Paul Charlson, BCAM president, agreed with the points made by the BACN and emphasised, “The lack of statutory regulation to protect the public means that the industry must continue to support voluntary regulation and maintain good standards. BCAM conducted a member’s survey recently and, as a result, arrived at the decision that it does not support non-clinicians practising to level 7 in line with JCCP current guidance. BCAM therefore does not support its members training or prescribing to non-clinicians attempting to practice independently at level 7. These measures, it hopes, will help discourage the practice."
He continued, "We feel this protects the public from the higher level of risk posed by non-clinicians. This is in line with the BACN’s recent motion. It is regrettable that despite considerable effort we still do not have statutory legislation which will improve public safety. We will continue to lobby for a law change.”
The Aesthetics Clinical Advisory Board, of which BACN Chair Sharon Bennett is a member, also agrees with the BACN’s motion.
Nurse prescriber Jackie Partridge noted, “I think this stance is long overdue and I certainly welcome this as best practice,” while dermatologist Dr Stefanie Williams added, “I fully agree that non-healthcare professionals must not inject fillers or botulinum toxin, so I am pleased that BACN and BCAM are ‘outlawing’ training non-healthcare professionals in these procedures.”
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