A nurse has been struck off the Nursing and Midwifery Council (NMC) register after prescribing botulinum toxin without the required face-to-face consultations.
50-year-old Heather Hazzard supplied botulinum toxin to beauticians via an online app, advising them to order in bulk – practices that violate established prescribing guidelines.
The misconduct came to light in 2021 after an undercover journalist contacted Hazzard through the Faces app, posing as a beautician. Hazzard failed to verify the journalist’s credentials, admitted her approach was “not the right way to do it,” and incorrectly claimed that botulinum toxin could be frozen.
The NMC panel concluded that Hazzard’s actions posed serious risks to patient safety and demonstrated dishonesty, prioritising profit over professional integrity. They noted that her failure to conduct proper consultations or ensure the competence of those administering the toxin placed patients at unnecessary risk.
The Aesthetics Journal reached out to the British Association of Medical Aesthetic Nurses (BAMAN) who reiterated their firm stance against remote prescribing for non-surgical cosmetic treatments.
BAMAN shared that the recent NMC Fitness to Practise Committee decision concerning Heather Hazzard highlights the vital importance of adhering to ethical and legal standards in prescribing practices within medical aesthetics. BAMAN highlighted that the case reinforces the necessity of stringent safeguards to ensure patient safety and uphold professional integrity.
Sharon Bennett, nurse prescriber and BAMAN chair, commented, “To ensure prescribing practices align with ethical and legal standards, medical aesthetic nurses must integrate a range of measures into their practice. Nurses should follow the Royal Pharmaceutical Society’s Competency Framework, prioritising safe, patient-centred care. Continuous professional development, reflective practice for NMC revalidation, and maintaining detailed records are essential. Recognising practice limits and seeking collaboration through BAMAN resources and events further supports best practice and patient welfare.”
The Aesthetics Journal also reached out to The Joint Council for Cosmetic Practitioners (JCCP). Andrew Rankin, registered nurse and JCCP Trustee, commented, “The prescribing standards set by the Royal Pharmaceutical Society provide the accepted standard for a number of professional regulators, but naturally there are variations in how the standards are administered across the various statutory professional bodies. The JCCP have sought to identify the common themes that apply across all professional regulators and set them out for the guidance of cosmetic sector professionals as a whole, in the interests of patient safety and public protection.
We welcome the outcome in this instance as indicative of this alignment and the future direction of prescribing in the cosmetic sector. The JCCP’s recent publication in response to the NMC outcome reflects this, and we take this opportunity to highlight some key findings:
- Remote prescribing is unacceptable for cosmetic procedures. This applies across all professions, to all cosmetic procedures for any product prescribed.
- Prior to delegating the procedure, the prescriber must first assess the competence of the person to whom they delegate it.
- The prescriber retains overarching responsibility and must be available to intervene in the event of an adverse incident or any unexpected outcome.
- The prescriber must prescribe only what is required for the specified procedure and do so within the limits of their competence. They must provide (patient specific) directions to that effect, and they should seek assurance of compliance against same.”
