Tough new standards for doctors carrying out cosmetic procedures

The guidance makes clear the ethical obligations doctors have towards patients and the standards of care they need to provide.

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.
— Professor Terence Stephenson, Chair of the GMC.

It has been produced following a review of the cosmetic industry in England by Professor Sir Bruce Keogh. His report highlighted the risks associated with cosmetic interventions and how patients needed greater protection.

The new GMC guidance comes into force from June, and covers both surgical (such as breast augmentation) and non-surgical (such as Botox) procedures.

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 also includes a ban on offering procedures as prizes. Doctors must not allow others to misrepresent their services.

Give patients time for reflection – make sure they have the time and information about risks, to decide whether to go 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.

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 – making full and accurate records of consultations, using systems to identify and act on any patient safety concerns, and contributing to programmes to monitor quality and outcomes, including registers for devices such as breast implants.

Professor Terence Stephenson, Chair of the GMC, said:

‘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.’

Professor Terence Stephenson, Chair of the GMC.

Anyone who chooses to have a cosmetic procedure should expect to have high quality and safe clinical care. This new guidance for doctors is an important step forward in improving standards and ending the lottery of poor practice in parts of the cosmetic industry.’

Professor Sir Bruce Keogh, National Medical Director, NHS England, said:

The GMC’s new guidance will play a pivotal role in raising standards and protecting people who choose to have a cosmetic procedure. The independent review I chaired, following the PIP breast implant scandal, highlighted major problems with unsafe practices in the cosmetic sector, including poor follow-up care and record keeping, and misleading and inappropriate advertising and marketing techniques.

‘This addresses these issues and will drive safer care, more ethical practice and, overall, a better experience for people undergoing cosmetic procedures. It will also help ensure doctors are seen to be open and honest, that they work within their competence and seek appropriate training and advice where necessary. This marks an important step forward for patient protection across a wide range of cosmetic and lifestyle procedures, including areas such as laser eye surgery.’

Catherine Kydd has campaigned for better regulation of the cosmetic industry after she was given breast implants which ruptured, and which have since been banned because they contained industrial silicone. She welcomed the new guidance, saying:

‘Patients have a right to expect to be safe
at the hands of any doctor carrying out a cosmetic procedure. The GMC’s new guidance will significantly strengthen the protection patients have, and make it easier for them to seek action if things do go wrong. It’s a big step forward for patients.’

The GMC is working closely with the Royal College of Surgeons (RCS), which is today also publishing its own set of professional standards, specifically for cosmetic surgery, which will supplement the GMC’s guidance.

Stephen Cannon, Vice President of the RCS and Chair of the Cosmetic Surgery Interspecialty Committee, said:

Our professional standards for cosmetic surgery, coupled with the GMC’s new guidance, will raise the bar and make absolutely clear what we expect of all surgeons working in the private sector.

‘The 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 today, you should not be treating patients at all. We, and regulators including the
GMC, will do everything in our powers to protect patients and to stop unscrupulous individuals from practising.’
Later this year the RCS will also launch a new certification scheme, allowing patients to more easily search for a surgeon who has the necessary skills and experience to perform the procedure they are considering.

Details of all UK doctors, including any specialisms they have, are published on the GMC’s online List of Registered Medical Practitioners. The GMC is continuing to explore how additional information about doctors and their qualifications, in areas such as cosmetic practice, can be made available to patients via the register. This may require legislative change, and was the subject of a public consultation by the GMC in 2015.

In addition, the GMC is currently developing a guide for patients considering cosmetic procedures, which will give advice and information on things to consider and the questions they should ask their doctor.

Full details of the GMC’s new guidance for doctors carrying out cosmetic procedures is available.