People assume that a treatment which involves a needle, a medicine and a face must be tightly controlled, because everything else in healthcare is. It is a reasonable assumption and, for non surgical cosmetic procedures in most of the UK, it is wrong. This article sets out what is actually required, because misunderstanding it is the root of almost every avoidable problem in this sector.
What is not required
There is currently no UK wide law that requires a person performing non surgical cosmetic injections on an adult to:
- hold a healthcare qualification of any kind;
- appear on a statutory professional register;
- hold indemnity insurance;
- have completed any particular training course or assessment of competence;
- work from premises registered with or inspected by a health regulator;
- have a documented process for managing complications.
All of those are good practice. Several are required of registered healthcare professionals by their own regulators, which is a different thing: those obligations attach to the person because of their registration, not to the activity because of what it is. A person with no registration is outside all of them.
What is required
The controls that do exist attach mostly to the product rather than to the practitioner.
Prescription only medicines. Botulinum toxin products are prescription only medicines under the Human Medicines Regulations 2012. They may be supplied only against a prescription for a named patient written by an appropriate prescriber, and professional guidance requires the prescriber to have assessed the patient. This is the strongest patient protection currently in force for injectables, and it operates indirectly: it puts a qualified person in the chain even when the injector is not one.
Advertising. Prescription only medicines may not be advertised to the public, and marketing generally must comply with the CAP Code enforced by the ASA. That constrains what may be said to you, not who may treat you.
Under 18s. The Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 made it an offence in England to administer botulinum toxin or a subcutaneous, submucous or intradermal filler for cosmetic purposes to a person under 18, subject to narrow exceptions. See our guide to that Act.
Consumer law. The Consumer Rights Act 2015 requires a service to be performed with reasonable care and skill. That is a genuine legal standard and it applies whoever performs the treatment.
The general law. Negligence, and in serious cases the criminal law on assault, apply to everyone. They are remedies after harm rather than controls before it.
What you are entitled to, whoever treats you
- A service performed with reasonable care and skill, under the Consumer Rights Act 2015.
- Valid consent, which requires information about material risks and alternatives.
- Not to be given a prescription only medicine unless a prescriber has assessed you and prescribed it.
- Marketing that is not misleading, under the CAP Code enforced by the ASA.
- To bring a claim in negligence, and to report a suspected adverse incident to the MHRA.
These rights exist regardless of whether the person treating you is regulated. Enforcing them is easier when they are.
Where professional regulation does apply
If the person treating you is a doctor, dentist, nurse, midwife or pharmacist, a substantial framework applies to them personally. They must be registered, must hold indemnity, must work within their competence, must obtain consent properly, must keep records, and must comply with their regulator's guidance on cosmetic interventions. Breach can cost them their registration.
This is why the register check is the highest value action available to a patient. It does not tell you the person is good. It tells you they are inside a system of accountability rather than outside it. See how to run the check.
Fully qualified, fully certified, or accredited, without naming the qualification, the certifying body or the register. In a field where certificates are sold by training providers, the word certified carries no fixed meaning. Ask what, awarded by whom, and checkable where.
The licensing scheme that would change this
The Health and Care Act 2022 created a power for the Secretary of State to make regulations establishing a licensing scheme for non surgical cosmetic procedures in England, covering both practitioners and premises. A consultation on the scope of such a scheme has taken place. At the time of writing the power has not been exercised and no scheme is in operation.
That distinction matters and it is routinely blurred. A power is not a protection. Until regulations are made and commenced, the position described in this article is the position. We track the detail in our guide to the scheme.
The nations differ
Scotland regulates independent healthcare more broadly through Healthcare Improvement Scotland, and has consulted on further regulation of non surgical procedures. Wales has a special procedures licensing regime under the Public Health (Wales) Act 2017 covering procedures such as acupuncture, body piercing, electrolysis and tattooing, and has consulted on extending licensing further. Northern Ireland regulates independent healthcare through the RQIA. Any sentence beginning in the UK, the law says is likely to be inaccurate in at least one nation, which is why we treat them separately in the nations guide.
What to do with this information
Not despair. The absence of a licensing regime does not mean the sector is uniformly unsafe. It means the filtering that regulation would otherwise do has to be done by you, in advance, using the checks that are available: the public registers, the prescriber question, the complications questions, the indemnity certificate, and the insistence on time to reflect.
That is more work than buying any other service, and it is the accurate description of the current position. A publication that told you otherwise would be more comfortable to read and less use.