While great effort has been deployed from within and outside the aesthetic profession to create regulations similar to other medical fields, nothing concrete has been established.
The British Association of Cosmetic Nurses (BACN) is the largest platform available to nurses involved in non-surgical aesthetic treatments in the UK. This dynamic association continues to expand, and now includes over 1000 members. This is remarkable given the upheaval and closures of clinics during the COVID-19 pandemic. As we slowly emerge from the pandemic, and are stronger and more united, we have restructured the ways that regional meetings will be led.
Following the initiative, which was led by board member Lisa Feliz, the BACN has been inundated with responses from members who wish to have the opportunity to become regional leaders. This tremendous enthusiasm reflects the need, as well as the willingness, to support the regions further. Specifically, we have developed a strategy to expand the number of leads to two per region. All of this reflects truly exciting times for the BACN and, indeed, for the profession. This has been eloquently expressed by Lisa, the regional lead board coordinator, who has been instrumental in the transition, and stated how excited she is to begin working with all the fresh talent who have so much to give with the wealth and breadth of experience within medical aesthetics. This process is moving fast, and it is due to be completed by the end of October 2021.
In line with this, the BACN management board would like to express its gratitude for all the support from the regional leaders throughout a very challenging 18 months. The support they have provided to our members has been significant, as reflected by feedback. This is likely the main reason why many nurses choose to become part of our supportive community, and it should be embraced and celebrated.
The board would like to express a special thank you to the regional leaders who have decided to step down. Some of them have been there since the very beginning of the association and have dedicated their time and devotion to aesthetic nursing. They have helped to improve standards and pave the way to delivering excellence. They will certainly be greatly missed. The organisation could not have run the way it has without those dedicated nurses.
To all the new regional leaders who are about to step into their new roles: we welcome you with open arms (albeit 2 metres away). What exciting times await us!
Fond farewells and welcoming new staff
The board was very sad to say goodbye to our wonderful events manager, Tara Glover. Tara was instrumental in putting together all of our regional meetings and events. Her passion and commitment to the BACN and its members was inspirational. We wish her every success in her future position.
In September, we also bid a fond farewell to our operations manager, Sarah Greenan, who displayed a great deal of innovation in her role within our annual conferences, as well as supporting the BACN through the difficulties that were faced during the pandemic.
We are proud to announce that Gareth Lewis has moved into the operational manager role. Gareth has been with the BACN for 4 years, and he is a real inspiration. His extensive experience and understanding of the BACN vision will help the organization to develop, grow and move towards a greater future.
The board would also like to welcome its newest team members at BACN: Bec Coleman and Laura Watts. Bec will fill the role of marketing and membership coordinator, while Laura will be the events and membership coordinator. We welcome them with open arms. The new team will be at Clinical Cosmetic and Reconstructive (CCR) Expo in London this month, and we very much hope to see you all there.
Continuing challenges and dilemmas in medical aesthetics
All this exciting news and the bright horizon must not make us become complacent. The time has come to face the prospect of a non-regulated profession.
A great deal has been written and said about the necessity to regulate the aesthetic profession, in the medical literature, but also in the wider press. The latter regularly reports negative aspects and exposes several flaws of the field. This inevitably includes the ‘wild west’-type access to injectables by non-medically trained individuals or the facilitation of this access by medical professionals to non-medical professionals. While a great effort has been deployed from within and outside the profession to create regulations similar to other medical fields, nothing concrete has been established. The profession is still the victim of ‘rogue’ practitioners.
This fact is rather astonishing, as the stakes are well defined and, for the most part, there is no resistance from our profession—quite the contrary. There have been many appeals and requests to do so (King, 2021). As we know, the vast majority of aesthetic nurses strive to work within an ethical framework and continue to better themselves by attending regular training from learned societies. Furthermore, many nurses recognise the need for lifelong learning and evidence-based practice in order to provide excellence in medical aesthetics. As nurses, we are bound by our governing body, and must work within our professional code of practice (Nursing and Midwifery Council (NMC), 2018). Those who work outside of the code can be judged accordingly (Barton, 2021).
Perhaps the time has come to contemplate what would happen if we continue to work in a non-regulated atmosphere. There are several precedents that cannot be overlooked or ignored. In recent history, the most significant is the Bristol Royal Infirmary scandal. Although the magnitude of this issue cannot be compared to the mini scandals that are regularly reported in the field, the basic elements are somehow similar and include complacency, lack of attention to whistleblowing and practice by inadequately trained individuals (Smith, 2001).
On reflection, and with the benefit of hindsight, the Bristol affair has had an enormous impact on the way that day-to-day heart surgery is conducted. This includes all steps throughout the patient journey. The inquiry found that, because clinicians had only to ‘satisfy themselves’, there was a lack of governance and accountability, which, ultimately, affected patient safety (Smith., 2001). The chilling reality is that, despite the ongoing struggle to regulate aesthetics, it remains very much unregulated with some who flout the rules and put patients at risk.
One should bear in mind that, in the aftermath of the Bristol Royal Infirmary scandal, regulatory bodies were given more power to guide and, sometimes, impose drastic steps, such as stopping surgeons operating or, for those who were found outside of their duty of care, being ‘struck off’ from the register (Smith, 2001). Stringent training criteria was introduced. Strict adherence to clinical governance was implemented, along with rigorous reporting of outcomes. Another consequence relates to public confidence, which has not yet totally recovered.
Aside from the aforementioned weaknesses and the potential consequences, the profession seems to be moving against the natural current of super-specialisation, which has been prevailing in all the medical specialties. The underlying rationale of the recent trend of super-specialisation is to provide the best possible care. While most medical specialities have split into subspecialties and niches developed by super-trained practitioners, the field suffers from the reverse trend, where poorly trained individuals from pop-up training academies have access to and offer the same procedures as an experienced medical practitioner, and there appears to be no specialisation. Additionally, the ‘global portfolio’ of the available techniques and technologies continue to expand, thanks to ingenuity of the industry and the researcher. This phenomenon needs to be recognised and integrated into our professional perspective.
Furthermore, while job titles within the NHS remain clear and transparent, in private clinics, titles are used with no evidence of competence. This further muddies the water and confuses the general public. Worse, it can mislead the patients who may have a misconception about who is treating them. With that respect, the new BACN initiative by the educational committee, led by board members Anna Baker and Mel Recchia, will help define these titles. Although this is unlikely to solve the wider issues in aesthetics in regard to the misuse of titles, it will ensure that, as nurses, we are taking steps to remedy this problem by providing benchmarks to evidence practice and competence, and thereby justifying the use of a title.