Dr. F Didar Cosmetic Facial UK

Dr. F Didar Cosmetic Facial UK

2005 sir Harry Cayton (regulation of cosmetic surgery) Increasing specialist training and accountability Provision of cosmetic surgery in England ( healthcare commission 2007) Good Surgical Practice 2008 Good Medical Practice in Cosmetic procedures Independent Healthcare Advisory Service 2010. NCEPOD (National Confident Enquiry into patient Outcome and Death 2010 Lack of appropriate facilities Surgeons competence Lack of information for patients to understand risks of procedures. RCS published this year Professional Standards for Cosmetic Procedure

AuStralian Government in 2010 New training Standards Advertising restrictions Hong Kong : where to draw line between medical treatment and the beauty one Denmark has introduced new regulation ( who can perform the procedures) Sweden is following Denmark France set new Standards and regulation in details

Safety and quality To act in case of concern on patient safety To protect patients and public 1. To improve and promote patient safety via quality assurance 2. Regular clinical audits including feedback from patients 3. To report adverse incidents either via using a device or products as well as suspected events. 4. To contribute to to confidential enquiries. 5. To co- operate with other organization dealing with public health. 6. To seek advice from colleagues or defence body if any concern regarding performance of colleague (not fit for practice and put patients at risk) 7. To consult a colleague if Any concern regarding health and performance of ours 8. To be immunized against common serious contagious disease. 9.To be registered with a GP.

Knowledge,skill and performance License to practice Must have a license to practice Should be registered with GMC AND other regulating body Must demonstrate the confidence and knowledge through appraisal and revealideation process. Professional performances 1. Competent in all aspect of work a. Management b. Research c. Teaching

Knowledge,skill and performance To keep professional performance up to date a. Participate in activities to maintain and develop it b. Mentoring c. Up dated with guidelines and knowledge d. To monitor and improve the quality of care

Applying knowledge and experience to the NSFA a. Practice in the limit of competence b. To provide a high quality of care c. To provide advice, treatment and investigation if necessary d. To prescribe the medication when needed with taking patient needs into consideration e. To provide the best suitable treatment based on available evidence. f. To consult colleagues as needed g. To get the consent before implementation or involving in patients in a research project.

Safety and quality, Knowledge,skill and performance, 4. Record keeping a. Clear,accurate and legible records b. Confidentiality and data protection c. clinical records should include: i. Clinical finding with the case ii. The decision for treatment iii. Provided information to the patient iv. Medication or other investigation

Communication,partnership and teamwork 1. To listen to the patients 2. To respond honestly to their question and concerns 3. Provide enough clear information about the procedure,complication and out come 4. With keeping confidentiality in mind providing information to those close to the patient. 5. Been access able and available on duty and other time if any concern or emergency arises 6. To treat colleagues family and respectfully. 7. To contribute toward teaching of staff and other colleague. 8. To supervise other colleague if needed. To explain and justify If refuses to provide a treatment.

To treat patients as individual and respect their dignity To be polite in the treatment procedure To keep patients' confidentiality To provide enough information in order to help patient for an informed decision To share treatment plan with patients To correlate with colleague in order to maximize patients' care and therapeutic plan

1. Not to use professional position in pursuing a sexual relationship with a patient or close relative 2. To be honest with patients if things go wrong a. To put matter right b. To offer an apology c. To explain fully what happened and what to expect as long and short term effect. d. Not to discriminate against patients or colleagues. e. To response promptly,fully and honestly to complaints f. To apologies when needed and appropriate. g. To end a professional relationship with a patient just when the trust is broken. h. To have adequate insurance and indemnity cover. i. To be honest about qualification and experience as well as current role j. To be honest while designing,organizing research k. To be honest on providing information as well as communicating with colleagues and patients l. Marketing and advertising should be factual and does not exploit patients' vulnerability(this emphasis in Keogh report too) m. To be honest and trust worthy in writing reports and signing forms. In area of conflict of interest,to act in the best interest of patient and community.general

1.The report and review was initiated by PIP implant scandal. 2. Non surgical procedures accounts for 9/10 of all procedures. 3. NSA accounts for 75% of market value. 4. It emphasis the consumer of this market does not have any protection and so much vulnerable. 5. It emphasis dermal fillers are particularly the cause of concern 6. There is no control on fillers in comparison to purchase a bottle of toilet cleaner. 7. The commercial income is stalling. 8. Dermal fillers are a sitting duck. 9. Previous attempts failed. 10. The report provide a framework for surgical and non surgical fields. 11. Practitioners will need to have appropriate skills as well as safe products. 12. The report has emphasis on individual safety and health. 13. There is no balance between the rapidly growth of cosmetic procedures and existing regulatory framework.

High quality care plus safe products(effectiveness,safety) i. Fillers as prescription only medical device ii. EU medical device to expand to cover all cosmetic implants including fillers iii. UK legislation to facilitate this expansion 1) To set standard 2) Formal certification of all practitioners 3) Training and experiences iv. RCS(Royal College of Surgeons) to established an inter speciality committee on cosmetic surgery v. Performers of cosmetic procedures to get registered. vi. Record keeping for patients and their GPs vii. Skilled practitioners in line with responsible providers

People to get accurate advice ii. Vulnerable are protected iii. Accessible redress and resolutions in case of complications iv. Multi-stage consent process for operation in order to share understanding of desired out come between patients and practitioners (RCS to do this) v. Patient information leaflet by RCS vi. Record of consent for non surgical procedures Advertisement and marketing should be up dated in a way not to avoid inappropriate influence on pubic.

Accessible resolution and redress Continuity of care should be provided in the event of complication. Insurance schemes to provide support and reassurance Patients' access to guidance and help in case of dispute resolution.

Current situation No restriction on a person performing No qualification Training course by anyone to offer a qualification A number of self accredited training organization have sprung up. Non-medical,non-dental and non- nursing practitioners were greatly valued by consumers No specific accredited training on i. physiology ii. Anatomy iii. Infection control iv. Treatment of anaphylaxis v. Understanding of co morbidity or per-existing health problem

a-practitioners should be register with Denish Health board and pay1850 pounds per year: b. Non-surgical cosmetic procedures like botulinum toxin injection,dermal fillers injections, lasers or IPL,chemical peel should be performed by: i. Consultant dermatologist ii. Plastic surgeons iii. Ophthalmologist and neurologist for Botox iv. Nurses and junior doctors can performs all of them but undersupervision and the consultant remains responsible for the procedure or any complication.

Non- health care professional can perform dermal filler,weaker chemical peel and IPL but no botulinum toxin injection,microdermabrasion or sclerotherapy 1) They should hold recognized beauty therapy qualification 2) To demonstrate their competent 3) Qualification should be recognized by Denish Health Board 4) The doctor employed them should deem their competent too.

1. RCS to stablished Cosmetic Surgery inter speciality committee: a. To set standards for training and practice of cosmetic surgery b. Issuing formal certification of surgeons c. To work with PHSO(Parliamentary Health Service Ombudsman) regarding dispute resolution d. Regular meeting with GMC, CQC and MHRA(Medicine and Healthcare products Regulatory Agency) e. To develop A specific code of ethic for cosmetic surgery (advertising, insurance and psychological Assesment of patients

i. Training necessary to able parishioners to identify complications and treat them ii. Regular trading for practitioners to deliver latest treatments iii. The curriculum and training Requirement should be reviewed regularly. iv. Accountability to a professional regulator in case of prescribing filler or performing other potentially harmful non surgical cosmetic procedures.

2. Performing non surgical aesthetic procedures must be under responsibility of an accredited and qualified clinical professional. 3. Non- health practitioners with required accredited qualification may perform the procedures but under supervision of qualified clinical professional. 4. HEE(Health Education England ) mandate should include the development of appropriate accredited qualification for non surgical procedures and its various professional groups. 5. All practitioners must register with annul fee to fund the registration body. a. Accredited qualification b. Premises meeting certain requirements c. Code of practice to cover handling complain and redress, responsible advertising and consent practice. d. Annual appraisal 6. Criteria to enter to the Registery should be: a. Accredited qualification b. Premises meeting certain requirements c. Code of practice to cover handling complain and redress, responsible advertising and consent practice

7. Non- surgical premises subject to inspection by local authorities. a. Awareness of requirement to operate from a safe premises and responsibility involved. b. Training curriculum should include infection control, treatment room safety and adverse incident report. c. Code of conduct: minimum standards for premises. 8. UK legislation to make fillers as prescription only medical device. (EU Medical Device Directive to cover dermal fillers and all cosmetic implants.) 9. For any non surgical intervention a record of consent is necessary (must) 10. Advertisement should be conducted in a socially responsible manner.

11. The following advertisements should be prohibited a. Time- limited deals b. Financial inducements c. Refer a friend, reduced price for two people, buy one get one free d. Competition prize as cosmetic intervention

12. Continuity of care and follow up should be offered 13. Medical director on board for all organization offering cosmetic procedures 14. Complains investigated by the Ombusdman should be publicly available. 15. Adequate professional indemnity cover is a must. The insurance status should be displayed on the practitioner register. 16. Creation of insurance risk pool