Independent cosmetic surgery services – emerging concerns

We have inspected 65 services that provide solely cosmetic surgery and/or hair transplant surgery. This represents just under two thirds of those currently registered.

These inspections have identified some good individual practice. But they have also found some common areas of concerns. These include:

• staff without the appropriate training, qualifications and competencies to carry out their role
• unsafe practice in the use of sedation and anaesthetics
• poor monitoring and management of patients whose condition might deteriorate
• a lack of attention to fundamental safety processes
• variable standards of governance and risk management
• failure to ensure consent is obtained in a two-stage process, with an appropriate cooling off period between initial consultation and surgery
• infection prevention and control standards not always being followed
• concerns about equipment maintenance

We have published 58 reports on these inspections to date. Within these, CQC has issued requirement notices or taken enforcement action against 12 different providers, ordering them to improve.

Today, Professor Ted Baker, CQC’s Chief Inspector of Hospitals has written to all independent cosmetic surgery providers. His letter highlights these emerging concerns and clarifies the standards of patient care that CQC expect and patients deserve. It also reminds providers of their responsibility to deliver safe and effective services.

Professor Ted Baker, CQC’s Chief Inspector of Hospitals, said:

“Patients should be able to expect safe, high quality care from all providers of cosmetic surgery. Staff must be appropriately trained and supported to carry out their role, effective processes should be in place to monitor patients during and after procedures and emergency equipment on hand to ensure patient safety.

“We know there are some independent cosmetic surgery providers doing all these things and providing a very good standard of care. Unfortunately, our initial inspections suggest that this is not always the case.

“Where we have found concerns we have held those providers to account and have been clear where improvements must be made. We expect providers to deliver on their commitment to provide safe, high-quality care. And we will do everything within our powers to ensure this happens.

“I urge everyone who is considering cosmetic surgery to read our reports before deciding which provider to consult."

We aim to complete our current inspection programme of independent cosmetic surgery services in the next 12 months. This will include follow up inspections of those providers where we have already identified concerns.

CQC regulates cosmetic surgery carried on by a healthcare professional that involves any instrument or equipment (such as an implant) being inserted into the body. This includes procedures such as breast enlargements, liposuction, nose surgery and facelifts.