HEE Guidelines 2016: A Brief Summary

On 8th January 2016 Health Education England (HEE) published Part Two of their qualification requirements for delivery of cosmetic procedures. Below is a summary of the background of and latest changes to these guidelines, as far as they will affect those who train or deliver injectable treatments (e.g. botulinum toxins and dermal fillers).

The latest publication is Part Two of HEE’s guidelines, and builds on 2015 requirements for cosmetic training that we summarized in an earlier article here.

“Part One sets out the qualification requirements, which include guidance on the application of the requirements for different groups of practitioners working in the cosmetics or aesthetic field. Part Two describes the second and final phase of the project to produce the detailed qualification requirements for delivery of non-surgical cosmetic interventions and hair restoration surgery.” – Health Education England (2016)

Currently HEE requirements are best-practice guidelines, and do not yet represent statute law.

 

HEE guidelines: a background

The current landscape that the HEE guidelines are responding to:

   – No legal restrictions on who may perform cosmetic procedures.

   – No qualification requirements.

   – An absence of accredited training courses in an increasingly lucrative industry (worth over £3.6 billion).

Timeline of HEE cosmetic regulations 2016 botox fillers
Timeline of the evolution of Health Education England guidelines on qualification requirements for delivery of cosmetic procedures.

 

Five main modalities covered by HEE requirements

1. Botulinum Toxin

2. Dermal Fillers

3. Lasers, IPL and LED Treatments

4. Chemical Peel / Skin Rejuvenation

5. Hair Restoration


General key points about the requirements (Parts 1 & 2)

The requirements apply to all practitioners, regardless of previous training and professional background.

All groups will be required to:
– undertake additional education and training to be able to deliver cosmetic interventions
or
–  formally demonstrate that they already meet the qualification requirements.

How to meet education and training requirements (Figure 2, HEE requirements Part One, 2015)
How to meet education and training requirements (Figure 2, HEE requirements Part One, 2015)

  Recognition of Prior Learning: Practitioners have already completed training will be able to apply for formal recognition of this from an accredited cosmetic training provider.

   –  Very short courses, e.g. 1-2 days in duration, will not met the requirements for Recognition of Prior Learning.

General key points about Part 2

   – A joint council is to be formed, which will take ownership of cosmetic industry standards for education and training.

  –  HEE do not expect practitioners to stop practicing whilst new qualification frameworks are in development

“Although adoption of the new requirements will be voluntary at this stage, it is recommended that the qualification requirements be adopted as best practice and accepted as the standard that the industry should adopt improve public safety and raise standards of practice and professionalism”

   – Practitioners should take care to select courses which promote safe practice.


For Practitioners

Part One & Two: Key Points that remain unchanged

– As in Part One, only GMC-registered practitioners may administer permanent fillers.

– Dermal Fillers are still classed as a medical device and don’t require a prescription.

– HEE Agrees with GMC, GDC and NMC guidance on face-to-face consultations before prescribing. And, as in Part One, the following groups are able to prescribe Botulinum Toxins for cosmetic purposes:

   – Doctors and dentists

   – Pharmacist independent prescribers

   – Nurse and midwife independent prescribers

– Dermatologists and Plastic surgeons are exempt from some areas of additional theoretical learning

– Following completion of training, practitioners are encouraged to identify a professional colleague or mentor with whom they can discuss complex clinical or ethical developments.

 

Part Two: Key changes for Practitioners

 Clinical oversight required for a practitioner
Initially high for someone who has just completed their training (AKA oversight for botulinum toxin and dermal filler treatments will require oversight by an independent prescriber), but it will be a matter of clinical and professional judgement to determine the degree of oversight required.

 Education
– Practitioners do not require a clinically relevant qualification before they apply for training to deliver cosmetic procedures.  In other words, you don’t necessarily need a medical degree.

– However, practitioners performing injectable treatments (botulinum toxins & dermal fillers) amongst others (below) will now be required to study to at least postgraduate degree level (where previously this was specified as undergraduate level).

   – Part Two of the HEE requirements (2016) gives the deadline of September 2018 to complete this postgraduate training.
Key fr treatmnts

Cosmetic treatments to be studied up to postgraduate level.
Cosmetic treatments to be studied up to postgraduate level.

 

What kind of theoretical learning will be required?
Below are some example learning requirements for cosmetic knowledge (HEE Requirements Part One):

  • Understanding of relevant dermatological conditions/diseases, eg cherry angioma, spider naevus, actinic lentigo, melasma, benign dyschromias related to sun damage, acne, hirsutism, rosacea
  • Understanding of common health conditions which may affect treatment, eg diabetes, hypertension, cardiovascular disease/stroke, autoimmune disease, immunocompromised patients, those with transmissible infections, alcohol/drug abuse
  • Ability to take photographs both pre and post-treatment photography and understand how they should be used

Example Learning Requirements for Botulinum Toxins (HEE Requirements Part One):

  • In depth understanding of facial and neck anatomy including relevant vessels, nerves and muscles
  • Identification of contraindications for use, e.g. pregnancy, breast feeding, history of neuromuscular disorder
  • Understanding of potential risks including facial asymmetry, ptosis, dry eyes, drooling, lip drooping, difficulty speaking or swallowing, dry mouth, respiratory distress

Example Learning Requirements for Dermal Fillers (HEE Requirements Part One):

  • In depth understanding of facial anatomy including relevant vessels, nerves, muscles and fat pads
  • Understanding of biochemistry, pharmacology of various types of dermal filler: permanent, semi-permanent and temporary; replacement vs stimulatory; with or without local anaesthetic
  • Understanding and recognition of specific adverse events including hypersensitivity, biofilm, granuloma, nodule formation with suppuration and abscess formation and treat or refer on appropriately

For Training Courses

Part One & Two: Key Points that remain unchanged for Training Courses

   – Training courses must have their own degree awarding powers or be Ofqual-regulated, or work in partnership with such organisations.

   –  A minimum of 50% of the curriculum must be devoted to the development of practical skills:

– Botulinum Toxin: Students must observe 10 treatments, followed by 10 supervised treatments
– Dermal Fillers: Students must observe 10 treatments, followed by 10 supervised treatments
Delegates must subsequently pass a rigorous and standardised assessment

Supervisors must be able to provide clinical oversight and be be proficient with injectables (a minimum of 3 years experience).

It is up to education providers to determine the detailed learning outcomes for individual courses or modules of study and the number and size of required modules.

 


Harley Academy’s learning materials and courses have been specifically designed using the HEE guidelines. Consider taking our postgraduate qualification, which takes you from a Botox & Fillers foundation training day all the way to a fully qualified aesthetic practitioner, with more experience than any

Do you have any thoughts on these new guidelines? Comment below.


Related articles: Health Education England Guidelines: what you need to know

HEE Cosmetic publication part one (.pdf) 610.5 KB

HEE Cosmetic publication part two (.pdf) 233.85 KB

16 thoughts on “HEE Guidelines 2016: A Brief Summary

  1. Hello I am a bsc registered adult nurse, I was just wondering what the course actually involves ? I would do the level 7, once completing the course would I be able to prescribe the medication or would I need another course for this ? Also could I have more Clear prices please ? Thank you.

    1. Danielle,
      You’re very eligible for the course (foundation day and level 7). However, you will not be able to prescribe botox until you have completed a V300 nurse prescribers course, which will likely have to be self-funded unless your NHS trust are willing to sponsor you.

      The v300 will make your aesthetics practice marginally easier, but is not a necessary pre-requisite.

      As a non-prescriber, you can procure and administer dermal fillers, the 2nd most requested cosmetic procedure, independently.

      You can also administer botulinum toxins independently, provided you work with a doctor who can consult and prescribe for your patients. Many will do this for small fee.

      After a year of practise in aesthetics you are eligible for the V300 in botulinum toxins, which will circumvent the need for an outsourced prescriber. I recommend you call and talk to some universities who offer the V300 to check your eligibility, and fees, etc.

      I know this can be confusing, so please call 0203 859 7598 if you would like a member of our team to run you through your options, and prices for each element of the courses that we offer.

  2. Hi Team,

    Just wondering if I was able to be provided with more information, I have looked through the HEE guidelines which unfortunately no other company have discussed when requesting information on botox and dermal filler courses, so thank you for that. I am currently a Tissue Viability Nurse who would like to get into providing cosmetic treatment in my spare time and wondering the prices and what courses you provide and if you had any dvice on the path i could take to achieve this.

    Many thanks
    Sean Phillips

    1. Hi Sean, thanks for your considered comment. We recommend the Level 7 course because it complies with the HEE guidelines. You can either pay for the whole course before attending a foundation day here (instalment options available), or if you would like to ‘try before you buy’ then just book onto a convenient foundation training day here and see whether aesthetics is the right specialty for you.

      Please call us on 0203 859 7598 if you have any further questions 🙂

      Look forward to seeing you on a course soon!

  3. Is the level 7 course the ONLY way you can continue to provide injectibles after 2018? Or are there shorter alternatives that still adhere to this new guidance? Will no other course be accepted after this? How long does your level 7 course take?

    1. Hi Danislle,
      The new guidelines are helping to create a new, higher standard of practitioner. This will likely lead to a two-tiered system, of those who have achieved a level 7 in Injectables, and those who have completed very rudimentary training. The proficiency of the former will likely secure their place at the top of a highly competitive industry. Those who do not achieve the higher, level 7 standard may still be able to practice (unless legal restrictions do come into place) but they will profit only from public ignorance about the higher expected standard, and that may not last long past the suggested deadline of 2018. This field is dynamic and shifting so we recommend that you try to keep ahead of the curve, and keep reading about new guidelines and training opportunities!

      Our course takes between 6 months and 3 years, depending on your level of experience (if any) and how much time you can commit to it. This is still shorter, and more adaptable, than a master’s degree at a university (not to mention cheaper!)

  4. Hi I’m an assistant practicioner and have a foundation degree in health and social care would I be able to administer Botox ?

    1. Hi Natalie,

      We accept only fully registered medical professionals with undergraduate degrees in medicine, nursing/midwifery, dentistry or pharmacy. If you’re set on aesthetic medicine, we highly recommend an undergraduate degree in one of these disciplines as it will enable you to keep yourself and your patients safe and to refine your practise to the highest level.

  5. Hi i am a registered adult nurse at diploma level is this sufficient for entry to the course?
    Also do you no of students that were able to get help or loans for course fees
    Kind regards Sarah

  6. Hello I am a registered dietitian. I live and work in Greece. I am practicing aesthetic medicine for seven years. I have also been an aesthetic medicine trainer in a Greek company for three years.
    Is it possible for me to undertake the level 7 course?
    Thank you for your response.

    1. Hi Athanasios,
      Sadly we only take on registered medical professionals who have a GMC/GDC/NMC number. Thanks for your enquiry. For news about more general aesthetics courses sign up to our newsletter: harleyacademy.com/contact

  7. Hi I’m a dental therapist looking to get into dermal fillers as to avoid botox as the dentist tend not to pass on the work as they themselves do it. Would I be able to continue doing dermal fillers after 2018 if I went on the course this year I am In Scotland is the Law UK wide

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