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Home > Blog > 2012 > New standards for cosmetic surgery in Europe... Have your say!

New standards for cosmetic surgery in Europe... Have your say!

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The recent PIP implants controversy has raised more concerns about regulation, operation and standards within the cosmetic surgery industry. In the UK, the Guardian newspaper has recently highlighted private cosmetic clinics that employ surgeons to carry out breast enlargements, nose jobs and tummy tucks who do not hold qualifications as plastic surgeons within the NHS (Private cosmetic clinics employing 'unqualified' surgeons).  There are also concerns about the quality standards and practices of cosmetic surgery clinics both within the UK and across Europe. A new European Standard on Aesthetic Surgery Services represents a significant move to address these shortcomings.

Regulating the cosmetic surgeons

In general, cosmetic and plastic surgeons who carry out cosmetic surgery at one of the private hospitals owned by UK groups such as Nuffield, BMI and Spire hospitals will hold an NHS consultant position, usually in Plastic Surgery or ENT Surgery - NHS consultants who do some private cosmetic surgery work. In contrast, many of the surgeons working for the cosmetic surgery chains such as Transform, Harley Medical Group and the Hospital Group are not NHS consultants.

The British Association of Aesthetic and Plastic Surgeons (BAAPS) has raised concerns about the influx of cosmetic surgeons into the UK from Europe. The BAAPS President told the Guardian, "We very often get applicants from Europe. Although they automatically get on the specialist register, the quality of training they have had is in no way equivalent to a trainee in the UK and they are often not deemed suitable for an NHS post".

According to Transform, "Qualifications obtained in other parts of Europe are at least the equal to those obtained in the UK" and said it was "completely untrue and highly misinformed" to suggest otherwise.

In June 2011, the European Commission published a Green Paper, “Modernising the Professional Qualifications Directive”. This Directive, adopted in 2005, sets the rules for mutual recognition of professional qualifications between Member States.  Consultation on this paper has now closed.

Regulating the cosmetic clinics.... The European Standard on Aesthetic Surgery Services

Many businesses, clinics and doctors working in the cosmetic surgery sector across Europe are still blissfully unaware of what’s coming their way – a European Standard on Aesthetic Surgery Services.

CEN (the European Committee for Standardization) is currently running a public consultation on the draft of this standard.  The aim of the consultation process is to develop a European best practice standard for surgeons, doctors and nurses in private healthcare facilities that offer cosmetic procedures. As may be seen from its title, the standard is primarily concerned with “services”, rather than with products or devices (such as breast implants).

When the final standard is released in 2013, it will result in:

  • Improvement in aesthetic surgery services through enhancing patient safety and avoiding the risk of complications and patient criticism about poor services;
  • Adoption of consistently high standards for aesthetic surgery providers across Europe;
  • Enhancement of patient satisfaction and reduced criticism of poor service delivery.

In terms of scope, both surgical and non-surgical medical services are included.  It provides recommendations for procedures for clinical treatment, including the ethical framework and general principles according to which clinical services are provided by all aesthetic practitioners. Dentistry procedures are excluded. Cosmetic non-medical procedures (e.g. tattoos, piercing) provided by non-doctors (e.g. beauticians, masseurs, hairdressers) in non-medical facilities (such as spas, salons) are excluded from the scope of the European Standard.

Find out about the new Standard

A copy of the draft European Standard 16372 is available from the national standardisation bodies of each EU state and the EFTA member states, Croatia and Turkey. You are able to submit comments on the draft standard to your national standards body.

  • UK clinics: You can view and comment on the new standard on the British Standards Institute web site. Search on either: “Aesthetics surgery services”, or the draft standard number: “prEN 16372”. This will take you through to a "Draft details" option. You will then be asked to register with the site. After that you can make comments on a clause by clause basis.
  • Non-UK clinics: Other member countries within CEN are also running public consultations, and for details of how to take part, you should contact your NSB (National Standardisation Body).

So, if you are involved in cosmetic surgery in Europe, now’s the time to “have your say” on the new aesthetic surgery standard.

Date published: 9 February 2012


Comments provided below do not represent the views of IMTJ. Comments will be published 'as is' and will not be edited by IMTJ staff. IMTJ is hosting these comments, and is not undertaking an editorial role. However, it is editorial policy to publish comments that have been submitted anonymously. 

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Keith Pollard

Keith Pollard

I am CEO of Intuition Communication Ltd, a web publishing business in the healthcare sector. Our sites include International Medical Travel Journal, Treatment Abroad, the medical tourism portal, DoctorInternet, the Arabic medical tourism portal and Private Healthcare UK, the UK's leading site for private healthcare services. I am a regular speaker and commentator on medical tourism and the independent healthcare sector.

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Mercury Healthcare has long published standards that meet or exceed industry rigors on physician qualifications, credentials verification and criteria-based core privileging.

Here the applicant picks a predetermined group of procedures or treatments that are common to that specialty. An example would be a urologist picking core urologic procedures. These would include all general urology endoscopic and open procedures as well as the pre and postoperative care and the ability to consult and care for patients with non-operative urologic conditions. The burden then is on the medical staff to include or exclude all pertinent procedures in core privilege list.

If any procedure requires special qualification such as LASER or lithotripsy, these procedures would be asked for specifically with a showing of the specific required training. If however the medical staff has stated that a certain number of any one type of case, such as radical cystectomy, is required, this type of case should not be a part of the core procedures. The verified numbers of these cases may be totaled from various institutions.

It makes no difference which method is used. In order to apply for either, the applicants must show they have the training, education, experience and current competence for the requested privileges. The medical staff needs to have predetermined criteria that meet minimum standards and then verify the qualifications of the applicant against these criteria. These criteria should apply to specialty or procedure, not to a specific department. This allows for all qualified physicians to perform a procedure or treatment and take away the “turf war”. Another deterrent to a dispute among physicians is setting realistic minimum standards that can be met by any qualified group or individual. The requirements need to be fair to all and related to the quality of care. If the applicant does not meet these threshold criteria the request is incomplete and not denied and fair hearing procedures are not needed. If the threshold criteria are met and the request is denied, then the due process and fair hearing requirements are available to the applicant.

We are glad to see these issues being raised on the medical tourism forefront.

Maria K Todd, MHA PhD
CEO and Founder
Mercury Healthcare International
Denver, CO USA

Maria K Todd, MHA PhD (11/02/2012 00:03:59)