Conclusion
Agreement of a standard
Standards serve society on many levels. Early examples include our 365-day calendar, which the Egyptians developed based on the rising of Sirius every 365 days. This was important as it coincided with the annual inundation of the Nile, which enriched the soil and was the foundation for crops. Another example is King Henry I of England standardising measurement by devising the ell, the equivalent to the length of his arm.
In 2013, or thereabouts, aesthetic medicine will have its own EU standard—the European Standard for Aesthetic Surgery Services, distinguished by the seemingly innocuous, eminently forgettable CEN TC403. Nevertheless, in a couple of years this designation will probably stick in practitioners’ memories like used chewing gum to a pavement.
Up to 22 May, CEN (European Committee for Standardisation) will collect comments from associations and aesthetic medicine practitioners for helping to devise a common standard. Already, some noses in the UK have collectively been put out of joint because their skills have have not been recognised in the preliminary consultations as pertinent to aesthetic medicine. Dentists and registered nurses were looked over; although, the former are likely to have input through dental committees, and the latter, to some extent, through aesthetic associations.
The associations are all trying to be heard, because the standard’s final wording will very much depend on their influence. This is a loud clamour, as the UK has a fair number of associations whose members practise aesthetic medicine. Add each member state’s associations and the total climbs steeply.
How the wording is determined will be influenced by the practice of aesthetic medicine in each state, and this does vary. In France, for example, prospective patients must wait a minimum of 15 days after consultation before any cosmetic procedure—be it an injectable or surgery. And if patients desire a toxin treatment, their choice will be restricted because it is considered a drug best administered by five medical specialities—dermatology, plastic surgery, opthamology, neurology and ENT.
In the UK, such restrictions would suit the British Association of Aesthetic Plastic Surgeons (BAAPS), which censures most other practitioners as predictably as a forecast for a tepid, cloudy summer. In September 2010, BAAPS called for the government-sponsored quality assurance mark to be put on hold pending guidance from CEN and its UK affiliate, the BSI.
Nigel Mercer, BAAPS president in 2010, said: “Clinics already have to register with the Care Quality Commission because it is the law and it is the job of this agency to regulate the facilities where these treatments are performed. IHAS [Independent Healthcare Advisory Services] has no teeth to stop poor practice. It seems to be sold to the profession on the basis of marketing rather than patient safety.”
BAAPS has high hopes for the CEN standard, citing its emphasis on patient safety rather than marketing. It will have “teeth”, it opines, because it cannot be ignored by national governments.
Predictably, CEN, rather self-servingly, sees the standard as providing real added value for aesthetic surgery by “helping consumers to make informed choices by creating a level playing field for aesthetic surgery providers, complementing existing legislation and filling gaps where no regulation or standard exists”.
The reality is that European standards are voluntary. Nevertheless, their impact can be significant and influence the law of member states.
Ultimately, patient safety is of the utmost importance. By working collectively the aesthetic sector can reduce risk, improve products and services, and fine-tune technique for the benefit of patients across the EU.
To progress, posturing, petty squabbling, self-interests and egos need to be checked in at reception. Such self-effacement will help the development of aesthetic medicine. This will be for the good of all concerned. I hope it is not asking for too much.
