Training and accreditation
Our expert panel debate training requirements and regulation in the medical aestheitc industry
Q: Do all laser technicians need to have a Level 4 laser or IPL qualification by 2016 in order to carry out treatment?
Gill Herrick: Due to under-qualified people using IPL and laser systems they have purchased from the internet and abroad, The British Association of Beauty Therapy and Cosmetology (BABTAC) were getting increased claims in this area for all skin types. So they decided that from 2016, any therapist insured with them must have a Level 4 Laser and Light qualification— whether in hair removal, rejuvenation, or a joint qualification.
Sally Durant: A lot of the time in our industry, certainly in the case of chemical peels and laser, we are being governed by the insurance companies because these treatments are not currently regulated by a qualification structure. I think the insurance companies, as much as we need them, have not been working in the best interests of the industry by broadly insuring as many people as they can get premiums from, without adhering to a sufficiently stringent and specific criteria. I have encountered many people who think they don’t need training because they can get insurance without it.
Elizabeth Raymond Brown: We also have another vagary, which is with the laser and light therapies. In London, Birmingham and Nottingham, clinics delivering light-based therapies can insist—because there are special treatment licenses—that only practitioners who are NVQ Level 3 beauty therapists will be able to practice. The rest of the country won’t insist on that, so it’s difficult and frustrating.
Q: Who should the Government be talking to? There doesn’t seem to be agreement amongst the various bodies to nominate somebody who can speak on behalf of the industry.
Elizabeth Raymond Brown: The Government took the decision that the cosmetic sector should be deregulated, so for cosmetic procedures there is no Government involvement and the local authorities have picked it up.
There is a certain mindset that will say what we need another high profile case, such as the PIP scandal, which brought about the Keogh report. Many cynical people will say we need a serious laser or filler scandal before we can bring the industry together and get the government involved. The government will feel it is too complicated and expensive for them to regulate, so will advise self-regulation, and everyone is aware how well self-regulation works.
Q: Would it be sensible to suggest to the Government that there ought to be some minimum standards? If insurance companies would then support those basic minimum standards this would be a good step in the right direction.
Gill Herrick: We need to educate the public to look for the good practice, research qualifications and be discerning in whom they choose for treatment. Instead of selecting a practitioner on price, the patient should be looking for the right credentials, and we should enable the consumer to make the right choices.
Q: Do you think setting these standards would be expecting an awful lot from the Government, unless somebody helps them?
Elizabeth Raymond Brown: It won’t come from the Government—it will come from trade bodies. The Independent Healthcare Advisory Service (IHAS) for example, devised “treatments you can trust”—a voluntary register. There is a cost to join though, and many practitioners may not see a reason to pay to join if they are happily running their practice. The government is very hands off, they won’t regulate this sector, and so we’ve got to get our act together ourselves.
Q: It’s great that BABTAC is taking a lead, but is that going to go further?
Gill Herrick: BABTAC are working with some laser companies, of which Lynton are one, who will be voluntarily offering the laser and light qualification so that clinicians don’t have to go back to college. Instead, the practitioner can do a theory workbook, and case studies on the laser or IPL that they are using and then take a theory and practical exam. This is something that the Confederation of International Beauty Therapy and Cosmetology (CIBTAC) wanted to work. There are many good therapists in the industry who want to take qualifications voluntarily.
Sally Durant: I think that BABTAC need to go a stage further and not just focus on laser qualifications, but qualifications across the spectrum of clinical skin care, in line with the commissioned review by HEE. I would like to see all insurance companies be more informed on each different element of particular treatments. Chemical peeling in particular needs to be looked at as it is so variable and the different levels of cover relating to peel agent strength, pH and therefore penetration should be made much clearer.
Q: What are the chances of BABTAC looking at the entire spectrum and applying the same reasoning that they will apply to IPL and laser to other disciplines, to create a common approach?
Sally Durant: I think we need to specify a point of entry—what level qualification do practitioners need to practice certain treatments and get away from the ‘supplier driven’ training which is sometimes very good, but often lacking in its educational quality and assessment of proficiency. The Government isn’t going to do this in the foreseeable future, so we as an industry have to self regulate by firmly setting our standards of accredited education and training for the clinical sector.
Q: Theoretically, if the manufacturers broadly speaking agree, the training bodies broadly agree and the insurance companies agree, some kind of guidelines could be created to present to the Government?
Sally Durant: Health Education England (HEE) is doing just that, having been appointed by the government to make recommendations for a qualification structure in the aesthetic sector. Originally the focus of the HEE was very much on looking at the more medical elements of aesthetics such as cosmetic surgery and injectables and the higher education recommendations relating to that. However, whilst the HEE standards has now designed a degree course for medical practitioners to train in non-surgical treatments, the structure of the qualification framework also encompasses the levels of occupational standards to be incorporated into qualifications for therapists at levels 4, 5 and 6 to become properly qualified in procedures such as chemical peels, laser, IPL and micro-needling. This is a great step forward in regaining the credibility of our industry and the safety of the public.
Gill Herrick: Toxins and fillers will always be down the medical route—in fact The Royal College of Surgeons have been asked to put together the training for that module. HEE have set up a working group for laser and light treatments and different levels have now been established, starting from level 4, going up to level 7 or 8 for lasers. Hair and skin rejuvenation are level 4, tattoo removal is level 5.
HEE are looking at the moment for qualifications to be voluntary, but if there is a lot of take-up and interest they will perhaps legislate it. There is talk that other qualifications already available in the industry can be aligned with them.
Sally Durant: My hope is that if we don’t have compulsory qualifications, we can create a self-imposed standard that is not a question of paying membership. Instead it should be based on credentials, commitment to education, professional development and professional integrity. I think having a certain level of CPD every year, to make sure your skills are up to date is something to be incorporated.
Sally Durant established her training consultancy in 2009 offering the provision of post graduate training, practice development services and education programme design in the clinical aesthetics sector.
Gill Herrick is a clinical trainer for Lynton and has worked in the aesthetic industry for many years. She has extensive laser and IPL knowledge, and has been involved in developing training courses for various awarding bodies.
Elizabeth Raymond Brown authored the internationally recognised BTEC qualifications in medical and aesthetic laser/IPL therapies and national occupational standards in light-based therapies. She is director of education at LCS Academy Ltd.