RCS calls on surgeons and private hospitals to prepare for changes in cosmetic surgery

The Royal College of Surgeons (RCS) has today called on surgeons and hospitals to prepare for changes that will radically drive up standards of care in cosmetic surgery.

From next spring (2016), surgeons will be able to apply for ‘certification’ to show they are qualified and competent to perform specific procedures. It will enable surgeons working in the private sector to demonstrate they have the appropriate standards of training and experience to perform cosmetic surgical procedures - such as breast enlargements or tummy tucks.

Currently, cosmetic surgery is not a defined surgical speciality and there are no common standards available to surgeons who perform it. The law allows any doctor - surgeon or otherwise - to perform cosmetic surgery.

The new system of certification will address this and allow the public and employers to distinguish highly qualified, experienced individuals, from those who are working without adequate insurance or the necessary specialist training.

The RCS is today setting out what surgeons need to do to apply for certification. Mr Steve Cannon, Chair of the Cosmetic Surgery Interspecialty Committee, (CSIC) which was set up to oversee the changes, said:

“We are calling on all surgeons who perform cosmetic surgery to prepare for these very important changes. This new system of certification will raise standards of care for patients and enhance the reputation of the profession as a whole.

“From spring next year, surgeons will be able to apply for certification and demonstrate their skills and expertise.

“It will make cosmetic surgery safer for patients, who for the first time, will be able to identify a highly qualified, experienced surgeon to perform a procedure through a register of surgeons. It will also make it simpler for hospitals to check the qualifications, experience and training of the doctors who work there.  All eligible surgeons should apply for certification.”

Surgeons will be able to obtain certification in one or more groups of closely related procedures as long as they are on the General Medical Council’s (GMC) specialist register in a specialty that demonstrates training and experience in the chosen area of practice, and they can demonstrate they meet certification requirements. This will include providing evidence they have: 

• performed a minimum number of surgical procedures in the area of certification and of their outcomes;
• indemnity insurance which covers practice in the UK;
• undergone successful revalidation including at least one appraisal that has taken into account their cosmetic practice;
• attended an accredited masterclass on professional skills in cosmetic surgery;
• confirmation of knowledge and adherence to relevant General Medical Council’s and Royal College of Surgeons’ guidance (read full details of what is required).

These changes have been introduced following the PIP breast implant scandal, which prompted the government to ask Professor Sir Bruce Keogh to undertake a review of the regulation of cosmetic interventions. The review was published in April 2013.

It asked the Royal College of Surgeons (RCS) to establish a Cosmetic Surgery Interspecialty Committee (CSIC) to set standards for practice and training, establish a system of certification for surgeons to demonstrate whether they meet these standards, support the accessibility of outcome data, and help patients to make informed decisions about their surgery. The new system of certification is in direct response to this and is supported by all the relevant surgical speciality associations.

Individuals will be able to apply by submitting evidence of their work through a secure website. Evaluators will review the

application and decide whether or not to award certification. 

Notes to editors

1. Read more about the services and tools the RCS is developing to help surgeons and providers prepare for the changes.
    
2. A range of stakeholders have publicly endorsed the CSIC’s work and the plans for certification. Read their statements. 
3. Membership of the CSIC and its sub-groups has included representatives of the relevant speciality associations including: the Association of Breast Surgery (ABS), The British Association of Aesthetic Plastic Surgeons (BAAPS), The British Association of Oral and Maxillofacial Surgeons (BAOMS), The British Association of Plastic and Reconstructive Aesthetic Surgeons (BAPRAS), The British Association of Urological Surgeons (BAUS) and The British Association of Otorhinolaryngologists (ENT-UK).
    

   It also included: The Royal College of Ophthalmologists (RCOphth), The Royal College of Obstetricians and Gynaecologists (RCOG), patients (including the RCS Patient Liaison Group and The Patient Information Forum), Academy of British Cosmetic Practice, Association of Independent Healthcare (AIHO), Private Healthcare Information Network (PHIN), Regulators (General Medical Council, Care Quality Commission), NHS Choices, Psychologists, The Departments of Health in England, Wales and Northern Ireland, and the Scottish Health and Social Care Directorate (as observers). 

4. It will be a legal requirement for every provider of cosmetic surgery to collect a defined set of private patient episode data as set out by the Competition and Markets Authority (CMA). This will enable publication of performance measures by procedure, at both hospital and consultant level, by the Private Healthcare Information Network (PHIN).  Later this year, the RCS will publish a data set of key clinical quality indicators, which are broadly in line with CMA requirements, to help surgeons and providers collect relevant data. 
5. To prepare for certification, surgeons should familiarise themselves with their obligations under the CMA requirements on performance, as set out by their employer. They should also include evidence of their cosmetic practice within their annual appraisals and ensure they have indemnity insurance that covers their cosmetic practice in the UK. 
6. To help capture patients’ views of the outcome of their surgery in a consistent way, the RCS is recommending the use of Q-PROM questionnaires for selected procedures to measure a patient’s quality of life and how this has been improved by surgery. These will be available on the RCS website.
7. There will also be new codes to make sure the language used to describe cosmetic surgical procedures is consistent and accurate.
8. Next spring, the RCS will also be launching information for patients online, so they can access clear, credible and unbiased information about cosmetic surgery. This will include an option to search for a certified surgeon and a checklist to help guide patients and surgeons through the pre-operative consultation.
9. For more information, please contact the RCS Press Office
   Telephone: 020 7869 6047/6052
   Email: pressoffice@rcseng.ac.uk