Nursing and midwifery prescribers will soon be required to consult people in person before issuing prescriptions for non-surgical cosmetic medicines, under new guidance from the nursing regulator.
The change comes as part of an updated position statement from the Nursing and Midwifery Council (NMC) on the prescribing of non-surgical cosmetic medicines, including some anti-wrinkle injections and other aesthetic emergency kit items.
Face-to-face consultations will be required from June 1, including initial consultations and any subsequent consultations and follow ups, the NMC said.
Professionals will also be required to ‘undertake and document’ a clinical assessment of the client or patient before they prescribe any products used for any non-surgical cosmetic procedure.
The regulator hopes these changes will ensure the prescribing of non-emergency medicines is done ‘safely and appropriately’.
In its new statement, effective from June 2025, it will say ‘independent nurse and midwife prescribers must carry out a face-to-face consultation and undertake and document an appropriate clinical assessment of the intended recipient of the medicine before they prescribe any products used for any elective nonsurgical cosmetic procedure’.
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‘It is not appropriate to prescribe medicinal products for these purposes by remote methods such as telephone, email, online, video or communication via a third party. This applies to the initial consultation and any subsequent consultations and follow ups,’ it will state.
How was this decision made?
The decision to update the NMC’s position was made following the regulator’s research into perceptions of remote prescribing, including analysis of how any changes could impact those administering and receiving non-surgical cosmetic procedures.
In 2024, the NMC commissioned independent research into this area by the agency Thinks who spoke with members of the public who had undergone non-surgical cosmetic procedures, as well as those who had not.
What did the research reveal?
The research found that participants, in general, agreed that the NMC should strengthen its stance and agreed that the move would improve the safety of those using non-surgical cosmetic services.
Many of those who underwent non-surgical cosmetic procedures had not fully examined how the medicine was obtained, or whether the person administering or injecting it was a healthcare professional or not. They were also not aware that the medicines they were accessing were prescribed.
A number also believed the procedures were overly accessible and taking place in unregulated environments and were unsure whether those administering or injecting the medicines had received sufficient training.
Some participants, particularly business owners, suggested that video consultations should be permitted and suggested that the requirement for face-to-face consultations felt outdated.
Around the same time, the NMC also held a roundtable on the subject, which was attended by various stakeholders, including:
- regulated health and care professionals who prescribe non-surgical cosmetic medicines
- non-prescribing, regulated health and care professionals who administer non-surgical cosmetic treatments
- unregulated practitioners who administer non-surgical cosmetics treatments such as beauticians
- cosmetic business owners.
Anne Trotter, NMC assistant director of education and standards, said that the regulator was ‘confident’ that the updated position will best serve ‘public safety and protection’ and ensure ‘competent and effective’ prescribing.
‘Face-to-face consultations will further improve their ability to assess people holistically and ensure non-surgical cosmetic medicines are prescribed as safely and appropriately,’ she said.
‘We’ll continue to engage with our stakeholders, professionals, employers and the public as we bring this new requirement into effect.’
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Which nursing and midwifery professionals can prescribe?
Currently only registered nurses (level 1) and midwives, and specialist community public health nurses (SCPHN) who have completed an NMC approved prescribing programme and have their qualification recorded on the register can prescribe.
Nursing associates and registered nurses (level 2) are not eligible to undertake a prescribing qualification, so are not able to prescribe.
There are two categories of nurse or midwife prescribers: community nurse or midwife prescribers, and independent and supplementary nurse or midwife prescribers.
Once qualified and registered, all nurse and midwife prescribers are expected to adhere to the Royal Pharmaceutical Society’s (RPS) Competency Framework for all Prescribers.
What is a ‘cosmetic procedure’?
The Health and Care Act 2022 defines a ‘cosmetic procedure’ as a procedure, other than a surgical or dental procedure, which may be carried out for cosmetic purposes and can include:
(a) the injection of a substance
(b) the application of a substance that is capable of penetrating into or through the epidermis
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(c) the insertion of needles into the skin
(d) the placing of threads under the skin; (e) the application of light, electricity, cold or heat.
