Lies, damned lies and statistics

Abstract

ISSN 2050-3717 Printed by Pensord Press Ltd, Blackwood, NP12 2YA CONSULTANT EDITOR Cheryl Barton Aesthetic Nurse and Managing Director, Aesthetika, Sheffield EDITORIAL BOARD Julie Brackenbury Aesthetic Nurse Consultant, Bristol Susie Byass Aesthetic Nurse Practitioner, Rejuvenating Solutions Ltd, Berwick Upon Tweed Annie Cartwright Advanced Aesthetic Practitioner and Director, Skin & Face Clinics Ltd, Cardiff, Wales Leslie Fletcher Aesthetic Nurse Specialist, USA. Founder of the InjectAbility Institute for Aesthetic Education Trudy Friedman Aesthetic Nurse Practitioner, Aesthetic Skin Centre Sarah Holness Clinic Director, Sarah Holness Aesthetics, Kent Yvonne Senior Advanced Aesthetic Nurse Practitioner, Independent Prescriber and mentor. Trainer and co-founder of PIAPA Nicola Webster Clinical Director and Aesthetic Nurse, Rejuven8, Doncaster Lynn Warren Clinic Director, The Retreat Beauty Clinic and Cosmedical Ltd, Leeds EDITOR: Natasha Devan natasha.devan@markallengroup.com GROUP CLASSIFIED MANAGER: Rachel McElhinney rachel.mcelhinney@markallengroup.com CIRCULATION DIRECTOR: Sally Boettcher PRODUCTION MANAGER: Jon Redmayne PUBLISHER: Anthony Kerr anthony.kerr@markallengroup.com ASSOCIATE PUBLISHER: Julie Smith COMMERCIAL MANAGER: Katie Smith katie.smith@markallengroup.com CHIEF EXECUTIVE OFFICER: Ben Allen MANAGING DIRECTOR: Jon Benson T he letter ‘D’ stands for many things in aesthetic nursing, including dermal fillers, dermatology and patients’ desire to change their facial appearance. But it’s also one of four letters in a word that is relatively unheard of in cosmetic medicine—data. Not only does nobody know the total number of aesthetic nurses practising in the UK, let alone those who are injecting outside of their NHSbased positions as staff and specialist nurses, but trying to decipher how many dermal filler injections are administered in the UK per year, and more to the point how effective the products are that are being used, is like getting blood from a wrinkle-free stone. For a profession that prides itself on achieving consistent results and wants to standardise best practice, this is simply not good enough. When Sir Bruce Keogh published his ‘Review of the Regulation of Cosmetic Interventions’ on the back of the Poly Implant Prothese (PIP) breast implant scandal, which ironically was fraught with its own data reporting issues, it stated that there is a ‘concerning lack of data’ (Department of Health (DH), 2013). Further down in the report, on ensuring an informed and empowered public, it recommended that patients ‘are helped to make informed decisions based on clear, easily accessible and unbiased information and data’ (DH, 2013). Unsurprisingly, not much has changed such the report’s publication—aesthetic practitioners not only continue to use products which haven’t been subject to extensive clinical trials or research, but some also consistently fail to report complications or adverse events that occur as a result of their use. I would tell you how many practitioners inject questionable dermal fillers and the number of complications that go unreported per year, but I can’t. That data does not exist. It appears that what is lacking in the sector is another ‘D’ word—definition. Keogh surmised that the ‘weakness of the professional regulatory oversight arises in part from the fact that cosmetic surgery is not a discrete defined specialty’ (DH, 2013). How many procedures are aesthetic nurses providing? How can patients be sure they are safe in the hands of practitioners who are qualified? How can we define education and training? Health Education England (HEE) is still at work with its expert reference group to try and tackle the structure of education and training in non-surgical cosmetic interventions, to ensure all aesthetic practitioners are ‘appropriately qualified’ to administer injectables, as well as perform key procedures such as chemical peels, mesotherapy and laser skin rejuvenation, which is covered in this issue on pages 424–9. But even a DH-backed health authority is further changing the parameters of who can do what, clearly stating that it will introduce ‘a flexible education and training framework which addresses the training requirements for all practitioners’ (HEE, 2014), whether they are registered health professionals or non-regulated beauticians. It all comes back to the old adage that ‘if you want something done, do it yourself’. Nobody knows better than you what treatments aesthetic nurses carry out, what products they use and what complications present. By making it your mission to record information about your patients and your practice, you can help to bring medical aesthetics out of the danger zone, and into the data zone.