Standard 27: Aesthetic and Cosmetic Procedures (non-surgical only) (Version 11)

Each practitioner holds the qualification and training for each specific procedure they perform, verified with the issuing body. A general medical licence is not sufficient on its own.

Rating: Minimum in humanitarian settings; Must in transition and fragile settings; Must in standard settings.

Not assessed (N/A) for: Hospital, primary health clinic, long-term care, telemedicine, home care, fitness and wellness, dental clinic.

Guidance

A practitioner is qualified for each procedure they perform, not only for a general medical licence. The scope of practice and competence record (AES-POL-001) lists the procedures each practitioner is permitted to perform, and the qualification is verified with the issuing body.

A procedure outside a practitioner's recorded scope is not performed. Where a new procedure is added, competence is reviewed first and the scope is updated in writing.

The competence of each practitioner is reviewed at a set interval, and the review is recorded with the date and the person who carried it out.

What good looks like

• The scope of each practitioner is posted in the clinic and reviewed at each change of staff.
• The verification with the issuing body is repeated at a set interval.
• A new procedure is added to a practitioner's scope only after a documented assessment.
• Training records are kept with the scope, so that a practitioner's competence can be shown at any time.

Common mistakes

• Allowing a practitioner to perform a procedure outside their recorded scope.
• Relying on a general medical licence as proof of competence for a specific procedure.
• Adding a new procedure without reviewing the practitioner's training.
• Keeping the scope in a document that is not updated when staff change.

Questions the surveyor asks

• Is each practitioner qualified for each procedure they perform? The surveyor checks the scope of practice and competence record (AES-POL-001) against the procedures each practitioner performed in the sample.
• Is the qualification verified with the issuing body? The surveyor checks the verification record held for each practitioner in the sample.
• Is competence reviewed before a new procedure is added to a practitioner's scope? The surveyor checks the competence records for a sample of procedures added in the period.

How the surveyor verifies this criterion

For elective procedures, the patient receives realistic information about expected results, risks, complications and alternatives, and has a defined period to reconsider before the procedure.

Rating: Minimum in humanitarian settings; Must in transition and fragile settings; Must in standard settings.

Not assessed (N/A) for: Hospital, primary health clinic, long-term care, telemedicine, home care, fitness and wellness, dental clinic.

Guidance

For an elective procedure, the patient is given realistic information about the expected result, the risks, complications and alternatives. Results vary between people and may not be permanent, and this is stated in the consent.

The patient has a defined period to reconsider before treatment. The period is recorded in the consent record (AES-FRM-001), and the procedure is not done before it ends.

A patient who postpones or cancels is not pressured to continue. The reason is recorded in the consent record and the practice procedure (AES-SOP-001).

What good looks like

• The consent form explains the expected result in plain language, with examples of variation.
• The reconsideration period is written on the consent form and given to the patient to keep.
• The consent is signed before any preparation for the procedure starts.
• The patient is offered a follow-up conversation after the consent to answer any question.

Common mistakes

• Taking consent in the chair and treating the patient the same day.
• Promising a permanent or guaranteed result.
• Using a general consent form with no outcome or reconsideration section.
• Pressuring a patient who wants more time.

Questions the surveyor asks

• Does the consent state realistic outcomes, including that results vary and may not be permanent? The surveyor checks the consent record (AES-FRM-001) for the outcome statement in each sampled consent.
• Is there a defined period to reconsider before the procedure? The surveyor checks the dates of consent and treatment in the sample against the period set in AES-SOP-001.
• Is a patient who changes their mind before treatment handled without pressure? The surveyor checks the record of postponed or cancelled procedures and the reason recorded for each.

How the surveyor verifies this criterion

Each patient is assessed before the procedure for medical history, current medicines (including anticoagulants and supplements), pregnancy, allergies and conditions that make the procedure unsafe.

Rating: Minimum in humanitarian settings; Medium in transition and fragile settings; Must in standard settings.

Not assessed (N/A) for: Hospital, primary health clinic, long-term care, telemedicine, home care, fitness and wellness, dental clinic.

Guidance

Before each procedure, the patient's medical history, current medicines (including anticoagulants and supplements), pregnancy status, allergies and conditions that could make the procedure unsafe are assessed and recorded (AES-SOP-002).

The assessment record (AES-FRM-002) lists each contraindication checked. A contraindication found is either resolved or the procedure is not done, and the outcome is recorded.

The assessment is completed by a clinician before treatment starts. Where the assessment is incomplete, the procedure is delayed until it is complete.

What good looks like

• The assessment is completed on a form that lists each contraindication to check.
• Medicines and supplements are recorded with the dose and the date of the last use.
• A pregnancy test or a documented pregnancy status is recorded before procedures where it matters.
• The clinician signs the assessment and the date before the procedure starts.

Common mistakes

• Treating a patient without a recorded assessment.
• Recording pregnancy as unknown without asking the patient.
• Not asking about anticoagulants and supplements.
• Continuing with a procedure when a contraindication has not been resolved.

Questions the surveyor asks

• Is a pre-procedure assessment completed before every procedure? The surveyor checks the assessment record (AES-FRM-002) for a date before the procedure in each sampled case.
• Are pregnancy, allergies and current medicines, including anticoagulants and supplements, recorded? The surveyor checks each assessment in the sample for these items (AES-FRM-002).
• Is each contraindication resolved before the procedure, or the procedure is not done? The surveyor checks the record of each contraindication found and the outcome recorded (AES-SOP-002).

How the surveyor verifies this criterion

Any sedation or anaesthesia is given by staff trained and credentialed for it, with monitoring and emergency equipment, and with a written agreement for transfer to a hospital if a complication occurs.

Rating: Minimum in humanitarian settings; Must in transition and fragile settings; Must in standard settings.

Not assessed (N/A) for: Hospital, primary health clinic, long-term care, telemedicine, home care, fitness and wellness, dental clinic.

Guidance

Sedation and anaesthesia are given only by a clinician trained and credentialed for the technique. The competence record is kept with the sedation and anaesthesia procedure (AES-SOP-003).

Monitoring is continuous from the start of the procedure to discharge. Each entry in the monitoring record (AES-FRM-003) is timed, and the equipment used for resuscitation is checked before each procedure.

A written agreement is in place for transfer to a hospital if a complication occurs. The agreement names the hospital, the transfer route and the person responsible for the decision to transfer.

What good looks like

• The sedation or anaesthesia record names the clinician and the competence that qualifies them.
• Monitoring equipment is checked and signed before each procedure.
• The recovery area has a named person who stays with the patient until discharge.
• The transfer agreement is reviewed each year, and the hospital is told of the arrangement.

Common mistakes

• Giving sedation without a documented assessment of the patient.
• Discharging a sedated patient without continuous monitoring.
• Having no written transfer agreement for complications.
• Using equipment that has not been checked on the day.

Questions the surveyor asks

• Is sedation or anaesthesia given only by a clinician trained and credentialed for it? The surveyor checks the competence record of each clinician in the sample against AES-SOP-003.
• Is monitoring continuous and recorded through to discharge? The surveyor checks the monitoring record (AES-FRM-003) for entries at set intervals up to discharge.
• Is there a written agreement for transfer to a hospital if a complication occurs? The surveyor checks the transfer agreement and the equipment check record (AES-SOP-003).

How the surveyor verifies this criterion

Advertised results, prices and credentials are accurate. Before-and-after images are used only with written consent and without altering the result.

Rating: Minimum in humanitarian settings; Medium in transition and fragile settings; Must in standard settings.

Not assessed (N/A) for: Hospital, primary health clinic, long-term care, telemedicine, home care, fitness and wellness, dental clinic.

Guidance

Advertised results, prices and credentials are accurate and can be shown to be accurate. Each claim is checked against evidence on file before it is published, and the review is logged (AES-POL-002, AES-REG-002).

A before-and-after image is shown only with the patient's written consent and without altering the result. A statement of the typical result accompanies each image.

Published prices match the current fee list. A change to a price is made on the fee list first and then published.

What good looks like

• Each advertised claim is reviewed by a named person before publication, and the review is dated.
• Before-and-after images are stored with the consent form and the date of the photograph.
• Prices are shown with what is included, and any extra cost is stated before the procedure.
• The claims review log is reviewed at set intervals by the manager.

Common mistakes

• Publishing a result that has no evidence on file.
• Using a before-and-after image without written consent.
• Advertising a price that differs from the fee list.
• Stating credentials that cannot be verified.

Questions the surveyor asks

• Is every advertised claim supported by evidence on file before it is published? The surveyor checks each sampled claim against the evidence file (AES-POL-002).
• Is written consent held for each before-and-after image, with a typical-result statement? The surveyor checks the claims review log (AES-REG-002) for consent and the statement shown with each image.
• Do published prices match the current fee list? The surveyor compares each sampled published price with the current fee list (AES-REG-002).

How the surveyor verifies this criterion

Each patient has scheduled follow-up and a named contact for problems. Complications are managed through a pathway the patient was told about before the procedure.

Rating: Minimum in humanitarian settings; Medium in transition and fragile settings; Must in standard settings.

Not assessed (N/A) for: Hospital, primary health clinic, long-term care, telemedicine, home care, fitness and wellness, dental clinic.

Guidance

Each patient has follow-up arranged before leaving, and each follow-up is attended or chased. The follow-up is recorded in the follow-up and complication management procedure (AES-SOP-004).

Each complication is recorded in the complication and follow-up record (AES-FRM-004), treated, and reviewed. A serious complication is referred and reported.

The patient is told before the procedure whom to contact about a problem and how the complication pathway works, and that information is recorded.

What good looks like

• The follow-up date is given to the patient in writing before leaving.
• A named contact and a telephone number for problems are printed on the aftercare sheet.
• Each complication is reviewed by the clinician who treated it within a set time.
• Serious complications are discussed at a monthly review of the complication record.

Common mistakes

• Sending a patient home with no follow-up arranged.
• Not chasing a patient who missed the follow-up.
• Treating a serious complication at the clinic without a referral.
• Recording a complication without a review.

Questions the surveyor asks

• Is follow-up arranged for each patient, and is it attended? The surveyor checks the follow-up entries in each sampled record (AES-SOP-004).
• Is each complication recorded, treated and reviewed? The surveyor checks the complication and follow-up record (AES-FRM-004) for each complication in the sample.
• Are serious complications referred and reported? The surveyor checks the referral and report for each serious complication in the sample (AES-SOP-004).

How the surveyor verifies this criterion