The shifting landscape for practitioner groups
Whether you are a nurse, doctor, dentist, or beauty therapist, it’s essential to understand how evolving guidance, legislation, and professional standards will affect your practice
In the UK, nurses have played a pivotal role in the growth and development of aesthetic medicine, helping to position the country as a global leader in the field.
According to our annual survey, nurses represented the largest group of respondents, making up 43.5%, compared to doctors (22.5%), dentists (13.1%), dental therapists (2.6%), and plastic surgeons (2.6%). From setting standards of practice to championing patient safety, UK aesthetic nurses have been instrumental in shaping the industry's progress and reputation. In 2025, we have seen a lot happening in the world of aesthetic nursing from a regulatory and standards POV.
Most significantly, were changes made by the Nursing and Midwifery Council (NMC) around remote prescribing for cosmetic procedures, which came into effect on June 1, 2025. This followed increased scrutiny around patient safety in aesthetic settings, particularly involving botulinum toxin.
The new guidance now makes it clear that remote prescribing is not appropriate for injectable cosmetic treatments, aligning with General Medical Council (GMC) expectations. This means:
Prescribers must conduct an in-person consultation before prescribing prescription-only medications (POMs) for aesthetic use.
Non-prescribing nurses must work under a formal prescribing arrangement where the prescriber assesses the patient face to face.
For clinics that had previously relied on video or telephone assessments, this marks a significant operational shift — and reinforces the need for robust protocols and clear documentation.
Speaking about the changes to Eddie Hooker and Vicky Eldridge on a recent episode of the Hamilton Fraser Aesthetic Business cast, Andrew Rankin said, “The problems that we've seen from remote prescribing have been profound. The activity was prevalent across much of the cosmetic sector and the problems that arise from it, sometimes directly in terms of patient safety, sometimes indirectly in terms of illegal activity have been very difficult to enforce.
We have seen situations where the quantities of medicines that people have been prescribed have been well beyond the sort of things that people should have been receiving. They've been using these [products] as stock medicines, almost to enable them to illegally give the medicines to another named patient.
“The standard of consultation has been entirely inadequate, because that first consultation hasn't happened from the prescriber.
The industry is in some senses robustly regulated, and I think it's worth thinking about the supply of a medicine from its origin with the manufacturer, along with a supply chain, and that supply chain is there to protect patient safety, and it is robust, but anytime it breaks is a very real concern.
We have to look at that supply chain along its full length from the manufacturer, being a regulated manufacturer supplying medicines that are approved by the MHRA for use in England, through regulated pharmacies that have their own set of standards supplying to regulated professionals. And those regulated professionals abiding by their standards for patient safety. And when that chain is solid, it really does work, but it is disconcerting, frustrating and disappointing to see things breaking down at that last stage with regulated healthcare professionals.
There is also growing momentum around enabling nurses to legally hold prescription stock, a privilege currently limited in England, Wales, and Northern Ireland.
Recent court cases, such as that of Nichola Hawes in Northern Ireland, have highlighted the issue. In Northern Ireland, independent nurse prescribers are prohibited from holding emergency stock. Instead, nurse prescribers must secure prescriptions for each individual patient on a named patient basis when required.
Hawes was fined £8,000 after unlawfully supplying botulinum toxin and other prescription-only medicines (POMs) without the required pharmacist oversight. She came to the attention of the Medicines Regulatory Group (MRG), part of the Northern Ireland Government’s Department of Health, in November 2022, following a report from a former patient who received unsolicited medication in their name.
Following an investigation, the MRG seized several quantities of POMs from the nurse’s residence, including weight-loss pens, hydroxocobalamin and hyaluronidase. The nurse’s actions were deemed a breach of legal protocols designed to safeguard patient safety, particularly concerning the administration of high-risk injectable treatment.
In a statement, BAMAN said, “The British Association of Medical Aesthetic Nurses (BAMAN) acknowledges the recent conviction of one of our members, Nichola Hawes, who was fined £8,000 in Downpatrick Crown Court after pleading guilty to charges under the Human Medicines Regulations and the Fraud Act.
BAMAN is clear in its commitment to upholding the highest standards of professional conduct, ethical practice, and patient safety. We do not condone unlawful behaviour. We recognise the personal and professional strain that legal proceedings can place on any healthcare professional. The matter has now been further referred to the Nursing & Midwifery Council (NMC), and BAMAN will await an update.
“BAMAN is actively seeking legal advice to understand the wider implications of this case. Important work is still continuing on a campaign to address the issue of nurse prescribers being unable to hold medicines in England, Northern Ireland, and Wales. We understand the serious concerns this case has raised across our profession.
“BAMAN remains committed to working constructively with the NMC, government, and other organisations to secure prescribing parity and ensure fair, transparent guidance for all nurse prescribers.”
Scotland recognised the need for reform of the law by allowing independent nurse prescribers to hold medicines stock within regulated clinical governance frameworks. The time is well overdue therefore for the rest of the UK to follow suit. Nurses are now calling on the government and regulatory bodies to:
Amend the Human Medicines Regulations 2012 to allow independent nurse prescribers to hold stock within strict professional guidelines that can be set out
Allow nurses to hold stock and thus reduce delays in emergency treatment, such as vascular occlusion reversal and the critical care which is crucial to prevent sepsis
Allow nurses to support patients, operate safely and efficiently, and fulfil their mandatory duty to nurse their patients in accordance with the reasonable standard of care, as their counterparts in Scotland can do.
The consultation response by the UK Government regarding licensing also made reference to the issue around emergency stock:
Some responses also drew attention to the way in which current legislation in England prevents nurse independent prescribers from holding stock of prescription medicines. Concern was voiced that this is impeding timely access to prescription medicines needed in the event of an emergency or complication, such as accessing adrenaline in the event of anaphylaxis or hyaluronidase to dissolve dermal filler to prevent vascular occlusion, and it was proposed that legislation needs to be amended to rectify this situation.
Another significant milestone for nurses was that, on International Nurses Day 2025, the UK Government announced plans to legally protect the professional title “nurse”, making it a criminal offence for anyone to use the term without being registered with the NMC. This long-awaited move is a major win for both healthcare and aesthetics, making sure of public trust and professional integrity.
As explored in Hamilton Fraser’s article, this legislation will:
Prevent unregulated individuals from misleading the public by adopting the “nurse” title.
Reinforce the importance of verified clinical credentials in aesthetic practice.
Support calls for more stringent licensing and enforcement in the wider aesthetics field.
The change follows sustained lobbying from groups like the British Association of Medical Aesthetic Nurses (BAMAN), who have long campaigned for clarity, accountability, and protection of the profession.
For more read our guide to Getting started in aesthetics for nurses and listen to our podcast Voices of aesthetic nursing – the leaders of BAMAN.
While dentists are highly qualified healthcare professionals, the General Dental Council (GDC) has become increasingly concerned with how some registrants market themselves in the aesthetics industry. In 2024, the GDC warned that misleading job titles — such as “aesthetic doctor” — could breach professional standards and lead to fitness to practise concerns.
As explored in Hamilton Fraser’s article, the GDC now expects dental professionals to:
Use titles that clearly reflect their registration and qualifications
Avoid implying expertise in areas outside their scope or training
Be transparent in marketing and advertising.
For aesthetic dentists, this means being mindful of both how they present themselves to patients and how they align with broader regulatory requirements.
Check out our guide to Getting started in aesthetics for dentists for more.
While doctors are among the most regulated professionals in the aesthetics sector, the bar continues to rise as the sector becomes more tightly scrutinised. Doctors should make sure their training, insurance, and scope of practice align with emerging licensing frameworks.
Doctors are expected to meet the high standards set by the General Medical Council (GMC), including:
Face-to-face consultations for POMs.
Full patient assessment and documentation.
Adherence to good medical practice and consent guidelines.
The British College of Aesthetic Medicine (BCAM) recently updated its mission statement, reflecting the organisation’s continued dedication to excellence, integrity, and patient safety in aesthetic medicine.
The new mission statement reads:
“Empowering clinicians. Elevating standards. Protecting patients.”
This update underscores BCAM’s unwavering commitment to supporting medical professionals, driving the highest standards of practice, and safeguarding the wellbeing of patients across the UK.
"Our refreshed mission statement captures the essence of who we are today and where we are heading as a professional body," said the Board of Trustees at BCAM. "It reaffirms our promise to champion clinical excellence, raise industry benchmarks, and place patient safety at the heart of everything we do."
In addition, BCAM announced that a new cohort of doctors had successfully completed the MBCAM (Member of the British College of Aesthetic Medicine) examination.
The MBCAM examination is a rigorous and comprehensive assessment that spans the full aesthetic medicine curriculum, extending well beyond injectable treatments. It comprises a detailed MCQ paper and an in-person Objective Structured Clinical Examination (OSCE). The examination is recognised by Health Education England and approved by the Joint Council for Cosmetic Practitioners (JCCP), underlining its status as a benchmark for clinical excellence in aesthetic medicine. Undertaking this level of training puts doctors in good stead with upcoming changes to the regulatory landscape.
Passing this examination is a significant professional milestone and forms a key step in the transition from Associate to Full Membership within BCAM. It reflects each doctor's dedication to maintaining the highest standards of safety, ethics, and patient care in aesthetic practice. This is crucial with regulation and a proposed licensing scheme now on the horizon.
BCAM Trustee, Dr Haidar Hassan, says: "We are incredibly proud of all the candidates for passing the MBCAM examination. Their hard work and passion for raising standards in aesthetic medicine are truly inspiring, and this achievement reflects their commitment to delivering safe, ethical, and effective care for patients."
Check out our guide on How to become an aesthetic practitioner.
Language shapes perception, and in aesthetics, the words we use carry significant weight. Whether it’s “advanced practitioner,” “cosmetic doctor,” or “aesthetic nurse,” terminology influences how patients understand qualifications, how regulators assess conduct, and how enforcement is applied.
Hamilton Fraser’s article on navigating aesthetic terminology underscores the need for:
Clear, honest communication with patients
Avoid titles that misrepresent qualifications or imply protected status
Aligning job titles with your actual registration, training, and scope of practice
With regulatory reform on the horizon, practitioners who communicate transparently will be better placed to navigate changes, protect patients, and build a reputation for integrity.
Nurses: Must now follow stricter prescribing rules
Dentists: Should avoid using misleading job titles and align with GDC expectations
Doctors: Must make sure all consultations for injectables are conducted in person and compliant with GMC standards
Everyone: Should use accurate and transparent terminology to build trust and comply with emerging regulations
As regulation advances, professionalism and language will become cornerstones of safe, ethical aesthetic practice.
