Putting patients first
How to safeguard your patients. From record keeping and storage of imagery to protecting vulnerable patient groups and the role of chaperoning for intimate procedures.
Safeguarding patients is a cornerstone of ethical and professional aesthetic practice. This chapter explores the critical aspects of patient protection, from clear communication to managing sensitive data and the importance of chaperones during intimate treatments. Whether addressing the unique needs of vulnerable groups or complying with data protection laws, safeguarding fosters trust and safety at every stage of care.
While there is a debate about whether or not chaperoning should be standard practice when treating any vulnerable patients, there is a clear argument for patients undergoing intimate treatments to be offered chaperones to enhance comfort and safeguard against misconduct.
Dr Lakhani comments, “When you're dealing with intimate areas, there's a vulnerability that both the patient and the practitioner need to be aware of. Chaperoning protects both the patient and the doctor from any potential misunderstandings or accusations.
When you're in such sensitive situations, the last thing you want is for a patient to misconstrue your actions or words. We’re probably heading toward a future where every patient interaction needs to be chaperoned, and rightly so.
If you are providing intimate health treatments, you may also have patients present who have experienced sexual trauma in the past. As with any vulnerable patient, extra care must be taken to safeguard them."
Dr Lakhani advises, “I try to create a comfortable environment where patients feel safe sharing that kind of information. It’s vital for their treatment, especially with sexual dysfunctions or intimate health issues.
If a patient volunteers this information, it helps us understand how best to proceed with care. But again, I always make sure that intimate treatments are done with a chaperone present so no one feels exposed or unsafe.”
The survey revealed a lack of consistency in the use of chaperones, despite their importance in safeguarding both patients and practitioners:
71% of practitioners always offer chaperones, but 19% use them inconsistently, with 10% never using them at all
Patients generally respond positively to chaperones, with an average satisfaction rating of 3.5 out of five
77.41% of respondents believe chaperones significantly enhance safeguarding, but some clinics still lack formal chaperone policies
These statistics reinforce the importance of offering chaperones as a standard practice, particularly in intimate health treatments.
Before and after photographs are an important part of record keeping and documentation. In fact, taking before and after images is an insurance requirement in many instances, so familiarise yourself with your policy conditions to see what’s required of you when it comes to imagery. But they can also be a safeguarding issue if not handled appropriately.
Hamilton Fraser founder and CEO Eddie Hooker comments, “Under most malpractice policies and indemnity policies, you are required under the terms of the policy to take before and after photos. If a claim or allegation is made against you, and you don’t have those photos, that puts you in breach of your policy condition, so you've got to make sure you have before and after photos.
But then there's the discussion about how you do that. How do you make the patient comfortable when you are taking those photos? Offer the opportunity for a chaperone, or ask if they want to bring someone in with them, perhaps a close partner or family member. If you are offering a chaperone, make sure they are suitable and ask permission from the patient. And then, what do you do with the storage of all of those photos? I hope no one would dream of putting them on their website or social media, but you must be very, very careful about what you do with these images, who can access them and how you keep them.”
Compliance with data protection laws, such as GDPR, is critical when storing patient photos. Failing to properly and securely store images could be breaching patient confidentiality and could be a safeguarding issue if, for example, images are of intimate areas, a real concern with more and more clinics offering treatments for intimate health.
Dr Lakhani says, “Safeguarding extends beyond patient interaction – it includes how we handle sensitive data like photos. The images are stored securely in the system we use, but it doesn’t separate the patient’s facial before and after photos and intimate before and after photos.
That means any member of the medical team treating them facially would also be able to see their intimate images. I think this needs to change and have raised this with our software provider.”
Managing sensitive patient data is a critical safeguarding issue, yet the survey found notable gaps in compliance:
77.41% of respondents were aware of ethical guidelines for handling before-and-after images, but 22.59% were not aware of these guidelines
Among those aware, 74.19% always follow the guidelines, but 12.9% only follow them "often", raising concerns about inconsistencies in data protection
Practitioners must prioritise secure storage, restricted access, and obtaining explicit patient consent before using images. Mishandling patient imagery could lead to both legal consequences and breaches of patient trust.
Our partner, Aesthetic Nurse Software, advises that photos should be stored securely on encrypted systems
Access to images must be restricted to authorised personnel
You should regularly review and update storage protocols to make sure you are compliant
Molly Gaunt from ANS comments, “You can’t be keeping sensitive images like patient photos next to pictures of your weekend BBQ on your phone – that's just not safe or professional. Our software makes sure that everything is stored securely on protected servers, everything’s password-protected, and it’s all compliant with data protection laws.”
Mishandling patient images could lead to complaints or legal consequences. We recommend taking swift action if issues arise, and having robust protocols for obtaining consent and secure storage minimises risks. You can read our article on complaints and claim handling for more.
And remember, patient consent is non negotiable when using images for any purpose. If you want to share your patients’ before and after photos publicly, you must obtain explicit consent from them to use those photographs. Sometimes, patients may consent to their images being used for educational purposes but not on social media, so you need to be very specific and keep a clear audit trail.
If you do not have the patient’s consent to use their photographs, you are potentially breaching data protection laws and must not use them.
The rise of social media has dramatically influenced younger audiences' perceptions of beauty and skincare, leading to trends that raise serious safeguarding concerns. As aesthetic practitioners, it is essential to adopt ethical practices and marketing strategies that prioritise the wellbeing of young people.
In September 2021, The Botulinum Toxin and Cosmetic Fillers (Children) Act made it illegal for anyone under 18 to receive botulinum toxin or dermal fillers, except when administered by a licensed medical professional for medical reasons. Further protections came into effect in May 2022, banning advertisements targeting under-18s for procedures such as breast augmentation, facelifts, chemical peels, and dermal fillers. These regulations aim to protect young people from unnecessary and potentially harmful cosmetic interventions.
However, platforms like TikTok have recently fuelled a concerning trend among children and teens adopting anti-ageing skincare routines, often influenced by popular influencers. This has led to children as young as 10 reportedly using prescription strength skincare products, such as retinoids and exfoliating acids. These routines are unnecessary for young, healthy skin and may foster unhealthy obsessions with ageing and appearance.
Additionally, the desire to tweak and alter appearance for selfies is growing among younger people. Studies have shown that distorted features in selfies are driving younger patients to seek cosmetic interventions like rhinoplasties.
This highlights the need for aesthetic practitioners to educate young audiences on realistic beauty standards and the natural ageing process.
The lack of formal age verification on social media platforms makes it crucial to make sure all marketing activities align with ethical standards and do not exploit younger audiences' vulnerabilities.
The aesthetic industry must take responsibility for safeguarding young people by making sure its practices prioritise ethical standards over profit. This means avoiding marketing strategies that exploit vulnerable groups and adhering to regulations that protect younger individuals from unnecessary or harmful treatments.
Practitioners are encouraged to promote body positivity and educate patients about safe and appropriate treatment options.
Avoiding creating content that could inadvertently target or appeal to users under 18
Refraining from enlisting teenage followers to market services
Balancing promotional activities with educational content that promotes healthy perceptions of beauty
Practitioners play a critical role in making sure transgender or gender-fluid patients feel respected, supported, and safe. Safeguarding individuals with diverse gender identities is not only an ethical responsibility but also a vital step toward fostering inclusivity and trust within the industry.
Individuals with diverse gender identities often face unique challenges, including:
Discrimination and stigma: Many transgender and non-binary individuals have experienced prejudice in medical and aesthetic settings, leading to anxiety and distrust of healthcare providers
Mental health vulnerabilities: Studies show higher rates of depression, anxiety, and trauma among transgender individuals, often stemming from societal pressures or personal struggles with gender dysphoria
Sensitive medical histories: Gender affirming care may involve previous surgeries, hormone treatments, or specific medical needs that practitioners must approach with sensitivity and care
Here are some safeguarding best practices:
1. Respect and inclusion:
Always use the patient’s preferred name and pronouns
Create an environment where patients feel safe to share their needs without fear of judgment
Make sure all staff are trained in gender sensitivity to avoid unintentional microaggressions
2. Informed consent:
Provide thorough consultations, explaining procedures and potential outcomes clearly
Discuss the patient’s motivations and expectations to make sure the treatment aligns with their goals and wellbeing
Address any psychological concerns, as individuals seeking aesthetic treatments may be influenced by external pressures or unrealistic expectations
3. Confidentiality:
Safeguard sensitive patient information, particularly when it pertains to their gender identity or medical history
Have robust data protection policies in place to prevent breaches of trust or confidentiality
4. Referral pathways:
Recognise when patients may need additional psychological or medical support and provide referrals to appropriate specialists
For those undergoing significant gender affirming changes, consider partnering with mental health professionals to offer a holistic approach to care
5. Tailored treatments:
Understand that gender affirming treatments, such as facial feminisation or masculinisation, often have distinct considerations compared to traditional aesthetic procedures
Use a patient-centred approach to design treatment plans that reflect the individual’s unique goals and needs
It is vital that practitioners challenge unconscious biases within themselves and their teams.
Clinics should adopt clear anti-discrimination policies and engage in regular training to make sure that every patient, regardless of gender identity, receives the same high standard of care.
Mental health is an integral aspect of safeguarding in the aesthetics sector, where the impact of poor body image and societal pressures can have profound psychological effects on patients and practitioners alike.
The July 2022 findings by the Health and Social Care Committee highlighted the link between body image and mental health outcomes, emphasising the need for psychological awareness in aesthetic practices.
Practitioners must remain vigilant, recognising subtle signs of distress and understanding emerging psychosocial factors that may drive risk taking behaviour or dissatisfaction with treatment outcomes.
Safeguarding individuals with Body Dysmorphic Disorder (BDD) is also crucial to prevent harm and provide ethical care. BDD is a psychological condition characterised by an intense preoccupation with perceived flaws in physical appearance, often minor or non-existent to others. In the aesthetics industry, practitioners may encounter patients seeking treatments driven by BDD, making it essential to recognise the signs.
Symptoms include obsessive behaviours such as excessive mirror checking, seeking constant reassurance, or avoiding social situations due to self consciousness. Practitioners have a responsibility to screen for signs of BDD, engage in thorough consultations, and, when appropriate, refer patients to mental health professionals for support.
Not confident at all
Slightly confident
Neutral
Confident
Very confident
Yes
No
Not sure
Effective safeguarding requires:
Prevention: Encourage a clinic culture where staff and patients feel safe reporting concerns without fear of judgment. Establish clear policies and provide regular supervision
Proportionality: Address concerns with the least intrusive response while prioritising individual well-being
Empowerment: Educate patients about treatment choices and clearly define confidentiality limitations to build trust and confidence
Partnership: Collaborate with local safeguarding authorities for guidance and support when handling complex cases
Accountability: Make sure safeguarding decisions uphold the best interests of vulnerable individuals, adhering to professional standards.
Looking after your own mental health and wellbeing: Practitioners themselves are at risk of burnout and mental health struggles, which can affect their ability to safeguard effectively. Regular peer support, reflective practice, and taking necessary breaks are vital for maintaining personal well-being and professional competence
