The APPG Report: what kind of changes can we expect to see in the regulation of aesthetic non-surgical cosmetic treatments? 

The All-Party Parliamentary Group on Beauty, Aesthetics and Wellbeing (APPG) is a cross-party group established in May 2019 to champion the aesthetic industry in Parliament.  It has recently published  its comprehensive report following a year-long inquiry into the standards for non-surgical cosmetic treatments. The APPG’s report sheds  light on the absence of legal framework in this area.

The APPG identifies “a need for the beauty industry and the medical professions to work together to seek solutions that raise standards and protect the safety and wellbeing of consumers”.  This article will outline some of the APPG’s key recommendations which are likely to have a significant impact on all parts of the industry.

A national minimum standard

The report criticises the current lack of regulation defining who can carry out these treatments. At present, procedures can be carried out by virtually anyone and there is no legal obligation for the provider to be insured. The APPG has proposed that both aesthetics practitioners and medical practitioners must be able to prove their competence by passing a minimum standard of training before administering treatments. The report considers how CPD could be used as a mechanism of ensuring this minimum standard continues to be met by practitioners.

Mandatory regulated qualifications

In response to the rising popularity of self-accredited courses, the report calls for stricter qualification rules to be put in place. There is strong support from the likes of the British College of Aesthetic Medicine that high-risk procedures, such as dermal fillers, should be restricted to being carried out by medical practitioners. The APPG recommends reclassifying dermal fillers as Prescription Only Medicines. This change in regulation would likely result in a higher proportion of doctors carrying these treatments out in the future, if non-medically qualified aesthetic practitioners are unable  to continue offering them.

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New ‘Speaking up’ guidance for GOC registrants

On 28 October 2021, the General Optical Council (GOC) launched new ‘Speaking up’ guidance, previously known as ‘Raising concerns with the GOC (whistleblowing) policy.’ The guidance is aimed at helping both individual and business registrants identify where they need to consider the professional requirement to speak up when a patient or public safety may be at risk. It should be read alongside the GOC Standards for Optometrists and Dispensing Opticians, Optical Businesses and Optical Students. It should also be considered in conjunction with the GOC’s professional duty of candour. The guidance is split into two parts, with Part 1 applying to individuals and Part 2 to business registrants.

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Delving Deeper into care rates

The BBC has this week reported on data obtained from a number of sources in respect of care rates in the UK. The figures will be of interest to personal injury practitioners attempting to value the cost of care.

Figures at a glance

  • The Homecare Association considers the true minimum hourly rate for a care agency carer in the UK is £21.43
  • The average hourly rate for a directly employed carer is £24.94 according to software company The Access Group
  • The government has announced a £162.5m fund for carers having already confirmed a £5.4bn levy for social care over the next three years


BLM’s Care, Statutory Funding and Rehabilitation Subject Matter Group has crunched the numbers from these data sources and note that data collected by the Homecare Association includes care rates that provide for a profit element of 60p per hour which, based on the quoted rate of £21.43, is a 3% mark-up.  Local authority (LA) payments for care do not cover the minimum cost set out by the Homecare Association. Whereas the private care rates obtained by The Access Group include a mark-up of £4.11 which is around 19%. Therefore, what the report suggests is a very wide discrepancy in profit margins between LA funded care and private care.

This report from the Homecare Association coincides with the release of the updated ASHE figures which shows an average increase in care rates across the 60th-90th percentile of 2.6%. BLM’s Actuarial Subject Matter Group will be analysing these findings.  It is important to note that the figures provided in the ASHE data largely cover state funded care rates, which, as the Homecare Association study shows, are much lower than private care rates typically seen in catastrophic injury claims funded by insurers.

BLM’s own experience is that private care rates have seen a steady increase in recent years, with support worker/rehabilitation assistant rates reaching as high as £26 per hour.  This links in with data obtained from The Homecare Association which found Wiltshire to be the area in the UK attracting the highest hourly rates for carers at £26.11. Whereas Halton is only attracting hourly rates of £12.68, highlighting the inequality in care rates across the country with the most deprived areas having the lowest carer rates.

It remains to be seen if private care rates will continue to rise.  The answer could be gleaned from data obtained from ‘Skills for Care’ who have found that:

  • Vacancy rates in carer roles are now back above their pre-pandemic levels
  • Since March 2021, there has been a decrease in jobs (filled posts) of around -1.8%
  • In 2020/21 adult social care jobs increased by 2.8%.  In domiciliary care services jobs increased by 7.4%

The data suggests a struggle in recruiting carers which will of course lead to a higher demand and therefore potentially increasing care rates. BLM will continue to monitor this position and the effect it will have on the costs of future care.

This update has been written for the Care, Statutory Funding and Rehabilitation Subject Matter Group at BLM. For more information on our Subject Matter Groups, please click here.

Written by Phillip Sturley at BLM (

Care rates continue to increase, but by how much?

On 26 October 2021 the Office for National Statistics released the latest data from the Annual Survey of Hours and Earnings (ASHE). These are provisional figures based on estimates of income from a 1% sample of workers’ HMRC records for the tax year ending 5 April 2021, and they will be revised and updated in due course as the data is finalised. The provisional data provides a steer on how the earnings across all industries are changing. Those dealing with catastrophic injury claims will be particularly interested in the data relating to care workers as the rates are directly applicable to the recalculation of existing periodical payment orders.

The latest data shows an average increase in care rates across the 60th-90th percentile of 2.6%. Practitioners will be aware that the hourly rates actually compensated within a catastrophic injury claim are typically significantly higher than those quoted in ASHE, given that ASHE covers all care workers (most of whom are state funded) whereas a catastrophic injury claim is typically compensated on the basis of a private care package which can be twice the hourly rates quoted within ASHE. That being said, the rates might offer an indication of trends in care costs generally.

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The Assisted Dying Bill: the potential regulatory implications for health professionals

On Friday 22 October, Baroness Meacher’s Assisted Dying Bill progressed to the Committee Stage after being debated in the House of Lords. If enacted, it will undoubtedly be a seminal moment in healthcare law. It would permit medical professionals to lawfully prescribe end of life medication to terminally-ill adult patients of mental capacity who are reasonably expected to die within six months (and voluntarily making such a request), essentially legalising physician-assisted suicide. Although the majority of speakers were in favour of the bill, Hansard reveals how many members hold great concern for the safeguarding of vulnerable individuals and for the impact the bill may have on the public’s trust in doctors. It is therefore entirely understandable why this issue is prompting such widespread debate.

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Gardner v Secretary of State for Health and Social Care – Judicial Review Further Update

The public challenge brought by claimants Dr Cathy Gardner and Fay Harris in respect of the government’s COVID-19 hospital discharge policy reconvened on Friday, 22 October. The days’ submissions followed from the adjourned hearing on Tuesday, 19 October, reported here. This blog will explore the key issues addressed at the hearing, and consider the way forward for the claimants’ case.

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Gardner v Secretary of State for Health and Social Care – Judicial Review Update   

The judicial review of the government’s early response to COVID-19, specifically in respect of discharging COVID-19 positive patients into care homes, commenced yesterday with Lord Justice Bean and Mr Justice Garnham presiding. Permission for the review was granted on all grounds by Justice Linden following an appeal by the bereft claimants Dr Cathy Gardner and Fay Harris. This blog will explore the key issues addressed at the hearing yesterday.

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Report critical of the UK’s handling of the coronavirus pandemic and effect on care homes

A joint report by the House of Commons All Party Health and Social Care and Science and Technology Committees says the UK’s failure to prevent the spread of COVID-19 pandemic was one of the worst ever public health failures. 

Focusing predominately on England, the report criticises delays in introducing a county wide lockdown.  The delays in dealing with the pandemic meant that certain vulnerable groups such as care home residents and people with learning disabilities were particularly susceptible to the virus, and the government did not prioritise the social care sector at the outset.  In particular the report criticises the rapid discharge of patients from hospitals into care homes.  Also lack of testing of social care staff meant that the virus could enter care homes from the community.   

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What is the UK’s legal position on compulsory vaccination?

It has been confirmed that the COVID-19 vaccination will become compulsory for staff that care for the elderly and vulnerable. In enforcing such a requirement, organisations are likely to face a number of issues and potential pitfalls, and it is important therefore to explore the key steps if you are considering introducing compulsory vaccination for staff or those deployed in the organisation.

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Judicial review of Government response to COVID in care homes: imminent hearing in England & significant developments in Scotland

Last November we reported on Mr Justice Linden’s decision to grant permission for judicial review on all grounds of the UK government’s policies and measures which had a bearing on the protection of care homes during the COVID-19 pandemic. The claim, which relates to patient discharge policy in England, will be heard later this month. In respect of Scotland, recently released information by public health authorities appears to acknowledge some important difficulties there in the early part of last year. This blog explores the key issues in both jurisdictions and sets the scene for the (English) judicial review later this month.

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