Frequently Asked Questions
Before contacting us, you may find the answer to your query here.
Is there corporate or group membership?
Membership is specific to individuals and we do not offer group discounts. CMAC supports personal professional development through education and shared experiences. Organisations might choose to sponsor an individual to act as ‘complications lead’, but sharing of CMAC member resources, passwords, helpline number our clinical help email address or access to the Facebook forum would be a breach of our terms and conditions. Members found in breach of terms and conditions of membership would have their membership privileges withdrawn.
Why does membership exclude Health and Care Professions Council (HCPC) regulated professions?
CMAC has considered inclusion and exclusion criteria very carefully. It is certainly not our intention for our membership criteria to be an indication of who can and who cannot practice safely or competently in medical aesthetics.
CMAC recognizes that registration by one regulator or another does not in itself represent competency in medical aesthetics, and that there is no legal restriction on anyone choosing to practice in aesthetics.
We have agreed the inclusion criteria on the objective facts that only the GMC, NMC, GPhC and GDC recognize medical aesthetics as within scope of practice for their registrants.
The HCPC Policy Director has advised the following;
‘Our position to date has been that, whilst we do not prescribe or limit the scope of practice for our professions, there is a difference between the 'legally permitted' scope of practice from the HCPC’s perspective (the limit of a registrant’s skills, knowledge and experience, subject to any legal restrictions) and what the profession itself considers to be their legitimate scope of practice.
We are aware that a number of professional bodies for our prescribing professions consider cosmetic practice to be outside the scope of practice for their profession. This includes the College of Paramedics and the Chartered Society of Physiotherapists (CSP). This therefore means that registrants from these professions will be unable to secure insurance for their cosmetic practice work through their professional body.
In addition, prescribing rights are tied to a registrant’s protected title. Therefore, a registrant would not be able to rely on their prescribing rights whilst practising outside the scope of their registered profession. Guidance set by professional bodies can be very clear in this regard. The CSP on their website states ‘physiotherapists cannot prescribe medicines for purely cosmetic purposes’, for example.
There appears to be an increasing number of registrants moving into this area, despite concerns by their professional bodies that this is out of scope. This is of concern to us, particularly as we are working towards increasing medicines and prescribing rights for our professions. Misuse of these entitlements could preclude future professions from gaining these rights, impacting the care they are able to provide their patients’.
Why does CMAC make a distinction between prescribers and non-prescribers?
Whilst CMAC recognizes that there are non-prescribing nurses, midwives, hygienists and dental therapists that may be very knowledgeable, competent and safe, the fact remains that when a complication arises, a prescriber must share care and responsibility, and direct the assessment and decision making throughout the management process.
Prescription medicines, with the exception of adrenaline in the event of an anaphylaxis, should not be administered without a direction to do so from the prescriber (see CMAC Prescribing partnership agreement).
Why does membership include pharmacists?
Membership inclusion makes a distinction between pharmacists and Clinical Prescribing Pharmacists. Due to evolving clinical roles, the traditional idea of the pharmacist is very different to what is in found current practice. It is common for clinical pharmacists to hold specialist roles, responsible for clinical care, procedures and case management beyond the prescribing and dispensing of medicines. In addition to this Pharmacists can undertake their Advanced Clinical Practitioner (ACP) qualification, a role which involves significant clinical responsibility and carries a protected title. For these reasons we include and specify clinical prescribing pharmacists. Pharmacists who are prescribers, or non-prescribing pharmacists with a post graduate diploma in clinical pharmacy, can join CMAC. Non-prescribers must join with their prescribers and both parties must agree to the Prescribing Partnership Agreement (PPA), or can join as Associate members.
Why does membership include dental hygienists and dental therapists?
The GDC has determined that for dentists, hygienists and dental therapists, medical aesthetics, whilst not within the scope of dentistry specifically, is within their skill set and is included for the purposes of GDC Standards and regulation. Therefore, if we are to include dentists, we cannot reasonably exclude dental hygienists and dental therapists, who can join on the same terms as other included professions.
Does CMAC intend to widen the inclusion criteria at any time?
An important function of CMAC will be to gather data, to inform our protocols and identify learning needs. For the time-being, we have no plans to extend our inclusion criteria, but we will keep under review based on data, patient outcomes and any changes in regulation.
When making these decisions we were mindful of our primary goal to improve patient outcomes and the quality of learning, and to gather data. We accept that both will be limited to some extent, by the fact that we may be excluding a significant number of practitioners treating patients and encountering complications, however, a data set which reflects those regulated professions for whom medical aesthetics is deemed within scope, will be of value.
I have a prescriber but they are not a member, can you recommend a prescriber who IS a member?
It is important that your prescriber is a member also because when you have a complication they will be sharing care and responsibility with you, and our clinical support team may need to communicate and support both of you. We also feel it’s important that your prescriber is on-board with our principles, the terms of your prescribing partnership and our advice and guidelines. This is all designed to ensure you are properly supported and your practice is safe, should a complication arise. Please encourage your prescriber to join also.
I am a very experienced (non-prescribing) practitioner who only offers dermal fillers. Why do I need to have a prescriber?
CMAC is all about the management of complications. Whilst dermal fillers are not prescription only, when complications arise prescription medicines are often required. Non-prescribing practitioners must have support from a prescriber who can share care and accountability in these circumstances, no matter how experienced and competent you are, you cannot manage complications alone, if you cannot prescribe. It is not legitimate to administer hyaluronidase without a valid prescription and patient specific direction (from your prescriber).
You may join as a Associate member for access to all the educational resources.
My prescriber does not practice in aesthetics so would have no interest in joining.
No matter what profession, all statutory bodies require prescribers to prescribe WITHIN their field of practice and be competent (and be able to evidence competency- should a Fitness to Practice investigation arise) to do so.
How can I get an emergency kit if I’m not a prescriber?
You cannot order or add prescription only medicines to your kit without a prescription and a prescriber to direct administration on a patient specific basis.
It is not legal to supply prescription only medicines as stock (not supplied against a patient specific order (prescription), except by regulated pharmacies or companies with a wholesale dealers license). Training providers cannot legally supply kits inclusive of Prescription Only Medicine (POMs).
Patient Group Directions cannot be used (at all) unless in CQC /HIS/HIW registered premises.
I am a prescriber but not a doctor or dentist (not able to order or hold stock medicines), how can I be safe (have necessary emergency medicines such as hyaluronidase and adrenaline to hand), whilst being compliant with regulations/legislation?
In the matter of prescription only medicines which need to be administered quickly in an emergency in aesthetics, and legislation, there is a clear conflict between our obligation to practice safely and in the patients best interests and compliance with the legislation.
CMAC have no authority to recommend you act outside of regulations and best practice standards. The highest authority will be your professional regulator and they cannot suggest or authorise behaviours which breach legislation.
You must demonstrate practice whereby you can evidence there has been a thorough risk assessment to justify your actions, omissions and decisions and in the interests of patient safety at all times.
If you are supplied hyaluronidase for example, against a patient specific prescription, and in an emergency situation (a vascular occlusion) need to administer the hyaluronidase prescribed for Mrs. Jones, to Mrs, Smith, you have not harmed Mrs. Jones and protected Mrs. Smith. If you are a prescriber, you can document the assessment and decision making and also document your administration as a prescriber. If you are not a prescriber, you must contact your prescriber and involve them in the assessment and diagnosis. They must give you a direction to administer and this must be documented. It may be that in the moment, they are not able to physically attend, so the assessment must be a remote one in the short term) like a verbal order over the phone in a hospital). The more thorough the assessment (i.e., if not face to face then by video call) the better.
It is best to have a written protocol agreed with your prescriber in advance of any such event. See The Prescribing Partnership Agreement template we have prepared (members' area).
If I cancel my subscription do I get a refund?
No refund or partial refund is not given. The subscription fee is a contribution towards the administration and running of the collaborative.
Does my subscription renew automatically?
This is not currently an option. You will receive an automatic reminder two weeks before your membership is due to expire, which will contain a link to renew. If an automatic renewal option becomes available we will let you know.