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ABC News
17 hours ago
- Health
- ABC News
Queensland cosmetic nurses warn storage rules could shut down clinics, push patients underground
Megan McRae took the leap last year to open her small cosmetic injectable clinic in Brisbane after more than three decades as a registered nurse, and seven years as an injector. She sunk her heart, soul and savings into the business to get it off the ground, but within eight months she is already facing the threat of closure — and she's not alone. A recent rule clarification from Queensland Health has left hundreds of cosmetic injectable clinics across the state "scrambling" and Ms McRae said it has forced a dozen to close. The clarification in its guidelines means registered nurses cannot store certain prescription medicines, like botox and injectables, at their clinics without a doctor or nurse practitioner present. Some in the sector have criticised the move, claiming it could harm patient safety and drive them underground for treatments, as dozens plan to rally outside parliament house today. It comes a week after the Australian Health Practitioner Regulation Agency introduced sweeping new industry guidelines for dentists and nurses working with injectables. It included mandating further education and training, minimum periods of experience for nurses, and more restrictions around advertising. Queensland Health doubled down on its guidelines in April, after the industry questioned a fact sheet it released in December stating that registered nurses could not buy or hold stock of S4 class cosmetic injectable medicines at a clinic if they work there. Prior to this, registered nurses believed they were able to stock the prescription medications under strict guidelines. "[We] have scripting companies that look after drug register, live register, checks and balances and logs in place, prescribed by a doctor and stored under lock and key," Ms McRae said. Queensland Health has now confirmed only prescribers of the medicines, like doctors or nurse practitioners could stock them, reaffirming it was not a change of law, but a clarification of the Medicine and Poisons Act 2019. Queensland Health said there has been no change in rules. But registered nurses said up until the point the clarification was issued, they always believed they were operating within the regulations, and have been holding stock of S4 medicines for years. "We thought we were practising safely up until that point … and we've been left scrambling to make ourselves compliant." Ms McRae said two pathways were offered to registered nurses — they could hire a doctor or nurse practitioner to work onsite and take responsibility for the stock, or patients would have to get a script from a doctor and go to a chemist to have the product dispensed, before taking it to the clinics to have it injected. She said these options open dangerous pathways, including a patient potentially misusing the product. "That potentially opens the market up for patients injecting themselves, or selling it on themselves," Ms McRae said. She said it was not logical that a patient could be trusted to collect and handle S4 medicines, but registered nurses could not. "The reason that it should be in the hands of medical professionals is that we have studied, we do know how to administer safely, we do know our anatomy," Ms McRae said. "I've spent thousands on upskilling over many years. "It's a little patronising to not respect the skill set that we have as medical professionals." Ms McRae said even if she could find a doctor to work onsite, it remained unclear how often they would need to be at the clinic, and guaranteed those costs would need to be passed onto the client. She is worried the price hikes could drive customers underground to get their treatments. "We do know there are cowboys out there. We're not against compliance. We just want a pathway that is economically viable that's not going to shut us down." Griffith University school of applied psychology researcher Dr Veya Seekis said she did not think women would turn to the black market for treatment, but it could leave the door open for medications to be misused. "There will always be a small proportion of people who misuse prescription medication, but I think generally women and people who do seek these procedures are more aware of the risk," she said. Dr Seekis said while she was fully in support of more regulation in the industry, in this case, she stood with the registered nurses. "The risks I think outweigh any benefits there," she said. "I do stand with the nurses, who are registered and who do have the additional qualifications and who have done everything right, because they're working and serving the patients. "I feel they should not be penalised simply because there are people out there who are doing the wrong thing." In response to questions from the ABC, Queensland Health said patients deserved to feel informed, safe, and confident in their service provider when receiving treatments and procedures, including cosmetic injectables. "Queensland Health's focus is the safety of Queenslanders and we are committed to ensuring cosmetic injectable providers are aware of their legal obligations and operating legally," a spokesperson said. "In most cases, cosmetic injectable prescription and administration takes place at the same time; we strongly advise against giving cosmetic injectable medicines directly to the client or patient." Ms McRae said more than anything, injectable clinic owners want a "seat at the table" to ensure they can remain complaint.
Time of India
3 days ago
- Health
- Time of India
New rules for cosmetic injectables aim to make industry safer. Will they work?
Tired of too many ads? Remove Ads Tired of too many ads? Remove Ads So, how tough are these guidelines? And can they be enforced? Popular in Cons. Products 1. De Beers draws interest from billionaire Agarwal, Qatari funds, sources say Botox is a prescription-only drug subject to strict controls. Tired of too many ads? Remove Ads Screening for suitability What about under 18s? So, how are these rules enforced? New guidelines to regulate Australia 's booming cosmetic procedures industry have been called "tough" and "a crackdown" in media reports this Tuesday, the Australian Health Practitioner Regulation Agency AHPRA ) announced the new guidelines - one for procedures, the other for advertising - and said it put the lucrative industry "on notice".The guidelines stem from AHPRA's 2023 review of non-surgical cosmetic procedures - think injectables (such as Botox and dermal fillers), laser skin resurfacing, chemical peels, hair transplants and review was established only after AHPRA investigated widespread reports about unsafe practices in cosmetic surgery in 2022, exposing risks and deficiencies in both the surgical and non-surgical cosmetics included the predatory targeting of under-18s, inadequate training for practitioners , and poor screening of patients. For example, 52-second telehealth new rules aim to put safety before sales and cover many more issues than any previous also fill a gap, as they apply to all health practitioners. Previously only doctors had clear guidelines, while nurses and midwives had been guided by a "position statement" published by the Nursing and Midwifery Board of Australia These new rules ban financial incentives, discounts and other financial arrangements, such as "contra deals" - where Botox injections might be administered in exchange for restaurant meals, as occurred in one New South Wales also ban perks for social media influencers , who often get free guidelines confirm influencers recruited by practitioners should not create unreasonable expectations of benefits for patients (which is already against the law if practitioners do it). If influencers do, the recruiting practitioner will be several practitioners have been disciplined for administering or procuring it inappropriately, such as in day spas or by arranging "remote" prescriptions by email. Recent cases of unregistered people injecting it at parties, resulting in botulism (a serious condition), also suggest gaps in new rules allow only suitably trained practitioners to prescribe these drugs following an in-person or video consultation. Batch prescribing - issuing prescriptions for multiple patients - is now clearly guidelines emphasise skills and training. Registered nurses will now need a year's experience in other fields before giving cosmetic treatments. Enrolled nurses will be expected to first have a year of supervised, relevant must also be robust protocols to manage any complications after a procedure. Practitioners must provide detailed aftercare instructions, and ensure patients are aware of their right to complain and to and impersonal cosmetic consultations have often not met the legal requirements for informed guidelines address this by requiring registered nurses and nurse practitioners to thoroughly assess a patient's suitability for a must confirm the patient's expectations are realistic, discuss risks and alternatives (including no treatment), be transparent about their own skills and experience, and explain all guidelines specify that screening assessments must check for underlying conditions, such as body dysmorphic disorder, which is known to be more common in those seeking cosmetic is one of several mental health disorders diagnosed in people who experience anxiety and persistent thoughts about perceived flaws in their physical experiencing this condition would likely be unsuitable. That's because people with body dysmorphic disorder are at higher risk of poor psychosocial outcomes (such as poorer mental health or wellbeing).If found unsuitable, patients must be refused treatment and referred to another appropriate practitioner, such as a psychologist, for appropriate the new guidelines foster better informed consent processes. They prompt practitioners to screen for and discuss the psychosocial risks known to be associated with cosmetic says the new rules offer greater protection for young people through new safeguards and special rules for guidelines say prescribing dermal fillers to minors is inappropriate. For other procedures, they require parental or guardian consent where practicable, and a cooling-off period of seven days between obtaining informed consent and the health practitioners will still be able to exercise their clinical judgement for under-18s within the limits of the because the general law permits "mature minors" to lawfully consent to medical treatments if they have been assessed as having sufficient understanding and intelligence to appreciate fully what is being guidelines are not parliamentary they define the standards expected of all registered health practitioners who perform non-surgical cosmetic procedures - except doctors, who have their own a health practitioner does not comply with the guidelines, the board responsible for their registration and accreditation - for example, the Nursing and Midwifery Board - can take "immediate action" to suspend them or launch disciplinary proceedings for extended guidelines will make it easier for national boards and state complaints organisations to support any allegations of professional wrongdoing against health professionals performing or promoting cosmetic now, there were no specific rules about cosmetic procedures - just the general (but important) codes of conduct for each guidelines give real teeth to the bodies that regulate the health profession and will likely enable them to weed out bad actors from the cosmetic workforce. Even so, they cannot compensate or redress patient that, patients may sue practitioners in court, report unlawful drug advertising to the Therapeutic Goods Administration (where fines can be issued), or take action under Australian consumer law.
News.com.au
03-06-2025
- Business
- News.com.au
Health regulator crackdowns on cosmetic injectables industry
Healthcare regulators in Australia have brought in new guidelines for dentists and nurses who perform non-surgical cosmetic injections, aiming to safeguard the public from practitioners who prioritise profits over patient safety. On Tuesday, the Australian Health Practitioner Regulation Agency (AHPRA) released new rules requiring healthcare practitioners to undergo additional education and training before conducting cosmetic procedures such as botulinum toxin injections (Botox) and filler injections. They also introduce minimum experience requirements for nurses wishing to work with injectables, saying that they must have at least one year's full-time experience as a nurse outside of non-surgical cosmetic procedures. For years, nurses and dentists have operated in the billion-dollar cosmetic injectable industry without needing to complete any formal extra training or education before injecting patients with neurotoxins such as anti-wrinkle injections. While many practitioners in the industry operate safely and comply with existing laws, regulators have flagged rising concerns about unqualified providers and inadequate oversight in some sectors. Crackdown on influencer testimonials and ads The new changes also stipulate that advertisements for cosmetic injectables must include the details of the registered practitioner who will perform the procedures. Targeted ads directed at minors will also be banned, along with testimonials from social media influencers, who will no longer be eligible for free or discounted cosmetic injectable treatments. Justin Untersteiner, CEO of AHPRA, noted that not all cosmetic injectors would be pleased with the stricter regulations and he expected some would decide to leave the industry, according to ABC. 'There will be others who have to modify their business models and modify their practices to meet these guidelines,' he said. 'This is a growing industry and, I've got to say, what we do see in some cases is that there are people out there putting profit before patient safety.' Nurses and dentists will need to implement the changes before September to ensure they are compliant with the new rules, which are in line with those already in place for doctors. '(After that) we will be identifying those that are doing the wrong thing and we will take action where we need to,' Mr Untersteiner said. Increase in 'dodgy' Botox There has been a recent spike in cases involving unregistered practitioners and clinics using off-brand or outdated dermal fillers and anti-wrinkle injections on patients, resulting in multiple hospitalisations after patients fell ill with botulism. In January, three people were treated in intensive care for suspected botulism, a potentially fatal illness, after reportedly receiving unregulated anti-wrinkle treatments at a home. Dr Jeremy McAnulty, Executive Director of Health Protection at NSW Health, issued a health warning to those thinking about anti-wrinkle injections, highlighting the risks and side effects associated with unregulated cosmetic injections. In March, a cosmetic clinic in Sydney received a health warning due to its 'highly concerning' infection-control practices. The NSW Health Care Complaints Commission (HCCC) advised clients to undergo testing for possible exposure to bloodborne viruses, including hepatitis B, hepatitis C, and HIV. Speedy telehealth calls The new federal guidelines mark the latest action by state and federal regulators, who have been ramping up their stance on cosmetic injectable providers. Many injectable businesses across the country are operated by nurses who administer the injections, often stock prescription fillers and anti-wrinkle injections like anti-wrinkle injections on-site, and organise telehealth consultations for their patients so doctors can remotely prescribe the products. A report by The Age in March revealed that these telehealth consultations saw doctors spend as little as 52 seconds with patients before writing a script for anti-wrinkle injections and fillers. While the new guidelines don't specify how long doctors and nurses must spend talking with patients before prescribing injectables, they do state that practitioners must conduct detailed evaluations, including assessing the patient to ensure expectations are realistic. They should also discuss alternative options with patients and complete a lengthy checklist to confirm that patients have provided proper consent. Peak body for cosmetic plastic surgery in Australia responds Dr Lily Vrtik, a specialist plastic surgeon and President of the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), welcomes the change but argues that more needs to be done. 'Non-surgical cosmetic procedures are growing rapidly in popularity, yet regulation and clinical standards have not been keeping pace,' Dr Vrtik said. While ASAPS 'welcomes the call by AHPRA for the requirement of appropriate education, training, experience, and ongoing education,' they need to crack down further on Continuing Professional Development (CPD) requirements. 'CPD is a condition of health professional registration,' she explained. 'Practitioners who perform cosmetic injectable procedures should undertake regular, evidence-based training updates that are specific to cosmetic medicine and that include a strong emphasis on ethical practice. 'These new guidelines now stipulate that CPD should be in the area of their practice (i.e. cosmetic medicine), but alarmingly, there is no minimum quality standard for the CPD educational activity and no plan for enforcement.'
ABC News
02-06-2025
- Business
- ABC News
Health practitioner regulator gets tough on cosmetic injectable industry to protect patient safety
The Australian health practitioner regulator has introduced sweeping new guidelines for dentists and nurses performing non-surgical cosmetic injectable procedures, in a bid to better protect the public from players putting profits ahead of patient safety. The new rules released by the Australian Health Practitioner Regulation Agency (AHPRA) today mandate further education and training before healthcare practitioners can perform cosmetic procedures like botox and filler injections. They also introduce minimum periods of experience required for nurses wanting to work with injectables. Nurses and dentists have been operating in the billion dollar cosmetic injectable industry for years without being required to undertake any formal additional education or training, before injecting patients with neurotoxins like botox. While many have become highly skilled at the practice, there's concern clearer rules are needed for those wanting to enter the industry to ensure they have enough training. Under the changes, advertisements will be required to include the details of the registered practitioner performing the procedures. Testimonials from social media influencers will be banned, along with targeted advertising of cosmetic procedures to minors. AHPRA CEO Justin Untersteiner said not all cosmetic injectors would be happy with the tighter rules and expected some would choose to leave the industry under the changes. "There will be others who have to modify their business models, and modify their practices to meet these guidelines," he said. Nurses and dentists have until September to prepare for the changes and ensure they are compliant with the new guidelines, which align with those already in place for doctors. "[After that] we will be identifying those that are doing the wrong thing and we will take action where we need to," he said. There's been a recent spate of cases of non-registered practitioners and clinics using off-brand or out-of-date dermal fillers and botox on patients leading to multiple hospitalisations after patients became ill with botulism. The NSW Health Care Complaints Commission (HCCC) warned patients of a Sydney cosmetic clinic to be tested for blood borne viruses after finding evidence that non-registered staff were injecting patients with dermal fillers and botox. The new federal guidelines are the latest salvo from state and federal regulators, who have been cracking down on cosmetic injectable providers, throwing some clinics into chaos as they scramble to ensure they comply with regulations. Many injectable businesses around the country are run by nurses who do the injecting, and often hold supplies of prescription fillers and anti-wrinkle injections like botox on site, and arrange telehealth consults for their patients so doctors can remotely prescribe the products. Recent guidance released in Queensland has made it clear the practice isn't legal unless the nurse is a Nurse Practitioner with prescribing rights and additional qualifications, or there's a doctor on site. State pharmaceutical and poisons regulators in both NSW and Queensland have also been conducting compliance checks on clinics, monitoring the possession and storage of schedule 4 medications like botox and fillers. AHPRA said it was concerned some telehealth practitioners weren't meeting their professional obligations, after media reports revealed patients were sometimes being issued botox scripts in less than a minute. The new guidance from AHPRA reinforced practitioners were responsible for understanding relevant state and federal drugs and poisons laws, and that those who prescribed cosmetic injectables were still responsible for the patients, regardless of whether or not they performed the procedure. The guidelines also mandate written information must be given to the patient, including the health practitioner who prescribed the cosmetic injectable, the practitioner who performed the procedure, details of the products used, what aftercare was needed, and who is responsible for coordinating the patient's care. From September, nurses will be required to complete a set period of 12 months of full-time practice before expanding their scope to include non-surgical cosmetic procedures. The guidelines state further education will be necessary for those practitioners wanting to work with cosmetic injectables. Those practitioners will need training in anatomy and physiology, education in assessing patients for suitability for the procedure, and both theoretical and hands-on training in the specific procedure being offered. While AHPRA CEO Justin Untersteiner said there had always been an obligation for practitioners to ensure they had appropriate skills, the new rules were "really making it crystal clear" about what it expected for those sorts of procedures. "That will likely require specific training around facial anatomy or physiology and I can tell you that is not a weekend course, this is proper training that will be required," Mr Untersteiner said. He said the regulator had heard multiple cases of permanent irreversible facial nerve damage as well as potentially life-threatening strokes from cosmetic injectables. "All registered health practitioners are responsible for ensuring they are sufficiently educated, trained and competent to safely undertake any cosmetic procedure they may perform." Do you have a story to share? Email Nursing and Midwifery Board of Australia chair, Veronica Casey, welcomed the new guidelines and said the safety of the Australian public was paramount. "These types of procedures are undertaken every day and can have serious consequences if not done correctly," she said. The new AHPRA regulations outline that "registered health practitioners must also disclose any financial interests that could be perceived as influencing the advice they provide to people about cosmetic procedures". Some doctors and nurses working in cosmetic injectable clinics operate on commission-based models, meaning the more work done or greater the volume of product injected, the more money they stand to make from a consultation. But whether commission-based models need to be disclosed to patients will be subject to clinician's judgement and assessed by the regulator on a "case-by-case basis". It is illegal to advertise almost all prescription medications or related services including cosmetic injectables, with the Therapeutic Goods Administration (TGA) responsible for regulation. Despite this, cosmetic clinics have been widely flouting advertising rules for years on social media and their own websites. The TGA said it had recently sent around 100 "targeted guidance letters" to providers in the cosmetic injectables industry, following identification of alleged non-compliance and that more will follow "in the coming weeks". The agency said in a statement that last financial year it submitted over 12,000 requests for removal to social media platforms over the alleged unlawful advertising of therapeutic goods, including "over 2,500 advertisements relating to cosmetic injectable products". The AHPRA guidelines now state any imagery used in advertising of higher-risk cosmetic procedures must be focused on information or education, citing concerns advertising was promoting the "trivialization and glamourisation" of cosmetic procedures to vulnerable patients, especially on social media. Examples of features more likely to be considered entertainment included imagery like music, dancing, singing, or comedic comments. It comes almost four years after a joint ABC and Sydney Morning Herald investigation revealed a shocking video of two doctors dancing while performing liposuction on an unconscious patient, which led to a crackdown on the cosmetic surgery industry. Under the new injectables guidelines there will be a total ban on targeted advertising towards patients under 18, as well as a mandatory seven-day cooling off period between the first consultation and any procedures for minors. Patients considering cosmetic injectables have been encouraged to check if a health practitioner is registered on the Australian Health Practitioners Regulation Agency website.
Sydney Morning Herald
02-06-2025
- Health
- Sydney Morning Herald
Cosmetic crackdown: End looms for speedy Botox scripts, influencer freebies banned
Speedy telehealth consultations granting patients access to Botox, lip fillers and other beauty treatments will become 'unviable' under a crackdown on Australia's booming cosmetic injectables industry. New guidelines to be released on Tuesday by the Australian Health Practitioner Regulation Agency (AHPRA) also ban cosmetic injectors from offering free or discounted cosmetic injectables to social media influencers, and will prevent nurses entering the lucrative sector straight out of university. The changes follow revelations in this masthead in March that some Australian doctors were using telehealth to spend as little as 52 seconds with patients before writing a script for cosmetic injectables such as Botox and fillers. Speedy telehealth calls are the foundation of Australia's $4 billion, fast-growing cosmetic injectables sector. Nurses in stores take customer details before doctors issue scripts for beauty treatments after consultations usually lasting less than a few minutes. While the new guidelines stop short of specifying how long doctors and nurse practitioners must spend with patients when prescribing cosmetic injectables, they state practitioners must conduct detailed evaluations of patients, including 'an assessment to ensure expectations are realistic'. Loading They must also discuss alternative options with patients and complete a lengthy checklist to ensure patients have provided proper consent. 'Telehealth consultations, often reported as short as 52 seconds, will clearly no longer be viable under these new guidelines,' said Jenny Valance, general manager of the Australasian College of Cosmetic Surgery and Medicine. While the college welcomed the changes, it warned that enforcement would be AHPRA's greatest challenge and said tougher penalties were needed.
