Ask most people who inspects a cosmetic clinic and they will name their nation's health inspectorate with some confidence. Ask them which activities that inspectorate registers and the confidence goes, because that is the question that actually determines the answer, and it is answered differently in England, Scotland, Wales and Northern Ireland.
Registration attaches to activities, not to buildings
Every one of the four schemes works the same way at the level of principle. Statute defines a set of activities. A person carrying on one of those activities must register with the relevant body. If they carry on none of them, they must not register, and there is nothing for an inspector to inspect.
This is why the word clinic is useless for this purpose. A room can be called a clinic and carry on no regulated activity. A room can be called a studio and carry on several. The sign has no legal significance at all.
So the correct question, the one to hold onto through this whole section, is this: is the specific service I am buying, in the nation I am buying it in, a regulated activity. Not whether the place looks clinical. Not whether the staff wear tunics.
| Nation | Body | What triggers registration |
|---|---|---|
| England | Care Quality Commission | Carrying on a regulated activity as defined in regulations under the Health and Social Care Act 2008 |
| Scotland | Healthcare Improvement Scotland | Providing an independent clinic service involving certain regulated healthcare professionals |
| Wales | Healthcare Inspectorate Wales | Operating an independent health care establishment as defined in Welsh regulations |
| Northern Ireland | Regulation and Quality Improvement Authority | Providing independent health care as defined in Northern Ireland legislation |
Definitions differ between the nations and are set by each nation's own legislation. Check the body for the nation you are treated in, not the one you live in.
Where the boundary sits in England
In England the Care Quality Commission registers providers who carry on regulated activities defined in regulations made under the Health and Social Care Act 2008. Those regulated activities include, among others, the treatment of disease, disorder or injury, and surgical procedures.
Purely cosmetic treatment given by a person who is not providing it as a health professional treating disease, disorder or injury frequently falls outside those definitions. The consequence is one that surprises people: a clinic offering only cosmetic injectables may quite lawfully hold no CQC registration, and no CQC inspection report about it will ever exist.
There is a second and separate point, often confused with the first. Laser and intense pulsed light treatments used for cosmetic purposes were removed from the CQC registration requirement in England in 2010. Where those treatments are regulated at all now it is generally through local authority special treatment licensing, which is a local matter and varies from council to council. Detail on how to check that is in the England procedure.
Where the boundary sits elsewhere
Scotland took a different route. Independent clinics providing services by certain regulated healthcare professionals require registration with Healthcare Improvement Scotland, which brought a body of independent clinic activity into a registration scheme. The result is that the scope of premises regulation in Scotland is not the same as the scope in England, and a service unregistered in one may be registered in the other.
Wales operates registration of independent health care establishments through Healthcare Inspectorate Wales. Northern Ireland operates registration of independent health care through the Regulation and Quality Improvement Authority. Each has its own statutory basis and its own definitions.
None of these is a general aesthetic clinic licence. All of them are activity based registration schemes with their own boundaries, and each is covered in its own procedure: Scotland, and Wales and Northern Ireland.
What an absent registration does and does not mean
This is the point at which people go wrong in both directions, so it is worth being very clear.
An absent registration usually does not mean an offence. If the service is not a regulated activity, no registration is required and none should exist. Treating absence as evidence of illegality will lead you to reject perfectly lawful providers and will teach you nothing.
An absent registration does mean a specific protection is missing. Where a provider is registered, a body has assessed the service against published standards, has powers of entry and inspection, publishes findings, and can act on concerns. Where the provider is not registered, none of that exists for that service. That is a real difference and it is reasonable to weigh it.
The practical consequence is that for unregistered services you carry more of the checking yourself. That is not a counsel of despair. It is the reason this site exists, and every other section is a piece of that work.
- Open
- The inspectorate for the nation where you will be treated
cqc.org.uk | healthcareimprovementscotland.org | hiw.org.uk | rqia.org.uk - Type in
- The registered company name first, then the trading name, then the street address. Search all three, because providers appear under names that differ from the shopfront.
- A good result looks like
- An entry for the provider showing the regulated activities it is registered for, the location address matching where you will be treated, and any published inspection report.
- An ambiguous result looks like
- No result at all, which is common and often lawful. An entry for a different location run by the same provider. An entry whose registered activities do not obviously include the service you are buying.
- What it does not prove
- That the cosmetic treatment you want is covered. Registration lists activities, and your treatment may sit outside every one of them while happening in the same building.
- Note
- If nothing is found, ask the provider in writing whether they are required to register for the service you are buying, and if not, why not. The answer is informative either way.
The other rules that apply to premises anyway
A clinic outside health service registration is not outside law altogether. Several regimes apply regardless.
- Health and safety law applies to any workplace, enforced by the Health and Safety Executive or the local authority depending on the setting.
- Waste rules apply to clinical and sharps waste, which must be handled and disposed of properly. Asking how sharps waste is dealt with is a fair and revealing question.
- Local authority licensing covers certain special treatments in some areas, and covers skin piercing and related activities under various local and national provisions. What is covered varies by council, which is why the answer is always to ask the council.
- Data protection law applies to your medical and photographic records, and the Information Commissioner's Office is the regulator for that.
- Consumer law applies to the contract regardless of any health registration, and is covered in what consumer law actually gives you.
None of these is a substitute for clinical regulation. All of them give you a route that exists even when no inspectorate is involved.
What to ask, and what a good answer sounds like
- Is the service I am buying a regulated activity in this nation, and if so, which one.
- Are you registered for it, and under what provider name and location, so that I can search it myself.
- If registration is not required, which body, if any, has any oversight of this service here.
- Does this local authority operate a special treatment or skin piercing licence that applies to you.
- How is sharps and clinical waste handled, and by which contractor.
A provider who answers all five plainly has told you a great deal, whatever the answers are. A provider who becomes evasive at question one has also told you a great deal.
Reading an inspection report if one exists
Where a report does exist, read the report rather than the rating. Ratings compress a great deal into a word. The text tells you what was looked at, what was found, and when. Note the date. An inspection is a picture of a service on a day, and services change, in both directions.
Note also the scope. An inspection covers the registered activity. If a provider is registered for one activity and also offers cosmetic treatments outside the scheme, the report covers the first and not the second. Reading a good report about a registered activity and concluding that the cosmetic service is inspected is a common and understandable error, and it is still an error.
The summary you can act on
There is no United Kingdom wide inspectorate of cosmetic clinics. There are four national schemes, each attaching to defined activities, each drawing the boundary differently, and a large amount of non surgical cosmetic work sits outside all of them. Establish which side of the line your treatment falls on, in your nation, before you assume either protection or wrongdoing. The consolidated version of this procedure is on the checklist.