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Emma Davies, Clinical Director of Save Face, reviews the background to the current regulatory framework in the aesthetics industry, exploring its weaknesses and makes a case for voluntary self regulation for non-surgical cosmetic interventions, based on government reviews, reports and strategic policy.

Introduction

“You are where you are right now because of the actions you’ve taken, or maybe, the inaction you’ve taken.” ― Steve Maraboli, Life, the Truth, and Being Free.

Why does this topic go round and round? We are faced with an unacceptable and  apparently overwhelming web of political, regulatory, commercial and professional conflicts to unify in order to focus and succeed in protecting public safety.

Background

This field of practice is quite unique.  Though medical in nature, there is no provision, nor ever has been, in the NHS, which has left training provision and standards to evolve organically and without recognised accreditation.  The client base is healthy and treatment is a choice rather than a necessity. Unlike other medical procedures, it is possible to provide these in a variety of venues with relatively low capital cost and overheads.

Because of the association with beauty the vanguard of early adopters commonly provided services in association with beauty salons, chartering new territory without reference to any expert authority to interpret and apply regulation developed with accountable institutions in mind. It is no small wonder, given the exponential growth of the market, and the commercial gains to be made, that providers from a wide variety of backgrounds have exploited the apparent loop holes in legislation and regulation and seized the opportunities to practice with apparent impunity. The resulting diversity of practice and growing accessibility of services, left unchecked for over two decades, has led us where we are today.

Non-surgical cosmetic services may be provided by ANYONE, ANYWHERE and where legislation and regulation are breached, sanctions are not robustly applied and fail to deter.

It is reliably estimated there are some 7000 providers in the UK alone. Approximately 800 belong to professional associations (e.g.BCAM/BACN/BAD) providing influence, guidance and political representation on standards and education related specifically to Aesthetic Medicine. This suggests there are thousands who don’t know what they don’t know and likely do not care.

The Case Against More Statutory Regulation

In 2011 the Prime Minister, in a letter to Cabinet ministers said, “We need to tackle regulation with vigour to free businesses to compete and create jobs, and give people greater freedom and personal responsibility …I want us to be the first Government in modern history to leave office having reduced the overall burden of regulation, rather than increasing it.”

It is quite wrong to complain that this field of practice is entirely unregulated. Every aspect of practice falls under regulation, however the framework is complex, expensive and unable to adapt quickly to new challenges.

“..regulators are frequently unable to make important changes that would allow them to improve their performance, work less bureaucratically, reduce costs to registrants and respond more fairly and effectively to both public and professional concerns. The current legislative framework over-regulates the regulators themselves by constraining their freedom to adapt and modernise.” (DOH, 2011)

The statutory professional regulators are  largely dependant on the cooperation of employers/ providers in managing concerns at a local level, but some 28% of regulated health and social care professionals for whom data is available, work in the private sector, many in a self employed capacity. The regulators are too distant from where the risks arise to be able to act proactively and preventatively in all circumstances and an over reliance on centralised regulation, weakens local responsibility for good governance mitigating risk and managing complaints. (DOH, 2011)

Legislation which applies to our practice isn’t specific to the practice of Aesthetic Medicine which explains the necessity for the layers and devolution of responsibilities, accountabilities, overlap and gaps.

This overlap and duplication of accountability and responsibility leads to confusion and pillar to post reactions to concerns raised. Leaving the individual victim at a loss.  The case of Maria McGinty being one in point. The victim, not equipped or expert in navigating the web of regulations and regulators in place for her protection had nowhere to turn.

Post-Keogh, the government measured the value, cost and impact of instigating and enforcing yet more legislation. It has called upon the regulators (primarily the MHRA, GMC, NMC and GDC) to examine what more they can do in line with the responsibilities they have under statute, and there is an expectation that non-medical, non-prescribing practitioners will (voluntarily) work under the supervision of regulated and accountable practitioners. (DOH, 2014)

National Diversity

“The Destiny of Man is to unite, not to divide. If you keep on dividing you end up as a collection of monkeys throwing nuts at each other out of separate trees.”― T.H. White

In England, The Healthcare Commission charged with inspecting, regulating and auditing the NHS, private healthcare and voluntary organisations, was replaced by The Care Quality Commission in 2009, and in 2010, provision of non-surgical cosmetic services was excluded from the scope, presumably, because its impact was negligible and the cost proved prohibitive.  Like many regulators, their remit is clear, but their scope is diverse; hospitals, care homes, private health services, GPs, dentists. The annual cost to the tax payer is £110M and the CQC will have to be cost neutral by 2016. The £230M annual budget will have to be met by registration fees. (Secretary of State for Health, 2011)

The Public Health Bill (Wales, 2015) proposed licensing for special treatments; tattooing, body piercing, acupuncture and electrolysis. The inclusion of dermal fillers and botulinum toxin at a later date is not completely ‘off the table’ and no new legislation would be required for them to expand the list of ‘special procedures’, but the licensing would be entirely inclusive. (Welsh Government, 2015)

This year (2016) Scotland is implementing regulation for  private clinics where services are provided by healthcare professionals within the scope of Healthcare Improvement Scotland (HIS). The definition of an independent clinic in terms of the National Health Service (Scotland) Act 1978, are clinics that are not part of a hospital and from which a medical practitioner or dental practitioner provides a service, which is not part of the national health service. The term “service” includes consultations, investigations and treatments.  Currently the regulation of any other staff group (eg. beauty therapists) other than those indicated above, is not included in the Bill. (SCIEG, 2015) It is proposed that providers of cosmetic procedures, who are not covered by HIS, will be licensed by local authorities, the details of when and how have not yet been determined. In only including healthcare professionals it patently fails to address the risks and we are likely to see many unintended consequences, detrimental to public health and safety.

The Case for Voluntary Self Regulation

“The principal purpose of regulation of any healthcare profession is to protect the public from unqualified or inadequately trained practitioners. The effective regulation of a therapy thus allows the public to understand where to look in order to get safe treatment from well-trained practitioners in an environment where their rights are protected. It also underpins the healthcare professions’ confidence in a therapy’s practitioners and is therefore fundamental in the development of all healthcare professions.” (House of Lords, 2005)

Everyone had high hopes for a positive change to come from The Keogh Report and there was wide spread disappointment, if not despair once the recommendations and government response were published in July, 2014.

Continuing to call for greater regulation is an emotional rather than an intellectual demand. There is no perfect fix for the risks to the public and the practitioners who treat them. The commercial imperative and market forces will constantly shift and evade any legislation or regulation and budgets, manpower and priorities will always limit the impact of any such regulation.

We may take one of two positions. Either we consider ourselves hopeless and helpless in the absence of further targeted statutory regulation, or we apply ourselves to the gaps and the distance and consider how we might address them through voluntary co-(self) regulation. We must focus on what we can achieve rather than accept defeat and allow the ‘market’ to be driven by the lowest common denominators. Let us take ownership of the SAFE, responsible, credible, ethical and professional and draw a line in the sand between best practice and the shameful headliners, which embarrass and frustrate us.

The ‘distance’ lies between the consumer/patient and the statutory regulators. But also between the unaccountable practitioner ,self employed in private practice, and the regulators. The ‘gaps’ lie in the lack of credible, objective data to inform regulation, the paucity of public and media education and the lack of direct  accountability; of the provider to the patient, when things go wrong.  We need to close the distance and seal the gaps. These are not insurmountable challenges.

A Way Forward

“Success is determined not by whether or not you face obstacles, but by your reaction to them. And if you look at these obstacles as a containing fence, they become your excuse for failure. If you look at them as a hurdle, each one strengthens you for the next.”― Ben Carson, Gifted Hands: The Ben Carson Story.

If nothing else, Keogh and HEE have given us experience of working together and insight into our shared challenges and concerns. Since it now seems unlikely that any of the recommendations will be mandated by statute, there is a real danger that the reality of the current landscape (the public making unsafe choices and unsafe, unethical practice flourishing with impunity) will not improve for the better in any meaningful way.

In February 2011, the Government published the Command Paper ‘Enabling Excellence – Autonomy and Accountability for Healthcare Workers, Social Workers and Social Care Workers’. This document sets out the current Government’s policy on regulation, including its approach to extending regulation to new groups. In particular, it sets out the Government’s policy that, in the future, statutory regulation will only be considered in ‘exceptional circumstances’ where there is a ‘compelling case’ and where voluntary registers, such as those maintained by professional bodies and other organisations, are not considered sufficient to manage the risk involved.

The paper also outlines a system of what is called ‘assured voluntary registration’. The Health and Social Care Act 2012 has implemented a number of the policies described in the Command Paper. The Professional Standards Authority for Health and Social Care now has powers to accredit voluntary registers of people working in a variety of health and social care occupations. The idea behind this, to provide assurance to the public that these registers are well run and that they require their registrants to meet high standards.

It is our duty to work towards achieving fit for purpose self regulation. In the select committee report it was recommended  ‘that, in order to protect the public, professions with more than one regulatory body make a concerted effort to bring their various bodies together and to develop a clear professional structure.’ (Stone Report, 2005)

In working towards effective regulation for complimentary and alternative therapies, a federal structure was explored and determined, and we might take inspiration and heart from their journey and success (PFIH, 2006) (House of Lords Select Committee, 2002).

When considering the options for Complimentary Alternative Medicine (CAM) a great deal of work was undertaken, the author has identified a great deal of commonalities  and  rather than ‘reinvent the wheel’, refers the reader directly to the  documents already published, to describe the risks and benefits of a Federal Structure from which to base a sound framework for self regulation in Cosmetic Medicine.

Health Education England published its final report in January 2016 and proposed a new landscape which included; A Joint Council (inclusive of ALL stakeholders) to establish a competent authority to oversee and accredit new education and training standards in line with the proposed educational framework, and an independent register accredited by The Professional Standards Authority (PSA).

Whilst the government support inclusion (of beauty therapists etc), The PSA only regulates registers of health and social care registers, including the statutory bodies. Given that none of the proposals are mandated by legislation, the author would entreat the professional bodies to focus on expediting progress addressing the issues faced by regulated healthcare professionals, primarily that of appropriately accredited education and training. Whether or not progress is made on an inclusive Joint Council, which they may also be part of.

  • A Federation to unify the regulated healthcare professionals (nurses, doctors, dentists and prescribing pharmacists) (HEE, 2012) and foster collaboration to minimise duplication of activity and resources.
  • The Professional Associations to represent, educate and support the individual professional groups
  • A single independent register to accredit those who meet the standards set by The Federation- undertaking verification and inspection and providing a direct connect with, and accountability to, the consumer.

Joined up – we have a real chance of educating and supporting patients to make safer choices and strengthen the  credibility of the regulated professionals providing these services.

Save Face, in just over 12 months have demonstrated how much can be achieved with a ‘can do’ attitude. This work and achievement has required significant risk and investment- in excess of £500,000 to date. It has delivered credible standards, published policies, procedure protocols, patient information and consent forms, guidelines and CPD accredited learning to support best practice and mitigate risk. Unlike any other register of non-surgical cosmetic service providers, it verifies each accredited practitioner- registration, training, insurance and CPD and inspects every premises accredited. It provides guidance, information and resources to support best practice standards and most importantly, it encourages and facilitates patient feedback and when concerns are raised or complaints made, it ensures fair and professional resolution.

Ultimately, the consumer drives and shapes the market. Whatever regulation is in place, the public does not fully benefit unless it is well informed and motivated to make safe choices. Website SEO, blogs, engagement on social media, local and national campaigns and working with journalists are all an essential part of this, but behind every story, the offending practitioner must be held accountable to the regulations in place, and made an example of.  Independent of political and professional agendas, Save Face has focussed entirely on the needs of the risk averse consumer. It has strategically invested and acted to build awareness of not only the register, but to rock the assumption that nothing can be changed.

Having examined numerous government reviews and reports, and in particular, The Hampton Review (Hampton, 2004) the author is confident the model Save Face presents is not only fit for purpose, and PSA accreditation will give assurance of that,  but represents the best way forward for regulated healthcare professionals specialising in non-surgical cosmetic practice. There is great potential for real progress if only we all joined forces and harmonised from a single hymn sheet rather than singing individual tunes to smaller audiences.

 

Since starting out in 2001, there are now over 1.65 billion active Facebook users across the world. Speak to your friends, your family or your colleagues and the chances are a lot of them will be using Facebook. So how does this apply to your aesthetic practice? We take a look at the importance of having a Facebook Business Page for your aesthetic clinic and outline some tips and tricks to maximise your efforts.

What is a Facebook Business Page?

A Facebook Business Page allows you to extend your clinic services to a wider audience as well as engage with your current clients. On your Facebook Business Page you can add your contact details, create a portfolio of before and after photographs, gather reviews from your clients and much more. It’s purpose may be slightly different depending on your circumstances:

  1. If you are just setting up your aesthetic practice and don’t have the money to invest in building your own website, a Facebook Business Page can act as a website on your behalf making it a great place to start connecting with potential clients.
  2. If you already have a website but are looking for ways to boost your marketing efforts and reach a wider audience, Facebook may be just what you’re looking for.

Benefits of a Facebook Business Page for your Aesthetic Clinic

In an industry obsessed with talking about our looks and the latest celebrity treatment Facebook becomes a fantastic platform to discuss, inform and advertise our services. The main benefits include:

  • Brand Awareness – Allowing your clinic to be discoverable on Facebook means you can build your brand and reach a wider audience
  • Engagement – Stay connected with your current clients by asking them to like you on Facebook. The people that like your Facebook Page are interested in the services you provide so it is an extremely targeted form of advertising
  • Search Engine Optimisation (SEO) – We won’t go into this in detail (we’ll leave that for another blog) but we do know that Google takes social signals into account. So if you are seen to be active on social media this will help your business rank in Google when someone is searching for your brand
  • Know your audience – Integrated into your Facebook Business Page is Facebook Insights so you can begin to understand what your customers are interested in, what they’re liking, sharing and talking about. This means you can adjust the content you’re posting so that people become more engaged over time.

Creating a Facebook Business Page is a cheap and easy way of marketing your services to potential customers. If you’re not tech-savvy then don’t panic because Facebook has a fantastic support network meaning you’ll be able to get your page set up in a matter of minutes.

Click here to see Facebook’s guide to setting up your business page

So you’ve set up your Facebook Business Page, you’ve entered in your clinic information, now what?

Build your Audience

As we said, Facebook allows you to reach a wider audience but most importantly, it allows you to reach the people who are actually interested in having cosmetic treatments.

Your first step is to like your business page yourself and share it on your personal Facebook account (if you have one). This means if your friends are interested in having non-surgical treatments they can like your business page and stay up to date with what’s on offer.

The second thing to do is invite your current customers:

  • Add links from your website to your Facebook page
  • Include your Facebook page in email correspondence with clients
  • Include your Facebook url on all print advertising
  • Basically just shout about it!

Top Tip

If you have a list of clients’ email addresses you can actually upload these into your Facebook Business Page so that they get notified that you are now on Facebook. Nifty, eh? Find out more here.

Now for the fun part…

Start Posting!

Start posting updates, before and after photos, client testimonials, treatment videos, upcoming events, offers, news articles, anything you can think of! Just test a few different types of posts and see what works and engages your customers. We’d recommend posting a couple of times a day so you’re consistently reaching out to your audience.

Importantly, it’s not purely about the content that you post. The aim of your Facebook posts is to engage your audience and start a conversation. That means you need to make sure you get notified when someone comments on a post or sends you a direct message. We recommend downloading the Facebook Pages app on your mobile device and turn on push notifications so no matter where you are, you can respond to your clients.

Top Tip

Use the 80:20 rule. You don’t want to bombard your potential clients with information about you. You want to be informing them about treatments, the benefits they can get, any informative blogs you have and industry news: ‘What’s Kim Kardashian had done this month?’, ‘Has Katie Price had any more procedures?’ This is what people are actually interested in. So try and keep 80% of your content informing your patients and 20% of your content about your clinic directly and the services you provide.

Facebook Advertising

If you notice that a particular post you’ve sent out is receiving a lot of engagement you can do something called ‘Boosting a Post’. This means you pay a set amount of money to reach a larger audience such as friends of those who liked your page. It’s inexpensive, extremely targeted and you can turn it on and off with the click of a button.

Facebook advertising is an amazing tool to reach a specific client base. You can create targeted adverts that reach people based on things like gender, age, location and interests. Let’s go through an example. Say I wanted to advertise that my Birmingham-based clinic now does the 8 Point Facelift.

First thing I would do is choose my objective which in this case I want to be clicks to my 8 Point Facelift website page. I would then work out my audience, let’s say:

  • Gender: Female
  • Age: 35 – 60
  • Location: Birmingham + 40km radius
  • Interests: Beauty Treatments, Skincare, Facial, Anti-Ageing

I would then set a budget and a timeframe for my advert. So I want to spend a maximum of £3 per day and just run it continuously until I decide to turn it off. (You can adjust all of these settings at any time so they’re not set in stone).

You will then need:

  • A compelling image – in this case it could be a before and after photograph
  • Some text describing the treatment
  • The url of the page you want them to click on to

Then voila! You now have an advert that will appear in the Facebook newsfeed of potential clients who fit your 8 Point Facelift profile in your local area. And hopefully that will start generating traffic to your website! Easy as that!

Important

With Facebook there are a few things to be careful of. If you are posting Facebook adverts, they will decline your ad if you can see the injection in the picture. Also be careful when advertising the word Botox. As it is a POM you can get reported for discounting and advertising Botox treatments. So just be vigilant.

We hope if you’re considering setting up a Facebook Business Page this has offered you some insight into how it can benefit your aesthetic clinic and some tips on how to maximise these benefits. If you have any questions on setting up your page or any other elements of marketing your practice please don’t hesitate to contact us.

P.S If you’d like updates on what we’re up to here at Cosmetic Courses you can like our Facebook Page here!

 

For those of you that have attended our Foundation and Advanced Botox and Dermal Fillers courses, you will be aware that dermal fillers are used to introduce volume back into areas of the face that have lost volume during the ageing process. When it comes to dermal filler training, there’s a lot to cover, do you know your Juvederm Ultra 2 from your Ultra 4? And what about knowing your marionette lines from your tear troughs?

Where can dermal fillers be used?

Dermal fillers have a wide multitude of uses from the obvious to the not so obvious. If you have a patient that is interested in having dermal filler, we advise that you get them to attend an initial skin consultation with you before having the treatment. This will allow you to find out more about the patient’s medical history, and the look that they are hoping to achieve.

Tear troughs Cosmetic Courses;Picture showing Tear Trough Treatment Before & After

These are the lines under your eyes that make your eyes look tired. A loss of volume in the area, a loss of tissue elasticity or a mild reduction in bone density could all be causes of concern. By using an advanced technique, dermal fillers can be placed in either the tear trough itself, slightly lower in the cheek area, or indeed a combination of both to achieve brighter, more rejuvenated eyes.

Naso-labial folds
Commonly known as the smile or laughter lines, these are the two skin folds that run from each side of the nose to the corners of the mouth. If you are bothered by your nasolabial folds, and wonder what to do to improve the area then filler is perfect to fill out these folds, and partnered with cheek filler the face will appear much younger looking.

Mouth corners

Sometimes the corners of your mouth can droop leaving you looking unhappy. Dermal filler can be placed below the corners of the mouth with a small amount directly into the corners of the lips.

Marionette lines
Marionette lines run between the corners of the lips down towards the chin and jaw giving a puppet-like effect. As we age, our facial bones become smaller resulting in lines like these appearing. Dermal filler is great for filling in these lines making them less prominent.

Cheeks

As you age you lose an amount of subcutaneous fat which can result in a loss of volume and elasticity to the face. This in turn highlights hollow cheek bones, and the presence of excess skin resulting in sunken cheeks. This can cause someone to appear gaunt and tired-looking. Dermal fillers can be injected into this area to plump out the face with natural volume and a gentle lift. This is an advanced technique and is offered at one of our specialist training days.

Lips & vermillion borderCosmetic Courses; Image showing Lip Fillere treatment before & after

A celebrity favourite and probably the most well-known use of filler. The lips can be injected with dermal filler either in the body of the lip to boost fullness or the border of the lips to increase definition. This treatment is ideal for correcting thin lips but can also help solve problems with a downward smile and the need to lengthen the mouth.

Chin augmentation

A perfect alternative to a surgical chin implant, is a non-surgical chin augmentation which is achieved with dermal fillers. Fillers will help define your jaw line and although only a temporary solution it is a great way to see what can be achieved surgically if you are unsure.

Smoker’s lines

These are the vertical lines above the lip that appear when you pout. They are mostly caused by regular lip movements but are also called smokers lines, because regular smoking means pressing the lips together.  If your lines are deep enough then they can be drastically reduced with a small amount of injectable filler to achieve a smoother appearance.

Nose
Have you heard of the lunchtime nose job? Dermal fillers can now be used to straighten out any lumps or bumps in your nose without the need for any surgical downtime. Fillers are injected into the nose to smooth out slight bumps in the bridge of the nose, or rectify a crooked line of the nose (particularly in profile view) and even cartilage irregularities at the tip of the nose all in less than 15 minutes! This is another advanced course available for those that have been practicing in dermal filler for a while.

Hands

Hands are a new use for fillers, patients have found that the use of the fillers in their face is great for concealing their real age, but then it is often their hands that give it away. Ageing hands lose volume and the skin appears thinner. Having filler injected into the skin on the back of the hands can make them appear plumper and less veiny.

So now you know your areas, let’s look at the product that we use on our training days at Cosmetic Courses:

Juvaderm®  Vycross Range

The Juvaderm® Vycross range is a smoother gel which means you get a comfortable treatment. The risk of bruising and swelling is reduced as is any discomfort as anesthetic is added into the formulation of the filler. The Vycross range provides subtle and natural outcomes due to the smoothness of the gel making it easier to inject with precision.

The Vycross range has 3 different forumulas;

Juvederm® Voluma 

Juvederm® Voluma is a much thicker hyaluronic acid gel which has been made by altering the cross-linking technique used in Ultra to create a more viscous result. Voluma can be used for recontouring and restoring the face in the case of age-related volume loss. Designed for deep volume restoration to re-contour the face in areas such as the cheek bone and chin regions.

The effects of Juvéderm® Voluma® last for approximately up to 18 months.

Juvederm® Volbella
Launched in Paris Juvederm® Volbella® is specifically designed to enhance lip volume and define lip contours, with a completely natural look and feel.  The filler has a smooth, liquid consistency for a smoother look and the addition of lidocaine anaesthetic makes the treatment even more comfortable in an otherwise uncomfortable area.

The effects of Juvederm® Volbella® last for approximately up to 12 months

Juvederm® Volift®
This revolutionary dermal filler is produced using VYCROSS™ technology. This creates an ultra-smooth gel for natural appearance with minimal swelling and bruising. It is best used for smoothing nasolabial folds and facial contours.

The effects of Juvederm® last for approximately up to 15 months.

Juvederm® Hydrate Cosmetic Courses; image showing dermal filler product Juverderm Hydrate

The Juvederm Hydrate is used to improve skin hydration and restore elasticity which is lost through ageing. It works by replacing hyaluronic acid but unlike traditional filler it acts as a hydrating agent attracting and keeping moisture within the skin to achieve that healthy natural glow. Juvéderm® Hydrate is most commonly used for very fine lines and wrinkles associated with ageing. It has also been recommended as an early treatment for crow’s feet and fine lines around the mouth.

The effects of Juvéderm® Hydrate last for approximately four to 6 months

Juvederm® Ultra is our most common dermal filler. The filler contains non-animal hyaluronic acid with the addition of 0.3% lidocaine which is a local anaesthetic to make you feel comfortable both during and after the treatment.
There are actually four different formulations for Juvéderm® ULTRA available;

Juvederm® Ultra 2 is a highly cross-linked formulation which is used for the subtle correction of medium facial lines, in particular those around the corners of the eyes and those very close to the surface of the skin. It can also be used to around the lips to enhance natural lip contour.

Juvederm® Ultra 3 Cosmetic Courses; image showing dermal filler product range Juverderm Ultra 3

Ultra 3 is another highly cross-linked formulation but is instead used for more versatility in contouring and volumising anything from moderate to medium facial lines and skin depressions, in areas such as the nasolabial folds. It can be used subtly in lips to enhance lip contour, increase volume and maintain a youthful smile.

Juvederm® Ultra 4 [image]

Ultra 4 is a highly cross-linked robust formulation used for volumising and correction of medium to deep folds and wrinkles, including adding volume in the cheeks and chin improving contour to the face.

Juvederm® Ultra SmileCosmetic Courses; image showing dermal filler product range Juverderm Smile

The newest arrival to the Juvéderm® ULTRA family the Juvéderm® Ultra Smile is based on the Ultra 3 product but it is specifically targeted for use in the lips. It works by providing fuller but softer and natural looking lips and smooths fine lines to fully enhance the mouth area for a fresh new look.

The effects of Juvéderm® Ultra Smile lasts approximately up to 18 months

If you would like to find out  more about our Advanced Dermal Filler Training Course and the product range that we use, you can call the team on 01844 390110 or email [email protected]

With so many things to consider when setting up on your own, one of the most important is to think about the structure of your business. This will determine the tax structure that you will be operating in going forward.

To help you to be able to make an informed decision, we have taken the most popular structures and looked at the pro’s and con’s for each one.

Sole Trader

Sometimes known as “one man bands,” a Sole Trader is a business that’s run by one person, who takes full control, responsibility and makes all the decisions. This structure can also be referred to as a micro business due to its size, and is used by many skilled tradesman such as electricians, plumbers and decorators to name a few.

This structure will need to yearly account for all sales, expenses and profits for any income tax and National insurance.  VAT will also need to be paid if the businesses yearly turnover exceeds the limits that have been set by HMRC.

Advantages and disadvantages with this structure include the following:

Full control

You would have full control over the daily and strategic planning and operations of the business and the size and rate in which you would wish for it to grow.  However, this has it’s pitfalls in that you will be solely liable for any business failures, debts and other liabilities.

Easy to set up

Cosmetic Courses;picture showing account and financeThe process to register is quick and easy as it would only be yourself that you would need to declare. You would need to inform the Inland Revenue that you are self -employed within three months of starting up. Failing to do this could result in penalties and charges.

Less regulations and start-up costs

There is less paperwork needed for a sole trader than there is for the other structures.  You would need to fill in an annual self-assessment tax return form to the Inland Revenue each financial year. All financial information would be private and would not have to be registered to companies house at the end of each year as is with limited companies and you would not need to register your company.

No management or staffing required

As you would be working on your own, any profit made would not need to be split between anyone else.  As great as this sounds, it is important to remember that your income will stop if you do. You will need to factor in your earnings if you decide to take holidays and plan for what would happen if you were suddenly taken ill. Critical illness insurance is available but it would be worth checking to see how long you would need to be off work for before this would take effect.

Lower accounting costs

As there is less work to undertake due to this being a personal tax return, accountants tend to charge less. A profit and loss account would need to be completed for the accountants to check, and it is advised to create a balance sheet and cash flow statement to help you control and manage the cash flow of your business on a regular basis.

Partnership

This is an agreement between two or more people to operate a business. Each partner has a proportion of or equal amount of shares with the same authority to run the business, and should be involved in the day to day operations and decision making.  With any decision made, each partner will be held equally responsible. You can enter into a partnership with anyone, but it is advised to have an impartial lawyer draw up a partnership agreement for everyone to sign, and a business agreement can be created to protect you and the business should someone choose to leave in the future.

Advantages and disadvantages of a partnership

They are easy to establish

Partnerships are easy to establish, but to ensure that everyone involved has a clear direction on their individual roles. It is best practice to draw up a partnership agreement. Within this agreement you can determine the processes and course of action for any scenario including; what would happen if a partner dies, if one of more members of the partnership wishes to dissolve the partnership, as well as how the business will be financed.

Easy to raise funds

Unlike a sole trader, the ability to raise funds is increased. The members within the partnership may be able to contribute more, or the borrowing capacity maybe slightly greater.  With this, any profit that is made must be split between all the partners. However, tension can be created if there is one partner who has put in less time than others, and this will need to be taken into consideration at the time of setting up the business.

Broader set of skills

Each individual will have certain strengths and skills to help drive the business forward. Just remember that when it comes to expanding or growing the business, some partners may or may not be prepared to take risks. This may cause a slow decision process and friction within the partnership, and can make the business not as flexible as it could be.

Limited Companies

Cosmetic Courses ; image showing Weighing scalesA limited company allows the person setting up the business to keep their own assets and finances separate from the business  along with a separate bank account.  This means that if the aesthetic business was ever in a position where it needed to terminate trading, you should not have to use you own personal belongings to pay off any outstanding debts.

There are two types of limited companies to choose from:

Public Limited Company (PLC) – companies that allow members of the public to invest in the company and buy part of the business (known as shares).  Any profits and losses made for the company must be made public on the Stock Exchange. There must be at least two directors of the business to be able to trade as a PLC.  Generally, this is for very large business with a turnover of £20 million.

Private Limited Company (LTD) – can be run with one director, but differ to a PLC in that they cannot trade shares publically. These types of business are normally family run or business partners looking to run a business and wanting the protection that a limited company gives over a partnership.

Both private and limited companies must be registered with Companies House to be able to legally start trading. Each company will be taxed on its trading profits and where relevant will pay VAT on its products and services.  The director or directors take full control of the running of the business and any person that has bought shares within the company (known as shareholders) help to fund the business and reap the rewards of any profits that are made. It is important to note that that under The Companies Act 2006 , a director cannot be under the age of 16.

Advantages and Disadvantages of Limited Companies include:

Financial security

Any debts accrued by the either a PLC or a limited Company should not fall to the Director the business to pay with any personal belongings. The shareholders become liable according go the levels of their investment (how many shares they own). For a limited company, it is important to remember that there is a restriction on the raising of capital when it comes to selling shares, as they are only available if someone wishes to invest in the shares.

Separate entity

A big plus for limited companies is that they will be able to exist beyond the life of its original members, as they are run and function as a separate entity. Employee security can be ensured with this, but there can sometimes be disputes between directors and shareholders of public companies when it comes to decision making for the business.

Don’t always need office premises

When you start out your limited company, your funds will more than likely be limited and a big office space is something at the present time that would not be needed. Until your business expands, you can run it from the comfort of your own home, and then claim back a proportion of the cost of heating, lighting and electricity from your business.  The accounting for any limited company is more complicated than those of a sole trader with many different documents legally required to be kept up to date throughout the year. These can be difficult to understand, time consuming and costly, but they are essential.

Ownership and Control

Directors of Private Limited Companies are normally the main shareholders, leaving both the ownership and control in their hands. Decisions can be made quickly and effectively, but it can be difficult to know what the best option is when faced with a difficult decision, and mistakes and obstacles can occur. Public Companies don’t have it so easy. There can sometimes be disputes between directors and shareholders of when it comes to decision making as ideas and direction can vary between each individual. Further sales of shares can lead to more investors, with a counter balance of there being more people that are involved in any decision making and having to keep happy. Decision making therefore can be slow, and time consuming.

Cosmetic Courses; image showing The Right KeyMaking the right decision for your aesthetic business

There is not right or wrong choice when it comes to deciding on the type of business you want to be.  Each type has their differences, advantages and disadvantages which all need to be taken in to consideration.

To ensure you make the right decision for you we advise that you:

Conduct more research on all of the structures – gather as much information as possible to help you be certain of your choice.

Seek advice – if you find yourself with information overload, or you’re still not sure, you can make an appointment with a business manager at your local bank, or with an accountant who can give advice on what they think would be the best option for you.

Our team can offer support for you and your business after completing one of our courses. If you would like to find out more information on the courses that we offer, please call the team on 01844 3901101 or drop us an email; [email protected] 

You can also enroll on our online business course to further your knowledge here!