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Botox
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yorkshiredevil

5 Posts

Posted:  10-Oct-2012 17:22
Hi guys. Just after a bit of advice. I am an independent prescriber and have been approached to prescribe Botox for qualified beautitiens. I'm just wondering of anyone else does this and what they do about insurance
rugbymum

14 Posts

Posted:  14-Oct-2012 10:07
I know quite a bit about this having worked for A nurse led aesthetic clinic. There are 2 big issues with this.
Firstly you should only prescribe within your competence and if you have no experience in this field then you should not be prescribing . Secondly if you do prescribe you are then delegating the administration of the POM which you can do but you are responsible for their competence in that administration if something goes wrong you are the one that could be sued or struck off. The beauticians are not regulated and not insured for this work .I would seriously Advise that you don't get into this unless you are prepared to train in aesthetics and administer it yourself or delegate to another aesthetics trained and health care regulated professional .
Insurance is available for this work through specialist insurers but you have to show them you have training and expertise .I am pretty sure the MDU and MPS put botox prescribing as an exclusion in Nurse practitioner cover
choclit

8 Posts

Posted:  17-Oct-2012 08:33
You really need to lpok into this in depth. Legislation has just changed to prevent remote prescribing. Lpok into getting yourself trained or leave alone.
choclit

8 Posts

Posted:  17-Oct-2012 08:34 Log in to like this post
Oops I mean look!
n/a

1 Posts

Posted:  17-Oct-2012 09:03
Beauticians should not be administering Botox injections. Don't risk your registration!
kama

3 Posts

Posted:  17-Oct-2012 09:08
Hi
I would really look into this, simular concerns as previous reply,i would only prescribe in areas that i have competencies in, and would be very wary prescribing for beauticians, i understand that it should only be administered by nurse, doc or dentist. Personally i would leave well alone even as i work in aesthetics.
kairen
n/a

3 Posts

Posted:  19-Oct-2012 19:01
This has to be the most stupid post i have read on this forum!!! I can't believe this is actually genuine?/
rugbymum

14 Posts

Posted:  20-Oct-2012 12:20 Log in to like this post
Maybe a bit naivebut not stupid in my view.It is a common issue in the aesthetic industry which isn't well regulated . There are loads of beauty therapists who want to administer botox and are trying to find back door routes to be able to obtain the prescription only botulinum toxin . Nurse prescribers are seem as easy targets to engage in the process but they need to be aware of their competencies and being a prescriber does not allow you carte Blanche to prescribe anything . I was approached by an aesthetic clinic and did 6 months training with them before I wrote any prescription and only delegated administration of botox to trained aesthetic nurses. All prescribing consultations were face to face with the client and we never did remote prescribing. Later I supported each of those nurses to do their V300 courses so they could offer a complete service . Nurse prescribers cannot order botox from the manufacturers that still has to be done through a pharmacy or a doctor as far as I am aware
I think it important that all questions on here are not treated as "stupid". This should be safe place to find professional support without being made to feel silly otherwise people will worry about posting .
yorkshiredevil

5 Posts

Posted:  24-Oct-2012 11:13
Thanks for all the comments. I have researched massively into this and trained aesthetic technisions are actually allowed to give the Botox. You do not need to be a nurse. Doctor or dentist at present. I contacted the NMC and told them what was the plan and they said they were fine with this and I was able to do it. I do not currently give the Botox but I am only prescribing for people who have been fully trained to do so and who also have a current anaphylaxis training. All the consultations will be face to face and the client fills in a health questionnaire and signs it. Also just before their treatment t hey sign a consent for which states if anything goes wrong they hold all responsibility for this and can not sue!!!
Rugbymum, they are fully insured and I am only involved with people that belong to a national association called CTIA that fully regulates and audits their members. I order the Botox direct from a pharmacy and I have spoken to them about this and they say all is ok.
I would really appreciate your feedback on this. Many thanks
yorkshiredevil

5 Posts

Posted:  24-Oct-2012 11:20
P.s I have watched the Botox given and also have the training manual that I have worked my way through, but currently I do not give the treatment. I have every intention of doing the course though when I have the cash to do so.
rugbymum

14 Posts

Posted:  26-Oct-2012 11:30
It isn't really as simple as you would like to think as you as the prescriber are responsible for the administration even if delegated . It is not true that it is legal for beauticians to administer, thsy are doing it through the back door and enlisting prescribers such as yourself to legitimise what they are doing - it is a prescription only medicine and has to be administered by a health care professional . Also if beauticians get it wrong they cannot be struck off as they are not on any regulated register but you as the prescriber can - training is free from Allergan the makers of Botox . I did not pay for my 6 months training before I felt competent to write Botox prescription - that training included learning to administer , correct uses , a written exam and knowing all the interactions with other medicines and the clinical contraindications for administration . Making patients sign disclamers against possibe problems isn't legally binding either and any professional worth their salt wouldn't ask for that. Consent must acknowledge that things can go wrong but having that inforamtion doesnt preclude possible legal action if the client can prove you did something incorrectly . Professional indemnity is not provided by the RCN and you have to get a specialist insurer who will want to see evidence of you competency before insuring you for prescribing - I thin my employer paid abotu £1800 s year to cover both prescribing and administration of Botox for me alone and for each of the other 4 nurses employed
Most beauticians insurance I think has an exclusion for injectables.
You really shouldn't see this as any easy way to make money it really is a complicated issue and could compromise you professionally if you don't understand what you are getting into - just having a prescribing qualification doesn't give you carte blanche to prescribe anything you want and it is very worrying that you think watching a video and a bit of home study confers a competency .You wouldn't think you were competent to prescribe chemotherapy to a cancer patient on that basis so why assume it is OK for Botox . If you a member of the RCN try to get in touch with one of the leading lights taht used to run the Aesthetic Nurses forum, these are highly skilled aesthetic nurses most of which have gone on to do ther prescribing , I am sure they will help if you want to do this competently and protect your registration .
nakrdnurse

17 Posts

Posted:  26-Oct-2012 14:56
Spoke to a nurse prescribing friend who specialises in aesthetics ... She says don't touch with a barge pole as remote px now banned and you outside of code of conduct to prescribe a drug for a purpose you not trained in. Professional training is certified by professional body.   Do more research 




rugbymum

14 Posts

Posted:  26-Oct-2012 16:32
Hi nakrd - I don't think  yorshiredevil is planning to do remote prescribing from what they say   as they are planning to see all the clients face to face  and just do a a health questionnaire  so that is not an issue here -but it does seem that the prescribing would be deemed to be out of competency as they have never  trained  to administer the botox themselves  and will delegate the administration to a beautician whose competency they  as the responsible prescriber cannot verify.
yorkshiredevil

5 Posts

Posted:  27-Oct-2012 14:45
Hi rugbymum, thank you very much for taking the time to reply to me. I have taken a note of the training course you did and once i log off here i will be going and taking a look.
I have spoken to a Consultant in my main area of work who happens to do a Botox clinic as a side line and explained my intentions. She didn't really seem to have any issues with what I had to say but with you being so knowledgeable about the subject I am more than listening to you.
I would like to say that I am not doing this for the money at all, it is just another path I would like to explore running alongside my NHS job. I find it a very interesting subject.
Can I ask, does the qualification the administer has as an aesthetic technician, and botox administration qualification along with level 3 anatomy and physiology, not by law count because they do not have a nursing, dentist or doctor background? I am only working with 1 person and she has all this and also does the training to others for an association called CTIA. (please check their website out and give me your views)
xx
n/a

5 Posts

Posted:  31-Oct-2012 18:21
Agree that it isnt remote prescribing but would wonder about the motivation of the beauty therapists for getting you to prescribe for free.Also wonder about it being within your area of expertise as this would depend on where your regular job was.
An example would be that I would be happy to prescribe meds in diabetes and palliative care but wouldnt prescribe say betablockers.
The biggest motivation behind botox used in this way is simply profit, so I would tread carefully and avoid being taken advantage of.

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