The health regulator is threatening to shut down beauty clinics that perform unsafe facelifts, nose jobs and breast enlargements after finding that one in five are putting clients at risk.

Too many people undergoing cosmetic surgery are treated by untrained staff and left in danger while sedated during liposuction, the Care Quality Commission (CQC) warns in a report published on Tuesday.

It has sounded the alarm after inspections of premises providing solely cosmetic surgery uncovered an array of “areas of inadequate practice” that put clients at risk of serious harm. “Common areas of concerns” among independent clinics across England include:

  • Poor monitoring of patients whose health may deteriorate

  • Staff failing to obtain proper consent before starting treatment

  • Patients not being given a proper “cooling-off” period between their consultation and the procedure

  • An inability to manage anaphylaxis, an allergic reaction which can be life-threatening

  • A lack of attention to fundamental safety processes

The CQC has inspected 65 of the 102 services it licenses to carry out cosmetic surgery and published reports on 58 of the 65. It has taken enforcement action against 12 of those 58 – a fifth of the total.

It cancelled the registration of the Bearwood cosmetic clinic in Solihull in the West Midlands after uncovering a number of unsafe practices. A magistrate approved the CQC’s application to shut the service down. The clinic’s owners initially contested the court’s decision but then dropped their appeal.

Full details of the poor standards inspectors found at Bearwood will be disclosed when their report is published soon, the CQC said.

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In August it also suspended the operating licence of the Look Younger clinic in Chichester in west Sussex after identifying a host of problems. Its report [pdf] makes clear that:

  • Staff put patients and themselves in danger by doing too little to control the risk of infection

  • The clinic had too few properly trained staff to keep patients safe from harm and provide proper care

  • It used out-of-date medicines

The findings are a blow to the image of the booming cosmetic treatment and wider beauty industry, which has come under fire for pressuring clients into having procedures, ignoring evidence of psychological vulnerability and using dubious marketing techniques, such as offering two treatments for the price of one.

Prof Ted Baker, the CQC’s chief inspector of hospitals, responded to the evidence by writing to all cosmetic surgery clinics to warn them that the regulator would crack down hard when it comes across inadequate or unsafe care.

In his letter, he says that while some operators display good practice, inspectors found many examples of substandard care. “Where we have concerns about the quality and safety of services, we will use our enforcement powers to demand improvements and, in the case of very significant concerns, to suspend or cancel a provider’s registration in order to protect people receiving care.”

He also warns clinicians undertaking “high-risk or novel procedures” that they must be able to prove they are ensuring patients’ safety, alerting them to the risks involved and acting in their best interests.

The Royal College of Surgeons of England said the CQC’s findings showed that some clinics were not meeting its own professional standards for cosmetic surgery.

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