The Royal College of Surgeons is to establish a group to bring together all those involved in setting standards for cosmetic surgery following a new report by the National Confidential Enquiry into Patient Outcome and Death [NCEPOD].

The sobering study, entitled On the face of it, reviewed the organisational structures of cosmetic surgery providers and found that many were failing patients. Of particular concern to the College was evidence of ‘occasional surgery’ with operations being spread over too many units with some surgeons not doing enough to maintain skills. The findings that some units lacked equipment and were not undertaking full psychological assessment of patients are also of grave concern.

The RCS believes that nobody should be practising surgery without contributing to audit in order to prove safety, so the failure of so many units to participate in this study is alarming – particularly as one reason seems to be the very high turnover of small start-up organisations in this field.

The College already expects all surgeons to meet high individual standards of care through ‘Good Surgical Practice’ and revalidation standards that apply in the NHS and independent sector. However, the problems highlighted by NCEPOD also indicate that the unique working environment in cosmetic surgery means that further work may be required in setting specific service standards for use by the regulator. This will improve safety and be in the best interests of patients.

John Black, President of the Royal College of Surgeons, said: “This incisive report from NCEPOD shows that patients are not being properly protected. The Royal College of Surgeons is not a regulator, but sets the standards for surgery that the regulators use – this study makes it clear specific action is necessary. NCEPOD make a series of recommendations for the Care Quality Commission and General Medical Council and we shall aim to provide clear standards to those bodies to help them fulfil that.”

RCS council member Steve Cannon will chair a multi-disciplinary group to bring together the standards for surgery, drawing in evidence from the plastic surgery specialty societies, and other groups across the medical profession. The group’s findings will be published in summer 2011.