The Women and Equalities Committee reported this year on the health impacts of cosmetic procedures, and the conclusion was blunt: regulation has not kept pace with demand. Evidence put to the Committee described procedures being carried out in Airbnbs, hotel rooms, garden sheds and public toilets.
That is the sentence worth sitting with, because it defines what licensing is actually for.
Where the framework has got to
The power to license non-surgical cosmetic procedures in England came in under the Health and Care Act 2022. A consultation ran in 2023. The Government's response arrived in August 2025 and confirmed a three-tier model — red, amber and green, by clinical risk. As things stand the scheme is still not in force, with further consultation expected before regulations are made. Scotland has moved ahead separately. Wales and Northern Ireland have not.
Meanwhile the Care Quality Commission's scope was extended only narrowly, to a small set of high-risk procedures involving the genitals and intimate-area injectables. Standard facial injectables remain outside it. A great many patients assume otherwise.
What licensing will fix
It will fix the floor. Premises standards, insurance, infection control, a requirement to be identifiable and traceable. The garden shed problem is a licensing problem and licensing will substantially solve it. That alone justifies the scheme and it should have happened years ago.
It will also fix the information asymmetry at the point of booking. A patient currently has almost no way to distinguish a well-trained practitioner from a confident one. A licence gives them something to check.
What it won't
A licence is a threshold test. It establishes that someone has met a standard on a particular day. It says nothing about volume, about outcomes, about whether the practitioner audits their own complications or has ever managed one. The distinction that actually predicts patient safety — between someone who does forty of these a year and someone who does four hundred — is invisible to a licensing scheme and will remain so.
Nor will it address the commercial pressure that produces most of the harm I see. Practitioners don't treat inappropriately because they're unlicensed. They do it because the economics of a clinic reward treating and punish declining. Licensing changes who may treat. It does not change what they're paid to do.
I'd support the scheme without hesitation and I'd argue it's the beginning of the work rather than the end of it. The next question — the harder one — is whether this field will ever accept outcome reporting. Surgery has slowly, painfully, moved toward it. Aesthetic medicine has not begun.