This blog compares the Non-surgical Procedures and Functions of Medical Reviewers (Scotland) Bill, with previous Scottish Government consultations and approaches taken elsewhere in the UK to regulate non-surgical procedures.
This SPICe blog examines Part 1 of the Non-surgical Procedures and Functions of Medical Reviewers (Scotland) Bill, answering key questions on its provisions. A separate SPICe briefing examines both Part 1 and Part 2 of the Bill in detail.
How does the Bill differ from the proposals on which the Scottish Government consulted?
Scottish Government consultations
The Scottish Government undertook two rounds of public consultation on the regulation of non-surgical procedures.
The initial consultation in 2020 focused on the principle of regulating non-surgical procedures. 98% of respondents supported regulation, especially for procedures performed by non-healthcare professionals. This confirmed public backing and the Programme for Government 2025 to 2026 committed to introducing a Bill to regulate non-surgical cosmetic procedures.
In 2024-25 the Scottish Government consulted again, seeking views on proposals for a licensing and regulation scheme for non-surgical cosmetic procedures. This included:
- The roles of local authorities and Healthcare Improvement Scotland (HIS) in inspection and enforcement.
- Grouping procedures into three categories to determine appropriate settings and qualified practitioners.
- Setting standards for hygiene, training, and insurance.
- Introducing age restrictions.
After the second consultation, the Scottish Government changed its approach. The Bill introduced to the Scottish Parliament is different from the original version that was consulted on. The main changes are outlined below.
Proposals for groups of procedure
Proposals in the 2024-25 Scottish Government consultation | Differences to proposals in the Bill |
The Scottish Government proposed 3 groups for non-surgical procedures determined by risk-level, which would be subject to different levels of licensing and regulation:  Group 1: Lower-risk procedures (e.g. microneedling) – required both practitioner and premises licensing.  Group 2: Medium-risk (e.g. Botox, fillers) – could be performed by non-healthcare professionals in HIS-regulated settings under supervision.  Group 3: Higher-risk – restricted to qualified healthcare professionals in HIS-regulated settings. | The Bill does not formally group procedures in the same way but instead gives Ministers power to set differentiated rules through regulations. However, effectively, the Bill is concerned with two groups:  Procedures that pierce or penetrate the skin, as listed in Schedule 1 are included in the Bill. Procedures subject to a separate licensing scheme under the Civic Government (Scotland) Act 1982. These are not listed or defined in the Bill and are not included within it. |
Licensing and premises
Proposals in the 2024-25 Scottish Government consultation | Differences to proposals in the Bill |
The Scottish Government consultation proposed that lower risk, less invasive procedures could be carried out in business premises licensed by the local authority, while the more invasive, higher risk procedures could only be carried in a HIS regulated setting. | This is still the case under the Bill. There are cosmetic procedures that are either lower risk or do not require a healthcare professional, for example, some types of facials or other beauty treatments. This Bill would not regulate these procedures, these are subject to a separate licensing scheme under the Civic Government (Scotland) Act 1982. |
Role of Healthcare Professionals
Proposals in the 2024-25 Scottish Government consultation | Differences to proposals in the Bill |
The Scottish Government consultation proposed that Group 2 procedures should be restricted to HIS regulated premises, therefore meeting any standards set by HIS. For these procedures there must be supervision by an appropriate healthcare professional, including a prescriber where prescription-only medicines are in use. | The Bill would not require supervision for all procedures in the same way the proposals did. However, it does define who could manage or provide services in permitted premises. |
Training
Proposals in the 2024-25 Scottish Government consultation | Proposals in the Bill |
The Scottish Government consultation proposed detailed and structured training requirements, relating to the groupings:  Group 1 procedures would require minimum training standards (which would vary according to each procedure) and insurance requirements, with these being reviewed by the local authority under the licensing scheme.  Group 2 procedures would require supervision, the healthcare professional would have been responsible for ensuring that the practitioner’s training and competence is appropriate to the procedure. Group 3 procedures would require to be conducted by an appropriate healthcare professional. These procedures would require advanced anatomical and medical knowledge so the appropriate professional would be a doctor or a nurse prescriber with advanced training. | The Bill does not set out training levels. Instead, it would give Scottish Ministers the power to set training and qualification standards via regulations. |
How is the Bill different from approaches taken in the rest of the UK?
The Bill, and the proposals in England, both aim to regulate non-surgical cosmetic procedures. However, they differ in scope, by their enforcement mechanisms, and legislative progress.
While a dedicated Bill has been introduced in Scotland, in England, section 180 of the Health and Care Act 2022 (the 2022 Act) came into force in July 2022.
The 2022 Act gives the Secretary of State for Health and Social Care the power to introduce a licensing scheme for non-surgical cosmetic procedures through regulations, but these have not yet been introduced in England. These would ban individuals from performing certain cosmetic procedures without a licence and require premises offering these procedures to be licensed. Licenses would be issued by local authorities and the licensing scheme would:
- Set national standards for training, education, and qualifications.
- Ensure hygiene standards in treatment premises.
- Require insurance and indemnity for practitioners.
The 2022 Act defined a cosmetic procedure as: “a procedure, other than a surgical or dental procedure, that is or may be carried out for cosmetic purposes; and the reference to a procedure includes: (a) the injection of a substance (b) the application of a substance that is capable of penetrating into or through the epidermis (c) the insertion of needles into the skin (d) the placing of threads under the skin (e) the application of light, electricity, cold or heat”.
Schedule 19 of the 2022 Act outlines additional details for the regulations, including provisions for charging fees, establishing criminal offences, and applying financial penalties.
Next steps
The UK Government has reportedly outlined a tiered approach to regulation based on the level of risk associated with procedures. This approach does not appear to be vastly different from that proposed by the Scottish Bill, although there are expected differences in groupings of procedures which may be significant.
Under the UK approach to regulation, local councils will oversee licensing for medium- and low-risk procedures through a licensing scheme. High-risk procedures would be restricted to qualified healthcare professionals operating in Care Quality Commission (CQC) registered premises.
Under the Scottish approach to regulation, local councils will oversee licensing for low-risk procedures that do not require the intervention of a healthcare professional though a licensing scheme under the under the Civic Government (Scotland) Act 1982. All other procedures would be subject to provisions in the Bill, restricted to Healthcare Improvement Scotland (HIS) registered premises and provided or managed by healthcare professionals.
In the UK, a new consultation is expected in early 2026 to define which procedures fall under medium- and low-risk categories, how licensing will apply to non-healthcare professionals and what training standards will be required.
In Scotland, Section 5 of the Bill gives Scottish Ministers the power to set standards and rules for how non-surgical procedures are provided, including training and qualifications, hygiene and safety standards, supervision and enforcement. Under the Bill, these regulations must follow the affirmative procedure, meaning they require Parliamentary approval.
Susan Brown, Health and Social Care Researcher, SPICe