CHAPERONE CULTURE

Do we need to think more broadly about chaperoning in aesthetics, asks Vicky Eldridge

Safeguarding is becoming increasingly important in aesthetic practice. As the sector continues to move closer to regulation, professionalism, transparency and patient safety are becoming more and more of a focus.

And rightly so. One topic that sits firmly within the safeguarding conversation is chaperoning.

In the context of aesthetics, it’s fair to say chaperoning has been viewed as more of a situational safeguard rather than a routine part of care. Something you should be offering if you are doing intimate health treatments, but that isn’t necessary in your standard toxin or filler consultation. But in reality, the role of chaperoning is much broader.

Chaperones can support clear communication, reinforce professional boundaries, and provide reassurance in situations where patients may feel anxious or vulnerable. They can also help manage more challenging consultations, particularly where expectations need to be addressed or treatments need to be declined.

This raises an important question for those working in aesthetics: are we thinking broadly enough about when and why we are using chaperones, and if not, why not?

Having a chaperone present can support communication, education and ensure understanding for both the patient and practitioner

SEXUAL MISCONDUCT: A CLEAR ARGUMENT FOR CHAPERONING

One area where chaperoning plays a clear and established role is in safeguarding against sexual misconduct. And this is where it can disproportionately impact women.

While this remains a relatively small part of day-to-day clinical practice, recent data and guidance have reinforced the importance of accountability across healthcare when it comes to sexual misconduct.1-5

Updated recommendations published in November 2025 emphasise that any behaviour of a sexual nature towards patients – regardless of intent – represents a serious breach of trust.6-7In response, The Royal College of Surgeons of England has adopted a zero-tolerance stance, introducing clearer reporting pathways and frameworks to support those affected by sexual misconduct .8

THE RISKS IN AESTHETIC MEDICINE

The lack of consistent regulation within aesthetics means it occupies a more ambiguous space when it comes to safeguarding. While CQC-registered clinics are required to carry out enhanced DBS checks and offer chaperones as standard, aesthetic treatments are frequently delivered in private clinics, home settings or rented rooms that fall outside of this framework.

Consultations may be more informal, relationships more personal, and the language of the industry often leans towards lifestyle and wellbeing rather than medicine.

This is where concerns around safeguarding lie. Patients undergoing aesthetic treatments may be partially undressed, positioned in vulnerable ways, or, particularly in the case of laser and light-based procedures, visually impaired due to protective eyewear. Many are also navigating deeply personal concerns around appearance, ageing or confidence. Some may also have experienced prior trauma, which they may or may not disclose.

Yet safeguarding processes are not always standardised – particularly outside of medical settings.

The issue becomes even more complex when considering the breadth of practitioners operating within the sector.

Cases such as that of Terry James – who was sentenced in 2023 for sexually assaulting and covertly filming women while offering intimate laser hair removal – highlight the potential consequences of these gaps. While extreme, such cases serve as a reminder of why safeguards matter.

THE ROLE OF CHAPERONES IN AESTHETICS – IS IT TIME TO RETHINK?

A Hamilton Fraser survey found that while 75.9% of respondents believed chaperones significantly enhance safeguarding, only 69% of practitioners always offered one, with 31% saying they did so inconsistently and more than 10% saying they did not use chaperones at all.

So, the question is whether chaperoning in aesthetics should be viewed as part of routine best practice?

WIAM board member and nurse practitioner Tracey Dennison believes so. “It is absolutely important that every clinic has the option for patients to request a chaperone if they want to. For CQC-registered clinics, having a chaperone policy and offering that service is mandatory – but it should be considered best practice across the board.

“For any patient under 18, where we may be seeing them for acne or rosacea management, I would insist on a chaperone being present – for their protection and for mine.”

This aligns with views from across the WIAM board. Dr Mayoni Gooneratne adds that chaperones should not be limited to a specific treatment type, but should “apply to all clinicians and should be offered to all patients.”

Amy Bird also highlights the role chaperones can play earlier in the patient journey, particularly when managing expectations or declining treatment.

“Sometimes the red flags appear before treatment. Having a chaperone present can support communication, education and ensure understanding for both the patient and practitioner,” she says.

And this distinction is important. While chaperoning is, of course, about protecting patients, it’s also about protecting practitioners, whether that’s from inappropriate behaviour, misinterpretation, or, in rare cases, false allegations.

WHAT CAN CLINICS DO?

For many clinics, the concept of chaperoning is already familiar, particularly if they are CQC-registered. For those who aren’t routinely offering it, here are some practical steps you could take:

• Routinely offering a chaperone, rather than waiting for patients to request one

• Clearly documenting whether a chaperone was offered and accepted or declined

• Developing and communicating a clear chaperone policy

• Exploring technology, such as consultation recording tools, where appropriate and consented. This may include using AI software such as Heidi Health to support accurate, transparent documentation of patient interactions. As Dennison notes, “With AI note-taking tools like Heidi Health, we now have a verbatim record of what’s said in the consultation room. That provides an additional layer of protection – for both the patient and the practitioner – should any concerns arise.”

A SHIFT IN MINDSET

Although we are still waiting for formal regulation of the aesthetics sector in parts of the UK, there has been a clear shift towards aligning more closely with medical standards.

Safeguarding – and, in turn, chaperoning – is an important part of that conversation.

As Dennison summarises, “It should be good practice for every clinic to have a safeguarding and chaperone policy in place, with chaperone facilities available whenever they are needed.”