JCCP Position Relating to Reports of Botulism

The JCCP has been concerned to receive recent reports of the detection of botulism following the delivery of some non-surgical surgical procedures in the Northeast of England. We welcome the investigations currently underway by the competent authorities and await confirmation of their findings.

Initial reports suggest that several hospitalisations are related to the use of botulinum toxin injections. Botulism is a potentially fatal public health concern. We understand that its incidence is rare, but we note that the risk is likely to rise where practice is unregulated or is not compliant with regulations.

Botulinum toxins must only be administered against the directions of a competent, prescribing healthcare professional, following a face-to-face assessment. Other than for doctors and dentists, these products must be procured from a UK-registered pharmacy, dispensed against a named patient prescription.

The JCCP receives numerous reports of the illicit supply and use of unlicensed botulinum toxins. When unlicensed botulinum toxins are used, there can be no confirmation of the product’s efficacy and safety. When the products are procured outside of authorised supply routes, including from online sources, there is also no assurance that they have been subjected to the appropriate manufacturing and distribution standards required for product safety.

The JCCP encourages members of the public to ensure that they receive a face-to-face consultation with a prescribing professional in advance of a botulinum toxin procedure. They should request information about the product to be used, including its brand and intended dose. At the time of the procedure, they should confirm this same information with the practitioner performing the procedure, and they should ask to see the product, in its packaging, and confirm that it has been dispensed in their name. Members of the public should consider the standard of hygiene at the premises  and refuse to accept a procedure in  the event of any doubts. For more information and guidance on choosing a practitioner to perform a cosmetic procedure, please see Choosing who will do your cosmetic procedure - NHS

The JCCP also take this opportunity to urge the government to proceed with previously proposed plans to implement a scheme of licensing, adopting recommendations for clinical oversight by regulated healthcare professionals who are accountable for their practice and those they delegate procedures to.

For more information or for guidance on the actions to be taken in the event of a concern, please see

Durham: Botulism cases :: County Durham and Darlington NHS Foundation Trust