Social Media Marketing: The CAP Code & The ASA

Those who rely on social media platforms like Instagram and Facebook to find new patients and communicate with existing patients need be aware of the rules that apply to marketing aesthetic services. Because, whilst there are no checks and balances in place for non-medical practitioners, medical practitioners have a statutory registration to protect!

Last January, the Committee of Advertising Practice (CAP), together with the Medicines and Healthcare products Regulatory Agency (MHRA), issued an enforcement notice to the beauty and cosmetic services industry on advertising Botox and other botulinum toxin injections on social media platforms.

Here's the low down on what you can and can't do when marketing your business on social media.

What is the CAP Code and who are the ASA?

The CAP Code is produced by the Committee of Advertising Practice and sets out the rules for advertising across a whole range of products and services.

Section 12 of the CAP Code relates to medicines, medical devices, health-related products and beauty products. In this section, the code makes it clear that prescription-only medicines or prescription-only medical treatments may not be advertised to the public (Rule 12.12). This has not changed. This is not new.

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The ASA is the Advertising Standards Authority. It’s a self-regulatory organisation, responsible for enforcing the rules set out in the CAP Code and ensuring that all advertising communications are inline with the CAP Code. It cannot, however, enforce legislation.

Whilst some rules within the CAP Code are legally enforceable, the majority are not. They are based on self-regulation and the commitment of the professionals in the industry to follow best practice.

Has anything changed recently?

No. The guidance remains the same as it always has:

You must take care not to directly or indirectly promote prescription-only medicines or prescription-only medical treatments to the public.

From 31st January last year, CAP began using new technology to discover posts on social media that do not adhere to the CAP code and flag them for removal as part of ongoing work with Facebook (which also owns Instagram).

There is a significant amount or work to do given that #botox alone has 11.7 million unique posts. So when you consider the other alternative hashtags too, there is quite a lot to get through! Remember also that the ASA can only act upon those in the UK.

The scale of the problem might be why we've yet to hear of a single incidence of post removal.

So...what can’t I post on social media?

You cannot advertise the sale of Botox® or any other POM directly - no hashtags, no before and after photos referencing Botox and no mention of price directly next to the term Botox or any other brand name of botulinum toxin.

You also can’t advertise the sale of POMs using terms that are easily identifiable as being a POM. So, for example, you can’t use the term ‘anti-wrinkle injections’ or ‘wrinkle relaxing injections’ next to before and after photos or prices.

You can't publish product prices alongside any reference to the product claims, nor should prices appear next to before and after photos. You also can't encourage users to choose a product based on price.

So, as always - you cannot advertise the sale of prescription-only medicines.

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OK, so what can I post on social media?

You can promote a “consultation for the treatment of lines and wrinkles”, and you can put a price next to a “consultation for the treatment of lines and wrinkles”.

You can also provide your clients with balanced and factual information. Content which is factual and informative is not deemed to be advertising.

For example, you can publish a factual price list for the treatment of lines and wrinkles alongside a labelled diagram of which lines and wrinkles can be treated.

The statement "treatments for lines and wrinkles" can refer to a range of treatments, from microneedling to dermal fillers, and isn't directly or indirectly advertising a POM. So, if you offer a range of lines and wrinkle treatment options, using this as a blanket phrase for all treatments is your safest bet.

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Audit your social media

Regularly check your social media. Sometimes, we can post things that retrospectively don't adhere to the standards.

Remove posts with

• direct references for POMs, including hastags
• promotions relating to botox
• indirect references that can only refer to a POM e.g. wrinkle relaxing injections
• references to anti-wrinkle injections with prices

Add posts that

• promote a 'consultation for the treatments of lines and wrinkles'
• regularly educate patients on all available treatment options for lines and wrinkles

What happens if you breach the CAP Code?

If the ASA identifies a post that breaches the CAP Code, they will likely take the following steps:

1) A complaint is made about a post, or their technology identifies a non-compliant post.

2) The ASA gets in contact with you and asks you to amend or remove the post.

3) You remove the post or it's automatically removed.

4) No further action.

OR

1) A complaint is made about a post, or their technology identifies a non-compliant post.

2) The ASA contacts you and asks you to amend or remove the post.

3) You disagree with their judgement.

4) They investigate your argument.

5) Their decision is upheld.

6) You remove the post.

7) A summary of your dispute is placed on the ASA website.

8) No further action.

OR

1) A complaint is made about a post, or their technology identifies a non-compliant post.

2) The ASA contacts you and asks you to amend or remove the post.

3) You disagree with their judgement.

4) They investigate your argument.

5) Their decision is upheld.

6) You refuse to remove the post.

7) They potentially refer the case to your regulatory body (GMC, NMC, GDC).

It’s important to note that they cannot take you to court or press legal charges. But actions they can take include asking internet search providers to remove your paid-for search, or you may face adverse publicity as a result of failing to act upon the guidance they give. Your business could, for example, feature on a page on the ASA website which lists companies in breach of the code.

Don't put all your eggs in one basket

With this in mind, it's actually really important to remember that social media isn't the only tool out there you can use, and it's far better to have multiple channels of communication for customers. That way, they will have a great understanding of the brilliant work you do.

One other point to note...

Glowday is fully in favour of proper, government-led regulation of the aesthetics industry as yet again, medic practitioners are held to a different set of standards and rules versus their non-medic counterparts. Aesthetic doctors, dentists, nurses and Pharmacist prescribers are reliant on their registrations with the GMC, NMC, GDC and GPhC, and will act in a manner to maintain these registrations. They will adhere to any guidance issued by the ASA and act upon any notices sent by them in order to protect their registration status.

But what recourse is there for non-medically qualified practitioners? Which regulatory body or professional register is going to hold them accountable? What incentive do such practitioners have to remove posts and adhere to the CAP code?