Health and Care Act 2022 cosmetic procedures, watch position

The Health and Care Act 2022 section 180 created the power to license non-surgical cosmetic procedures in England. The 2023 consultation closed; the government's consultation response was published 6 August 2025; no commencement regulations are yet in force as at spring 2026. This guide describes what's in scope, what's not, where the devolved positions sit, and what working tattoo and PMU artists should watch for.

Status as at 2026-05-17: power exists, consultation closed, response published. Not yet operative.

What HCA 2022 s.180 does

Section 180 of the Health and Care Act 2022 gives the Secretary of State for Health and Social Care the power to make regulations:

Prohibiting individuals from carrying out specified cosmetic procedures in the course of business without a personal licence.
Prohibiting the use of premises for those procedures without a premises licence.
Setting standards, conditions, fees, offences, and penalties.

The legal hook is delegated power, s.180 doesn't itself create the licensing scheme. Secondary regulations are required to:

List which specific procedures fall in scope.
Set licence conditions and standards.
Set fees and renewal periods.
Designate which licensing authority (local authority vs CQC) handles which tier of procedure.
Set commencement dates.

As at 2026-05-17, none of these secondary regulations are in force.

What the consultation response confirmed

The DHSC consultation response of 6 August 2025 confirmed the general direction:

A risk-tiered scheme

Procedures will be classified into risk tiers:

Lower-risk procedures licensed by local authorities under a new scheme parallel to existing LG(MP)A 1982 Part VIII registration.
Medium-risk procedures requiring stricter operator qualifications, in many cases prescribers or supervising healthcare professionals.
Highest-risk procedures restricted to CQC-regulated healthcare professionals only.

Two-part licence

The scheme creates linked practitioner licences and premises licences:

The practitioner is qualified for specific procedures.
The premises is suitable for those procedures.
Both must be in place for lawful trading.

Procedures expected to be in scope

Botulinum toxin injections.
Dermal fillers.
Skin boosters.
Microneedling.
Lasers (some).
Other invasive non-surgical procedures.

Highest-tier procedures restricted to healthcare professionals

Non-surgical Brazilian Butt Lift (BBL).
Genital fillers.
Some other procedures.

Tattooing and PMU, likely outside the new scheme in early rollout

The consultation response and earlier government commentary indicate that standard tattooing and semi-permanent skin colouring (PMU) are likely to remain primarily under the existing LG(MP)A 1982 Part VIII registration regime in early rollout. The reasoning: PMU is already regulated via LG(MP)A 1982; the new scheme focuses on the higher-risk injectable and energy-based procedures where current regulation has the bigger gaps.

This is the current draft direction, confirm against the eventual commencement regulations when published.

Age controls likely to extend

The Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 already bans injectable cosmetic procedures on under-18s in England. The new HCA 2022 scheme is expected to extend this to other in-scope procedures.

What's NOT clear yet

Outstanding questions as at spring 2026:

Commencement date: Government has committed to implementing but not fixed a date. Some commentary suggests 2026-2027 phased commencement.
Specific procedure list: The full schedule of in-scope procedures is being worked through.
Qualification requirements per tier.
Fee structure.
Transition arrangements for existing practitioners.
Treatment of tattoo studios offering adjacent procedures (e.g. PMU studio that also does microneedling).

The devolved positions

Scotland

The Scottish Government is pursuing its own Non-Surgical Cosmetic Procedures (Scotland) Bill, separate from the HCA 2022 scheme. Scottish position is being developed independently and may diverge from England in:

Scope of procedures.
Licensing body.
Operator qualifications required.
Premises standards.

Wales

Wales is engaging with the English reforms but has not yet announced an equivalent scheme. Existing Welsh special-procedures licensing under the Public Health (Wales) Act 2017 continues to apply.

Northern Ireland

NI has not implemented a parallel scheme. Standard NI piercing/tattooing registration under the 1985 Order continues.

What tattoo and PMU artists should watch for

Direct triggers, your work may come into scope

Microneedling offered alongside PMU, likely to be in scope.
Laser tattoo removal offered in-house, may eventually be in scope.
Skin boosters or other injectables added to the service menu, definitely in scope.
Any procedure that involves penetrating skin beyond traditional tattooing/PMU, watch this carefully.

Indirect triggers, your operating environment changes

Insurance industry response to the new scheme, premiums and coverage may shift.
Council enforcement priorities, councils may direct enforcement toward unlicensed practitioners as the scheme comes in.
Client awareness and expectations, clients may start asking for proof of compliance with the new scheme.
Cross-sector competition, beauty practitioners who can't meet HCA 2022 requirements may pivot away from injectables, potentially affecting market dynamics.

What to do now

While the regulations remain pending:

1. Track the policy timeline

DHSC press releases and consultation responses, official source.
Trade publications. TPIU, BTAF updates.
Insurance broker updates, your broker will tell you when the scheme affects your cover.

2. Maintain current compliance

The new scheme adds to, not replaces, current regulation. Continue to:

Hold council registration under LG(MP)A 1982 or the relevant jurisdictional regime.
Maintain treatment-risk insurance with all your procedures explicitly scheduled.
Comply with UKHSA infection prevention and control guidance.
Comply with UK REACH on pigments since 30 December 2025 in GB.

3. Don't add high-risk procedures speculatively

If you're considering adding microneedling, laser, injectables, or other procedures likely to be in scope of the new scheme, factor in:

The eventual licensing requirement.
Transition arrangements (likely some grandfathering for established practitioners).
Increased qualification expectations.
Higher insurance loadings under the new framework.

It may be worth waiting for clarity on the new scheme before significantly expanding your service offering.

4. Be ready for the consultation cascade

When commencement regulations are published, they typically come with:

Industry consultation periods.
Transition windows for existing practitioners.
Phased commencement by procedure tier.

Engage with consultations through trade bodies (TPIU, BTAF, ACE, BABTAC, etc.). Most regulators prefer practitioner input ahead of finalisation.

What this guide cannot do

The HCA 2022 scheme is in flux. Commencement timelines and specific scope can change between drafting and publication of this guide.

Information, not advice. For your situation, track the DHSC cosmetic procedures pages directly, engage with trade bodies, and verify your specific service offerings against the eventual published scheme when commencement regulations are laid.