IVO guidelines for aesthetic treatments and supervision in Sweden

The market for aesthetic treatments in Sweden was unregulated until 2021, which created significant risks to patient safety. With the new law (2021:363), IVO (the Health and Social Care Inspectorate) became responsible for supervising businesses that perform aesthetic procedures and treatments.

Summary

The law aims to protect people's lives and health by introducing requirements for professional licensing, competence, patient insurance and clear information about risks. Since 2022, IVO has carried out 130 inspections of 86 businesses, resulting in more than 180 decisions that reveal extensive shortcomings and patient-safety risks.

One of the biggest shortcomings IVO has identified is that unlicensed staff, such as assistant nurses and dentists without the right authorisation, perform injection treatments and surgical procedures. In some cases, physicians without specialist competence have even performed advanced surgical procedures or anaesthetised patients, leading to serious injuries and deaths. To guarantee patient safety, the law requires that only licensed physicians, dentists or nurses with relevant competence perform the treatments.

Medication management

Medication management is another area with major shortcomings. Many businesses handle medicines incorrectly, for example by using products not approved for the Swedish market, storing medicines unsafely or issuing general prescriptions without individual assessments. Such errors increase the risk of injuries, infections and serious complications.

Gaps in record keeping

Documentation shortcomings are common, meaning patient records are often missing or inadequate. Many businesses lack a record system or store records in a way that compromises confidentiality. Documentation gaps mean important medical decisions cannot be followed up, which jeopardises both patient safety and the quality of care.

Poor hygiene routines

Hygiene routines are also a major problem in many businesses. Staff do not always have sufficient training in basic hygiene requirements, and infectious waste is sometimes handled unsafely. In several cases basic equipment such as defibrillators and oxygen for handling emergencies is missing, which further jeopardises patient safety.

Aesthetic surgery is a high-risk activity, and although these businesses often have better structures than injection clinics, serious shortcomings have been identified. The presence of unscrupulous operators who do not follow the law is a significant risk, and several patients have suffered complications or serious injuries in connection with aesthetic surgical procedures.

According to IVO, many of the problems are linked to unscrupulous or criminal operators who deliberately break the law. They avoid supervision by changing names, moving between addresses or using false information. To improve supervision, IVO proposes extended powers, including covert test purchases and inspections in private homes where treatments are carried out.

The bottom line

In summary, IVO stresses the need for continued supervision and the development of supervisory methods to protect patients and eliminate unscrupulous operators. It emphasises the importance of cooperation with other authorities while strengthening its own tools and powers to ensure a safe market for aesthetic treatments in Sweden.