Topical guides
Topical guides
Botulinum toxin injections are health care procedures even if administered for cosmetic purposes.
Botulin toxin injections can be administered by a physician or a qualified nurse* under the direction and supervision of a physician in a health care facility. Physicians can administer injections as part of their standard practice, but businesses need special authorisation for nurses* to administer botulinum toxin.
Nurses* can only administer botulinum toxin injections under the supervision of a physician
It is the physician’s responsibility to assess the need for botulinum toxin treatment and write the prescription for each patient. However, the physician can delegate the administering of injections to a qualified nurse* employed by the same health care facility. The physician must be easily reachable during the procedure, i.e. physically present in the health care facility.
A note of the prescription and the procedure must be entered into the patient’s records. Further information is available on our website.
Supporting documents
In addition to the usual supporting documents needed for licence applications, the following are also required:
- a copy of the additional training received by nurses* for administering botulinum toxin injections
- a written authorisation signed by the supervising physician for nurses* to administer botulinum toxin injections under their supervision
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a copy of the health care provider’s pharmacotherapy policy, including a description of botulinum toxin procedures
*) In this context, nurses include registered nurses and public health nurses as well as midwives.
Telemedicine services are services that can be provided remotely e.g. via a video link, online or a smartphone. The transmission of such information and documents include clinical consultations, diagnostics, observations, monitoring, treatment, and clinical decisions.
Licensed private health care providers and registered sole traders (e.g. general practitioners and physiotherapists) are automatically authorised to also provide telemedicine services.
Businesses that only provide telemedicine services must apply for a telemedicine licence from the National Supervisory Authority for Welfare and Health (Valvira). Registered sole traders can provide telemedicine services after notify the competent Regional State Administrative Agency.
You can find out more about the rules governing telemedicine on the National Supervisory Authority for Welfare and Health’s website.
Opioid detoxification refers to the use of substitution drugs (buprenorphine and methadone) to treat the withdrawal symptoms of opioid addicts.
Opioid substitution therapy refers to the use of substitution drugs (buprenorphine and methadone) to rehabilitate addicts, prevent relapses, reduce other negative effects of addiction and give recovering addicts a better quality of life.
In this context, ‘opioid substitution therapy’ covers both opioid detoxification and substitution therapy.
General licensing criteria
1. Description of the operation
- Applications must include a description of what services the operator intends to provide, how and with what resources.
- A description of the kinds of patients to be treated, where the referrals originate and how many patients the operator intends to treat
- An explanation as to which operator will be responsible for the patients’ opioid substitution therapy
- A description of the operator’s staff, including qualifications, the number of staff and how they will be allocated to shifts
- A description of how patient records will be kept and of the safeguards in place to ensure that the records are accessible to other social welfare and health care service providers
2. Director
- Licensed medical practitioner who specialises in addiction medicine OR
- Licensed medical practitioner with at least two years of clinical experience in addiction medicine in Finland (including opioid substitution therapy)
3. Staff
- Licensed social welfare and health care professionals and social welfare and health care professionals with a protected occupational title
- Ideally with specialist training in mental health or addiction medicine
4. Self-regulation plan
- Applicants must supply an up-to-date self-regulation plan that takes into account the scale of the operation and the nature of the services to be provided and includes a description of the operator’s pharmacotherapy and psychosocial rehabilitation procedures.
5. Pharmacotherapy policy
- All operators who provide opioid substitution therapy must have a pharmacotherapy policy signed off by a physician.
- The pharmacotherapy policy must include
- a description of the operator’s pharmacotherapy procedures (including a description of the nature of the operation and the pharmacotherapy to be administered),
- a description of how the risks involved in pharmacotherapy have been taken into account (including descriptions of high-risk operations, high-risk drugs and procedures in the event of an emergency),
- a description of the duties, responsibilities and division of labour between the staff involved in administering pharmacotherapy (including how their competence has been verified and information about authorisations, orientation and in-service training), and
- a description of the pharmacotherapy process (including how prescriptions are written and filled, how the drugs are dispensed, stored and handled, how records are kept, how drugs are disposed of and how cooperation with other operators has been arranged).
Licensing criteria for different kinds of service providers
In addition to the general licensing criteria, the following must be taken into account:
1. Outpatient clinics
- Walk-in facilities such as substance abuse clinics:
- The need for treatment must be determined and the treatment begun on an outpatient basis unless there are special reasons for admitting the patient for evaluation and treatment.
- Whenever a shift involves administering opioid substitution therapy, at least two social welfare and/or health care professionals must be on duty at the same time, one of whom must be a licensed health care professional.
- Supported living facilities (social services):
- Treatment must not be begun in a supported living facility.
- A private health care licence is always required for the provision of opioid substitution therapy in supported living facilities run by social services.
- No licence is required, however, if the therapy is administered by another organisation (such as a public service provider or a private service provider who is licensed to administer opioid substitution therapy).
- Opioid substitution therapy can only be administered in a supported living facility once the patient’s treatment regime has become established.
- The drugs must be dispensed by the organisation in charge of the patient’s regime so that the staff of the supported living facility only need to give the drugs to the patient.
- Administering opioid substitution therapy to a resident of a supported living facility always requires at least two social welfare and/or health care professionals to be present at the same time, one of whom must be a licensed health care professional.
- Home-based therapy:
- Treatment must not be begun in a patient’s home.
- Special attention must be given to how the drugs are transported and to ensuring the safety of the procedure as well as appropriate recording practices.
- Administering opioid substitution therapy in a patient’s home always requires at least two social welfare and/or health care professionals to be present at the same time, one of whom must be a licensed health care professional.
2. Rehabilitation facilities
- Health care and rehabilitation services provided on a 24-hour basis under the supervision of a physician
- Treatment can be begun in the rehabilitation facility.
- Staff:
- At least 0.7 social welfare or health care professionals per patient
- Whenever a shift involves administering opioid substitution therapy, at least two social welfare and/or health care professionals must be on duty at the same time, one of whom must be a licensed health care professional.
- If a shift does not involve administering opioid substitution therapy (e.g. night shifts), at least one of the members of staff on duty must be a health care professional with a protected occupational title.
3. Hospitals
- Health care and rehabilitation services provided on a 24-hour basis under the supervision of a physician
- Treatment can be begun in the hospital.
- Staff:
- At least 1.5 health care professionals per patient
- At least two health care professionals always on duty at the same time, one of whom must be a licensed health care professional