Stoma care “failing patients and the NHS”

The companies that make stoma bags and accessories sponsor 75% of stoma nurses (those involved in the care of patients requiring ostomy bags and accessories) in England, Wales and Northern Ireland, and also own the companies that deliver the prescriptions. This, says one writer on bmj.com, is not allowing patients enough choice.

The Managing Director of Patient Choice (a social enterprise company which supplies stoma care products to patients) says that due to the control medical companies exert, patients don’t get all the information and choices they should.

More than 102,000 patients in the UK have a stoma and in 2012, £228m worth of ostomy bags and accessories were dispensed in England alone, but Neil Basil says that the market “performs poorly and fails patients and the NHS” with patients receiving “equipment that isn’t needed”.

NHS hospitals are receiving money to discharge ostomy patients as customers of companies. After discharge, ostomy supplies are dispensed by the sponsor company which requests prescriptions directly from the general practitioner. As GPs generally have limited knowledge of ostomy care, they “rely on the company and the patient to write the prescriptions”. Basil says this means the clinical expert is “absent from the decision making process” and that UK patients are “unaware of the choices available to them”.

Basil adds that most patients have “little information” and “irregular nurse appointments, turning to the company for advice rather than the medical profession”. He says patients should never have to pay for ostomy supplies, but the “current system encourages patients to use more rather than to use what’s best for them”.

Having seen, first hand, the amount of waste this causes, Basil says that what matters the most is improving patient care and that no individual company or nurse should be blamed. He adds that the “system” is broken; nurses aren’t being supported and “private businesses are [being] allowed to exploit patients”.

Basil suggests that we “need a market that is transparent and offers independent, impartial advice”. He concludes that once patients understand that they can receive a good independent service the “market might start to change”.