Ostomies and the NHS

For many people living with a stoma in the UK, the NHS is a lifeline that plays a vital role in providing essential ostomy supplies and support. It all began (though not from a blank slate) on the 5th July 1948. Few people working in it now were even born when it started.  Many say that the NHS in 2024 is now on its knees, and it's not the first time in it's history that it has faced some kind of struggle. Despite it's current state,  it still offers a commendable system for accessing ostomy supplies ensuring you get what you need and without any financial burden.  So lets take a brief look at our NHSs' blessing and shortfalls in terms of supporting Ostomates today. 

UK Prevalence:

In the UK alone it is estimated that 205,000 people are living with a stoma, and around 21,000 new surgeries are performed each year (Colostomy UK 2021).   So it’s not an insignificant sector for the NHS to deal with and you are certainly not alone. 

The Good Bits: Access and Support

Here's what works well:

• Surgery:  it's a safe place to have surgery on the whole compared to other countries and if your sugery is planned you will be given time to be educated about living with a stoma and maybe even wear a bag and experience it before surgery.
• Free Prescriptions: 
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• Most ostomy supplies in the UK are prescribed by a stoma care nurse and dispensed free of charge through the NHS. This removes a significant financial burden for ostomates. Repeat prescriptions and dedicated ostomy delivery/dispensing companies like Charter, Fittleworth, Medilink etc make it all relatively stress free. This is of course 'free' at the point of use but we have all been paying into the NHS our whole working lives in the form of taxes and national insurance, so you could say it's pre-paid
• Stoma Care Nurse Support: The NHS provides access to specialist stoma care nurses who offer invaluable guidance on product selection, application, and troubleshooting. This starts in hospital and continues in the community, though many ‘veteran’ ostomates don’t even know who their stoma nurse is any more. 
• Choice of Products: A range of ostomy products are available within the NHS, allowing for personalization based on individual needs. Choices such as one peice or two peice bags, differfent bag sizes or colours (mostly beige, grey or black) and even flange types for different body shapes (concave, flat ot convex)This choice extends to not only ostomy bags, adhesives, deoderants etc but also support wear and stoma protectors which can make the world of difference to your quality of life. The right support wear can really improve self confidence and also reduce your risk of develping a hernia. There are many styles and levels of support to suit all needs.

The Not-So-Good Bits: Challenges and Concerns

Despite the positives, there are some challenges:

• Product Availability: Occasionally, specific products may experience temporary shortages, causing inconvenience and potential anxiety for ostomates who rely on them.
• Postcode Lottery: Unfortunately, when it comes to ostomy accessories there can be widely varying allowances on what’s available to you and this seems to come down to the individual GP or stoma nurses’ opinion or understanding of your needs. There is no national standardised system, the variations are influenced by various regional and local pressures that impact funding and subsequent decisions.
• Trial and Error: Finding the right products can be a process of trial and error, leading to some frustration. Not all stoma nurses offer all products from the off, partly because it can be overwhelming to you in the beginning and possibly because they favour what they’ve seen good experiences with so don’t look at other alternatives. This seems prevalent when it comes to support wear as many nurses are not aware of what’s on offer or how to advise. This leads to people leaving hospital with no knowledge about support wear and then only find it through their own research. 
• Cost for Temporary Stoma: In England, those with temporary stomas (unless diagnosed with cancer) may have to pay prescription charges, which can be a financial strain as the cost of a prescription will be £9.90 per item from 1^st May 24 or 332.05 for three months with PPC (Prescription Prepayment Certificate)

We’d love to hear feedback on your experiences as an ostomate using the NHS

Additional Resources:

• Colostomy UK: https://www.colostomyuk.org/

Disclaimer: This blog is for informational purposes only and does not substitute for professional medical advice. Always consult your stoma care nurse for guidance on ostomy supplies and care.