Update on 3 consultations relating to Stoma and Incontinence applicances under Part IX of the Drug Tariff

The statement issued by the DH and Caroline Flinton the 23 May appeared to relate to all three consultations that closed on 2nd April but the content only focused on two concerning services provided by dispensing contractors. Whilst it is stated, ''The needs of patients are paramount and the Department is committed to ensuring that their care is maintained and, where appropriate, improved''.

Information Incontact has received on reclassification of products is of continued concern to patients who use continence and urology applicances such as catheters, sheaths and drainage bags. Reclassification appears to be taking place with no patient involvement, even though patient users are the main stakeholder.

In a reply to a question raised by Lord Roberts of Conwy, Lord Hunt seems determined that savings of £27 million will be made from changes to the reimbursement price for these items. It is likely that some of these products will no longer be viable to manufacture if these proposals are instigated. It is vital that patients have continued access to products they trust and use in all life situations to manage bladder or bowel dysfunction, 24/7, often for life.

Products used by healthcare professionals in a clinical setting are not always suitable or useable by patient users in situations such as public toilets. A full range of products must continue to be available to meet individual user need and overcome any disability.

Incontact is working with Spinal Injuries Association and Urostomy Association in order to make sure a pledge made in April by Ivan Lewis is kept ( that patients/product & service users should and would be at the heart of all further consultation on this matter).

Questions continue to be raised in both the House of Commons and House of Lords on all 3 consultations.

LATEST UPDATE - 25TH JUNE

This notice has been posted from No 10

Please visit the No 10 Petitions website to view the notice  http://www.number-10.gov.uk/output/Page12071.asp  or read on below:

25 June 2007

We received a petition asking:

"We the undersigned petition the Prime Minister to reconsider his
Government's proposal to halt payments for home delivery of prescription
continence products to urology patients including those with multiple
sclerosis, spinal injury, spina bifida and bladder cancer."

Details of Petition:

"The NHS currently reimburses licensed Dispensing Appliance Contractors
for the services they provide to NHS patients who require continence and
stoma care, including home delivery of prescriptions, specialist nurse
visits and telephone helplines. Despite the fact that many of these
patients are mobility-impaired, the Department of Health is currently
consulting on proposals which will make the provision of home delivery
services not viable. For urology patients it is likely that all such
services will end. In addition, a restrictive banding structure proposed
by the Department will force major Dispensing Appliance Contractors to
severely scale back their services to stoma patients. 350,000 patients use
continence appliances, of whom around 50% use home delivery; the
implications of these proposals for patient care, quality of life and
these individuals' ability to maintain their independence require the
Prime Minister's urgent attention."


Read the Government's response:

The Department has been most disturbed by the activities of some
dispensing contractors during the consultation phase of the review that
the Department is carrying out into the arrangements for the provision of
incontinence and stoma appliances. It is clear that the tone and content
of those contractors' communications have led service users to believe
that services could be withdrawn or scaled back. This is absolutely not
our intention.

It is estimated that around 450,000 individuals, ranging from children to
older people, use stoma and urology appliances. Such patients include
people with multiple sclerosis, spina bifida, cerebral palsy, spinal
injury, cancer and age related conditions.

All of these patients want to be as independent as possible and to live
fully active lives. We also recognise that being in need of stoma and
urology services is an intensely personal matter. Patients rely on
appliances they are familiar with and, in many cases, greatly value the
discretion that services such as home delivery allow. The review has also
taken into account our policy in relation to patients with long term
conditions, namely that self-care is important and that every effort
should be made to reduce hospital stays.

The arrangements for the provision of stoma and urology appliances have
not been reviewed for more than 20 years. Therefore, as a considerable
amount of money is spent on appliances each year, we need to make sure
that prices paid for these items are fair to the providers whilst also
offering value for money for the NHS and for the taxpayer.

The Department also wants to address the current inconsistencies in the
services provided. No matter where in England an appliance user lives or
who dispenses their prescription, we want to ensure that patients receive
the same quality of service as that offered anywhere in the country.

The consultations closed on 2 April and the Department received a
significant number of responses which officials are now considering. Due
to the volume and complexity of responses, we have decided that more time
is needed to evaluate the information provided. Consequently, no changes
will be implemented in July as had previously been proposed. We do not
expect the overall review to be concluded before the end of the year.

 From the outset it has been the Department's overriding goal to maintain
and, where possible, to improve the quality of patient care in this area.
This continues to be the case - no decisions will be made that compromise
this aim.

(Taken from the No 10 Petitions website)