Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what safeguards are in place to ensure that patients with a stoma are (a) offered a choice of dispensing provider and (b) actively involved in decisions relating to appliance selection; and how is compliance with those safeguards is monitored across Integrated Care Systems.

There are a range of legislative and operational safeguards in place to support patient choice and facilitate co-decision between clinicians and patients regarding stoma appliances. In terms of legislation, the National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 aim to ensure that pharmaceutical services are delivered in a manner that is not conflicted with inducements that may be provided.

Guidance on Managing conflicts of interest in the NHS, updated in 2024, outlines that in services like stoma, where staff may be sponsored by industry, then such post holders must not promote or favour the sponsor’s specific products, and information about alternative products and suppliers should be provided. In addition, the British Healthcare Trade Association agreed a Code of Practice with its members who are involved in the dispensing of these appliances. The code aims to ensure ethical conduct and to safeguard patient interests in the dispensing process.

How compliance with the safeguards is monitored is a decision for the integrated care systems. Some areas have introduced central prescribing hubs in order to avoid any undue influence from sponsored posts or the dispensing contractors. Under the prescribing hubs a patient can use any dispensing contractor, but the prescription cannot be changed by them.