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StoMap Programme

The Hub's Integrated Care team launched the StoMap Programme (stoma mapping) with a conference on the 28th of June 2019 at the Newmarket Racecourses.

Conference attendees were placed in strategic groups based on their STP/ICS to discuss issues facing current stoma service models and share feedback. There were common themes and issues arising which have been divided into nine main groups:

1. Formulary: It was suggested that accessories formularies should be reviewed as an STP-wide exercise, based on clinical effectiveness and taking in account price and quality of products. A standard prescription volume was also suggested as part of the formulary.

2. Pricing: National pricing for all products should be created to ensure fair and best value pricing for both trusts and CCGs. It was highlighted that the true cost of products in trusts were not transparent.

3. Products: Consistent units of issue (UOI) were suggested for all suppliers; it was also noted that product samples were being sent to patients without proper clinical input and as such not ethical. It was advised that charities should be educated about sending out sample products to ostomates.

4. Medicines Optimisation: An option for centralised electronic prescribing of stoma products was discussed, with the stoma care nurse prescribers leading the process. Regular clinical review would help in monitoring prescription overloads and, where necessary, standard prescription volumes should be made as standard.

5. Process and Patient Pathways: No clear pathway and patient followup process exists across stoma service delivery, resulting in disparity of service provisioning. The need for standard patient pathways and SOP would help improve service delivery. It was also suggested that DACs should be taken out of the process to reduce the number of communication points.

6. Service Delivery: Funding from trusts directly into service delivery is inadequate due to sponsorship models. There is a suggested conflict of interest between DACs and manufacturers due to bonus payments in place for new referrals. A variance in patient-level support due to resentments between industry sponsored nurses and NHS funded nurses.

7. Education: Nurse training is very limited where available; there is a clear need to improve education and training of nurses. GP education on stoma care was highlighted as gap in system. Patient education would also help to reduce anxiety around stock levels to prevent overstocking of products.

8. Contracting: A single joined up approach at STP level could be used as a way of addressing contracts. Effective monitoring of current contracts will ensure new service requirements are captured at renewals. A more transparent contract should be developed clearly specifying costs, quality, KPIs, accountable persons, SLAs etc.

9. Recruitment and Retention: The delegates pointed out the lack of nurses in the field of stoma. Career progression and staff level banding were highlighted as a non-incentive for new entrants. As part of work packages to attract new nurses, funding of courses to improve skill set which in turn helps in career progression must be considered.


Following the event, we are pleased to have initiated STP/ICS discussions in Suffolk & North East Essex and Norfolk & Waveney.


If you are interested in joining any of these workstreams or initiating a STP or ICS discussion, please contact Mo Aminu: mo.aminu@eoecph.nhs.uk

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