Despite the small numbers prescribed, stoma care bags are extremely expensive. For most practices, they feature as one of the most high-cost items from the Prescription Pricing Division.
Traditionally patients take delivery of the stoma products direct from the manufacturer via courier, rather than them being supplied by local pharmacies or dispensing doctors. Prescriptions are often only issued by doctors after the treatment is supplied.
But, with few external checks, possible over-ordering or over-supply, there is concern that this process is causing unnecessary waste.
By acting as an agent for a supply company, the practice can manage the supply, provide a more localised familiar service to patients, and generate a profit for the practice.
This is available for any patient whether or not they are normally eligible for dispensing and for all practices, even if they do not normally dispense.
The supply companies act as intermediaries and are able to supply all brands of stoma care products along with accessories such as wipes and sprays. They also employ stoma care specialists to support patients and doctors with advice and cutting and fitting services.
Giving patients choice
While many patients appreciate the current service with delivery to their home, few realise they have a choice. Those who are more active may dislike waiting at home for the delivery but feel embarrassed about a neighbour having to take the delivery of the package in their absence.
Having products delivered to their surgery may suit many patients. Many appreciate the convenience of picking up their treatment at the same place as it is prescribed, believing prescriptions and products less likely to go astray.
They may prefer being able to order all their stoma products and medicines from one place rather than a surgery and a separate company.
The practice can then check that the correct treatment is given and that the prescription has been completed correctly.
Because stoma patients are exempt from prescription charges, the practice does not have to collect this fee. In recompense for practices supplying this service on behalf of the company, they will receive a fee, typically 10-15 per cent of the product's value.
As well as stoma care products, the same companies can supply dressings and catheters for patients, with practices again acting as agents.
Two companies that operate nationally are recruiting practices as agents (see box below). They will send forms or visit the practice to arrange registration as an agent.
A suitable computer search can identify relevant patients. Practices can then write to patients informing them of the offer of a new service available, emphasising the local benefits and offering to let them change their current supplier.
A system can then be established to notify patients who are new to the practice.
The most important part of the process is how the patient's request for treatment is converted into their supply.
The prescriptions need to be produced and signed and an order is normally then faxed to the company, with the prescription to follow after the patient has received the products.
The treatment arrives by courier and will then need to be stored in a suitable area until collected by the patient.
The delivery needs to be checked against the patient's request and the prescription has to be checked to ensure it has been correctly completed.
A suitable patient collection point within the surgery will need to be allocated.
Payment usually arrives from the company direct to the nominated bank account via automated payment, and checks should be made to ensure that the amount has been received.
While the fees may not generate enough income to compensate for the current drying up of resources to primary care, they will help the practice finances and reduce NHS waste.
Dr Phipps is a dispensing GP in Lincolnshire
- Contact GPDispensing@haymarket.com or on (020) 8267 4865
- Average practice of 6,000 patients has approximately 15-20 patients eligible.
- Average cost of products is £800 per annum per patient.
- At 15 per cent agent fee, additional potential practice income is £1,800-£2,400.
- North West Ostomy Supplies, contact Angela Charlton on (0800) 3167117.
- Wardles, contact Kelly Lacey on (01782) 220710.
The DDA is the only organisation that ensures the views of dispensing practices are heard by the government and key negotiating bodies. We also provide telephone advice to members and essential updated information via our website, and email alerts. To find out more call Jeff Lee on (01751) 430835 or visit www.dispensingdoctor.org
The DDA does not necessarily support or endorse the opinions or information contained on this page.