People living with a stoma face unequal access to essential care as Colostomy UK calls for action ahead of Scottish and Welsh elections

28 April, 2026

Colostomy UK is urging political parties to commit to improving stoma care across Scotland and Wales ahead of the upcoming devolved elections, warning that people living with a stoma continue to face variation in access to specialist support and care.

More than 200,000 people across the UK live with a stoma and rely on specialist nursing, appropriate products, and regular clinical reviews to manage a lifelong condition and maintain quality of life. Stoma care requires ongoing clinical management, including education, specialist input and timely reviews to support health and wellbeing, as set out in national clinical guidance (British National Formulary; NICE).

However, evidence from clinical reports and patient data highlights clear variation in access to these services across the different nations of the UK.

In Scotland, the Scottish Stoma Forum Specialist Nurse and Patient Survey 2023 highlights significant workforce pressures. Approximately 19,993 people are currently being supported by just 39.2 whole- time equivalent specialist nurses. Data in the same report shows that this figure is substantially higher than in England. These pressures on Scottish stoma nurses significantly limit their capacity to deliver routine follow-up and ongoing care

This workforce pressure also has a direct impact on access to services. All responding Health Boards reported they were unable to provide annual reviews for all patients, while 44% of people had not had a face-to-face review in over a year and 19% had never had one (Scottish Stoma Forum, 2023).

The same UK comparison data shows that Wales also has higher numbers of patients per specialist nurse than England, indicating similar workforce pressures, although the disparity is less pronounced than in Scotland. Together, this points to systemic challenges in specialist stoma care capacity across the devolved nations.

Colostomy UK survey data shows that unequal access to care results in poorer patient outcomes. While rates of leakage are broadly similar across the UK (47% in England, 48.5% in Scotland, and 48% in Wales), other key indicators reveal pronounced disparities. Skin irritation, a common and often preventable complication, saw 38% of people in England reporting this compared with 47.7% in Scotland and 45% in Wales suggesting disparities in access to timely specialist reviews and support (Colostomy UK, 2024).

In Wales only 25% of people reported seeing a specialist stoma nurse in the last year, compared with 29% in England. At the same time 57% of people in Wales report unmet need or negative outcome indicators, highlighting wider gaps in access follow up and ongoing support for a long-term condition. (Colostomy UK, 2024).

Across England, while variation still exists, survey data indicates more consistent access to specialist support and follow-up, suggesting a more established baseline of care compared to Scotland and Wales.

These differences are significant. Stoma care is a long-term condition requiring ongoing management, and gaps in access to specialist support and timely review increase the risk of complications such as skin damage and leakage, as well as wider physical and psychological challenges. The Scottish Stoma Forum highlights that lack of access to healthcare professionals and wider support can contribute to isolation, reduced wellbeing, and poorer quality of life (Scottish Stoma Forum, 2023).

National clinical guidance states that care should be person-centred and involve shared decision-making, with healthcare professionals and individuals working together to make decisions about treatment and care (NICE NG197). Access to specialist expertise and appropriate products should not therefore be considered discretionary, but rather a core part of safe, effective long-term stoma care, as reflected in national guidance

(British National Formulary; NICE).

Colostomy UK’s Chief Executive – Libby Herbert said:

“People living with a stoma should be able to expect consistent, high-quality care wherever they live.

Access to specialist nurses, regular clinical review, and the right products are essential to preventing complications and maintaining dignity, independence and quality of life

The upcoming Scottish and Welsh elections are an opportunity for all parties to commit to practical, evidence-based improvements that will make a real difference to people’s lives.”

Colostomy UK is calling on political parties to act to by strengthening specialist stoma nursing capacity and ensuring that everyone living with a stoma receive regular annual reviews as part of a standardised care pathway. This includes involving people in decisions about their care and products, improving prescribing systems and access to supplies, strengthening data transparency, and ensuring that funding linked to stoma care is reinvested directly into frontline patient services.

These priorities align with recommendations from the Scottish Stoma Forum, which highlight the need for more equitable service delivery, improved workforce planning, and routine specialist nurse review for patients (Scottish Stoma Forum, 2023).

Mae pobl sy’n byw gyda stoma yn wynebu anghydraddoldebau mewn mynediad at ofal hanfodol wrth i Colostomy UK alw am weithredu cyn etholiadau’r Alban a Chymru

Mae Colostomy UK yn galw ar bleidiau gwleidyddol i ymrwymo i wella gofal stoma ledled yr Alban a Chymru cyn yr etholiadau datganoledig sydd ar ddod. Mae’r elusen yn rhybuddio bod pobl sy’n byw gyda stoma yn parhau i wynebu gwahaniaethau sylweddol mewn mynediad at gymorth a gofal arbenigol.

Mae mwy na 200,000 o bobl ledled y DU yn byw gyda stoma ac yn dibynnu ar nyrsys arbenigol, cynhyrchion priodol ac adolygiadau clinigol rheolaidd i reoli cyflwr hirdymor a chynnal ansawdd bywyd. Mae gofal stoma yn gofyn am reolaeth glinigol barhaus, gan gynnwys addysg, cyfraniad arbenigol ac adolygiadau amserol i gefnogi iechyd a lles, fel y nodir mewn canllawiau cenedlaethol (Fformiwlari Cenedlaethol Prydain; NICE).

Fodd bynnag, mae tystiolaeth o adroddiadau clinigol a data cleifion yn dangos amrywiadau clir mewn mynediad at y gwasanaethau hyn ar draws gwahanol genhedloedd y DU.

Yn yr Alban, mae Arolwg Nyrsys Arbenigol a Chleifion Fforwm Stoma’r Alban (2023) yn tynnu sylw at bwysau sylweddol ar y gweithlu. Mae tua 19,993 o bobl yn cael eu cefnogi gan ddim ond 39.2 nyrs arbenigol cyfwerth ag amser llawn. Mae hyn yn sylweddol uwch na’r gymhareb yn Lloegr, gan gyfyngu ar allu nyrsys i ddarparu dilyniant rheolaidd a gofal parhaus.

Mae’r pwysau hwn hefyd yn effeithio’n uniongyrchol ar fynediad at wasanaethau. Nododd pob Bwrdd Iechyd a ymatebodd nad oeddent yn gallu darparu adolygiadau blynyddol i bob claf. Nid oedd 44% o bobl wedi cael adolygiad wyneb yn wyneb ers dros flwyddyn, ac nid oedd 19% erioed wedi cael un.

Mae data cymharol ar draws y DU yn dangos bod Cymru hefyd yn wynebu pwysau tebyg, gyda mwy o gleifion fesul nyrs arbenigol nag yn Lloegr, er bod y gwahaniaeth yn llai amlwg nag yn yr Alban. Gyda’i gilydd, mae hyn yn tynnu sylw at heriau systemig o ran capasiti gofal stoma arbenigol ar draws y cenhedloedd datganoledig.

Mae data arolwg Colostomy UK yn dangos bod anghydraddoldebau mewn mynediad at ofal yn arwain at ganlyniadau gwaeth i gleifion. Er bod cyfraddau gollyngiadau yn debyg ar draws y DU (47% yn Lloegr, 48.5% yn yr Alban, a 48% yng Nghymru), mae gwahaniaethau amlwg mewn dangosyddion eraill. Nododd 38% o bobl yn Lloegr lid y croen, o’i gymharu â 47.7% yn yr Alban a 45% yng Nghymru — cymhlethdod cyffredin y gellir ei atal yn aml — gan awgrymu gwahaniaethau mewn mynediad at gymorth arbenigol amserol.

Yng Nghymru, dim ond 25% o bobl a adroddodd eu bod wedi gweld nyrs stoma arbenigol yn ystod y flwyddyn ddiwethaf, o’i gymharu â 29% yn Lloegr. Ar yr un pryd, mae 57% o bobl yng Nghymru yn nodi anghenion heb eu diwallu neu ganlyniadau negyddol, gan amlygu bylchau sylweddol mewn dilyniant a chymorth parhaus ar gyfer cyflwr hirdymor.

Er bod amrywiadau yn bodoli o hyd yn Lloegr, mae’r data yn awgrymu mynediad mwy cyson at gymorth arbenigol a dilyniant, gan ddangos llinell sylfaen gofal fwy sefydledig.

Mae’r gwahaniaethau hyn yn arwyddocaol. Mae gofal stoma yn gofyn am reolaeth barhaus, ac mae diffyg mynediad at gymorth arbenigol ac adolygiadau amserol yn cynyddu’r risg o gymhlethdodau megis niwed i’r croen a gollyngiadau, yn ogystal â heriau corfforol a seicolegol ehangach. Mae Fforwm Stoma’r Alban yn nodi y gall diffyg mynediad at weithwyr gofal iechyd proffesiynol a chymorth ehangach gyfrannu at unigedd, lles is ac ansawdd bywyd gwaeth.

Mae canllawiau NICE yn pwysleisio y dylai gofal fod yn ganolog i’r unigolyn ac yn cynnwys gwneud penderfyniadau ar y cyd. Ni ddylid ystyried mynediad at arbenigedd a chynhyrchion priodol yn ddewisol, ond yn elfen graidd o ofal stoma diogel ac effeithiol yn y tymor hir.

Dywedodd Prif Weithredwr Colostomy UK, Libby Herbert:

“Dylai pobl sy’n byw gyda stoma allu disgwyl gofal cyson o ansawdd uchel ble bynnag y maent yn byw. Mae mynediad at nyrsys arbenigol, adolygiadau clinigol rheolaidd a’r cynhyrchion cywir yn hanfodol i atal cymhlethdodau ac i gynnal urddas, annibyniaeth ac ansawdd bywyd.

Mae’r etholiadau sydd ar ddod yn gyfle i bob plaid ymrwymo i welliannau ymarferol, seiliedig ar dystiolaeth, a fydd yn gwneud gwahaniaeth gwirioneddol i fywydau pobl.”

Mae Colostomy UK yn galw ar bleidiau gwleidyddol i weithredu drwy gryfhau capasiti nyrsio stoma arbenigol a sicrhau bod pawb sy’n byw gyda stoma yn derbyn adolygiad blynyddol rheolaidd fel rhan o lwybr gofal safonol.

Mae hyn yn cynnwys cynnwys pobl mewn penderfyniadau am eu gofal a’u cynhyrchion, gwella systemau rhagnodi a mynediad at gyflenwadau, cryfhau tryloywder data, a sicrhau bod cyllid sy’n gysylltiedig â gofal stoma yn cael ei ailfuddsoddi’n uniongyrchol mewn gwasanaethau rheng flaen.

Mae’r blaenoriaethau hyn yn cyd-fynd ag argymhellion Fforwm Stoma’r Alban, sy’n galw am ddarparu gwasanaethau mwy cyfartal, cynllunio gweithlu gwell, ac adolygiadau rheolaidd gan nyrsys arbenigol i gleifion.

To find out more about Colostomy UK’s campaigning visit www.colostomyuk.org/campaigns

Notes & sources

• Over 200,000 people across the UK live with a stoma, requiring ongoing specialist support and regular clinical review to manage a lifelong condition (British National Formulary; NICE).
• 58% of people living with a stoma across the UK report not having seen a specialist stoma nurse in the last 12 months, indicating widespread access gaps (Colostomy UK, 2024).
• Approximately 19,993 people live with a stoma in Scotland, supported by 39.2 whole‑time equivalent specialist stoma nurses (Scottish Stoma Forum, 2023).
• Scotland and Wales both have higher patient‑to‑specialist nurse ratios than England, limiting capacity to deliver routine follow‑up and annual review (Scottish Stoma Forum, 2023).
• In Scotland, 44% of patients had not had a stoma review in over a year, and 19% reported never having had a face‑to‑face review (Scottish Stoma Forum, 2023).
• In Wales, only 25% of people reported seeing a specialist stoma nurse in the last year, and 57% reported unmet need or negative outcome indicators, highlighting significant access gaps (Colostomy UK, 2024).
• Patient‑reported outcomes show higher rates of skin irritation in Scotland (47.7%) and Wales (45%) compared with England (38%), despite similar leakage rates across the UK, suggesting differences in access to timely specialist support (Colostomy UK, 2024).
• Colostomy UK survey data also shows that specialist stoma care is rated as excellent when accessed, indicating that the primary challenge is access rather than care quality.
• NICE guidance emphasises person‑centred care and shared decision‑making as a core requirement for long‑term condition management, dependent on access to specialist expertise (NICE NG197).