NICE Guidance on One-piece Closed Bags for Colostomies

22 April, 2026

In this issue we report on two projects that may have an impact on how stoma care looks in the future in the UK.

As we have previously reported on, Colostomy UK has been working with The National Institute for Health and Care Excellence (NICE) to look at the use of one-piece closed colostomy bags in the NHS.

NICE is the organisation that provides national guidance for the NHS in England and Wales. Their role is to make sure care is based on the best available evidence, is consistent across the country, and represents good value for taxpayers’ money.

This review focused on bags that are already widely used in the NHS. The aim was to check whether differences in price between products are justified by differences in quality, effectiveness, or benefits for people living with a stoma.

The final guidance has now been published. Here’s what it means for you.

What NICE recommends

• There isn’t enough evidence to show why some one-piece closed bags cost more than others.
• You should have access to a wide range of one-piece closed bags on NHS prescription, so you can find the one that works best for you.
• Choosing a bag should be a shared decision between you and your stoma care nurse or healthcare professional.
• Decisions should consider things like:
  • preventing leaks or seepage
  • protecting the skin around your stoma
  • your individual needs and preferences, which may change over time
• If more than one bag is suitable for you, and you are happy with all the options available, the NHS will usually provide the least expensive option, but this should only be if you feel it meets your needs and are happy with it.

What this means for people with a colostomy

• You have the right to discuss different bag options with your healthcare professional.
• The bag you use should be chosen based on what’s right for you, not just cost.
• If you ever experience problems like leakage, discomfort, or skin irritation, ask your stoma care nurse for a review. Your needs may change, and switching bags or using extra products could help.
• Remember: your voice matters. Decisions about your care should always be made with you, not for you.

What this means for healthcare professionals

• Bag choice should never be influenced by sponsorship or brand promotion.
• Decisions should follow NICE’s principles of shared decision making.
• Clinical appropriateness and the person’s needs come first – but if more than one bag is suitable, the least expensive option should be used.
• These recommendations apply when someone is starting on a new bag. If the bag you already use works for you, there’s no need to change.

Why NICE made these recommendations

• There is currently limited and low-quality evidence comparing one-piece closed bags.
• There isn’t enough proof that one bag is more effective than another, or that higher prices mean better outcomes.
• What matters most to people with a colostomy is reducing leaks, preventing skin problems, and feeling confident in daily life.
• More research is needed that focuses on outcomes that truly matter to people living with a stoma.

Colostomy UK’s response to the NICE recommendations.

While the NICE guidelines refer specifically to people who use one-piece Closed Colostomy bags, we believe that the considerations for health care professionals and patients provide a sound basis for joint decision making and improved patient choice for everyone living with a stoma, and should be considered best practise by health care professionals regardless of which type of stoma they have, and bag they use.

Product choice should always be based on clinical appropriateness and the needs and preferences of the person with a colostomy[RU6.1]. However, we recognise the financial burden of stoma care to the NHS, so support the recommendation that if more than one bag is suitable, the least expensive option should be used. We all have a responsibility to ensure value for money.

NHS England review of stoma and continence products

In July NHS England announced that they are carrying out a major review of how stoma and continence products are prescribed and supplied through the NHS. This includes all products listed on Part IX of the Drug Tariff (the official NHS list of appliances and items that can be prescribed).

The review aims to:

• Ensure patients receive products and support that meet their clinical needs.
• Improve outcomes and patient experience.
• Deliver services that are sustainable and offer value for money.

As part of the process, NHS England has issued a Request for Information (RFI) to stoma care manufacturers and delivery companies to gather insights into current products and services. Topics covered include the role of industry-funded specialist nurses, and support partnerships and prescription management services.

Colostomy UK is actively engaging with NHS England on this review to ensure that the voices and experiences of people living with a stoma are heard, and that future services reflect patient needs and priorities.