The government is looking at reducing costs by choosing those companies which offer the cheapest price for products,this in turn will reduce the number of one piece  appliances available on the Stoma Aplliance Scheme . I work as a Stomal Therapy Nurse and often see Ostomates (people with a Stoma who have to excrete into a bag on their abdomen) and who  have problems with leakages, skin reactions, hernias and  issues with the stoma itself. To solve these problems requires a wide variety of Stoma appliances. To reduce the choice of products will have a massive impact on the quality of life of  Ostomates, many of whom will be too afraid to leave their homes in fear of leakages. Continued leakages will cause ulceration of the skin and inability for any product to adhere. Many elderly have had the same appliance for a number of years and will be forced to change to a appliance they wont be able to manage. There are also many much younger Ostomates who are having to cope and come to terms with having a stoma, which in itself is difficult enough, let alone trying to deal with management issues caused by an inappropriate appliance. For an Ostomate to change product they will need the assistance of a Stomal Therapy Nurse -many of whom are unable to offer such a service due to workload and lack of facilities. Please reconsider the proposed tender for the Stoma Appliance Scheme and look at other ways of saving money such as introducing costs for accessories which are often over used.