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New chemotherapy report sets out additional roles for community pharmacists (updated)

By News team

Additional roles for community pharmacists in the delivery of oral chemotherapy and systemic anticancer medicines have been suggested in a new report published today (25 January 2011).

The report (PDF 130K)— which is authored by Steve Williamson, consultant pharmacist in cancer services at Northumbria Healthcare, and has been developed as part of collaborative work between the NHS, pharmacy organisations and pharmacy specialist practice groups — suggests that care can be delivered at a number of levels:

  • Level 1 (baseline service): service providers undertake supply of the oral anticancer medicine for the patient ensuring compliance with the recommendations of the 2008 National Patient Safety Agency alert on oral anticancer medicines
  • Level 2 (specialised service): service providers check the oral anticancer medicine prescription, referring to a regimen protocol and undertake the basics of chemotherapy verification as defined by the British Oncology Pharmacy Association Verification Standards 2010
  • Level 3 (advanced service): service providers assess the patients clinically to ensure that it is safe to proceed with chemotherapy

Entitled "The dispensing and supply of oral chemotherapy and systemic anticancer medicines in primary care", the report says that common to all three models of service delivery is the need for service providers to be able to access oral anticancer medicines protocols in order to check that the drug doses have been prescribed appropriately, to receive appropriate training or to have previous experience in oncology and to develop links with secondary care cancer pharmacists from the hospital where treatment is initiated.

Special accreditation needed

For the recommendations to work, the report states that it is essential for patient safety that any development of community oral anticancer medicine services is part of a planned and commissioned process. It adds that commissioners and secondary care trusts should discuss potential opportunities for oral anticancer medicines to be dispensed in primary care, including a baseline assessment of the potential demand, and that only those who have undertaken additional training and can comply with the service models should be accredited to provide the service.

"The aim of the document is not to tell community pharmacists what they can and can’t do, but rather to tell them how they can do it safely," Mr Williamson explained.

Royal Pharmaceutical Society's head of corporate communications Neal Patel said: "The cancer reform strategy has reaffirmed Government’s commitment to improving the care of people with cancer, at all stages of their journey. The opportunity to harness the interactions that pharmacists have with these people would considerably widen the net the NHS can use to improve outcomes."

Community pharmacists are willing and able

Head of information at the National Pharmacy Association Leyla Hannbeck added: "In leading edge practice across the country, community pharmacists have shown themselves willing and able to take on an expanded role in supporting cancer patients. This includes dispensing and administering oral anticancer medicines and monitoring the progress of cancer patients. The NHS White Paper emphasises patient choice, and more widespread pharmacy-based cancer services would add a new dimension that patients would welcome. This report lays out what is possible and contains practical recommendations for transforming the possible into the real."

In-store chemotherapy services

Boots has refused to confirm or deny that it is planning to provide in-store chemotherapy services following a report in the Daily Mail this week (24 January 2011) that patients receiving chemotherapy would be able to go a medical centre at their nearest Boots, staffed by nurses who would administer the drugs.

A spokesman for Boots said: "We are working in partnership with the NHS to continue to develop our in-store services for patients. A number of options are currently being considered, but these are still in their early stages."

Mr Williamson said: "This is a very interesting development and not entirely unexpected. The NHS has been looking at the potential for community chemotherapy services since publication of Department of Health guidance in 2010. With chemotherapy ‘closer to home’ so clearly on the Government’s agenda, it is imperative that action is taken quickly and decisively to ensure that all service providers deliver the same standard of care and assurance of safe practice as current NHS chemotherapy units."

Citation: The Pharmaceutical Journal URI: 11065297

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