Chemotherapy in the community for adult patients with cancer

The NHS Operating Framework for the NHS in England 2010/11 proposed more community-based services for people receiving chemotherapy. This is also advocated in the Department of Health publications NHS 2010-15 from good to great: preventative, people centred, productive (2009b) and Chemotherapy services in the Community - A Guide for PCTs Chemotherapy closer to home (DH, 2010a). This article reflects on the provision of chemotherapy services closer to home, with the aim of engaging community practitioners in considering this area of service provision. It examines the need for this service, reviews the chemotherapy pathway, and considers what models have been adopted to deliver this in the community. Education and training to ensure patient safety and practitioner competence will be briefly considered in light of new national initiatives. The article also aims to provide information for service commissioners ahead of the transition from PCT to GP commissioning in 2013. Although for several years the trend has been towards delivering services closer to home, there is not a wealth of research-based literature on this subject. While patient experience can be captured and analysed it also needs to be placed in context with that of those delivering the service, as safety and quality is paramount. Until then we should be optimistically cautious in rolling out these services until the meaning of closer to home is defined by local context.