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Systemic Anticancer Therapy Administration in Community Care Settings: Key Considerations for Implementation and
Laura Clifford1, Noeleen Sheridan1, Caroline Smyth1
1Community Intervention Team, Anam Cara, Dublin, Ireland.
Objective:
To examine the factors influencing the development and implementation of community-based systemic anticancer therapy (SACT) delivery and to identify evidence-informed recommendations that support safe, sustainable, and equitable integration of oncology services into community care.
Methods:
This discussion paper was informed by an environmental scan of evidence from systematic reviews and primary studies evaluating the design and implementation of community oncology services. Searches of MEDLINE, CINAHL, and PsycINFO were complemented by critical reflections from multidisciplinary healthcare professionals, and nursing management and leadership staff involved in the establishment of the Community Intervention Team (CIT) Oncology Service in Ireland.
Results:
Community-based SACT delivery is feasible and safe when supported by structured governance, adequate infrastructure, skilled multidisciplinary teams, and strong alignment between hospital and community services. Key enabling factors included clear accountability frameworks, shared electronic information systems, collaborative communication pathways, and investment in workforce education. Challenges related to capacity, digital interoperability, and sustainable funding remain significant. The synthesis highlights the importance of policy alignment, stakeholder engagement, and ongoing evaluation to ensure quality and safety.
Conclusion:
Experience from the CIT Oncology Service demonstrates that community-based oncology care can improve access, efficiency, and patient experience while maintaining clinical quality, provided that systems are designed with integrated governance, data-driven evaluation, and multidisciplinary collaboration.
Implications For Nursing Practice:
Health systems seeking to expand oncology services into community care should prioritize clear governance, workforce readiness, interoperable digital infrastructure, and robust evaluation frameworks to support safe, equitable, and sustainable implementation.
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