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Systemic Anti-Cancer Therapies (SACT)

The content of this page is aimed at providing information and guidance on SACT to healthcare professionals. Information for patients can be found HERE.

Systemic Anti-Cancer Therapies (SACT) Clinical Group

SACT Clinical Lead: Dr Catherine Bale (Betsi Cadwaladr UHB)

SACT Nurse Lead: Dr Rosie Roberts (Velindre NHS Trust)

SACT Pharmacy Leads: Diana Matthews (Velindre NHS Trust), Tracy Parry (Betsi Cadwaladr UHB) and Gail Povey (Swansea Bay UHB)


The All Wales SACT Group meets three times a year and aims to provide a strategic lead for national SACT priorities, enabling a coordinated approach for developments such as e-prescribing, SACT datasets, coordination and monitoring of horizon scanning of cancer drugs and accessibility on a once for Wales basis.


For further information on the All Wales SACT Group, please contact

All Wales Immunotherapy Toxicity Group

The All Wales Immunotherapy Toxicity Group has been established by the Wales Cancer Network as a subgroup of the All Wales Acute Oncology Service (AOS) Group and All Wales Systemic Anti-Cancer Therapy (SACT) Group. It aims to provide a strategic lead for immunotherapy toxicity priorities and a forum for the ratification of all Wales developments enabling a coordinated approach to service provision.

National Immuno-oncology (IO) Education Forum

The national immuno-oncology education forum is a multi-disciplinary meeting that was established by Helen Winter, Consultant from Bristol Haematology and Oncology Centre, and Ricky Frazer, Consultant at Velindre Cancer Centre in Cardiff. It has grown to more than 100 colleagues from across the whole of the UK that come together once a month to discuss immunotherapy related topics. Topics covered so far include recognising myasthenia gravis, management of colitis and review of national steroid guidelines. The National IO Education Forum is open to all healthcare professionals regardless of experience; the only requirement is an interest in immunotherapy and a desire to improve patient care. The meetings take place virtually via Microsoft Teams on the first Thursday of every month at 1pm regardless of the date it falls on and lasts no more than 1 hour. If you are interested in joining the National IO Education Forum, please contact Ricky and the team on

Medicines Management Sub-Group

Previously known as the ePrescribing sub-group, the SACT Medicines Management Sub-Group was established by the All Wales SACT Group.

The group meets three times a year and aims to provide a multidisciplinary platform for making consensus recommendations relating to the best-practice use of SACT and SACT-supporting medicines, ensuring equity of access and optimisation of use. It also provides strategic leadership for medicines management priorities of the All Wales SACT Group.

This enables a coordinated approach for developments such as ePrescribing, SACT dataset, horizon scanning, governance and accessibility, and prioritising a Once-for-Wales approach, ensuring delivery against national standards agreed by the All Wales SACT Group.


SACT Pharmacy Directory

Please follow the below link to the SACT Pharmacy Directory form. This should take you less than 5 minutes to complete. By completing this form you will be entered onto Wales Cancer Network's directory of SACT Pharmacy staff, and will be contacted usually by email (but occasionally by telephone) on topics that may interest you. Your information will be held securely by the Wales Cancer Network and will not be shared or distributed. The information held will be used only by Wales Cancer Network staff.

SACT Pharmacy Directory Form

The Wales Cancer Network SACT and AOS Education Event was held virtually on the 11th and 12th May 2022.

Please CLICK HERE to view the full agenda. 

Recordings of the event are available via the links below:

Day 1 recording

Day 2 recording

For any queries please contact

All Wales SACT Authorisation & Prescribing Passport

The All Wales SACT Authorisation & Prescribing Passport is endorsed by the Wales Cancer Network. These competencies are designed to be used to allow all healthcare professionals to gain the appropriate skills, expertise and experience in the assessment, monitoring and prescribing of SACT in the area of their practice.

This passport is currently in use but is being reviewed and the updated version will be uploaded as soon as available.


UKONS SACT Administration Competency Passport

The UKONS SACT Administration Competency Passport is the agreed standard for administration of SACT.


Clinical Resources

Cisplatin Hydration

The purpose of this protocol is to standardise hydration schedules and administration of cisplatin chemotherapy for adult patients across Wales.

Cancer Network Guideline for management of hydration during systemic anti-cancer therapy containing cisplatin

Tumour Lysis Syndrome

This document outlines prevention and management guidelines for tumour lysis syndrome, for adult patients across Wales.

Cancer Network Guideline for prevention and management of tumour lysis syndrome

Further protocols are  in development and will be published soon.


Patient Education Videos

Education videos have been developed for patients and their families in both Welsh and English to provide information regarding SACT, side effects and related information. For more information, click here:

Patient Information Videos - NHS Wales Executive


The All Wales Cancer Treatment Alert Cards have been developed for patients receiving chemotherapy and immunotherapy. There are three versions available:

  1. Cancer Treatment alert card, for adult oncology and haematology patients receiving SACT.  
  2. Paediatric Cancer Treatment alert card, for oncology or haematology children (or their parents/ guardian) receiving SACT.
  3. Chemotherapy and DPD alert card: for patients receiving fluoropyrimidine chemotherapy  who have a DYPD genetic variant resulting in a DPD deficiency.

For more information on the cards, including instructions for use and for re-ordering, please click here.


Translations for non English / Welsh speakers

Translations are available in some commonly requested languages of the patient information sections of the alert cards. These are available below, and can be downloaded and printed as required. This translated information must be attached to the English/Welsh card so that the guidance for healthcare professionals is available to all staff managing the patients care. A translator should be used to provide a full explanation when the card is given to the patient.

Cancer Network staff are currently working on translating and proof-reading translations in additional languages – if you are able to assist with this, or have any requests for translation, please contact

Arabic - Cancer Treatment

Arabic - Chemotherapy and DPD

Arabic - Paediatric

Chinese - Cancer Treatment

Chinese - Chemotherapy and DPD

Chinese - Paediatric

Czech - Cancer Treatment

Czech - Chemotherapy and DPD

Czech - Paediatric

Farsi - Cancer Treatment

Farsi - Chemotherapy and DPD

Farsi - Paediatric

Polish - Cancer Treatment

Polish - Chemotherapy and DPD

Polish - Paediatric

Romanian - Cancer Treatment

Romanian - Chemotherapy and DPD

Romanian - Paediatric

Russian - Cancer Treatment

Russian - Chemotherapy and DPD

Russian - Paediatric

Ukrainian - Cancer Treatment

Ukrainian - Chemotherapy and DPD

Ukrainian - Paediatric

The All Wales SACT Group collaborates with a range of national groups. Key groups include:

SACT Nurse Forum

The SACT Nurse Forum has been established to provide nurses from across Wales an opportunity to share best practice through collaboration and to collectively inform the development of practice and workforce standards. The forum is chaired by Dr Rosie Roberts (Velindre NHS Trust).


The Wales Cancer Network has set up the All Wales Genomics Oncology Group (AWGOG) to facilitate a multidisciplinary and coordinated national approach to the development and implementation of oncology-specific genomic services provided by the All Wales Medical Genomics Service (AWMGS).

For further information about Genomics and AWGOG, please CLICK HERE.


The All Wales AOS Group was established by the Wales Cancer Network and aims to provide a strategic lead for national acute oncology priorities and a forum for the ratification of All Wales developments enabling a coordinated approach, for example in the development of AOS datasets, pathways, documents and support tools in order to ensure a standardised, cohesive acute oncology service for Wales.

For further information about AOS and the All Wales AOS Group, please CLICK HERE.

All Wales Therapeutics and Toxicology Centre (AWTTC)

AWTTC is an NHS Wales organisation that works with patients, carers, patient organisations, healthcare professionals, the pharmaceutical industry, Welsh Government and other relevant UK organisations to recommend and ensure appropriate and effective use of medicines.

For further information about AWTTC, please CLICK HERE.

Peer Review

Peer review is a collaborative quality improvement process, which allows for the evaluation of scientific, academic or professional work by others working in the same field.

It constitutes a form of self-regulation by qualified members of a profession, encouraging peers to share information, learn where their strengths and weaknesses lie and agree plans for improvements to patient care.

Peer review methods are employed to maintain standards of quality, improve performance and provide credibility.

A national steering group within NHS Wales was involved in the development of the peer review measures which were designed to assess the quality and performance of SACT against the All Wales National Standards for SACT (December 2020).  This is the first time that SACT has been reviewed in Wales.

Peer Review is a cyclical review – therefore SACT services will once again be reviewed in coming years. 

All SACT services in Wales must take part in Peer Review and services will in future be measured against relevant national standards. 

For further information about Peer Review, please CLICK HERE.

SACT Dataset

All SACT services are required to collect data in line with:

  • All Wales Core Cancer Minimum Reporting Requirements
  • National Cancer Data Standards for Wales – Systemic Anti-Cancer Therapy (SACT)

The National Cancer National Cancer Data Standards for Wales – Systemic Anti-Cancer Therapy (SACT) were approved in December 2020.

Quality Performance Indicators (QPIs)

Alongside the Cancer Minimum Reporting Requirements for Systemic Anti-Cancer Therapy (SACT), two QPIs that aim to measure the quality of the service and patient care and will provide intelligence and insight to help drive service improvement, have now been developed.

The QPIs are as follows:

  1. Time from decision to treat to treatment start
  2. Monitoring death within 30 days of SACT

The detail and parameters of the data that needs to be captured to support these QPIs has been developed and agreed by two working groups, consisting of nurses, oncologists, haematologists and pharmacists working in SACT services across Wales. This detail can be found in the SACT Clinical Quality Performance Indicators document.


All Health Boards / Trusts in Wales aim to begin capturing data in line with the agreed QPIs from the 1st November 2022 with a view to report this data to the All Wales SACT Group from the 1st April 2023 onwards. This will allow Health Boards to identify any issues with their current reporting processes / systems which can be taken to the national group for discussion and support.

For further information on the SACT Clinical Quality Performance Indicators, please contact


National Institute for Health and Care Excellence (NICE)

NICE offers evidence-based guidelines and advice for practitioners in health, public health and social care.

For further information on NICE guidance for Cancer, please CLICK HERE.


National SACT Consent Forms

The All Wales SACT Group endorse the National SACT Consent Forms hosted on the CRUK Website.

The Wales representatives for the National Consent Form Steering Group are Dr Rosie Roberts (Velindre NHS Trust) and Simon Waters (Velindre NHS Trust).


UK Chemotherapy Board

The UK Chemotherapy Board has representation from the following National bodies:

  • The Association of Cancer Physicians (ACP)
  • The Royal College of Radiologists (RCR)
  • The Royal College of Physicians (RCP)
  • The Royal College of Pathologists (RCPath)
  • The UK Oncology Nursing Society (UKONS)
  • The British Oncology Pharmacy Association (BOPA)

The Wales representative for the UK Chemotherapy Board is Dr Catherine Bale (Betsi Cadwaladr UHB).

Current workstreams include:

  • Chemotherapy consent forms and related documents
  • Hepatitis B testing
  • Intrathecal Chemotherapy Standards
  • National SACT protocols
  • Standards for Reducing Risks Associated with Electronic Prescribing
  • Steroid prophylaxis for immunotherapy
  • National consensus on validity periods of blood tests and threshold values
  • Extravasation