B02. Chemotherapy


This Clinical Reference Group (CRG) covers chemotherapy services. Chemotherapy is the use of certain drugs to treat solid tumour cancers and haematological (blood) cancers through the systemic delivery of agents that have anti-tumour effects. Chemotherapy may be given through a number of routes including intravenous (in a vein), subcutaneous (under the skin), intrathecal (around the spinal cord), oral (swallowed) and topical (applied directly to a body surface).

Chemotherapy may be used in any type of cancer, often in combination with other treatments such as surgery or radiotherapy.


Chair: Professor Peter Clark, Consultant Medical Oncologist, Clatterbridge Cancer Centre NHS FT.

Ernie Marshall, North
Andrew Wardley, North
Andrew McMillan, Midlands & East
Karen McAdam, Midlands & East
Jonathan Ledermann, London
Martin Gore, London
Andy Peniket, South
Elaine Lennan, South
David Thomson, Lead Pharmacist
Kirsty Henderson, Patient & Public Voice
Sally Greenbrook, Patient & Public Voice
Jonathan Savage, Patient & Public Voice
Lisa Jordan, Lead Commissioner, lisa.jordan4@nhs.net


A key part of the CRG’s work is the delivery of the ‘products’ of commissioning. These are the tools used by the 10 Hub Commissioning Teams to contract services on an annual basis.

Service Specifications

Service specifications are important in clearly defining the standards of care expected from organisations funded by NHS England to provide specialised care. The specifications have been developed by specialised clinicians, commissioners, expert patients and public health representatives to describe both core and developmental service standards. Core standards are those that all funded providers should be able to demonstrate, with developmental standards being those which may require further changes in practice over time to provide excellence in the field.

The following service specifications fall within the scope of this CRG:


A commissioning policy is a document that defines access to a service for a particular group of patients. A NICE Technology Appraisal Guideline on the same topic will replace, or be incorporated into, a commissioning policy as appropriate. These are important documents that are developed to ensure consistency in access to treatments nationwide.

The following policies fall within the scope of this CRG:

Policy statements

Policy statements are brief documents that define the current commissioning position to support service contracting. They are interim documents for use while a full commissioning policy is being developed or until a formal NICE Technology Appraisal Guideline has been published.

The following policy statements fall within the scope of this CRG:

National dose banding tables

The Chemotherapy Dose Standardisation initiative has been developed by NHS England’s Medicine Optimisation and Chemotherapy CRGs.  NHS England is supporting the standardisation of chemotherapy doses which will deliver benefits for patients, Hospital Trusts and achieve improved value from our investment in chemotherapy services.

Historically when patients received chemotherapy intravenously their dose would be based on a combination of their height and weight and would mean that pharmacies would waste any medicine left over from vials containing fixed doses. A number of hospitals have already moved to a system of dose banding where a range of doses are delivered to closely match to vial size. This means there is reduced waste and as these doses tend to be ready made it also reduces the waiting time for patients within the chemotherapy unit.

The National Dose Banding Tables are to be used by Hospital Trust Pharmacy Teams to ensure a standard approach to dose banding of Chemotherapy across all Hospital Trusts.  The initiative is initially focussed on 19 commonly used drugs. This will help the NHS achieve improved value through the ability to purchase standard off the shelf products.