Chemotherapy, or systemic anti-cancer therapy (SACT), is used in the treatment of cancer. It is often used in combination with other therapies such as surgery and radiotherapy.

NHS England Specialised Commissioning is the responsible commissioner for all chemotherapy services (including drug procurement and delivery) across England. The exact scope of NHS England’s commissioning responsibility is set out in the Manual for prescribed specialised services.

Chemotherapy clinical reference group

This service area is supported by a Clinical Reference Group (CRG). The main function of a CRG is to provide the primary source of clinical advice for specialised services and the membership comprises clinical, Patient and Public Voice (PPV) representatives and professional associations. Each CRG is also supported by an NHS England Commissioning Lead and Public Health Lead.

Membership of the chemotherapy clinical reference group:

  • Anne Rigg, Chair
  • Ernie Marshall, Clinical Member
  • Andrew Wardley, Clinical Member
  • Gordon Cook, Clinical Member
  • Samantha Toland, Clinical Member
  • Lisa Pickering, Clinical Member
  • Yvette Drew, Clinical Member
  • Lindsey Cook, Patient and Public Voice Representative
  • Jessica Lewington, Patient and Public Voice Representative, (Bowel Cancer Now)
  • Duncan Sim, Patient and Public Voice Representative), Cancer Research
  • Emma Foreman, Affiliate Member, (British Oncology Pharmacy Association)
  • Catherine Oakley, Affiliate Member, (UK Oncology Nursing Society)
  • Neil Bayman, Affiliate Member (Joint Collegiate Council for Oncology)

The Chemotherapy CRG is also supported by an NHS England Pharmacy Lead.

Commissioning products

A key part of the CRG’s work is the delivery of the ‘products’ of commissioning. These are the tools used by the Regional Commissioning Teams to contract services.

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:

Clinical commissioning policies

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:

Clinical commissioning policy statements

Policy statements are brief documents that define the current commissioning position to support service contracting.

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


Chemotherapy waste data collection and evaluation tool

This tool was developed in 2019/20 as part of an NHS England commissioning for quality and innovation (CQUIN). The Chemotherapy Clinical Reference Group has made the tool available to providers who wish to improve their efficiency in reducing chemotherapy waste. It can automate the calculation of waste according to the method agreed by the NHS England Medicines Optimisation Committee.

The tool and accompanying user guide are available below

The tool was originally developed to allow trusts to share their chemotherapy waste for the purposes of benchmarking as part of the CQUIN. There is currently no ongoing support from NHS England available for benchmarking using the tool, however users are free to benchmark within their networks. Any users who experience technical issues with the tool can report them to

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