Background
Cancer pharmacists are vital in supporting the safe provision of cancer therapies. Since 2018, the expansion of regional cancer services across South Australia has doubled chemotherapy unit activity, allowing more patients to receive treatment closer to home. Despite this growth, geographical and workforce limitations have created service discrepancies between metropolitan and regional sites. In response, SA Pharmacy and the Rural Support Service developed a new model to enhance cancer pharmacy services across regional South Australia.
Method
The Regional Local Health Network (RLHN) cancer pharmacy team was expanded to achieve a 1:10 staffing ratio, with protocol verification for 14 of the 15 regional chemotherapy units centralised to the metropolitan Adelaide-based team. The service scope was broadened to include patient pre-treatment consultations, pathology review prior to treatment, monthly visits to medium-complexity centres, participation in clinical governance and safety meetings, and establishment of a weekday on-call cancer pharmacy service. Medication supply was also streamlined for infusion units without on-site dispensary. The model was introduced over two years alongside the rollout of an electronic chemotherapy prescribing system.
Impact on Practice
Since implementation, protocol verifications have increased by 104%, from 2,802 in 2018–19 to 5,720 in 2024–25. In 2024–25, cancer pharmacists conducted 35 onsite visits, and this year to date 82 pre-treatment consultations have been completed, either via telehealth or in person. The model has also contributed to reduced courier costs, improved cancer pharmacist availability through the weekday on-call service, and reduced incident reports for missed chemotherapy orders.
Discussion
This model has improved access, safety, and continuity of cancer pharmacy care for regional patients. Ongoing evaluation through patient and staff feedback, improved access to clinical trials, and sustainable funding will support continued development and help maintain high-quality cancer care in regional areas.