There is a need “for greater resilience in the system” to mitigate against disruptions in the delivery of anti-cancer therapies, according to the Director of the National Cancer Control Programme (NCCP).
Prof Risteárd Ó Laoide made the call in an email to the HSE Chief Clinical Officer (CCO) Dr Colm Henry on 18 December 2024. The email was obtained by the Medical Independent (MI) through Freedom of Information law.
The email was written after a third-party provider of outsourced parenteral systemic anti-cancer therapy (SACT) products experienced a disruption to its compounding service last year. This disruption impacted the supply of parenteral SACT products to HSE-funded hospitals.
In his email, Prof Ó Laoide wrote that “building greater resilience in hospitals can be achieved by increasing in-house compounding of SACT within dedicated aseptic compounding units (ACUs)”.
This “helps mitigate the risks associated with relying on outsourced supply chains, which are often fragile and vulnerable to disruptions”.
The current status of ACUs for SACT has been of “critical concern to the NCCP for a number of years”, according to Prof Ó Laoide.
He wrote that 10 hospital pharmacy ACUs are providing SACT from outdated units, some of which are 20 years old.
Another two hospitals do not have an ACU and are wholly reliant on outsourcing.
“Therefore, prioritising the development or refresh of ACUs is imperative to bolster resilience and enable a more agile response to external supply disruptions,” according to the NCCP Director.
“Additionally, it will allow for reduced SACT cost and waste, which is critical for HSE’s medicines sustainability.”
In the email, Prof Ó Laoide referenced a recent report written on the issue.
A HSE spokesperson told MI that a HSE/NCCP oversight group was convened to oversee the impact caused by the supply disruption and to identify any necessary actions.
Once the disruption had stabilised and no further impacts on patients were reported by hospitals, the oversight group prepared and agreed a final report.
It is understood the report recommended the construction of new ACUs. It also advised that outdated ACUs should be upgraded to increase resilience and reduce the need for these hospitals to outsource SACT products, thus mitigating future SACT supply disruptions.
“The group recommended that staffing challenges in cancer services be reviewed and considered in an effort to build greater resilience in times of disruption and meet the increasing demand going forward,” according to the spokesperson.
This report was shared with Regional Executive Officers in each health region and the CCO.
In addition, the NCCP wrote to the health regions to recommend that each hospital’s business continuity plan was documented and in place.
The letter further recommended that SACT resilience measures should be included as a standing agenda item in the NCCP cancer network meetings within each health region.
It stated capital build plans for ACUs within each region should be considered for prioritisation, referencing the recommendations of the oversight group.
The HSE Capital Plan 2025 states the intention to support the development of ACUs at University Hospital Kerry, Cork University Hospital, Letterkenny University Hospital, Cavan General Hospital, and Tallaght University Hospital, Dublin.
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