Enhancing Systemic Anti-Cancer Therapy Delivery Through Early Screening and Workflow Optimisation: A Two-Cycle Service Evaluation in a UK Cancer Centre

Timely administration of systemic anti-cancer therapy (SACT) is essential for optimal oncological outcomes (1). Pre-treatment screening plays a critical role in ensuring fitness for therapy; however, workflow inefficiencies, delays, and scheduling inconsistencies within high-volume NHS oncology services may adversely affect care (2,3). This evaluation examined the SACT screening process within an NHS cancer centre to identify operational gaps and assess the impact of targeted service improvements. A two-cycle before-and-after service evaluation was conducted in Ward 202 between August 2024 and January 2025. Weekly data were collected on screening volumes, duration, delays or cancellations, supportive prescriptions, and clinical advice provided to nursing staff. Interventions implemented between cycles included introduction of a structured two-day advance screening process, early supportive prescribing, and the separation of haematology/immunology cases from solid-tumour oncology cases (4). Key metrics were compared descriptively across cycles. Cycle 1 comprised 1026 screened patients with 39 delays (3.8%), while Cycle 2 included 1773 screened patients with 62 delays (3.5%). The proportion of oncology patients increased from 71% to 73%. Mean screening duration increased minimally (2.22 to 2.30 minutes), while advice provided to nurses declined from 8% to 6%. The most frequent causes of delay were inpatient admission and completion of treatment courses.