Update on Systemic Anti-Cancer Therapies (SACT) and the Pharmacy Manufacturing Unit at Cheltenham General Hospital

Why the PMU remains closed

Earlier this year, our PMU was temporarily closed on the advice of the Regional Quality Assurance team following concerns raised during a routine inspection. A detailed review has since taken place, identifying a number of issues that require substantial estate and process improvements. These improvements are underway but complex and although we continue to explore all options, it is unlikely we will be able to find a sustainable solution until the opening of our new purpose-built modular unit - scheduled for Spring 2026.

We are sharing this update so that patients, families and carers know what to expect in the months ahead and where to find support.

What this means for your care

We want to reassure patients that:

• This situation does not affect the safety of any chemotherapy treatment you have already received or are due to receive
• Most patients continue to receive their treatment locally as planned at Cheltenham General Hospital (Avening Ward) or Gloucestershire Royal Hospital (Edward Jenner Unit)
• A small number of patients may experience changes to treatment schedules or be asked to attend another hospital such as Bristol or Hereford when we cannot source and provide the treatment locally. This is particularly affecting a very small number of drugs that need to be produced and administered in a very short time frame which we cannot achieve without our in-house manufacturing unit.
• In a few cases, treatments may be delayed at short notice if medicines are not available

We are very sorry for this disruption and any impact it is having on our patients; we are working hard to minimise this as far as possible.

Why there may be delays

Because we are sourcing SACT medicines from trusted external partners rather than producing them ourselves, each batch goes through extra safety checks once it arrives. This sometimes leads to:

• Short-notice delays on the day of treatment
• Changes to treatment plans upon arrival
• Occasional cancellations followed by urgent rescheduling

If you are coming for treatment, please allow extra time and let anyone accompanying you know that there could be a longer wait than usual.

Support for patients

We understand how stressful and worrying this can be. Please be assured that your safety and care are our highest priorities and your clinical team is here to support you. They will always discuss with you how any changes might affect your treatment or outcomes.

• If you do not hear from us directly, please attend your appointment as planned.
• If any changes are required, we will contact you as soon as possible. We know how important consistency and communication are during cancer treatment and will keep you informed every step of the way.

Additional information for parents and carers of children

For some paediatric patients, alternative arrangements may also be necessary. This may mean:

• Travel to another hospital for part of the treatment
• Rescheduled appointments at short notice

Your child’s doctor will speak to you directly about any changes. If you have not been contacted, please assume your child’s appointment is going ahead as planned.

Looking ahead

A comprehensive plan is in place to improve our facilities and restore on-site SACT manufacturing as soon as possible. In the meantime, our focus remains on:

• Delivering safe and timely care wherever possible
• Keeping disruption to a minimum
• Supporting our patients and staff through this difficult period

We will share further updates as soon as more information becomes available.

Thank you for your understanding and continued trust in our care teams.

Frequently asked questions

Why has SACT production been paused at Cheltenham General Hospital?
We paused in-house production following concerns raised during a routine inspection of our sterile manufacturing environment. This was a precaution to ensure the highest standards of patient safety.

Are the SACT medicines I am receiving still safe and effective?
Yes. All SACT drugs are now being provided by trusted external suppliers who meet strict quality and safety standards. Your treatment continues to be safe and effective.

Will my treatment be delayed or cancelled?
Most patients will continue with their treatment as planned. If your appointment needs to be changed, our team will contact you directly. If you do not hear from us, please attend your appointment as usual.

Why might there be delays on the day of my appointment?
As the SACT drugs are now being delivered from external providers, we are taking extra time to check and prepare them to the highest standards. This may cause short-term delays on the day of treatment.

• In some cases, a medicine may reach its expiry date before we are able to give it. If this happens, we will reschedule your treatment as quickly as possible.

Does this only affect patients attending Cheltenham General Hospital for SACT treatment?
No. It also impacts patients who attend the Edward Jenner Unit for haematology treatment and children attending paediatric oncology appointments at Gloucestershire Royal Hospital.

Will I have to travel away from Gloucestershire for my SACT treatment?
Most patients will not have to travel. However, a small number of specialist treatments may need to be delivered at other local centres. If this applies to you, we will contact you directly to explain the options.

Can you still provide Intrathecal chemotherapy treatment?
Yes, we are able to source intrathecal chemotherapy. Intrathecal chemotherapy is used for certain cancers, especially in children or in some blood cancers.