London South East Region

Q. How do Trusts deal with the transition between v3 and v4, especially about handling patients whose treatment plans began under version 3

A. Once a Trust switches to version 4, all mandatory fields must be present for new submissions, but it is not expected to retrospectively update old plans unless required by mandatory fields.

Q. Isotope therapy: Clarification was requested on whether isotope therapy should be reported in SACT or RTDS?

A. Treatments involving isotopes are outside of the scope of SACT and should be included in RTDS (Radiotherapy Dataset) submissions. Please contact your local DLM if you require further details.

Q. Oral chemotherapy: A question was raised about reporting oral chemotherapy administered as take-home packs versus inpatient administrations?

A. New fields in version 4 allow for recording the number and length of cycles dispensed, addressing the previous data gap.

Q. Performance status: There was discussion about challenges in collecting performance status data for each cycle

A. Performance status is a required data item (not mandatory) and can be collected at the start of each regimen and/or cycle. If the regimen or cycle changes, then a new performance status can be recorded, but it should not be reported or changed at multiple times within the same regimen/cycle.

Q. Clarification was sought by delegates as to how many new data ‘Mandatory’ data items there were in v4.0.

A. New mandatory fields in SACT v4.0 include care professional details (if recorded), curative/non-curative line of treatment, cycle number, and date/time fields, and confirmation provided that most mandatory fields remain unchanged from SACT v 3.0.

Q. Supplier readiness: Concerns were raised about system suppliers, particularly ChemoCare, not being ready for SACT v4.0 by the July deadline.

A. Trusts were advised to continue reporting with SACT v3.0 submissions until suppliers are ready and assured that no fines would be imposed due to supplier delays.

A. NDRS continue to work with all the system suppliers to ensure that an update can be made available at the earliest possible time. This has involved starting these conversations back in May 2025 and allowing an additional 3-month window for implementation, to support system suppliers who have multiple clients.

Q. Supplier transition and testing: Some delegates had identified that they were transitioning between suppliers and had concerns about limited testing windows.

A. The panel recommended involving the NDRS DLMs and the NDRS Loading Team for local support and advised confirming with their system supplier whether the SACT upload is included in their upcoming update.

Q. Supplier communication: There were several questions from the delegates about supplier communication.

A. There have been ongoing communication with system suppliers, including providing documentation, presentations, and regular updates to ensure suppliers were prepared for the transition to SACT v4.0.

Q. Trust responsibility: There was clarification required around Trust responsibilities.

A. Trusts were reminded to maintain direct contact with their system suppliers, as they hold the contracts and can apply pressure for timely updates; NDRS does not have contractual authority over suppliers.

Q. Feedback and updates: More information was requested about feedback and updates from NDRS.

A. The regional NDRS DLMs are the main point of contact for updates on supplier readiness, and the SACT Project Manager will provide briefings to them as needed for regional dissemination.

Q. Data loading: There was a question about testing and data loading support. 

A. Trusts must send files to their DLMs for testing in a beta environment, with feedback provided on validation results.

Q. Multiple reporting systems: There was a concern about Trusts which handled multiple systems.

A. The challenges for Trusts using multiple systems (e.g., Aria and ChemoCare), is that all files must be ready for SACT v4.0 before a Trust can fully transition and advised affected Trusts to plan accordingly.

Q. CTYA options: There were questions around the use of the ‘CYTA Only’ option, for example, ‘should this be the default for all CYTA patients?’

A. This cannot be applied to all CTYA patients as default. This is applicable only to a small number of CTYA patient who receive SACT as both ‘Neoadjuvant’ and ‘Adjuvant’ treatment, alongside their main treatment.

Q. 'SACT Only' as well as 'Adjuvant' and 'Neo-adjuvant': This may be confusing for prescribers as we have patients that could be recorded as 'SACT Only', as well as ‘Adjuvant’ and ‘Neo-adjuvant’?

A. ‘SACT Only’ would apply to any patient where the only treatment they had was a SACT treatment (both adult and/or CTYA). This is not a multiple repeating data item, only one option can be applied to each ‘Regimen’.

A. Also, if a patient has multiple Regimens, there could be different ‘Treatment Contexts’ applied to each regimen, as the patient progresses through their treatment programme.

Regimen modification

Q. Upfront dose modification: A delegate asked if the panel could confirm if the intention of this data item is to just capture upfront dose modifications i.e. before a patient receives their first cycle/day/week of treatment, thus we shouldn’t include any regimen modifications that happen after the patient has started treatment?

A. Regimen modification is upfront, so if the there is a Dose modification later in the Regimen, you do not need to go back to adjust “Regimen modification” as this is upfront only.

Q. Assuming that the above is the case: A delegate wanted to confirm that NDRS were only looking to capture dose changes (both increase and decrease) for SACT and not any other changes to a regimen upfront i.e. deleting or adding drugs/changing intervals/frequencies of treatment/using non-standard routes of administration/using non-standard drug dose calculation formula?

A. Yes that is correct, we are looking to capture Dose changes only.

Q. What is the threshold/criteria for an upfront dose modification? Is this: Any dose modification that occurs prior to patient receiving C1D1 or within a specific time frame (e.g., within 1 week of prescribing the regimen) or does this apply to modifications that occur immediately as the regimen is being prescribed?

A. This should record modifications - prior to commencement of regimen (as Example 10.1 above)

Cycle modification

Q.  Drugs omitted: A delegate asked if the panel could confirm that this only includes drugs omitted from the cycle and not any other modifications i.e. adding drugs/changing intervals of treatment/frequencies.

A. Yes that is correct - only includes drugs omitted from the cycle.

Q. Definition of drugs: Could we clarify the definition of drugs being omitted from the cycle? Does this mean  when a drug is removed from the cycle and never given as intended (fully removed from regimen) or if the drug was intended to be given but not administered for some reason?

A. When the patient never received the planned administration, so both examples would fall under “omitted” from cycle.

Q. Number of cycles administered (on a named day): Is this related to patients on multiple SACT regimens (therefore multiple cycles administered) or to early dispense of oral chemo (e.g., 3 cycles supplied to patient)?

A. This is related more towards Oral Chemotherapy and is intended to capture when more than a single cycle is dispensed. Therefore, the second example as above.

Dose modification

Q. A delegate asked the panel if they could confirm that the intention of this data item is to only capture dose modifications (both increase and decrease) for SACT and not any other changes to a drug i.e. deleting or adding drugs/changing intervals/frequencies of treatment/using non-standard routes of administration/using non-standard drug dose calculation formula

A. Yes that is correct - only includes modification of the Dose.

Q. There were a variety of questions around the timeline and compliance.

A. Trusts are instructed to contact their system suppliers early to schedule updates and arrange local training, and to continue submitting version 3 data until their systems are upgraded.

Q. There was a question asked about documentation.

A. All attendees received the slide deck, including live links to all documentation, following the webinar. For those who did not attend a webinar, the main websites for accessing all the documentation are:

DAPB1533: Systemic Anti-Cancer Therapy Data Set (SACT) - NHS England Digital:

• requirements specification
• change specification
• implementation guide
• data set v4.0
• technical guidance
• information standard notice

SACT v.4.0 downloads - NDRS:

• SACT v4.0 user guide (HTML and pdf versions)
• technical guidance (HTML version)