"'Intermittent' or 'delayed' chemotherapy medication from a hospital pharmacy."

I am a cancer patient with regular ongoing treatment in a regional public hospital Oncology unit.  Chemotherapy drugs are provided 'on the day' to the Oncology unit by the Hospital Pharmacy, a process which had been working very efficiently, but in the past 3 months I have been inconvenienced twice by the non-availablity of the take-home Chemotherapy medication Lenalidomode on the day of treatment. I had been told when my treatment started that the Pharmacy would handle "all scripts and medications" and when a new script was required, they would contact the Haematologist directly.

1st time ... I was told by a Pharmacy member "Sorry, Lenalidomide wasn't ordered", despite knowing when my next appointment was.  This resulted in a Chemotherapy medication cycle-start-date delay of 5 days for me, having to return to the hospital after 5 days to collect the medication, and having to reschedule future treatment dates.  Not ideal for my treatment.

2nd time ... I was told that the Haematologist was advised by the Hospital Pharmacy that "The Daratumumab script has been lost" requiring her to obtain authorisation for a new script.

3rd time ... As I was leaving the hospital after treatment, a Pharmacy member advised me that "We don't have a new Lenalidomide script for next month".  We agreed that the Pharmacy would 'chase down' a new script but one month later I was again advised by the Pharmacy member that 'We still don't have a new script so we can't issue Lenalidomide today".  This (again) resulted in a chemotherapy medication cycle-start-date delay of 5 days for me, and having to return to the hospital after 5 days to collect the medication.  Lenalidomide is an important part of my treatment ... I had been told to ensure that it was taken 'on the right day, at the same time of the day, and at specific intervals before/after food'.  Having a 5-day delay in starting the cycle (on two occasions) does not fit in with this protocol!

I emphasise 3 things ... (1) My feedback is not critical of the Pharmacy staff, but I suggest that the process would benefit from a review and improvement.  I appreciate that the staff had made attempts to remedy the problem the 3rd time, without success, but there seemed to be no 'closure' of the problem.  That is, when they did not receive a response to the emailed request for a script, another email was sent, with no response, then ... no follow-up.  The end result was that as a patient, I was twice disadvantaged by the 5-day delayed availability of chemotherapy medication ... which was stressful at a time when there is enough for a patient to manage.   

(2)  The staff and processes in the Oncology unit are 1st-class.  Jess and her team provide a remarkable and very professional service, and have ensured a 'work-around' when the medications were unexpectedly delayed. 

(3)  I hope that my feedback is received in the positive way that it is intended.  I am not being critical of individuals, but my experience indicates that when Hospital staff are extremely busy, they and their patients are very dependent on sound workable processes ... I have been told a number of times "Sorry, that slipped through the gap".   My hope is that "those gaps" can be closed and that the process becomes less stressful for both the Pharmacy staff and for the patient.