Consent forms for SACT (Systemic Anti-Cancer Therapy)
Contact
If you have specific queries or are looking for something not covered here, please email us.
Are you a clinician or other healthcare professional involved with consenting and treating patients with Systemic Anti-Cancer Therapy (SACT)?
We are working with Guy’s and St. Thomas’ NHS Foundation Trust to produce national standardised SACT regimen-specific consent forms.
We want to support clinicians in ensuring all patients are fully informed when consenting to SACT. These forms are endorsed by the UK Systemic Anti-Cancer Therapy Board (UK SACT Board). This was previously known as the UK Chemotherapy Board.
The UK SACT Board has also issued guidance for the introduction of the national SACT regimen-specific forms by individual chemotherapy providers.
The consent forms and guidance document are available to download in PDF format. Forms are grouped by tumour-site.
This guidance about remote consent has been developed as a result of the COVID-19 pandemic.
SACT Form update
SACT consent forms are currently being reviewed on a rolling schedule. Please see FAQs for order of roll-out. Republication dates may exceed the date of review indicated on each form. All forms are valid until new versions are available.
Guidance on remote consent for SACT
Guidance for SACT by Healthcare Improvement Scotland
Last updated: 9th October 2020
Guidance on electronic consent for SACT
Last updated: 7th September 2021
Which tumour site group’s forms are available and when will they be reviewed?
The regimen-specific forms have been published for the following tumour site groups.
Each group of forms will be reviewed on a rolling schedule. The process by which each group of forms is revalidated may result in the republication dates exceeding the date of review indicated on each group of forms. All forms are valid until new versions are made available.
| Tumour site | Issue date | Review date |
| Generic consent form | Jan-20 | Jan-23 |
| Generic Immunotherapies form | Mar-20 | Mar-23 |
| Breast | Mar20 | Mar-23 |
| Head & Neck | Aug-16 | Aug-19 |
| Skin - Melanoma | Nov-16 | Nov-19 |
| Gynaecology | Dec-16 | Dec-19 |
| Lung | Jan-17 | Jan-20 |
| Colorectal | Mar-17 | Mar-20 |
| Supportive meds | Apr-17 | Apr-20 |
| Urology-bladder | Apr-17 | Apr-20 |
| Thyroid | May-17 | May-20 |
| Upper GI - OG & GIST | Aug-17 | Aug-20 |
| Upper GI - HPB | Aug-17 | Aug-20 |
| Urology - Germ cell | Sep-17 | Sep-20 |
| Urology - Prostate | Oct-17 | Oct-20 |
| Chronic Myeloid Leukaemia (CML) | Feb-18 | Feb-21 |
| Brain & CNS | Mar-18 | Mar-21 |
| Urology - Renal cell & Small cell | Jul-18 | Jul-21 |
| Skin - Non-Melanoma | Nov-18 | Nov-21 |
| Neuroendocrine & Adrenal | Jan-19 | Jan-22 |
| Chronic Lymphocytic Leukaemia (CLL) | Jun-19 | Jun-22 |
| Myeloproliferative neoplasms (MPN) | Jun-19 | Jun-22 |
| Multiple Myeloma | ||
| Lymphoma | ||
| Acute Myeloid Leukaemia (AML) | ||
| Acute Lymphoblastic Leukaemia (ALL) | ||
| Sarcoma (Bone and Soft Tissue) | ||
| Paediatric generic consent form |
Please check the website regularly (e.g. once a month) for new forms and updates.
What should I do if I cannot find the regimen-specific form I need?
We would encourage Trusts to us the generic form where a regimen-specific form does not exist.
When will the consent forms for the haematology tumour groups be available?
CML, CLL, MPN consent forms have now been published. The other haematology sub-groups will follow.
How have the forms been developed and what is the governance process?
The forms are based on the Department of Health consent form 1. The template form has been approved by the UK SACT Board. Each hospital/Trust will need to ensure that the forms are approved for use locally by their governance or consent committee, whichever is most appropriate for the individual organisation. Please refer to the “Guidance on consent for SACT” on this website.
The consent forms and the legal process
The consent form is not a legal document but it represents best practice and conforms with and complements the guidance documents available to clinicians taking consent. Several guidance documents have described best practice in the area of consent with respect to law, ethics, training and experience required and the need for documentation that consent has taken place.
We explored informal counsel with a medico-legal advisor, in response to the issue of the Montgomery judgement. The following has been taken from their reply:
The Montgomery judgement really only brings the legal situation in the claims process into line with what doctors have been obliged to do since this GMC guidance was issued in 2008.
The most important aspect of the GMC guidance is that information about risk must be individualised for that patient. So for example, risk of cardiac events may be higher in a patient with pre-existing cardiac disease, or peripheral neuropathy may be more relevant if you are a concert pianist, as opposed to a patient who is not.
These are probably the most comprehensive and patient friendly consent forms I have seen.”
The consent forms are developed to ensure a high level of consistency in the information giving and discussion with the patient. Your Trust Governance and/or consent committee must agree before you use these forms.
How do I give a copy of the completed form to the patient?
The patient can be given a photocopy of the completed form. We recommend retaining the original form in the patient’s records, or a scanned copy in the patient’s electronic records.
Are there plans for the forms to be made available in Welsh and/or other languages?
The generic SACT and generic immunotherapy consent forms have been translated to Welsh. There are plans to translate and provide the generic forms in other ethnic languages (Polish, Guajarati). Please check the website for these forms and updates.
Are there any plans to develop chemo-radiotherapy consent forms?
These forms are designed specifically for taking consent for SACT. For instances where the SACT is given in combination with radiotherapy, the radiation therapy will need to be consented for separately. We do not currently plan to develop chemo-radiotherapy consent forms.
Are there plans for the forms to be made available for paediatrics and TYA groups?
We plan to develop national SACT regimen-specific consent forms for these patient groups.
Are there plans for the forms to be made available electronically?
We are currently exploring the feasibility of editable electronic consent forms with Cancer Research UK.
Where can I find more information about the regimen-specific consent forms?
Further information can be found on www.cruk.org/sact_consent.
You can also email lucy.cox1@gstt.nhs.uk (from 10th July 2019) if you have any queries and with any comments.
Generic checkpoint inhibitor immunotherapy form
Welsh Generic Immunotherapy form
Last updated: 14th November 2023
ALL in Children and Young People
Children and Young people generic form
Last updated: 10th August 2023
AIDA (All- transretinoic acid and Idarubicin)
High dose cytarabine (ARA C) + Amsacrine
DA (Daunorubicin and Cytarabine)
Gemtuzumab ozogamicin with daunorubicin and cytarabine
Liposomal daunorubicin + Cytarabine ( Vyxeos)
Low dose cytarabine ( ARA C) + Venetoclax
Midostaurin + chemo (DA + HD Ara C)
Midostaurin (+/- chemotherapy)
Last updated: 17th August 2023
AC (Doxorubicin-Cyclophosphamide)
Atezolizumab - Paclitaxel albumin-bound
EC (Epirubicin-Cyclophosphamide)
FEC-PPH (Paclitaxel-Pertuzumab-Trastuzumab)
FEC-TPH (Docetaxel-Pertuzumab-Trastuzumab)
Kadcyla® (trastuzumab emtansine)
Liposomal doxorubicin (Myocet®)
Liposomal doxorubicin (Myocet®)-Cyclophosphamide
Paclitaxel albumin-bound - Carboplatin
TC (Docetaxel-Cyclophosphamide)
TCarboH (Docetaxel-Carboplatin-Trastuzumab)
TCarboPH (Docetaxel-Carboplatin-Pertuzumab-Trastuzumab)
TPH (Docetaxel-Pertuzumab-Trastuzumab)
Tucatinib, trastuzumab and capecitabine
Last updated: 18th August 2023
Last updated: 10th August 2023
Last updated: 14 July 2022
Cisplatin-Fluorouracil + Radiotherapy
Liposomal doxorubicin (Caelyx®)
Liposomal doxorubicin (Caelyx®) - Carboplatin
Last updated: 16 February 2021
Atezolizumab, bevacizumab, carboplatin and paclitaxel
Atezolizumab, carboplatin and etoposide
CAP (cyclophosphamide-doxorubicin-cisplatin)
Carboplatin, pemetrexed and pembrolizumab
Carboplatin, paclitaxel and pembrolizumab
CAV (cyclophosphamide-doxorubicin-vincristine)
Cisplatin- pemetrexed - pembrolizumab
Last updated: 18th August 2023
Cyclophosphamide-Vincristine-Dacarbazine (CVD)
Etoposide-Doxorubicin-Cisplatin (EDP) +/- Mitotane
Irinotecan-Fluorouracil (FOLFIRI)
Streptozocin-Cisplatin-Fluorouracil
The published forms listed here are not exhaustive for neuroendocrine cancers. They reflect mostly (but not exclusively) those regimens for gastroenteropancreatic neuroendocrine tumours.
The regimen-specific consent forms for neuroendocrine cancers of other areas of the body can be found within their respective anatomical groups.
Last updated: 15 February 2019
Capecitabine-Cisplatin + Radiotherapy
Cisplatin-Capecitabine-Trastuzumab
Cisplatin-Fluorouracil (+/- Radiotherapy)
Cisplatin-Fluorouracil-Trastuzumab
Docetaxel-Oxaliplatin-Fluorouracil (FLOT)
ECarboF (epirubicin-carboplatin-fluorouracil)
ECarboX (epirubicin-carboplatin-capecitabine)
ECF (epirubicin-cisplatin-fluorouracil)
ECX (epirubicin-cisplatin-capecitabine
EOF (epirubicin-oxaliplatin-fluorouracil)
EOX (epirubicin-oxaliplatin-capecitabine)
Fluorouracil PVI + Radiotherapy
Irinotecan-Fluorouracil (FOLFIRI)
Oxaliplatin-Capecitabine (CAPOX)
Oxaliplatin-Fluorouracil (FOLFOX)
Paclitaxel-Carboplatin + Radiotherapy
Last updated: 5 April 2022
Last updated: 16th August 2022
Last updated: 14th September 2023
Who has approved the content in these forms?
The programme is being led by a dedicated CRUK-funded oncology pharmacist at Guys’ and St. Thomas’ NHS Foundation Trust.
All forms are independently checked by an oncology/haematology pharmacist, oncology/haematology consultant and member of the UK SACT Board.
Publishing, additions and updates
We are publishing forms by tumour site, the first were for breast cancer in May 2016. We will publish new forms for other tumour sites regularly.
Recent additions and updates will be highlighted on the "What's new?" section on this page, and details of when forms have been last updated is stated in each section. Please check for updated versions and ensure that you use the latest version of each form.
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What's new?
14th November 2023: Updates CLL SACT consent forms, Generic SACT consent and Generic checkpoint inhibitor immunotherapy forms
14th September 2023: New form added for Pazopanib
18th August 2023: Updated lung, breast, GIST and AML Azacitidine SACT consent forms updated
10th August 2023: Updated children and young people, kaposi sarcoma and CML SACT consent forms updated
25th July 2023: Updated brain & CNS forms for Temozolomide and Temozolomide-RT
12th May 2023: Brain & CNS SACT consent forms updated and a new form added for Ibrutinib
1st November 2022: Lung cancer SACT consent forms updated
21st October 2022: Generic paediatric SACT consent form updated
6th September 2022: New form added for Abemaciclib and Trastuzumab Deruxtecan
5th September 2022: Head and neck cancer SACT consent forms updated and new form added for Tucatinib, trastuzumab and capecitabine
25th August 2022: Renal cell cancer (urology) SACT consent forms updated
16th August 2022: Prostate cancer (urology) SACT consent forms updated
10th August 2022: Small cell cancer (urology) SACT consent forms updated