This article reflects on the changing nature of the provision of care and delivery of ambulatory systemic anti-cancer therapy (SACT) services. It reviews the national guidance and looks at ambulatory SACT in terms of patients being treated closer to home, i.e. ambulatory care in its truest sense. It considers the impact on quality of life for patients receiving treatments at a place of their choice. It explores the role of the nurse as an advanced practitioner while also examining the safety and delivery of complex regimens ensuring robust pathways are in place to deliver care in a safe and standardised way.