When patients can't afford to wait, Expanded Access Programmes become a vital lifeline. With growing demand in rare diseases, oncology, and advanced therapies - and increasing expectations from regulators, physicians, and patients - the pressure to execute programmes effectively has never been higher. With 18 of the 27 EU countries having their own compassionate use guidelines, access teams are navigating a complex and high-stakes landscape. Faced with inconsistent regulations, limited internal resources, and heightened scrutiny over compliance, data, and supply, success demands precision, collaboration, and expertise.