NHS genomics nursing plans ‘need joined-up support’

The Department of Health and Social Care announced plans for increased training of nurses in genetic testing as part of the expansion of its genomic medicine service, one of the 10-year innovation schemes launched by the government.

But Louise Fullwood, a medical law expert at Pinsent Masons, says the venture needs close alignment from other aspects of the health service if it is to have any significant impact.

“With an ageing population it is very beneficial to the NHS to have a proactive, community-led service to use the potential of genomics to spot people’s individual risk markers for chronic conditions,” she said. “This will allow for tailored interventions, management and monitoring with the aim of avoiding or mitigating the risks of developing such conditions.”

“However, the success of the programme will be dependent in part on the other elements of the process being available – for example, if an analysis indicates markers for breast cancer, but there is a long waiting list for diagnosis/treatment then it is potentially increasing anxiety and associated harms to patients who are sitting with a knowledge of increased risk but a long wait.”

Under the scheme, specially trained nursing staff will guide patients and their families through testing to identify inherited causes for conditions such as cancer, heart disease or genetic disorders - and will identify patients suitable for genomic testing.

The chief scientific officer for England, Professor Dame Sue Hill, said in the announcement that it would build on the NHS’ existing genomic work.

“It will enable more people to access genomic testing, not only for risk prediction and prevention, but also to help tackle the unmet needs of patients with undiagnosed conditions.”

As part of the scheme, nurses will offer support to accessing genomic counselling for those undergoing testing - and ensuring support and care is available will be essential for the service’s success, says Fullwood.

“This is an area where this service has the potential to distinguish itself from some current private providers of genomic testing who provide only very limited counselling – which can also increase distress and confusion,” she said.