Transformation Projects
Primary Care
Increasing capacity and capability in genomics in primary care.
Project Background
North Thames and South East GLHs had established a Pan London HEE/GLH (at the time) Workforce Steering Group working on a collaborative approach to supporting mainstreaming through pre-registration / doctors in training programmes.
Following the release of the Topol Review, the launch of the Genome UK Strategy and the GMSAs we wanted to reach out to HR/OD and DoN and Midwifery, HEIs to understand what was currently happening in terms of Genomic Education and what/if any support required.
North Thames GMS education and training approach:
- Foundation level – awareness raising and increasing genomic literacy
- Intermediate level – upskilling the workforce to support safe mainstreaming activities
- Advanced level – CPD for mainstreamers and specialist CG workforce
Progress to Date
A number of training sessions have been provided across the region to GP trainees, their PDs and the wider PC teams, however, as part of the NTGMS strategy we were keen to develop a systematic approach and started with the trainees sponsored by the Heads of GP School London.
Aim: a systematic approach to delivering genomic education to primary care, sponsored by the Head of GP School London
- GPVTS Genomic Medicine Modules – developed mapped to the curriculum
- GPVTS Genomic Medicine Modules – delivered to all North Thames programmes and wider community
- GPVTS Genomic Medicine Modules – collaboration with National Lead for PC, HEE and RCGP to develop standardised programme integrated with the wider programme for trainees
GPVTS Modules
Learning objectives:
- To be able to explain why genomics is important.
- To be able to explain the current healthcare applications and implications of genomics.
- To be able to explain the future healthcare applications and implications of genomics.
- To be able to communicate effectively, support their patients and institute appropriate management in terms of Genomic Medicine.
Topics:
Session 1
- Basic genetics with more information on genomic nomenclature e.g. non-coding DNA, VUS, pathogenic variant
- Genomics in primary care
- Overview of genetic susceptibility to common complex diseases e.g. cancer, ischaemic heart disease, diabetes
- Taking a family history
- Familial breast & ovarian cancer syndromes
- Overview of types of genomic tests and intro to Panelapp
- When to refer
Session 2
- Rare diseases overview
- Prenatal diagnosis
- Neonatal screening
- Pharmacogenomics
Genomic education – pre-registration
- Medical Schools – placements and curriculum
- Foundation Trainees – taster sessions and curriculum
- Nursing and midwifery – Pan London Collaboration core principles document and signposting to E&T resources (now national interest)
- Allied Healthcare Professionals – working with HEE London Lead to seek genomic champions
- Physicians Associates – collaboration with St Georges
Think Genomics: Primary Care Genomic Education Programme
Aim: To provide an overview of the Genomic Medicine Service (GMS) and an opportunity to explore its application within primary care.
Learning Outcomes
- Outline the provision for genomic medicine now available and the future of the service
- Describe what to look out for when patients present.
- Be aware of available risk assessment tools and their application.
- Know how to manage a patient requiring a genetic referral.
- Explain the current situation regarding Direct to Consumer Testing
Module 1
- Introduction to Genomics
- Overview of ‘red flags’
- Overview of the National Genomic Test Directory
Module 2
- Explore familial cancer, in particular breast cancer and Lynch syndrome
- An introduction to risk assessment tools
Module 3
- Introduction to Pharmacogenomics
- How to respond to Direct To Consumer Testing
Resources to Signpost
Resources catalogue:
- Family History Video
- Podcast series – Genomics Now. Get the podcast on Apple Podcasts, Google Podcasts, Spotify or Amazon Music.
- Narrative slides
- Handbooks
Education events:
- Mainstreaming programme
- Prenatal programme
- Monthly ‘Genomics Question Time’
Key Contacts
Dr Anwar Khan
GP Lead
North Thames GMSA
Corinne Trim
Education & Training Lead
North Thames GMSA