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GPs buried under trusts' workload dump

​Genomic testing in five million patients could worsen GP workforce problems

GPs have warned new plans to introduce genomic testing for millions of patients could increase GP workload and costs. 

It comes after the Department of Health and Social Care announced five million NHS patients will have their genomes sequenced in the next five years to predict their likelihood of developing conditions such as cancer, heart disease and dementia. 

GPs have expressed concern over the programme and its impact, saying it could lead to increased numbers of consultations and greater costs. 

Up to £160m is expected to be invested by businesses and charities in the Government's ‘accelerating detection of diseases’ programme (ADD), which will see five million UK patients receive personalised health reports on their risk of developing diseases. 

Researchers will use data from people taking part in the sequencing programme to create polygenic risk scores, which will help identify people at risk of certain diseases and enable them to make lifestyle changes before their onset.

However, GP experts have voiced concerns about the effect the programme could have on health anxiety and GP workload and have called for long-term data on the possible adverse effects of the programme. 

A spokesperson for the RCGP overdiagnosis group, chaired by GP Dr Jane Wilcock, commented: 'Members of the overdiagnosis group have concerns about the ADD by genetic testing of a population not known to have serious genetic concerns. 

'We do not know the risks of false positive and false negative results, the costs to the NHS of retesting, counselling, onward referrals if needed and relatives testing.

'Genetic information is one of multiple factors which may predict disease but there is much uncertainty about results at present. It is possible that patients with adverse genetic information may present more often to GPs and our allied health care teams with symptoms they perceive to be related, creating increased and changing presentations in consultations at a time of GP understaffing.'

They added: 'As GPs we expect individuals entering ADD will have full counselling for informed consent, understanding possible benefits, risks and options available if information is adverse before participation. We hope there is long-term data collection on possible adverse effects as well as benefits.

'We also think we and our teams will require updates to keep us abreast of this changing field to best support our patients and to address our own concerns. We expect clear specialist pathways for those with adverse genetic profiles so that they are not left unsupported.'

The DHSC said that the programme ‘has the potential to transform the way people are treated’ and save thousands of lives.

The research will support government plans to use AI and data to transform the prevention and early diagnosis of chronic disease by 2030.

Professor Sir John Bell, lead for the ADD programme and professor of medicine at the University of Oxford, said: ‘The ability to identify people at risk or suffering from early forms of disease with greater precision will have a profound impact on how we develop diagnostics and new ways to treat disease.

‘I am delighted that this challenge will bring together the NHS, charities and industry to develop a truly world leading resource.’

Last week, the DHSC announced its intentions to make screening in the NHS ’more personalised and stratified by risk’ in its green paper on preventing ill health

Readers' comments (10)

  • Only a problem if GP persists with the lunacy of FATPOA. Charges for appointments would reduce demand and improve GP funding.

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  • Dear All,
    To what extent cn genomic testing actually reliably predict anything?
    Can we have a list with predictive values please?

    Regards
    Paul C

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  • Another photo of a doctor using a toy stethoscope, with a box of Lloyd George notes on the desk! Come on photo editor, you can do better

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  • Great. More work. Just what we need. I doubt 10 min is sufficient and where is the guidance and training?

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  • Time to go private......

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  • DrRubbishBin

    a gold mine for private business once they can get their sticky hands on it

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  • National Hopeless Service

    This is incidentalomas on a grand scale and will create forever panic in some individuals. So glad I am at the end of my career.

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  • This will doubtless be an enhanced service run by the PCNS- at least initially - and an easy sell off with lots of data for any willing provider.

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  • There is a forthcoming RSM meeting on “direct to consumer genetic testing” which may Be useful

    https://www.rsm.ac.uk/events/medical-genetics/2019-20/mgn01/

    I’m going, to increase my level of ignorance!

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  • why would you want to know? Why would you want to live an extra long life? if you don't smoke, exercise, normal weight and eat healthily, drink sensibly and lead a stress free life, not much else is going to significantly reduce your risk for any of these conditions, unless you have a strong genetic risk and then you are screwed anyway and I could pick that up from a family history. Plus who has access to the database and your personal genome? If a company sequences the DNA who owns the sequence? you or them? scary stuff.

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