Professional

  • Overview
  • How to order a test
  • National test directory
  • Getting the results
  • 100k guidance for clinicians
  • Educational resources
  • Education & Training events calendar

Genomic medicine is now part of mainstream NHS care and all healthcare professionals (not just genetics specialists) need to have a good understanding of its relevance. The pathway below outlines the Whole Genome Sequencing (WGS) pathway. 

STEP 1
Clinician requests a test from the National Test Directory by completing a Test Order Form and sending this to the GLH with the Patient Choice form and appropriate samples.
STEP 2
The GLH receive the forms and samples. The information from these forms are entered into the NGIS Test Ordering System. DNA is extracted from the samples.
STEP 3
THe GLH sends all required DNA samples for WGS testing to the plating organisation.
STEP 4
The GLH performs interpretation and issues a NHS Genomic Report to the ordering clinician.

Library of resources

Carefully created and curated for healthcare professionals across the region to make the best use of genomics in their practice.

Education & events calendar

Our programme of genomics education for healthcare professionals is delivered through a mixture of face-to-face and online events.

We want to hear from you!

How to order a test

Cancer
test order form

Rare disease
test order form

Record of Discussion form

Getting results

All genetic and genomic test results will be returned by the London South Genomic Laboratory Hub after appropriate interpretation and analysis has been completed. These reports will be returned directly to the ordering clinician, unless instructed otherwise.

A GTAB meeting at Guy’s Hospital

Results will need to be discussed at a Genomic Tumour Advisory Board meeting prior to a report being issued. These meetings have been established to ensure there is appropriate expert knowledge and oversight of genomic test results and that they are managed and acted upon in a coordinated way.  These GTAB meetings will take place on a regular basis across the London South region and responsible clinicians will be invited to their local meeting to review their patient’s results with the Board members. Below is a mapping of the overall MDT model through which genomic test results will be monitored and reviewed.

A GARD meeting at Guy’s Hospital

Results will need to be discussed by the Genomic Advisory team for Rare Disease at a MDT meeting prior to a report being issued. These meetings have been established to ensure there is appropriate expert knowledge and oversight of genomic test results and that they are managed and acted upon in a coordinated way.  These GARD meetings will take place on a regular basis across the London South region and responsible clinicians will be invited to their local meeting to review their patient’s results. Below is a mapping of the overall MDT model through which genomic test results will be monitored and reviewed.

100k guidance for clinicians

A big thank you to all the healthcare professionals in the South London, Kent, Surrey and Sussex region who helped recruit over 2000 Cancer participants and nearly 4000 Rare Disease participants and their families to the Project. Recruitment to the Project has now come to an end and our current focus is on returning the results of the project to patients. Your continued cooperation and support are critical in ensuring this happens.

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Referring clinicians may be invited to a Genomic MDT meeting to review the results and discuss next steps for the patient. Depending on this discussion, more work may be required before the final result can be returned to the referring clinician (i.e. further analysis and validation of the findings).

In some cases an MDT discussion may not be appropriate and the report may be issued directly after the analysis at the lab. The referring clinician is then responsible for discussing the result with the patient.

Information for healthcare professionals on the 100,000 Genomes Project can be found on the Genomics England website:

Education & Training events calendar

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Calendar of Events

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Tests available to order will be listed in the National Genomic Test Directory. A test order form will soon be made available for clinicians on this webpage to download and complete. This form will include the address of the laboratory that the appropriate sample and completed form needs to be sent to.

Until the new Genomic Laboratory Service goes live, please continue to follow existing test order processes.
 
From April 2019 the interactive test ordering tool will be integrated into the National Genomics Informatics System (NGIS) and clinicians will be able to directly order tests online.
With any Whole Genome Sequencing (WGS) test ordered, a Record of Discussion (RoD) form will also need to be submitted. This document is to record the patient’s consent for genomic testing and their choice on taking part in research. Guidance on the patient choice conversation can be found here
 
This RoD form will be available for clinicians to download from this webpage. Once completed with the patient, it can be send to the lab with the corresponding test order form and sample.

 

As you are aware the NHS is dealing with unprecedented pressures and the GLH Network is working with NHS England to mobilise services to support the national response to the COVID-19 outbreak.

This will have an impact on the provision of genomic testing and as directed by NHSE we have been working with clinical colleagues to implement measures to safeguard the most critical genomics tests.

As a result, roll out of some of the changes to deliver the London South GLH operating model have been postponed. Therefore, from 1st April you will not experience any changes to the way you order tests and your test provider and funding arrangement will not change unless new arrangements have already been finalised.

To ensure we continue to provide the most urgent genomics tests our business continuity plan is as follows:

  • Prioritisation of services has been agreed across the GLH Network with the support of NHS England. The list of tests can be found here.
  • Prenatal and cancer testing will be prioritised and we aim to comply with the nationally agreed turnaround times. However, please be aware some delays may be experienced.
  • During this period, please refrain from sending any non-urgent genomic tests. Any tests already sent to the laboratory will be processed but results will likely be delayed.
  • We are continuing to assess our laboratories capacity on a daily basis to identify whether Amber or Red category tests can be delivered.
  • As the number of staff that are required to self-isolate or redeploy increases, we have prepared plans to operate with minimum on-site staff at our laboratories in order to allow continuation of Green category testing.

We are aware that some clinics have implemented remote consultations by teleconferencing and are considering issuing DIY sample collection kits to patients. Please be aware we are unable to accept saliva/buccal samples as an alternative to blood for DNA extraction at this time.

This is a rapidly changing situation and we will continue to provide regular updates on our website. Where more detail is available, our local genomics laboratories will continue to contact you directly to inform you of the interim changes to their services.

Mobilisation of the national Genomics Medicine Service and National Genomics Test Directory will resume once the situation has stabilised and we look for to working with you to launch the new services.

We appreciate your understanding and patience during this challenging time. If you have any questions or concerns please do not hesitate to contact us at gst-tr.londonsouthGLH@nhs.net.