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BSGM submission to the Science and Technology Committee inquiry

posted on Tuesday, 18th April 2017   |   Not tagged.

The BSGM has made a submission to the Science and Technology Committee (Commons) inquiry on genomics and genome-editing. For more details about the scope of the inquiry and details of other submissions see - http://www.parliament.uk/business/committees/committees-a-z/commons-select/science-and-technology-committee/inquiries/parliament-2015/inquiry2/

1. The British Society for Genetic Medicine (BSGM, ) is an independent umbrella organization encompassing the Clinical Genetics Society, Association for Clinical Genomic Science, Association of Genetic Nurses and Counsellors and the Cancer Genetics Group, thereby representing the views of approximately 1800 professionals who work as doctors, genetic counsellors, scientists and researchers in supporting families and individuals with genetic or genomic disorders. These professionals work to predict, diagnose, prevent and treat these disorders.

2. The BSGM forms part of a network of specialist clinicians (known both as Clinical Geneticists and Consultants in Genomic Medicine) equipped to deliver genomic medicine in the NHS via 23 regional genetic services covering the entire United Kingdom. These NHS medical consultants working with genetic counsellors and diagnostic scientists provide:

• A body of medical experts already familiar with genomic testing as part of clinical practice.

• Expertise in the phenotyping and clinical diagnosis of rare and ultra rare genetic disorders.

• Strategies to make and confirm the molecular diagnosis of rare diseases. • A family based service that spans prenatal care to old age medicine. • Clinics for the diagnosis, treatment and health screening of affected and at risk individuals.

• Contributions to major research discoveries in genomics.

3.The diagnosis of a genetic condition can impact not just on the individual tested but also on their family members. A genetic diagnosis is life-long and there is a major potential for risk and harm if we provide incorrect information. It is not the case that a genome sequence can be interpreted in isolation, or that inability to do is simply because bioinformatics analysis is not yet sufficiently advanced. Careful analysis of genomic variation together with clinical examination and family history interpretation is needed to provide useful information.

4. The BSGM works with a number of agencies, including the Human Embryology and Fertilization Authority (HFEA), Medicines and Healthcare Regulation Authority (MHRA) the Nuffield Council on Bioethics, the NHS and Genomics England to provide expert advice about the appropriate regulation of genomic medicine. The BSGM does not see an immediate need for additional regulation in this area beyond that already planned or in place. Together with the above agencies, and other professional bodies and statutory authorities, including the National Data Guardian, we will continue to review the ethical issues raised through these technological advances. Any new regulation should be guided by the principles that apply to medical practice, ones that aim to maximize benefits and minimise harms whilst recognizing the importance of consent and confidentiality in any medical encounter.

5. The BSGM is supportive of Genomic England's 100,000 Genomes Project providing whole genome sequencing for individuals with certain rare diseases, infectious diseases and cancer. The Project is facilitating new diagnoses where previous NHS testing was unavailable or was too limited to determine the underlying cause. It has already resulted in improvements in the genomic analysis of tumour samples through multidisciplinary approaches. The BSGM is confident that the bioresource created through the 100K project will provide opportunities for researchers and pharmaceutical companies to increase understanding of and strategies to deal with different health problems.

6. Once recruitment to the 100,000 Genomes Project finishes (anticipated autumn 2018), it is vital that Genomic Medicine services are invested in through staff and laboratory infrastructure and training to enhance the delivery of genomic medicine. Effective services will also require a robust, secure infrastructure for storing and sharing relevant genomic and phenotypic data, as the ability to share these data is a key element of sequence variant interpretation, especially in rare genetic diseases. It is important to reinforce that whole genome sequencing is just one technique, albeit a very powerful one, that can be used to aid diagnosis and inform treatment decisions. Genomic laboratories need to be equipped with the range of platforms and skilled scientific staff, supported by integrated informatics systems, to provide a full repertoire of genomic tests to meet the needs of patients in all areas of medicine.

7. BSGM encourages the mainstreaming of genomic medicine into all specialties and general practice and strongly believes that regional genetic services will retain an important role in meeting the increasing demands in this area. For example, in leading the training of other healthcare professionals in the application of genomic medicine. This will require sustained investment in these existing services to ensure that the NHS is in place to deliver the safe, equitable and effective care that patients require and deserve.

References. 1. Ribeil JA, Hacein-Bey-Abina S, Payen E, et al. Gene Therapy in a Patient with Sickle Cell Disease. N Engl J Med. 2017 Mar 2;376(9):848-855. 2. Baldridge D, Heeley J, Vineyard M, et al. The Exome Clinic and the role of medical genetics expertise in the interpretation of exome sequencing results. Genet Med. 2017 Mar 2. doi: 10.1038/gim.2016.224

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