In October 2022, NHS England published Accelerating Genomic Medicine in the NHS, the first NHS genomics strategy. The strategy included a plan to establish ‘NHS Genomic Networks of Excellence’ as part of its commitment to provide a world-leading NHS Genomic Medicine Service (GMS) which provides cutting-edge benefits for patients in the NHS.
NHS England is now funding eight innovative networks to develop the evidence and model of adoption for cutting edge genomic advances and technology applications that will be transformative for patients. The NHS Genomic Networks of Excellence are designed to be partnerships between the NHS, academia, the third sector and industry to leverage expertise and resources from the broader genomics ecosystem, and to ensure there is a route towards rapid informing commissioning decisions.
Following a rigorous process of expressions of interest and business case submissions, reviewed by NHS England Genomics Unit, NHS England national clinical directors, national specialty advisors, the Office for Life Sciences, Genomics England and other key stakeholders, eight networks of excellence have been established in the following areas:
- Prenatal genomic medicine
- Circulating tumour biomarker testing
- Rare and inherited disease
- Severe presentation of infectious disease
- Improving the identification and outcomes for individuals with inherited and acquired cardiovascular disease
- Pharmacogenomic and medicines optimisation
- Genomics artificial intelligence (AI)
Genomic technology is rapidly transforming the type and range of genomic tests which can be offered, and with significant advances in therapy the NHS is able to embed prenatal genomic testing for rare and inherited diseases.
This network is set to bring together key leaders to drive prenatal genomic medicine services by delivering more non-invasive prenatal testing. The network will also develop evidence to expand the eligibility for fetal genomic testing, as well as review clinical pathways.
This NHS Genomic Network of Excellence will work with industry sequencing providers and will link with the Great Ormond Street Hospital (GOSH) National Institute of Healthcare Research (NIHR) Biomedical Research Centre (BRC).
Increasingly it is becoming possible to use blood samples to test for disease-causing mutations in circulating tumour DNA (ctDNA) without the need for invasive biopsies. Implementing circulating biomarker testing will help reduce the number of patients who require tissue biopsy and reduce waiting times for patients to receive the most appropriate treatment.
This NHS Genomic Network of Excellence will build on existing circulating biomarker testing projects, for example in non-small cell lung cancer, as it looks to expand the innovative test into a range of other tumour types.
This NHS Genomic Network of Excellence will link with the Institute for Cancer Research, the Christie Cancer Research UK Manchester Institute, Kings Health Partners and a number of NIHR BRCs.
This NHS Genomic Network of Excellence will utilise expertise within the NHS Genomic Laboratory Hubs (GLHs) and NHS GMS Alliances to deliver new technologies for patients with or at risk of haematological malignancies, regardless of geographical location.
This will include a rapid (tumour-only) whole genome sequencing service for haematological malignancies for access to all NHS GLHs, which would make data available to all clinicians within ~7-10 days, to better inform next steps in the clinical pathway.
This NHS Genomic Network of Excellence will work with industry sequencing providers to develop the technologies and work flows in a partnership with the Oxford Translational Myeloma Centre (OTMC), as well as the Oxford NIHR BRC, the Leeds NIHR BRC and Genomics England.
Although rare diseases may be individually rare, they are collectively common, with 1 in 17 people being affected by a rare disease at some point in their lives.
The focus of this NHS Genomic of Excellence is to help patients get a diagnosis faster; reduce genomic health inequalities; develop new testing approaches, especially for those patients with a suspected rare disease that remain undiagnosed using current genomic testing in the NHS GMS; increase the efficiency of analysis; and increase capacity for rare condition clinical trials.
This NHS Genomic Network of Excellence will align with NIHR BRCs in Exeter, Manchester and Bristol and will develop industry sequencing provider partnerships including with Illumina and Oxford Nanopore.
This NHS Genomic Network of Excellence will bring together experts to transform the understanding and management of patients with life threatening infectious disease, through the application of novel genomic technologies in pathogen detection and host immunity profiling.
The Network of Excellence will focus on pathogen sequencing and host immunity profiling in patients with acute illnesses in healthcare settings. This can accelerate personalised treatments for vulnerable patients.
This NHS Genomic Network of Excellence will build upon a clinical service at Guy’s and St Thomas’ NHS Foundation Trust, in partnership with Oxford Nanopore Technologies. It will work in partnership with UK Health Security Agency (UKHSA) for data systems. It will also work with a number of NIHR BRCs including in Oxford, Birmingham, Southampton, GOSH, Manchester and University College London Hospital.
Improving the identification and outcomes for individuals at risk of inherited and acquired cardiovascular disease NHS genomic network of excellence
Cardiovascular disease (CVD) is a leading cause of death worldwide, with 25% of all deaths registered in England and Wales being attributed to CVD. The NHS Long Term Plan has identified CVD as the main condition where lives can be saved.
This work will pilot approaches to improve the outcomes for individuals at risk of both inherited and acquired cardiovascular disease through precision diagnostics to tailor management in a well-established and phenotyped cohort of patients.
This NHS Genomic Network of Excellence will align with the Barts NIHR BRC, linking with the NIHR BRC Polygenic Risk Scores (PRS) Collaborative, which coordinates activity from seven NIHR BRCs, as well as the BHF supported Rare Arrhythmia Syndrome Evaluation (RASE) consortium.
Almost half of all UK adults regularly take prescription medicines and the NHS’s annual budget for medicines is approximately £17.4 billion per year, with over 1.1 billion items prescribed annually. One approach to addressing adverse or ineffective medication reactions is to leverage knowledge of an individual’s genetic information to support medicines optimisation, better informing medicine selection and dosing, a concept known as pharmacogenetics.
This NHS Genomic Network of Excellence will develop the rollout of pharmacogenomics and medicines optimisation in the NHS, including furthering the rollout in primary care.
This NHS Genomic Network of Excellence aligns with the Manchester NIHR BRC, Health innovation networks , industry partners and a Horizon 2020 Grant.
The convergence of AI and genomics across research and healthcare delivery settings offers opportunities to accelerate diagnoses, improve the precision of diagnoses and resultant personalisation of care, release skilled staff of which there is a national shortage, and potentially offer cost efficiencies in the delivery of testing and care.
The NHS Genomic Network of Excellence will build a national community in genomics and AI, create frameworks to support AI deployment for the benefit of NHS patients, including improved and accelerated diagnosis and personalised medicine.
This NHS Genomic Network of Excellence aligns with the Southampton NIHR BRC, the AI Centre for Value Based Healthcare, and the Centre for Innovation, Transformation and Improvement.