Commissioning of genomic services in Wales

Organisation/institution: CHEME, Bangor University.

What was the question that HCEC could help with?

Genomics is an area of expansion within NHS Wales. However, we must ensure that resources are used effectively, such that commissioned genomic services are considered in the context of competing priorities. The Welsh Health Specialised Services Committee (WHSCC) required a commissioning model to evaluate genetic tests to replace the historic UK Genetic Testing Network (UKGTN) dossier, and supplement the current NHS Test Directory policy especially for testing, horizon scanning, or research tests that sit outside this policy.

What did we do?

 WHSSC and the All Wales Medical Genomics Service (AWMGS) commissioned CHEME to develop an evidence-based prioritisation framework for genomic technologies and services. This included reviewing the literature to place research into context, and to understand what approaches to commissioning had been reported previously, a review of the WHSSC prioritisation framework and benchmarking the criteria used by WHSSC against criteria utilised to guide commissioning and development of the new framework. Following consultation with stakeholders, the framework was applied to three case studies of different types of genomic tests and contexts for patient management.

What is the expected impact?

The framework developed in this project is expected to impact on patient access to genomic services in Wales. Our work links to Welsh Government policy. The Genomics Delivery Plan for Wales details how advances in the understanding and application of genomics will transform public health strategy and delivery of care in Wales. This is achieved through an appropriate commissioning policy and equitable, evidence-based, high-quality and sustainable genomics services that provide benefits for the people of Wales and value for money to commissioners and the public. This project supports the mechanism by which this can be achieved.