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<p>In July 2015, NHS England published a new Clinical Commissioning Policy: Genetic
Testing for BRCA1 and BRCA2 Mutations. In accordance with the criteria set out in
that document, NHS England will commission genetic testing for (breast cancer genes
1 and 2) <em>BRCA1 </em>and <em>BRCA2 </em>in those that have a pre-test <em>BRCA1
</em>and <em>BRCA2 </em>carrier probability risk of 10% or more as recommended in
NICE clinical guideline (CG)164. The document is available at:</p><br /><p><a href="http://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2015/10/e01pb-brca-ovarian-cancer-oct15.pdf"
target="_blank">www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2015/10/e01pb-brca-ovarian-cancer-oct15.pdf</a></p><br
/><p>The independent Cancer Taskforce recognised the need for more accessible molecular
diagnostic provision in its report,<em> Achieving World-Class Cancer Outcomes, </em>published
in July 2015. NHS England is currently working with partners across the healthcare
system to determine how best to take forward the Taskforce’s recommendations. A cross-system
Cancer Transformation Board is being established to oversee implementation of the
Taskforce recommendations, alongside an independent Advisory Group, chaired by Dr
Harpal Kumar, Chief Executive of Cancer Research UK.</p><br /> <br /><p>Regional Genetic
Laboratories are central to all NHS Genomic Medicine Centres (GMCs) and have been
the focal point for adoption of genomic technologies into healthcare for over 40 years.
These laboratories are currently the focus of an NHS England Specialised Commissioning
intended procurement exercise. The procurement aims to create a new genomic laboratory
infrastructure for the National Health Service in England based on centralised and
local genomic laboratory hubs to support rare, inherited and acquired disease as well
as the future personalised medicine requirements inclusive of molecular diagnostics
in stratified medicine.</p><br /><p>In addition, in September 2015, the NHS England
Board approved the development of a Personalised Medicine Strategy for the NHS by
March 2016. The Strategy will build on the 100,000 Genomes Project, in which the NHS
is a key delivery partner.The Project will sequence whole genomes from eligible patients
with rare diseases and cancers.It is moving the NHS to a new model of diagnosis and
treatment based on understanding of underlying genetic causes and drivers of disease
and a comprehensive phenotypic characterisation of the disease (rather than deduction
from symptoms and individual diagnostic tests).</p><br /><p>The high-level vision
and strategy is to create a Personalised Medicine service embracing four overarching
principles: the prediction and prevention of disease; more precise diagnoses; targeted
and personalised interventions; and a more participatory role for patients. Personalised
medicine informs the selection of the most appropriate treatment and better outcomes
for individual patients – the right drug at the right time, earlier screening and
treatment, smarter monitoring and the adjustment of treatments.</p>
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