The NHS North West Genomic Medicine Service Alliance (NW GMSA) and NHS North West Genomic Laboratory Hub (NW GLH) are working together to make genomic medicine part of everyday healthcare for everyone across our region.
Our aim is simple: to ensure that every person in the North West, regardless of their background or where they live, can benefit equally from advances in genomics.
Our vision
To deliver a leading genomic diagnostic and clinical service for the entire North West population – one that is representative, accessible, and focused on achieving the best health outcomes for all.
Our mission
We are committed to removing barriers to access and ensuring that genomic services reflect the diversity of the communities we serve. Through collaboration, education, digital innovation, and community partnership, we aim to make genomics an equitable and routine part of NHS care.
Why this matters
Genomic medicine can transform healthcare – helping clinicians to prevent disease, diagnose conditions earlier, and tailor treatments to individual patients. But for this potential to be realised, genomic services must reach everyone. Evidence shows that people living in deprived or remote areas, or from under-represented ethnic groups, have less access to testing and are less represented in genomic datasets. This limits our ability to deliver fair and effective care.
The NW GMSA Equity and Mainstreaming programmes directly address these challenges, guided by principles from the Marmot Review and the Core20PLUS5 approach to tackling health inequalities.
Our approach
Representation: We are improving the diversity of genomic datasets so that they truly reflect our region’s population. This means partnering with communities, increasing participation in research, and ensuring all voices are heard.
Equitable access: By embedding genomic testing in local hospitals, GP practices, and community pathways, we are bringing genomics closer to home – reducing waiting times and improving access for underserved groups.
Improved outcomes: Genomic results must lead to better care. We are working with clinicians and integrated care systems to ensure patients can access timely treatment, including NICE-recommended therapeutics.
Education and workforce development: We are upskilling healthcare professionals across disciplines so that genomics becomes part of routine decision-making, not a specialist exception.
Digital integration: Through enhanced data and digital systems, we are ensuring that genomic results are seamlessly accessible within NHS workflows.
Working together
Delivering equity in genomic medicine is a shared responsibility. By working with patients, community groups, Integrated Care Boards, cancer alliances, and research partners, we are building a fairer, more inclusive genomic service that serves every community across the North West.
Together, we are mainstreaming genomics – and making equity a reality.
Patients across the North West of England are benefiting from faster access to genetic testing as genomic medicine becomes embedded within routine cancer care.
In the past, patients who required genetic testing were often referred to specialist genetics centres, sometimes involving additional appointments at different hospitals. Today, many oncology teams can initiate genomic testing directly within their own services — bringing genetics closer to patients and helping clinicians make more informed treatment decisions earlier.
At East Lancashire Hospitals NHS Trust, Family History and Genomic Mainstreaming Practitioners Charlotte Knowles and Mandy Darbyshire are seeing first-hand how this shift is changing clinical practice.
Faster access and fewer hospital visits
Mainstreaming genomics means genetic testing is now integrated into cancer care pathways rather than sitting outside them.
Charlotte Knowles explains that this change has made a noticeable difference to routine care.
“Mainstreaming has made a big difference. A lot more patients are coming through who are aware of genetics, particularly in breast cancer. Instead of referring them elsewhere, we can often organise testing within their local hospital trust.”
For patients, this means fewer separate appointments and faster access to important information that could influence treatment decisions.
Genetics discussed earlier in care
Genomics is also becoming a standard part of multidisciplinary team (MDT) discussions — where clinicians from different specialties review patient cases and plan treatment.
Rather than considering genetics later in the patient journey, teams are now discussing it much earlier.
Mandy Darbyshire says: “It’s now part of our MDT discussions. We consider whether a patient meets the criteria for genetic testing based on their cancer diagnosis and family history. It’s no longer an afterthought.”
By identifying eligible patients earlier, clinicians can ensure genetic testing is initiated promptly and integrated into treatment planning.
Supporting personalised treatment
Early genetic testing can also help clinicians plan more personalised treatments.
Having genomic information available from the start of a patient’s cancer journey means clinicians may already know which therapies could be effective if the disease progresses.
“We’re doing testing at the beginning so that we have that information early,” Mandy explains. “If a patient progresses, we already know what personalised therapies might be appropriate.”
For example, some targeted treatments — such as PARP inhibitors — may be considered when certain genetic mutations are identified.
Building genomic awareness among clinicians
Embedding genomic expertise within hospital teams is also increasing awareness of genetics among clinicians who may not specialise in the field.
Charlotte says the presence of dedicated genomic practitioners helps ensure genetics remains part of everyday conversations. “Because we’re there, genetics doesn’t get forgotten. It’s not just something people hear about in a one-off lecture — it becomes part of routine care.”
As a result, clinicians are increasingly confident about identifying when genetics may be relevant and seeking specialist advice when needed.
More conversations about family history
Another change is the growing number of discussions clinicians have with patients about their family history.
Assessing family history remains an important part of identifying people who may benefit from genetic testing.
“We’re having more family history conversations to see whether patients meet different criteria for genetic testing,” Mandy says.
Even when patients do not meet testing criteria, these discussions help ensure genetic risk factors are considered consistently across care pathways.
Transforming cancer care
The experiences of Charlotte and Mandy highlight how genomic mainstreaming is reshaping cancer services across the region.
By embedding genomic expertise within oncology teams, healthcare services are:
- speeding up access to genetic testing
- integrating genomic information earlier into treatment planning
- increasing awareness of genetics among clinicians
- supporting more personalised cancer care
As genomic medicine continues to evolve, integrating these approaches into everyday clinical practice will be key to delivering the next generation of precision oncology.
March 2026