TABLE 2.

Genomic competencies for nurses and midwives essential for GMS delivery in the NHS. These key competencies were identified based on the existing literature (Jenkins et al., 2001; Calzone et al., 2002; Kirk et al., 2003; Lewis et al., 2006; Skirton et al., 2010; Kirk, 2013; Boucher et al., 2014; Camak, 2016; Ha et al., 2018), from qualitative interviews conducted with three Lead Cancer Nurses in the West of England Genomic Medicine Centre delivering the 100,000 Genomes Project for the South West, and with the involvement of key stakeholders (HEE, Macmillan Cancer Support, British Heart Foundation, Genomics England, and Higher Education). The wording of the competencies was intentionally very simple enabling higher education providers to adopt it at various levels (particularly at levels 6 and 7) meeting the Higher Education Qualification descriptors (QAA, 2022).

Competencies
1. Understanding of the basic scientific concepts of inheritance, genetics, and genomics
2. Understanding of the difference between the germline and somatic genome and clinical implications associated with germline or somatic genetic variants
3. Understand what local genetic testing services are available and how to refer patients
4. Ability to carry out appropriate risk assessments to identify patients that might be at a higher risk of inherited conditions
5. Understand the wider roles and services offered by local clinical genetics teams
6. Conduct a comprehensive family history exercise to understand potential high-risk patients for inherited conditions
7. Understand the national genetic test directory and its potential relevance for your patients and practice
8. Understand the targeted therapies available for patients
9. Understand the broad mechanism of action of targeted therapies
10. Understand how genomic data can be used in the context of prevention and earlier diagnosis
11. Understand how genomic data can be used in the context of patient prognosis
12. Understanding how genomic data is analysed and the potential implications of the analysis process on the outcome on patient management
13. Understand the wider legal, social, and ethical considerations of genetic testing for patients