Table 1.

The clinical genetics team’s perceptions of TFGT

Role responsibility: Facilitating individual and familial decision-making

In genetics we’re like acutely aware of families and, other people who are at risk, the implications of your test for your family CG5

…if testing is done through, say for the breast patients through the breast unit by the breast clinicians, the genetics services then only have to engage with those with an underlying genetic condition, so perhaps genetics services could be more focused on the patients that need that service. CG3

Redesigning the care pathway: Providing the best service

As professionals we have to look at the best service for the patients, whether it’s having genetic discussion and testing at the point of diagnosis or whether they are referred on to our service, that’s obviously the most important thing. I think as professionals we have the skills to pick up someone coming along with a positive gene test and take them on their journey rather than starting their journey with them pre-test…I think the things to take into consideration are sort of speed, if speed is what people want, and also the practicalities, take into consideration the practicalities of the lady who has maybe a distance to travel from the hospital she’s been diagnosed at, if she then has to return to that hospital two days later for another consultation you could perhaps take that into consideration, the literal practicalities of the genetic testing…. CG2

Patients are getting referred at the point of diagnosis, and it’s meant that we’ve had clinics put aside on a weekly basis that are for patients who’ve just got a diagnosis, …. usually the patient just needs half an hour for that consultation CG1

Relevance for practice: Less relevant for clinical genetics practice

if it’s being done for treatment implications it’s therefore a diagnostic test. And it perhaps shouldn’t be considered any differently from any other diagnostic test that you would do if there are true treatment implications for that person. GC3

I think there’s an assumption that treatment is going to become a bigger and bigger thing, that we’re seeing the start of treatment being influenced by genotype, so in a way it’s partly, it’s a good place to start, isn’t it. I think that women are also, there’s stuff out there sort of suggesting that it might change their treatment, and if you were going through breast cancer you might think, oh actually I need to know that. It’s come out of trying to do genetic counselling in a woman that’s just been diagnosed with breast cancer and how the counselling model doesn’t fit so well with somebody that’s got all that other stuff going on and it actually sits neater in the oncology model. CG4