GP genetic counselling benefit
Basing specialist genetic counselling services in general practice could improve the management and referral of patients at moderate or high genetic risk of developing cancer.
Researchers from the University of Southampton found that educating GPs about genetic testing helped them to make more appropriate cancer referrals, while the large majority of referrals could be managed effectively without patients needing to attend a hospital-based genetic counselling clinic.
Dr Greta Westwood and colleagues evaluated the impact of genetic counsellor-led education on cancer and non-cancer referral rates. They randomised 73 general practices to receive a case scenario practice-based seminar (education) or no intervention (control), and patients at these practices to have a genetic counsellor-led appointment in primary or in secondary care.
Writing in the British Journal of General Practice, the team reports that significantly more of the GPs' cancer referrals were appropriate in the educated than in the control group, at 23 (79%) compared with 10 (67%), translating into a 2.3-fold relative increase.
Overall, patients spent 49% less money on travelling to a primary than a secondary care clinic and travelled 33% less distance. Moreover, 60% of all GP referrals and 80% of cancer referrals were managed by genetic counsellor-led primary care clinics without the need for a hospital appointment, with 83% meeting the 18-week target referral-to-treatment time.
RCGP Chair Dr Clare Gerada commented: "This study is really revealing because it demonstrates that with training and access to community services, GPs can improve the experience of patients with a greater genetic risk of developing cancer, making the best possible use of the NHS's excellent specialist genetics services."
GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012
By Caroline Price