Genetic screening by nurses reduces specialist referrals

Using nurses to pre-screen people for genetic risk of cancer, cardiac or endocrine disease before they're sent to specialist services can reduce referrals by up to 75 percent, a preliminary trial has found.

Dr Paul Brennan, clinical director of the Northern Genetics Service, is testing pre-genetic triage where trained nurses ensure only patients with a moderate-to-high risk of disease are sent for genetic screening and counselling.

The number of referrals to NHS genetic services is growing at 10 percent per year due to increased public awareness of the genetic influence on inherited or chronic disease. But many people referred show little or no genetic risk of disease.

'We've shown it works. We can train nurses to take family histories and undertake genetic testing - it doesn't need to be done by specialist genetics services and can be integrated into mainstream healthcare', said Dr Brennan, who is based at the Newcastle upon Tyne Hospitals NHS Foundation Trust.

Trials of pre-genetic triage using trained cardiac nurses from the North of England cardiac family history service at the Sunderland Royal Hospital reduced the number of patients referred to the Northern Genetics Service by 30 percent since 2009, says Dr Brennan.

Similar trials, using two cancer nurses at the Macmillan Cancer family history service at Middlesbrough's James Cook University Hospital decreased referrals to genetic services by 75 percent since 2004.

An endocrine nurse at Newcastle's Royal Victoria Infirmary began to trial pre-genetic triage in 2011. The hope is to reduce referrals by 70 — 80 percent by providing genetic testing and taking a family history of endocrine disease.