NHS England to integrate genomic medicine into pharmacy education and training

NHS England has outlined plans to review curriculum requirements and educational resources that will “integrate genomic medicine into pharmacy education and training”.

In its ‘Pharmacy genomics workforce, education and training strategic framework’, published on 18 January 2024, NHS England sets out a three-year plan to equip pharmacists with the skills and confidence to use genomic information as part of routine medicines optimisation.

The framework follows findings from a survey of 615 pharmacy professionals, carried out by The Pharmaceutical Journal in April 2022, which found that 1 in 10 respondents felt prepared to offer more personalised medicine through pharmacogenomic testing.

The framework notes: “The upskilling of the pharmacy workforce in genomics, alongside the multiprofessional team, is crucial for the effective integration of genomic medicine into mainstream NHS healthcare and to the use of precision and targeted medicines including advanced therapeutic medicinal products.”

“Their role in supporting genomics informed medicines optimisation is clear and this strategic framework describes how we are aiming to develop the pharmacy workforce for this role,” it adds.

Informed by the NHS England Pharmacy Workforce Group for Genomics’ stakeholder engagement, the framework sets out four aims: integrating awareness of genomics as part of pharmacy practice, building and joining networks, identifying pharmacy genomics workforce needs, and educating and developing the pharmacy workforce.

To help achieve these aims, the framework says NHS England will “review the current genomic medicine literacy in the pharmacy workforce, at all career stages and in all areas of pharmacy practice” and “identify pharmacy workforce gaps and development needs” to deliver genomic medicine services.

Within the next three years, NHS England plans to start the “review and implementation of curriculum requirements, educational frameworks, key educational resources and credentialing pathways to support the pharmacy workforce in managing genomic pathways of care”.

The Royal Pharmaceutical Society (RPS) previously called for pharmacogenomics to be embedded into lifelong education and training.

Alwyn Fortune, RPS policy and engagement lead, said: “We are delighted to see the publication of the pharmacy genomics workforce, education and training strategic framework. Pharmacists, as the experts in medicines, will play an increasingly pivotal leadership role in supporting genomics informed medicines optimisation for the benefits of patients, and this framework sets out how this will be integrated into their training and development.

“The application of genomics within prescribing practice will be vital, with many pharmacists already prescribers and that number ever increasing, and we look forward to the workforce having the necessary support and protected time to upskill.”

The training plan is in response to the NHS’s wider genomics strategy, published in October 2022, and follows an announcement on 17 January 2024 that pharmacogenomics and medicines optimisation will be one of eight NHS ‘genomic networks of excellence’.

Commenting on the framework, David Wright, a professor of health services research and head of the School of Healthcare at the University of Leicester, said pharmacogenomics is an area in which there is a “real opportunity to improve patient care”.

“There is a lot of myth busting required regarding pharmacogenomics and some important messages that require conveying across the UK,” he said.

“People still see it as futuristic and costly. It is widely available in many countries, relatively inexpensive, and point-of-care tests are emerging. A pharmacist recently told me that there was no evidence to support the use of PGx [pharmacogenomics] in their patients and that we were years away from it being useful. With large numbers of systematic reviews and meta-analyses available showing completely the opposite, it demonstrates the need for education across the pharmacy workforce.”

However, he expressed concern that training would focus on the detail rather than the practicalities, resulting in practitioners understanding the science but not what to safely recommend in response to a test result.

Wright continued that he was pleased to see consultation skills and regulation included within training to help pharmacists ensure patients understand the limits of pharmacogenetics and can reassure them about the use of their DNA.

“Perhaps, most importantly, the databases which underpin guidance following someone’s PGx test are largely based on white European populations and therefore, again, it is important that in providing such results to non-white members of the population, this is taken into consideration and discussed with the patient in an appropriate manner,” he added.