Clinical Genetics Workforce Welcomes Establishment of National Service

Clinical Geneticist, Professor Stephen Robertson says the decision to make clinical genetics a national service has been welcomed by those who work in the specialty.

"The clinical workforce are at one on this, there's no doubt about it. There will be challenges about the detail, but in terms of assuring quality and equity of access to clinical genetic services, this is the solution."

Clinical genetics is one of five vulnerable services chosen to become national services in the next financial year. The others are: Paediatric Pathology, Paediatric Metabolic Services, Paediatric Cardiology and Paediatric Cardiac Surgery.

These services will be planned and funded centrally by the National Health Board (NHB) instead of by individual District Health Boards (DHBs).

Professor Robertson is a clinical geneticist with the Central and Southern Regional Genetics Service and consults on genetic disease in Christchurch, Dunedin and Invercargill.

He says clinical genetics has a small, widely geographically dispersed workforce with a very defined expertise, and national coordination is very important.

"We're still going to be widely dispersed, but if we have a defined and formalised set of objectives, protocols and key performance indicators, and we're measuring our activity in the same way and undertaking it in a coordinated fashion, then the harmonisation, equity and quality issues that are so important can be met with a greater degree of confidence. I hope that we'll be as cohesive as we would be if we were under one, central bricks and mortar roof."

Professor Robertson says the role of geneticist associates (known overseas as genetic counsellors) will especially benefit from having a national service.

"These highly specialised members of the clinical genetics workforce are specialists in communicating complex medical genetic concepts to patients and families. They are very much at the coalface in terms of rolling out clinical answers to people's questions, especially in assessing people for genetic predisposition to cancers, which is where the vast bulk of our work lies.

"There aren't many of us nationwide, and we are geographically dispersed as well. Through this service our ability to harmonise our operations at a national level is also going to be greatly improved."

He says one of the greatest challenges will be information technology (IT) solutions that can cross DHB boundaries, because of the way various IT mechanisms have evolved and to a degree diverged over the past 15 years.

"We're going to be very reliant on telecommunications, and the National Health IT Plan is absolutely critical to being able to deliver a truly integrated and seamless national service."

The NHB is working closely with clinicians and service managers in each of the five services to progress implementation. National Services will be established by July 2011.