HS England is responsible for commissioning the NHS Genomic Medicine Service (GMS). Genomic testing in the National Health Service in England is provided through the NHS GMS and the genomic testing nationally commissioned and funded by NHS England for patients in England is set out in the National Genomic Test Directory.

NHS England captures Patient Level Contract Monitoring (PLCM) data across the NHS GMS to facilitate a national approach to reporting and validating activity data and turnaround times for the genomics element of the pathway. NHS England holds quarterly assurance meetings with the NHS GMS to oversee delivery and publishes PLCM data on a quarterly basis on the NHS England website, at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/genomic-testing-activity/

NHS England continues to develop this dataset, and in the future will develop the collecting and reporting of outcome data.

The Department estimates that there are approximately 1,500 men currently known to have both a BRCA2 gene variant and a family history of breast, pancreatic, ovarian, or prostate cancer who will be eligible for the targeted prostate cancer screening programme. The Department has not estimated the costs of identifying additional BRCA2 variant carriers, as the UK National Screening Committee, which advises the Government on all screening related matters, did not recommend proactively identifying BRCA2 carriers.

The Government is committed to ensuring that all patients across the UK have access to cutting-edge clinical trials and innovative, lifesaving treatments, and we are working with the devolved administrations, delivery partners across the health system, and key stakeholders from across the clinical research sector – all under the umbrella of the UK Clinical Research Delivery Programme (UKCRD) – to increase commercial research participation, and make the UK a world leader in clinical trials.

To increase participation by patients across all four nations, we are establishing 21 new Commercial Research Delivery Centres (CRDCs) across the UK, alongside a UK-wide CRDC Network, which will coordinate activity, provide strategic leadership, and support consistency across the centres. The CRDC Network complements established UK-wide infrastructure, including the Experimental Cancer Medicine Centres Network and the UK Clinical Research Facility Network, which support research delivery, strengthen capability, and enable patients across England, Scotland, Wales, and Northern Ireland to access innovative clinical trials.

The Hon Member may also be aware that the National Institute for Health and Care Research provides a UK-wide online service called Be Part of Research, which promotes participation in health and social care research by allowing users to search for relevant studies and register their interest. This makes it easier for people across the UK to find and take part in commercial clinical trials and other health and care research.

In addition to the activity set out above, the Government is taking specific action through the UK Rare Diseases Framework to improve the lives of people living with rare diseases, and last year extended the framework to continue until 2027. The framework sets out four shared priorities for addressing rare diseases across England, Scotland, Wales and Northern Ireland: improving speed of diagnosis; raising awareness of rare conditions with healthcare professionals; coordinating care; and providing access to specialist care and treatments.

Genomic testing and analysis of genomic data is at the heart of the UK Rare Diseases Framework, and the agencies contributing to that activity are taking constant steps to increase interoperability between rare disease registries, genomic data systems, and clinical records held across the four nations, to assist in research, testing and analysis.

The UK National Screening recommendation was for a targeted screening programme, involving prostate-specific antigen testing every two years, for men aged 45 to 61 years old who have a pathogenic, or able to cause disease, BRCA2 variant with a family history of breast, ovarian, pancreatic, or prostate cancer.

It is estimated that approximately 1,500 men in England will be eligible for the targeted prostate cancer screening programme. Based on similar programmes for people with genetic risk factors, uptake is expected to be high.

The intention is to use the National Inherited Cancer Predisposition Register (NICPR), to identify men with a known BRCA2 gene variant. Individuals are added to the NICPR as their gene variants are identified, and this is usually through cascade screening or as the result of having cancer and their tumour being genotyped. No estimate has been made of the additional numbers that may be identified using this method.

The Department is not undertaking analysis of the costs associated with identifying additional BRCA variant carriers. The committee did not recommend proactively identifying more men with a BRCA variant, as this would constitute a separate screening programme. The committee recommended that the best method of identifying men with a BRCA2 gene variant should be evaluated over time.

The UK National Screening recommendation was for a targeted screening programme, involving prostate-specific antigen testing every two years, for men aged 45 to 61 years old who have a pathogenic, or able to cause disease, BRCA2 variant with a family history of breast, ovarian, pancreatic, or prostate cancer.

It is estimated that approximately 1,500 men in England will be eligible for the targeted prostate cancer screening programme. Based on similar programmes for people with genetic risk factors, uptake is expected to be high.

The intention is to use the National Inherited Cancer Predisposition Register (NICPR), to identify men with a known BRCA2 gene variant. Individuals are added to the NICPR as their gene variants are identified, and this is usually through cascade screening or as the result of having cancer and their tumour being genotyped. No estimate has been made of the additional numbers that may be identified using this method.

The Department is not undertaking analysis of the costs associated with identifying additional BRCA variant carriers. The committee did not recommend proactively identifying more men with a BRCA variant, as this would constitute a separate screening programme. The committee recommended that the best method of identifying men with a BRCA2 gene variant should be evaluated over time.

Genomic testing in the National Health Service in England is provided through the NHS Genomic Medicine Service and delivered by a national genomic testing network of seven NHS Genomic Laboratory Hubs (GLHs). The NHS GLHs deliver testing as directed by the National Genomic Test Directory, which includes tests for over 7,000 rare diseases with an associated genetic cause and over 200 cancer clinical indications, including testing for genetic predisposition conditions. Further information on the National Genomic Test Directory is available at the following link:

https://www.england.nhs.uk/publication/national-genomic-test-directories/

Genomic testing is available for all eligible patients across the whole of England. Individuals should discuss with their healthcare professional whether genomic testing is appropriate for them. Their healthcare professional will then make a decision whether to refer the individual either directly or via an NHS Clinical Genomics Service or other relevant clinical speciality for genomic testing following clinical review of their and their family’s medical history if known, and the relevant genomic testing eligibility criteria.

Testing for inherited breast and ovarian cancer, where there is a living unaffected individual, is covered in the National Genomic Test Directory under clinical indication R208.

The current eligibility criteria include unaffected individuals who have a first-degree relative with breast cancer or high-grade serous ovarian cancer, where the individual or affected relative meets the relevant risk threshold. Testing is available where no living affected relative is available for genetic testing and no tumour material is available from a deceased affected relative.

The NHS England Genomics Programme and Cancer Programme has also, in recent years, supported the NHS Jewish BRCA Testing Programme, a three-year pilot programme to offer testing to individuals living in England, aged 18 years old or over with at least one Jewish grandparent, regardless of faith, religious practice, or any other criteria.

Genomic testing in the National Health Service in England is provided through the NHS Genomic Medicine Service and delivered by a national genomic testing network of seven NHS Genomic Laboratory Hubs (GLHs). The NHS GLHs deliver testing as directed by the National Genomic Test Directory, which includes tests for over 7,000 rare diseases with an associated genetic cause and over 200 cancer clinical indications, including testing for genetic predisposition conditions. Further information on the National Genomic Test Directory is available at the following link:

https://www.england.nhs.uk/publication/national-genomic-test-directories/

Genomic testing is available for all eligible patients across the whole of England. Individuals should discuss with their healthcare professional whether genomic testing is appropriate for them. Their healthcare professional will then make a decision whether to refer the individual either directly or via an NHS Clinical Genomics Service or other relevant clinical speciality for genomic testing following clinical review of their and their family’s medical history if known, and the relevant genomic testing eligibility criteria.

Testing for inherited breast and ovarian cancer, where there is a living unaffected individual, is covered in the National Genomic Test Directory under clinical indication R208.

The current eligibility criteria include unaffected individuals who have a first-degree relative with breast cancer or high-grade serous ovarian cancer, where the individual or affected relative meets the relevant risk threshold. Testing is available where no living affected relative is available for genetic testing and no tumour material is available from a deceased affected relative.

The NHS England Genomics Programme and Cancer Programme has also, in recent years, supported the NHS Jewish BRCA Testing Programme, a three-year pilot programme to offer testing to individuals living in England, aged 18 years old or over with at least one Jewish grandparent, regardless of faith, religious practice, or any other criteria.

Genomic testing in the National Health Service in England is provided through the NHS Genomic Medicine Service and delivered by a national genomic testing network of seven NHS Genomic Laboratory Hubs (GLHs). The NHS GLHs deliver testing as directed by the National Genomic Test Directory, which includes tests for over 7,000 rare diseases with an associated genetic cause and over 200 cancer clinical indications, including testing for genetic predisposition conditions. Further information on the National Genomic Test Directory is available at the following link:

https://www.england.nhs.uk/publication/national-genomic-test-directories/

Genomic testing is available for all eligible patients across the whole of England. Individuals should discuss with their healthcare professional whether genomic testing is appropriate for them. Their healthcare professional will then make a decision whether to refer the individual either directly or via an NHS Clinical Genomics Service or other relevant clinical speciality for genomic testing following clinical review of their and their family’s medical history if known, and the relevant genomic testing eligibility criteria.

Testing for inherited breast and ovarian cancer, where there is a living unaffected individual, is covered in the National Genomic Test Directory under clinical indication R208.

The current eligibility criteria include unaffected individuals who have a first-degree relative with breast cancer or high-grade serous ovarian cancer, where the individual or affected relative meets the relevant risk threshold. Testing is available where no living affected relative is available for genetic testing and no tumour material is available from a deceased affected relative.

The NHS England Genomics Programme and Cancer Programme has also, in recent years, supported the NHS Jewish BRCA Testing Programme, a three-year pilot programme to offer testing to individuals living in England, aged 18 years old or over with at least one Jewish grandparent, regardless of faith, religious practice, or any other criteria.

The National Cancer Plan commitment for all cancer patients who would benefit from a genomic test to receive one to inform treatment decisions applies specifically to genomic testing. While the Plan supports the wider use of biomarker testing, including non-genomic tests, these are being expanded and integrated across cancer pathways rather than subject to a similar universal guarantee.

The Plan commits to the wider integration of biomarker testing across cancer services to improve treatment selection and outcomes. Non-genomic biomarker tests form part of wider diagnostic pathways, alongside histopathology, imaging such as magnetic resonance imaging and computed tomography scans, and other laboratory investigations, all of which contribute to multidisciplinary team decisions on the most appropriate treatment.

Through the National Cancer Plan, more equitable access to precision cancer treatments will be supported by reducing unwarranted variation, reviewing the scope of testing, and bringing additional biomarker tests, both genomic and non-genomic, into routine use where clinically appropriate. This will be supported by national guidance and commissioning processes to ensure consistent access across the National Health Service.

The National Cancer Plan commitment for all cancer patients who would benefit from a genomic test to receive one to inform treatment decisions applies specifically to genomic testing. While the Plan supports the wider use of biomarker testing, including non-genomic tests, these are being expanded and integrated across cancer pathways rather than subject to a similar universal guarantee.

The Plan commits to the wider integration of biomarker testing across cancer services to improve treatment selection and outcomes. Non-genomic biomarker tests form part of wider diagnostic pathways, alongside histopathology, imaging such as magnetic resonance imaging and computed tomography scans, and other laboratory investigations, all of which contribute to multidisciplinary team decisions on the most appropriate treatment.

Through the National Cancer Plan, more equitable access to precision cancer treatments will be supported by reducing unwarranted variation, reviewing the scope of testing, and bringing additional biomarker tests, both genomic and non-genomic, into routine use where clinically appropriate. This will be supported by national guidance and commissioning processes to ensure consistent access across the National Health Service.

The current eligibility criteria for genetic testing are set out in the NHS National Genomic Test Directory. The aim is to offer individuals at higher risk of developing cancer (those with pathogenic variants in their genes) clinical pathways to support them to manage their risk, offer their family members testing and ultimately lead to more cancers being prevented or detected earlier. The directory is available at the following link:

https://www.england.nhs.uk/publication/national-genomic-test-directories/

NHS England is currently funding the Retrospective Genetic Testing Programme to offer genetic testing to people who have not yet received a test, in line with the current eligibility criteria set out in the directory. More information is available at the following link:

https://brca-direct.icr.ac.uk/privacy_policy

All individuals who test positive will be added to the National Inherited Cancer Predisposition Register. More information is available at the following link:

https://digital.nhs.uk/ndrs/our-work/genomics/nicpr

Following this, individuals will be invited for screening in line with guidance available at the following link:

https://www.gov.uk/government/publications/breast-screening-higher-risk-women-surveillance-protocols/protocols-for-surveillance-of-women-at-higher-risk-of-developing-breast-cancer

The UK National Screening Committee has not been asked to consider whether a screening programme for BRCA1 would be appropriate for women with a family history of breast or ovarian cancer, and no cost effectiveness estimates have been made of such a policy.

The current eligibility criteria for genetic testing are set out in the NHS National Genomic Test Directory. The aim is to offer individuals at higher risk of developing cancer (those with pathogenic variants in their genes) clinical pathways to support them to manage their risk, offer their family members testing and ultimately lead to more cancers being prevented or detected earlier. The directory is available at the following link:

https://www.england.nhs.uk/publication/national-genomic-test-directories/

NHS England is currently funding the Retrospective Genetic Testing Programme to offer genetic testing to people who have not yet received a test, in line with the current eligibility criteria set out in the directory. More information is available at the following link:

https://brca-direct.icr.ac.uk/privacy_policy

All individuals who test positive will be added to the National Inherited Cancer Predisposition Register. More information is available at the following link:

https://digital.nhs.uk/ndrs/our-work/genomics/nicpr

Following this, individuals will be invited for screening in line with guidance available at the following link:

https://www.gov.uk/government/publications/breast-screening-higher-risk-women-surveillance-protocols/protocols-for-surveillance-of-women-at-higher-risk-of-developing-breast-cancer

The UK National Screening Committee has not been asked to consider whether a screening programme for BRCA1 would be appropriate for women with a family history of breast or ovarian cancer, and no cost effectiveness estimates have been made of such a policy.

The current eligibility criteria for genetic testing are set out in the NHS National Genomic Test Directory. The aim is to offer individuals at higher risk of developing cancer (those with pathogenic variants in their genes) clinical pathways to support them to manage their risk, offer their family members testing and ultimately lead to more cancers being prevented or detected earlier. The directory is available at the following link:

https://www.england.nhs.uk/publication/national-genomic-test-directories/

NHS England is currently funding the Retrospective Genetic Testing Programme to offer genetic testing to people who have not yet received a test, in line with the current eligibility criteria set out in the directory. More information is available at the following link:

https://brca-direct.icr.ac.uk/privacy_policy

All individuals who test positive will be added to the National Inherited Cancer Predisposition Register. More information is available at the following link:

https://digital.nhs.uk/ndrs/our-work/genomics/nicpr

Following this, individuals will be invited for screening in line with guidance available at the following link:

https://www.gov.uk/government/publications/breast-screening-higher-risk-women-surveillance-protocols/protocols-for-surveillance-of-women-at-higher-risk-of-developing-breast-cancer

The UK National Screening Committee has not been asked to consider whether a screening programme for BRCA1 would be appropriate for women with a family history of breast or ovarian cancer, and no cost effectiveness estimates have been made of such a policy.

The Department recognises the vital role that histopathology services play in supporting timely diagnosis and access to advanced pathology testing, including molecular profiling where clinically appropriate. These services underpin cancer pathways and enable more personalised treatments, while also supporting the diagnosis, monitoring, and treatment of a wide range of non-cancer conditions.

To support the expansion of high-quality histopathology capacity, we will deliver significant investment in laboratory modernisation, including a £96 million investment to automate histopathology. This investment will aim to speed up the processing and reporting of tissue samples and enable the National Health Service to meet the 98% standard for results to be reported in 10 days by March 2029. Delivering these improvements will enable the Department to meet our commitment of providing comprehensive molecular profiling of all cancers, which will help to inform risk stratification and support the use of more precise, targeted medicines earlier in the treatment pathway.

The Government recognises the importance of ensuring that children, including those with complex visual needs such as albinism, can access appropriate optical care and appliances.

National Health Service optical vouchers are designed to support eligible groups, including children, with the cost of clinically necessary glasses or contact lenses. Voucher values range from £42.40 to £233.56, with individuals with more complex prescriptions receiving the high voucher values. There are no plans for a review of NHS optical vouchers.

Children and young people with significant or complex vision impairment may also be supported through NHS low vision services. These services provide specialist assessment and, where appropriate, low vision aids to help maximise functional vision and independence.