UK
Clinical Pharmacy
Association
UK
Clinical Pharmacy
Association
Its first strategic roadmap, Accelerating Genomic Medicine in the NHS, outlined a five-year ambition to make genomics part of everyday healthcare. The framework focused on four areas: a modernised service model; fair access to testing across cancer, rare, inherited and common conditions; harnessing genomics within digital and data-driven systems; and, promoting continuous improvement through research and innovation.
These goals now underpin the government’s new Fit for the Future: 10 Year Health Plan for England (2025), which positions the NHS as a leader in genomic-driven healthcare and introduces a population-based genomic service designed to support prediction and prevention.
According to the 2025 plan, genomics and predictive analytics constitute one of five major “big bets” for transforming healthcare delivery. Central components include:
By 2035, policymakers anticipate that genomics will play a role in up to 50% of all patient interactions. Achieving this will require significant scale-up of the GMS and faster, more efficient testing processes. With this in mind, the following key focus areas for genomics application have been earmarked.
A major driver of this future landscape is the Generation Study, run jointly by Genomics England and the NHS. This research programme will sequence the genomes of 100,000 newborn babies to screen for over 200 rare but treatable genetic conditions, with the aim of enabling diagnosis and access to treatment far earlier than current pathways allow. If the study demonstrates tangible benefit, genomic testing could become a standard part of newborn screening, with appropriate consent.
The 10 Year Health plan sets out a vision for widespread genomic testing beyond cancer and rare disease, as part of the genomics population health service. Polygenic risk scores (PRS) and the combination of PRS with other clinical factors as an ‘integrated risk score’, are proposed to identify patients at risk of common diseases. Risk scores are expected to be embedded into digital care pathways to support earlier identification of at-risk individuals, targeted screening and personalised prescribing.
Whole genome sequencing, traditionally applied to rare and inherited conditions, will be expanded for risk prediction in cardiovascular disease, kidney disease and diabetes. The Adult Population Genomics Programme, led by Genomics England, will sequence the genomes of 150,000 adults to evaluate how whole genome sequencing can routinely support preventive healthcare. This includes assessing both common and rare disease risk, and integrating pre-emptive pharmacogenomic testing.
A major headline of the 10-year strategy is the commitment to “universal” cancer genomics. Every cancer patient will be offered comprehensive genomic testing and tumour profiling to enable precision therapy selection. Liquid biopsy—testing circulating tumour DNA (ctDNA) from blood samples—will become a standard tool both for early detection and treatment monitoring.
Liquid biopsy tests (ctDNA) for non-small cell lung cancer and certain breast cancer indications are already included in the National Genomic Test Directory, forming part of the national rollout of this technology.
Pharmacogenomics is highlighted as a central pillar of personalised medicine in the 10-year plan. Routine use of pharmacogenomic information is expected to become part of NHS medicines optimisation strategies. The plan outlines intentions to record pre-emptive pharmacogenomic results within the Single Patient Record and to incorporate testing into the NHS Health Check for people over 40. Mental health prescribing is identified as an early priority area.
Three major themes underpin the 10-year plan: moving from analogue to digital practice; from treatment to prevention; and from hospital-centred to community-based models of care. Population-level genomics exemplifies all three shifts.
Neighbourhood Health Services will become key delivery units. A single neighbourhood provider will typically serve around 50,000 residents, while larger multi-neighbourhood organisations may cover over 250,000 people and deliver a broader suite of services, including end-of-life care. “Genomics champions” will support workforce development within these teams, helping staff confidence and capability to grow in line with increased demand for genomic testing and interpretation.
The vision for 2035 is a fully integrated system in which genomic information, technology and digital tools sit within a unified patient record, enabling tailored predictions, prevention and personalised interventions.
Although not emphasised in the core 10-year plan, genomics has significant potential to bolster antimicrobial resistance monitoring and infectious disease control. Genomic approaches to pathogen detection and respiratory infection surveillance could provide an early warning network across up to 30 NHS sites. These capabilities would support quicker diagnoses, more precise antimicrobial use, and strengthen pandemic preparedness through metagenomic surveillance.
The NHS 10-Year Health Plan marks a significant turning point in embedding genomics within mainstream healthcare. By expanding testing, integrating genomics across prevention and treatment pathways, and building workforce capability, the plan aims to deliver personalised care at scale. In doing so, it seeks to improve patient safety, enhance medicines optimisation and generate measurable population-wide health benefits.
The authors have also published an article in the Pharmaceutical Journal.
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