According to the NHS confederation, in March 2017 there are approximately 33000 full-time GPs working for the NHS (3). There are 65.5 million people in the United Kingdom, they all have a right to healthcare from the NHS. Genome sequencing identifies the sequence at every single base pair location therefore rare variants are also included; this technique is very complex and very large datasets are produced which would be very overwhelming for GPs to interpret. Genotyping can only look at known variants, up to 4 million SNPs are covered by most arrays, these data sets are smaller and easier to interpret, especially when considering clinical outcomes. 1§1
23and me is a private company which currently offers genotyping using SNP chips, this…show more content… Increased genomic knowledge for all GPs and improved referral methods will be needed to cope with the number of patients(5). GPs would have to receive additional training to interpret and analyse genome sequencing results. This provides a challenge for existing GPs and may only be possible to implement in new doctors in medical school. Health England have set up a genetics skills and training programme for workers in the NHS, however further progress will need to be made to account for all the data that will be generated (6).
Medical professionals adhere to the Hippocratic oath which promotes doing no harm to patients and acting in the best interests of patients. Mandatory genome sequencing would give rise to ethical dilemmas such as what to do with incidental clinical findings, as disclosing these may generate concern to healthy individuals. If the GP finds a variant with possible life altering consequences for the patient, do they have a right to pass this information on to the patient? These concerns may lead to invasive follow-up tests such as X-rays or computed tomography (CT) scans, which could be as damaging to patient’s health with respect to radioactive dosage and also raises questions about who pays for these services (7).
GPs can use genetic prediction of disease to help with diagnosis however it may cause more harm than good. If prediction accuracy is low then patients may be diagnosed