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Table 2 Genetic service delivery models proposed and ranked

From: Identifying future models for delivering genetic services: a nominal group study in primary care

Service Models Meeting 1 Meeting 2 Meeting 3  
  Rank Score Rank Score Rank Score Score Total
Community based service provided by genetic counsellors, not managed by general practice, but could be located in practices or local community centres to provide local patient assessment and advice. 1 8 1 8 3 6 22
Enhanced primary care: a service located within primary care, with specialists in genetic risk assessment, with support made possible by information technology and software applications. 2 7 3 6 1 8 21
Special 'genetic' clinics: this model was suggested so that the privacy and discretion analogous to 'genitourinary clinics' was built in, and where self-referral is possible and anonymity and confidentiality respected. 3 6 4 5 2 7 18
Traditional gatekeeper model: where general practitioners undertake an initial assessment, using standardised referral guidelines, and refer patients who are not categorised as 'low' risk. 4 5 2 7 4 5 17
Direct access telephone service: a 'genetics direct' model where patients have their genetic pedigrees assessed by counsellors with assess to pedigree software tools. 5 4 5 4 5 4 12
Drop in service for genetic assessment: e.g. similar to the Citizen Advice Bureau model. 6 3 - - - - 3
Private service: patients with concerns are directed to commercial providers either in the UK or elsewhere. 7 2 - - - - 2
Pharmacy led service: patients with concerns are directed to pharmacists, who could also undertake pharmacogenetic profile testing and offer lifestyle advice. 8 1 - - - - 1