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 | Â | |||
|---|---|---|---|---|---|---|---|
| Â | 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 |