Clinical medicine has changed significantly over the past 10 years. In the past there has been a fundamentally ‘intuitive’ approach towards diagnosis and treatment, but new tools and techniques are available to allow more accurate diagnosis and precision treatment to be tailored to an individual patient.

ARCH recognises the importance of this because people differ in the way they respond to a medicine.

Precision medicine combines the use of new tools allowing more accurate diagnosis of disease with the tailored selection and use of therapeutics to have maximum benefit and minimal side effects for an individual patient. The main objective of this ‘precision medicine’ approach is to provide the right drug at the right dose to the right patient at the right time.

It means applying technology and know-how to making the right diagnosis and selecting the right treatment for an individual patient, at the first attempt.

Precision and Personalised medicine provides the opportunity to revolutionise patient care by translating molecular diagnostics and big data informatics to inform and to deliver sophisticated personalised management for care. The ARCH Programme is collaborating with global experts in this industry, placing the NHS in South West Wales and its population of nearly a million people at the pioneering centre of excellence of this transformation of medicine and the treatment of diseases such as cancer, our ambition is to be a locus of innovation and world-class research in this field that others will follow.

Statement of Intent for Genomics & Precision Medicine by Health & Social Care Minister Mark Drakeford:
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The fields of genetics and genomics are rapidly evolving, with new technologies driving down the costs and increasing the speed of DNA and RNA sequencing.  This is already revolutionising medicine and public health by providing more accurate, rapid and cost-effective genetic tests.

Wales is well positioned to take advantage of these developments with a single provider of NHS laboratory and clinical genetics services, a universal and powerful health informatics capability and strong links with internationally renowned genetics and genomics research at Welsh universities.  

Genomics studies are increasingly becoming a global endeavour.  With the ability to delve deeper into DNA, the likelihood of identifying variation of unknown significance increases.  Understanding the potential clinical significance of such variants requires global collaboration and we must ensure that our genetics and genomics services are able fully to participate within global networks.  Moreover, in order fully to exploit its potential to be a major international force in genomics and precision medicine, Wales needs to establish strong strategic partnerships within the United Kingdom and across the world.

In order to prepare for the future, and capitalise on recent developments in the UK and beyond, it is vital that we now develop as a national priority a strategy for genomics and precision medicine in Wales.  To prepare for this, over the last 10 weeks a Welsh Government-led Genomics Taskforce has developed a Statement of Intent.  The statement of intent outlines the work that will be undertaken to progress the strategy and recommends four key priority areas for development:

  • Clinical and laboratory services
  • Research and Innovation
  • Strategic partnerships
  • Workforce

Through the strategy, we aim to create a sustainable, internationally-competitive environment for genomics and precision medicine to support the delivery of prudent healthcare for the population of Wales.  This will:

  • be based on all-Wales NHS genetics and genomics laboratory and clinical services, working to internationally-recognised standards, as part of an integrated clinical and academic infrastructure for translational genomic medicine
  • be flexible and able to adapt to rapid change and new technologies, building on excellent relationships, within and beyond Wales, to capitalise on the potential of collaborative working between the NHS, public health in Wales, academia, industry and the citizens of Wales
  • contain plans to develop the NHS workforce to support the delivery of precision medicine
  • create a framework to forge new strategic research / industry partnerships, to maximise and accelerate health and economic benefits
  • outline our ambition to be a major contributor to the UK genomics capacity, working collaboratively across borders to obtain the maximum benefit and value for money from developments in genomic technologies
  • capture the potential of genomic data for R&D through supporting Wales’ involvement in world-leading clinical research and trials.

The strategy will bring many benefits for patients, families and the population of Wales, including:

  • a more efficient and prudent healthcare service, directing resources to where they are most effective and needed
  • earlier, more accurate diagnosis, supporting early intervention and better targeted treatments, resulting in better responses to treatment, fewer side effects and quicker recovery from illness
  • better infection prevention and control strategies and more effective management of infectious diseases in healthcare settings and the community
  • patients will be empowered through more detailed information, appropriately communicated, allowing them to have a greater understanding of, and take greater responsibility for, their own health
  • patients will have greater opportunities to take part in clinical trials and other innovative research studies and contribute to future discoveries that will improve health and healthcare.

The genomics taskforce, on which ARCH is represented by Professor Kathryn Davies,  will now move to develop the full strategy based on these key principles and priorities.  It will be chaired by Dr Andrew Goodall, Chief Executive NHS Wales and aims to report back to Welsh Ministers on progress in September 2016, following engagement with key stakeholders, across Wales and beyond.

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