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Genetic Services

  

Clinical genetics is a specialist regional service based at Birmingham Women’s Hospital.


About the Clinical Genetics Service

We provide genetic counselling across the West Midlands, through a combination of virtual and face to face clinics, depending on clinical needs.

This is provided by Consultant Clinical Geneticists and Genetic Counsellors. Find out more about the team.

We see patients for:

  • Diagnostic testing
  • Predictive (pre-symptomatic) and carrier testing
  • Preconception counselling
  • Prenatal counselling and assessment for hereditary disorders and congenital defects affecting foetuses, newborns, children and adults.
  • Diagnostic testing (when patients have symptoms of a possible genetic condition and testing is requested to look for the specific genetic variant causing their condition).

With the new test directory many diagnostic tests can now be requested by clinicians in various specialities (mainstreaming of genetic testing). However we are always happy to provide advice and answer questions regarding such testing or you are welcome to refer such patients to us.

Predictive (pre-symptomatic) testing is to look for a previously identified genetic variant in the family before the patient has symptoms of the condition (i.e. they may or may not have inherited the condition).

It is essential that patients having predictive testing are prepared emotionally, and that they have appropriate support in place for results both negative and positive. According to the test directory, all predictive testing is to be undertaken by the Clinical Genetics team. As such, we would encourage clinicians to refer such patients to us, and how to do this is described below.

Clinic Locations

We run our face-to-face clinics in Birmingham in the Outpatient Department at the Clinical Genetics Department in the modular building (called Lavender house) next to the Birmingham Women’s Hospital (please see map for where to find us) and at District Hospitals across the West Midlands. Please see map for genetics service in your area and contact the department for details.

Map of West Midlands

We run our virtual clinics via phone or Zoom, so that patients can have a consultation from the comfort of their home when this is suitable for their condition.

These virtual clinics serve a number of District Hospitals in the West Midlands including patients from Birmingham. You can find a list of where we hold clinics with maps here.

Specialist Clinics

We also run a number of specialist clinics. You can find out which consultant has the relevant special interest or you can contact the department.

  • Adult Neurology
  • Aortopathy
  • Arthrogryposis (adult and paediatric)
  • Birt-Hogg-Dubé
  • Deafness
  • Differences in Sexual Development (adult and paediatric)
  • Genetic Bone Service (adult and paediatric)
  • Gorlin Syndrome
  • Endocrine
  • Hereditable Vascular Malformations (e.g. HHT; CCM)
  • Huntington’s Disease
  • Inherited Cardiac Conditions
  • Neurofibromatosis
  • Neurometabolic (paediatric)
  • Paediatric Neuromuscular
  • Paediatric Tumours
  • Renal (adult and paediatric)
  • Short Stature/Growth
  • Structural Eye Anomalies
  • Von Hippel Lindau

Referral guidelines for the NON-cancer genetics service:

We accept referrals from GP, physicians, midwives and other health care professionals.

We would suggest patients to fill in the relevant family history form (see also link right) .

If you are referring children please also give parents the development form (see also link right)

We would be grateful if you could hand the form(s) to your patients when you send us their referral. We accept ERS referrals otherwise you can refer by writing to us or emailing us at genetics.info@nhs.net. We have separate forms for cancer and non-cancer referrals. Please ensure the correct form is used as this is very important to ensure the referral is dealt with appropriately.

Please provide as much information as possible in your referral including;

  • Patient’s contact details and NHS number
  • Medical history
  • Any known family history (including names and dates of birth of affected relatives if known)
  • Copies of relevant investigations including the genetic laboratory report
  • If there are language or learning difficulties
  • Any pertinent social issues.

We also offer healthcare professionals a telephone consultation service (between 9am and 5pm on weekdays). Outside these hours there is an answer phone service.

Once the forms are completed, patients can send the FHF to us by email to genetics.info@nhs.net or by post to:

Clinical Genetics Department
Lavender House
Birmingham Women’s and Children’s NHS Foundation Trust
Mindelsohn Way
Birmingham B15 2TG

Tel: 0121 335 8024

General family hisotry form (see also link right)

Development form (see also link right)

Referral guidelines for the cancer genetics service

Guidelines for referrals for Breast Cancer, Ovarian Cancer, Breast and Ovarian Cancer, Colorectal Cancer and Other Cancers are listed below.

The overall benefit of surveillance outside these guidelines has not been established.

If you are unsure, please call 0121 335 8024 and ask for the cancer genetics service (WMFACS) for advice.

Please note close relatives are mother, father, sibling, child, parent’s siblings or grandparents.

Breast Cancer

The patient to be referred is affected by cancer and fulfils one of the below criteria/is part of a cluster OR is unaffected and has a close family history of:

  • Breast cancer below 40
  • Medullary/basal or triple negative under 60
  • Bilateral disease, first cancer diagnosed under 50
  • Male breast cancer, any age
  • Two close relatives (including one first degree), average age below 50
  • Three close relatives (including one first degree), average age under 60
  • 4 or more relatives with breast cancer on one side of the family

Ovarian Cancer

The patient to be referred is affected by cancer and fulfils one of the below criteria/clusters OR is unaffected and has a close family history of:

  • One ovarian cancer (papillary serous, epithelial origin).
  • There is little benefit in referring unless there is a living affected relative if the patient is unaffected themselves.
  • Two close relatives with ovarian cancer under 70

Breast and Ovarian Cancer

The patient is affected by or has a close family history of one of each tumour; both under the age of 70.

Colorectal Cancer

The patient to be referred is affected by cancer and fulfils one of the below criteria/clusters OR is unaffected and has a close family history of:

  • Colorectal cancer below 45
  • Two close relatives (who are first degree relatives) average age under 60 (includes both parents)
  • Three or more close relatives with other gastrointestinal, renal, urinary tract, uterine or ovarian cancer at any age, or two average age below 60
  • Multiple polyps potentially in keeping with a polyposis disorder

Other Cancers

The patient to be referred is affected by cancer and fulfils one of the below criteria/clusters OR is unaffected and has a close family history of:

  • Multiple primary cancers in one individual
  • Three or more relatives with cancers at the same site
  • Three or more relatives with cancer at an earlier age than expected in the general population
  • Three or more relatives with cancers of breast/ovary/prostate/ pancreas/ melanoma/thyroid/sarcoma/adrenal cortical tumours, or other non-melanoma skin tumours or carcinoma
  • Renal cancer below 50

The overall benefit of surveillance outside these guidelines has not been established

Please provide your patient with the following form and ask them to complete it.

Your details can go on the first page and you are welcome to also send a covering letter.

Unfortunately we cannot accept most cancer referrals without this completed form.

Cancer Family History Form (see also link right) 

Urgent referrals for the cancer genetics service

For patients where there is a reason why a test needs to be considered urgently please state:

  • URGENT at the top of your letter
  • The reason the referral is urgent
  • The timeframe in which a result is ideally needed (as relevant)

A common reason that a test may need to be requested urgently is if it will modify treatment. This is especially important for late stage patients where it will impact on prognosis. For patients where it will modify surgery decisions (such as bilateral vs. unilateral mastectomy) we will always try to see these patients in a timely manner, however it is important that this is not something we will always be able to achieve within the desired time frames.

We provide specific training, called ‘Generate’ training, for clinicians who wish to request BRCA testing for their eligible breast or ovarian cancer patients. If you wish to take part in this training please contact us by email (genetics.info@nhs.net) or telephone (0121 335 8024) and ask that your query is directed towards Anna Considine and Phil Leonard.

If you have any questions about any urgent referrals for the cancer service please do not hesitate to email us at genetics.info@nhs.net or call us on 01213358024. Please state clearly that it is an enquiry about an urgent referral.

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