Genomic counselling

Genetic counsellors* work directly with patients and families offering genetic/genomic information and support allowing them to make health decisions.

You’ll use your specialist knowledge to support patients and their families. You’ll order genetic and genomic tests to clarify health risks and use counselling skills to support and empower patients as they incorporate this information into their lives.

*Previous training programmes for genetic counsellors have been called genetic counselling, but the title genomic counselling in this programme reflects the increased focus on the use of genomic information and technologies in healthcare.  At the moment individuals trained in this area work under the professional title of ‘genetic counsellors’. 

Working life

As a genetic counsellor, you’ll be part of a multidisciplinary team alongside clinical geneticists and clinical scientists, helping to diagnose, manage, predict and screen for genetic disease. You’ll do this through taking and analysing family history information, assessing the risks of inheriting or passing on a medical condition, ordering and interpreting genetic and genomic test results and explaining these to the individual patient and their relatives. 

Genetic counsellors also use techniques from counselling to help patients adjust to having a genetic condition and to help them make difficult decisions associated with this.  For example, this might include helping a couple decide whether to continue with a pregnancy where their child would have Duchenne muscular dystrophy or helping an individual decide whether to have a genetic test to determine whether they will develop Huntington’s disease like their mother has.

Increasingly, genetic counsellors are using their expertise to support genomic testing in specialist multidisciplinary teams such as in cancer teams, neurology, ophthalmology, cardiology and reproductive medicine.

You’ll use your communication and counselling skills to support and empower people at emotionally difficult times as they adjust to the genetic condition in them or their family. 

You’ll also act as a genetic and genomic specialist at multidisciplinary meetings with other hospital staff eg. in a breast or bowel cancer clinic.

The typical work activities that you might undertake include:

  • taking a family tree and interpreting the risks of inheriting or passing on a genetic condition
  • assessing which genetic or genomic test is the most appropriate and ordering this
  • translating genetic and genomic test results into lay language for patients and non-genetic health professionals
  • using a core set of counselling skills to communicate appropriately with patients taking into account cultural, linguistic and ethical issues
  • conducting and documenting patient consultations appropriately, including writing letters to patients
  • speaking to patients on the telephone to offer support, give results or answer questions.
  • teaching genomic counselling to other health professionals
  • liaising with clinical and other healthcare staff, often in a multidisciplinary team setting
  • participating as a researcher in clinical, genetic, genomic and psychosocial research

Where will I work?

You will usually be based in a regional clinical genetics department or genomic medicine centre that is responsible for the care of patients covering a large region. You are likely to travel to do specialist genetics clinics in local hospitals in your region. 

Who will I work with?

You will work in a team that includes clinical geneticists (medical doctors specialising in genetics), molecular geneticists and clinical scientists (laboratory scientists who have specialised in genetics) and other healthcare science staff working in the life sciences.

Want to learn more?

  • Like most jobs in the NHS, genetic counsellors are covered by Agenda for Change (AfC) pay scales. This pay system covers all staff except doctors, dentists and the most senior managers. As a trainee genetic counsellor, your starting salary would typically be AfC band 6.  Once qualified and working as an autonomous practitioner, you would typially receive a salary at AfC band 7-9 depending on your precise role and level of responsibility. Bands 8 and 9 usually include significant additional senior responsibilities such as management, service improvement, research and academic teaching.

    Staff will usually work a standard 37.5 hours per week. There may occasionally be unsociable hours but this is unusual.

    Terms and conditions of service can vary for employers outside the NHS.

  • With further training, experience or both, you may be able to develop your career and apply for vacancies in areas of further specialism, management, research or teaching. Genetic counsellors have a structured career progression that takes them to principal and then consultant positions (AfC band 8a-9).

  • Job market information

    In November 2018, there were 6,123 clinical scientists registered with the Health and Care Professions Council.

    The NHS Scientist Training Programme (STP) attracts many more applicants than there are places and so there is considerable competition for places. 

    Looking for job vacancies

    When you’re looking for job or apprenticeship vacancies, there are a number of sources you can use, depending on the type of work you’re seeking.

    Check vacancies carefully to be sure you can meet the requirements of the person specification before applying and to find out what the application process is. You may need to apply online or send a CV for example.

    For the NHS Scientist Training Programme (STP) there is an annual recruitment cycle. Applications usually open in early January for the intake in the following autumn.

    Applications for the STP should be made through the National School for Healthcare Science website, where you can also find information about the programme and the recruitment process.

    Key sources relevant to vacancies in the health sector:

    As well as these sources, you may find suitable vacancies in the health sector by contacting local employers directly, searching in local newspapers and by using the Universal Jobmatch tool.

    Volunteering is an excellent way of gaining experience (especially if you don’t have enough for a specific paid job you’re interested in) and also seeing whether you’re suited to a particular type of work. It’s also a great way to boost your confidence and you can give something back to the community.

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