This document is written on behalf of the two professional bodies in the United Kingdom that represent genetic counsellors (the Association of Genetic Nurses and Counsellors) and clinical geneticists (the Clinical Genetics Society) and aims to support multidisciplinary working of these professional groups highlighting within a quick-reference format, areas of shared practice and the distinctions between role profiles for a Consultant Clinical Geneticist, Principal/Consultant Genetic Counsellor and the new support role that we have termed ‘Genomic Associate’, see AGNC career structure . This builds on published documents that articulate the scope of practice of the clinical genetics workforce  and specifically the genetic counsellor  and clinical geneticist  roles.
In the United Kingdom clinical geneticists are medically qualified Members/Fellows of the Royal College Physicians or equivalent, where Clinical Genetics is an affiliated medical specialty. Genomic or genetic counsellors are allied health professionals with Masters level accreditation from the Genetic Counsellor Registration Board included in the Academy for Healthcare Science register and clinical scientists (genomic counselling specialty) accredited by the Health and Care Professions Council.
We acknowledge there is currently variability in these roles between NHS trusts and exceptions where the scope of practice for one professional group exceeds what is provided below in Fig. 1.
In Fig. 1 the roles are deliberately forward looking, i.e. they acknowledge that there are some areas of practice that may have traditionally been performed by one professional group, can now be shared with or devolved to other groups. Broadly speaking, the clinical geneticist leads on diagnostics and therapeutics and the genetic counsellor leads on psychosocial issues and care of the extended family. Both groups have skills and training in clinical genetics and there is much cross over between roles. The genomic associate leads on administrative support for the clinic, the patient and the clinical activities of the clinical geneticist and genetic counsellor. The genomic associate is part of the genetic counsellor career structure and has a clinical role that is different to a secretary; it is a position that has already been discussed in relation to the Genomics Service Specification for the National Health Service in the United Kingdom.
Association of Genetic Nurses and Counsellors. Career structure for genetic counsellors and support roles. 2020b. https://www.agnc.org.uk/info-education/documents-websites/.
Dragojlovic N, Borle K, Kopac N, Ellis U, Birch P, Adam S, et al. The composition and capacity of the clinical genetics workforce in high-income countries: a scoping review. Genet Med. 2020;22:1437–49.
Middleton A. et al. The genetic counsellor role in the United Kingdom: Position on behalf of the Association of Genetic Nurses and Counsellors (AGNC), Endorsed by the Genetic Counsellor Registration Board (GCRB) and Academy for Healthcare Science (AHCS). Eur J Hum Genet. https://doi.org/10.1038/s41431-022-01212-9 (2022).
Clinical Genetics Society. Policies and Resources around the role of the clinical geneticist. 2022. https://www.clingensoc.org/information-and-education/policies-and-resources/.
The original idea for developing a quick reference format for visualising the different roles of genetic counsellor and clinical geneticist came from discussions within the Joint Committee on Genomics in Medicine in the UK and we thank Prof Helen Firth for starting these discussions. The two professional bodies representing genetic counsellors (Association of Genetic Nurses and Counsellors) and clinical geneticists (Clinical Genetics Society) led on the development of the conceptual framework. Consensus was reached on the scope of professional practice through discussion with members of the committee representing each professional body. The negotiations were led by AM, NT and CH on behalf of the AGNC and led by SS, FE and MB on behalf of the CGS.
AM was funded by Wellcome grant 108413/A/15/D awarded to Wellcome Connecting Science and grant G115418 from the Kavli Foundation to the Kavli Centre for Ethics, Science and the Public, University of Cambridge.
The authors declare no competing interests.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Middleton, A., Taverner, N., Houghton, C. et al. Scope of professional roles for genetic counsellors and clinical geneticists in the United Kingdom. Eur J Hum Genet 31, 9–12 (2023). https://doi.org/10.1038/s41431-022-01214-7
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