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Genomic testing ensures best cancer treatment for each child


Children with cancer are being offered treatment plans tailored to their specific cancer thanks to a single genomic test that reads more than three billion letters of DNA to identify cancer-causing mutations.


Whole genome sequencing testing provides a complete readout of the genetic makeup of cancer cells and identifies every single known cancer-causing mutation. This helps clinicians to understand which treatments will be best to treat the cancer, for example they may choose immunotherapy rather than chemotherapy or they may be able reduce the amount of chemotherapy a child has. NHS England is one of the first healthcare services in the world to offer whole genome sequencing to every child diagnosed with cancer, through the NHS Genomic Medicine Service and this study, published in Nature Medicine, is the first time that the impact of the new scheme has been assessed.


Whole genome sequencing was found to provide


more benefits than all existing tests combined, when it was assessed by researchers at Great Ormond Street Hospital for Children, the Wellcome Sanger Institute and the University of Cambridge. Previous standard-of-care tests only look at tiny portions of the cancer genome, and therefore many more tests are often required for each child. The team analysed the use of routine genome


sequencing taken as part of standard NHS care in two hospitals, Great Ormond Street Hospital and Cambridge University Hospitals, with the sequencing run through their regional NHS Genomic Laboratory Hubs (GLH) – the North Thames GLH and East GLH. They found that cancer sequencing gave new insight that improved the immediate clinical care of


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King’s Fund explains key issues around NHS productivity


NHS productivity continues to be of much interest, both politically and from a research perspective. A new ‘explainer’ on the subject, has been published by the King’s Fund, which looks at some of the key issues. Charlotte Wickens, Policy Adviser at The


seven per cent of children, while also providing all the benefits of current standard tests. In 29 per cent of cases, genome sequencing


provided additional information that helped clinicians better understand the tumours of individual children and therefore which treatments would work best for them. For example, uncovering unexpected mutations that increase future cancer risk leading to preventative measures being taken, such as regular screening. Senior author from the Wellcome Sanger


Institute, the University of Cambridge and Cambridge University Hospitals, Professor Sam Behjati, said: “Whole genome sequencing provides the gold standard, most comprehensive and cutting-edge view of cancer. What was once a research tool that the Sanger Institute started exploring over a decade ago, has now become a clinical test that I can offer to my patients. This is a powerful example of the genomic data revolution of healthcare that enables us to provide better, individualised care for children with cancer.”


Free World Sepsis Day resources


As World Sepsis Day approaches, on 13th September, the UK Sepsis Trust is inviting healthcare professionals to join them in helping to raise awareness and improve sepsis care. The UK Sepsis Trust is offering a free sepsis


awareness pack to support Trust’s efforts in educating staff and patients about this life- threatening condition throughout sepsis awareness month in September. This comprehensive resource includes educational materials, posters, and healthcare-friendly fundraising suggestions for ways that you can help support their work through fundraising. Raising awareness of the signs and symptoms of Sepsis is also vital to ensure early


10 www.clinicalservicesjournal.com I August 2024


intervention. (Find out more about the signs of sepsis at: https://sepsistrust.org/about/about- sepsis/). Five people die with sepsis every hour in the UK and 40% of people who develop sepsis are estimated to suffer physical, cognitive, and/or psychological after effects. By helping the UK Sepsis Trust to reach more people with the signs of sepsis, healthcare providers can work towards ending preventable deaths from this condition. Any healthcare organisation can sign up – from hospital and GP practices, to dental practices and care homes – by visiting: https://sepsistrust.org/ world-sepsis-day-2024-clinical-sign-up/


King’s Fund, said: “There is evidence that shows that, over the past few decades, the productivity of the health care sector in the UK has been growing at a faster rate than other public sector services, such as education, and, more recently, faster than the wider economy. However, evidence shows that in 2020/21, productivity fell by 23%, largely due to the COVID-19 pandemic, and has not yet recovered to pre-pandemic levels, despite increased funding and more staff. “‘Reasons behind the stalling of productivity


may include outdated kit and buildings due to repeated raids on capital budgets, low levels of managers to overall staff, high levels of staff burnout, industrial action, issues with hospital flow, and patients having more complex care needs than pre-pandemic. There is also evidence to suggest changes to the way the NHS works, such as an increase in virtual wards, may not be fully captured in the current data. There are already several initiatives aimed at improving NHS productivity, including a financial package set out in the 2024 Spring Budget earmarked for technology, as well as a forthcoming NHS productivity plan. However, there are more actions a future government can take, including addressing the £11.6 billion capital backlog, investing more in social care to improve hospital flow, and going further on making health and care careers more attractive to retain staff and reduce staff sickness absence due to burnout “It is right that politicians focus on the


productivity of the health service. It is a high area of public spending, and taxpayers and patients understandably want a productive health service. But it is also a complex area and spurs to improve productivity can come at a cost, such as staff burnout. “There are areas in which the NHS can become more efficient and reduce waste, but previous national reviews of productivity have shown there needs to be realism over how easy and quickly that can be achieved.” The ‘explainer’ can be found at https:// tinyurl.com/2rjeda4j.


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