Genetic Counsellor

Genetic counsellors are HCPC-registered Allied Health Professionals who support individuals and families to understand and adapt to the implications of inherited conditions or a genetic predisposition to disease. Working within NHS genomics and genetics services — now integrated into the NHS Genomics Medicine Service (GMS) — you take detailed family histories (constructing pedigree diagrams), interpret and explain genetic test results (including whole genome sequencing, panel gene testing, chromosomal microarray, and single gene tests), explain inheritance patterns (autosomal dominant, autosomal recessive, X-linked, mitochondrial), and help patients understand the meaning of uncertain variants (variants of uncertain significance — VUS).

You work across a wide range of clinical areas: oncogenetics (inherited cancer — BRCA1/2, Lynch syndrome), cardiology genetics (inherited cardiomyopathies, channelopathies, Marfan syndrome), neurology genetics (Huntington's disease, inherited ataxias, muscular dystrophies), prenatal genetics (chromosome conditions, fetal anomaly), and paediatric genetics (rare inherited conditions in children). Consultations involve high-quality risk communication — explaining numerical risk in meaningful ways — and psychosocial support, helping patients cope with a life-altering diagnosis or the anxiety of an uncertain result. You facilitate cascade testing (identifying at-risk relatives), discuss predictive and prenatal genetic testing options, and address the ethical complexities of genetic information in families. Genetic counsellors work as part of a multidisciplinary clinical genetics team including consultant clinical geneticists, genomic scientists, and clinical nurse specialists.

The NHS Genomic Medicine Service represents a structural commitment to embedding genomics across NHS care — from rare disease diagnosis to cancer treatment stratification and newborn genomic screening. The NHS-Genomics England Whole Genome Sequencing programme has sequenced over 500,000 genomes, and genomic testing is now embedded in cancer, rare disease, and cardiac care pathways across NHS England. This expansion creates sustained demand for genetic counsellors who can translate genomic data into meaningful clinical conversations.

HCPC registration provides statutory professional protection. The specialised training (MSc entry, minimum two years), the technical genomics knowledge, and the psychosocial counselling skills required create a genuinely complex professional role. The NHS GMS structure ensures genetic counselling is embedded within commissioned clinical services rather than dependent on discretionary funding, and the expansion of genomics into oncology and screening means the profession will grow substantially over the next decade.

Morning: three outpatient genetics clinic consultations — a 34-year-old woman who has tested positive for a BRCA2 pathogenic variant following her sister's breast cancer diagnosis (supporting decision-making about risk-reducing surgery and surveillance); a family with a child newly diagnosed with a rare chromosomal condition (explaining the result, recurrence risk, and implications for other family members); a 42-year-old man with a family history of Huntington's disease considering predictive genetic testing (pre-test counselling, exploring motivations and concerns). Afternoon: review and prepare letters from the morning's consultations. Attend the multidisciplinary genetics team meeting. Cascade testing coordination — contacting relatives of a patient with a newly identified inherited arrhythmia gene variant. Clinical supervision with a senior genetic counsellor.