 I'm going to talk on the genomics education programme, and this is a talk of two parts, so I suspect I'm going to talk about the work of the genomics education programme, and then Michelle is going to follow on to describe our evaluation strategy and the work that we've been doing on assessing the impact of our genomic interventions. So, just by way of introduction for those of you who aren't aware of our genomics education programme, Health Education England's education programme was established in 2014 with £20 million of Departments of Health funding to take us up until March 2018. And this is not the end of the programme after 2018, we're anticipating that the programme will be taken on as business as usual for the subsequent future. And we're hosted within Health Education England, which is an arm's length body of the Department of Health with responsibility for ensuring the NHS has the right numbers and right skills of staff in the right place at the right time to provide the relevant services for the NHS. And so it's really right that our genomics education programme sits within that body. And it's also important to point out as well that the genomics education programme builds on the legacy of the National Genomic Education Development Centre that preceded it. And the aims of the genomics education programme up to 2018 are to support the England's 100,000 genomes project and also to increase capacity and capability of the workforce in genomics and also the long lasting legacy to support workforce transformation to embed genomic medicine into mainstream clinical practice. So the strategy and the approach that we have taken is to ensure that we have a comprehensive reach across the 1.3 million NHS staff and that we impact across the whole of the education continuum for the perspective and the current workforce and that we're doing this across all of the professions. And so our remit is really broad and it ranges from awareness raising such as, for example, thinking about genetics versus genomics, just that simple level to very highly specialised aspects of genomics, for example, looking at assessment of tumours for neoplastic content and cellularity. So in order to approach our work, we undertook a gap analysis to ensure that we're not duplicating efforts that have already been made and there is a lot of formal education for genomics already in the healthcare system. But that we're initiating joint up activity between specialist groups under establishing networks so that we're not working in isolation. And very critically important to us as a group is that we're using the most up to date methods for delivery of our educational intervention so that we can reach the greatest number of people in a very accessible format. But it's also important to us that we are routing our products in educational theory and practice and that we have an evidence based approach and that we are evaluating our impact. And this is what Michelle is going to talk about a little bit later on. So just to give you an update on our progress today to date, so one of our major aims is to provide resources to support the 100,000 genomes project pipeline and that's depicted there on the screen at the moment. And it's a pipeline that involves identifying participants who then go through a consent process for the 100,000 genomes project. Then there is a need to collect samples and to undertake DNA extraction for whole genome sequencing. And the samples are then sent away to a sequencing centre where they are sequenced and there's also annotation validation and interpretation that takes place next. And then there is the reporting of findings back to the clinician. And so all of those aspects of the pipeline required from our gap analysis, some interventions. And just on the other side of the screen you can see here some of the products that we've actually already developed or are in the process of developing. So that includes a series of eligibility wheels, which are athigrance guides across 50 medical specialties that help clinicians identify patients who are eligible to join the 100,000 genomes project. We've already undertaken and developed a short online course for clinicians seeking participants consent to join the 100,000 genomes project and that's been hugely popular and very successful results that we've developed to date. We've also done a series of instructional videos to assist staff in molecular genetics and histopathology for the sample processing in DNA extraction from blood and also from solid tumours. And we're working on a tumour assessment tool, which is a tool that's got education and training modules for healthcare scientists and clinical histopathologists to aid them to accurately assess the cellularity in the neoplastic content of their tumour samples for obtaining high quality DNA for genomic sequencing. Very importantly now as the 100,000 genomes project is producing results is to think about how to train and educate the scientists in the laboratory to verify and the pathogenic variation has been returned by sequencing process. And that's more how their knowledge actually needs to evolve in the light of them taking genomic sequencing because they're already trained in pathogenic variant interpretation. And then there is also a very important is the feedback of results, a package of education aimed at clinicians to who interpret the genomic results report and to identify the elements that will inform the patient's prognosis and treatment. And we're beginning to plan those additional resources over the course of this summer. In addition to that, we are very involved in reaching out to the professions and looking at the relevant formal training curricula. And so we've been developing curricula across a whole range of different levels within the healthcare scientists programmes. So looking at apprenticeships for quite junior staff, looking at our formal scientist training programmes for clinical scientists in the laboratories. So one particular aspect of that has been in addition to the standard programme in genomics we've established a specialist outcome in genomic counselling. And that has been allowed this important profession to be accredited by our healthcare professions council, which means that there are now a regulated profession. We're also looking at developing a specialist outcome in molecular pathology and we're advising on new curricula development where genomics is relevant. So, for example, in decontamination science. In addition to this, in the UK we have a programme of high specialist scientific training which trains our scientists to become the future leaders and consultants in their chosen specialism. And so we have led the development of this HSST programme in clinical bioinformatics genomics. And we've facilitated registration of the first clinical bioinformaticians onto our healthcare professions council register. We've also funded places on the HSST for genetics and electro pathology of acquired disease and clinical bioinformatics. In addition to this, we are now working very closely with our nursing midwifery workforce. And we are looking at the curriculum framework for nursing associate roles as well as looking at getting genomics across a whole range of roles within the nursing midwifery workforce. And we have an ongoing programme of work with our medical colleagues and we have already been invited to comment on the curriculum as part of their review process. Our high priorities include accredited scientific practice, undergraduate nursing medical curricula and engaging with our relevant role colleges to discuss postgraduate medical and surgical curricula. In addition to this, we have our flagship genomic medicine master's framework in which we have developed a curriculum and commissioned 10 universities to deliver this programme. So they're all delivering the same curriculum, although they all deliver slightly different optional modules. And we have funded through the genomics education programme 550 places on this master's programme and also 1000 CPD places. So that's where individuals can undertake just one single module to upskill themselves in particular areas. And this has been hugely successful and 86% of all our places have been filled as of March 17. Slightly less uptake of the individual CPD modules, but we have 33% of those filled at the moment. And the benefits of this master's framework is that you don't actually have to do the full masters. You can also do the PG cert and the PG dip so you can take four modules or the PG dip as well, which involves some of the research aspects. Moving on to our research and innovation elements of our genomics education programme, we are in the process of awarding postdoctoral, doctoral and secondment research fellowships with 1.3 million of funding available. With the aim of trying to develop research capabilities within genomics at all levels of the NHS to enhance and diffuse evidence based genomics practice. And to date we have had more than 60 applications for this fellowship funding equivalent to 12 million. So it's a shame, very much a shame that we've only got 1.3 million to give away. And in that we've had representation from a range of health professions, including medical, nursing and midwifery allied health professions and health care management. And the project topics include personalised health care, cancer, rare diseases and infectious diseases and working on 100,000 genomes project data from both clinical and social perspectives. And work just completed our short listing for that and we're going to be going out to interview at the end of May. So that's hugely exciting aspect of our work as well. In terms of workforce transformation, we have funded a cohort of 13 training and education leads who work at the regional level on our behalf. But their main role is to really work at the local level and to undertake training and education functions that relate to implementing genomics, very much aligned to what is needed in their local practice. We've also engaged with a range of professional groups, for example, nursing and midwifery, our biomedical scientists who are primarily involved in histopathology and also with our primary care physicians. We very recently launched our NHS faculty of genomic medicine and this is where our alumni from our genomics medicine framework and from any of our educational interventions connect and join as experts to act as genomic champions within the wider workforce. And we are establishing an oversight group or advisory group to help inform the genomics education programme strategy and policy as we move forward. So this is a way of capturing the expertise that we are developing within the workforce. We're also exploring various patient pathways to identify NHS touchpoints where genomics is required. So one of the areas that we're exploring in more detail is the pathway for familial hypercholesterolemia. And we're also forming the Health Education England Training and Education Genomics England clinical interpretation partnership to facilitate the rapid knowledge of transfer from the 100,000 genomes project into training and education. And in terms of how you can access our information and work for the genomics education programme, we have a very active website with our online learning programmes on there. We're now reaching about 23,000 or more visitors and 130,000 page views per quarter. And in addition to the 100,000 genomes project resources that I've already talked about, we have a range of introductory online courses, for example, the introduction to bioinformatics, additional just-in-time resources, some fact sheets about genetic conditions. We have a range of videos on genomics, rare diseases and health genome sequencing. We have an image library of educational infographics and genomics resource library curating links to relevant education that we can sign post people to. And another significant achievement is our future learn massive open online course on whole genome sequencing that we are about to run for its third course on the 22nd of May, so just coming up next week. And today we've had total learner registrations of 12,000 for this. So just very quickly before I move over to Michelle's part of the talk, just to say that the future is very important for the genomics education programme. It will continue to provide strategic oversight, policy development and direction to support implementation of the safe and high quality genomic medicine service in mainstream NHS. Through the development of the underpinning education and training for the specialist in the wider workforce. And that includes thinking about new skills and new roles in particular for bioinformatics and genetic counselling, but also new roles for specialist nurses and also thinking about how molecular pathology needs to change. In addition to that workforce planning is very critical to informing our approach and we need to make sure we have the right numbers of people with the right sort of characteristics in that workforce in the right place at the right time. And we're trying to maximise our impacts by working with all relevant stakeholders and very much important to us is our interactions and collaborations with international partners. When we look at the forward, we have many challenges ahead of us like everyone. There are many competing priorities and we need to secure the resources within our organisation. We need to do some work on workforce planning. Professional curricula, we need to embed genomic competencies in all undergraduate and postgraduate curriculum and that is a very large undertaking. We have to think about the future of our genomic medicine masters framework and where our future funding for this is going to come from. The faculty of genomic medicine needs to maintain momentum and we need to maintain the multi-professional group of the alumni and stakeholders and we need to respond very rapidly to changes in training models that are occurring within our health care system. So, for example, apprenticeships are a new model for us and obviously in having developed a number of education resources, it's really important to think of a mechanism for keeping them up to date. Refreshing out of date information and developing new resources and obviously very importantly and allows me to lead into Michelle is to evaluate the impact of what we're doing. Doing huge amounts of work is really important to make sure that we are actually making a difference and that our approach and strategy to genomics education is effective and has impact. I'm just going to pass over my headphones to Michelle and my seat so she can take over on the second part of this talk. Thank you. Great. Thank you, Annika. Hello. So hopefully you can all hear me now so even though it might come up on the screen that Annika is talking, I'll now be going through the rest of this presentation. And really it's just to highlight how we are actually evaluating all of our products in our program and the approach that we have taken. So all of the work of the genomics education program is very much underpinned by this very quite simple program development and evaluation cycle. So we always start with a needs assessment and this could be a single process if we're looking at developing one resource or it could be a much larger multifaceted project like what we're currently doing for workforce transformation. Our development process is always an iterative process so we always work with our stakeholders to ensure that what we're developing actually meets the needs that we identify during the needs assessment. During implementation we undertake a process evaluation which I'll go through a bit later in this presentation and finally we conduct an outcome evaluation which is measuring the impact. So in terms of the needs assessment, for us this is very much about identifying the learning need and requirements of either a subset of the workforce or the entire workforce. And when we're talking about the workforce I want to be very clear that we're talking about the entire NHS workforce so it's not just in one hospital or not just in one region, it's throughout England. We do this as I said before either for an individual resource but also for the program overall. In this presentation I will provide two examples of how we've actually conducted a needs assessment so you can see the different approaches that we've undertaken. Firstly about one for when we were starting the resource development for the 100,000 genomes project and then a bit later I'll go into more detail about our training needs analysis of NHS staff. So as an example this is how we undertook the needs assessment right at the beginning of this project to identify the education and training requirements for the 100,000 genomes project. And we undertook a gap analysis and essentially we did this by asking the experts who were involved in the design of the 100,000 genomes project two key questions. We first asked them to consider when they were considering the project pipeline what information will be new to the clinicians who will be delivering this project so the clinicians are the scientists. And this information could be new because it's protocol specific information or it might be new information for a particular professional group. And then what additional skills would these healthcare practitioners require? So they might need a new skill because they're dealing with a new technology or because of a protocol specific requirements. And through this process is how we identified all the resources that Anikari outlined earlier in the presentation that we needed to develop to support those that were delivering this project. Now needs assessment as I mentioned before is only one part of our evaluation cycle. The other aspects are process evaluation and impact evaluation. In terms of process evaluation from a single resource perspective this is just simply ask the question did how we expect to implement it and are implementing it work. And I'll go through an example of this in a couple of slides time. For our larger scale projects we're looking at how our approaches and seeing how they could actually be improved. So for example with the establishing of the master's program in genomic medicine which has been delivered through 10 universities. The way that this was established and implemented at each of the universities did that approach work. And as Anikari also mentioned we have also embedded education and training leads within 13 regional centres and these are called the genomic medicine centres. And these are the areas that are implementing the 100,000 genomes project at a regional level. We wanted to examine the process of embedding these leads within each of these GMCs to look at the process and see how we could improve it for the future. In terms of impact evaluation this is very much measuring the change that has resulted from the program. So for example for the resources this would be did learners who undertook online training did they acquire the new knowledge or skill that was intended. And did this have a direct or indirect change on their professional practice. But we also want to consider where we've had the most impact and the costs that have been associated with that. So I now just want to quickly run through one example of how this whole process fits together. And using the example of how the cycle played out for one of our established resources preparing for the consent conversation for the 100,000 genomes project. The first step when we think about developing a new resource or any part of our program is to develop a program logic. And essentially this outlines all the key stages in the program development and evaluation. And the program logic you can see there on the slide. So this particular resource was a six stage process. So it's actually quite a short process. The very first stage was a gap analysis which I've described previously. And then the next stage was an actual needs assessment that was specific to this resource. And for this resource we convened a group with experts in the area but also those that would represent the end users to identify what would actually be the knowledge needed for someone to actually undertake the consent conversation which identified the content for the resource. But we also looked about what would be the most appropriate mode of delivery. And for this particular resource it needed to be accessed by a multidisciplinary group but also have a flexible learning approach. So we decided to develop an online course that people could access at any time. As I mentioned with the development process on all of our resources this was an iterative process and those that were convened for the working group were involved in the development phase. In terms of the process evaluation for the implementation phase we undertook a pilot just to check whether the online resource actually worked. Just a simple thing is just checking whether all the links actually worked as well. And for the learners that undertake the course we also have some questions in the post course survey about their access to the course and the use of online learning. In regards to the outcomes, so the short term outcomes and the long term outcomes, we use the co-patrick model as a framework to map our outcome measures. And for this particular resource we measured levels 1, 2 and 3 of the co-patrick model. So this is learner reaction, the acquisition of knowledge and whether the learning had been applied in practice. And just to quickly run through the types of things that we are evaluating with this course for the short term outcomes, the level while we're looking at the number of course completions and learners reaction to the course, so are they satisfied with it, do they feel it's relevant to their practice. We're also checking their knowledge, so as part of the pre and post course survey, we ask participants to self-rate their knowledge and look for any change in that, but we also contest their actual knowledge through a summative assessment that's part of the course. And we also have, as part of the post course survey, a question about their intention to integrate into practice. As part of the long term outcome, sorry, apologies, we have an impact on, we're looking at the impact on practice and we're looking at these three interviews where we're actually seeing how they've taken their learning and implemented it into practice. So I now just want to finish on the training needs analysis that we've done NHS-wide, which was one of the purposes of actually of this presentation. The aim of this training needs analysis was really to get a snapshot in time about the genomics training needs of the wider NHS workforce, and this training needs analysis forms part of our workforce transformation work stream. This was conducted through a structured online survey and it was coordinated through each of the genomic medicine centres. So as I said before, in each of these GMCs we have a funded education and training lead and it was a lead that actually developed the survey and to answer key areas that were asked by the genomics education programme. And this is just a map of where all the education and training leads are based throughout England. The primary purpose for the education and training leads was to understand what the training requirements were of the staff in their own regional area. But from the genomics education programme, we wanted to develop a national picture of the broad education and training themes of NHS staff and to use this as a baseline for future evaluation activities. And I just quickly want to run through some of our very preliminary findings just to give you an idea about the demographics of the people who completed the survey, their perceptions of their needs for training and a preference for how they want this training to be delivered. So the survey was carried out between September of 2016 and February of this year and it was sent to NHS staff by internal hospital communication routes. So it was then that whatever communication bridge their education and training leads had access to. But because of this, it is actually impossible to calculate what our response rate is because we're not sure how many staff actually received the links to the survey. However, we have received the raw data from seven of the regional areas and to date we've got responses from over 2,500 NHS staff. And as you can see from this pie chart here, it does cover all the professional groups in the NHS with the medical professions, nursing in midwifery and the healthcare scientists, being those that are predominantly represented. But we do actually have some responses from diverse fields such as from the chaplain service and many who are involved in healthcare management. Because each of the Genomic Medicine Centre's education and training leads designed their own questionnaire, overall they were very similar, but there are differences and so it's made analysis from our perspective quite tricky. Some questions were consistent so in those aspects we've been able to pull the data, but others were not. So we had to look at common trends and this is an example of the common trends. We've had to analyse each of the questionnaires separately. So in terms of the NHS staff's belief whether they need further training in genomics, this was asked in a number of different ways, but the general trend is yes, there is a need. So for example, in one of the questionnaires the question was asked, do you feel you have sufficient genomic knowledge and skills to perform your current role? And as you can see they're just from a subset of the groups. Not everyone has said yes. So there is definitely a need for education. Sorry, I do apologise. But there is significant difference between the groups. In terms of another questionnaire asked, do you feel you need further training in genomics? And 80% responded yes to this question and there was no significant difference between the groups. When asked an open-ended question about what type of education and training they would like, the common theme from all of the professions and all of the questionnaires was that they want education and training that is specific to their clinical role and can be utilised as part of their current practice, which I suppose is not really a surprise. However, they do want this education at different levels. So for some people it was understanding how genomics is relevant to their clinical role. For other groups there was a recognition of a need to acquire new knowledge and develop new skills. And for those already working in the field, there were still areas in which they felt they needed to up skill in both their knowledge and in their skills. So they didn't want us to forget about them in this process. In terms of delivery methods, both face-to-face and online were the most accessible methods of delivery. But in one questionnaire they actually went into quite depth, a lot of depth about what type of delivery methods could be used. And social media, websites and apps were actually the least preferred. But in this questionnaire it was primarily medics and nursing staff who worked in secondary and tertiary level care who answered the questionnaire so this might be quite a skewed response. So this just gives you an overview of the preferences for the different medical groups. And as you can see there's only two groups, the medics and the pharmacists, where there's actually a significant difference. But actually online is the preferred method of delivery. And in terms of looking at these results from some of the open-ended comments it's clear that in some cases the preference for face-to-face teaching may actually be a pragmatic choice as well as a preferential learning style. As one medical professional said they can't get study leave for online learning. So I just wanted to leave it there in terms of the TNA that we've done because one of the primary aims of actually doing this presentation was start the discussion with other people who have done a training needs analysis. And we had talked earlier about looking to see if we could publish papers as part of a special issue. And we're almost at the point of drafting a paper now and we're really wanting to see if others were in a similar position and whether we wanted to take this forward to see if we could publish as part of a special issue because it might have a greater impact if we do that. At some point we did talk about writing an introductory paper on the who, what and how really of training needs analysis to lead into this special issue and we're more than happy to lead on drafting this paper. But I also wanted to leave the question of what journal would be the most appropriate for this but we can talk about that a bit later. So just to finish off the presentation I just wanted to acknowledge all of the members of our genomics education program team. As you can see we're quite a small team really but we work collaboratively with a number of people in the wider NHS. And we do provide people with an overview of what our education program does. We do have to do a lot of awareness raising about us and what we can offer. And all of our information can be found on our website and we're quite active on social media as well. So if you want to keep up to date with anything please do follow us on Twitter. Thank you.