David Hunter ('Live from Leeds', 3 September) is absolutely right to highlight the almost total failure so far to pay proper attention to the impending genetic revolution in healthcare.

In 1995, we brought together 20 leading clinicians, researchers and managers to identify the key challenges which genetics would pose the NHS. Only recently have managers and professionals begun to grasp that genetics should be on their agendas now.

Adding to Hunter's excellent overview, we highlight two immediate challenges revealed by our work since 1995. First, the pre-registration education of all professional groups gives inadequate attention to genetics. Nurses, for example, typically receive less than 10 hours' training in this field, usually from a non-specialist, and yet genetics will have a fundamental influence on both the physiological and psychological needs of their clients.

Second, the general public has a profoundly ambivalent - and volatile - attitude to the impact of genetics on their NHS. Our research reveals great excitement at the prospects for health gain, which could easily be over-whelmed by fear, generated by the unregulated introduction of unfocused genetics testing.

These issues - and others - need a detailed airing among managers and clinicians, followed by a series of policy shifts relating to service reconfiguration, capital development (including all new private finance initiative bids), professional education, and public engagement. We will be hosting the first major conference in this area next June, and copies of our research and other publications are available on request.

In the meantime, the NHS needs to raise its eyes a little from waiting lists and financial pressure to see the tidal wave heading its way.

Marcus Longley

Associate director;

Maggie Kirk

Rachel Iredale

Tony Beddow

Senior fellows

Genomics Policy Unit

Welsh Institute for Health and Social Care

University of Glamorgan

Pontypridd

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