Giving consent to the 100,000 Genomes Project

People who are taking part in the 100,000 Genomes Project sign a consent form before they give samples of their blood or tissue. People are encouraged to discuss risks and benefits of taking part with a member of the health care team and people are given information to read about the project. Hospitals try to aim to ensure that people are given time to look over the information and consent form before they decide to take part.

When and where do people consent for the 100,000 Genomes Project?

Consent forms are usually signed in hospital after a face to face discussion with a member of the health care team. But the point at which people are asked to join the Project differs for the rare disease and cancer programme. While consent must be given before a sample of blood/saliva is taken for the rare diseases arm, as of March 2017 people in the cancer arm of the project people can consent to tissue that has already been taken (during a biopsy or surgery) being used for the project. This is because people are asked to consent only after a cancer diagnosis is given. The tissues removed for the biopsy/surgery can be stored ready for use by the Project when consent is given. This change came into effect in response to feedback and guidance from service users and the cancer community, however, most of the people we interviewed participated before March 2017 and were asked to consent in advance

The research nurse visited Sheila and her son, Edward, at home where they signed the consent forms and had bloods taken. If consent forms cannot be signed during a routine medical appointment, people may be invited to an appointment with the genetics team at the hospital to sign the consent form and have their samples taken. People can also consent by post or over the phone in some circumstances. Heather, her Mum and Dad travelled to a hospital several hours away to sign consent forms and have blood samples taken.

During her first appointment with her consultant, Aileen was given an information pack to read at home. At her pre-op appointment she had a discussion with the research nurse before she signed the consent form.

Age at interview 57

Gender Female

Age at diagnosis 56

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Raymond was told about the project just before an operation for prostate cancer. He signed for that much stuff he can hardly remember, but says he was happy to sign if it would help someone else.

Age at interview 58

Gender Male

Age at diagnosis 57

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Arthur was told all about the project at his pre-op assessment and thought let’s do it. He took an information pack home with him but didn’st take too much of it in.

Age at interview 82

Gender Male

Age at diagnosis 82

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Some people had concerns about the timing of their being asked to participate in the project. Barbara had seen a poster and heard about the project, but wasn’t given the consent form until she was told the results of her biopsy, which showed she had cancer. She and her daughter went through the consent form and she initialled all the boxes but said ‘you don’t always take it all in do you at the time’. Others who were given the consent form in their pre-operation assessment didn’t have much time to read about the project before consenting for samples to be taken during their operation.

Vanessa was invited to take part by a nurse when she was waiting for an appointment. She only wanted to know if participating would involve taking any trial drugs. The nurse explained that it wouldn’st.

Age at interview 60

Gender Female

Age at diagnosis 54

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Despite this, most were happy to participate and didn’t feel pressured into it. Bart described the consent process as ‘friendly and supportive.’ Betty recalled, ‘there’s no rush, no pressure. It’s all done very well’, and Lucy Z said it was ‘professional’.

Lucy Z didn’t feel under any pressure to take part in the project when the research nurse gave her leaflets to read in the waiting room at her pre-op assessment.

Age at interview 53

Gender Female

Age at diagnosis 53

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Some people signed the consent form without looking through the paperwork in detail because they trusted the health professionals and it sounded like a worthwhile project that would help medical science. Pauline was told it would help other people, and maybe help her too, and she was happy to take part on that basis.

Pam signed the consent form before she went in for her breast cancer operation. Although there wasn’t time to read much about it before her operation she trusted the health care team and felt happy to give her written consent.

Age at interview 84

Age at diagnosis 84

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The hospital Stuart went to for his eye tests is at the forefront of research so when they asked him to participate in research related to his condition it was an easy decision to make.

Age at interview 52

Gender Male

Age at diagnosis 37

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Completing the consent form

Several people recalled that the person taking the consent spent a long time talking through the form with them, carefully explaining to check that they understood what they were consenting to, with opportunities to ask questions. Leanne said it ‘wasn’t long speeches or anything’, the person just asked about her preferences. Lucy X said her specialist nurse answered all her questions and gave her an e-mail and phone number if she had any more things she wanted to know.

Mark and Julie found it helpful to have a face to face discussion with the genetics counsellor who went through the consent forms very carefully with them.

Age at interview 50

Age at diagnosis 52

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The researchers talked through the consent forms carefully to Nicola. She was sure she wanted to take part because of her family experiences of cancer.

Age at interview 57

Gender Female

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The consent form contains a series of boxes which participants are required to read and initial and some found them complicated. Mark and Julie said it was ‘a very contractual looking and sounding document’. Talking through with a medical professional helped to put the information into layman’s terms. Kay has to complete ethics forms as part of her job and said she understood the need to be thorough, and Nick said the questions were ‘quite informative’ and just what he was expecting in terms of data protection. Lucy Z (above) completed the form with her daughter without a health professional present.

Julie and her daughter were surprised how detailed the consent forms were.

Kay says she was expecting the sorts of questions she was asked on the consent form and once it was explained to her she felt it was understandable.

Age at interview 35

Gender Female

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Deciding what to consent to

There are parts of the project which people must agree to in order to participate in the project. But there are also additional findings, which people can opt into or out of, such as finding out about whether they are at risk of developing certain genetic diseases (different to the cancer or rare disease that brought them to participate in the project) in future. Sheila and Edward chose to give written consent to everything.

Since Linda’s identity will not be revealed she is not worried about sharing her data. She ticked all the boxes on the consent form.

Age at interview 58

Gender Female

Age at diagnosis 57

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But some people were glad to have the choice.

Lucy Y, who has a rare genetic condition, was happy to consent to her samples being used for most aspects of the project but for a couple of the uses she asked to be contacted beforehand.

Age at interview 39

Gender Female

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Aileen liked that there were options on the consent form about how much you could agree to take part in.

Age at interview 57

Gender Female

Age at diagnosis 56

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Birgit found it reassuring that she could opt out of the project at any time. You can read more about how these choices affected people’s thoughts for the future.