Scotland’s NHS, academia and industry will come together over the next five years to improve the country’s ability to detect, understand and protect against infectious diseases that pose the biggest threat to public health.

Launched this week by Public Health Scotland (PHS), Scotland’s first ever Pathogen Genomic Strategic Plan sets out key objectives to deliver an integrated pathogen genomic laboratory and surveillance services.

The plan also commits to progress and develop the workforce and to ready the country for infectious disease emergencies.  

A national organisation will be tasked with leading the delivery of the plan, which will include facilitating a joined-up approach to innovation, data sharing and skills and equipment, all with the aim of strengthening surveillance activities.

Introducing the plan, Cabinet Secretary for Health and Social Care Neil Gray says it marks a “significant milestone” in Scotland’s commitment to advancing public health services:

“Recognising the transformative impact that pathogen genome sequencing is making in public health, this strategic plan establishes the framework necessary for a state-of-the-art genomic service, equipped to leverage the opportunities presented by this rapidly evolving field.

“The strategic plan represents our first step towards creating a world-class pathogen genomics service, centred on principles of precision and responsiveness.”

Pathogen genomics is the study of the genetic makeup of disease-causing organisms called pathogens to understand how the develop, evolve, and spread disease.

By sequencing the genome of pathogens, critical information can be gained to help develop diagnostic tools, treatments and vaccines for infectious diseases like COVID.

Mr Gray says the delivery of the new strategy will link in with wider healthcare science work across Scotland and the rest of the UK – including Scotland’s genomic medicine strategy which commits to advancing innovative methods of diagnosis and treatment for people at risk of cancer and rare conditions.

Pandemic learnings

Against the “challenging fiscal environment” and substantial pressure on public health services, Mr Gray adds that the initial implementation plan will develop from the “strong foundations” and “legacy” of the pandemic response:

“This ensures that investments and partnerships are strategically directed to benefit those most in need and deliver maximum value, contributing to the resilience and renewal of our health services.

“We will work diligently to advance all components of this strategic plan, with the expectation that by the end of its five-year span, Scotland’s pathogen genomics services will be fully equipped to support clinical decision-making, optimise diagnostics and therapeutics, and enhance pandemic preparedness.

“By integrating these strategic elements, we aim to position Scotland at the forefront of pathogen genomics, ensuring a robust, responsive, and forward-looking public health infrastructure.”

The plan says sequencing developments that accelerated during the pandemic will be built upon, first by addressing the current gaps in capability.

It says COVID highlighted the need for scalable sequencing capacity.

PHS and the Scottish government will now work together to address a wider range of pathogens beyond coronavirus to support NHS recovery and responsiveness.

PHS explains that the benefits of pathogen sequencing extend from an individual patient level – for accurate, timely diagnosis and treatment – to local population interventions and at a global population level to detect, track and prevent the spread of emerging pathogens.

Partnership working

To deliver “transformative impact”, the plan states a core public health workforce team focused on bioinformatics is needed, which will use NHS data infrastructure to coordinate sequencing and integrate genomic data with partner datasets for public health.

PHS will work with the government’s policy leads this year to identify and resource a national organisation that can coordinate the operational delivery of pathogen genomics needed.

The government and PHS will also work to understand the sequencing and data analytic needs within and outwith NHS Scotland to support pathogen genomics that can deliver most effectively across partners with access to a centralised data infrastructure.

Public Health Scotland will work with the government, and the National Services Division NHS National Services Scotland and its National Services Division which leads on planning, commissioning and coordinating health services, to identify the best way to fund and deliver laboratory services to meet the sequencing needs for priority pathogens.

Meanwhile, the strategy says work is already underway to with wider partners to support closer working across pathogen genomics.

Earlier this year, the Scottish government signed up to a joint UK plan for combatting antimicrobial resistance and now PHS says this strategic plan will help Scotland maintain a state of readiness for emergencies while capitalising on new learning.

Mr Gray adds:

“Aligned with the World Health Organization’s ‘10-year Global Genomic Surveillance Strategy,’ our strategic plan outlines strategic actions with specific performance measures, coordinating organizations, and timelines.

“These actions will guide the development and enhancement of Scotland’s pathogen genomics capabilities over the next five years, building on the legacy of SARS-CoV-2 sequencing service towards a comprehensive, pathogen-agnostic service that meets public health demands and fosters ‘One Health’ partnerships.”

Read more: Dementia care services need urgent reform; Realistic medicine to help the climate; Researchers: policy needed for patient ‘missingness'; European approval for Livingston-made vaccine; Working together for climate action and good health; Smashing stigma to save lives in Scotland; Workforce and public to inform NHS reform; Doctors call for action on air pollution