The experiences of UK-based genetic counsellors working in mainstream settings.

Most UK-based genetic counsellors (GCs) work within clinical genetics services; yet there is a small and expanding group of GCs working within other clinical specialties, termed "mainstream" GCs. To our knowledge there have been no projects to date examining the experiences of mainstream GCs working in the UK. The aim of this workforce evaluation was to explore the experiences of mainstream GCs. Online surveys were sent to mainstream GCs to obtain general demographic information and baseline data regarding experiences of working in these roles. Those who completed the surveys were then invited to take part in online focus groups. Data was transcribed and analysed using thematic analysis to draw out major themes that arose from the discussions. Major themes were found to be: "Benefits", "Challenges", "Career Progression" and "Support". Overall, participants expressed enjoyment of their roles and described key benefits of working in a clinical specialty, including autonomous working and developing expertise. Still, career progression was limited in many cases due to issues obtaining professional registration, lack of support, and unclear definition of the mainstream GC role. Findings are brought together as a list of suggestions to support this subset of the profession going forward. We hope these findings could be of utility to both employers and policymakers when advancing the national provision for mainstream genomic services.