Exploring the feasibility, acceptability and impact of genomic newborn screening for rare diseases in England: A study protocol for the Generation Study - Process and Impact Evaluation (Version 2)

Abstract The role of genomics in healthcare is expanding rapidly and many countries are exploring the possibility of using genomic sequencing to expand current newborn screening programmes. Offering routine genomic newborn screening (gNBS) would allow newborn screening to include a much broader range of rare conditions, but there are many technical, practical, psychosocial, ethical and economic challenges to be addressed. Genomics England and NHS England have established the Generation Study to deliver gNBS for 100,000 births to explore the benefits, challenges, and practicalities of offering gNBS to parents in England. Here we describe the study protocol for the Generation Study - Process and Impact Evaluation, an independent mixed-methods evaluation of the Generation Study. The evaluation will have oversight from a Study Advisory Group that includes academic, clinical and patient representatives and a Patient and Public Involvement and Engagement (PPIE) Advisory Group that includes members from parent and patient organisations and parents with relevant experiences. The Process and Impact Evaluation will examine whether offering gNBS in routine care is feasible and acceptable and inform our understanding of the clinical utility and cost effectiveness of gNBS in England. Through surveys and interviews conducted at two time points we will explore the attitudes and experiences of parents, professionals and patient organisations. We will also consider the clinical, psychosocial and health economic impacts, both positive and negative. The results will be presented at national and international conferences and submitted for peer review and publication.