2026/27 National Genomic Test Directory released in England

On April 8, 2026, NHS England published the 2026/27 National Genomic Test Directory (NGTD). The directory lists genomic tests commissioned by NHS England and provided through Genomic Laboratory Hubs. 

The key update concerns hematological and neurological cancers, for which separate files were published with a significant restructure: new genomic test (GT) codes were introduced, gathered into new clinically relevant test packages (TP), and mapped to existing M-codes. The new separate directories were published for these indications:

• NGTD for Haematological oncology (HaemOnc) – Excel file (version 1) and supporting PDF document with eligibility criteria (version 1). A total of 341 GT codes were introduced and organized into 14 Test Packages.
• NGTD for central nervous system (CNS) cancers – Excel file (version 1). A total of 80 GT codes were introduced and organized into 7 Test Packages.

The structure of the NGTD for non-central nervous system cancer remains largely unchanged from the previous edition – Excel file (version 14), covering solid tumours, sarcomas, and paediatric cancers. No new codes have been added for these indications.

The structure of the NGTD for rare and inherited diseases remains largely unchanged from the previous edition. As in prior years, two documents were released:

• National Genomic Test Directory for rare and inherited diseases (version 9);
• Rare and inherited disease eligibility criteria (version 9).

Multiple changes were introduced, including implementing 19 new codes (test-indication combination). Some examples are provided below:

• R470.1 T21, T18, and T13 aneuploidy testing - NIPT NHS Fetal Anomaly Screening Programme (FASP);
• R462.1 Childhood interstitial lung disease;
• R464.1 Recurrent miscarriage where products of conception are not available for testing - parental karyotype;
• R461.1 Cerebral amyloid angiopathy;
• R471.1 Neurodegenerative Disorders, adult onset – Prenatal Exclusion Testing (C9orf72 haplotype);
• R458.1 Young onset or familial dementia.

See the full details here.

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