Harmonising the scope of practice for genetic counsellors in the D-A-CH region: a cross-border consensus for Germany, Austria, and Switzerland.

Rapid integration of genomics into clinical practice has increased the demand for genetic counselling services. While the genetic counsellor (GC) profession is well established in the Anglo-American healthcare systems, the D-A-CH countries, Germany, Austria, and Switzerland, operate under distinct, physician-led legal frameworks. To ensure high-quality care and professional mobility, a harmonised definition of the GC's role is necessary. The newly founded GfH Commission for GCs, in collaboration with the national human genetics societies of Germany (GfH), Austria (ÖGH), and Switzerland (SGMG), the Association of German Human Geneticists (BVDH), and the Swiss Association of GCs (ASCG), conducted a multi-stage consensus-building process. The methodology involved a comparative analysis of national legal prerequisites and the application of the entrustable professional activities framework to define the interprofessional interface between GCs and medical geneticists (MGs). The resulting scope of practice (SoP) categorizes competencies across three clinical phases: pre-counselling preparation, the active counselling process, and post-analytical follow-up. The SoP distinguishes between independent GC tasks, shared clinical responsibilities, and tasks requiring MGs. Key to this model is the preservation of the legal physician-prerogative for aspects like the final medical diagnosis and test-ordering while maximizing the GC's contribution to patient-centred communication and care. This cross-border consensus represents a landmark in European professional policy, providing a scalable blueprint for the integration of GCs into regulated medical systems. By harmonising standards across the D-A-CH countries, the SoP ensures quality assurance, provides a robust evidence base for future legislative recognition and reimbursement of GCs, and facilitates professional mobility in Europe. Genetic counsellor, professional policy, D-A-CH region, interprofessional collaboration, entrustable professional activities, scope of practice, Genetische Fachberater, GfH, ÖGH, SGMG, BVDH, ASCG.