The NHS in England has embraced genetics and genomics since its lnception in 1948. The NHS contribution to the highly successful 100,000 Genomes Project led to an understanding of the transformation required to systematically introduce genomic medicine as a construct into the NHS in England for the 55 million people that it serves. In 2018 the NHS Genomic Medicine Service was launched with equity of access for all and standardisation at its core. The investment in infrastructure and multi professional leadership, coupled with the rapid adoption of cutting edge technologies, development of education and training resources, linking with precision treatments and medicines optimisation and support for and alignment with research and innovation is seen as world leading. There is an ongoing drive to fully embed genomics across multiple clinical pathways and in striving for excellence to use the power of genomics to improve patient outcomes across the life course. This potential can be enhanced by working in collaboration with multiple partners across the globe.