Abstract The 1+Million Genomes Initiative (1+MG) has been fostering reflection in European countries on their national strategies for genomic medicine, and how these can contribute to research development and improved medical practice. For all citizens to truly benefit from genomic medicine, there must be equitable access across Europe. However, European countries are currently at different stages of implementation of genomics in medical practice. To bridge these gaps, health decision-makers need to understand the maturity of genomic medicine practices in their healthcare systems, to make informed decisions about investment, resources, and practices towards optimized adoption of genomics in healthcare systems. This presentation will focus on the 1+MG Maturity Level Model (MLM), developed in the context of the 1+MG Initiative and B1MG project. This MLM was created as a tool for countries to self-assess the maturity of genomic medicine practices in their healthcare systems, and to define a path to optimization. The MLM content was validated through a Delphi survey with international genomics and public health experts, and a pilot in real-life settings was conducted in eight European countries. The 1+MG MLM pilot provided valuable insights regarding common strengths, weaknesses, and asymmetries across Europe, highlighting the need for national and cross-European investments to close existing gaps, and make personalised medicine accessible to all citizens and patients in Europe.