Ovarian Protect
Primary Care Risk Stratification and Early Detection Programme
In partnership with East Midland Cancer Alliance (EMCA), West Midlands Cancer Alliance (WMCA) and ECLIPSE
Practice Pro Forma
Background:
The Ovarian Protect Programme is a clinician-led initiative delivered in partnership with East Midland Cancer Alliance (EMCA), West Midlands Cancer Alliance (WMCA) and ECLIPSE to help identify ovarian cancer earlier. It uses proactive risk stratification in primary care to find patients at higher risk sooner and support timely diagnosis.
Ovarian cancer remains one of the most challenging female cancer pathways. Nationally, over 6 in 10 ovarian cancers are diagnosed at Stages III or IV, significantly reducing treatment options and survival rates.
Currently, no systematic, population-level risk stratification mechanism exists in primary care to proactively identify women at high risk of ovarian cancer. Symptoms are often vague, overlap with benign conditions, and rely on patients presenting, leading to missed opportunities for early detection.
Leveraging ECLIPSE’s integrated dataset across the Midlands, the programme operationalises a risk prediction model at scale using routinely collected GP data, enhanced by targeted patient-reported symptom questionnaires. This enables systematic identification of women at elevated risk - many of whom may not yet have presented or met referral thresholds under current pathways.
Participating practices will receive their risk-stratified patient cohorts, supported by a clear and streamlined clinical pathway to enable timely review, investigation, and referral in line with NICE guidance.
This programme directly supports national and regional Cancer Alliance objectives to improve early diagnosis, reduce inequalities, strengthen screening-adjacent pathways, and reduce 62-day delays associated with late-stage presentation.
Objectives
Increase early identification of women at elevated risk of ovarian cancer through proactive digital risk stratification in primary care
Improve stage at diagnosis, contributing to a shift toward Stage I-II detection across participating practices
Support 62-day and Faster Diagnosis Standard (FDS) performance by reducing delays caused by late presentation
Reduce unwarranted variation and health inequalities, targeting areas with highest emergency presentations or lower awareness
Enhance patient experience by providing clear education, faster triage, and digital access to symptom assessment
Enable a sustainable, repeatable primary care process for gynaecological cancer risk detection across both regions
Patient Cohort:
Women aged 18+ registered at participating GP practices across the EMCA and WMCA footprints, identified via the Eclipse risk stratification algorithm as moderate-high risk of ovarian malignancy, which is based on as moderate or high risk based on:
Coded clinical history (symptoms, diagnoses, family history)
Medication history
Risk factors (age, menopausal status, BRCA/Lynch syndrome, personal cancer history)
Patient-derived symptom questionnaire responses
Risk Banding:
The programme uses a two-stage risk model aligned to NICE NG12 (Suspected cancer: recognition and referral). Combined Electronic health record and questionnaire data produces a three-band risk classification:
| Risk Band | Criteria | Recommended Action |
|---|---|---|
| Low | Few or non-specific symptoms, no concerning pattern | Reassurance and safety-netting advice; flagged in EHR for re-check if symptoms persist |
| Moderate | Concerning symptom patterns or risk factors but not high-risk cluster | CA125 and/or ultrasound per NICE NG12; GP review prompt |
| High | Multiple classic symptoms (persistent); strong family history; previous abnormal tests | Urgent clinical review with view to 2WW referral and full work-up |
The algorithm stratifies women into risk bands mapped to clear, NICE-aligned actions for primary care.
Patient Engagement Pathway:
Once your practice has opted in via the pro forma below, the programme follows a structured patient engagement journey:
Cohort identification - algorithm runs against the Eclipse integrated primary care dataset; eligible women are identified and dashboard access is configured.
Pathway activation – Access to ECLIPSE Ovarian Cancer Protect Pathway, showing longitudinal mapping of patients within specified cohort, risk stratified priority groups and further tracking of outcomes and responses following patient engagement and further clinical review.
Patient invitation - centralised SMS sent to the identified cohort with a link to the programme landing page
Patient education - landing page provides programme information, benefits, and guidance on next steps
Questionnaire completion - patient completes an online structured digital questionnaire, informed by elements of the Goff Symptom Index and UKCTOCS-style symptom questions
Risk scoring - combined EHR and questionnaire data produces a risk band
Practice notification – high risk patients are flagged on the practice pathway dashboard.
Clinical triage - practice reviews flagged patients; orders CA125, ultrasound, or makes 2WW referral as indicated according to risk.
Safety-netting - low-risk patients receive reassurance and guidance on when to re-present
Monitoring - monthly metrics on uptake, risk levels, investigation rates, outcomes, and inequalities
Vulnerable and digitally deprived patient groups are supported through ECLIPSE using our Virtual Support Team (VST) telephone engagement.
Clinician Participation in the Programme:
With practice approval, Eclipse will text eligible patients directly to coordinate and support their journey through the programme on the practice’s behalf, using the PEGASUS (Patient Engagement Governance Assuring Standardised Utilisation of Services) model. Patients who do not respond to this initial SMS will be followed up by the Virtual Support Team via telephone to maximise engagement and ensure equitable access to care.
Proforma:
If your practice would like to take part, please complete the pro forma below to provide the necessary permissions and practice consent for this service. This includes outlining your preferences for patient engagement, data sharing, and key contacts.