Introduction/Background The Advanced Nurse Practitioner (ANP) led Gynaecology Oncology Family History Clinic is a new, innovative approach to the care of women with BRCA 1, BRCA 2 and other pathogenic variants (PV). This service prioritises prevention of ovarian cancers in these patients, through risk reduction surgery.

Methodology The National Cancer Control Programme (NCCP) identified that patients with pathogenic variant should have specialist pathway, with adequate support, due to their high cancer risk. Previously, patients with a genetic predisposition to gynaecological cancers were seen in a variety of Gynaecology clinics without formal nursing support. An ANP role was developed to establish agreed pathway, provide individualised holistic care, as well as post-operative support with surgical menopause. Virtual clinics, first introduced during Covid- 19 Pandemic, reduce the need for hospital attendance. Using a four phase service improvement model, this clinic was established in September 2022, the first of its kind in Gynae Oncology nationally.

Results In the first 12 months, 119 ANP virtual consultations were completed with 60 patients. Within the Gynaecology department, 9 risk reducing procedures were planned/completed in 2023: 7 patients with BRCA 2 PV, one patient with BRIP1 and one patient with PALB2. 5 of these patients had a personal history of breast cancer. Three patients with breast cancer were referred directly to surgery by their Medical Oncologist, while 6 patients undergoing surgery were under the care of the ANP-led Family History Clinic. A further 2 patients with BRCA 2 elected to have risk reducing surgery in a private hospital.

Conclusion Within the first year of service, 9 patients underwent RRBSO to reduce their risk of ovarian cancer on the newly established ANP-led pathway, receiving specialist nursing support and education pre and post-operatively. Continuation of this clinic in 2024 will better inform practice and requires formal evaluation.

Disclosures For one author only, Prof Donal Brennan. See attached document.

No other disclosures.