The Opportunity
Designing the digital foundations for safe and effective national screening
Lung cancer remains Scotland's leading cause of cancer death, with 66% of cases diagnosed at a late, less treatable stage. Scotland's first nationally-delivered screening programme aims to change that by identifying risk earlier and reaching the people most likely to be affected; improving survival rates and addressing health inequalities.
As the programme was still being established with no clinical baseline to work from, PSD Scotland required a strategic partner to translate evolving clinical protocols, operational models, and technical constraints into a clear, robust foundation for a safe digital platform before moving to procurement and implementation.
The Solution
Mapping the end-to-end screening pathway
Over the eight-week discovery phase, we mapped the end-to-end screening pathway into comprehensive service blueprints (accommodating both known and unknown smoking status scenarios, hybrid delivery modes, and complex clinical pathways). We built a detailed catalogue of over 200 functional, non-functional, security, and accessibility requirements.
We developed risk-informed prioritisation models aligned to NHS Scotland Integrated Risk Management and UN Sustainable Development Goals to support transparency in prioritisation and investment decisions as scope evolves. Furthermore, we designed a high-level technology and data architecture that was validated by the NHS’s Technical Design Authority (TDA), ensuring the platform would be secure, scalable, and capable of supporting a unified national research dataset. The intention for this architecture is that it represents the vision underpinning the future model for all screening programmes across NHS Scotland.
The Impact
Our discovery phase successfully defined the structural conditions and critical success factors required for a safe national rollout. We provided PSD Scotland with a validated understanding of what must be true for MVP (e.g., longitudinal participant tracking, automated risk scoring, configured call/recall logic, and a self-referral pathway) alongside a clear roadmap for scaling to national delivery. This included a Technology and Data Vision focused on equity, participant safety, and programme improvement intelligence, positioning Scotland as a leader in lung cancer screening.
By establishing clear service blueprints and surfacing systemic risks early, we reduced ambiguity and delivered a highly actionable, stakeholder-validated foundation to support confident progression into procurement and implementation.
Client Testimonial
"This is a really good demonstration of how to engage with stakeholders and collaborate well together. I'm really impressed with the high quality of outputs produced and presented by the team in such a short space of time (eight weeks!) and it felt very natural and easy working with Waracle."
Lorna Dryburgh, Product Lead, PSD Scotland
