Add 2x design history posts for breast screening reporting (#335)

Author: edwardhorsford

app/breast-screening-reporting/2025/12/running-a-film-reading-design-sprint/index.md

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+---
+title: Running a film reading design sprint  
+description: After beginning with the simplest report in BSIS, the KC63, we are moving on to one of the most complex 
+date: 2025-12-19
+tags:
+  - design sprint
+  - breast screening
+  - NBSS
+  - KC63
+  - BSIS
+---
+
+## What is film reading?
+
+Film reading – looking at x-ray images – is done by radiologists, and is how we identify areas of concern in a mammogram.
+
+Radiologists reading performance is routinely quality assured to ensure accuracy, consistency, and patient safety. The reports also provide film reading performance data to the film readers themselves to help them understand their performance and support improvement where needed.
+
+The Film Reading Quality Assurance report (FRQA) is a set of reports within BSIS that supports the assurance process and helps us understand if our radiographers are detecting cancer at the rate we would expect, and in the way that we would expect.
+
+FRQA is therefore central to our core purpose of detecting cancer, preferably as early as possible.
+
+## Can we move existing FRQA reporting into FDP?
+
+We already know that there are lots of areas for improvement in film reading reporting that will represent a significant step forward for the programme.
+
+But we also must look at something more fundamental - does FDP have what we need in order to host and visualise the report?
+
+The current FRQA report in BSIS contains custom data visualisations that were specially created for this data type. FRQA needs multiple role-based access control views, and uses personally identifiable information. These reports are therefore clinically sensitive, operationally important, and tightly governed.
+
+By focusing on in FRQA we will surface any strategic or technical blockers to delivering a better solution for this report as soon as possible.
+
+As mentioned we have also that the current report in BSIS can be made more useful in future by, for example, producing data to film readers in a more timely way.
+
+In this design sprint, we will also explore how we can go beyond the definition of the FRQA report and support both quality assurance and real-time performance reporting at the same time, using a common solution.
+
+## What our film reading QA design sprint will cover
+
+During the sprint, we will:
+
+- explore how FRQA reports are created and their data requirements
+- explore what film reading performance reporting could look like for the new Breast Screening pathway
+- consider what better architectural solutions could look like in FDP and otherwise to serve both needs
+- produce an options analysis weighing up clinical assurance, governance and technical feasibility
+- outline an early roadmap to support the future delivery decisions
+
+Compared to the KC63 design sprint, the aim of this design sprint is not to produce a finished prototype. Instead, it will provide stakeholders with clarity on what different solutions could be, the trade-offs and constraints that exist, and what further work would be required to deliver safe, usable reporting for film readers in future.
+
+We are in the process of doing some pre-work to we can set up the design sprints to be as effective as possible. This means learning more about the current FRQA, including engaging with users. We’re keen to hear from FRQAr users who may struggle to use the FRQA report in BSIS or have ideas about how to view film reading performance going forward.

app/breast-screening-reporting/2025/12/using-design-sprints-to-help-us-learn-quickly/index.md

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+---
+title: Using design sprints to help us learn quickly 
+description: Adapting a tried and tested method to speed up our first Federated Data Platform (FDP) product 
+date: 2025-12-19
+tags:
+  - breast screening
+  - NBSS
+  - KC63
+  - BSIS
+  - design sprint
+---
+
+## Introduction
+
+Reporting is a challenge for many of us in Breast Screening – from getting the accurate data we need, compiling it together, before finally interpreting it to inform vital data driven decisions.
+
+As part of our programme of system modernisation that includes replacing NBSS (National Breast Screening System), the Breast Screening Reporting team is evolving current reports with automated, more intuitive dashboards with more timely insights, starting with reports that currently exist in Breast Screening Information System (BSIS) that were built to help quality assure the services.
+
+This entry touches on how the team have approached the problem and the work done so far
+
+## A different approach
+
+One of the ways we can accelerate our work is to run a design sprint. It’s a methodology developed by product teams at Google to help them move forward quickly by validating with experts and users.
+
+We tried this approach earlier in the year with our first BSIS report, KC63, and found that with some adaptation of its original structure, design sprints can be very effective at moving us forward in our uniquely complex and challenging clinical context.
+
+We want to be quick to decide and iterate, and this method echoes the principle of loving the problem, not the solution. We also learned that these design sprints can be difficult to run when we have so many users and stakeholders, so we are ensuring that we are more prepared and notifying others of them ahead of time.
+
+## Why we use design sprints
+
+The time-boxed, structured process of a design sprint brings the right people together to understand a problem, explore options, make a decision, and test it quickly.
+
+As we look at evolving the data and reporting in BSIS, our design sprints will focus on a single BSIS report as a problem space, allowing the team to run an entire discovery and early alpha in as little as one week.
+
+Each sprint brings together:
+
+- key users
+- stakeholders
+- subject matter experts (SMEs)
+- the full team – engineering, product, design, and delivery
+
+This ensures that expertise, data constraints, and delivery risks are considered in every activity.
+
+**The benefits include:**
+
+- Fewer surprises later, as technical, data, and delivery constraints are identified early
+- Investing in little time upfront leaves more time later to build, improve or even change the solution if needed
+- The whole team getting close to the problem and the users, with team members working together across all activities which creates clarity and focus
+- A change from the usual day-to-day rhythm gives the team dedicated time and space to ideate and creates momentum for the quarter
+
+## What we took away from the KC63 design sprint
+
+For our first design sprint in July 2025, we focused on understanding the simplest report in BSIS – KC63. This report compiles coverage data from all breast screening services in England. Coverage helps us understand how well the screening programme is reaching the eligible population and is formally published annually for public accountability.
+
+We explored how KC63 could be improved and delivered in FDP with the underlying question to answer being ‘does FDP have the capabilities we need to replace this report?’.
+
+We found that the report in BSIS was not used regularly, it lacked helpful visualisations of the data and must be used in combination with other reports to gain meaningful insights. We have found that this is a theme with a lot of the BSIS reports; that many individual tables could be replaced with fewer, more holistic insights.
+
+By the end of the design sprint we had iterated and validated a prototype dashboard that shows:
+
+- Key metrics together with uptake, coverage, and round length
+- Appropriate benchmarking and trend analysis
+- The ability to compare regions and Breast Screening Offices (BSOs)
+- Infographics, like maps, showing performance at a glance
+- Breakdowns by deprivation
+
+We are building the first, very basic version of this dashboard in FDP as Breast Screening Coverage (KC63). This helps us understand how to deliver an early version of the dashboard and the underlying setup needed for the final version.
+
+Next we will look at more complex reports like Film Reading Quality Assurance (FRQA).