BUSINESS CHALLENGE

The National Cancer Screening Register (NCSR) is a critical national health initiative designed to provide the infrastructure for recording, analysing, and reporting cancer screening data across Australia. Its purpose is to support early detection, ensure continuity of care, and improve long-term health outcomes for participants.

Before the client engaged Adactin, the NCSR implementation was being delivered predominantly through a traditional waterfall methodology. While this approach offered structure, it was not suited to the pace and complexity required for a modern national digital health platform. The program faced escalating challenges related to budget overruns, missed timelines, code instability, and release bottlenecks.

More than 60 high-priority production defects had been reported, reflecting deep issues in development governance, testing practices, and solution quality. Decision-making was centralised and rigid, heavily dependent on documentation rather than working software and objective metrics. Multiple teams worked in parallel without synchronisation, causing code conflicts, rework, and inconsistent release cycles.

Testing was pushed to the end of each release, which meant many issues were identified far too late, triggering design changes that delayed delivery even further. Telstra Health recognised that continuing in this way would jeopardise the success of the national program. They needed a scalable Agile framework, strong governance, continuous delivery capability, and a shift towards business-driven solution design.

STRATEGIC SOLUTION

Adactin was engaged to lead a complete transformation of the NCSR delivery model by establishing a Scaled Agile Framework (SAFe) across the entire program and embedding strong Agile governance from the ground up. This required structural, cultural, and process-level change across all functional streams.

Adactin began by conducting Lean-Agile leadership workshops, training change agents and senior managers in both Lean principles and Agile ways of working. This helped shift the mindset from documentation-driven delivery to business-value driven delivery, where teams release small increments quickly and continuously refine the solution based on feedback and economics.

To enable fast and predictable delivery, Adactin established SAFe Agile teams working in two-week sprints. These teams followed core Scrum practices — refining user stories, demonstrating working software each iteration, and identifying improvement opportunities in retrospectives. Decision-making was decentralised within teams to reduce bottlenecks and empower faster progress.

A major step forward was the creation of the Agile Release Train (ART), bringing four cross-functional teams together with synchronised planning, integration, deployment, and release activities. This aligned the entire program around a single cadence and allowed the teams to operate as a coordinated delivery engine.

Each ART was supported by a continuous delivery pipeline, incorporating:

• Continuous Exploration
• Continuous Integration
• Continuous Deployment
• Release on Demand

This pipeline enabled automated builds, automated testing, and seamless deployment cycles.

To further strengthen quality, Adactin introduced Test-Driven Development (TDD), ensuring testing began early and occurred continuously throughout development, rather than at the end. This reduced defect rates dramatically and increased confidence in production releases.

Adactin also guided Telstra Health in applying Lean Portfolio Management to streamline future investment planning, optimise funding allocation, and ensure strategic alignment across initiatives. This enabled the organisation to expand SAFe across other projects, creating a unified and mature Agile governance model.

BUSINESS OUTCOMES

Adactin’s intervention delivered measurable and immediate improvements across the NCSR program and the client’s broader delivery ecosystem.

• 28% cost savings were achieved by reducing rework, avoiding unnecessary delays, and improving overall efficiency.
• Project timelines stabilised, with teams consistently delivering to schedule due to improved planning and continuous delivery practices.
• Testing early and continuously led to earlier defect detection and significantly fewer production issues.
• Faster production releases were achieved through the continuous integration and continuous deployment pipeline.
• The shift to a business-solution-driven approach ensured that releases delivered meaningful value to end users and clinical stakeholders.
• The SAFe-based Agile governance model was successfully implemented across the organisation, establishing a consistent delivery framework.
• Newly trained Agile leaders and change agents continued driving SAFe and Lean principles long after the initial engagement.

Collectively, these changes helped stabilise one of Australia’s most important national health registers and set the client on a strong trajectory for future transformation initiatives.

References

Frameworks Used: SAFe, Lean-Agile Leadership, Scrum, TDD, Continuous Delivery