Project overview
As part of Bupa UK's wider CRM transformation programme, the organisation set out to consolidate more than 15 fragmented systems into a single platform built on Microsoft Dynamics and Power Apps. The long-term vision was to enable more than 1.200 agents to support customers end-to-end without switching between multiple systems.
The pre-authorisation process applies to 80% of customer queries. It is a critical workflow used to assess, approve, and manage treatment requests. The business priority was redesigning the pre-authorisation journey.
The legacy experience was difficult to learn, inaccessible, and heavily dependent on agent experience and institutional knowledge.
Duration: 18 months
Outcomes
Reduced average handling time by 2 minutes per pre-authorisation
Contributed to approximately £500,000 annual savings
Achieved 80% adoption across approximately 1,200 agents
Reduced training time from weeks to approximately 1 hour
Improved accessibility through keyboard navigation, focus management, zoom optimisation, and screen reader compatibility
*Some mock-ups are representative recreations. Due to confidentiality constraints of legacy/internal systems, the original interfaces cannot be publicly shared.
Goals
The objective was not simply to redesign an existing form. The project aimed to improve a critical operational workflow while supporting Bupa's wider CRM transformation programme.
Business goals
Increase adoption of OneView across customer service teams
Reduce average handling time for pre-authorisation calls
Lower operational costs through workflow efficiency
Reduce training effort for new agents
Establish a scalable foundation for future CRM capabilities
User goals
Reduce cognitive load during customer conversations
Simplify the pre-authorisation process
Improve accessibility for agents with diverse needs
Minimise switching between systems
Increase confidence when making treatment decisions
Provide clearer guidance throughout the workflow
My role
Senior Product Designer (solo)
I led:
UX Research
Interaction Design
UI Design
Accessibility
Usability Testing
Product Discovery
Stakeholder Workshops
Pilot Testing
Design Validation
The challenge
Pre-authorisation agents manage complex customer conversations every day. To approve or decline treatment requests, agents need to gather information about medical conditions, treatments, healthcare providers, eligibility, and policy coverage.
The existing experience exposed large amounts of information simultaneously, forcing agents to navigate a dense interface while speaking to customers.
The experience:
Created significant cognitive load
Required extensive training
Offered little guidance
Was difficult to use with assistive technologies
Encouraged workarounds and reliance on experience
At the same time, the business wanted to reduce handling times and increase adoption of the new CRM platform.
The legacy experience exposed system complexity directly to users, requiring agents to interpret large amounts of information with limited guidance.
Understanding the problem
Over the course of the project, I conducted more than 120 observations, live call shadowing sessions, accessibility reviews, usability testing sessions, and pilot group activities.
My goal was not simply to understand usability issues, but to understand how agents actually worked.
Agents worked around the system
Experienced agents relied on memory, personal workarounds, and years of operational knowledge to complete requests efficiently.
The system was not supporting decision-making. The agents were compensating for it.
Cognitive load was slowing people down
Agents needed to interpret unfamiliar terminology, navigate dense forms, remember business rules, and switch between systems while handling live customer conversations.
Adoption is not feature-level
One of the most important discoveries was that users do not adopt individual features.
They adopt workflows.
Although the new pre-authorisation experience significantly improved usability, agents continued returning to the legacy platform whenever information they needed was unavailable in OneView.
This challenged the assumption that delivering a better form alone would drive adoption.
Trust matters more than usability
Performance issues, occasional bugs, and data mismatches between systems reduced confidence in the new platform. Even when users preferred the experience, trust strongly influenced adoption behaviour.
Mapping the existing workflow
Designing the new workflow
Research revealed that agents frequently left the workflow to access separate systems before returning to complete a request.
This introduced friction, increased handling times, and interrupted customer conversations.
Before
Rather than redesigning screens, I focused on redesigning the workflow itself. The goal was to reduce cognitive effort and guide agents naturally through the process.
Aligning with Agents' mental models
The workflow was reorganised around how agents gather information during customer conversations:
1. Health condition
2. Treatment
3. Healthcare provider
4. Assessment
5. Results
This reduced the effort required to understand the system and improved learnability for new agents.
The workflow structure reflects how agents think and work rather than how data is stored.
Reducing context switching
One of the most common behaviours observed during research was agents leaving the workflow to search for provider information.
This often involved using Bupa Finder, a separate platform containing thousands of hospitals and consultants.
To streamline the experience, provider search was integrated directly into OneView, allowing agents to search for hospitals and consultants without leaving the workflow.
This reduced context switching and helped create a more seamless experience.
After
Provider information was integrated directly into the workflow, reducing the need to switch between systems.
Accessibility beyond compliance
One of the most valuable parts of the project involved working directly with a visually impaired agent. Observing how they navigated the system changed my understanding of accessibility.
The challenge wasn't simply meeting WCAG requirements. It was understanding how people actually experience digital products.
Research revealed the importance of:
- Focus visibility
- Keyboard navigation
- Zoom behaviour
- Screen reader compatibility
- Information hierarchy
- Action proximity
When users zoomed significantly, interfaces behaved very differently. Actions needed to remain visible, information needed clear structure, and navigation needed to remain predictable. The project reinforced an important lesson:
Designing for edge cases often improves the experience for everyone.
Mapping the workflow revealed opportunities to reduce context switching and simplify decision-making.
Accessibility considerations were incorporated throughout the workflow to support a wider range of user needs.
Creating confidence through workflow transparency
The final workflow introduced a clear progress indicator across three stages:
- Details
- Assessment
- Results
This helped agents understand where they were in the process, what had already been completed, and what remained.
The workflow also extended beyond issuing a decision.
Agents were provided with communication guidance, email actions, SMS actions, and next steps to support customer conversations.
The workflow concludes with decision support and communication guidance, helping agents confidently complete customer interactions.
Agent feedback
‘‘Having everything integrated onto the pre-auth form makes a massive difference when serving customers."
Toby, Customer Service Agent
‘‘I quite like it for the pre-authorisation. It is a bit slow at the moment, but I'm a big fan of what it's likely going to be."
Helen, Customer Service Agent
‘‘The more I use it, the more confident I become."
Charlotte, Customer Service Agent
‘‘Being able to duplicate treatment in the new form is a lifesaver."
Laura, Customer Service Agent
Metrics
2-minute reduction in average handling time
1.
A year later, the agents could take 2 minutes back per phone call
Approximately £500,000 annual savings
2.
Decreasing average handling time and improving customer experience is predicted to save the business more than half a million pounds per year. The cost saving also includes talent retention, reduced training time and improved employee wellbeing
Training reduced from weeks to approximately 1 hour
3.
Experienced and new agents were able to take pre-authorisation calls following the new intuitive design only after an hour training.
80% adoption across approximately 1,200 agents
4.
Lack of end-to-end workflows for all customer queries, API performance issues and system errors have been a blocker to adoption, However, 80% is more than the business expected to achieve within the first year.
Key learnings
Adoption is driven by workflows, not features. Users do not adopt individual features. They adopt workflows they can complete end-to-end. Delivering a better experience for one task does not guarantee adoption if critical information or functionality still exists elsewhere.
Performance is part of the user experience. Even when users preferred the new workflow, performance issues affected confidence and trust.
Speed, reliability, and data quality proved just as important as interface design.
Trust takes longer to build than usability. Occasional bugs and data inconsistencies had a disproportionate impact on adoption. Users were willing to learn a new workflow, but they needed confidence that the system could be relied upon.
Accessibility extends beyond compliance. Working directly with a visually impaired agent fundamentally changed my understanding of accessibility. Focus management, zoom behaviour, keyboard navigation, and information hierarchy proved just as important as traditional accessibility standards. Designing for edge cases improves experiences for everyone
Reflection
The biggest lesson from this project was that successful transformation requires more than good design.
While usability improvements contributed to better outcomes, adoption was ultimately influenced by workflow completeness, system performance, trust, and organisational change.
The project reinforced the importance of viewing enterprise experiences as interconnected systems rather than isolated features.
Most importantly, it demonstrated how reducing cognitive load in complex operational environments can improve both user experience and business performance at scale.