Designing for Healthcare Complexity: How I Redesigned an NHS Platform for 67 Million Users

When the consultancy I was working for was engaged to redesign a seven-year-old healthcare platform used by NHS hospital staff across the UK, we thought we understood the scope of the challenge. Four months later, we realised we had underestimated one of the most intricate design puzzles we'd ever encountered: creating a unified experience for vastly different user roles while maintaining strict healthcare compliance and accessibility requirements.

Note: At the end of this article, we'll explore how AI could revolutionise this design process and enhance healthcare examination platforms in the future.

The Web of Healthcare Hierarchies

The first revelation came during stakeholder workshops. What seemed like straightforward "hospital staff" quickly unravelled into a complex ecosystem of roles with distinct needs, permissions, and limitations.

Four Roles, Four Different Realities

The platform serves four distinct user types: Consultants, Trust Speciality Clinical Leads, Responsible Officers, and Medical Directors. Each role operates with different permission levels and information access requirements, creating a complex hierarchy of data visibility and functionality.

The challenge was creating a unified interface that could seamlessly adapt to these varied access levels while maintaining strict privacy and compliance standards. Each role required an entirely different user journey through the same underlying data, ranging from simple workflows to complex administrative functions.

The Permission Matrix Challenge

Creating healthcare user journeys isn't like designing for typical business users. Every piece of information carries clinical, legal, and ethical implications that could affect patient care.

We spent weeks mapping permission matrices for four complex healthcare roles:

"If user = Role A AND viewing certain records, apply privacy controls. If user = Role D, show administrative functions. If user = Role B, display summary data for designated users..."

The complexity was staggering. Some roles had minimal access with just basic workflows, while senior roles required extensive user journeys spanning multiple administrative and oversight functions.

This wasn't just about showing different data—it was about creating entirely different workflow experiences for users who might be accessing the same patient information with completely different purposes and permission levels.

Modernising Critical Systems

The existing platform hadn't been updated in seven years. Hospital staff were accessing critical patient information on interfaces that lacked mobile or tablet support, in an industry increasingly relying on portable devices.

The Card System Revolution

We developed a flexible card-based interface that adapted to different roles and devices. Each card contained patient test results, but the information displayed, actions available, and visual hierarchy changed based on user permissions.

The card system underwent significant changes based on user roles. Junior-level users saw essential patient data with appropriate privacy controls, while senior roles accessed comprehensive information and administrative functions—all from the same underlying interface architecture. The system was responsive not just to screen size, but also to user role—a concept we referred to as "permission-responsive design."

The Mobile Healthcare Reality

Healthcare professionals don't sit at desks reviewing patient information—they move constantly between wards, consultation rooms, and emergency situations.

Designing for Bedside Decisions

Creating mobile interfaces for healthcare means understanding that doctors need to:

• Access patient test results while walking between rooms

• Compare multiple patients' data during ward rounds

• Make quick decisions based on limited screen real estate

• Use interfaces with potentially wet or gloved hands

The tablet interface became crucial for bedside consultations, requiring touch targets that are large enough for medical gloves while maintaining the information density necessary for clinical decisions.

Accessibility: Beyond Compliance

Healthcare accessibility isn't just about meeting WCAG guidelines—it's about ensuring that tired doctors working 12-hour shifts and nurses under pressure can access critical information effectively.

Real-World Accessibility Challenges

• Cognitive Load: Healthcare professionals multitask under stress. The interface needed to minimise mental overhead while maximising information clarity

• Visual Fatigue: Long shifts in varying lighting require careful contrast and typography choices

• Motor Accessibility: Medical professionals might have temporary impairments affecting interface interaction

• Urgent Notifications: How do you alert doctors to urgent test results without overwhelming them with non-critical updates?

We developed a layered notification system with visual, auditory, and haptic feedback, each calibrated for different urgency levels and user preferences.

Key Lessons from Healthcare Design

Permission Complexity as a Feature

What initially seemed like unnecessary complexity revealed itself as thoughtful protection of privacy. The restrictions weren't bureaucratic obstacles—they were ethical safeguards protecting patient privacy while enabling professional collaboration.

The Efficiency-Safety Balance

Every design decision involved striking a balance between efficiency and safety. Making interactions too quick could lead to errors; making them too slow could delay critical care. This balance required constant iteration with real users in clinical situations.

Mobile-First Healthcare

The healthcare industry's shift toward mobile-first workflows is accelerating. Designing for this transition means understanding not only technical constraints but also the operational realities of healthcare environments.

The Impact

Four months after launch, the redesigned platform supports more efficient patient care delivery across NHS hospitals. Hospital staff can now access critical patient information on any device, with role-appropriate displays and improved accessibility features.

The project demonstrated that complex healthcare systems don't have to sacrifice user experience for functionality. With careful planning, thorough user research, and thoughtful implementation of a design system, we can create healthcare technology that truly serves both providers and patients.

Looking Forward: AI-Enhanced Healthcare Design

As we completed this platform for reading and analysing medical examinations like liver resections and other complex procedures, it became clear that artificial intelligence could significantly enhance both the design process and the end-user experience.

AI for Intelligent Role Adaptation

Future iterations could leverage AI to adjust interfaces based on user behaviour patterns dynamically. Instead of static permission matrices, machine learning could observe how different roles interact with examination data and automatically optimise information hierarchy and workflow efficiency.

Smart Content Prioritisation

For examination readers analyzing liver resections or other critical procedures, AI could intelligently surface the most relevant data based on patient history, urgency indicators, and procedural complexity—reducing cognitive load for medical professionals already managing high-stress decisions.

Predictive Interface Design

AI could anticipate what information different roles need next in their examination review process, pre-loading relevant data and suggesting logical workflow paths. This would be particularly valuable when reviewing complex surgical procedures that require correlating multiple data points.

Enhanced Accessibility Through AI

Voice interfaces and AI-powered screen readers can provide hands-free access to examination results, which is crucial when medical professionals need information while maintaining sterile environments or during active procedures.

The future of healthcare interface design lies in combining thoughtful human-centered design with AI capabilities that adapt to the complex, dynamic nature of medical practice—creating truly intelligent systems that support better patient outcomes.

Healthcare design requires more than design skills—it demands empathy, patience, and deep respect for the complexity of care delivery. Every pixel serves a purpose, and every interaction could impact someone's health outcome.