Foreword from the Ombudsman
Improving public services and building trust between people and the state is a core mission of my Office and is at the heart of my role.
To do this, we must be fair and impartial so that we strengthen accountability when things go wrong. Since taking up this role, I have been listening carefully to the people and organisations that rely on us to live up to these values.
I have spoken with complainants, ministers, MPs, clinicians, senior officials, regulators and frontline teams across health and government. These conversations have grounded me in the realities that people experience, shaped my view of the current challenges faced by the public sector, and made clear the contribution my Office must make in the years ahead.
We know that public services are under increasing pressure. Through that pressure, the need for ombudsman services has risen sharply.
Last year, the NHS received a record high of 256,777 written complaints. This has increased year on year and is almost 14% higher than the volume recorded in 2021 to 2022. In the same year, my Office considered more than 38,000 complaints and passed 9,700 for primary investigation: a 38% increase in primary investigations since 2021 to 2022.
Yet trust that people’s voices in these complaints will be listened to is fragile. Only one in four people believe their complaint will make a difference, and younger people, disabled people and people from ethnic minority backgrounds are even less confident. That loss of trust matters. Public services only function well when people believe that their voices count.
We have a critical role to play in rebuilding that trust. We see a wide range of views and experiences from people who use public services and have insights into where things have gone wrong in organisations and systems. We have a duty to use this information to improve and prevent the same issues happening again. At this organisation, I have found colleagues who are deeply committed to fairness and who want their work to improve lives and make lasting change. Already our investigations are robust, our expertise is strong and our purpose is clear. We are now in a position to make a deliberate shift towards greater systemic and preventative impact, alongside continued delivery of individual redress.
We are also in a position to use technology to generate more consistent, meaningful insight. Partnership with other bodies in the justice, regulatory and assurance space is essential to achieving this. And as an Ombudsman accountable to Parliament, our relationship with individual MPs and parliamentary committees is one of our most important levers for change. When Parliament understands what we are seeing in complaints, it can use this to strengthen accountability across the Government and the NHS.
Every complaint brings an opportunity to learn. The cost of not learning is significant. Statutory inquiries exceeded £130 million last year, and the NHS spent billions of pounds addressing harm that could and should have been prevented. Complaints give us early warning of where things are going wrong. We must use that insight to prevent failings, not just respond to them.
This strategy reflects what I have learned so far. It considers the complex environment in which we are working, and the pressures on our service as well as the services provided by the public sector. But it is also the beginning of a new chapter in our story that is designed to tackle the challenges we face. We will continue to deliver fair outcomes for individuals and will also take a more active role in system improvement. This means identifying risks earlier, supporting organisations to address underlying causes, and strengthening accountability with the help of Parliament and others across public services.
We will also modernise our service, so that people have access to clearer information, receive faster decisions and experience a genuinely person-centred process.
Crucially, we will create a clear, recognisable identity within the justice landscape, so that people know we provide individual redress and drive improvements across public services. A change to our name is part of achieving that clarity of purpose. It is not a goal in itself, but a way to make sure people can find us, understand what we do and trust in our ability to shape the future of public services. We will use our profile to promote a culture of accountability, transparency and continuous improvement.
Public services are under real pressure. By listening carefully, working in genuine partnership and acting on what we learn, we can all help to build a system that is more responsive to the people it serves.
Paula Sussex CBE
Ombudsman