Introduction
Our role
Our role is to independently investigate complaints about the NHS in England, UK government departments and other public organisations. Our service is free to use, fair and impartial, and open to everyone.
We provide a final, independent check when people believe a public service has let them down, treated them unfairly or failed to put things right. By doing this, we help make sure public services are accountable, champion higher standards, and help to inspire a better relationship between citizens and the state.
We are here to put things right for individuals and to help prevent others from experiencing the same issues.
We use evidence from complaints to identify the underlying causes of failings in public services and help to deliver lasting change.
Our insight into people’s reasons for complaining shapes how we work and our emphasis on driving public service improvements for everyone. Our complaints research found that 93% of people who come to us want to make sure failures are rectified and 91% want to protect others in future.
Through our Public Value Model and systemic investigations, we prioritise complaints that will have the greatest impact and potential to improve services for many people. We do this by identifying underlying patterns, themes, recurrent issues and multi-agency failures in complaints. We aim to reduce the risk of things going wrong, improve complaint handling, and ultimately reduce the need for people to complain at all.
To make sure our recommendations lead to real change, we share learning from our work with NHS and government bodies, report to Parliament, and support parliamentary committees to scrutinise public services.
We are independent of the Government and the NHS and, as a parliamentary body, we are accountable to Parliament. Our work is scrutinised by the Public Administration and Constitutional Affairs Committee.
We are open about what we do and do not do.
We carefully consider every complaint we receive, but we do not investigate every case in detail. We make impartial, evidence-based judgements about whether an investigation is justified. If we find an organisation has followed the correct guidance and procedures, we will not investigate further.
There are also legal limits on what we can investigate, including which organisations fall within our remit and the requirement for people to have first complained to the organisation before coming to us.
When we identify failings, working with the organisation under investigation, we can recommend actions such as apologies and service changes to prevent repeat mistakes. When we are not best placed to help, we advise complainants of their options, rights and where they can get support.
We are shifting our approach to deliver greater systemic impact that benefits people who use public services.
We are currently experiencing unprecedented and sustained demand for our service. With finite resources, we must make choices about how we use our capacity to maximise the public value from our service.
We will continue to prioritise the most serious individual injustices, as well as groups of cases that reveal recurring, systemic or emerging risks across public services.
By undertaking a smaller proportion of more detailed investigations and prioritising the most serious and systemic issues, we aim to address root causes, prevent wider harm and reduce complaints over time. This focus on systemic improvement is essential to the long-term sustainability of our service. It enables us to protect individuals who experience the most severe injustice, while strengthening public services for people who rely on them.
This shift in our approach will be realised within a framework that addresses key themes across a large proportion of the cases we receive. Focusing on these themes means we will have impact on the following areas:
Example: Our 2017 report into eating disorder services, ‘Ignoring the Alarms’, found that failings across multiple NHS organisations had led to an avoidable death. Our wider casework and engagement helped us uncover serious failings across the system that required urgent improvements to training, standards, service transitions and commissioning. While some issues remain, organisations have made sustainable improvements. For example, early intervention services have been expanded to support children and young people, and the General Medical Council has done work to address gaps around eating disorders in medical training.
Example: In 2024, we published a report about the processes and communication around do not attempt cardiopulmonary resuscitation (DNACPR) decisions. We engaged with ministers and co-hosted a roundtable with the Department of Health and Social Care and sector stakeholders. This highlighted the importance of DNACPR conversations in advance care planning and the need for greater public awareness of the issue. Since then, there have been positive developments in line with our recommendations. This includes updated guidance from the Care Quality Commission and e-learning training developed by the Resuscitation Council.
Example: Between 2023 and 2024, we received a small number of complaints that HMRC had paid income tax repayments to third-party agents who were not authorised to act for individuals. When we engaged with HMRC, it had already taken steps to resolve the complaints, including consulting with the public and changing legislation to prevent more people from being affected. Quicker resolution was made possible because HMRC had followed the latest guidance and had effective internal governance and collaboration processes.
Example: In 2024, we published our spotlight report on the Windrush Compensation Scheme and shared stories of the Windrush generation and their families who had been affected. This revealed that people had been wrongly denied the money they were owed and evidence had not always been properly reviewed. Our work helped to secure compensation for individuals and make changes to the eligibility criteria of the Home Office’s Compensation Scheme so that systemic problems with the way it was run did not affect more people.
Our strategy
Our vision
We deliver fair and impartial justice for individuals and drive improvements in public services for everyone.
In five years, we will be an established and influential voice in public service improvement, working in partnership to set standards and drive system-level change in the NHS, government departments and other public bodies.
Our aims and objectives
 Impact |  User experience |  Awareness | |
| Aims | To drive meaningful improvements and system-level changes in public services. | To provide an accessible, timely and person-centred complaints process. | To be a recognised and influential voice in improving public services. |
| Objective one | We will focus on common, recurrent and systemic themes, highlighting underlying causes and emerging risks. | We will transform how people access and experience our service, using digital tools and AI-enabled pathways to make it clearer, faster and more transparent at every stage. | We will maximise our role as a parliamentary body to support scrutiny and inform public debate. |
| Objective two | We will turn complaints data, user experience and wider evidence into high-quality insight, making it open and accessible to others. | We will provide clear, responsive advice that helps people understand their options, access the most appropriate support and resolve issues early wherever possible. | We will reach, support and share the experiences of underrepresented complainants, working with partners and using targeted communication channels. |
| Objective three | We will track compliance and implementation of our recommendations and work with partners to make sure our findings lead to measurable improvements across public services. | We will collect and analyse real-time feedback and user insight to continuously improve the design and delivery of our service, better meet people’s needs and model a culture of learning. | We will create a clear, recognisable identity within the justice landscape, so that people know we provide individual redress and drive improvements in public services. |
Helping us to deliver our strategy
Capabilities
We will build our skills and capabilities in key areas, including:
- data analysis and insight generation
- user research and service design
- systems thinking and systemic investigations
- collaborative, multidisciplinary ways of working
- monitoring compliance and implementation
- measuring our impact
- public affairs and influencing policy and practice.
Products
We will strengthen the tools and products we use to deliver our work, including:
- online accounts that let people track the progress of their complaints
- AI-enabled tools, including a digitised Public Value Model, to help process cases more quickly, and robustly spot patterns and themes in our casework
- better data systems and dashboards to manage information and share insight
- evidence-based reports and policy submissions that inform debate and decision-making
- accessible communications such as news stories, blogs, podcasts and social media
- outreach and engagement activities to connect with the people and organisations we serve.
Partnerships
We will deepen our partnerships with other organisations through:
- sharing data and knowledge responsibly
- co-producing reports, recommendations and standards for good public service
- joint research and thought leadership
- co-hosting events and discussions that shape debate
- contributing to public inquiries, reviews and investigations.