It’s a Thursday in September and day four of the week-long tube strikes. We’ve both made it to our offices. And as the clouds darken and threaten rain, I’m grateful that those offices happen to be in the same building – a lift down, a dozen steps across, up another, and into the Parliamentary and Health Service Ombudsman’s London HQ.
CSW last interviewed Paula Sussex nine years ago. Back then, she was chief executive at the Charity Commission, her first public sector role after 26 years in the private sector – a move she says she made because she wanted to do something more ”pointful”. Next, she ran the Student Loans Company, before leaving in 2023 to become the chief exec of financial technology startup OneID.
But Sussex soon felt the pull to return to public service. This summer, she was appointed as PHSO, a role that looks into complaints from members of the public about services provided by the UK government and its agencies and the NHS in England.
Sussex says the role was another opportunity to “contribute to making things better, which is simply irresistible”.
She takes this contribution seriously: when asked about her leadership style, she says public servants need “that huge and constant reminder of how responsible you are in your job”.
“I have a firm belief that it is never about you, the individual, and that means you need to listen very carefully… to what people are saying. It is a privilege to be doing these jobs and the Student Loans Company, Charity Commission, this organisation are really important to the fabric of our country. You’d better do it well then, I always think,” she adds.
One way Sussex tries to listen well is by hearing directly from customers. At SLC, she would sit down each week with colleagues to review the most significant complaints that had come through, and talk to either a student or a repayer about the issues.
“I used complaints as almost an audit function,” she says. “I would look at the complaint and say, ‘Is what we're doing in our technology transformation going to address this? If not, are there more of these? Is this systemic? Is there something else that we need to do?’ I found it an incredibly useful process. I think that gave me an appreciation of the power of complaints. ‘Complaints’ is not always seen as a positive word, but it's the voice of the user, which is so important to have in your ear.”
In her second week at the ombudsman, Sussex had her first meeting with PHSO’s public engagement and advisory group – members of the public who have been complainants and operate as an advisory committee.
“I have no sense that the team will say, ‘We've increased productivity on our complaints work, that's enough.’ They are saying, ‘Where can we have more impact?’”
She says several of the group’s members had made complaints that the ombudsman had not upheld, but that they were nevertheless “so positive about the experience that they had and also that their voice was heard”, and keen to talk about their experiences. “Getting that window onto the world of the customers that you serve… is incredibly valuable,” she says.
Upon her appointment as ombudsman, Sussex said she planned to focus on “the key themes where PHSO's investigations and recommendations can have the greatest impact”. She tells CSW these themes are still being finalised but are “likely to be quite complex, involving different organisations”.
She does hint at one potential area of focus when asked about PHSO’s report into the Waspi – Women Against State Pension Inequality – scandal. In December 2024, the government accepted the ombudsman’s finding of maladministration and apologised for a 28-month delay in writing to women born in the 1950s about the increase to the state pension age from 60 to 65. Despite this, the government said it could not justify paying compensation.
“With Waspi there are ongoing legal proceedings, which I don't think we are conjoined in,” Sussex says. But she adds that PHSO will be looking at the systemic issues “that may be at the root cause” of what went wrong, “about communications, about the accuracy of information given to the public”.
In 2023, then-ombudsman Sir Rob Behrens told a select committee that in 2017 he had inherited a “a deeply unhappy organisation, unclear where it was going, with a toxic organisational culture”. Behrens, who left the role in 2024, said PHSO had needed a year to bring itself out of this crisis.
Sussex’s experience as Behrens’s successor has been a far cry from this. She says her staff have supported her effort to focus on a set of key themes – and have wowed her with their attitude.
“I see an organisation that is markedly proud of the work it does, hugely focused on the purpose of working there, highly values-based, and also really thoughtfully thinking about where the organisation can have more impact,” Sussex says.
“I have no sense that the team will say, ‘We have rising demand, we're running as fast as we can, we've increased productivity on our complaints work, that's enough.’ They are saying, ‘Where can we have more impact? How can we bring better outcomes, better results?’”
Assessing PHSO’s strengths and weaknesses after a few weeks in the job, Sussex picks out case handling for both – and her predictions on technology and process also look to have been a good bet.
“‘Complaints’ is not always seen as a positive word, but it's the voice of the user, which is so important to have in your ear”
She says the ombudsman’s “extraordinary team of caseworkers” are able to spot patterns and trends in their casework. However, she says staff have to do “a lot of manual work” due to the state of legacy IT, meaning PHSO cannot fully make use of its “fabulous reservoir of data, which is unique in England”.
Like many areas of the public sector, PSHO has experienced a spike in demand since the Covid pandemic. Sussex says it is currently receiving around 10% more complaints than it had forecast for this year. With every complaint needing to be properly assessed, the ombudsman can't always handle complaints as quickly as it would like to.
“All of us would like to be able to get to handling complaints and cases faster,” Sussex says. “But I am very clear-eyed and realistic about the state of data in all IT estates that have been going longer for 10 years.”
One area where PHSO has come in for criticism over its approach to case management relates to its use of a “severity of injustice scale” to decide which cases to prioritise. The Public Administration and Constitutional Affairs Committee said in 2024 that the approach was a temporary measure introduced while Covid restrictions were in place that had led to some cases not being resolved, and also not being subject to detailed investigation.
PHSO is now using a “public value model”, which Sussex describes as a “significant upgrade”. This model aims to prioritise cases with the “highest potential impact” using a scored test that focuses on the seriousness of the impact on the affected person and whether investigating the complaint could lead to a wider public benefit.
This enables caseworkers to focus on the most important complaints, Sussex says, adding: “We are taxpayer funded – we must do that.”
On hybrid working...
“I observe that it is working well. I can't see any particular issue and there's quite a good level of collegiality in both offices [London and Manchester]. The teams are mostly in two-to-three days a week and there's a lot of kitchen chat. If I sit out in the open area, I hear a lot of: ‘Can I just ask you a bit about this case?’ So it feels to me as though it is working, and people have settled into a truly hybrid form.
“There's a role for the office, there's a role for working at home. A number of these cases are complex, which means you do need to get your head down. It's the nature of the type of casework that we do. You need that quiet time, and you need time with colleagues to compare notes. I think it's also the way the brain works.”
In her pre-appointment hearing with PACAC in April, Sussex said she wanted the ombudsman to play a more active and proactive role in improving public services. What opportunities has she spotted so far to do that?
As heavy rain patters the building and thunder begins to roar, Sussex notes that PSHO does already play an active role in improving public service through its statutory powers of laying reports, publishing recommendations and working directly with organisations. “And there is a very, very high compliance rate with our recommendations,” she adds.
But she says she wants to go further and “get right to the heart of the substance of the complaint and work deep within the organisation” to identify systemic issues and, where appropriate, help set standards.
Sussex also says she anticipates working with a small number of organisations where it is “thematically sensible”, and with whom PSHO can find a common agenda and retain its independence.
Such organisations include the Health Services Safety Investigations Body, the Care Quality Commission and NHS Resolution in the health domain. As for government, Sussex says she’s looking forward to meeting with the National Audit Office, which she describes as “a really important body… doing superb value-for-money work”.
She also wants to get a message out to MPs asking them to pass on more complaints from their constituents. Unlike health-related complaints – which make up around 80% of PHSO’s casework – complaints about departments and arm’s-length bodies must first go to an MP, who can then pass them on to PSHO.
“We would very much like to have more central government work,” Sussex says. “We have a low number of complaints coming through the MP route. I still don't think I understand why. We're extremely keen to be able to support MPs in their constituency work by taking on these complaints.”
In 2024, the Victims and Prisoner Act removed the so-called “MP filter” for complainants who are victims of crime. Sussex says it is too early to tell what impact this has had.
More comprehensive legislative reforms to PSHO’s structure and operations have long been sought but failed to get government go-ahead. PACAC has been calling for reform of PSHO since 2014, while both of Sussex’s predecessors’ attempts to drive forward changes have failed to bear fruit.
Desired legislative reforms include creating a single public service ombudsman; bringing it together with the local government ombudsman, as is already the case in Scotland, Wales and Northern Ireland; and giving the ombudsman “own-initiative powers” to investigate issues, which most of its European equivalents have.
The then-Conservative government said in May 2024 that it was “not convinced” that fundamental reform was a priority, “nor that legislation is the answer to many of the issues identified by the committee”. The current administration has yet to address the question of reform publicly. A Cabinet Office spokesperson said: “The PHSO does important independent work, setting high standards across government and improving public service delivery.”
“We would very much like to have more central government work. We have a low number of complaints coming through the MP route. I still don't understand why”
What is Sussex’s view on the reform debate? She says there is some “some really good thinking” in the reform proposals put forward by her two predecessors, but adds: “Equally, I know that many of them require legislation, and it's always a busy legislative agenda, so I'm realistic about that. There are some good proposals, but let's see how far we can go under our own powers as we are at the moment.”
Along with the change to the “MP filter” for victims of crime, another reform Behrens achieved was the creation of new national frameworks on complaint standards in the NHS and in central government, which he has described as “a lasting legacy” of his time as ombudsman.
Sussex says the Department for Transport, Department for Environment, Food and Rural Affairs and Natural England have thus far adopted the UK Central Government Complaint Standards. “Would we want other departments to [follow suit]? Yes. Do we have the power to mandate? No.”
All raising the question: what would stop them from adopting it? “As I work my way around the departments of state, I will be asking that question as part of my introductory meetings,” Sussex says.
The ombudsman has reported this year on issues at two organisations that Sussex previously led.
In March, it urged the SLC to improve its advanced learner loans processes after finding around 4,000 students had been hit by a system error that meant their loans were not written off. The timing of the errors include the period when Sussex was chief exec.
Reflecting on the concerns PSHO found, Sussex says: “It was a known issue around that particular loan type – legacy IT estates, too many financial products, having to do manual rework around highly complex policy.
“But that's not to say that we didn't appreciate it being pulled out by PHSO to say ‘Yes, we’ve got it, we agree, we’re fixing it as fast as we can and we're learning from it’.”
In September, a few days before our interview, the ombudsman called on parliament to hold the Charity Commission to account, saying the organisation had failed to comply with recommendations following an investigation into its handling of concerns about sexual abuse. Sussex – who left before these failings took place – says she can’t comment on the case because legal proceedings are ongoing.
How useful does she think it is that she’s led organisations under PHSO’s remit? “I do think it is hugely important if you do this job that you have experience of delivering public service. So I hope all of your readers appreciate that I feel as though I have been in their shoes,” she says. “With a number of organisations in our jurisdiction, I understand how they tick… which gives a better understanding when we're looking at our complaints to what the root cause analysis might be.”
In her interview with CSW nine years ago when she was at the Charity Commission, Sussex said the organisation’s demands made it a “morning, noon and night job, leaving little time for other interests”.
These days, she says she does “all the usual things” to unwind: “Family and friends and galleries and a bit of exercise… and a little bit of travel.”
“I do naturally unwind very easily,” she says, as the clouds start to clear and are replaced by blue sky.
She reflects that “as you get more experience, the stress hits you less,” and that “a sense of perspective is important”.
“I remember when I was working in IT thinking that I'd had a really dramatic, stressful day. And I would always find a way on a Friday night of doing something to round off the week, which sometimes was going to the British Museum and going to some of those epic battle scenes of ancient Sumerians where 3,000 people died in a day or something, and you go, ‘that's much more stressful than my day’. That helps.”