Newswise — A recent collaborative investigation by The BMJ and The Guardian reveals that between 2017 and 2022, NHS trusts documented over 35,000 incidents of rape, sexual assault, harassment, stalking, and abusive remarks. These distressing findings highlight the failure of NHS trusts in safeguarding both their staff and patients. Consequently, there are demands for an independent inquiry to address these issues.

The information obtained through Freedom of Information (FOI) requests from 212 NHS trusts and 37 police forces in England reveals that a total of 35,606 incidents related to sexual safety were recorded on NHS premises during the span of five years.

Out of the recorded incidents, it has been found that at least 20% involved serious offenses such as rape, sexual assault, or non-consensual kissing or touching. It is important to note that not all NHS trusts provided a detailed breakdown of the types of incidents recorded. The remaining cases consisted of incidents related to sexual harassment, stalking, and the use of abusive or degrading remarks.

The data also show that patients are the main perpetrators of abuse in hospitals. Most incidents (58%) involved patients abusing staff, with patients abusing other patients the next most common type of incident (20%). 

During the same time period, the police recorded approximately 12,000 alleged sexual crimes that occurred on NHS premises. Among these cases, there were 180 instances of rape involving children under the age of 16. Shockingly, there were also reported incidents of gang rape involving four children under the age of 16.

Yet the investigation found that fewer than one in 10 trusts has a dedicated policy to deal with sexual assault and harassment, and are no longer obliged to report abuse of staff to a central database. 

According to Latifa Patel, the BMA (British Medical Association) workforce and equalities lead, trusts that lack specific policies regarding sexual safety are likely to have numerous unreported incidents. She finds this implication deeply concerning and describes it as truly disturbing. Patel suggests that the absence of dedicated policies may contribute to a lack of awareness and reporting, potentially leading to a significant underestimation of the problem.

The data show that 193 of the 212 trusts reported 10 or fewer staff-on-staff incidents between 2017 and 2022, but doctors describe this as “implausible” given their numbers of employees, and say that staff are reluctant to report sexual assault.

Simon Fleming, an orthopaedic registrar and author of the book "Sexual Assault in Surgery: a Painful Truth," has stated that he personally knows numerous female doctors who have experienced assault, thousands who have faced harassment, and a significant number who have been subjected to rape while working within the NHS. His statement highlights the distressing prevalence of such incidents within the healthcare system.

And although more than 4,000 NHS staff were accused of rape, sexual assault, harassment, stalking, or abusive remarks towards other staff or patients in 2017-22, the investigation found that only 576 have faced disciplinary action.

Deeba Syed, senior legal officer for Rights of Women, an organization that supports women who have experienced sexual assault or harassment at work, highlights that when women file complaints against their colleagues within NHS trusts, there is a reluctance to suspend the perpetrators. This reluctance is attributed to the overall shortage of staff within the healthcare system. This situation raises concerns about the response and actions taken by NHS trusts in addressing such complaints effectively.

The Academy of Medical Royal Colleges, the Liberal Democrats, the Hospital Doctors Union, the GMB union, the Society of Radiologists and the British Dietetic Association have all called for an independent inquiry into the epidemic of sexual assault in the NHS in light of the findings.

Fleur Curtis, 43, was sexually assaulted on three occasions by a junior doctor in 2016 and 2017 when she was working as a physician associate at the Princess Royal Hospital in Telford. She told The BMJ that the trust’s poor handling of her complaint had a massive impact on her mental health, forcing her to quit her job in 2020.

So what can trusts do?

Tamzin Cuming and Carrie Newlands, representatives from the Working Party on Sexual Misconduct in Surgery, emphasize the need for NHS trusts to follow NHS-wide policies regarding the handling of allegations related to sexual misconduct. This includes clear guidance on when to suspend staff and when to involve the police in reported cases. They emphasize the importance of swift action by the trusts in addressing complaints of sexual misconduct. Implementing these measures can contribute to a more robust and effective response to such incidents within the healthcare system.

Patel emphasizes the urgency for action, stating that employers must prioritize the support and empowerment of victims, creating an environment where they feel safe to report incidents of sexual harm. She expresses her deep concern and disappointment at the extent to which the NHS has failed to provide a safe and secure environment for both patients and healthcare staff. Resolving this issue is crucial in order to ensure the well-being and safety of everyone involved in the healthcare system.

Health secretary Steve Barclay said that the government has doubled the maximum sentence for those who are convicted of assaulting health workers and is working closely with NHS England to prevent and reduce violence against staff.

In an opinion article, Simon Fleming asserts that it is the collective responsibility of everyone to hold sexual predators within the NHS accountable. He warns against the danger of becoming complicit bystanders and emphasizes that criminal behavior must be taken seriously, regardless of the perpetrator's position or status. Fleming argues that failure to challenge such attitudes, both on an individual and organizational level, is equivalent to accepting them as the norm. Taking a stand against sexual misconduct is essential to promote a culture of safety and respect within the healthcare system.

Rosalind Searle, from the Adam Smith Business School at the University of Glasgow, highlights in an opinion article that the failures to properly document, investigate, and address cases of sexual harassment and abuse within healthcare have allowed perpetrators to continue their actions. She suggests the implementation of three sanctioning mechanisms to combat these violations. These mechanisms include self-sanctions, where individuals hold themselves accountable for their behavior, social sanctions, where there is societal disapproval and consequences for misconduct, and legal sanctions, where appropriate legal measures are taken against offenders. Searle argues that incorporating these mechanisms is crucial in reducing instances of sexual harassment and abuse in both workplaces and society as a whole.

The BMJ will be hosting a webinar on this topic on June 8. Register in advance here: https://bmj.zoom.us/webinar/register/WN_LDW5KZ0eTLqdE5kDaNoZZA

Journal Link: The BMJ