A joint investigation published today by The BMJ and The Guardian finds that NHS trusts recorded more than 35,000 cases of rape, sexual assault, harassment, stalking, and abusive remarks, between 2017 and 2022. The findings, which show that NHS trusts are failing to protect staff and patients, have led to calls for an independent inquiry.
The data, based on responses to Freedom of Information (FOI) requests from 212 NHS trusts and 37 police forces in England, show that a total of 35,606 sexual safety incidents were recorded on NHS premises over this five year period.
At least 20% of incidents involved rape, sexual assault, or kissing or touching that a person did not consent to, although not all trusts provided a breakdown of the type of incidents recorded. The other cases included sexual harassment, stalking, and 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%).
Police recorded nearly 12,000 alleged sexual crimes on NHS premises in the same time period. These include 180 cases of rape of children under 16, with four children under 16 being gang raped.
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.
Latifa Patel, BMA workforce and equalities lead, says she assumes that trusts without dedicated sexual safety policies are "sitting on huge numbers of unreported incidents," which she describes as "a truly disturbing implication."
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 Sexual Assault in Surgery: a Painful Truth, said: "I know hundreds of female doctors who've been assaulted, thousands who've been harassed, and a decent number who've been raped within the NHS."
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.
What's more, when complaints are made against colleagues, women claim that NHS trusts show a "reluctance to suspend perpetrators due to overall staff shortages," says Deeba Syed, senior legal officer for Rights of Women, a helpline that provides support for women who have been sexually assaulted or harassed at work.
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?
Trusts need to be guided by NHS-wide policies on how to deal with allegations, including when to suspend staff and when to report individuals to the police, and should act swiftly to deal with complaints, say Tamzin Cuming and Carrie Newlands, from the Working Party on Sexual Misconduct in Surgery.
Others agree that action is needed fast. "Employers must ensure that victims are supported and feel empowered to report sexual harm and resolve to take appropriate action," adds Patel. "It is heartbreaking to see the extent to which the NHS has failed to provide this safety to patients and healthcare staff."
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 a linked opinion article, Simon Fleming says it is everyone's responsibility to hold sexual predators in the NHS accountable or risk becoming complicit bystanders. "Criminal behaviour should be dealt with seriously, regardless of who has committed the crime," he argues. "Failure to challenge, individually or organisationally, these attitudes is akin to accepting them as 'just how things are.'"
In another opinion article, Rosalind Searle at the Adam Smith Business School, University of Glasgow, says failures to record, investigate, and act on cases of sexual harassment and abuse in healthcare have enabled perpetrators. She outlines three sanctioning mechanisms—self, social, and legal sanctions—that are needed to reduce these violations in workplaces and society.
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
