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'Epidemic' of Sexual Misconduct and Violence on NHS Premises

Health Secretary Steve Barclay said he expected NHS leaders to be "proactive" in protecting its workers after an investigation found that more than 35,000 cases of sexual misconduct or sexual violence were recorded on health service premises in England between 2017 and 2022. 

The figures, from a joint investigation published today by The BMJ and the Guardian, have led to calls for an independent inquiry into what witnesses described as an "epidemic" of sexual assaults in the NHS.

The Hospital Consultants and Specialists Association, the HCSA, told Medscape News UK that most employers lacked safeguarding policies and such an inquiry was "long overdue".

Freedom of Information Requests

The statistics emerged after investigators sent freedom of information requests to 212 NHS trusts in England asking for data on how many sexual safety incidents – an umbrella term for a wide spectrum of behaviours, from abusive remarks to rape – had been recorded on NHS premises.

The results disclosed 35,606 sexual safety incidents reported over the 5 years, with 62% of those affecting health service staff. Almost three-quarters of the incidents on NHS premises occurred in mental health trusts.

The NHS statistics showed that 22,143 staff experienced sexual abuse, which included rape, sexual assault, harassment, stalking, and abusive remarks. Of those, 20,928 staff were abused by patients, 902 by other staff members, and 313 by visitors.

There were 12,234 patients affected, of whom 7464 were abused by other patients, 3218 by staff, and 1552 by visitors.

Police Reports

Figures collated during the investigation from freedom of information requests to all 32 police forces in England, and from other sources, revealed there were 180 cases of rape of children under 16 on NHS premises between 2017 and 2022, with four children under 16 being gang raped. Over the 5 years, 56 gang rapes were recorded on NHS premises by 10 police forces, with Leicestershire Police recording 18 cases of gang rape, all but one of which took place in a mental health unit. 

Among other incidents compiled from police sources were 186 reports of children under 16 being sexually assaulted, and 127 reports of crimes including grooming, assaulting a child by penetration, sexual communication with a child, inciting sexual activity with a child, and causing a child to watch a sex act.

The investigation found that fewer than 1 in 10 trusts had a dedicated policy to deal with sexual assault and harassment. It said that sexual safety incidents involving patients were currently reported through the national reporting and learning system, but that its remit did not include abuse of staff, and that trusts were no longer obliged to disclose them to NHS England.

Although more than 4000 NHS staff were accused of rape, sexual assault, harassment, stalking, or abusive remarks towards colleagues or patients in 2017-22, "few have faced action from their employers", the report said. In cases where complaints were made against colleagues, there was a "reluctance to suspend perpetrators due to overall staff shortages", Senior Legal Officer from Rights of Women, Deeba Syed, told investigators.

The BMJ said it had been told by the British Medical Association that the Government should produce an action plan to protect health workers, while the Academy of Medical Royal Colleges was among organisations wanting a full independent inquiry into the scale of sexual abuse and how it could be prevented.

Dr Naru Narayanan, president of the HCSA union, said: "A formal independent inquiry is long overdue to expose the scale of this endemic issue and lay out clear recommendations. We have little faith in the current approach from the health service. It speaks volumes that most employers do not even have a policy in place to keep staff safe from sexual harassment and assault. It's time for a joined-up approach to protect health professionals and patients."

The organisation Surviving in Scrubs, which campaigns against harassment and sexual assaults in the healthcare workforce, told Medscape News UK that the figures presented in the investigation "likely under represent the true extent of the problem" and called for a public inquiry and "accountability from healthcare bosses".

Trusts 'Have a Duty of Care'

Responding to the investigation, Steve Barclay, Secretary of State for Health and Social Care, said: "NHS leaders have a statutory duty of care to look after their staff and patients and prevent harassment, abuse, or violence in the workplace. I expect employers to be proactive in ensuring staff and patients are fully supported, their concerns listened to and acted on with appropriate action taken where necessary."

Mr Barclay said the Government had doubled the maximum prison sentence for anyone convicted of assaulting emergency workers and other frontline health staff and was "working closely with NHS England as it takes action to prevent and reduce violence against staff, including through body-worn camera trials and a national violence prevention hub to ensure NHS staff can work in a safe environment".

Navina Evans, chief workforce officer at NHS England, said it had "established a dedicated team to ensure people who experience violence and abuse are supported in the workplace". She added: "All NHS trusts and organisations have measures in place to ensure immediate action is taken in any cases reported to them and I strongly encourage anyone who has experienced any misconduct to come forward, report it and seek support."

'Everyone's Responsibility'

In an opinion article linked to Tuesday's BMJ report, Rosalind Searle, professor at the Adam Smith Business School, University of Glasgow, said the investigation had exposed "shortcomings in the NHS, with inconsistent and inadequate recording making early detection impossible, and inconsistent sanctions leading to further ambiguity".

In another opinion article, orthopaedic surgeon Simon Fleming said that everybody should be responsible for holding perpetrators to account. "Failure to challenge, individually or organisationally, these attitudes is akin to accepting them as 'just how things are'," he argued.

Earlier this month, Isslia Roberts, a national officer at the HCSA union, called for employers to get a grip on the problem, citing a 2019 Medscape report which found that 7% of doctors had experienced or witnessed sexual abuse, harassment, or misconduct, with 1% having been accused of those misdemeanours. 

Ms Roberts warned that changes to working practices due to the COVID-19 pandemic and mass adoption of social media had created new opportunities for perpetrators and an "evolution of new forms of harassment".