Only about 1 in 6 NHS trusts in England provided 'active bystander' training to address workplace sexual harassment, according to an analysis by the University of Cambridge.
The researchers explained: "Reports identify that sexual harassment is troublingly pervasive in the NHS." This is supported by a 2019 survey by public service union UNISON that showed nearly 1 in 10 (8%) healthcare staff reported being sexually harassed at work in the previous year, with more than half (54%) of these acts being perpetrated by co-workers. Another survey by UNISON and the Nursing Times in 2021 revealed that 3 out of 5 nurses (60%) had experienced sexual harassment at work.
Active bystander training encourages individuals to recognise and respond to poor behaviour, equipping them with skills to intervene effectively. The training typically includes role-playing, case studies, and group participatory discussions. It has been actively promoted by the Home Office as an intervention to reduce sexual harassment and violence against women and girls.
The researchers, from Cambridge Public Health and the Intellectual Forum at Jesus College, Cambridge, set out to assess the extent to which such training programmes were being used within the NHS. For their study, published in JRSM Open, they submitted freedom of information (FOI) requests to 213 NHS trusts across England in December 2021.
Training Offered by Only 1 in 6 Trusts
Of the 199 trusts (93%) that responded, only 35 offered active bystander training, and the researchers said that most of those did not deliver content specific to sexual misconduct, and they added that participation was voluntary.
Among the other 164 trusts, only 23 had plans to implement training in the future. Just one stated that it was actively developing plans for sexual safety training that would incorporate active bystander training, while several suggested they would consider implementing it if there were "a need for this form of training", as one said. Others replied that implementation would occur "if members of staff or working groups within the Trusts' organisation advocated for it".
Just five of the trusts that had active bystander training said their training addressed sexual harassment in some form, while the remainder said that their training taught participants to challenge antisocial behaviour only in a general context. Only one trust delivered content that specifically tackled sexual harassment in the workplace as its focus.
The majority (22 of the 35) of the trusts that did offer active bystander training were in London. Yet 14 of London's NHS trusts offered no training, despite it being paid for by NHS England, not individual trusts.
Training Failure 'Could Thwart Attempts to Tackle Sexual Harassment'
The researchers said that their data suggested that failure to implement active bystander training could thwart NHS attempts to tackle sexual harassment.
Lead researcher Dr Sarah Steele said: "We found low uptake of active bystander training among NHS trusts in England, particularly outside London, and very little of the training that was on offer focused on sexual harassment. This is deeply worrying, given the continued problem of sexual harassment in the healthcare sector."
She added: "The NHS is failing to take advantage of a very effective training tool to address workplace harassment, sexual harassment and other forms of unacceptable behaviour such as bullying and racism. It's a tool well used by the military, universities and educators, and which even the UN and UK Government promotes."
Sexual Harassment 'Totally Unacceptable'
Asked to comment by Medscape News UK, Kate Davies, NHS director of sexual assault services commissioning for the NHS, said: "We will work with the Government and other partners to ensure the NHS is a safe space for all staff and patients – local services must not tolerate sexual misconduct, violence, harassment or abuse – it is totally unacceptable.
"All NHS trusts and organisations must have robust measures in place to ensure immediate action is taken in any cases reported to them, and we’d encourage anyone who has experienced any misconduct or violence to come forward, report it and seek help – there is support and care available for anyone who needs it.
"Preventing these attacks from occurring in the first place is a priority, and we have a programme of work dedicated to this and have appointed our first national clinical lead to drive forward action – together we must do all we can to keep staff and patients in our services safe."
Researchers declared no funding for the study. The authors declared no competing interests.
