Eradicating sexual misconduct in healthcare
When I started on College Council in March 2022 one of the first things I volunteered to do was join the Working Party for Sexual Misconduct in Surgery (WPSMS) as the RCoA representative.
This is an area I was very interested in. As an educator of many years, I have been involved in dealing with numerous aspects of this behaviour in the workplace. After seeing first-hand the devasting consequences it can have on people’s wellbeing and the knock-on effects on their career, I felt passionate about making a positive change and helping to try and eradicate these behaviours.
An endemic problem
The trigger for the request for an RCoA representative was a survey conducted by a group of determined female surgeons who recognised the problem and were unafraid to call it out.
We invited our members to participate in the survey a few weeks before it closed and in that short time, anaesthetists contributed 10% of the responses received. 150 of our members were brave enough to share their experiences of sexual harassment and worse in the workplace.
The results were devastating, demonstrating these behaviours were endemic. Of the 1,500 responses to the survey there were 5 unreported rapes and 1 in 3 women and 1 in 15 men had experienced sexual assault.
There was a difference in the genders as to whether they felt the GMC and the NHS were dealing with these behaviours adequately. 15% of women felt these organisations were dealing with this adequately versus 48% of men.
Alongside the WPSMS survey, Dr Becky Cox and Dr Chelcie Jewitt founded Surviving in Scrubs, and invited people impacted by sexism and sexual violence to submit their stories. Their Surviving Healthcare report is a powerful analysis of 150 of those stories.
Taking action
As a consequence of this medical #MeToo moment we reached a tipping point and as a group initiated a number of actions. We started with a roundtable with the GMC and other stakeholders, which led to the WPSMS report, Breaking the Silence. Many of the report’s recommendations have since been implemented.
We now have questions in the GMC National Training Survey and NHS staff survey, which show 58,000 staff have experienced sexual misconduct in their daily work (1 in every 12 NHS workers). The evidence is incontrovertible and the time to address this is now. As quoted in the Breaking the Silence report, “we need to change the culture from everyone knows but nobody does, to everyone knows and everybody does.”
The GMC has produced guidance for employers and individuals on how to manage sexual misconduct and included sexual behaviours within the updated Good Medical Practice.
The NHS launched a sexual safety in healthcare charter, which 400 trusts/boards have signed up to, committing to taking and enforcing a zero-tolerance approach to sexual misconduct. NHS England has also developed a new template for a compulsory sexual misconduct policy framework for all NHS trusts/boards, as well as an anonymous reporting tool for all trusts to implement locally. Many organisations, including the College, have also signed up to the BMA’s Ending Sexism pledge.
Importantly, there has also been a change in the law, which means all employers are now required not just to take appropriate action in response to sexual misconduct, but to be proactive in preventing it. This might sound minor but it’s a huge change in culture, as it means employers that don’t take steps to prevent sexual harassment in the workplace will be in breach of the law.
The Royal College of Surgeons has produced a very clear Code of Conduct for all their members, which includes tackling sexual misconduct. We are in the process of developing a similar Code of Conduct at the RCoA.
The WPSMS held a follow up meeting in October 2024 last year, and has published a new report, Breaking the Silence on Sexual Misconduct in Surgery: One Year On.
In summary
The WPSMS broke the silence on sexual misconduct in healthcare with its 2023 British Journal of Surgery paper. This misconduct causes untold harm and is a major patient safety issue.
The WPSMS continues to work with the NHS, Royal Colleges, the BMA and the RCN, as well as healthcare regulators to make healthcare safer for staff and patients. Individuals who have been impacted need access to a trusted national anonymous sexual misconduct reporting system so they can be safe and so that perpetrators who continue to hide in plain sight, can be brought to justice. There is a long way to go but a lot of progress has been made in a very short time.
If you need help or support, our wellbeing hub includes a list of services and contact details. The WPSMS website has a more detailed list of services available for people affected by sexual abuse, violence or other forms of sexual misconduct.