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Sexual abuse perpetrated by NHS colleagues & the phenomenon of under reporting

Between 2017 and 2022, 35 000 cases of sexual misconduct were reported in the NHS, and recent research conducted by the Working Party on Sexual Misconduct in Surgery (WPSMS) has correlated this finding, highlighting high rates of sexual violence in the surgical workforce, perpetrated by colleagues. A recent analysis of NHS staff by WPSMS has shown that female surgeons are being subjected to sexual harassment, sexual assault and rape by colleagues, with nearly two thirds of female surgeons being subjected to sexual harassment. These findings unfortunately echo the general findings of sexual misconduct throughout the UK in which 1 in 4 women have been subjected to rape and sexual assault.

However, the statistics obtained may only be the tip of the iceberg as it is difficult to confirm the true data relating to sexual misconduct, due to under reporting. Survivors often do not report incidents due to a multitude of factors, such as embarrassment, fear of repercussions, and absence of justice. Research has shown that 34% of survivors choose to omit reporting due to shame, a surgeon interviewed described that the assault caused her to feel “dirty” and “humiliated”. The fear of repercussions contributing to lack of reporting is particularly prevalent in the surgical community, due to the training of junior surgeons often relying on assisting senior surgeons, therefore meaning survivors do not feel able to report assaults due to the influence on their future career. A survivor interviewed disclosed "I didn't feel I could make a fuss, I felt like there was a very strong culture of just putting up with whatever was done to you". Other survivors said they were unwilling to report due to risking their career and they did not trust the NHS to take action.

The lack of a specialised system in place in the NHS to report sexual misconduct and the absence of sexual violence policies, can be said to significantly contribute to the trend of under-reporting. Past research indicates that healthcare workers often do feel know or feel they can report incidents of sexual misconduct. The British Medical Journal(BMJ) calls for a clear policy to support a “safe, timely and trauma informed response” mitigating “further harm”. A civilian talking in Parliament urges for a “simple and clearly signposted process” for survivors to report incidents within the NHS. However, Sarah Steele, a researcher from the University of Cambridge says that a clear policy is not sufficient, and a comprehensive structure needs to be implemented across all trusts in order to increase confidence in reporting and consistency of procedures. An NHS policy is critical to reinforce a clear message that sexual misconduct is not acceptable and to show a united front across the NHS in a stand to stop sexual abuse. Steele highlights that the NHS needs a “holistic, empathic and human-centred approach” to sexual misconduct and that policies are not enough.

In response to recent research published regarding sexual misconduct, NHS England have announced the introduction of its first sexual safety charter to provide healthcare workers with “clear reporting mechanisms, training, and support”. Under the charter, NHS managers will be provided supplementary training to “improve awareness and ensure allegations are appropriately investigated”. Dr Binta Sultan, Chair of NHS England’s National Clinical Network of Sexual Assault and Abuse Services said “signing up to this charter shows how committed NHS England and other healthcare organisations are to supporting those under their responsibility, where leaders will be supported to take charge and act upon signs of abuse, signposting to the appropriate support networks”.

- Erin Bieler


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