Doctors will be expected to demonstrate “zero tolerance” of sexual harassment, the General Medical Council has announced.
For the first time, new professional standards, published on Tuesday, introduce explicit rules on sexual harassment towards colleagues.
The announcement follows a Guardian/BMJ investigation that found more than 35,606 “sexual safety incidents” were recorded by NHS hospitals in England over the past five years. However, these did not often result in sanctions.
Under the rules, which will come into effect on 30 January, doctors on the UK medical register “must not act in a sexual way towards colleagues with the effect or purpose of causing offence, embarrassment, humiliation or distress”.
This covers verbal and written comments, displaying or sharing images as well as physical contact.
It is the first significant update to the GMC’s professional standards in 10 years and also the first time a medical regulator has introduced detailed specific wording on sexual misconduct against colleagues.
Although existing GMC guidance says doctors must not act in a sexual way towards patients or use their professional position to “pursue a sexual or improper emotional relationship”, until now sexual harassment of other staff was not included in Good Medical Practice, which sets out the professional standards expected of all doctors working in the UK.
The guidance also introduces a requirement for doctors to take action if they witness harassment or bullying, including by supporting the victim, challenging the behaviour and reporting it, if the victim agrees.
The guidance says: “Everyone has a responsibility – to themselves and their colleagues – to do something to prevent these behaviours continuing and contributing to a negative, unsafe environment.”
Managers, in particular, must make sure “behaviours are addressed, dealt with promptly and escalated if necessary”.
Figures show that in the five years to March 2023 , the GMC received 526 complaints of sexual assault involving patients and staff. But of the 233 completed investigations, only 13 led to the doctor being struck off.
Dr Becky Cox, a co-founder of the Surviving in Scrubs campaign, said though she was pleased at the announcement, it was just a first step. “The GMC needs to investigate all cases of sexual misconduct being investigated (currently only a small percentage do), increase the number of cases going through to tribunal, and to recognise that sexual misconduct is a safeguarding issue.
“We hear too many times that cases are dropped before investigation and when investigation does happen it does not lead to appropriate outcomes despite the severity of the incident.”
Sarah (not her real name), a consultant radiologist, says that was her experience when she was assaulted repeatedly by one of her colleagues four years ago.
“He repeatedly groped my breasts and grabbed my bottom,” she says. “He would make sexually aggressive statements like, ‘I’ve come to molest you’ or ‘it’s not rape if you shout surprise’.”
Sarah reported him to the trust, the police and the GMC. She says despite providing evidence, including written documentation through the Speak Up website, the trust’s internal investigation accepted his word that his behaviour was consensual.
The police investigation took more than a year and concluded that it could not be taken forward on the basis of getting beyond reasonable doubt. The GMC did not take disciplinary action or issue a warning.
The trauma of her experience has left Sarah with PTSD and other mental health issues, for which she still has therapy. “I will be forever changed,” she said.
Prof Dame Carrie MacEwen, the chair of the GMC and a consultant ophthalmologist working in the NHS, said: “Sexual harassment, bullying and discrimination are entirely unacceptable. Those who experience harassment or discrimination must feel supported to speak out, by employers, peers, managers and leaders.”
The GMC hoped the new standards would help lead to meaningful cultural change throughout medicine, she added.
Danny Mortimer, the chief executive of NHS Employers, welcomed the announcement and said he believed the new rules would empower more staff, as well as patients, to “feel safe and confident” to speak up.
But Sarah said the new rules alone would not suffice. “Until both the GMC and trusts improve their processes, the guidance is merely lip service. At the moment, speaking up is not a culture that is tolerated let alone supported or encouraged in many trusts.”
She said the worst thing was the lack of support or understanding of what she was going through. “I have felt accused of being dishonest and behaving unprofessionally, it feels like you are the one on trial,” she added.
The BMA doctors’ union said it “welcomes and supports many of the individual updated standards, such as much-needed clarity about unacceptable behaviours of sexual harassment and discrimination”.
But the BMA council chair, Prof Phil Banfield, added: “If we are to truly create a fair and equal place of work within the NHS, then a three-tier approach must be adopted with a focus on not just reporting unacceptable discriminatory or sexual behaviours, but also improving the resolution of problems and creating a more supportive and inclusive culture, including mediation and resourced remediation processes.
“Encouraging individuals to speak up and report bullying and harassment, for example, will not be effective if doctors do not trust those who they are complaining to or if complaints are not taken seriously when people do.”
