More than 100,000 incidents of sexual violence and misconduct in NHS hospitals in England are not being recorded and investigated every year, experts have warned.
An investigation by the Guardian and the British Medical Journal found more than 35,606 “sexual safety incidents” were recorded by NHS hospitals in England over the past five years. The term covers a spectrum of allegations, from abusive remarks to rape, allegedly perpetrated by staff, patients and visitors.
Responses to freedom of information requests from 212 NHS trusts found that 22 each recorded more than 500 alleged incidents over 2017-2022, including seven with between 1,000 and 2,000.
But according to the data released, 59 trusts recorded 20 or fewer incidents, of which 41 recorded between zero and 10. Experts said such low numbers appeared to be highly improbable, given the huge numbers of patients treated and staff employed.
Of the cases that were disclosed, 20,928 were incidents in which patients abused staff. Nearly 7,500 were cases of patients abusing other patients and more than 3,000 were cases of staff abusing patients.
Experts were particularly concerned that NHS trusts disclosed just 902 alleged incidents of sexual misconduct by staff against staff in a five-year period, equivalent to less than one case in each trust each year.
A 2019 survey by Unison found that 8.1% of NHS staff had experienced sexual harassment at work during the past year, with more than three-quarters saying the perpetrator was a fellow staff member. Other research estimates the rate is much higher.
Taking the most conservative estimates of prevalence, Dr Sarah Steele, a senior researcher at Cambridge University, said with more than 1 million staff employed by the 212 NHS trusts, she would have expected them to have recorded many more incidents of sexual misconduct.
“Based on past self-reporting figures in surveys by health unions and others, we would expect more than 120,000 cases of sexual misconduct per year at NHS trusts in England where the victim is a staff member, of which 90,000-95,000 would be staff-on-staff,” said Steele.
This suggests that at least 100,000 alleged incidents against staff a year are not captured in the annual figures that NHS trusts declared in their FoI responses.
“While some people would never report sexual harassment or abuse to their employer and there is a hidden figure of sexual misconduct, such low numbers suggest extremely worrying under-reporting,” said Steele. “It is clear many staff either don’t feel able or don’t know how to report incidents involving their colleagues.”
Dr Claudia Paoloni, a consultant anaesthetist at University hospitals Bristol and Weston NHS foundation trust and a former president of the Hospital Consultants and Specialists Association (HCSA) trade union, said: “I was sexually assaulted in front of everyone early in my career, but when I raised it internally at that time, they said: ‘You could report, but you do realise you would be known as the person who got a senior consultant sacked?’, so I didn’t take it any further. Because I never went to the police, there’s no record of it having happened. In my HCSA role, I’ve seen that many trusts only pay lip service to sexual safety.”
An analysis of the FoI responses showed that while all trusts have policies that govern behaviour at work, fewer than 10% of respondents had standalone sexual safety policies, which contain specific measures to protect patients, visitors and staff from sexual violence and misconduct and set out what processes to follow when cases are reported. Only one of the NHS trusts that recorded zero or few incidents had a dedicated sexual safety policy. In contrast, those that had a specific policy tended to record far more cases.
Research published earlier this month by the University of Cambridge showed that only one NHS trust in England provides dedicated training to prevent sexual harassment.
Police figures show 11,880 alleged sexual crimes on NHS premises in the past five years, with the vast majority alleged to have taken place in hospitals. FoI responses from 37 police forces in England list 3,084 rapes, including 56 gang rapes, and 5,164 sexual assaults. Forces did not consistently provide a breakdown of who the alleged perpetrator was.
These include 493 alleged child sexual offences in hospitals, mental health units and GP surgeries in England recorded by 32 police forces, with at least 171 alleged victims aged under 13. The alleged offences include 180 alleged rapes of children under 16, of which four were gang rapes, 186 sexual assaults of children under 16, and 127 other child sexual offences, 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.
Responding to the findings, medical colleges and health unions demanded immediate action. The BMA called on the government to “urgently produce a plan of action to protect our colleagues”, while the Academy of Medical Royal Colleges, the HCSA, which represents hospital doctors, the GMB union, the Society of Radiographers, the British Dietetic Association, and the Liberal Democrats called for a full independent inquiry into sexual assault and harassment in the NHS.
The health secretary, Steve Barclay, 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.”
An NHS spokesperson said sexual misconduct was “totally unacceptable”, adding: “NHS England is already reviewing how it supports the health service to develop policies, education, and training to tackle sexual misconduct in the workplace and better support staff. This includes building on the work of the government’s women’s health strategy.”
Sexual abuse in the NHS: what data is there?
The full extent of allegations of sexual violence and sexual misconduct in the health service – by staff, patients and visitors – is difficult to gauge due to gaps and inconsistencies in the way the NHS and the police record alleged incidents.
Although NHS England compiles figures on reports of physical abuse of patients in NHS trusts, it does not specifically collate numbers on sexual abuse, or on the abuse of staff.
NHS trusts record sexual safety incidents, a term which covers a spectrum of behaviours from abusive remarks to rape. However, while some trusts recorded sexual violence and sexual misconduct, others said they did not record sexual misconduct and could only provide data on the most “serious” incidents. One trust said it had 3,000 verbal incidents but could not identify how many were sexual.
Several trusts did not disclose the number of incidents allegedly perpetrated by staff, both where the complainants were patients and staff, due to gaps in their records.
A significant number of trusts said they did not record figures on incidents allegedly perpetrated by visitors, although the Lampard report into the abuse by the late BBC DJ Jimmy Savile raised concern that this poses a potential risk to patients, their visitors and staff.
The total number of alleged child sexual offences is also difficult to discover because of inconsistencies in the way these claims are recorded by the police. For example, some claims of crimes against children aged 13-15 are recorded under the category for victims aged 13 and above, which also covers alleged crimes against adults.
• Information and support for anyone affected by rape or sexual abuse issues is available from the following organisations. In the UK, Rape Crisis offers support on 0808 500 2222 in England and Wales, 0808 801 0302 in Scotland, or 0800 0246 991 in Northern Ireland. In the US, Rainn offers support on 800-656-4673. In Australia, support is available at 1800Respect (1800 737 732). Other international helplines can be found at ibiblio.org/rcip/internl.html
