There’s no place for bullying and harassment in the healthcare sector. David Hare appeals for everyone to join the growing campaign to foster a culture where colleagues can speak out when they have experienced or witnessed these behaviours.
While there is often a focus on the importance of keeping patients safe, here I want to talk about the often overlooked role of keeping our workforce safe, and particularly our female colleagues.
In recent years, there have been growing evidence of the bullying and harassment of women working all across the health sector.
The NHS Staff Survey, published earlier this year, found almost 9% of all NHS staff, and 18% of medical and dental staff in training, have been the target of unwanted sexual behaviour in the NHS from patients, service users, their relatives or other members of the public.
Overall, 58,000 staff reported unwarranted sexual approaches from patients or other members of the public last year – that is one in every 12 NHS workers.
One in 26 reported experiencing similar harassment from work colleagues.
Likewise, the British Medical Association’s (BMA) Sexism in Medicine report found that 91% of female respondents had experienced sexism, with:
- 61% feeling they were discouraged to work in a particular specialty;
- 70% of women respondents believing their clinical ability had been doubted or undervalued;
- 44% of women saying they have had fewer training opportunities compared to men.
Moreover, 56% of women and 28% of men respondents reported receiving unwanted verbal conduct, and 31% of women and 23% of men respondents experienced unwanted physical conduct.
Problem in surgery
Looking more specifically at certain specialties in healthcare, the problem is even more acute.
Research from the University of Exeter and University of Surrey, published in the British Journal of Surgery, analysed anonymous online survey responses from over half of the surgical workforce.
It found almost two-thirds of women (63.3%) had been the target of sexual harassment from colleagues, along with almost a quarter of men (23.7%).
The majority of participants (89.5% of women, 81% of men) said they have witnessed some form of sexual misconduct by colleagues, but just 16% of those impacted by sexual misconduct made a formal report.
Shocking figures
These figures are quite simply shocking and, above all, unacceptable.
And while some of this research relates to the NHS, the prevalence of harassment and misconduct that has been found means this issue absolutely cannot be seen as an ‘NHS only’ problem, but one that affects all healthcare providers.
At the Independent Healthcare Providers Network (IHPN) we are taking this issue very seriously.
This summer, we were pleased to hold a ‘Sexual Safety’ session with our members to look at this issue in more detail and discuss what independent providers can do to support their staff and ensure there is an absolutely zero tolerance approach to bullying, harassment and sexual misconduct of any kind in their facilities.
First-hand experience
As part of the session, we were pleased to be joined by the organisation ‘Surviving In Scrubs’, who spoke of the first-hand experiences of women in the health service.
This includes:
- How women were objectified during their ward rounds with their senior registrar gesturing to patients and saying ‘don’t we have a pretty female doctor with us today’;
- GP trainees being told almost every week ‘we don’t employ women of child-bearing age’;
- Multiple stories of known perpetrators working unchallenged within the healthcare environment –‘I was informed that he was known for this behaviour, that he’d got away with so much before and he was capable of ruining careers.’
Such behaviour is utterly unacceptable in any setting, let alone one where patients come to receive treatment and care during what can often be a vulnerable experience in their lives.
Thanks to the work of organisations like Surviving In Scrubs who campaign on this issue, some progress has been made in this area.
The General Medical Council’s (GMC) Good Medical Practice now explicitly makes clear that doctors ‘must not act in a sexual way towards colleagues with the effect or purpose of causing offence, embarrassment, humiliation or distress’, as well as guidance on active bystander behaviour.
Equally the Royal College of Surgeons of England – who also spoke at our event – is reviewing its own policies, including its Good Surgical Practice guidance, to make sure it reflects the need to tackle sexual misconduct.
Zero-tolerance approach
The NHS has also established a sexual safety in healthcare charter. This calls on signatories to commit to a zero-tolerance approach to any unwanted, inappropriate and/or harmful sexual behaviours towards their workforce.
It covers ensuring appropriate, specific and clear policies are in place, including appropriate and timely action against alleged perpetrators, as well as ‘ensuring appropriate reporting mechanisms are in place for those experiencing these behaviours, with the capturing and sharing of data on prevalence and staff experience transparently’.
So far almost 90% of IHPN’s Strategic Council members – our governing body – plus over half of our members, have signed up to the charter, but we are striving to ensure that 100% of our members are signatories.
Here at IHPN, we have specifically developed a ‘Sexual Safety’ managers toolkit for members, with six steps for well-led organisations to consider for tackling this issue.
We will also be establishing a Community of Practice, where members will be able to come together and share learning on this issue, including looking at specific anonymised cases, thinking about what worked well and identifying improvement areas.
Broader understanding
Through this, we hope to bring together different professional perspectives and broaden understanding of the issue and provide peer support.
Of course, the vast majority of staff working in the independent and wider healthcare sector behave with the utmost integrity and professionalism towards other colleagues.
But the evidence is unfortunately clear that too many people, largely women, are being subject to unacceptable levels of harassment and misconduct by their peers.
We know the culture of learning and the striving for continuous improvement that exists in the sector.
As part of this, we hope both providers and practitioners will equally work to foster a culture where healthcare colleagues who have experienced or witnessed these offences are empowered to speak up, report and call out this behaviour.
David Hare is chief executive of the Independent Healthcare Providers Network (IHPN).
