Turning the tide: Progress and actions to support targets of sexual misconduct in surgery

Sexual misconduct in the surgical profession is endemic. The Working Party on Sexual Misconduct in Surgery (WPSMS), supported by the Royal College of Surgeons of England (RCS England), has highlighted the scale of sexual misconduct, sexual harassment, and sexual assault in the surgical profession. The 2023 report, Breaking the Silence: Addressing Sexual Misconduct in Healthcare, emphasised the urgent need for systemic change.

RCS England is committed to a zero-tolerance approach to sexual misconduct and continues to work closely with the WPSMS to drive reform across surgery and healthcare.

Turning the tide: Progress and actions to support targets of sexual misconduct in surgery outlines the progress made to date and sets out the critical next steps needed to ensure sustained action in addressing this serious issue.

Eight priority actions to strengthen support for targets and enhance reporting of sexual misconduct in the NHS

1. NHS England/Department of Health and Social Care (DHSC) should establish a national anonymous reporting mechanism for sexual misconduct.
2. NHS England/DHSC should publish a roadmap by July 2025, outlining how NHS trust organisations will implement the National Sexual Misconduct Policy Framework.
3. The Medical Practitioners Tribunal Service (MPTS) should:
   
   a. update its decision making methodology and sanctions bandings for sexual misconduct cases by October 2025 to ensure they are fit for purpose and applied consistently;
   
   b. conduct a review of the appropriateness, influence and evidentiary weight of character references and testimonials in the decision making process for sexual misconduct cases;
   
   c. improve trauma-informed education and training for all staff involved in fitness-to-practice cases. Training should include: understanding vulnerability dynamics, abuse of power and breaches of trust; specific guidance on what constitutes acceptable evidence of insight; and remediation;
   
   d. urgently review and reform its approach to supporting targets of sexual misconduct during tribunal hearings by October 2025. Targets should be provided access to case preparation resources, guidance on compiling robust evidence and testimonies, legal support and psychological support.
   
   
4. NHS trust organisations, health boards, the independent sector, education bodies and professional regulators should collect and publish annual data on sexual misconduct cases.
5. The Professional Standards Authority (PSA) should conduct a review of how professional regulators manage sexual misconduct cases.
6. Medical indemnity providers and trade unions should set out how they will better support targets of sexual misconduct by October 2025.
7. The Independent Review into the Care Quality Commission should include specific metrics to address sexual misconduct.
8. All UK medical schools should sign the NHS England Sexual Safety in Healthcare Organisational Charter by September 2025.

Sexual misconduct in surgery is a pervasive issue that demands sustained effort, cultural transformation, and robust policy frameworks. RCS England, in collaboration with the WPSMS and other stakeholders, is committed to leading this change. By implementing the outlined next steps, we can create safer, more inclusive environments for healthcare professionals and patients alike.

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