Guidance for Healthcare Organisations
Recognise
Sexual misconduct in healthcare is currently very common. In 2023, the Working Party on Sexual Misconduct in Surgery (WPSMS) published data from a large-scale study of individuals working in surgery in the United Kingdom. 1704 responses were received with 23.7% of men and 63.3% of women reporting that they had been the target of sexual harassment in the past 5 years with 29.9% of women reporting sexual assault in that time period. [1]
Any healthcare environment can expose individuals to the risk of experiencing sexual misconduct, however hot spot organisations can be identified as those with high levels of incivility and also those with excessively long working hours, and locations with higher concentrations of vulnerable users (mental health especially).7 Situations in which there is an imbalance of power (worker-manager, trainer-trainee, healthcare worker-patient) pose particularly high risks for sexual misconduct occurring.
Listen
Healthcare organisations should foster a safe and open working environment. Mechanisms for reporting poor behaviours should be easy to access, supportive and confidential. Links and contact details for reporting of poor behaviours should be displayed at multiple points in the organisation including in bathroom areas. Staff surveys should include questions regarding experience of or witnessing of sexual misconduct to allow the confidential and psychologically safe screening of an organisation for behaviours that may not reach a threshold for individuals to formally report.
Support
Healthcare organisations should ensure that they have policies and processes to support staff members and service users who have experienced sexual misconduct. Human resource departments and Occupational Health Services should have clear pathways to support affected individuals.
Act
Organisational culture plays a significant role in the prevalence of sexual misconduct. An organisation in which incivility is normalised is at risk of becoming an organisation with high levels of sexual misconduct. Organisations which promote social integration and engage staff members in decision making and management have a reduced level of sexual misconduct.
Workplaces which have dominant roles undertaken predominantly by men are associated with higher levels of abuse than those in which gender equality is more apparent. Senior roles in surgical settings continue to be predominantly occupied by men.
Organisations should publicise their policies and procedures regarding acceptable behaviours. The process of reporting, and investigation and the enforcement of penalties should be clear to all staff members. Targets should feel reassured that if they speak up they will be protected and action will be taken. Perpetrators should be in no doubt that if they behave inappropriately, there will be significant consequences.
Organisations should ensure that the employees receive regular training regarding behavioural expectations, recognition of poor behaviour and bystander interventions.
Reference Links:
[1] Begeny CT, Arshad H, Cuming T, Dhariwal DK, Fisher RA, Franklin MD, Jackson PM, McLachlan GM, Searle RH, Newlands C.Br J Surg. (2023) 2. Sexual harassment, sexual assault and rape by colleagues in the surgical workforce, and how women and men are living different realities: observational study using NHS population-derived weights. National Library of Medicine. Vol. 110:11, pp. 1518-1526. DOI: https://pubmed.ncbi.nlm.nih.gov/37697690/
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