NHS England » Actions to tackle sexual misconduct in the NHS

Classification: Official
Publication reference: PRN02125

To:

NHS trusts and foundation trusts:
- chief executive officers
- chief people officers
Integrated care boards:
- chief executive officers
- chief people officers

cc.

NHS England regions:
- regional directors
- regional medical directors

Dear colleagues,

Actions to tackle sexual misconduct in the NHS

In September 2023, the Sexual Safety Charter was published by NHS England with the aim of promoting a zero-tolerance approach towards sexual misconduct in the workplace.

Every NHS trust and integrated care board (ICB) has since signed up to this Sexual Safety Charter and we are grateful for your efforts in making the NHS a safer place to work.

Today we are writing to you to ask you to take further actions to identify and act against potential perpetrators of sexual misconduct in the NHS.

NHS England is committed to supporting and challenging the system to ensure a sexually safe environment for our staff and patients.

We are asking all trusts and ICBs to:

begin self-assessment against the assurance framework
encourage staff to complete the e-learning on sexual misconduct, and consider specialist training
review staff policies and processes to ensure appropriate sharing of concerns about healthcare professionals with future employers and host organisations
- this should include investigation findings, relevant DBS information, and reflect cumulative patterns of behaviour
- sexual misconduct should be considered through a patient safety lens as well as through HR processes
ensure that ESR (where an organisation uses this to record employee relations issues) is up to date with ongoing and complete investigations into staff
- inter-authority transfers (IATs) may reveal where there are ongoing investigations, and should be built into onboarding processes
review chaperoning policies to ensure they empower chaperones and lead to the creation of auditable records
engage with your EPR suppliers (including prospective providers) to monitor unusual access to patient records and ensure safeguarding oversight

We are also asking any trusts who haven’t completed the sexual misconduct policy audit (sent to chief people officers in the spring) to do so by Monday 1 September.

We will write to primary care providers with guidance on how sexual safety frameworks such as the Charter and sexual misconduct policy framework may be adapted for their structures.

Ahead of that we ask that:

as commissioners of primary care services, ICBs ensure primary care providers receive the support needed to focus on the sexual safety of their staff and patients
primary care providers notify their commissioner of any allegations of sexual misconduct made against a member of their team
- if the subject of the allegation is on the Performers List (medical, dental and ophthalmic), this should be via the Regional Medical Director Systems Improvement and Professional Standards (MDSIPS)

Further details on these asks are set out below.

Assuring progress on sexual safety

NHS England issued a sexual misconduct policy framework and tools for trusts and ICBs to update their policies in October 2024. We need to complete our audit of implementation of the policy framework.

As a matter of urgency, we ask that trusts who have not completed this do so by Monday 1 September.

Today, we are publishing a refreshed sexual safety assurance framework, enabling boards to assess progress against the Sexual Safety Charter.

An audit will take place in the autumn to review progress on the implementation of the Charter, as well as the actions outlined in this letter.

Additional work in support of local action

We recognise the need for greater clarity on how regional and national identification of instances of sexual misconduct at an organisational level should feed into system-wide learning and actions to prevent them occurring.

We will work with all organisations to ensure that this happens.

Of particular concern is the movement of professionals between NHS organisations without appropriate information being shared, even where behavioural concerns exist.

For clarity, data protection should not be a barrier to sharing information that could protect patients or staff. We will publish new guidance by the end of the year clarifying responsibilities on information sharing.

In the meantime, NHS organisations should remind themselves of the NHS Employers guidance on disclosure, which is clear that an enhanced DBS check may not reveal all relevant concerns, and a lack of information should not be taken as reassurance.

Organisational policies and safeguards

Care must be taken to ensure that investigations do not take just a clinical or educational lens on issues where there is any possibility of sexual misconduct or a potential sexual motive.

The sexual misconduct policy framework includes guidance on how to ensure robust investigations are undertaken, including appointing expert advisers and investigators who are specifically trained in dealing with sexual misconduct.

Chaperoning policies

NHS chaperoning policies must also be reviewed. Chaperones are not always equipped and empowered to know whether a procedure is appropriate and how to speak up if they are concerned.

Policies should ensure chaperones understand the purpose of procedures; that the purpose is documented; and that they are empowered to act on or report concerns when necessary.

In due course, we will produce good practice guidance on chaperoning policies to support local review.

Electronic patient records

Finally, while electronic patient records could be misused to target vulnerable individuals, they also offer opportunities to detect inappropriate access.

Trusts should work with suppliers to audit and monitor access patterns, and – where they are in implementation or pre-implementation – ensure this capability is built into new systems from the outset.

People put their trust in the NHS every day and it is our duty to do everything we can to make sure that that this trust is deserved. We know that you will join us in our commitment to safeguard our patients and our staff against sexual misconduct in the NHS.

Yours sincerely,