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

Dear colleagues,

An update on actions to prevent sexual misconduct in the NHS

We write today in light of media reporting of historic allegations of sexual assaults against young and vulnerable patients at Royal Stoke University Hospital and Russells Hall Hospital.

With legal proceedings ongoing, NHS England – alongside the trusts and integrated care boards (ICBs) involved – is continuing to fully support Staffordshire Police in its investigation into these alleged offences.

We ask all employers of NHS staff to take extra care in supporting staff or patients that may have been impacted by these events. In particular, if staff raise concerns about their own time at the affected organisations, employers should direct them to the contact details for each trust.

If a member of staff needs to report criminal allegations, they should be directed to the dedicated police portal. Any additional allegations that employers receive must take account of statutory safeguarding thresholds and related guidance. More generally, please check in with your teams and make sure you offer wellbeing support to anyone that needs help.

The results from our recent audit of adoption of the sexual misconduct policy framework show progress. Every trust and ICB now has a policy in place or is in the process of adopting one, and 76 per cent have implemented anonymous reporting for staff who wish to speak up about sexual misconduct in the workplace.

However, the audit also highlights that further focus and consistency are needed in some parts of the NHS.

Actions for trusts; for all organisations delivering NHS care; and for primary care providers and their ICBs are set out below.

New actions for trusts

• Investigation training: Every chief people officer will be invited to put forward 2 people professionals to take part in national training on sexual misconduct investigations. This will follow a ‘train-the-trainer’ model, with the expectation that participants will share their learning with other investigators in their trusts. Training has been commissioned by NHS England for all trusts, and we are developing a national training specification that organisations will be able to use to commission their own local training. Training will cover core safeguarding awareness and the relevant referral processes. Training will begin in March 2026 and we will share sign-up details nearer the time.
• Specialist investigators: Organisations should ensure that investigators of sexual misconduct allegations have specialist training, as set out in the national sexual misconduct policy framework. Where trust policies require investigations to be carried out by doctors or dentists, the trust should ensure that this investigator has received specialist training in sexual misconduct. We are therefore asking trusts to build a pool of medical/dental investigators who are specially trained in sexual misconduct investigations. Responsible officers should also be trained in how to handle sexual misconduct cases. The national investigation training will support you in this objective.

New actions for all organisations delivering NHS care

• Chaperoning: Providers are required to review their chaperoning policies to ensure that the principles in annex A are adequately reflected. Where policies do not reflect these principles, please update them.
• Review groups: When concerns arise about an individual’s practice, it is important to consider whether the actions could have a sexual dimension, even if this is not immediately obvious from the allegation. All NHS organisations should strongly consider adopting review groups, supported by appropriate safeguarding advice, to ensure sexual misconduct reports are correctly and robustly considered and investigated where appropriate. Any necessary police involvement will also be considered by these review groups.
• Clarification on investigations involving resident doctors: When allegations of inappropriate sexual behaviour are made against a resident doctor, there should be an initial discussion between the employer and the Postgraduate Dean, as the doctor’s responsible officer, to agree next steps. A review group may also be helpful in identifying the most appropriate course of action. If Maintaining High Professional Standards (MHPS) in the NHS is followed, it recommends initial consideration of whether there is a training aspect to the allegations. Where there is a clear sexual element to an allegation, this is very likely to require conduct processes, following consideration of safeguarding and any needing police involvement.
• Referrals to the Disclosure and Barring Service (DBS): NHS organisations that employ or engage individuals in regulated activity with children or adults have a legal duty to make barring referrals to DBS. If someone is removed from work or specific clinical duties due to concerns about conduct that has harmed a child or adult, or put them at risk of harm, then a barring referral should be made. Failure of organisations to fulfil this duty could result in police action. The Making barring referrals to DBS guidance explains the legal requirement to refer. Organisations can contact their DBS regional outreach advisor for more information and additional advice on referrals is also available in the Safeguarding Accountability and Assurance Framework.
• Sharing information where there is an active police investigation: Where there is police involvement in a case, employers are required to engage with their police liaison to understand which elements of the misconduct investigation can continue while the police investigation is underway.
• In August, we said we would return to trusts and ICBs in the autumn to check progress against the Sexual Safety Charter assurance framework and against the actions outlined in the August letter. We are now requiring trusts and ICBs to complete a new sexual misconduct audit by Monday 2 February 2026.

New actions for primary care providers (working with their ICBs)

In our August letter, we indicated that we would follow up with actions for primary care providers on tackling sexual misconduct. All employers, including those providing primary care services, have a legal duty to take reasonable steps to prevent sexual harassment in the workplace. All primary care providers also have important regulatory duties around safeguarding and the reporting of incidents (for example, CQC regulation 13 and professional regulators standards). Primary care has specific sexual safety challenges, including the isolation that staff experience, and the one-on-one nature of many consultations. It is vital that patients can feel safe in the NHS, no matter what the setting.

Today, we are asking primary care providers to sign up to the 10 principles in the Sexual Safety Charter. These principles set the aspiration for the whole of the NHS and will ensure all providers have the same level of ambition.

However, we realise that some primary care providers will need help to fully implement the Sexual Safety Charter. ICBs should reach out to all their providers to offer support in helping primary care to fulfil the charter’s ambitions. We expect all primary care providers delivering NHS services to:

• sign up to the principles of the Sexual Safety Charter
• complete the new Sexual Safety Charter self-assurance checklist (annex B), which we are publishing today. This can help providers to consider gaps in their current processes. Documenting the self-assessment can be useful in evidencing compliance with the legal duty for all employers to take reasonable steps to prevent sexual harassment (see the Worker Protection Act 2023) and could be used as part of evidence of compliance in future regulatory inspections
• ensure that you know where to access a sexual misconduct policy should you need one. NHS England will share a streamlined version of its national sexual misconduct policy framework – specifically tailored for primary care – by the end of January 2026
• ask members of staff to complete the national e-learning module on sexual safety awareness
• review chaperoning policies in line with the new principles published today
• ensure reporting to NHS England, and, where applicable, to the Care Quality Commission (CQC), the professional regulator, and the police, is embedded in sexual misconduct incident management

It is our expectation that you will all join us in our national commitment to protect staff and patients. All providers also have statutory safeguarding responsibilities and regulatory responsibilities on sexual safety.

To help providers, ICBs should support primary care as follows.

• By Monday 2 February 2026: Contact all primary care providers to offer support in completing the self-assurance checklist. Primary care providers should then confirm to the ICB that they have signed up to the charter and completed the self-assurance checklist.
• By Tuesday 31 March 2026, NHS England will carry out an initial review with ICBs to check how many providers have confirmed completion.

We will be in contact with ICB domestic abuse and sexual violence (DASV) leads to coordinate each ICB’s response to these asks. Further resources will be made available for primary care over the coming months, including additional training by the end of 2025/26, posters to publicly display commitment to sexual safety, and webinars for ICB DASV leads in January to help with completion of the self-assurance framework.

Further assessment of progress

We are grateful for the response to our first audit and organisations’ commitment to improved processes around sexual misconduct. However, the NHS must continue to demonstrate its commitment to ensuring the sexual safety of both staff and patients.

Any form of discrimination, violence and aggression towards colleagues with a protected characteristic is unacceptable. We also strongly advise focused action in these areas, as set out in our letter of 17 October 2025 on racism.

Yours sincerely,

Duncan Burton, Chief Nursing Officer for England
Dr Claire Fuller, National Medical Director, NHS England
Professor Meghana Pandit, National Medical Director, NHS England