The Working Party on Sexual Misconduct in Surgery (WPSMS)
Who are we?
We are a group of committed NHS surgeons, clinicians and academic researchers who are working to raise awareness of sexual misconduct in surgery, to bring about cultural and organisational change. This work has been carried as a collaboration between WPSMS, and Exeter, Surrey and Glasgow Universities. Some group members are former targets, and some have been approached in the past for support by others. We all share a strong sense that many simply do not know where to turn. Group members and advisors can be found here.
Sexual misconduct happens. It is not new. There have been multiple powerful stories shared in the medical literature and in the wider media by colleagues who have been significantly impacted by this issue. Raising concerns is often difficult - reporting perpetrators of sexual misconduct who may be in positions of power is even more so. Definitions relating to sexual misconduct can be found here.
Sexual misconduct is a significant patient safety issue for several reasons.
1) We are aware that many trainees have been assaulted by their trainer, while operating on an anaesthetised patient. This is abhorrent and dangerous.
2) Evidence shows that patients under the care of a dysfunctional team, where there is a lack of psychological safety, have poorer outcomes, with higher complication and death rates.
3) Doctors who are harrassed, assaulted or raped by a colleague often develop depression and burnout, and are less able to care for their patients. They may leave the profession. This may be a contributing fcator to the persisting lack of gender equality amongst senior surgeons.
What are we doing?
In 2022 we produced a survey in conjunction with UoE which gained ethical approval from UoE and the Health Research Authority. This was circulated from September 2022 to members of the professions providing the surgical workforce in the UK and Ireland, to benchmark what is happening.
We asked what has happened to individuals, and importantly, how incidents were dealt with by impacted people, and finding out what responses they received if they raised concerns. Data from the survey was presented and published by the Working Party and shared with stakeholders to inform us all how to bring about change.
It is important that continue to hear all voices, including those who have never witnessed or experienced sexual misconduct. We also want to hear from those impacted who have left a career in surgery, as a result of experiencing or witnessing sexual misconduct.
Our work has been presented at the UK Institute of Medical Ethics Conference, the WIMIN Conference, NHS Providers National Conference, the Royal College of Surgeons of Ireland's Raising Concerns Conference, the Birkbeck Sexism in Medicine Conference, as well as at the national conferences of UK Surgical Specialist Associations.
The survey and our work have support so far from The Royal College of Surgeons (RCS) of England, The Royal College of Physicians and Surgeons of Glasgow (RCPSG), NHS England Safeguarding, the British Orthopaedic Trainees Association, The Association of Surgeons in Training and the Society of Women in Maxillofacial Surgery as well as the British Hip Society and the Royal College of Anaesthetists. We also have active engagement with other Surgical Royal Colleges, NHS England, NHS Employers, the General Medical Council, the Professional Standards Authority, the Royal College of Nursing and the Medical Schools Council.
We continue to liaise and meet with stakeholders and will hold a further meeting at RCSE with these and other organisations in October 2024, to focus on supporting the impacted, and making reporting processes fit for purpose.
We want surgery to be a safe place to work. We want to encourage inclusivity and diversity, so that those who want to be surgeons or to work within theatres, see surgery as a welcoming place. We want colleagues not to leave a career in the surgical workforce because they have been subject to sexual assault. We want a safe reporting system where impacted people can speak up without fear of personal detriment. We want robust mechanisms put in place by those with the power to sort this out, to ensure that perpetrators’ behaviours cannot continue, and that justice prevails for those who have been silenced or damaged.
We hope this work will help to continue the conversation, and that it will bring about change to ensure surgery is a safer place to work for all members of the surgical team, and ultimately a safer place for the patients who we are all privileged to look after.
Our survey results were peer reviewed and published in September 2023 in the British Journal of Surgery.
Prior to publication, a meeting was held at the GMC on 2 May 2023 to present our data was attended by the GMC, the BMA, Surgical Royal Colleges, the Royal College of Anaesthetists, NHS England, NHS Employers, and Medical Educators and Surviving in Scrubs. Together, we looked at challenges and solutions with those who have the power to make change happen.
A report, " Breaking the Silence" detailing our work and including outcomes of this round table meeting was published simultaneously with the release of our academic paper:
"Sexual Harassment, Sexual Assault and Rape by Colleagues in the Surgical Workforce and how Women and Men are Living Different Realities: An Observational Study using NHS Population-derived Weights"
Recipients of the report in 2023 included:
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Academy of Medical Royal Colleges
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Amanda Pritchard, Chief Executive NHS England
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London Ambulance Services
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Annaliese Dodds MP Shadow Secretary of State for Women and Equalities
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British Medical Association
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British Medical Journal
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Dame Helena Kennedy QC
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Dental Schools Council
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Douglas Bilton - Assistant Director of Standards and Policy, Professional Standards Authority
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Equality and Human Rights Commission
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Federation of Speciality Surgical Associations
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General Medical Council
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Health and Social Care Committee
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Health and Social Care Committee's Expert Panel
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Health Education England
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Henrietta Hughes, Patient Safety Commissioner
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Institute of Medical Ethics
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Kenny Gibson, National Head of Safeguarding NHS England
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Maria Caulfield MP Minister for Women
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Medical Education Leaders
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Medical Schools Council
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Medical Women's Federation
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National Medical Director's Office
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NHS Domestic Violence and Sexual Abuse
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NHS Employers
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NHS Workforce
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Post Graduate Schools of Surgery
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Professor Dame Jane Dacre, Chair, Health and Social Care Committee's (HSCC) Expert Panel
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Project S
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Protect
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Royal College of Anaesthetists
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Royal College of Physicians and Surgeons of Glasgow
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Royal College of Surgeons of Edinburgh
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Royal College of Surgeons of England
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Royal College of Surgeons of Ireland
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Stephen Barclay Secretary of State for Health and Social Care
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Steve Brine Chair HSCC
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Surviving in Scrubs
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Times Health Commission
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Victim's Commissioner
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Wera Hobhouse MP
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Will Quince Minister of State for Health and Secondary Care
Please note
We are not able to act on individual reports or take forwards concerns raised about a perpetrator.
We are in contact with and supportive of the work of our colleagues Becky Cox and Chelcie Jewitt, who have set up Surviving in Scrubs, where anonymised stories can be told. Please tell them here.
Sources of support or advice are available here.
Further reading including the 2022 statement from RCS England and WinS is available here.
WPSMS Terms of Reference
Terms of Reference Working Party on Sexual Misconduct in Surgery (WPSMS).
Aim:
The aim of the WPSMS is provide information and to raise awareness about sexual misconduct in the surgical workplace (SMS).
Objectives:
To share knowledge on SMS and signpost to sources of support
To gather quantitative and qualitative information on the experiences of the surgical and theatre workforce in relation to sexual misconduct, in association with the University of Exeter (UOE)
To liaise with professional bodies, regulators and other stakeholders to gather information, and to present the need for change
To maintain the conversation with the surgical and theatre workforce
To be a source of advice for stakeholders in making changes to improve the safety of a career in the surgical workforce.
Organisation:
The Working Party is an independent body.
Membership:
The membership is drawn from members of the surgical workforce, together with other relevant experts and advisers.
Ethical support is provided by UOE.
Academic support is provided by UOE and group members and advisers.
Meetings:
Meetings will be held as required plan our priorities. Priorities include communication with stakeholders, engaging with the workforce, and producing data to support required changes.
Meetings will be:
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From time to time as per current activity.
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At least quarterly.
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Usually on-line.
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Our website will be updated regularly to reflect our support, membership and progress.