The body responsible for Scottish medical training says it is continuously working to address abuse, in response to a recent report finding trainees are particularly at risk of sexual harassment.

NHS Education for Scotland’s (NES) Executive Medical Director, Professor Emma Watson, said sexual misconduct remains a “serious concern” in healthcare and the national board is working with senior leadership and wider partners to bring about change.

She said NES condemns any form of sexual misconduct, bullying, and harassment and is working to deliver a national reporting system, to ensure people can safely report incidents if they or others in their workplace are targeted:

“Sexual harassment disproportionately affects women and is usually perpetrated by men.

“Developing continued commitment to promoting zero tolerance and providing specialist support is essential to creating secure, respectful healthcare environments for all.

“NES is developing an incident reporting mechanism for staff to report incidents of discrimination and harassment, has created training modules for all health and care staff in Scotland, and regularly anonymously surveys medical trainees about sexual misconduct in their workplace, acting on that feedback.”

The Medical Director’s comments come in response to Scottish research finding medical trainees who report abuse are are regularly ‘shut down and silenced’, with current reporting practices falling short.

The researchers and doctors’ representatives said the creation of a national, anonymous reporting mechanism would enable staff to come forward “without fear of bias or retaliation”.

Professor Watson said NES is proactively working with partners across Scottish government, NHS boards, royal colleges, medical schools and advocating organisations such as Surviving in Scrubs to improve the situation.

NES has also supported the Royal College of Surgeons Edinburgh’s campaign to end healthcare sexual misconduct and said it “just this month” promoted the Independent National Whistleblowing Officer’s Speak up Week.

This collaborative work, she explained, seeks to “engage and support” medical trainees and students to understand, raise, appropriately challenge, and feel both safe and empowered to help change unacceptable behaviours and cultures.

However, the General Medical Council (GMC) recently heard too many doctors in training are hesitant to ask for help from supervisors around patient safety, in what it deemed an “unhealthy culture”.

Trainees reporting the greatest apprehension around escalating concerns, as well as higher levels of workload stress and bullying, to the GMC worked in obstetrics and gynaecology, surgery, and emergency medicine– many of the specialities which were found by the researchers to have higher levels of sexual harassment and abuse.

What now?

A GP, academic, and co-founder of advocacy organisation Surviving in Scrubs, Dr Becky Cox, told healthandcare.scot trainees face an “intensely challenging environment” when witnessing or experiencing sexual misconduct.

Dr Cox says the research echoes with Surviving Scrub’s findings of “systematic sexism in healthcare” that creates a toxic culture and environment fundamentally hostile to survivors of sexual harassment.

She added:

“There is a huge amount of work needed to undo decades of misogyny and change the culture the culture in the NHS. Trainees’ experiences must be recognised with specialist support, supervisors who are trained in responding to cases of misconduct and systems that hold perpetrators to account.

“Ultimately, we want cases to be prevented from happening and we need commitment from our healthcare organisation, including those who are responsible for training, to commit to cultural change.”

NES said it also working with NHS Lothian’s Medical Education team to rollout the ‘Beyond Bystander’ training, to equip staff to recognise and intervene when they see discrimination in the workplace.

The training provides staff with phrases and space to practice interventions, and was expanded across NHS boards, with the help of NES, this year.

NES has also developed online resources for people who experience, and are affected by, sexual misconduct, and has worked with Scotland’s Sharing Intelligence for Health and Care Group (SIHCG) to enable system-wide focus on sexual misconduct.

The organisation said it continues to work closely with healthcare regulators to coordinate and deliver further action.

Read more: Shocking levels of violence towards NHS staff; Corridor care ‘the norm' in struggling hospitals; Report spotlights burnout and discrimination; Racism in NHS Scotland still rampant, doctors reveal; Diversity in healthcare – what can we do?; Mr Yousaf: “Scotland is a great place to work”; A pharmacist on the frontline; Organisational change needed for women in healthcare; NHS Chair: “I'm sorry”