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Breaking the silence – sexual misconduct in surgery

RCS England is committed to a zero-tolerance approach to sexual misconduct, and we will actively work to eradicate this behaviour in surgery and healthcare.

Definition of sexual misconduct

We defer to The Working Party on Sexual Misconduct in Surgery’s definitions of sexual misconduct, sexual harassment and sexual assault.

Sexual assault: A painful truth

Keen to shed light on this sinister undercurrent in the surgical profession, we featured an article in our September 2021 Bulletin by members Simon Fleming and Becky Fisher, Sexual assault in surgery: a painful truth. The subsequent letter to the authors from Philippa Jackson, sharing their personal experience of sexual assault in the workplace, sparked a surgical #MeToo movement on Twitter, illuminating the shocking prevalence of sexual harassment in surgery.

We committed in January 2022 to zero tolerance of workplace sexual harassment and assault of any kind, and to work with groups such as the Working Party for Sexual Misconduct in Surgery (WPSMS) to take action. Since then, we have worked with the WPSMS, Surviving in Scrubs and other organisations to support much-needed research, conversations and next steps. We were signatories to NHS England’s Sexual safety in healthcare charter, published on 4 September 2023.

New research

For the first time, new research from the University of Exeter and University of Surrey as part of their involvement with the Working Party on Sexual Misconduct in Surgery has revealed the extent of sexual misconduct by colleagues - including sexual harassment, sexual assault, and rape - within the UK surgical workforce in the last five years. The in-depth study, which has been published in the British Journal of Surgery, analysed anonymous online survey responses from 1,434 participants (51.5% women) from the surgical workforce.

The research found that:

  • two-thirds of women (63.3%) had been the target of sexual harassment from colleagues, along with almost a quarter of men (23.7%).
  • the majority of participants (89.5% of women, 81% of men) said they have witnessed some form of sexual misconduct by colleagues.
  • only 16% of those impacted by sexual misconduct made a formal report.

witness graph

target graph

Figures from Breaking the Silence, the Working Party on Sexual Misconduct in Surgery report, September 2023

The study also found there is a widespread lack of faith in accountable organisations’ ability to deal with sexual misconduct. These included NHS trusts that have a duty to protect the workforce, the General Medical Council (GMC), the British Medical Association (BMA), Health Education England, and the Royal Colleges.

Read the research
Please note that this research contains information and experiences that are distressing and may be triggering to some. Please contact the RCS England Confidential Support and Advice Line on 0800 028 0199 if you want to talk to a trained counsellor.

Update on our actions to tackle sexual misconduct

RCS England is committed to a zero-tolerance approach to sexual misconduct.

Since the publication of The Working Party on Sexual Misconduct in Surgery’s (WPSMS) report Breaking the Silence: Addressing Sexual Misconduct in Healthcare and the in-depth study published by the British Journal of Surgery, we have redoubled our efforts to stamp out sexual misconduct, sexual harassment, and sexual assault. This has included signing NHS England’s Sexual Safety in Healthcare Charter and writing to the trusts that have not signed. 

We have also responded to the NHS Staff Survey results, published on 7 March 2024, which show that almost 9% of all NHS staff and 18% of medical and dental staff in training have been the target of unwanted sexual behaviour in the NHS from patients, service users, their relatives or other members of the public.

We work closely with the WPSMS to support their work. On 9 February 2024 we were proud to host their follow-up meeting on taking their report’s recommendations forward with trainees, trainers, and senior leaders in healthcare including from NHS England and the GMC. We have outlined our own progress against the recommendations of the WPSMS report, and our wider work, below.

Our Vice-President Professor Vivien Lees and, at a staff level, Lucy Davies, Executive Director ( will oversee implementation of our work to end sexual misconduct. We have also appointed Professor Rosalind Searle, an independent expert advisor, to provide external challenge.

Implementation and investigation

  • We are lobbying accountable government and NHS organisations on the WPSMS’ recommendations including the need for reforms of reporting and investigation processes of sexual misconduct. This has included the Women in Surgery Chair Tamzin Cuming giving evidence to the Women and Equalities Committee.
  • Together with the WPSMS, we have met with the shadow attorney general and Labour’s advisor on protecting women against workplace harassment to inform the Labour Party’s policies on tackling sexual misconduct. Labour’s advisor also attended the 9 February meeting.
  • While NHS England’s Sexual Safety Charter commits organisations to ‘ensure appropriate reporting mechanisms are in place’ there is more work to do to ensure this results in genuine reform of reporting and investigation which supports safety and confidence in raising concerns.

Policies and code of conduct

  • We are signatories to the NHS England Sexual Safety Charter and the BMA Sexism Pledge. We have also written to NHS trusts who are not signatories to encourage them to sign the Sexual Safety Charter as soon as possible.
  • We have also welcomed the GMC’s updated Good Medical Practice which makes clear that doctors ‘must not act in a sexual way towards colleagues with the effect or purpose of causing offence, embarrassment, humiliation or distress.’ It also guides active bystander behaviour.
  • We are developing a new clear and comprehensive policy on sexual misconduct to cover our membership and volunteer base, including our examiners. This will be in place before 1 July 2024.
  •  All staff and Council members currently must undertake regular Equality and Diversity training. We will be reviewing this to ensure it is still appropriate, clear and explicitly addresses sexual misconduct, and ensure it is rolled out to all College representatives.


  • Our role as a Royal College is rooted in education, awareness and standard setting. We are also committed to developing and signposting impactful, targeted resources and training on being an active bystander, with specific reference to incidents of sexual misconduct.
  • We are currently reviewing our own core surgical standards document, Good Surgical Practice, to make sure it reflects the need to tackle sexual misconduct. We will publish this during 2024.
  • We continue to provide our unconscious bias e-learning and guidance, available free of charge to all on our online learning platform.
  • We have set out a five-point plan for how we are going to close the MRCS differential attainment gap.

Culture and performance

We have diversity, equity and inclusion firmly rooted in our strategy, values and operational delivery. To note we have:

  • Changed our governance so that, from this year, our Council will always have at least one vice-President which will be a woman. The Chair of Women in Surgery, the SAS Forum, and the President of the Association of Surgeons in Training and the British Orthopaedic Trainees Association will also be able to vote at Council. These changes are subject to approval by the Privy Council which should take place shortly.
  • Hosted a webinar on our response to the Working Party on Sexual Misconduct in Surgery (WPSMS) report, Breaking the Silence.
  • Incorporated our response to sexual misconduct across the College’s events programme.
  • Refreshed our emerging leaders programme for women and non-binary people.
  • The Pride in Surgery Forum, supporting our LGBTQ+ colleagues, now receives formal support and advice from the College.
  • Launched our SAS strategy and activities to support SAS surgeons.
  • Developed our plans to support parents in surgery.

Read more about our Diversity, Equity and Inclusion work and our plans for the future.

Data collection

  • The NHS staff survey covering all hospitals in England, the GMC’s national training survey, and the Joint Committee on Surgical Training Survey, will now include questions around sexual safety so the health service can monitor progress.

Support and signposting

If you experience or witness sexual harassment or assault in the workplace, if you feel able, please report it through your hospital procedures and, if appropriate, to the police. There is third-party help and support available via the links below. 

If you need advice on the legal process or need emotional support from a trained counsellor, RCS England provides a 24/7 Confidential Support and Advice Service – the helpline can be reached on 0800 028 0199.

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