Sexual assault in the NHS: why HR processes are failing and how to fix them

David Liddle -

Recent stories of widespread sexual harassment and assault against female NHS surgeons are truly shocking. 

In the Breaking the Silence report almost 63% of women surveyed said they had been the targets of sexual harassment, while 30% reported being sexually assaulted by colleagues in the past five years.


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The report highlighted a culture of silence, where women were afraid to speak up about their experiences, for fear it would have a negative impact on their career – and colleagues routinely stood by, witnessing regular incidents and choosing to say nothing.

It is clear that there are deep-seated cultural and systemic issues within the surgical environment in the NHS, which need to be tackled as a matter of urgency.

But I strongly believe that if we want to see real change, we need to address the rules that underpin the system – as well as the system itself.

A big part of the problem, not just in the NHS, but in organisations across sectors, is that employees simply have no faith or trust in the traditional bullying and harassment and disciplinary and grievance procedures put in place to manage issues in the workplace.

These policies are dysfunctional, destructive and divisive. They perpetuate stress and distress for the parties involved, damage relationships to the point where they are beyond repair, and rarely result in issues being successfully resolved.

Even more concerning, as this latest scandal graphically illustrates, they actively encourage heuristics, abuse of power and bias.

I have heard many people describe the processes for resolving issues at work as being more traumatising than the original incident.

Hardly surprising then, that when faced with the prospect of going to head to head with powerful consultants, these female surgeons routinely chose to keep quiet, believing it was unlikely that any of the policies in place to supposedly protect them, would be fairly and justly applied.

Since the report’s publication, we have seen promises from NHS management of zero-tolerance policies and more robust reporting mechanisms for NHS employees facing these horrendous issues.

These interventions are welcome, but I hope the NHS doesn’t fall into the common trap of trying to buttress an already badly broken system with yet more additions and amendments to policies that clearly aren’t fit for purpose.

There is a better way. After years of campaigning, I am finally seeing the tide turning in favour of more compassionate, collaborative approaches to resolving conflicts, complaints and concerns of all kinds within the workplace.

Aviva, TSB, Nationwide, Burberry and the BBC are just a few of the organisations who have chosen to adopt a resolution framework – an alternative approach which is centred around a restorative rather than retributive approach to justice. 

The resolution framework gives dialogue primacy and places people firmly at the centre of attempts to resolve the myriad issues that arise in the modern-day workplace.

It allows organisations to spot issues arising early on, and tackle them at source, using a powerful triage system to direct people down the most appropriate route to resolution.

Those options might include facilitated conversations, coaching or mediation – and for more serious issues, could include formal action, leading to possible dismissal.

It is a highly successful, proven, and legally compliant approach, which is being embraced not just by boards and people and culture teams, but also by the employment lawyers that support them.

Of course, a resolution framework cannot on its own eradicate the kind of ingrained behaviours and attitudes that have clearly become culturally normalised within the NHS surgical environment.

Organisations need to listen to their people, develop a clear understanding of what is going wrong and why, and equip their managers with the skills they need to create healthy workplace climates where people can be at their best.

But a shift towards the more compassionate, collaborative, people centred approach that a resolution framework provides can act as a pivot point, helping organisations achieve psychologically safe working environments, where people are confident to speak up, safe in the knowledge their experiences will be taken seriously and dealt with fairly.

If a resolution framework had been in place in these NHS settings, would ‘surgery’s open secret’ been allowed to prevail?  I think not.

David Liddle is CEO and chief consultant at The TCM Group