Charter to tackle sexual harassment across NHS in England has failed, say unions

A flagship strategy to tackle sexual harassment across the NHS in England has failed to improve the safety of female staff, according to legal experts and healthcare unions.

The NHS sexual safety charter, launched in September 2023, was supposed to improve how hospitals, GP surgeries and other organisations address sexual harassment. But the UK-based charity Rights of Women said calls from NHS staff to its sexual harassment at work advice line have increased significantly since the charter was rolled out.

Laura Bolam, the employment law officer of the charity – which provides free legal advice to 3,000 working women each year across England and Wales – said that the proportion of its callers who are women in the NHS had doubled recently.

“In 2023, around 11% of our calls came from women working in the NHS; this rose to 19% in 2024 and increased again to 22% in 2025. This highlights that sexual harassment within NHS trusts is not only rising but appears to be an entrenched, systemic issue.”

All NHS organisations in England have signed the sexual safety charter, which commits them to taking a zero-tolerance approach to unwanted sexual behaviour. But a Guardian investigation found many trusts continue to report improbably low numbers of incidents, particularly for staff sexually assaulting or sexually harassing colleagues and other staff.

Responses by 212 NHS trusts in England to freedom of information requests disclosed just over 1,200 incidents of staff-on-staff sexual harm from 2022-23 to 2024-25. More than two-thirds (93) of acute trusts reported fewer than three sexual harm incidents by staff against other staff over those three years, while 24 recorded none.

But in the latest annual NHS staff survey, 3.7% of workers said they had been the target of unwanted sexual behaviour from colleagues. Given that the NHS in England employs 1.5 million people this would equate to 54,900 alleged victims in 2024 alone.

Bolam said there seemed little evidence that the charter has improved the safety of female staff. “We continue to hear from women whose workplaces have not upheld its commitments,” she said. “Many have told us that their managers were unaware of the charter’s existence, let alone implementing its provisions.

“Women have disclosed experiences including rape, physical assault and ongoing experiences of verbal and sexual harassment from male co-workers. We are disproportionately contacted by women in lower-grade roles, including nurses and healthcare assistants.”

The charter requires NHS organisations to improve their recording of sexual harm against staff, after widespread criticism that hospitals are vastly under-reporting incidents.

Respondents to a Royal College of Nursing (RCN) survey of the profession last month said they thought implementation of the NHS sexual safety charter “is uneven, and staff often lack protection or clarity, particularly when misconduct involves patients”.

The RCN general secretary, Prof Nicola Ranger, said: “It has become increasingly clear that elements of the charter, including around promoting a culture of openness and transparency, are not being adhered to or enforced effectively. The secretary of state and NHS leadership need to introduce a simplified national standardised method for reporting sexual assaults.”

Dr Emma Runswick, the BMA deputy council chair, said the charter’s commitment to a “zero tolerance” approach to sexual assault and harassment was meaningless without visible action and called for “clarity” on how NHS England holds them to account if they fail to protect their workforce. “The discrepancy between recorded incidents and staff-reported experiences shows a deep lack of trust in current reporting processes,” she added.

All NHS trusts are legally required to take reasonable steps to prevent sexual harassment under the worker protection act, with even stronger duties to do so coming into force under the Employment Rights Act.

“Fulfilling these obligations requires more than signing a charter – it demands consistent, transparent and enforceable action,” said Runswick.

Responding to the findings, a Department of Health and Social Care spokesperson said: “Sexual harassment is unacceptable in all forms. Healthcare leaders must take robust, compassionate action to stamp out sexual misconduct within their organisations and keep staff and patients safe. This includes making sure staff can speak up and be heard and making sure every incident is recorded and met with swift action.

“Beyond the work already under way to tackle sexual harassment, we will also introduce a series of new staff standards for NHS staff this year, covering sexual safety in the workplace, as well as tackling racism and reducing violence.

“Experiencing sexual misconduct is extremely distressing and can understandably be challenging to report, which is why all trusts must now offer anonymous reporting routes to make it easier – with three-quarters of trusts already putting this in place.

“Sexual violence or misconduct has absolutely no place in the health service and it’s essential all NHS organisations adopt the measures set out in the newly launched sexual safety charter which will ensure staff feel more supported to report incidents, and with confidence that action will be taken.”