This page contains information and discussions about sexual misconduct. If you need support we encourage you to seek help from trusted friends, family members, or professional services. Please find details of helplines in the support section below.
This ethical hub topic shows how our professional standards can be applied in this area of care and signposts to relevant resources. It does not set new professional standards and is not intended to replace the formal guidance. Page last reviewed: 13 December 2024.
Sexual misconduct in the healthcare environment, within or outside the workplace is unacceptable and can be a criminal offence. The impact on individuals and teams can be devastating.
This page includes advice on how to identify the behaviours, cultures and norms which may lead to sexual misconduct. It also outlines suggestions around how to make sure appropriate boundaries between doctors, physician associates, anaesthesia associates and patients, colleagues and students are maintained.
We know that reporting sexual misconduct can be very difficult and upsetting. To help anyone affected we've included where to go for help and support and how to raise a concern about a doctor.
Help and support to speak up
Help and support are available for anyone affected by sexual misconduct.
Advice helplines
- Rights of Women Sexual harassment at work advice helpline provides free and confidential legal advice to women and girls.
- SurvivorsUK operate a free, confidential national online helpline for men and boys.
- GALOP offer a free, confidential and independent helpline and support service for all LGBT+ people who have experienced sexual assault, violence or abuse.
- NHS advice on help after rape and assault provides advice on what to do, the services that can help and how to support people.
- Rape Crisis England and Wales, Rape Crisis Northern Ireland and Rape Crisis Scotland provide free, confidential emotional support, information and signposting by phone or email.
- Victim Support England and Wales, Victim Support Scotland and Victim Support Northern Ireland, provide free and confidential specialist help.
- Independent sexual violence advisors (ISVAs) - You can access ISVAs through sexual assault referral centres (SARCs). SARCs have specially trained doctors, nurses and support workers on hand 24 hours a day, offering medical, practical and emotional support to anyone who has been raped, sexually assaulted or abused.
- NHS social care support gives free, private support to people who have experienced different forms of abuse.
- NIA rape crisis gives free, private specialist support to women and girls who have experienced any form of sexual violence at any time in their lives.
How to raise a concern with us
If you have been affected by sexual misconduct and decide to raise a concern with us, there are several options available to you so that you can choose the one you feel most comfortable with.
Support with raising concerns about a colleague
We know that raising a concern can be tough. You may not feel ready or able to do this right away.
Our ethical hub pages on Speaking up provide tools that can help you. There are also other sources of information that you may find helpful, such as an article in the British Medical Journal which compiles advice from experts on the steps that can be taken if you are sexually assaulted at work.
If you think you want to raise a concern with us but you need some support and guidance to help you make a decision, you can call our confidential helpline on 0161 923 6399 Monday to Friday, 9 am - 5 pm. You don’t have to provide your name and although our staff aren’t trained to provide legal advice or counselling in relation to sexual misconduct, they are able to signpost you to the most appropriate organisation who can help.
Victims and survivors
Anyone can experience sexual misconduct. This information is intended for doctors, physician associates, anaesthesia associates and healthcare professionals who have been subject to sexual misconduct in the healthcare environment within or outside the workplace.
There is never an excuse or justification for sexual misconduct and there is support available. You can find details of organisations that can help on the support tab and we have a resource available to support anyone who has been affected by sexual misconduct in healthcare.
Sexual boundaries between colleagues
Consensual relationships
Consensual and reciprocated sexual attraction and relationships between colleagues are not sexual misconduct. However, when there is an imbalance of power between colleagues, or situations where training and career progression opportunities could be impacted, this could lead to environments where sexual misconduct can take place. There is no place for sexual harassment or any form of sexual misconduct in healthcare, within or outside the workplace.
An example of where this can be particular risky, and where it is likely to be inappropriate, is where an educational or managerial relationship exists.
Even if your relationship is consensual, in line with our professional standards, it is important professional boundaries are maintained in the workplace. This means there should be no negative impact on clinical practice or team environments during the consensual relationship or if the consensual relationship comes to an end.
Sexual misconduct
All forms of sexual misconduct in medicine, including all forms of sexual harassment, are unacceptable and can be criminal in nature. All healthcare professionals have the right to a workplace free of discrimination, bullying and sexual harassment. Sexual misconduct can have a negative and devastating impact on individuals, team cultures and patient safety. A culture of civility and respect benefits everyone.
Sexual misconduct can take many forms. In Maintaining personal and professional boundaries (paragraph 23) we set out examples of unacceptable sexual behaviours. These can include but are not limited to:
- sexual or sexist comments, jokes, innuendo and ‘banter’
- suggestive looks or leering
- groping or repeated unwelcome touching
- sexual gestures
- a person discussing their own sex life
- intrusive questions about a person’s private or sex life
- sending sexually explicit emails, text messages or posts on social media
- displaying sexually graphic pictures, posters or photos
- spreading sexual rumours about a person
- propositions and sexual advances
- making promises in return for sexual favours
- excessive or unwanted compliments on a person’s appearance.
Instances of sexual misconduct are rarely isolated – perpetrators often offend repeatedly, and some abuse can last several years. Serious sexual misconduct, including rape, is usually preceded by a period of inappropriate comments or touching.

33. Certain working environments in medicine might increase the level of risk of unacceptable sexual behaviours occurring. These can include residential settings, nightshifts, conferences, gender imbalances in specialties, workplace cultures, and large differences in seniority or power levels between colleagues. The risk is also increased in environments where fear of reputational damage or organisational inconvenience is prioritised over holding perpetrators to account.
(Maintaining personal and professional boundaries, paragraph 33)
Taking swift and early action can help stop the misconduct and prevent it from escalating. It can also help avoid this behaviour from developing into victimisation, bullying, and exclusion of the victim from the team in which they work.
Help and support are available if you have been affected by sexual misconduct in the workplace. You can find more about this on the support tab.
Sexual misconduct within doctor-student interactions
Given the specific power imbalance between doctors and students in higher education, notions of ‘wanted’ behaviour and consent are complex.
People in positions of power can use this to blur the boundaries between professional and personal relationships. They can perpetrate sexualised and predatory behaviours towards students. This can include sexual coercion and promising resources, for example, career advancement and access to training in return for sexual access.
If you are a doctor in a position of power, you have a responsibility to maintain your professional conduct in dealings with students.
- Placement providers, including those who are employers with responsible officers, have clear roles in identifying and managing sexual misconduct. This includes a doctor’s alleged sexual harassment and abuse of colleagues, including students, within and outside medicine.
- If students report sexual misconduct, the placement provider and for medical students, the medical school should be in contact. For example, inappropriate sexual remarks, persistence in asking for social engagement clearly directed to them as individuals, and unwelcome physical contact. Complaints must be taken seriously.
- For medical students, medical schools should make sure procedures are clearly signposted on placements and inform students how to report misconduct. Information should be easily accessible, clear and give confidence that reporting misconduct won’t impact their education.
- Placement providers should make sure local policies addressing different aspects of sexual misconduct are up to date. They should be well publicised to raise awareness among employees and students. It should be known that all incidents are taken seriously.
If you witness sexual misconduct in doctor-student interactions, you have a responsibility to raise concerns about this. There is more information in the duty to notify tab, which sets out advice and the related professional standards on contributing to a positive working and training environment.
Sexual misconduct case studies
Patient relationships
As a doctor, physician associate (PA) or anaesthesia associate (AA), it is important you understand what your professional standards say about the relationship you have with patients. Sexual misconduct is a serious abuse of trust and a failure of the duty of care to the patient.
It is your responsibility to be aware of the power imbalance that exists between you and your patients and to retain clear boundaries. Personal relationships with former patients may also be inappropriate if this breaches the trust a patient has placed in you.
Maintaining a professional boundary and recognising when boundaries are threatened
In Good medical practice we say:
- You must not act in a sexual way towards patients or use your professional position to pursue a sexual or improper emotional relationship with a patient or someone close to them. You must follow our more detailed guidance Maintaining personal and professional boundaries.
Maintaining trust
Trust enables patients to feel confident and safe, discuss personal information with you and allow you to perform appropriate physical examinations. Sexual misconduct is a serious abuse of this trust and a failure of your duty of care to your patient.
Good communication
Open and clear communication helps maintain boundaries in the doctor-patient relationship and avoid misunderstandings. Good medical practice sets out that doctors, PAs and AAs must:
- listen to patients, recognising their knowledge and experience of their health, and acknowledging their concerns.
- listen to patients and encourage an open dialogue about their health, asking questions to allow them to express what matters to them, and responding honestly to their questions.
- take steps to meet patients’ language and communication needs, so you can support them to engage in meaningful dialogue and make informed decisions about their care.
- be satisfied that you have consent or other valid authority before examining or treating patients, or involving patients or volunteers in teaching or research.
The power imbalance
An imbalance of power is inherent in the relationship between a patient and a doctor, PA or AA, as you have access to knowledge and resources that your patient needs, whether seeking assistance, guidance or treatment.
A power imbalance exists because:
- patients share personal and private information and allow physical examination and procedures to be diagnosed and treated
- as the doctor, physician associate or anaesthesia associate you advise on the level of intimacy and physical contact required to provide care
- you know what constitutes appropriate professional practice, whereas, for the patient, it might not always be clear whether a procedure is being conducted appropriately or if it is violating the standard of care.
It is your responsibility to be aware of this imbalance in power and maintain clear boundaries with patients. Be alert to warning signs that could indicate that boundaries are being, or are about to be, crossed. Early recognition and action can prevent harm to both you and your patient.
Warning signs include:
- giving and receiving gifts
- social invitations
- revealing to the patient details of your life
- providing a patient with your personal contact information
- patients making inappropriate personal or sexual comments or displaying sexualised behaviour.
- seeing a patient at an unusual time or place when other staff are not present
You must follow our guidance on Maintaining personal and professional boundaries which builds on Good medical practice to provide more detail on our expectations in this area.

8. Trust is the foundation of the partnership between healthcare professionals and their patients. Patients must be able to trust that those involved in their care will behave professionally towards them.
29. If a patient behaves in a sexual way towards you, and you feel safe to do so, you should tell them that their behaviour is unacceptable and ask them to stop.
30. If the patient does not stop the behaviour, or you do not feel safe to challenge the patient or continue with the interaction, you should excuse yourself from the encounter and seek help.
31. You should report the incident in line with workplace policies and seek support if you need it.
(Maintaining personal and professional boundaries, paragraphs 8, 29-31)
Intimate examinations and chaperones
In our guidance, Intimate examinations and chaperones, we highlight some of the issues involved in carrying out intimate examinations. It covers the things you should discuss with patients prior to an examination, what to do during an examination and the role of chaperones.
You must follow this guidance and make detailed, accurate records at the time of the examination or as soon as possible afterwards.
Social media and other digital communication
Social media can blur the boundaries between your personal and professional lives and may change the nature of the relationship between you and a patient. The principles outlined across our professional standards apply whether you are interacting in a face to face, telephone or online setting – including digital communication tools such as email and text messages.
Our guidance on Using social media as medical professional can help you apply your professional judgement in key areas including behaving professionally, maintaining boundaries and respecting patient confidentiality, privacy and dignity when using social media.
You can also explore how to apply our social media guidance in practice on our ethical hub. This advice has been developed with input from doctors and medial representative bodies.
Ending your professional relationship with a patient
In our guidance on Maintaining personal and professional boundaries (paragraph 10), we say:
- if a patient pursues a sexual or improper relationship with you, you should try to re-establish a professional boundary, if it is safe to do so. If trust has broken down and you find it necessary to end the professional relationship, you must follow the guidance in Ending your professional relationship with a patient.
Personal relationships
Former patients
Personal relationships with former patients may also be inappropriate if this breaches the trust the patient placed in you. You should recognise your influence on the patient and that the power imbalance may continue long after the professional relationship has ended.
In Maintaining personal and professional boundaries (paragraphs 12-17) we set out what you should consider if you wish to pursue a relationship with a former patient.
Patients’ family members
In Maintaining personal and professional boundaries (paragraph 11) we say:
- that you must not use your professional relationship with a patient to pursue a personal relationship with someone close to them.
Sexual misconduct case studies
Duty to notify
You have a critical role in tackling sexual misconduct and ensuring that you have taken reasonable steps to protect patients, the public and your colleagues. This includes making sure the culture of teams you are part of are safe for colleagues and patients.
Taking action
The severity and nature of the misconduct in individual cases will determine the action that you might take. You should familiarise yourself with local policies addressing different aspects of sexual misconduct and use your judgement in making a decision.
Acting on information about sexual misconduct between doctors and patients

In Maintaining personal and professional boundaries we say:
25. If a patient tells you about a breach of sexual boundaries, or you have other reasons to believe that a colleague has, or may have, displayed sexual behaviour towards a patient, you must promptly report your concerns to a person or organisation able to investigate the allegation.
26. You must offer support to any of your patients affected by a colleague’s breach of sexual boundaries.
27. You should respect patient confidentiality when reporting your concerns, but the safety of patients must always come first. If you are satisfied that it is necessary to identify the patient, you should explain to the patient why disclosure is necessary. You should seek the patient’s consent to disclose information, unless you have already decided to disclose information in the public interest, or it is not appropriate or practical to ask for consent.
28. If you decide to disclose information in the public interest without consent, you must tell the patient of your intention to disclose the information, unless it is not safe or practical to do so. In all cases, you should only disclose relevant information. You must also follow our guidance Confidentiality: good practice in handling patient information.
(Maintaining a personal and professional boundary, paragraphs 21, 25-28)
Reporting what you have experienced or have been told

In Maintaining personal and professional boundaries, we say:
35. If you have experienced inappropriate behaviours, and are able to do so, you should report the behaviour to your line manager, or a person or organisation able to investigate the allegation.
36. If a colleague tells you, or you become aware of inappropriate sexual behaviours within your workplace, you have a responsibility to take some action.
For example, you could:
a. check in and offer support to anyone targeted or affected by the behaviour, and/or let them know that you feel that the behaviour you witnessed is unacceptable
b. challenge the behaviour by speaking to the person responsible – either at the time, if safe to do so, or at an appropriate time and place
c. speak to a colleague and/or consider reporting the behaviour in line with your workplace policy and our more detailed guidance on Raising and acting on concerns about patient safety. Before you report the behaviour you witnessed, try and make sure that the person who was targeted is aware of, and supports, your intention to report it.
(Maintaining a personal and professional boundary, paragraphs 35-36)
Taking action on behaviour you have witnessed

In Good medical practice we say you should act if you witness a doctor acting in sexual way towards colleagues with the effect or purpose of causing offence, embarrassment, humiliation or distress.
You could:
58.
a. check in and offer support to anyone targeted or affected by the behaviour, and/or let them know that you feel that the behaviour you witnessed is unacceptable
b. challenge the behaviour by speaking to the person responsible – either at the time, if safe to do so, or at an appropriate time and place
c. speak to a colleague and/or consider reporting the behaviour in line with your workplace policy and our more detailed guidance on Raising and acting on concerns about patient safety. Before you report the behaviour you witnessed, try and make sure that the person who was targeted is aware of, and supports, your intention to report it.
We recognise some people may find it harder than others to speak up but everyone has a responsibility – to themselves and their colleagues – to do something to prevent these behaviours continuing and contributing to a negative, unsafe environment.
59. If you have a formal leadership or management role and you witness – or are made aware of – any of the behaviours described in paragraphs 56 or 57, you must act. You must:
a. make sure such behaviours are adequately addressed
b. make sure people are supported where necessary, and
c. make sure concerns are dealt with promptly, being escalated where necessary.
75c. If you have concerns that a colleague may not be fit to practise and may be putting patients at risk, you must ask for advice from a colleague, your defence body, or us. If you are still concerned, you must report this, in line with your workplace policy and our more detailed guidance on Raising and acting on concerns about patient safety.
Creating an ongoing safe culture in healthcare settings
While tackling sexual misconduct in the workplace is a key responsibility for clinical leaders, the responsibility sits with all healthcare professionals.
To help create a safe culture in healthcare settings you can:
- foster open and clear communication between healthcare professionals and patients to help avoid misunderstandings and maintain boundaries
- listen to patients and colleagues, take account of their views, and respect their preferences
- be alert to warning signs that could indicate that boundaries are being or are about to be crossed. Early recognition and action can prevent harm.

In Maintaining personal and professional boundaries and Leadership and management for all doctors we say:
37. If you have a formal leadership or management role, you must take active steps to create an environment where people can talk about concerns safely (Good medical practice, paragraph 76). This includes concerns about unacceptable sexual behaviours. If you are aware of such concerns you must act (in line with Good medical practice, paragraph 59) to:
a. make sure such behaviours are adequately addressed
b. make sure people are supported where necessary, and
c. make sure concerns are dealt with promptly, being escalated where necessary.
(Maintaining personal and professional boundaries, paragraph 37)
7. You must tackle discrimination where it arises and encourage your colleagues to do the same. You must treat your colleagues fairly and with respect. You must not bully or harass them or unfairly discriminate against them. You should challenge the behaviour of colleagues who do not meet this standard.
Background
What is sexual misconduct?
Sexual misconduct is uninvited or unwelcome behaviour of a sexual nature, or which can reasonably be interpreted as sexual, that offends, embarrasses, harms, humiliates or intimidates an individual or group. It also includes any sexual activity that takes places without consent.
Sexual misconduct encompasses elements of harassment, violence and abuse and can be physical, verbal or visual. It can take place within and across different genders.
Cultural or social norms, such as rigid gender roles, can also increase the risk of misconduct and people with protected characteristics may experience sexual misconduct alongside other forms of discrimination.

20. All forms of sexual misconduct in medicine, including all forms of sexual harassment, are always unacceptable, and can be criminal in nature (such as rape and sexual assault).
(Maintaining personal and professional boundaries, paragraph 20)
The scale of the challenge
A report published by the British Medical Association, Sexism in medicine, found that 31% of female and 23% of male doctors, experienced unwanted physical conduct in their workplace. Additionally, 56% of female and 28% of male doctors received unwanted verbal conduct related to their gender. 42% of doctors who witnessed or experienced an issue relating to sexism felt they couldn’t report it.
A 2019 report for the Professional Standards Authority looking at fitness to practise cases brought against doctors, nurses and midwives, and allied professionals found that of 275 cases that included sexual misconduct as a charge, 232 related to sexual harassment or sexual abuse. It showed this commonly happened in general practice, surgical settings and mental health services. 59% of the cases involved patients, just less than half of who were young, infirm or had a mental health condition. And 39% of the cases were about colleagues.
Other studies have shown that poor professional boundaries including unchallenged sexual banter can lead to animosity and mistrust between colleagues, which can be a risk to patient safety. They also show how sexual misconduct impacts on other members of the team who are not directly involved, by creating an atmosphere of mistrust and uncertainty.
Why are clear sexual boundaries important?
For patients
- Patients have a right to be treated with dignity and respect and to receive healthcare without fear of abuse.
- Sexual misconduct damages and undermines the trust that patients have in their doctors and that the community has in the profession. Irreparable harm can be caused to patients and their loved ones.
- Sexual involvement with a patient impairs judgement. It can influence decisions about care and treatment and what’s in a patient’s best interest.
- It can cause a patient and their loved ones, serious psychological, emotional or physical harm, long after the abuse happens.
For healthcare professionals
- All healthcare professionals have a right to a workplace free of discrimination, bullying and sexual harassment.
- A culture of civility and respect benefits all staff, enabling health professionals to work together more effectively – ultimately improving patient safety.
- A breach of sexual boundaries can cause health professionals serious psychological, emotional or physical harm, long after the abuse happens.
- It can cause healthcare professionals and their loved ones, serious psychological, emotional or physical harm, long after the abuse happens.

3. Appropriate personal and professional boundaries are essential between medical professionals and their patients, and between medical professionals and their colleagues.
4. Patients must be able to trust that medical professionals involved in their care will behave appropriately towards them during consultations and not see them as a potential sexual partner, or as a target for abuse or harassment.
(Maintaining personal and professional boundaries, paragraph 3 and 4)