The process for handling sexual misconduct cases at the Medical Practitioners Tribunal Service (MPTS) has been branded “wildly inadequate” and “dangerously unsafe” in a BMJ article. 

An analysis by researchers from several UK centres and led by Mei Nortley, a consultant surgeon at Oxford University Hospitals NHS Foundation Trust, said that “deeply flawed” decisions undermine public trust and fail to protect victims.

NHS’s #MeToo Moment

The authors noted that sexual harassment is “endemic” in the NHS. They cited a 2023 BMJ and Guardianinvestigation that revealed more than 35,000 reports of rape, sexual assault, harassment, stalking, and abusive remarks recorded by NHS trusts between 2017 and 2022.

The report framed this as UK healthcare’s #MeToo moment.

A 2023 study of the surgical workforce found that almost two thirds of women and nearly one quarter of men reported sexual harassment in the previous 5 years. One third of women reported being sexually assaulted. 

A n analysis by the University of Cambridge in the same year found that most NHS trusts failed to offer adequate training to tackle sexual harassment.

A Medscape UK survey in December 2024 found that the number of doctors reporting personal experiences of sexual abuse, harassment, or misconduct had tripled since a previous poll in 2019.

Writing in the BMJ, the authors, from surgical and legal backgrounds, said: “To deter sexual misconduct and encourage reporting, everyone must be clear that these behaviours are unacceptable and will be punished, and that the punishment will be severe.”

Lenient Sanctions 

The analysis highlighted recent cases where sanctions were criticised as disproportionately light:

• Dr Aloaye Foy-Yamah, an acute medicine consultant found to have committed rape: 12-month suspension
• Dr James Gilbert, a UK transplant surgeon found guilty of multiple instances of sexual misconduct spanning over a decade: 8-month suspension
• Dr Cian Hughes, who knowingly entered into a sexual relationship with a vulnerable patient whom he had pursued and groomed from the age of 14: suspended for 12 months

The authors said these cases fuelled concerns about the consistency and adequacy of 

MPTS sanctions. They called for “major reform” of the process.

Subjective Criteria

Under current MPTS guidance, tribunal panels weigh aggravating factors such as lack of insight, abuse of position, and discrimination against mitigating factors such as insight, remediation, and good character references, as well as the time that has elapsed since the incident.

The authors of the analysis said these mitigating factors are often “highly subjective” and lack clear benchmarks, leaving room for inconsistent rulings.

Commenting to the BMJ’s Adele Waters, Nortley said that the concept of time elapsed is a flawed mitigating factor because victims often delay reporting due to fear of retaliation or disbelief.

She also criticised the requirement to prove sexual motivation. “There’s widespread recognition that sexual harassment, and even rape, is not sexually motivated,” she said. 

The team’s analysis found that in one year of reports, 83% of perpetrators held senior positions, suggesting that misconduct is “less to do with sex than with power.”

The authors condemned the use of character references as a mitigating factor, saying it retraumatises victims and may contribute to a “hierarchy of rape,” where violent attacks are seen as monstrous but misconduct by “good guys” is treated as forgivable.

They also noted that aggravating factors such as grooming, coercion, manipulation, and patterns of abuse are excluded from current criteria.

Clumsy, Creepy, or Criminal?

The team recommended a new system to categorise behaviour, with proscribed sanctions for each category. They commended the ‘3 Cs’ model used by the South East Coast Ambulance Service:

• Clumsy: behaviour lacking malice or intent, open to remediation.
• Creepy: deliberate, persistent, coercive, or an abuse of power.
• Criminal: sexual offences requiring prosecution.

The authors argued that while clumsy behaviour could be open to remediation, creepy behaviour “is not compatible with continued registration.”

Nortley said sanctions should reflect the values of society and the trust placed in doctors. “I think the general public thinks that if someone is a rapist, they should not be a doctor,” she said. 

Dr Sheena Meredith is an established medical writer, editor, and consultant in healthcare communications, with extensive experience writing for medical professionals and the general public. She is qualified in medicine and in law and medical ethics.