A secret report has warned that the NHS is failing to protect trainee paramedics from widespread sexual harassment and racism at work, The Independent can reveal.
A confidential NHS England report, uncovered by this publication, has found that “extremely alarming” conduct and undermining behaviour is rife in ambulance trusts across the country, with trainees subjected to derogatory comments about their age, ethnicity and appearance in front of patients.
There is a “worrying acceptance” that this is “part of the job”, with students hesitant to raise complaints about sexual behaviour by male colleagues in case it gives them a reputation as “annoying snowflakes”, the report says.
The revelations come after a recent NHS staff survey revealed that thousands of ambulance staff had reported unwanted sexual behaviour from colleagues and patients last year.
One healthcare leader described the findings as “harrowing”, warning that much more needs to be done to protect junior staff.
Examples of racist and sexist behaviour between colleagues, uncovered by The Independent, include:
- One male paramedic who touched a student inappropriately on multiple occasions – including her groin and breast – and made sexually inappropriate comments such as “that has got me going”
- Incidents reported at one trust including Blackface at a work fancy-dress party, making monkey sounds, and even laughing at colleagues unable to eat during Ramadan
- A male paramedic asked a student to go to a hotel room and said: “Women don’t have gag reflexes”
- One racism complaint was not taken forward because the staff member was simply deemed to be “set in their ways”
- A student who complained about bullying and a “toxic environment” was moved stations, while the mentor was given a new student straight away
- One professor told a trainee: “We’re not going to change the culture… so we try to protect our students from the worst”
The national report, which is understood to have gone through several edited versions and is marked commercially sensitive, was not due to be released until The Independent obtained the document through a Freedom of Information request.
It found an “undercurrent” of bullying in some areas, with examples of students leaving their jobs due to inappropriate behaviour.
Trainees reported feeling undervalued and unwanted while on the job, with one apparently told: “Your concerns don’t matter – we have to meet patient demands”.
Ambulance handover delays have also lead to student paramedics having less experience and training on the job, prompting fears that newly-qualified paramedics do not have sufficient levels of experience in life-critical situations.
Saffron Cordery, deputy chief executive for NHS Providers said: “Trust leaders have zero tolerance of sexual harassment and racism in the NHS. But these harrowing findings make clear that more can and must be done to ensure the wellbeing and safety of staff.”
She said important strides have been made but added: “It’s clear much more needs to be done to meaningfully address the roots of sexual harassment and racism.”
NHS England first triggered the review following “extreme challenges” faced by ambulance services in 2021 and 2022, which employs nearly 17,000 paramedics.
An independent review into ambulance services in February warned the NHS over “serious allegations of sexual assault, harassment or inappropriate behaviours” within ambulance services across the country.
And last year, The Independent exposed a vwarning from a Care Quality Commission official that ambulance services were failing to root out abusers. One female paramedic revealed she was left with PTSD after a colleague groped her chest while another “dry humped” her and locked her in an ambulance.
The Independent has since found multiple fitness to practice cases, published by regulator the Health and Care Professions Council, of paramedics being sanctioned for sexual misconduct against students.
In one case, a student paramedic working within the East of England Ambulance Service was left feeling “felt shocked and violated” after her male colleague Jonathan Moyes was found to have touched her inappropriately on multiple occasions.
He was suspended in 2022 before being struck off in 2023 following allegations from another colleague of sexually inappropriate behaviour, including telling her: “I am going to punish you for your attitude by putting you over my knee and spanking you.”
In another case in 2021, Devlyn Johnson was struck off for asking a student if they would would like to stay in his hotel room. He also was found to have said “it is my decision about who stays and who goes” and “women don’t have gag reflexes.”
Ambulance students take up to four years to quality and must carry out a set number of hours on the job which are signed off by student mentors.
Carol King, a former paramedic who quit after blowing the whistle on issues of sexism, bullying and harassment, founded a Facebook group which has more than 2,000 members, including trainee paramedics.
She warned the issue with students was the “tip of the iceberg”, adding: “They feel vulnerable. They have a lot riding on that very prestigious job. But it’s difficult to know [the scale] because everything is so undercover.”
Professor Will Broughton, professor of paramedicine at Buckinghamshire University, told The Independent: “The student experience in parts of the UK isn’t getting better, it’s getting worse.”
He added: “The environment can create or enhance vulnerabilities because there’s a power dynamic – [the students] are looking for the paramedic mentors to give them feedback and sign off their capabilities, so students think ‘I won’t raise concerns about person x because I need them to fill in my portfolio’.”
Unite said it would be speaking to its members in the ambulance services to deal with issues the report has highlighted.
General secretary Sharon Graham said: “Everyone has a right to safe working conditions but we can see from these findings that too many female paramedics cannot conduct their job without the fear of sexual harassment or BAME members suffering from racist abuse. It’s a disgrace.”
Anna Parry, managing director of the Association of Ambulance Chief Executives (AACE), said rooting out “inappropriate and outdated elements of toxic workplace” is one of the ambulance service’s top priorities to ensure staff are able to do their job “free of harassment of any kind”.
She added: ”While ambulance trusts are making progress, there is still much more to do.”
Tracy Nicholls, chief executive of the College of Paramedics, said the college has been aware for some time that student members have experienced these behaviours. She said: “Whilst we have not seen the report, we urge action to be taken to address the behaviours experienced by our students to promote a healthier learning environment, both in their universities, and in the workplace.”
It comes days after NHS ombudsman Rob Behrens claimed hospitals are cynically burying evidence about poor care in a “cover-up culture” that leads to avoidable deaths, with health leaders and hospital boards not doing enough to end the practice.
NHS England and the Department for Health and Social Care were approached for comment.