Doctor who was sexually assaulted at work wins case against trust after it asked colleagues if she had “inappropriate relationships”BMJ 2023; 382 doi: https://doi.org/10.1136/bmj.p1967 (Published 25 August 2023) Cite this as: BMJ 2023;382:p1967
A surgical trainee who was sexually assaulted by a colleague has won an employment tribunal case against her trust after the investigation into the incident questioned her relationships and failed to fully suspend the perpetrator until police told the hospital that he had been arrested for an alleged sexual assault on a girl under the age of 16.
Elizabeth,* who worked as a surgeon at Royal Stoke University Hospital, was assaulted on a late shift at work on 11 June 2020. A colleague asked to speak to her in the urology office before forcibly kissing her face and neck, massaging her back, touching her waist, and blocking her as she pushed him away to leave the room. The perpetrator did not challenge Elizabeth’s account of events at the tribunal.
She texted friends to tell them what had happened after her shift and reported the incident to her educational supervisor the next day. What followed was an investigation that her BMA representative said was plagued with “a catalogue of mistakes.” One of these mistakes, which the tribunal found amounted to harassment, was that the case investigator asked her colleagues questions about her character and “inappropriate relationships”—questions that were not asked of the perpetrator. The Birmingham employment tribunal ruled on 17 July 2023 that she had been unlawfully discriminated against by the University Hospitals North Midlands NHS Trust on grounds of sex.
The story comes after an investigation by The BMJ and the Guardian found that NHS trusts recorded more than 35 000 cases of rape, sexual assault, harassment, stalking, and abusive remarks from 2017 to 2022, but only one in 10 trusts had a dedicated policy to manage the problem. University Hospitals North Midlands did not have a dedicated policy, the tribunal observed, and when Elizabeth looked online for the Dignity at Work policy, which covered sexual assault, the link took her to a broken webpage.
The tribunal found that the trust’s policies were inadequate and that staff were not aware of them or trained in them. Multiple freedom of information requests sent to the trust, which are published on the trust’s website, show that her assault was not officially recorded despite it being reported to human resources (HR).
Elizabeth first had contact with the perpetrator in June 2019 when she was studying for her membership of the Royal College of Surgeons. He got her number from a WhatsApp group and asked if she wanted to revise with him, asked to have dinner, and asked to pick up some textbooks from her home. She said that she declined all these invitations. “I’d twigged that he was creepy, and I didn’t really want that much to do with him. But beyond that, I didn’t think he was a threat or anything,” she told The BMJ in an interview.
Elizabeth felt “absolutely violated” by the assault, she told the tribunal in evidence. “My mind was reeling—what if I hadn’t had that burst of strength to break free? What would he have done to me if I hadn’t managed to get out of that room? I felt sick,” she said.
On 12 June 2020 she reported the assault to her educational supervisor, who, according to Elizabeth’s evidence, said that he would seek advice from his wife, who was a doctor at a different trust, and the deanery. Elizabeth told the tribunal that he also suggested that he should have an informal chat with the perpetrator about the incident, saying that “such a complaint didn’t have to wreck [his] career,” although the educational supervisor disputed this version of events in the tribunal. The employment tribunal’s judgment said it was clear that the supervisor was sympathetic to Elizabeth’s situation but did not have a clear understanding of what steps needed to be taken under the trust’s Dignity at Work policy.
Initially, Elizabeth was reluctant to put in a formal complaint because she “didn’t want to be labelled a slut or her reputation to be dragged through the mud,” the judgment records, adding that there was a “gossipy environment” in the hospital that was not curbed by the trust. But after seeking advice from the BMA Elizabeth formally complained through the trust’s HR email address.
Although Elizabeth had been told by HR that the colleague had been fully suspended, in reality he was suspended only from clinical duties and was able to come to the hospital for research or continued professional development. The judgment states that it is “unexplained” why steps were not taken to exclude him entirely on 16 June when Elizabeth first reported her assault, given its serious nature.
On 22 June, six days after Elizabeth had reported the assault, the perpetrator was offered a conditional extension to his contract, the judgment records. However, this was retracted after the police contacted the trust on 20 June and informed it that he had been arrested for sexually assaulting a girl under the age of 16. The trust then excluded him from clinical practice on patient safety grounds, although he was not fully suspended until 21 July.
After Elizabeth had been informed that he would not be at work for the foreseeable future she noticed that he was still down on the clinical rota, which caused her “significant distress,” the tribunal found. She also complained multiple times about the delayed and poor correspondence from HR. Eventually Elizabeth’s GP signed her off as unfit to work, which the tribunal ruled was as a result of the trust’s failure to protect her.
Ingi Elsayed, a consultant in renal and intensive care medicine, was appointed as a case investigator to look into Elizabeth’s claim. The tribunal found that, although Elsayed had no “bad intent,” her “total lack of experience in conducting an investigation” resulted in her adopting a line of questioning that was “intrusive” and “well beyond the scope of the terms of reference for the investigation” and “provoked responses that commented upon gossip in the hospital relating to [Elizabeth]’s friendships with consultants that may have been inappropriate.”
Elsayed had done only a two hour training course on running investigations and had never run one before, the tribunal heard. Elizabeth gave evidence that she had asked Elsayed not to contact doctors she was friends with or whom she knew in a professional capacity in case it affected her reputation. However, Elsayed did not respect her wishes and began contacting doctors to ask them about Elizabeth’s character and relationships. She did not contact the perpetrator’s colleagues, as he had asked her not to. One consultant called Elizabeth and told her about the line of questioning. Elizabeth asked for Elsayed to be removed from the investigation, but the complaint manager, who the tribunal found had failed to investigate Elizabeth’s claims, refused.
On 27 July a member of the HR department also accidentally downloaded the recording of Elizabeth’s account of her assault, and it was shared with three other members who had no connection to the investigation.
Elizabeth was not informed of the investigation’s conclusions until 7 April 2021, 10 months after she had first reported her sexual assault. Although Elsayed’s original report found that on the balance of probabilities there was not sufficient corroborative evidence to support Elizabeth’s complaint, the complaint manager intervened and changed the conclusion to find that the perpetrator did have a case to answer to. By this point he had left the trust, and no action could be taken.
The trust’s chief executive, Tracy Bullock, apologised for the failings in the trust’s investigation procedures. “We have already put in place additional training and measures to ensure that any concerns raised will be listened to, fully investigated, and responded to appropriately,” she told The BMJ.
The General Medical Council has told The BMJ that it is investigating the perpetrator and has put interim restrictions on his licence to practise in relation to treating female patients, after a Medical Practitioners Tribunal Service hearing on 13 January 2023.
Staffordshire Police said that it had arrested a man on suspicion of sexual assault in May 2020. He was released pending further inquiries, but the investigation is ongoing. “We believe he has left the country, and we are working with partners to locate him,” a spokesperson told The BMJ.
The effect of these events on Elizabeth meant that she felt unable to continue working as a doctor, as the tribunal judgment records. She had taken a year out to do a masters degree but felt anxious going to a hospital even for personal reasons, let alone work, so she did not feel able to return to medicine. She was given diagnoses of anxiety, depression, and PTSD. She is now working as an administrator at a much lower salary.
“It’s kind of heartbreaking, to be honest,” she told The BMJ. “I was genuinely committed to surgery, and I was genuinely committed to medicine. I knew there was sexism in surgery. I always knew that. But I genuinely thought that if I worked hard enough, I could beat it.”
Elizabeth has another tribunal hearing, which will determine the compensation she will be awarded next year.
*Name has been changed to protect identity.