What counts as sexual misconduct in healthcare?
Sexual misconduct is a broad term. It covers any behaviour of a sexual nature that is unwanted, that exploits a professional relationship, or that is out of place in a professional setting. It ranges from comments and messages to physical assault, and it can be directed at patients, colleagues, students or anyone else you meet through work.
| Type | Examples |
|---|---|
| Verbal | Comments about someone's body or appearance, sexual jokes or innuendo, questions about someone's sex life, repeated requests for dates after a refusal |
| Non-verbal and online | Staring, sexual gestures, sending sexual messages or images, contacting patients or colleagues on social media in a sexual way |
| Physical | Unwanted touching, hugging or kissing, deliberately brushing against someone, blocking their way |
| Abuse of position | Pursuing a relationship with a patient, offering career help in return for sexual favours, treating someone worse because they said no |
| Clinical | An intimate examination without clinical need, valid consent or explanation; unnecessary undressing; sexualised comments during care |
Some of this behaviour is also a crime. A criminal case and a regulatory case can run separately. A regulator applies the civil standard of proof (the balance of probabilities), so it can find a concern proved even where there has been no prosecution or conviction.
What is the legal definition of sexual harassment at work?
Under section 26 of the Equality Act 2010, sexual harassment is unwanted conduct of a sexual nature that has the purpose or the effect of violating someone's dignity, or of creating an intimidating, hostile, degrading, humiliating or offensive environment for them. The law also protects people from being treated less favourably because they rejected, or gave in to, that conduct.
This matters especially for internationally educated professionals, because what is seen as normal workplace banter or friendliness varies between countries and workplaces. UK law and UK professional standards apply to everyone working here, whatever the norms they trained under.
What do the GMC, NMC, HCPC and GPhC expect?
Every UK healthcare regulator prohibits sexual behaviour towards patients and requires professionals to treat colleagues with dignity and respect. The detail differs, but the direction is the same.
| Regulator | Key standards |
|---|---|
| GMC (doctors) | Good Medical Practice 2024 says doctors must not act in a sexual way towards colleagues where it is intended to, or does, cause offence, embarrassment, humiliation or distress. It also prohibits sexual behaviour towards patients and sets out an expectation to act if you witness such behaviour. |
| NMC (nurses, midwives, nursing associates) | The Code requires you to treat people with kindness, respect and dignity and to keep clear professional boundaries. NMC guidance says sexual misconduct, including outside work, is likely to affect fitness to practise. |
| HCPC (allied health professionals) | The standards of conduct, performance and ethics require you to treat people with respect and to keep appropriate professional boundaries with service users and carers. |
| GPhC (pharmacy professionals) | The standards for pharmacy professionals require respect and professionalism, and the GPhC has guidance on maintaining clear sexual boundaries. |
Relationships with patients and former patients
A sexual relationship with a current patient is never acceptable, whatever the patient seems to want. You must also not use your position to pursue someone close to a patient. With former patients, the question is whether the relationship would exploit trust or knowledge gained through care. In mental health and other emotionally dependent relationships, it is very likely to.
Power between colleagues
Relationships between adult colleagues are not banned. But where one person has power over the other, such as a supervisor and a student, the person with power must recognise that the other may not feel free to say no. Many organisations require such relationships to be declared.
What is the NHS Sexual Safety Charter?
NHS England launched the Sexual Safety in Healthcare Organisational Charter in September 2023. Organisations that sign it commit to a zero-tolerance approach to unwanted, inappropriate or harmful sexual behaviour at work, backed by ten principles and actions. These include clear policies and reporting routes, training, support for people who come forward, taking every report seriously and collecting data to understand the problem. Many organisations now have a named sexual safety lead.
The employer's duty to prevent harassment
Since 26 October 2024, employers in Great Britain have had a legal duty to take reasonable steps to prevent sexual harassment of their employees. Employers are expected to assess risks and act in advance rather than wait for a complaint. The Employment Rights Act 2025 strengthens this duty to 'all reasonable steps' and extends protection to harassment by third parties such as patients and visitors. Check GOV.UK for the date these changes take effect.
How should intimate examinations and chaperones be handled?
Many allegations by patients come from intimate examinations, sometimes because the examination was inappropriate and sometimes because it was not properly explained. Good practice protects patients and professionals alike. Remember that patients may see other examinations as intimate too, for example anything involving undressing, or because of their culture or past experiences.
- Check it is necessary: Make sure the examination is clinically needed and that you are the right person to do it.
- Explain: Say why it is needed, what it involves and that the patient can ask you to stop at any time. Use a professional interpreter if needed, not a relative.
- Get consent: Obtain and record consent. If the patient lacks capacity, follow the Mental Capacity Act 2005 and act in their best interests.
- Offer a chaperone: Offer one for every intimate examination, whatever your gender and the patient's. If the patient declines, record it. If you are not comfortable proceeding, delay or refer unless it is urgent.
- Protect dignity: Give privacy to undress, provide a cover, keep to what is necessary and explain what you are doing as you go.
- Record: Document the explanation, consent, the chaperone's name and role (or that one was declined) and your findings.
What should you do if you witness sexual harassment?
Harassment often continues because people who see it say nothing. Professional standards now make clear that staying silent is not a neutral choice. You do not need to be certain or senior to act.
- If it is safe, interrupt at the time, for example by saying calmly that the comment is not appropriate.
- Check on the person affected privately afterwards. Ask what they want to happen and what support they need.
- Write down what you saw and heard, with the date, time and who was present.
- Report it through your organisation's policy, the sexual safety lead or your Freedom to Speak Up route. If a patient is at risk, you must act.
- If a crime may have been committed, support the person to consider reporting it to the police and seek safeguarding advice.
I heard a consultant make a comment about a student's body in theatre. Everyone laughed, including me. I did not think it was my place to say anything because he is senior.
In theatre I heard a consultant make a sexual comment about a medical student. I said it was not appropriate. Afterwards I spoke to the student privately, asked how she was and what she wanted, and told her about the sexual safety lead. With her agreement I reported what I saw and wrote down exactly what was said and who was there. I also reflected with my supervisor on why speaking up had felt so hard.
What happens if a sexual misconduct allegation is made against you?
Allegations can involve your employer, your regulator and the police at the same time. Regulators can impose interim orders while they investigate, such as restricting you to working with a chaperone or suspending your registration, if they think it is needed to protect the public or is in the public interest.
Regulators' sanctions guidance generally treats sexual misconduct involving patients, vulnerable people or abuse of trust as potentially incompatible with continued registration. Lower-level conduct, such as inappropriate comments to colleagues, is still taken seriously, but there is usually more room to show insight and change.
What insight looks like in these cases
- You understand that the effect on the other person matters, not only what you intended.
- You recognise any power imbalance, for example over a student, trainee or patient.
- You understand the likely impact on the person affected and on trust in your profession.
- You do not blame the other person or describe the behaviour as banter, culture or a misunderstanding.
- You can explain specifically what has changed in your understanding and conduct.
Daniel, a paramedic who mentored students, made repeated comments about a student's appearance and sent her personal messages late at night. When she asked for a new mentor, he told colleagues she was oversensitive. His first draft reflection said he had only been friendly and she had misunderstood. With his union's help he rewrote it to accept that his conduct was sexual in nature and unwanted, that she depended on him for her assessments and could not easily object, and that his comments afterwards were unfair to her. He stopped all personal messaging with colleagues and students, completed training on harassment and boundaries, stepped back from supervising students and took part in regular supervision with a senior colleague who knew the full details.
Training and reflection have limits. In the most serious cases they may not be enough to maintain public confidence, which is why early specialist advice matters.
Learning more
Our course Sexual Safety and Sexual Misconduct in Healthcare covers the legal definitions, each regulator's standards, the Sexual Safety Charter, intimate examinations, how to respond as a bystander or manager, and a guided reflection for anyone asked to complete learning after a concern. It is educational and does not replace advice from your defence organisation or union. The related courses on medication errors and record keeping are there if your learning plan covers other areas too.
Frequently asked questions
Can a nurse be struck off for sexual harassment of a colleague?
It is possible. The NMC treats sexual misconduct, including conduct towards colleagues and outside work, as likely to affect fitness to practise. The outcome depends on the seriousness, any abuse of power, the evidence of insight and whether the behaviour was repeated. Anyone facing an allegation should get advice from their union or defence organisation before responding.
Is a joke about someone's appearance sexual harassment?
It can be. Under the Equality Act 2010, unwanted conduct of a sexual nature that violates someone's dignity or creates an intimidating or humiliating environment can be harassment, whatever the intention. A comment meant as a joke can still meet that test if it had that effect and it was reasonable for it to do so.
Can a regulator act if the police took no further action?
Yes. Regulators apply the civil standard of proof, which is the balance of probabilities, rather than the criminal standard. The NMC, for example, has said it may investigate allegations the police decided not to pursue where there may be a risk to patients or to public confidence.
Can a doctor or nurse date a former patient?
Not if the relationship would exploit trust, knowledge or influence gained through the professional relationship. Regulators expect careful judgement about how long ago care ended, how vulnerable the person was and the nature of the care. In mental health and other emotionally dependent relationships, a relationship is very likely to be an abuse of position.
Do I have to offer a chaperone for every intimate examination?
GMC guidance says doctors should offer a chaperone for intimate examinations wherever possible, whatever their own gender and the patient's, and other regulators and employers expect similar good practice. Record the offer, and the chaperone's name and role or that the patient declined. Follow your organisation's chaperone policy.
What should I do if a patient sexually harasses me?
Make sure you are safe, tell the person in charge and report it through your organisation's system. Employers have a legal duty to take steps to prevent sexual harassment of staff. Illness may affect how the behaviour is managed, but you are not expected to accept it. Seek support from occupational health or your union if it has affected you.
Related courses
Sexual Safety and Sexual Misconduct in Healthcare
This course explains what sexual misconduct and sexual harassment mean in UK healthcare, towards both patients and colleagues, and the legal and…
Medication Errors: Reflection and Remediation
This course explains why medication errors happen, what you must do when one occurs, and how to show a regulator or employer that you have understood…
Record Keeping and Documentation: Remediation Course
This course explains what good clinical documentation looks like, why record-keeping concerns arise, and why altering or falsifying a record is…
Sources and further reading
- Good Medical Practice (2024). General Medical Council.
- Intimate examinations and chaperones. General Medical Council.
- The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates. Nursing and Midwifery Council.
- Standards of conduct, performance and ethics. Health and Care Professions Council.
- Sexual Safety in Healthcare Organisational Charter. NHS England.
- Equality Act 2010. legislation.gov.uk.
- Sexual harassment and harassment at work: technical guidance. Equality and Human Rights Commission.
Practitioner Insight is an independent education provider. It is not affiliated with or endorsed by the GMC, MPTS, NMC, HCPC, GPhC or any NHS organisation, and this information is not legal advice. If you have been referred to a regulator, speak to your defence organisation, trade union or legal representative.
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