Sexual behaviours between health and care practitioners: where does the boundary lie?

We have observed that regulators' fitness to practise panels may treat sexual misconduct between colleagues less seriously than when sexual boundaries with patients are overstepped. We believe this type of behaviour can have a negative impact on patient safety, so we commissioned research to get both public and professional perspectives on the subject

Does sex between colleagues put patients at risk?

This was the question we asked  when we noticed that professionals subject to fitness to practise proceedings for sexual misconduct towards colleagues could receive lesser sanctions than professionals who had crossed sexual boundaries with their patients. We referred three such cases to Court under our powers to appeal regulators’ panel decisions but lost.  

Why did we commission this research?

We wanted to find out if our views on how seriously this behaviour should be treated were out-of-step with public opinion. The research conducted for us by Dr Simon Christmas and colleague explored both the views of health professionals and patients using scenarios based on real cases. Three key questions covered in the report are:

1. When does behaviour towards/with a colleague cross a boundary?
2. How is boundary-crossing behaviour relevant to fitness to practise?
3. How should regulators respond to such behaviour?
    

What did the research reveal?

The research highlighted participants’ views on how this type of behaviour can have a negative impact on patient safety and the quality of their care:

• it may point to deep-seated attitudinal problems and motivations – including a lack of empathy (which many of the interviewees thought was an essential quality in a health professional) which may pose a risk to patients
• there may be wider impacts of boundary-crossing behaviour, including the effect it has on the colleague subject to it (stress, distraction, anxiety)
• it may create a culture where boundary-crossing behaviour becomes acceptable (potentially creating toxic working environments where bullying is normalised)
• it may affect public confidence and trust in health and care professionals where such behaviour is witnessed or heard about.
   

What next?

This research has shown ‘how’ people think about sexual behaviour between colleagues and when it crosses boundaries. We think it will prove a valuable resource for regulatory panels thinking about cases of this nature. It highlights the importance of professional conduct in protecting patients and maintaining public confidence.