Over the last few years, the UK oversight body for health and social service professions, the Professional Standards Authority (PSA), has been doing significant work on understanding and improving the handling of sexual misconduct matters. [In Canada, health regulators often call such conduct towards patients “sexual abuse” and conduct towards colleagues “sexual misconduct” or “sexual harassment.”] This work has included webinars with leading experts and researchers, a full conference on the topic, and analyzing its own and regulators’ experiences. The PSA has just published a Resource compiling the learning points it has assembled.
Its analysis is that sexual misconduct complaints, particularly those involving colleagues of registrants, have become more prevalent. The PSA’s appeals from sexual misconduct sanctions have increased as well, with a high success rate. Sanctions for sexual misconduct have also become more significant.
Key challenges identified by the PSA include:
- The trauma of sexual misconduct on witnesses affects the “memory, recall, and consistency of testimony…”
- In addition, “myths, stereotypes and unconscious bias [can have the effect of] potentially influencing case presentation, decision making and interpretation of evidence.”
- Witnesses often experience the complaints and discipline process negatively.
- “Traditional adversarial approaches in [discipline hearings] may discourage effective participation, increase distress and reduce the quality of evidence…”
Emerging good practices include:
- Individualized witness support. “Effective approaches include dedicated support services providing emotional support, procedural guidance and continuous contact. They also include advocacy and intermediary support and pre-hearing preparation and information.”
- Hearing accommodations, such as using video links, pre-recording evidence, and permitting “intermediaries” (i.e., support persons).
- Perhaps most controversially, the PSA suggests that there should be ground rules for discipline hearings which would include “agreement on questioning style”.
The PSA also made several recommendations, including:
- Clear published guidelines for registrants on sexual misconduct, including the importance of avoiding grooming behaviour and boundary violations, the significance of conduct towards colleagues, and the duty to act on concerning behaviour by colleagues.
- Training and guidelines for adjudicators (e.g., sanctioning principles, reason writing).
- Prompt triaging and responses in sexual misconduct matters including supporting witnesses.
- Trauma-informed investigation, including clear explanations of the process, timely updates, and avoiding repeated unnecessary questioning.
- “Consider language barriers, cultural norms and power dynamics.”
- “Provide training to panel members and staff involved in the process to ensure understanding of the particular considerations in sexual misconduct cases throughout the process … [including] the psychology of sexual misconduct from the perspective of both victim/survivor and perpetrator, and how this should be reflected in the process at every stage, for example in the approach to investigation…”
This summary just scratches the surface of the thirty-three page report, which is well worth reading in full by regulators.
