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Welcome to Meadow Education. My name's Jingjing. I'm part of the Meadow support team. Joining us today is Doctor Chelsea Jewitt H SD in emergency medicine and intensive care medicine. And Doctor Becky Cox general Practitioner, the founders of surviving in scrubs. Today. Doctor Jet and Doctor Cox will be providing an important introduction to the issue of sexual misconduct within the healthcare workforce. Exploring both the data and the human impact of sexism and sexual violence, learn how these behaviors affect healthcare professionals and what is being done to create positive cultural change within the industry. The event will also focus on the efforts of surviving in scrubs. An initiative aimed at addressing and reducing sexual misconduct in health care. There will be some time for questions. So do put your questions on the chat as we go along, this event will be recorded and although the chat won't be seen on catch up, please remember that the body of the questions will be repeated and answered. We will not be repeating anyone's names though. So it will remain anonymous other than the question itself. At the end of the event, there will be a feedback form, emailed to you once completed, your attendance certificate will be on your Meadow account. That's all for me. I'll let our speakers take it away. Lovely. Thank you so much, Jingjing. I'm just going to share my screen. So. Ok, lovely. So thank you so much to everyone for joining us today. Um We're here to talk about our campaign surviving in scrubs and specifically about the issue of sexism and sexual violence affecting the healthcare workforce. Um My name is Dr Becky Cox. I am a GP who specializes in um gynecology and also homelessness healthcare. And I work in Oxford as well as being one of the two co-founders of Surviving in Scrubs. I'm also going to let our other two presenters tonight um uh introduce themselves. So Chelsea, would you like to introduce yourself? Er, yeah, so, um, hi everyone. My name is Doctor Chelsea Deitz. I am er, an emergency medicine and intensive care medicine. J trainee um registrar up in Merseyside. Um I am the other cofounder of surviving in scrubs. And then we also have Isabel if you want to introduce yourself. Hi, everyone. I'm Doctor Isabelle Seddon. I'm a core surgical trainee up in Aberdeen in Scotland. Um And I'm a volunteer for Surviving Scrubs and joined the organization about six months ago. Um So the first thing that we'd like to do today is do a quick poll with you guys. So we have around seven questions. Um, just to get a feel for how much experience everybody has with this issue. Um And how much, how much awareness you have of surviving in scripts. Um Just a, a disclaimer. Some of these questions are a little bit sensitive. So if you don't want to answer them, please don't um only do what you're comfortable answering. All right. So I'm gonna just kick off, I'll give you guys about 30 seconds um per question. So hopefully everybody can see that question um And just submit your answer. Great. So we've got about 88% of people so far that have answered that question, have witnessed, experienced or um yeah, have witnessed or experienced section misconduct, violence or abuse in the healthcare setting. All right, we're getting up to about 0 30 responses. Great. Thanks everybody. So about half of you have. Um And I'll move on to the second question. So hopefully you can see the second question now. Great. So we've got kind of a mix of spread here. Um But about a third of people are very much aware of the prevalence of sex and, and sexual violence within the healthcare workforce. Great. Moving on to the third question. Wow. So 100% of people so far have put highly significant. I'll wait for a few more responses. That's great. So 88% of our 34 responses said highly significant. All right. Question for you guys. No. So the question was, how knowledgeable are you about the current measures in place to mitigate sex, some sexual violence in health care. Um, so you've got 30 responses and about a third of people not at all knowledgeable, slightly knowledgeable. So definitely on the, um, the lower end of that one. Ok. And now move on to question number five. So this one is, how likely are you to intervene, report or take action if witnessing or being victim to sexual misconduct within the workplace? Oh, that's great. Lots of people saying very likely that's good and I'll just give you a few more seconds to answer that one. Ok. Moving on to question six. Do you feel that healthcare institutions provide adequate resources and policies to address these issues? Thanks everyone for engaging with the pool. Um So we have disagree. About half of people have put that. Ok? And I'll move on to the final question now guys, and this one is, how familiar are you with the surviving scrubs initiative? I'll just wait a few more seconds for everybody to give an answer. Ok. We've got 40 responses and most people said not at all familiar. So I'm glad you've joined today. Hopefully by the end of the webinar, you'll be very familiar with our initiative. Um Thanks for answering all the poor questions guys and I'll hand over to you, Becky and to kick off things. Lovely. Thank you so much Isabel. Um And it's, it's super helpful to have everybody's responses to get an understanding. Of what, what your guys experiences of this are and what you're bringing to this webinar to start with. Um So I really appreciate you filling out those responses for us. Um The way that we're gonna do the webinar today is in chunks. So we're gonna do a chunk of knowledge and then we're gonna have an opportunity for questions and then we'll do another chunk and that will take us through the full hour. Um So the first bit today that I wanted to give you a little bit of background on is basically about the context of this issue in health care, as you can see on the screen about the numbers, but also about the impact. So it's giving you that basic knowledge that background knowledge of what's going on. Um So the numbers that I've got here up on the screen actually represent what we're experiencing here in the UK. And I'm aware that many of our audience are international. So hopefully, this will give you a bit of a feel for what things are like here in the UK. Um So the um first um bit of data that we've got up in the top, there is uh a survey that was done by the British Medical Association, which is our Doctors Union in the UK. Um It was a, a piece of work called Sexism in medicine. And actually Chelsea um Fellow co-founder actually set up this survey and this was a survey that went out to members um several years ago now and asked in the previous two years, have you experienced uh sexism, unwanted verbal conduct, unwanted physical conduct in the healthcare workplace? Now, 91% of female doctors had experienced sexism in the previous two years, about two thirds say 56% had experienced unwanted verbal conduct in the workplace and 31% had experienced unwanted physical conduct. Now, that tells us that there's quite a high prevalence of this. Um And it was really important that that data asked about the previous two years experience because that's current, that gives us a picture of what the current situation is here in the UK. But one of our big things that we do here at surviving in scrubs is that actually we frame this as an all of healthcare issue. This isn't just an issue that affects doctors or that is perpetrated by doctors. This is something that happens all across different professions who work within health care. So to put that into context, um the nursing times, which is one of our big nursing um journals and magazines here in the UK, asked their readers as nurses, have you experienced sexual harassment in your careers? And 60% replied and said, yes, I've experienced that at some point in my career and actually, that didn't just include nurses, it included uh nursing students, healthcare assistants as well. So, again, highly prevalent within the nursing workforce and when we think about the wider staff working in healthcare unison, which is one of our big trade unions that represents a lot of other allied healthcare staff in the UK. Ask their um allied healthcare staff members. Have you experienced sexual harassment? And actually 8% said they'd experienced sexual harassment in the previous year alone, which is a huge number. So from this data, we can gather that. Yes, this is a big problem in UK health care. Now, when we think about what the impact of that is on our staff as in the people who this as a survivor or as a victim, it's going to have a huge impact. So negative emotions, absolutely guilt, shame, fear, worried about repercussions, humiliation, all of these um emotions that many survivors will experience. But also this is in the context of your job as well. So for many people, this affects professional identity. And do you see yourself as a nurse as a doctor given the experience that you've had? And certainly I've had personal experience of that and it question made me question if I wanted to be a doctor or not anymore. As a result of that often it has an impact on people's work. So some studies have shown that there's a 45% lower work productivity. Um People fear repercussions from the colleague or from the perpetrator that caused this in the first place. Many people experience difficulty reporting and raising a concern as well. And unfortunately, up to 7% of people may consider resigning from their job as a result. So it is impacting our workforce and when we think about the mental health consequences of this, so, 35% of survivors said that this had affected their mental health. Um and when that was broken down and looked at what, you know, what kind of mental health impact specifically is it happening? Uh 58% said it affected um and caused anxiety. 24% said low mood and depression two thirds said PTSD, which is very understandable given that this is a form of trauma, but also people were reporting suicidal ideation and self harm. So this has a really, really big impact. Now, we're gonna take a pause here for some questions from you, the audience. Um So if you've got a questions, put it in the chat and we're going to focus on these questions on around the, the previous two slides that we've discussed. Hi, Becky, thanks. Um So we've got one question um which I think is more of a, a generic question about the, the numbers. Um So they've asked for context purposes, may I ask is the topic related to perpetrators within the workforce or patients committing the offense on healthcare workers? So it depends um which of the surveys you look at. So the um so the nursing time survey, for example, that was both patients and staff being perpetrators of this um Chelsea might be able to give some idea about the BMA survey. Um So the BMA survey specifically was asking about staff on staff um very much within the, so that was very much within the kind of medical um arena. So talk about doctor to doctor. Um So, so that's what those numbers are, are telling you in, in, in those rates and things we know from other data, which I'm sure we'll probably go on to that, that, that kind of those high numbers, those high percentages are mirrored throughout different um populations within health care. So not, not just with doctors generally, but we know a few surgeons and, and the other, the other work out there that, that this is happening time and time again. Um And we've got a question as well about um the difference in numbers of from those studies. So obviously, the, the Allied Health Professional Survey was um 8% of people experiencing it. Um So somebody's asked, do you have any theories about why that rate is lower? Um This is a person who's a physio wants to hear? Well, sees this a lot. Um So is thinking why that 8% is much lower than maybe the other numbers that we have? Well, actually that survey question only covered the previous year. So that's why it's much lower. So it's just a reflection of that past year alone. And actually, when they looked at, they did a really interesting breakdown of what those experiences were and actually quite a lot of those experiences were a wide range of stuff from digital stalking to face to face. Sexual harassment, sexual assault was also in there too. Um, so, yeah, so it's a, it's a very small reflection of just one year alone. And was it quite a large population that answered that survey? I imagine it was? Yeah. So it was quite, um, I can't remember the number off the top of my head, but it was several 1000. 0, wow. Ok. So a very large number of respondents. All right. Um Anybody else having any questions about the first couple of slides that we've discussed? I think that's it for now. So, um, we can move on. Ok. I'm gonna stop sharing my screen and let Chelsea share. Lovely. Ok. So I play from play from current slide. There we go. So we wanted to kind of tell you guys a bit about our story and about where surviving in scrubs has come from. Becky and Becky. And I, um started talking a couple of years ago. So around the time that I'd been doing the work with the, the BMA sexism and medicine survey. Becky got in contact with me. Uh, Becky and I have never worked together, um clinically, um but then started talking via Zoom or other online platforms. Um, and then eventually met in person and we've worked together ever since on surviving in scrubs. And we are both survivors, Becky and, and I habit of sexism, misogyny, sexual harassment. Unfortunately, um even sexual assault at work. And at the time of us getting to know each other and getting to know each other's individual stories. There were some things going on in the medical media, you know, the BMA survey, which is a piece of work I'm extremely proud of. But at the same time, the Royal College of Surgeons did a report about sexually assault within surgery. There was also work looking into the gender pay gap in medicine. So there were some things that were happening and we were really kind of quite, you know, happy and really excited to see where this would go. And then all of a sudden nothing happened, there was radio silence. So we thought what could we do? And the answer was we can start a campaign, we can do something about it ourselves. And, and that's where surviving in scrubs came from. This, this want this need to do something we have experience, we know what the issues are. We know the barriers to reporting. We know how it feels to be a survivor of these behaviors and it's really difficult. It's really hard, it can be really isolating at times. So we wanted to, to build a campaign that also, it almost felt like a bit of a community. So what we've done and what we've started off as was this website where anyone who works in health care because we know it's not just doctors, we know it's not just surgeons. We know this happens throughout the whole of healthcare and we all work together. So of course, it's going to affect us all. So anyone who works in healthcare anywhere can anonymously submit their stories, their testimonies of what's what's happened to them. And we now have a, a huge collective narrative on there. We have 230 if not more stories on there now. And that has really enabled us to have this collective voice and has allowed us to, to go into a lot of rather scary rooms sometimes but to go and, and talk to people and, and tell people what's happening and to say, what are you doing about this? What are you doing to protect your staff? And that's where we've come from um from the voices of, of survivors. And we have so much power with that collective narrative now and it's, you know, really exciting to see where we've been, what we've done over these past 2.5 years that we've been around, but also in terms of what, what's to come in the future. Um So, so yeah, so that says, so I'm just wondering if anyone had any questions about, about us, about the campaign. Um So we don't have any questions in the chat, but questions from myself. Um So I know you both are survivors. And I wonder how much you'd like to share about your experience um of how supportive maybe work has been. Um Because I know everybody's had different experiences and usually they aren't the most um positive. So I'm wondering how your NHS trust or your managers or your colleagues were when this was going on if you, if you don't mind sharing with that with everybody. So do you mean in terms of when we've been experiencing these issues as opposed to? Ok. So um in all honesty, um to be honest, yeah, yeah, in all honesty. So there isn't, there isn't just one incident. I think that's the first thing I should say. Um that I've, I've had several incidences and, and some have been on um all through the, all through the spectrum of, of misconduct. Some may seem minor to some people and then there's been some on the more kind of um harassment, assault end of the spectrum and um I haven't reported all of them. Um Reason being, I think it's very difficult to know who to talk to, who to report to. I don't think the the processes, the policies are, are that transparent or they definitely weren't at the time of me experiencing these problems. But then when I have tried to um seek support or raise a complaint, I've had experiences of being actively discouraged from doing it. Um I've had um what at the time what seemed like um good advice about how II was the one causing a fuss, how this would affect my career where actually realistically, um it was almost kind of like almost failed threats really about the fact that this will affect my career and not, and not the, the perpetrator. Um And when I've tried to raise a complaint, it's always been uh either a departmental level, a local level or a trust level. But I've also got the, the difficulty of being a rotational doctor. So when I have um often raised complaints, it's been towards the end of my stint in a particular trust due to the fact that um you know, I'm going to be leaving soon, so I feel safer to raise it at this point. But then there never seems to be any accountability, nothing seems to happen. So for me, unfortunately, overall, it's been a really negative um demoralizing and um potentially damaging experience. Thank you, Chelsea for sharing that. Um I think you raised an important point there where you've had different experiences and things happening over a diff like a period of time and sometimes things seem very minor and not important compared to like some of the more severe cases of sexual misconduct or a sort that you've experienced. And I think that is echoed with a lot of people that there are comments made and there are kind of inappropriate things said and you don't always feel like you can report it because it feels so small. Do you have any advice or? Yeah, I guess advice for things like that where the incidents feel kind of small and negligent but actually are completely inappropriate because I feel like that's probably the most common thing that we all see day to day. Yeah. Um, so we're talking about the, the comments, the inappropriate comments, the banter, the jokes. Um, I absolutely test the word banter. Um, yeah, it's used as an excuse. But anyway, I think, I think that isn't the responsibility of the individual. I think it's the responsibility of the, of the team of the culture in the department, the trust, the surgery, whatever it is. Um, and I think that comes down to the fact that people need to be aware of this and there is a normalization of these behaviors, these attitudes. Um, you know, people talk about there being dark humor within health care in order to get through and jokes are one thing but when they are victimizing and belittling and, and humiliating people and under the veil of banter that's not acceptable. And people need to call that out either directly in the moment or there needs to be open and honest conversations about what is, and isn't acceptable is, is what I would say to that. I don't know if you want to add anything to that. Becky. Yes. I think, um, if it was, if it was something that was happening to an individual, I think your decision about whether or not to do anything in the moment about it is always about, are you safe? And that is the first priority you do the thing that is the most safe for you. And it might be that the safest thing is to leave that situation at that point. Um If you do feel able to speak up, then it is about, you know, using bystander training principles, um which I won't go into loads of detail about because there's a whole, a whole another webinar of itself. Um But certainly, you know, gently questioning somebody's comments if you feel that you are safe enough to do that. Um And otherwise it would be a case of thinking about afterwards, you know, do you need to reach out to someone for support? Is there a senior or a supervisor that you can approach? Um, and perhaps seek that their advice and ask them to intervene on your behalf? Um It's a very, very complex situation to try and resolve and it certainly is something that makes all of us go. Is it worth my while doing this? And, you know, unfortunately, we all tend to bear the responsibility of it as a survivor. We feel that we need, you know, is anyone else gonna do something about it? Maybe not. And so what do, what do we have to do to fix the situation? And I think it's really worth always making sure. Are you safe. What do you feel happy with doing in that situation? Yeah, that's some very good advice. And we've got a couple of questions on the back of that. Um, somebody has asked, it's probably more of a statement actually than a question. Um, why is it so difficult to create a psychologically safe environment to speak and listen and follow up? Uh, I mean, it is, you know, that's a, it's a, it's hugely difficult. It shouldn't be on the face of it. It should be something that's very straightforward and easy and we should all be working in that lovely, safe open cultures and the workplace. But actually, we, you know, our healthcare systems are set up on decades and centuries of hierarchy. Unfortunately, of a lot of male dominance um in the founding of medicine and health care. And we're dealing with the issue in terms of the wider society and how that's feeding in as well. So there's so many different different influences that are affecting our workplace culture that it almost becomes impossible to tackle them all at once. And as much as we're trying to do that with surviving in scrubs, certainly we know that, you know, there is only so much we can do at one time. Um Culture change is something that takes decades. Um And you know, much of what we do at surviving in scrubs is going around educating healthcare employers in order to start the work to change that culture. Um Certainly there are things that we can all do in everyday practice that help. Um And the main thing is, you know, to be respectful of our colleagues, listen to their experiences, don't doubt or question them and to ensure that perpetrators are held to account for um the behavior that they, they perpetrate. Yes, definitely. And just drawing on that. So somebody has asked specifically about gender. Um and is there any difference in gender, what is the prevalence in those experiences in women and what prevalence in men um which we didn't break down on the first slide, but um there is a very clear discrepancy or difference. Um I don't know if anyone has the numbers at hand. Um um So, from what I can remember, so there is data out there um that absolutely does break this down. Um in terms of male versus female experiences, we know that women are disproportionately affected by this, but it's not to say they are the only people to be affected by this. Um Off the top of my head. I think in terms of the, the BM and the BM data, um I think it's something along the lines of um 56% of females have had unwanted physical verbal misconduct compared to 23% of men. So, you know, you're talking nearly twice the number there. Um I can't, I can't remember exactly off the top of my head, but that it is in that piece of work. So if you want to go and have a look at the figures, it, it's on, it's online, you just need to type in va and medicine and it will be on there. But it's also in other, other pieces of work that are out there too. Um So the, the breaking the silence report from the Royal College of Surgeons also breaks it down. Um So, so we do realize that yes, this does affect men too, but realistically, it disproportionately massively affects women. Yes, definitely. Um I wanted to say as well that we know this issue is not um complete, well, it's not completely within medicine. It's obviously a worldwide organizational problem. And I'm wondering if, when you started this campaign in this organization, you had any um other support from other organizations that were doing a similar thing in different um sectors. Um For example, in the business sector or in law or anything like that. Did, did you draw on anything from other sectors or maybe involved with other organizations from, from those from different areas? We actually, we actually didn't. So um so when we started out, we'd seen um there's a campaign called Everyone's Invited, which is about education. So school age education, um so we knew about that campaign existing. Um But beyond that, we weren't in touch with any other sectors, we actually have had other sectors get in touch with. Um Now that we've started this campaign. Um So for example, um we've had um, a group, a legal group got in touch with us and said, actually, we need this in law, this needs to happen. We need to have a similar campaign running. Um So certainly people are reaching out to us for advice for how to run their own campaign. Now, given that we were complete non, when we started out, it was very strange doing that sort of, um, 360 turn there. But it, you know, absolutely. This is something that has to happen across many, many other sectors. Yeah. Um, and somebody has also mentioned intersectionality and obviously a huge topic. Um I don't know if we're covering it today. But, um, and I also don't know if a lot of the surveys allude to any of this or specifically look at other factors, race, socio economic background, if they look at that in their data and see that there is disproportionate. Um, numbers, I don't know if you guys know about that in any of these areas. Um So one of the, the really frustrating things is that the data that we have for the healthcare workforce does not break it down at all. It splits into gender and then it stops there in the vast majority of studies and it's, I was the only other thing they boil it down to is profession or specialty. Um But that's, it really, isn't it? Yeah. So, um, in terms of um the data that we have available. Yeah. And the NHS staff survey doesn't break down either just to say I've seen that in the comments. Um So we're, we've been pushing for that. That's one of the goals of our campaign is to push for there to be research that breaks us down at an intersectional level because we know that out in the wider world when we look at wider society, if you have one or more protected characteristic, you are much more likely to experience a form of sexual violence or sexual harassment. And that absolutely is going to be the same in healthcare, but we don't have the data yet to evidence it. Um The GMC survey survey that um they published of their trainees this year does have some breakdown for certain protected characteristics, but it doesn't really break it down very well with the questions on uh sexual harassment. So that data is yet to be published and anyone who's out there thinking of a research project they like to do in this, please do it, please please do it because we really need that data. Yeah, definitely. Um Any other questions before we move on to doctor? I think that is all for now. So I think I'll stop sharing again. Brilliant. So I'm gonna take over now. Um OK, so um what we've talked about so far is the problem itself and how it, what the numbers are, how it affects people and we've talked a little bit about why our campaign started as well. What I want to talk about next is um what we've been doing as a campaign to tackle this issue and also about some of the other, some of the other projects that are going on um in the UK as well. Um So Chelsea just go back to how our campaign started that we started collecting stories. Um And actually, as a result of us collecting stories, um we decided to write to the GMC. So the GMC are our healthcare regulator here in the UK. Um And they have a guideline by which doctors practice called the Good Good Medical Practice. Um That sort of has a set of rules and regulations in there about how we should behave with patients and to certain extent with staff members too. But one glaring gap in it is that it didn't have anything about sexual harassment or sexual assault in there. Um And so we wrote them in an open letter two years ago. Uh So that was July 2022 as put in this tweet and said we are calling on you to update good medical practice. You need to explicitly say that doctors shouldn't behave in a sexist or misogynistic manner towards colleagues. Um And so that actually that open letter hit the media in the UK before that we'd had no media involvement. And what it led to was I suddenly being interviewed by all the different big newspapers in the UK. So this was the times that started it off and then it ended up being in the Guardian, it ended up, um, being across numerous different magazines, I think. Um, we were in Cosmopolitan magazine at one point. Um, and we were, we were all over the place. It just exploded and we were inundated with media requests. Chelsea was on the news at lunchtime, we were on the radio, we ended up being on women's hour, which is um a huge women's focus program in the UK. That's on the BBC. Um And it really, really snowballed and that led to us then in 2022 going around starting to do educational work on this. So we were being invited to do talks um at various different conferences across the UK. Um We were then uh also being invited into uh healthcare organizations. So that's our NHS Trusts, our hospitals here in the UK, being asked to deliver education about what the problem is and what are the solutions things like bystander training as well? Um How to change culture in the workplace, how to respond to a disclosure. So we are educating those who are likely to be involved with this in terms of this is the problem, this is what our professional standards and our behaviors should be. But also those who may well need to support a survivor with this. How can you manage that? Disclosure, what sort of level of support should you be providing for them? And also thinking about on a wider level, how can your healthcare organization do better at this following on from that? Um We were then um as a natural part of any campaign, you start contacting your MP um and you contacting ministers. Um So we were doing that here in the UK writing to them saying this is an issue you need to be engaged on this. Um And that led to us going to the Women's inequalities Committee in Parliament and speaking about this issue, giving evidence on what was happening on the ground. And that's Chelsea there talking to the committee with me in the background. Not long after that, we published our first report. So this is November last year. Um It's available on our website if you'd like some background reading. Um What we did was we analyzed 100 and 50 of the stories that were submitted to us and we did a quantitative analysis and a quality analysis as well looking at who are the perpetrators, what was the impact, who was being affected by this in the stories that were submitted to us? And we then looked at the um the written stories that were coming through and looking for themes and there were so there was the data was so rich that we had, that came from that and that covered all sorts of things such as um the power imbalance in healthcare, the value of women working in healthcare. Um The factors that allowed people to continue to often repeatedly perpetrate these behaviors and the teams around them that were essentially just tolerating it or allowing that behavior to happen. Um And we also found that there were certain challenges that survivors were facing in the way that they struggled to report concerns and the lack of support that they were receiving. Um And that ended up being published again out in the media, it was covered across the press um particularly in the Guardian. Um And we ended up um in December last year going and um submitting that report to 10 Downing Street as well, which was a huge um highlight for us in terms of the campaign and the impact that we were having. Um this year to date, we've had a number of different streams of campaigning running and actually the biggest one that we've been focusing on with our volunteer group has been um a campaign to get medical schools to take action on this because one of the biggest things that we know about why this happens in healthcare is power imbalance and hierarchy and being bottom of that hierarchy, medical students are unfortunately very likely to come into contact with this kind of behavior as a victim. And so we really wanted to push medical schools to be accountable for their students to really put prioritize their safety. Both when they're um in the university studying, but also when they're out on placement as well. Um So we started a campaign um with an open letter that went to all the medical schools in the UK, um particularly asking medical schools in England. We need you to sign up for something called the NHS England Sexual Safety Charter. Now the NHS England Sexual Safety Charter, I will be touching on in a minute, but basically, it's a set of requirements that healthcare organizations in the UK can sign up to, to show their commitment to, to challenge this behavior, to tackle this behavior in health care. And medical schools seem to be really hesitant at doing that. And when we started, um, back in July, writing to them, only three of 36 had signed up in England. Um So we, uh we put out these letters, we then put out a petition. It's got more than 37,000 signatures on it, which is incredible. Um And we're still pushing those universities to sign up. We have had a trick or more sign up and it's actually been discussed now at, um, something called the Medical Schools Council, which is a collective of all the medical schools in the UK. And we know that's being discussed, but we're still finding that there's some push back on that. So, um, just to say, um, as a result of all the work that we've been doing, these are just a handful of the organizations that we're working with here in the UK. So we're working with Royal Colleges, we're working with the ambulance service, NHS England Healthcare Regulators. We're working with other um charitable groups such as doctors in distress. Um I haven't got them all on here because they've just been way too many um to try and fit on one slide these days. Um But it's growing and growing and growing, which is fantastic. Um And just to highlight some of the other projects that are going on um that we're involved with but are being led by some other organizations in the UK. Um So the working party for sexual misconduct in surgery have been absolutely fantastic. So they published um and many of you may, may be aware of this. They published um er study last year that asked um people working in surgery and theaters, have you experienced sexual harassment, sexual assault, sexism in the workplace? And there was a resounding. Yes, they had and they published this report called Breaking The Silence, which has a, a really in depth coverage of the, the steps that need to be taken to address this issue in uh in the surgical environment. And actually much of that can be taken out across healthcare and those recommendations can be adapted to be used in other sectors within health care too. Um that is available on their website. Um If you Google, um the working party, it will come up um definitely recommend you have a little read of that. Um The ambulance sector in the UK have been absolutely brilliant in driving this work as well. Um They were setting up some of the first working groups over the last few years and that's been led by. Um I'm gonna give her a shout out because she's awesome. Um Bron Biddle who works for the Welsh Ambulance service and they have been setting up um, sort of Survivor L groups groups that are making recommendations about education, about training, about how to hold perpetrators to account. And they're being absolutely fantastic. So they've got some work published on their website. So if you look at the association of ambulance chief executives here in the UK, there's some background to what they're doing on there. Um And then the other thing that I mentioned, uh a couple of minutes ago is the um sexual Safety charter from NHS England. We've been sat on their working group, which has been running now for just over 18 months. Um They initially put out this charter. The charter is available online. You can read that and it has a number of so 10 different steps that organizations should be committing to, to tackle the behavior of um or sexual safety issues in the health care. Um, that came out earlier this year, almost every trust in the UK has signed up to that. But, you know, it's not just for trust, this is for any healthcare organization in the UK to sign up to and we want the medical schools to sign up to it. Um More recently. So last month, NHS England actually published a lot more information about this. So they've now published a gold standard policy. So a section was conduct policy that can be adapted to be used in healthcare organizations across the UK. And they've also put out an E learning module. So if you're here in the UK and you have access to E LH, you can log in and do a module on um on sexual misconduct. And they also have a framework that's been published and that framework is for healthcare organizations to use to check against, to ensure that they are putting the right steps in place um in order to promote sexual safety in um in the healthcare environment. So that's a bit of a whistle stop tour of what we've done, but also what other projects are doing here in the UK. Um And really happy to um to take any questions on that. Yes, of course, Becky. Thank you. Um We've got lots of comments and questions in the chat. So I'll just go back because we had an interesting question because we've been talking about medical schools um and our campaign with the medical schools. Um and somebody's asked, how can the situation be improved over time through education in medical schools? I feel like younger hospital workers are behaving like their older counterparts and perpetuating sexism and I guess to draw on from that as well is my question is why do you think that the medical schools are so hesitant to sign this um Sexual Safety Charter if you have any theories about that? Um ok, so there was a few questions. It's ok, no worries. Um So in terms of um bringing this education into medical school, um so as it stands, in terms of who's signing up to the sexual safety Charter, medical school wise, there's five from England. And interestingly, Glasgow has also signed up to the NHS England Charter, even though obviously not in England. So it doesn't necessarily um kind of, it doesn't necessarily kind of um it's not necessarily gonna work for them or gonna be enforced for them, but it's, I think that's great that Glasgow have realized that there's a framework here that they can work to. So even though they can't, they're not necessarily under NHS England reading it. They've been like, yeah, we need to follow these steps. Great. Um why medical schools aren't signing up to it? I honestly don't know. Um because there is some really easy steps in there that could make a huge difference. And we know that um we know that med students kind of fall through the gaps of reporting processes. If it's, if they're students, that something happens on university premises, then they're covered by a certain thing. But then if they are a student and something happens when they're out on placement, that's when things kind of don't always go to plan in terms of reporting, like who looks after them. Is it their supervisor out on the shop floor? Is it their, um, you know, personal tutor at university? What are the services available for them, for reporting, et cetera? So that's why we're really, really encouraging universities to, to sign up to this charter because it shows that kind of commitment to protect the safety of, of their medical students. Um And I think the final part was about students kind of um you know, kind of history repeating itself and I think that this culture is extremely normalized. Um It doesn't make it right, it doesn't make it acceptable, but it's very normalized in health care and people just wanna survive healthcare, whatever specialty you do, whatever profession you do is really hard. I think particularly within the NHS at the moment, it is probably the worst I've I've ever heard of ever being and people just wanna survive and to do that, the easiest thing to do is just to fit in and it is difficult and there are, there are, you know, personal risks on speaking up against um against this culture. But again, I think that goes back to universities, they need to start saying what isn't, isn't acceptable. And the health care organizations need to implement this charter as well and say what isn't, isn't acceptable. Yes, definitely. Um, Becky, do you have any comments about the medical schools? Safety Charter? Yeah. So, I think, um, one of the reasons that we have had, we've had some feedback from some of the medical schools and they said they don't, they feel like they don't really know where they stand with this. They don't necessarily think of themselves as being the right kind of organization to sign up to this charter. But actually, they can. And actually, we've had, we've spoken to NHS England and they said yes, we actively really want medical schools to sign up to them. So that isn't an issue. Some of them have cited Athena Swan as a as a barrier to signing up to it because they feel that all these criteria are already covered under Athena Swan, which it is to a certain extent, but it's not adapted for the healthcare academia. So we would say that actually, yes, it does to a certain extent, but realistically, if you want something more specific, it needs to be the NHS England Charter. Mm OK. Interesting. Um Somebody's asked, well, more of a highlight actually about the British Association of Urological Surgeons. Um and they published and disseminated their code of conduct to be signed by all members before registering for meetings. If someone just wanted to highlight the work that they've done, I don't know if you guys are aware of that. No, we weren't and that's um and somebody has also mentioned the working party which um I think we've answered that question. I'm just running through lots of positive comments. Um ok, I got a question here. Do you think the Workers Protection Act Amendment will help tackle this? We are certainly hoping our tu safety reps will assist to hold NHS organizations to account on this. Yeah, so I think we've seen um so if, if anyone else isn't aware of the Worker Protection Act update, um it's an update that came into force at the end of last month. Um That mean basically what it gives um a duty to employers now to take reasonable steps to prevent sexual harassment in the workplace. And it's brilliant that, that word prevent is in there because that's what we want to happen. We don't want in the first place. Um Now they face a penalty if they don't prevent it and a case goes through to a tribunal. So a workplace tribunal and they, it means they end up having to pay an extra 25% compensation to the victim. Um So there's a financial risk to it if they're not engaging with it. Um And I think that will have a big impact, but I think we're probably going to need a case of that being proven at tribunal first and an, an employing organization actually being faced with that penalty to ensure that sort of reality hits home with it for employers. Um we've got a comment from somebody saying, I think historically organizations have sent massive shut up signals but by not saying the right things when they needed to staying silent can be corporately safe but damaging. Definitely. Um I wanted to ask about the educational stuff that you guys do where you go out to conferences and NHS stress. Um And I'm wondering firstly, like, what's the audience members like? Is it a range of health care professionals or like, is there certain sectors that are more respondent or more um engaged? Um the people in the audience as well? II don't know if you probably assess it when you're there but are we getting, is it lots of women that are experiencing this or is it lots of men or you know, is there or is there a mix? It's, it's a real mix if we're honest. Um So, so we go out to a any basically anywhere that, that wants us essentially as long as we can fit it into, into our work schedules. Um And we run a variety of different sessions. Um Talking from about the overview, the facts, the figures, the prevalence going into more depth in terms of the work that's going on out there. The bystander intervention, how to manage first disclosures, how to support survivors, et cetera. And we tailor each session depending on, on who we're talking to, but we've spoken to um you know, large conferences, we've spoken to regional training groups for certain specialties. We've talked to, um, training program directors in the medical sphere. We've spoken at kind of just departmental wide or, or all sort of trust, wide open invitation events and in terms of, of who we get in, um, it, it, it sort of depends how the organization advertises it. We've had um, some sessions where they've closed surgery for the day, so they've closed all, um, non emergent theaters for the day and the whole surgical department has come. So surgeons, nurses, scrub nurses, o GPS, anesthetics, et cetera. Um And that's great because people have to come, essentially, there isn't an opt out because we do realize that a huge problem that we have with trying to gain traction with these issues and trying to drive this conversation forwards is that we very often end up talking to people who are interested in this and are aware of this. Is actually we need people who aren't aware about this or um are possibly even potentially perpetrating these issues will listen to us as well. Um So, you know, in those circumstances, we get some really interesting um insightful conversations um to, to put it politically. Um But also, you know, we do see that there is a real interest and a real drive. So when we've had, um when we do events where people have kind of been invited to come by the trust or by whichever organization has, has, has asked us to come in and deliver the education. We again, we see a real range of people who want to come and come and have, you know, have this teaching, have this training. Um, but it, but it does have to be said it is mainly women in that situation and, and actually this isn't just a women issue, this is a anybody and everybody issue. So we do need to see more men in the room. Um So that's, that's, that's kind of us really. Yeah. As expected. Um The people that are interested in the issue are the people that we don't really want to target as much as we do want to include everybody. Um Yeah, I don't know how you fix that problem or you get around it maybe by making things mandatory, but then we would need 100s of you guys to be going around. Um So that I guess draws me on to another question is for our viewers, the people listening. Um What are some ways that they could maybe get involved with the campaign or do things within their organization um to help with the cause? Is there any way that they can be a part of this? Yeah. So, um uh I think the probably the first thing is to if you haven't already have a look at our website and see and find out a bit more about what we do, read the stories that are on our website. Um Because they really drill down into what the issues are um in this um in on this subject. Um We have on our website, we have some educational materials we have blogs on there that are really helpful for background reading on this. Um Also follow us on social media as well because we post updates about what we're doing. We post some educational material on there as well. Um Other ways of getting involved that are not just following us and checking out what we do. So, um to, you know, the main thing is to talk about this as an issue to when you're in work, when you're out on placement, when you're studying to talk about it with your, with your friends, with your colleagues, um say, you know, I happened to sit, you know, watch this really interesting webinar the other night about this subject. Um You know, is that something that we're dealing with here in this workplace or we need to do to tackle this? And if you're somebody who's not really aware that this is happening in your workplace, it will be you're just not aware of it. So opening your eyes about what is going on on the ground. So if particularly if you're somebody who is in a more senior role, you're in a manager role or a supervisor role, this will be happening and you need to be aware of it and question what your workplace are doing about it when you go into work tomorrow or out on placement where you're going to ask them? Do is there a sexual misconduct policy? Is it there? Um You know, is it available, is it visible? How do you access it? Is there a reporting process to report a concern? And it's only by asking those questions, do we really figure out what the gaps are and what needs to be done to be changed? Um So I think it's about, yeah, it's about listening. It's about being curious, it's about asking those questions and spreading the message as well. Yeah, I think that's some really, really helpful tips. Um because it still surprises me that people have no idea that this is going on, have no idea about how prevalent it is and that's, you know, fellow women that are working in surgery that will definitely have been experiencing it or seeing it and still don't really recognize it. Um I think it's very interesting. Ok, we've got one more question I think. Um do you know anything about how sexual misconduct and harassment are dealt with in other countries or healthcare systems? So maybe if there's anywhere that we've taken some inspiration from or anything we can learn from other healthcare systems, I don't know if you guys have looked into that. Um So, um we did a project back. Um It was almost, I think it was about two years ago. Now we did a project with women in global health. Um So women in global health did um a campaign um that was asking they were sort of going out looking for data in countries across the world, um looking for both er lived experience but also uh for data and studies that have been done. So it was basically a bit of a, a search in a way and what they did was they put together a report that summarized what was going on around the world. Um mainly focused on what the problem was and prevalence and those kind of questions rather than projects and solutions were going on. Um So, II think it's still up on the website. If you um search women in global health, it will come up with that project. Um We're aware that there has been work in some countries. So Australia have been trying to tackle this. Um Australia has been doing a number of different work particularly in the surgical sector about this. Um And there have been some projects going on in the States as well. Um But that all focuses on um sort of Western society and actually the global issue, this isn't just an issue that affects the global North. Um And so we really need to see that there are projects going on across the globe on this because this will be happening and there will be different aspects to it and different challenges, but it will be there and it is something that we need to work together to address. Yeah. The other thing I was going to add on to that, um, we wrote a, we've written a chapter for a book that's hopefully going to get published. Um, next year. Um, so the, the, the main author and editor is, um, Prof Professor Louise Stone who is based in Canberra, um in Australia. Um, but she's um, brought together um, authors from, from all over the world. So um not just kind of westernized countries but, but also kind of um South Asia and African countries as well to, to get their kind of take on things and, and what's happening in, in those regions as well. So, um there's still, I think a little bit of, of funding needed to make it an open access um an, an open access book, but that is gonna be published in the, in the coming year. And I think that will add so much into this conversation um about Palace is such a, a worldwide issue. Yeah, definitely. Um So again, if anybody is looking for research projects or ideas, things to look into, um but we unfortunately don't have time to do it all. It would be great um for somebody to do a project about this as well. Um Any final comments from either of you guys um or let me just pull up, oh, someone has also mentioned if there's any difference in private and public health care establishments. Now, I do not know if there's been any information from the private sector. Um I mean, there is much, I'm not aware of anything that's broken it down to the public versus private sector, but we've definitely been asked to go and do talks in the private healthcare sector. So I think there's a recognition that there's an issue there, but I don't know if you research data on it. Very interesting. Yeah. Any final comments from Chelsea or Becky that you wanted to share. Um I think, I mean, the main thing I'm gonna plug off again. So have a look at our website. Follow us on social media. We are on Instagram and Twitter. We use Instagram as our main one particularly for educational resources. We are also on linkedin and if you want to get in touch with us, um then the best way is to contact us through our email, which is surviving inss at gmail.com. Um This QR code should go to our website. If you can't get it through the QR code, just Google us and it will come up. Um I think the other thing to say is that we are, this is the first in a series of webinars. Um The second of which will be happening in the new year. The date is to be confirmed, but the idea is that we're going to be going, this webinar was more of an introduction to the subject. The following webinars are going to go into a deeper dive on this, looking at other healthcare professions, particularly looking at survivorship. Um looking at a number of different factors that will, you know, give you a really, really in depth understanding. Yes. And the way the way you can track this is if you follow us on medal, um then you will see those events as they arrive. Um And one final thing to say is please, please please fill in our feedback form. Um Very similar questions to the ones in the poll. So we'd love to know if the webinar has been interesting, insightful, helpful. Um Any comments, any feedback, um We'd really like to know before we, I guess crack on with the future ones. So please do fill that in. That would be much appreciated. Yeah, and just um I'd just like to say, thank you everyone for, for coming and listening to us. Um I think we also just need to say thank you to everyone and anyone who's written into our website because without those stories, without that collected narrative, we absolutely would not be here. Um So please do look at our website. If you feel like you would like to share and add into that narrative, please do they're all anonymous. Um And we, we read every single one to, to ensure there is an they are as anonymous as possible. So if you're able to do that as well, that would be great. But yeah, just have a look at our website and hopefully see for, for some of our next webinars. Thank you so much, Doctor JTT, Doctor Cox and Doctor Seddon. That was a really important useful talk and a really insightful Q and A. We really appreciate you taking the time to give this talk. And thank you to everyone who joined. You'll all be sent a feedback form shortly. Please fill in the form and you'll get your certificate added to your Meadow account. Get the Meadow app on your phone and laptop to have easy access to certificates. Catch up content and slides as well as tools like QR codes to easily share patient info leaflets in the reference section. This event has been recorded and will be available on Catch Up Meadow Education's profile as well for anyone who's missed it. Please do let us know what other topics you want to learn about in the feedback form and we will try to arrange teaching sessions on those topics. Thank you for joining and take care of everyone. Thanks everyone. Bye.