Sexual assaults against older people in hospitals: awareness and support are key to reducing harm (by researcher, Amanda Wynn)

Summary

Amanda Wynn is an independent consultant, researcher and trainer based in Cambridgeshire, specialising in older and disabled survivors of domestic abuse and sexual violence. In this blog, Amanda talks about her recent research into sexual assaults against older people by hospital staff. She shares an overview of her findings and calls for greater awareness and support.

Content

Motivated by a patient death

I undertook my first research into sexual assaults against older people by hospital staff in 2021, after reading about the horrific case of an older patient who died from internal haemorrhaging due to severe vaginal injuries. A member of staff was arrested on suspicion of rape, but ultimately was not charged.

I found it staggering that more people weren't aware of what happened to this lady. After placing a post saying as much on social media, I received messages indicating that this wasn't the isolated case I assumed it was. 

I was curious to know how often older people in hospital are being sexually assaulted by staff - people in positions of trust who should be caring for patients.

So, I decided to find out for myself. 

The findings: increasing numbers, bias and poor support

As I don't receive any funding for my research, I had to rely on freedom of information (FOI) requests to get data from NHS England trusts. I looked at the number of incidents reported to staff and recorded on the hospital’s incident system over a 5 year period, from 2016/17 to 2020/21 (financial years).

My first paper highlighted at least 75 incidents of sexual assault against patients aged 60+ in NHS Hospitals in England, where the alleged perpetrator was a member of staff. I was surprised by the numbers but also at the responses to the follow-up questions I asked about support for these survivors. In the vast majority of cases, there was no referral to specialist services.  Only 21% (16) of the incidents recorded were reported to police. Of these 16, all but two had ‘no further action’ taken. I don’t have the data on how the other two progressed so it is unclear whether any convictions were made.

I was keen to review the data to see if anything had changed, so I undertook a similar research project in early 2024. This time, the number of reported incidents was much higher over a shorter reporting period (at least 274 incidents over three years). Once again, the number of victims being referred to Sexual Assault Referral Centres or specialist support was very low.

Responses to both sets of FOI requests included anecdotal comments from professionals making worrying assumptions about the reliability of people with dementia when disclosing sexual assault. It was also interesting to note that male victims in reported incidents had a higher prevalence than male victims of sexual assault in general - potentially highlighting an increased risk of sexual assaults against older men in hospital.

Limited data but a sad fundamental truth

Due to lack of funding for my research, I was able to merely touch the surface and report only quantitative data. That means I am unable to determine if the increase in the number of reported incidents is due to more sexual assaults against older people happening. Or if improved reporting and data recording methods can account, either fully or partially, for the increase. However, what is clear is that older patients in hospital are at risk of sexual assault from the very people who should be assuring their well-being and safety.

Opportunity for positive change to reduce harm

The main aim of my research is to raise awareness of the issue among front-line professionals. Whilst this can include the potential perpetrators, most will be the people who are best placed to stop such incidents, and to ensure an appropriate response when an incident is reported. 

NHS England has strengthened its approach to domestic abuse and sexual violence in recent years with duties placed on staff to record and report incidents. There may still be some complacency about how genuine patient reports are though, and therefore less emphasis on support. 

It's also important for both health care staff and the general public to be aware that sexual assaults in hospital do happen. More awareness of the issue will hopefully lead to more survivors being able to disclose and getting the right support when they do.

I would like to develop some training for health and social care staff around responding to disclosures of sexual assault and violence from older people - this will likely be in an eLearning format - but I am keen for access to the training to be free. Too much essential knowledge sits behind paywalls making it prohibitive for the target audience to access. I have the content, but if anyone can help with a platform for hosting and developing online training it would be great to hear!

You can contact me at [email protected] if you would like to hear more about my research or the online training. 

Hopes for the future

I would like all health and social care workers to be much more aware of sexual assault against older people - not just in hospitals but in care homes and the community too. Funding for services needs research and data to back it up - my research only touches the edge of the issue and it would be great if more research and eventually specialist support for older survivors of sexual violence can lead on from it.

I’d just like to add that I'm really grateful to Hourglass for publishing my research to help get the word out as wide as possible. And, of course, to Patient Safety Learning for giving me the opportunity to share the findings too.

Related reading

• Sexual violence and assault against older people in NHS hospitals in England (2024)
• Doctors practising despite sexual assault and rape allegations
• Hundreds of social care residents allegedly sexually assaulted, watchdog reveals

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