Failure to root out abusers in ambulance service leaves vulnerable patients at risk, watchdog warns

Emergency patients are being left open to abuse when they are at their most vulnerable because of a lack of vetting of ambulance workers, watchdog officials have warned.

One watchdog official warned that abusers would even seek out work as a paramedic because it provided an “attractive environment” for exploitation.

Figures show that dozens of ambulance workers have faced action over sexual assault in the past two years, while paramedics account for one in three cases of tribunal action against care professionals. But one survivors’ group warned the figures were just the “tip of the iceberg”.

It comes after a spate of cases in which abusers have used positions of power in the emergency services to carry out attacks. Met Police officer David Carrick was given 36 life sentences this week for 85 serious sexual offences, including 48 counts of rape. On Friday, another officer from the force was jailed for four years after tying up a woman and telling her: “Who are you going to call? I’m the police.”

Paramedics who have been struck off in the past two years include one who performed a sex act in front of a patient, while another was handed a suspended prison sentence for possessing thousands of images of child pornography.

Helen Vine, special adviser to the Care Quality Commission, told a recent webinar: “There is a small proportion of the population who are seeking to abuse our patients and the ambulance can be an attractive environment for that type of individual. One of the reasons for this is the ambulance sector is predominantly lone working … and ambulance services offer privileged often unsupervised access to patients who can be very vulnerable.

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“An individual seeking the opportunity to practice offending behaviours and commit abuse see this sector as an easier option.”

She said the lack of checks meant offenders were able to move between providers, adding: “They test the waters and their behaviours ... if they are challenged, they will move on, however, if they are not challenged then they can hide in plain sight, and they are wearing a trusted uniform and given responsible access to that patient group.

“For some of those patients, there is a risk they won’t be believed if they raise a concern about the way they have been treated.”

High-profile examples of sexual harassment assault within NHS ambulance services include the case of “manipulative sexual predator” Andrew Wheeler, of East of England ambulance trust, who was jailed in 2021 for raping two patients. The same year, the trust lost its training accreditation after an inquiry found students were being sexually harassed by tutors.

Also in 2021, an independent report published by the South East Coast Ambulance Service found staff were subjected to sexualised behaviour and harassment by other workers, which was described as “embedded” within the organisation.

In the past two years, 22 ambulance workers have faced action for sexual assault, abuse of colleagues, patients and children. NHS Health and Care Professions Council figures showed paramedics accounted for 84 of the 293 cases in which action was taken over sexual assault or abuse across all professions between 2012 and 2021 – the highest proportion of any care profession.

Ms Vine raised concerns about recruitment and barring checks on staff, particularly in the private ambulance sector. Dr Sean O’Kelly, CQC’s chief inspector of hospitals, said some of its private ambulance sector inspectors had concerns over poor adherence to safeguarding and a lack of appropriate recruitment checks.

Alan Howson chairman of the Independent Ambulance Association, which represents private ambulance providers, acknowledged the issue but told The Independent his members had found gaps in NHS vetting too, inheriting contracts from the health service to find that DBS checks had not been carried out on workers. He said: “Offenders know they can hide in plain sight and avoid their actions being shared by others … employment records are vanilla they don’t tell you why the person really left”.

Carol King, founder of the advocacy group Ambulance Service Action & Support Group, which has more than 1000 members and works to highlight cases of bullying and sexual harassment, said the official figures were just a tiny proportion of a much wider problem.

“This is absolutely the tip of the iceberg. I would say it’s an across-the-board thing. So it’s not just managers, it’s not just frontline crews, and it’s not just the support staff, it’s also call centre staff,” she said.

One former South West Ambulance Service paramedic told The Independent she had been left with post-traumatic stress disorder after being sexually assaulted while working.

She described a “sexualised” culture where “women were looked at as pieces of meat” and said she encountered multiple male “sexual predators”.

In the first incident, she said a male colleague groped her chest as she was cleaning the station cupboards and said she was “dry humped” by a crew mate at another station when she leaned over to access a log book. When she challenged him, she was told: “You shouldn’t bend over”.

At the same station, she said a male colleague unzipped his trousers and made a sexual innuendo as she opened the fridge door to get milk.  

When the incidents happened no one intervened and male crew members “just laughed and brushed it off”, she said.

Another time, she said she was locked inside an ambulance by a colleague who sexually assaulted her. He later made jokes referring to the incident, the victim said.

Despite the paramedic being suspended, and the trust recommending he be referred to professional regulators, he was allowed to resign and was never sanctioned. Meanwhile the woman said she was left so traumatised that she ended up in hospital after trying to overdose.

She said she fears the man could now have access to vulnerable patients elsewhere. “What happens if he goes to someone who has had a stroke and is not able to communicate or is deaf and cannot speak etc who’s going to advocate and protect them? He could be going to vulnerable children and vulnerable adults regularly.”

After resigning, she received a settlement of £25,000 following a personal damages claim.

South West Ambulance Service said it had robust policies and procedures, and dealt with this case in line with guidance. A spokesperson added: “We have a zero-tolerance approach to any behaviour that negatively impacts the safety of our people, and we take any issues raised extremely seriously.”

“The Trust progressed this case as per the guidance set out in our HR and safeguarding policies, and onward referrals to external agencies were made.”