WARNING: This article contains language and content some readers may find distressing

As a single mum, Lucy* looked forward to her rare nights out. A few years ago, during after-work drinks at a local pub, she started feeling unwell. When she collapsed and passed out, a bouncer called an ambulance. Lucy’s drink had been spiked.

The ambulance was crewed by two paramedics, a man and a woman. Still unconscious, Lucy was placed on a stretcher, strapped on to the bed, and driven towards the hospital.

After a scary episode, Lucy’s friends must have breathed a sigh of relief. She was safe, and being looked after. But, as the female ambulance driver looked in her rear-view mirror to check on Lucy, she says she saw the unimaginable – her male colleague sexually assaulting his patient.

Lucy still doesn’t remember what happened, but she has the police report and crime scene pictures of the inside of the ambulance.

Pointing to a photo of where she was strapped down, she says almost matter-of-factly: “He put my legs up, so my knees were up, and put his hand inside my groin area – possibly touching my vagina.”

When she regained consciousness, she was told what had happened to her. Years later, she is still struggling to process it.

The paramedic denied the charges and was found not guilty at trial, but later struck off by the paramedics’ regulator, the Health and Care Professions Council (HCPC).

They have a lower standard of proof than the criminal courts, and found against him, calling him a “serious threat to patient safety”.

Lucy still wouldn’t feel safe getting into an ambulance today. “It’s awful, you feel so violated and vulnerable,” she says.

“It’s a shock to think someone in that position would do that, when they’re supposed to be there to look after you.”

Her story is horrific, but Lucy is not alone. It forms part of a year-long Sky News investigation into sexual misconduct in the ambulance service, which has revealed a culture where abuse and harassment among staff are rife and patients are sexualised.

A senior ambulance boss admits the service has “let victims down”, while stressing that perpetrators are the “minority”.

Jason Killens, head of the Welsh Ambulance Service and the Association of Ambulance Chief Executives, says he expects “a steady increase” in the number of cases, with more paramedics being sacked for sexually inappropriate behaviour over the coming years, because of the work his organisation is doing to change the culture.

Data shared with Sky News shows one in five of the sexual misconduct complaints made against paramedics to their regulator, the Health and Care Professions Council, in 2023 were for acts against patients or members of the public.

While fewer than 1% of all HCPC members had concerns raised against them last year, in sexual misconduct cases, paramedics were hugely over-represented.

They make up just 11% of the HCPC register, but account for 64% of all investigations into sexual harassment against colleagues. The regulator’s chair, Christine Elliot, thinks the sexual misconduct cases are “just the tip of the iceberg”.

“This is all about patient safety,” she says. “Patients need to know when they see a practitioner, they can rely on them giving the best care possible with the best behaviour possible.”

‘Totally unnecessary breast examinations’

Cases like Lucy’s are rare but several whistleblowers across multiple trusts have spoken up about a culture in which “banter” or jokes about groping patients are commonplace.

Current and former paramedics claim to have heard patients, particularly young women, being sexualised by the men who had helped to treat or even save them.

One former paramedic revealed the phrase “totally unnecessary breast examinations” (or TUBEs), and said she had heard paramedics talking about “TUBEing” young, drunk women. She also claims to have seen a colleague grope another colleague’s breasts, telling her: “I just TUBEed you.”

A second woman said the same phenomenon was called “jazz hands” in her trust. Both said these were widely understood phrases which referred to colleagues accidentally, or deliberately, touching a woman’s breast during treatment.

A third paramedic told us she’d heard colleagues talk about patients in an explicitly sexual manner, saying things like: “She had nice tits” or “those were silicone”, while bragging about getting a patient’s number and having a “good feel”.

“That is assault. That is sexual assault,” she says.

‘It will be fun. Your career will progress’

“One of my biggest fears was that I wouldn’t be believed because of where I worked. It was the ambulance service and he was the man in charge,” says Ellie*, whose first job was as a call handler in an ambulance control room.

She loved the camaraderie and the idea that she was making a difference. Until one day, the manager called her into his office and invited her to a conference with him. At first, she was flattered and a little confused.

“He explained that he’d taken a liking to me and then he reached out and touched my leg.” Shocked, Ellie froze. “I was in my early 20s and didn’t know what his intention was. I was a bit naive, probably.” As he carried on talking, her boss slid his hand “as far up my thigh as it could go”.

Horrified, she shot back in her chair and asked him what he was doing.

“If you come, we’ll share a room. It will be fun. Your career will progress,” her boss replied.

“No,” she exclaimed, rushing out the room in a panic. Back at her desk, she carried on taking 999 calls while he watched over her.

Then she claims the messages started: “They were photos of his private parts, as well as messages suggesting meeting in the car park for sex and saying he wanted to kiss me. A whole manner of very descriptive sexual actions that he said he wanted to do with me.”

The messages carried on “for months”, she says, despite her pleading with him to stop. She was left dreading going to work for fear of seeing him, and avoided going to the toilet in case she ran into him in the corridor.

Eventually she showed the messages to HR, she says, but claims they suggested moving her to a different office. He wouldn’t be punished.

“It was sexual harassment,” Ellie says, caught between anger and despair. “They didn’t do anything. There was no investigation. No meeting with him that I’m aware of. No statement from me. Nothing. I was the problem.”

She eventually quit the service, but alleges he still works there to this day, an injustice that “makes me feel sick” she says.

An NHS England spokesperson said new national guidance and training has been recently introduced “to stamp out this awful behaviour”.

“Any abuse or violence directed at NHS staff is totally unacceptable and will not be tolerated, and the NHS is committed to tackling unwanted, inappropriate or harmful sexual behaviour in the workplace. We have recently introduced new national guidance and training that will help staff recognise, report and act on sexual misconduct at work to stamp out this awful behaviour,” they said.

‘We failed those individuals… I’m sorry’

Ellie’s story is simply “not right”, says ambulance boss Mr Killens.

“We failed those individuals,” he admits, saying “I’m sorry” to both staff and patients who have “been subject to poor behaviour from our people”.

Work is being done, he says, to tackle this kind of behaviour, citing it as his, and his organisation’s, top priority.

That will involve rooting out the perpetrators, but also playing the “long game” to change the culture “so that we can begin to tackle low level misconduct or inappropriate behaviour early, rather than let it fester and get worse,” he says.

According to the HCPC’s chair, cultural change is needed from leadership down. Sexual harassment, Elliot says, needs to be treated as high a priority as “waiting times and crumbling hospitals”.

Read more from this investigation:
Life as a female paramedic
‘Toxic’ culture of harassment revealed

But many of the victims we have spoken to say the HCPC takes too long (an average of three years) to investigate misconduct allegations.

Elliot agrees that isn’t good enough, but says they are running initiatives to speed things up, and wants to see legislative change to give her organisation more power to speed up investigations.

They have also created a sexual safety hub for both victims and witnesses of inappropriate behaviour.

It can be hard to hear allegations like Lucy and Ellie’s, contrasting their stories with a service in which the majority of people are dedicated to saving lives.

But it’s also clear that for far too long, abusers and those who commit sexually inappropriate behaviour have operated with impunity in the ambulance service. Some were perhaps protected by allegiances or cover-ups, many others simply hid behind the veneer of “banter”.

Ambulance and NHS bosses have made it clear to Sky News they are determined to root out not just the perpetrators of serious sexual violence, but also to stamp out the culture that breeds this behaviour.

But in the meantime women like Lucy, Ellie and countless others won’t hear an ambulance siren and feel safe, telling us they would even struggle to dial 999 in the case of a medical emergency.

*names have been changed

Illustrations by Rebecca Hendin

Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email jo@samaritans.org in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK