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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.

Rebecca Hendin illustration for Rachael Venables piece

“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”.

Rebecca Hendin illustration for Rachael Venables piece

“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.

Rebecca Hendin illustration for Rachael Venables piece

‘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.

Venables paramedics piece

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”.

What should the NHS do if a serious complaint of sexual abuse is made about a paramedic?

Anyone can raise a concern about a paramedic’s fitness to practise including patients, colleagues, police or members of the public.

Where the complaint is serious the NHS is expected to directly raise a concern with the regulator, the Health and Care Professions Council.

What happens when a paramedic is referred to the HCPC for a complaint of sexual abuse?

If the concern is very serious they can apply for an interim order to prevent someone from practising or to place conditions on how they can work until the case has been closed.

The claim is investigated and eventually considered by an independent tribunal panel who can impose a number of sanctions.

They can strike someone off the register or impose a temporary suspension; place a condition of practice or a caution order; or decide no further action is necessary.

How long does it take?

In 2023/24 it was around 160 weeks from receipt of a complaint to reaching the final decision

Why does it take so long?

Last year, there were a total of 2,226 concerns raised, a 26% increase from the previous year.

The HCPC say they face external pressures, like delays from NHS trusts, complex investigations, or having to run alongside the criminal justice system.

They also say “archaic” laws mean they have to take a huge amount of cases to a full tribunal, even when the preference might be to drop the case sooner and want legislative change.

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

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UK on ‘slippery slope’ to ‘death on demand’, Justice Secretary Shabana Mahmood warns ahead of assisted dying vote

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UK on 'slippery slope' to 'death on demand', Justice Secretary Shabana Mahmood warns ahead of assisted dying vote

The UK is on a “slippery slope towards death on demand”, according to the justice secretary ahead of a historic Commons vote on assisted dying.

In a letter to her constituents, Shabana Mahmood said she was “profoundly concerned” about the legislation.

“Sadly, recent scandals – such as Hillsborough, infected blood and the Post Office Horizon – have reminded us that the state and those acting on its behalf are not always benign,” she wrote.

“I have always held the view that, for this reason, the state should serve a clear role. It should protect and preserve life, not take it away.

“The state should never offer death as a service.”

Analysis: Justice secretary’s intervention is potentially embarrassing for the PM

On 29 November, MPs will be asked to consider whether to legalise assisted dying, through Kim Leadbeater’s Terminally Ill Adults (End of Life) Bill.

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Minister ‘leans’ to assisted dying bill

Details of the legislation were published last week, including confirmation the medicine that will end a patient’s life will need to be self-administered and people must be terminally ill and expected to die within six months.

Ms Mahmood, however, said “predictions about life expectancy are often inaccurate”.

“Doctors can only predict a date of death, with any real certainty, in the final days of life,” she said. “The judgment as to who can and cannot be considered for assisted suicide will therefore be subjective and imprecise.”

Read more: Gordon Brown says assisted dying should not be legalised

Under the Labour MP’s proposals, two independent doctors must confirm a patient is eligible for assisted dying and a High Court judge must give their approval.

The bill will also include punishments of up to 14 years in prison for those who break the law, including coercing someone into ending their own life.

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Details of end of life bill released

Read more: Where does the cabinet stand on assisted dying?

However, Ms Mahmood said she was concerned the legislation could “pressure” some into ending their lives.

“It cannot be overstated what a profound shift in our culture assisted suicide will herald,” she wrote.

“In my view, the greatest risk of all is the pressure the elderly, vulnerable, sick or disabled may place upon themselves.”

Kim Leadbeater waits to present the Assisted Dying Bill. File pic: House of Commons/Reuters
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Kim Leadbeater waits to present the Assisted Dying Bill. File pic: House of Commons/Reuters

Labour MP Kim Leadbeater, who put forward the bill, said some of the points Ms Mahmood raised have been answered “in the the thorough drafting and presentation of the bill”.

“The strict eligibility criteria make it very clear that we are only talking about people who are already dying,” she said.

“That is why the bill is called the ‘Terminally Ill Adults (End of Life) Bill’; its scope cannot be changed and clearly does not include any other group of people.

“The bill would give dying people the autonomy, dignity and choice to shorten their death if they wish.”

In response to concerns Ms Mahmood raised about patients being coerced into choosing assisted death, Ms Leadbeater said she has consulted widely with doctors and judges.

“Those I have spoken to tell me that they are well equipped to ask the right questions to detect coercion and to ascertain a person’s genuine wishes. It is an integral part of their work,” she said.

In an increasingly fractious debate around the topic, multiple Labour MPs have voiced their concerns.

In a letter to ministers on 3 October, the Cabinet Secretary Simon Case confirmed “the Prime Minister has decided to set aside collective responsibility on the merits of this bill” and that the government would “therefore remain neutral on the passage of the Bill and on the matter of assisted dying”.

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‘Immediate action’ taken after blueprints of prisons in England and Wales leaked on dark web

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'Immediate action' taken after blueprints of prisons in England and Wales leaked on dark web

“Immediate action” is being taken after blueprints of jail layouts were shared online.

The maps detailing the layouts of prisons in England and Wales were leaked on the dark web over the past fortnight, according to The Times.

The detailed information is said to include the locations of cameras and sensors, prompting fears they could be used to smuggle drugs or weapons into prisons or help inmates plan escapes.

Security officials are now working to identify the source of the leak and who might benefit from the details.

The Ministry of Justice did not disclose which prisons were involved in the breach.

A government spokesperson said in a statement: “We are not going to comment on the specific detail of security matters of this kind, but we are aware of a breach of data to the prison estate and, like with all potential breaches, have taken immediate action to ensure prisons remain secure.”

The leak comes amid a chronic prison overcrowding crisis, which has led to early release schemes and the re-categorising of the security risks of some offenders to ease capacity pressures.

Justice Secretary Shabana Mahmood is launching a sentencing review in a bid to ease the crisis.

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Starmer says UK will ‘set out a path’ to raise defence spending to 2.5% in spring

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Starmer says UK will 'set out a path' to raise defence spending to 2.5% in spring

The UK will “set out a path” to lift defence spending to 2.5% of national income in the spring, the prime minister has said, finally offering a timeframe for an announcement on the long-awaited hike after mounting criticism.

Sir Keir Starmer gave the date during a phone call with Mark Rutte, the secretary general of NATO, in the wake of threats by Moscow to target UK and US military facilities following a decision by London and Washington to let Ukraine fire their missiles inside Russia.

There was no clarity though on when the 2.5% level will be achieved. The UK says it currently spends around 2.3% of GDP on defence.

Volodymyr Zelenskyy, Nato Secretary General Mark Rutte and  Keir Starmer, during a trilateral meeting in 10 Downing Street.
Pic: PA
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Ukraine leader Volodymyr Zelenskyy, Sir Keir Starmer and NATO boss Mark Rutte in October. Pic: PA

Ukraine war latest: Follow live updates

A spokeswoman for Downing Street said that the two men “began by discussing the situation in Ukraine and reiterated the importance of putting the country in the strongest possible position going into the winter”.

They also talked about the deployment of thousands of North Korean soldiers to fight alongside Russia.

“The prime minister underscored the need for all NATO countries to step up in support of our collective defence and updated on the government’s progress on the strategic defence review,” the spokeswoman said.

“His government would set out the path to 2.5% in the spring.”

The defence review will also be published in the spring.

Read more from Sky News:
Strike using UK-made Storm Shadow missiles ‘very successful’
Putin warns US and UK over ‘escalation of aggressive actions’

While a date for an announcement on 2.5% will be welcomed by the Ministry of Defence, analysts have long warned that such an increase is still well below the amount that is needed to rebuild the armed forces after decades of decline to meet growing global threats from Russia, an increasingly assertive China, North Korea and Iran.

They say the UK needs to be aiming to hit at least 3% – probably higher.

With Donald Trump returning to the White House, there will be significantly more pressure on the UK and other European NATO allies to accelerate increases in defence spending.

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