Bad apples? Bad barrels? Or bad cellars? Antecedents and processes of professional misconduct in UK Health and Social Care: Insights into sexual misconduct and dishonesty

This report outlines the results of a sequential mixed methods analysis examining 6,714 individuals’ fitness to practise (FtP) cases from three distinct groups - doctors, nurses and midwives, and allied professionals working in the UK health and social care context. FtP is a process for handling complaints about professionals in order to determine whether someone is fit to practise. The most serious of these cases are referred to a formal panel hearing. We used the determination documents that record the decision taken in formal hearings in our analysis to consider the prevalence and difference in misconduct cases across and within each profession. From our multi-method analysis, we: 1) identify the most prevalent forms of wrongdoing; and 2) examine in further details three forms of misconduct whose existence and prevalence undermines trust in professionals and confidence in institutional systems. From our analysis we improve understanding of how and why professional wrongdoing occurs.