A damning report into an ambulance trust has revealed a culture of bullying and harassment with concerns over "toxic" atmospheres, sexual grooming and a fear of speaking out.
When bullying claims at South East Coast Ambulance Service (Secamb) emerged in February the trust commissioned an independent review.
About half the workforce surveyed experienced bullying in the past year.
The trust said the report revealed "unacceptable" behaviour.
In his report, Prof Duncan Lewis from the University of Plymouth said: "Common decency is a right, not a privilege, and harassment or bullying, including sexual harassment must end now."
He pinpointed Coxheath in Kent and Tangmere in West Sussex as areas "plagued by poor practices/behaviours".
In parts of Kent there are "serious questions of sexual harassment and sexual grooming", with newly qualified women often targeted.
The survey revealed good "peer support" between colleagues, with the reasons for bullying firmly located in manager behaviours and often "militaristic" leadership.
Prof Lewis added: "Whilst it is possible sexual harassment might not have been known to the executive because employees are fearful of speaking out against a macho, boys club culture in Kent and in other parts of Secamb, ignorance is no defence."
Key issues raised in focus groups:
- Groups of male managers, whose careers had progressed together, upheld a culture that was stubbornly resistant to change
- An absence of female role models amongst the senior officers
- Employees, some of 30 years experience, had never encountered members of the executive in their day-to-day workplaces
- "Toxicity" leading to a "complaining and reporting" culture instead of colleagues speaking to each other
- A detached culture as staff still assign their loyalty to their county a decade on from Secamb unifying Kent, Surrey and Sussex
- Staff being "punished" for sickness
Employees also frequently spoke of a fear of reporting bullying.
Those who voiced concerns had "suffered" for it, with more monitoring, work, and pressure because "managers default to supporting each other".
The frequently changing leadership at Secamb was also said to be contributing factor.
Chief executive Daren Mochrie, who has been in the post since April 2017, said: "I am truly disappointed and upset that so many of our staff have experienced bullying and disrespectful behaviour in the workplace.
"Secamb is full of extremely dedicated and professional people who are concerned about caring for their patients as well as each other.
"However, I was also aware that the trust is facing a number of challenges and areas where vital improvements need to be made.
"The behaviours it describes are completely unacceptable and will not be tolerated, in any sense and at any level, moving forward."
- More prominent roles for governors and non-executive directors in tackling bullying
- Enhanced training, support and development for managers to tackle harassment and make them more accountable
- Creation of a group drawn from across the workforce to drive change at board level