An NHS trust has become the first in the UK to be forced to tackle its "high levels" of sexual harassment.
Care Quality Commission (CQC) inspectors said the East of England Ambulance Service Trust (EEAST) had not done enough to ensure staff and patients were protected from abuse.
The trust has had to sign a legally binding agreement with the Equality and Human Rights Commission (EHRC).
EEAST said staff and patient safety was its "top priority".
The EHRC said "no-one should feel unsafe or threatened at work".
A CQC inspection in June 2020 found "continued high levels of bullying, harassment and discrimination and the organisation had failed to take adequate action to reduce this".
Inspectors said they had received information from seven whistleblowers related to "safeguarding patients and staff from sexual abuse, inappropriate behaviours and harassment".
Thirteen cases of sexual misconduct by staff had been reported to police, the health watchdog said.
The CQC approached the EHRC to consider taking enforcement action in August 2020 in accordance with the Equalities Act.
The commission said the trust had not demonstrated measures to ensure the risk had been addressed across the organisation and for staff working on their own.
'A strategic and important case'
EHRC acting chief executive Alastair Pringle told the BBC it was the first time it had had to enter into a legal agreement with an NHS trust.
"We only ever get involved in cases which we think are egregious breaches of the Equality Act," he said.
"We think this is a strategic and important case."
If the trust is found to be breach of the agreement it could be subject to a court order to comply, Mr Pringle said.
The agreement lays down specific measures, including:
- • Carrying out a staff survey to assess levels of sexual harassment within the trust
- • Implementing training which responds to the findings of the survey
- • Reviewing its Dignity at Work policy to include a clear harassment strategy statement and procedure
- • Having board and senior managers take part in a workshop on sexual and predatory behaviour
- • Completing risk assessments to identify areas in the trust where sexual harassment is most likely to occur and putting appropriate measures in place
Dr Tom Davis, interim chief executive and medical director at EEAST, said: "The safety of our staff and patients is our top priority and our agreement with the Equality and Human Rights Commission reinforces this commitment.
"The trust has acted quickly to address concerns and progress with the action plan and this has been recognised by the EHRC.
"This is a complex issue and we will continue to do everything possible at every level to further improve the protection of our staff."
In February, former EEAST paramedic Andrew Wheeler was jailed for 21 years for raping a patient in her own home and sexually assaulting another in the back of an ambulance.
Police said his decision to pursue a career in the ambulance service had been "influenced by the access... to potentially vulnerable" people.