Female NHS ambulance staff say they have been hounded for sexual favours in return for promotion.

The allegations, which include “highly sexualised gazing” in front of patients and “sexual predators” who “groomed students” for sex, emerged in a report which revealed widespread bullying at South East Coast ambulance service NHS foundation trust (Secamb).

Researchers were told that sexualised behaviour was embedded in parts of the management structure. The independent report was commissioned by Secamb after concerns were raised in the trust’s staff survey and a report was published last year by the NHS regulator, the Care Quality Commission (CQC).

More than 40% of about 2,000 staff who took part in the research said they had experienced bullying in the last 12 months.

The 69-page report, produced by Prof Duncan Lewis from Plymouth University, detailed “overt and covert sexualised behaviour” extending from former senior leaders through to frontline managers and the general workforce. Some of the senior staff interviewed believed those responsible had left the trust, but the report said researchers were told the culture was embedded at management level in some areas of the organisation.

“For example, female staff talked about sexual favours being sought in return for career progression whilst others were hounded by managers seeking sexual favours for personal reasons.

“Several female staff felt that such behaviours were the norm, with some stating ‘my arse was slapped regularly’ and others who felt they were demeaned by highly sexualised gazing in front of colleagues and even patients.

“Some female respondents talked about ‘sexual predators’ among male colleagues who ‘groomed students’ for sexualised ends. Some managers felt there was a history of comments being turned to lewd remarks but slowly these were being addressed.”

Researchers were said to be shocked at the number of staff reporting poor behaviour.

“The researchers were extremely distressed to hear of the experiences of several female Secamb employees,” it said: “The trust may not of course be aware that such a culture exists as employees are often extremely fearful of speaking out against such practices.

“However, as has been shown time after time, ignorance is no defence and too many British institutions have demonstrated failure to take matters seriously when it comes to sexual abuse.”

The report said the trust’s executive must now commission further investigations and take action “as an urgent priority to protect employees who are living in fear daily”.

Secamb, which covers Kent, Surrey, Sussex and north-east Hampshire, was put into special measures last September after the CQC ranked it inadequate.