Hundreds of doctors have been accused of bullying and sexually harassing colleagues in the past five years, prompting concern that a culture of intimidation is thriving in the NHS.

Data shows that reports of bullying and harassment in England rose from 420 in 2013-14 to 585 in 2017-18. The figures, obtained by the Guardian using a freedom of information request, showed that only a fraction of these cases led to dismissal or disciplinary action.

Leading doctors were troubled by the findings. Speaking anonymously, one surgeon from London said he had experienced racism in his job. He said bullying was endemic in some hospitals.

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Experts put the rise down to a number of factors. “Underpinning the environment in which bullying can fester are chronic staff shortages and systemic pressures, which factor into the pressurised workplaces our members tell us about,” said Kim Sunley, national officer for the Royal College of Nursing.

She added: “With 41,000 nursing vacancies in England alone, a solution to bullying in the health service goes hand in hand with solving the workforce crisis.”

Dr Anthea Mowat, British Medical Association representative body chair, said: “This is further evidence of the scale of bullying taking place in the NHS and it is essential that solutions are put in place immediately to eradicate unacceptable behaviour.”

She said the findings were very worrying, and that the problem was confined not just to doctors but affected all staff in the NHS. “Ultimately, this impacts the safety and wellbeing of patients, as staff who are either directly experiencing bullying, or are working in a toxic environment, will be unable to deliver the level of professional care they are capable of doing,” she said.

Mowat described current formal complaint numbers as “just the tip of the iceberg”.

One London-based surgeon, speaking on condition of anonymity, spoke about his personal experiences of bullying. “There have been times when I have been operating and racist comments were used – this was when I was more junior, and it happens less now I am more senior,” he said.

“There is a general culture where tools are used within the NHS to promote a bullying culture. The main way this is used is in patient safety as an umbrella to cover it all. A classic example is the understaffing issues everywhere. That is often used to bully junior staff into covering shifts in an unsafe manner.

“In my specialty, there have been instances where people worked an entire day and two minutes before they were due to leave they were asked to cover the night shift, and in that situation there is little way to say no. That puts pressure on people because they don’t want to disappoint patients and their department.

“The latter has got worse over the last three to four years. I am not sure if bullying is endemic as an NHS thing, but it is in certain hospitals. There are certain trusts in London where investigations have taken place and it’s been remarked that there is a culture of bullying. There are certain hospitals where it is more common. Racism, for example, is more indirect, but still a problem.”

Separate research conducted by the BMA found that one in five doctors had been bullied at work. The report, based on survey responses from 7,887 doctors of all grades in the UK, showed that two in five (39%) believed there was a problem with bullying, harassment or undermining in their workplace.

“The BMA recognises that there is a need to address the fear around doctors speaking up, particularly when it may be about other doctors they work with and employers need to cultivate transparency and openness,” Mowat said.

The Guardian’s own findings revealed that the hospital trust with the most complaints – of the 70 who responded – was the Royal Free hospital in London. It had 160 complaints about bullying across a five-year period, with 51 complaints last year alone. A Royal Free London spokesperson said bullying was not tolerated and that they were working to support all 10,000 staff in speaking out, which has resulted in more reporting.

Two trusts also resorted to using non-disclosure agreements, a contract through which the parties agree not to disclose information covered by the agreement, to resolve a number of bullying and harassment cases.

Six NDAs – also called “gagging clauses” – were also handed out by the University Hospital Southampton NHS trust and the University Hospitals of Derby and Burton NHS foundation trust.

University Hospital Southampton said non-disclosure agreements were used in relation to details around any settlement reached but they did not prevent individuals from raising any concerns or issues of public interest.

Dr Neil Pease, executive director of workforce and organisational development at University Hospitals of Derby and Burton NHS Foundation Trust, said: “There are times when both the trust and a member of staff may want to keep details relating to sensitive employment matters private.”

Figures also showed that only a fraction of incidents recorded resulted in people being dismissed. For example, in the Royal Free, of the 160 complaints, only a sixth resulted in dismissal (at least 26 people). At Leeds and York partnership trust there were 34 complaints and only four dismissals across the whole five-year period.

Dr Sara Munro, chief executive of Leeds and York partnership trust, said bullying and harassment was taken extremely seriously. She added that they aimed to resolve any issue or conflict in the most “positive way possible and formal disciplinary procedures and dismissal will always be a last resort”.

Ralph Fevre, professor of social research at the Cardiff School of Social Sciences, said that the “dreadful situation” of many NHS employees was “compounded by the anger of patients [and their relatives] who are getting the kind of service we might expect from an organisation at breaking point”.

He added: “The policies and procedures NHS trusts have on paper are often exemplary but, as the latest figures show, they are mostly window dressing. Take the example of zero tolerance of violence against NHS staff. Our research showed how many NHS staff [like social care staff] treat the risk of violence and injury as a part of their job. It is in fact, a risk to which they may have rather more exposure than police officers.”