Dress Code and Uniform Policy / Procedure

Dress Code and Uniform Policy / Procedure Policy/Procedure Reference Number PRS047 Status Ratified Version 7.1 Publication Date June 2017 Implementation Date November 2005 Current/Last Review Dates December 2007, May 2010, October 2012, May 2014, June 2016, December 2016 Next Formal Review December 2019 Sponsor Director of Nursing Sponsor Signature Author Director of Nursing Where available Trust Intranet Target audience All Trust Staff Ratification Record Clinical Governance and Risk Committee Jan 08 Procedural Document Sub Group October 2012 / May 14, Oct 2016. Feb 17 Committee Name Chairperson Date JCC, Infection Control Committee, Nursing & Midwifery Committee. Vikki Leivers-Carruth October 2016 Consultation Date Moving and Handling Co-ordinator Oct 07, May 10, July 2013, May14, Oct 2016 General Managers and Modern Matrons September 2013, May14, October 2016 Joint Staff Consultative Committee August & October 2013, May14, June 2016, Oct 2016. Regulators Requirements Document Control / History Version No Reason for change 1 New Policy 2 Updated in line with DoH guidance 3 Updated in line with DoH guidance 4 Amendment to Appendix 1 5 Updated in response to Senior Nursing Staff request for firmer guidance Form updated March 2015 6 Clarity on BBE in line with hand hygiene policy, use of Kara bracelet 7 New uniform supplier and ordering system. 7.1 Clarification of clinical area definition

Contents Section Page Document Summary 3 1. Introduction 4 2. Purpose 4 3. Definitions 4 4. Duties (Roles and Responsibilities) 5 5. Dress code for staff who do not wear uniform 5 6. Smoking 6 7. Infection control and personal safety issues 6 8. Uniforms 8 9. Outside wear for uniform staff 9 10 Religious considerations 10 11. Uniform supply and ordering 11 12. Equality Impact Assessment 13 13. Monitoring Compliance with this Procedural Document 14 14 Associated Documents/Further Reading 14 15. References 15 Appendices Appendix 1 Religion in relation to staff dress code 15 Dartford and Gravesham NHS Trust Page 2 of 16

Document Summary It remains true that in the absence of previous knowledge, a person forms an impression of an individual in the first ten seconds of meeting them. This impression can be difficult to influence once made and is based entirely on appearance, eye contact & body language; even before a conversation takes place. The appearance of the staff who work for the Trust affects the public perception of the Trust itself, the care they will receive here, the likely attitude of the staff they will meet and the impression they take away, whether patients, or visitors, who might not have experience of our actual services. This policy sets out a dress code for all Dartford & Gravesham NHS Trust staff. What identifies you as a member of staff is the wearing of a Trust uniform or ID badge. For those who work in our environment but are not employed by this Trust (e.g. Students of Nursing and other Health Professions) we have an expectation that their appearance whilst working in the Trust environment or externally with Trust patients, will meet the standards required by this policy. For those staff who wear uniforms, and/or who work in clinical settings, more detailed guidance is set out in this document. The Trust, in writing this policy, is mindful of The Equality Act 2010 and will comply with its provisions. The Trust believes that this policy is a proportionate means to achieve a legitimate organisation. Dartford and Gravesham NHS Trust Page 3 of 16

1. Introduction The way staff dress is an important influence on people s overall perceptions of the standards of care they experience. This Trust expects staff to take pride in their appearance and present a professional image. Professional image can be defined as: The set of qualities & characteristics that represent perception of your competence & character as judged by others (Professor Laura Morgan Roberts, Working Knowledge, 2013). This policy allows for individual needs, specialist areas, cultural and religious obligations and disability. Uniforms are worn to ensure the safety of staff and patients and to reflect the staff s professionalism. Uniforms enable patients to identify staff groups easily, enhancing communication & enabling appropriate choices to be made about whom to approach for help. Uniforms and work wear should be clean, tidy at all times, appropriate for a public professional environment and should not make effective hand hygiene harder to achieve. Where a choice of uniform options exist, e.g. trousers and tunics or dresses, staff should be involved in decisions about their work wear. It is vital that staff are easily identified by members of the public whenever and wherever they are working for the Trust. The wearing of identity badges when at work is mandatory. 2. Purpose The purpose of this policy is to set out the minimum dress requirements for all staff; this document is at aimed at all permanent and temporary staff including students. Breaches of this policy may lead to disciplinary action being taken against the individual and all staff have a responsibility to review this guideline and to adhere to the requirements detailed. Where the Trust works with partner organisations (e.g. Carillion, Oxleas) our expectation on them is that they will ensure their workers at the Trust are dressed appropriately and professionally. This policy is also applicable to contractors (a person or company that arranges to supply materials or workers). 3. Definitions Clinical environment In essence, any area in which care is delivered to a patient of the Trust, is a clinical area. WTE Whole time equivalent Professional in this context, this refers to all staff working for the Trust, not just those who belong to a registerable profession. Dartford and Gravesham NHS Trust Page 4 of 16

4. Duties (Roles and Responsibilities inc. Carillion, Staff and Uniform Room) This policy was developed by the Director of Nursing following discussions with a number of senior staff groups, clinical & non-clinical & consultation with Staff Side, Human Resources, Infection Control and Manual Handling. It is all managers and professional heads responsibility to ensure that their staff are compliant with the policy. The policy requires Ward Sisters/Charge Nurses/Senior Midwives and Heads of Departments and Services to carry out observational audits (visual and verbal) on a weekly basis to ensure staff comply with the appearance code which applies to their area of service. Non-adherence should be dealt with immediately by advising the staff member of the required standard. Findings of audits should be reported by the relevant lead to the appropriate forum within their service (See Section 13). This includes consultant medical and surgical staff. Ward sisters have ultimate authority on their own ward, and can request other clinical staff to change their dress or comply with the policy if they feel it necessary on the ward. They will advise the relevant professional head, if staff do not comply with this policy. Matrons, Departmental Heads and Supervisors are responsible for ensuring standards of dress and uniform across the hospital, with authority from the Director of Nursing. Staff must also take individual responsibility to ensure compliance. 5. Dress Code for Staff who do not Wear Uniform Many staff do not wear uniform. This includes clinical & non clinical staff; for example doctors, midwives & nurses working in the community, psychologists, Speech & Language Therapists, Dieticians, Pharmacists & laboratory staff, as well as administrative & other staff. Staff should always dress appropriate to the tasks they expect to carry out on that day. Where staffs work in an area not in direct contact with the public, they should still consider the possibility that a member of the public may find their way into their area and should dress accordingly. Clothing should be clean, tidy and professional in appearance. Dress should enhance the dignity of the wearer and respect those they come into contact with (i.e. respectful of cultural and social beliefs of patients, visitors and colleagues). In keeping with the controls within the clinical environment, the Trust has decided that standardisation is important for both clinical and non-clinical staff. This means that the following will apply: Nail varnish (including colourless and nail strengthener) or nail decorations are not permitted and nails should be kept short. Particular attention should be paid to them when washing hands (most microorganisms on the hands come from beneath the nails). False nails, veneers, acrylic coatings, extensions or any other artificial materials are not permitted as these are sources of fungal and bacterial infection. This means that, when at work the following are not acceptable, The wearing of shorts Skirts more than 2 inches above the knee T-shirts with logos and messages & vest tops Low necked tops or dresses (female) Shirts open more than two buttons (male) Tops which do not meet the item being worn on the lower half of the body Dartford and Gravesham NHS Trust Page 5 of 16

Leggings, Jeggings, Treggings, Trousers designed to cling to the body Jeans or other denim clothing The wearing of any item which obscures facial expression and therefore hinders communication with colleagues and members of the public. Shoes should be suitable and sensible for the job that the person is undertaking, taking into consideration Health & Safety at Work. All staff working in clinical areas should follow the rules in paragraph 8 below. 6. Smoking The Trust has a No Smoking Policy which extends to all areas of the building and grounds which are under its control. The smoking shelter outside the Main Entrance is intended for the use of patients and visitors only. Staff should not be visible to the public, in uniform, or when displaying an ID Badge, whilst smoking. The health promotion message this gives is not a good one. 7. Infection Prevention & Control and Personal Safety Issues Bare Below the Elbows / Hand Hygiene Policy The Trust is committed to the reduction of healthcare associated infections and has adopted the bare below the elbow rule as part of this ambition. Bare Below the Elbows A good hand hygiene technique covering all surfaces of the hands at the right time is more important than the agent used or the length of time taken to perform it. The practice of hand hygiene is repeated several times in the course of duty in a clinical environment. This practical dress code is designed to make repeated wrist and hand hygiene effective and easy to practice. When entering the clinical environment, such as a ward or outpatient consulting room, ALL healthcare staff, e.g. Ward Clerks, A & C Receptionist, Nurses, Pharmacists, Physiotherapists and Doctors should ensure that their hands can be effectively decontaminated and must follow the rule of Bare Below the Elbow :- Short sleeves or sleeves rolled up above the elbow. No wrist watches or wrist jewellery i.e. bracelets, charity bands. The wearing of rings with ridges or stones is not permitted. (Total bacterial counts on the hands are higher when rings are worn). Whilst we as a Trust promote bare below the elbows for all staff in the clinical areas we are aware that members of staff wish to wear a Kara to show their devotion to their faith. We support a single plain metal Kara, that can be cleaned along with normal handwashing (similar to a wedding band). Any oversized Kara should be moved above the elbow particularly during any invasive procedures. A plain wedding ring is permissible, but this must be able to be moved in order for hand decontamination under the ring to be carried out. Nail varnish (including colourless and nail strengthener) or nail decorations are not permitted and nails should be kept short when entering clinical areas, and particular attention should be paid to them when washing hands (most micro-organisms on the hands come from beneath the nails). False nails, veneers, acrylic coatings, extensions or any other artificial materials are not permitted when in clinical areas as these are sources of fungal and bacterial infection. Dartford and Gravesham NHS Trust Page 6 of 16

Housekeeping, Portering and Maintenance staff, do need to comply since they come into contact with patients and / or their environment. Make Up, Hair and Nails All clinical staff, whether or not in uniform For infection control and health and safety reasons, the following standards apply to all staff, in or out of uniform, who work in clinical areas: Short Hair must be worn in a style that is neat in appearance. The colour should be natural in appearance. Long hair (which would touch the shoulders when hanging loose) should be tied back removing it from the face and collar. This applies equally to both men and women. Hair adornments (clips, ties, bands) should be essential to achieving the stated standards for hair, small, discreet in nature and securely attached. Facial hair should be neat, tidy and trimmed. Make up if worn should be discrete. Nails should be trimmed short and kept clean (for staff working with patients). Nail polish should not be worn; this includes Gel or Shellac coatings. False (acrylic or attached with glue) nails/nail jewellery should not be worn by staff who undertake clinical duties or may be called upon to do so. Neck ties if worn should be tucked into the shirt when examining patients in clinical areas. Badges The Trust name badge/security badge must be worn at all times when at work, so it is visible to patients and colleagues. Lanyards or loosely hanging name badges should be removed or tucked away during direct patient contact. In clinical areas where patients may find reading the Trust security/name badge difficult, a magnetic Trust name badge may be worn to aid communication. The wearing of lanyards is discouraged for staff working in clinical areas. Other badges should be worn in moderation. One professional badge is acceptable, provided it cannot cause harm to wearer or patients. Jewellery, Piercings, Tattoos For infection control reasons, personal safety and in the interests of professional appearance, the only permissible jewellery to be worn in patient care areas (any area of the Trust, including external to the buildings, where care is delivered by Trust staff is: One simple wedding band (no stones that any infective material can collect under). One pair small stud type earrings, plain metal (no nose piercings permitted). Medic alert bracelets and necklaces may be worn by staff; however necklaces may still be a risk from confused, aggressive patients or children & should be tucked away inside clothing when in patient contact. Bracelets must be loose enough to be able to be pushed up the arm and secured in place for hand washing and direct patient activity. The following are therefore not acceptable: Necklaces (other than medic alert necklaces mentioned above) should not be worn (they may be pulled or damaged by confused or aggressive patients or children) Tongue, nasal, lip and other such visible piercings must not be worn Wrist watches must not be worn within the clinical environment by any member of clinical staff. Bracelets, bangles etc., must not be worn, either on wrists or ankles. Where, for religious reasons, members of staff may wish to wear a bracelet/bangle when not engaged in patient care, they must ensure that bracelet/bangle can be pushed up the arm and secured in place for hand washing and direct patient care activity. Dartford and Gravesham NHS Trust Page 7 of 16

Whilst we as a Trust promote bare below the elbows for all staff in the clinical areas we are aware that members of staff wish to wear a Kara to show their devotion to their faith. We support a single plain metal Kara, that can be cleaned along with normal handwashing (similar to a wedding band). Any oversized Kara should be moved above the elbow particularly during any invasive procedures. Visible tattoos can be seen as unprofessional by many patients and offensive by some. Staff in clinical practice are therefore discouraged from acquiring new visible tattoos while in Trust employment. Tattoos that contain nudity, swear words or symbols associated with extreme views must be covered regardless of the area of work. Ties Research has shown that the wearing of ties, other than bow ties in the clinical setting constitutes an Infection Prevent and Control Risk. The Trust therefore has applied a no ties principle for those in clinical practice. It is recognised that for some staff, the wearing of a tie is essential to them feeling that they are presenting a professional appearance; therefore the following is expected of all staff wearing ties. Ties should be worn with collared shirts Long ties, should be tucked into the shirt when delivering care. Ties should be changed frequently Ties should receive regular cleaning If not wearing a tie, a collared shirt remains the standard. Bow ties may be worn with collared shirts as an alternative to the above. 8. Uniform Standardised, unvarying, the same, identical Many people have a desire to express their personality through their appearance. This is perfectly acceptable in general life. When working for an organisation where a uniform is worn, the overriding principle (cultural and religious exceptions apply) is that all staff should appear the same within their uniform group. Within the Trust, uniforms vary considerably by professional group. In the case of Pharmacists & Laboratory staff, pharmacists uniforms are white tunics with amethyst trim, available for male and female staff. Laboratory coats are for Laboratory staff only. All staffing groups should have the same uniforms with no exceptions. Uniforms issued to staff shall remain the property of the Trust and must be returned at the termination of employment. Failure to do so may result in delay in payment of monies due as final salary. Members of staff should not wear their uniform for any activity except work undertaken for the Trust. Uniforms are designed to give a corporate look and should not be personalised. When working bank shifts, staff should wear uniform appropriate to the setting. When washing uniforms, staff should follow the directions on the label of the garment or follow the instructions of the washing detergent being used. When uniforms are handed out, a washing guide is supplied and all uniforms should be washed at the appropriate temperature accordance to the guidance. This is especially important for healthcare uniforms for infection prevention purposes. Dartford and Gravesham NHS Trust Page 8 of 16

Uniforms should also be washed separately from other clothes. All uniforms should be washed in the appropriate detergent to help prevent colour fading. If you do not have a washing guide please ask for one. If replacement uniforms are required because of lack of care when washing you may be required to pay for any replacements. Where uniforms have been in contact with bodily fluids, they can be laundered through the Trust laundry contract provided they are clearly labelled with the staff name and venue for delivery. 9. Outside Wear for Staff in Uniform Uniform over-garments such as overcoats, fleeces etc., will only be provided by the Trust in exceptional circumstances. These need to have managerial discretion and this applies only for uniformed staff who deliver care in the community (e.g. Surgical Navigator Team, Community Midwives, Occupational Therapist and Hospital at Home team). Uniforms should not be worn outdoors inappropriately (e.g. in public places, shops and supermarkets). Staffs are encouraged to change into and out of uniform at work if facilities exist within their area. If this is not possible, staff should wear an appropriate length coat / jacket / fleece which covers the uniform when travelling between home and work. This applies whether travelling by personal or public transport. Theatre Blues Scrubs Staff whose uniform is theatre blues ( scrubs ) may not wear them in the staff or visitors restaurants, the shops or main reception area. They must never be worn when travelling to or from the hospital. Ideally theatre blues should not be worn in non-clinical areas e.g. Philip Farrant Education Centre. Theatre shoes and hats must not be worn outside theatres. This applies to all staff who wear theatre blues, not just theatre staff. The wearing of theatre shoes outside the area of work is specifically not to be undertaken whether from theatres, SCBU or other location. Exceptions can be made if responding to a clinical emergency; however the staff member must then always change again when returning to theatre. Scrubs should not be worn unless working in a designated Theatre environment or specially defined areas e.g. cardiac catheter suite. This includes all nursing and medical staff. Uniform Colours Grade/Banding Nursing staff should wear the colour uniforms that is equivalent to their grade/banding. Specialist nurses again wear the colour equivalent to their grade/banding but with an amethyst trim. Allied professions will wear the colour that is equivalent to their profession: Occupational Therapy- white tunics with green trim Physiotherapy-white tunics with navy trim Radiology- white tunics burgundy trim Dental nurses- white tunics with pale blue trim Podiatrists- white tunics with black trim Allied Professional HCA s plain white tunics (no coloured trim, trousers should be the same colour worn by their specialty). Dartford and Gravesham NHS Trust Page 9 of 16

Cardigans Cardigans (or fleeces for staff who work primarily outside the building) may be worn in public areas and offices, over indoor uniforms, providing they are of Trust issue (Community only) or plain, and of smart design. Cardigans may not be worn over uniform in wards and departments, whilst carrying out direct patient care or clinical activities. This rule applies at any time of the day or night. If cardigans are worn in these areas when not in direct patient care they should still comply with the bare below the elbows rule. Fleeces or other outside clothing, may not be worn over uniforms in wards and departments whether in direct patient care or not, at any time of the day or night. This should also include Admin and Clerical Staff. Footwear and tights For female staff in uniform dresses, plain black/ natural or nude coloured stockings or tights are to be worn at all times, except during hot weather, when at the discretion of the nurse in charge / departmental manager a decision may be made that tights / stockings do not need to be worn to aid staff comfort. For all staff wearing uniform trousers, socks must be worn under shoes and should be plain black. The removal of socks in hot weather is at the discretion of the nurse in charge or departmental manager. All footwear worn on duty with uniform must be: Black, leather or of leather appearance, without colour, patterns, buckles, flowers, bows or other adornments Theatre clogs no longer need to be antistatic or white, however they need to be of washable material and of a style that is health and safety suitable (worn by persons who wear scrubs as their uniform within their clinical environment). Trainers are not appropriate and black shoes should be worn in public areas. Soft soled Have closed in toes and heels. Flat heels no more than an inch and a half. Training shoes that look like shoes will not be permitted. Theatre clogs are provided in areas only where operative clinical procedures are performed or where there is requirement to wash footwear in sterile conditions. Except in an emergency, theatre clogs should not be worn outside of the theatre complex. Croc style shoes are not acceptable footwear when in uniform. They are leisure footwear and do not present the professional appearance we are striving for. Steel toe capped shoes/boots will be provided where a health & safety risk assessment has recommended these. It is recognised that there are clear directives described above about the appropriate shoes to be worn. This list is not totally exhaustive and there may be times when individuals may still interpret appropriate footwear in different ways. With this in mind, the line manager is able to apply discretion on determining whether a shoe is suitable or not in line with the requirements of professional appearance. Belts A decision has been taken that belts will no longer form a part of the standard uniform. Dartford and Gravesham NHS Trust Page 10 of 16

10. Religious Considerations Please see Appendix 1 for advice and guidance. 11. Uniform Supply and Ordering Introduction This section outlines uniform entitlement, arrangements for issuing uniform, guidelines for obtaining replacement uniforms and the return of uniform on grade change or cessation of employment. Sizing/ordering and collection of uniforms Ordering of uniforms: ALL staff will be required to try on a uniform, or if appropriate, be measured for a uniform before it is ordered. Forms for ordering are available on Adagio. All staff should ensure that the form is completed in clear handwriting to avoid any delays in uniform being ordered. If there is a recycled uniform in the appropriate size and job role, staff will be issued this stock before any new uniform is ordered. Once a size has been determined, staff will be given a form from the Uniform Room with contact details and instructions for new starters. All forms must be signed by the appropriate General Managers, Managers or Matrons. Fitting or measured for uniforms are possible without a signed form however there is a requirement for an appropriate authorisation signature as soon as possible. NB. Your uniform will not be ordered without the appropriate signature. Location and times for fittings or for collection of uniform: Darent Valley Hospital Uniform Room (Near the Carillion Offices): Opening times: (except bank holidays) Mondays, Tuesdays and Thursdays- 7am 3pm No appointment is required to try on a uniform or for collection during these times. If staff are unable to make these times please contact the Carillion Uniform Room via e-mail: DVHelpdesk@Carillionplc.com (only in exceptional circumstances) and they will try and accommodate you within office hours. Queen Mary s Hospital Procurement Office Please make an appointment Mondays Friday - 7.45 am 9 am then 1.30 pm 2.30 pm (except Bank Holidays) Please e-mail: dgn-tr.procurementteam@nhs.net to make an appointment, other times may be arranged by appointment. N.B. Please ensure that you have put your preferred site for collection of uniforms on the form. Collection of uniforms: When uniform is delivered, staff will be contacted on two separate occasions to advise that there uniform is ready for collection. Uniform not collected within 4 weeks will be put back into stock to be re-issued unless advised otherwise. Staff will be contacted via e-mail in the first instant (please include Email address on the form). If this is not possible the a contact phone number with answer phone is required as a back-up contact. Ward/department contact phone numbers are not always appropriate as messages do not always get relayed. Staff may nominate someone to collect uniform on their behalf and the nominated colleague will be required to sign for this. Any missing uniforms will be the responsibility of the named staff member and any lost uniform may requirement payment. Dartford and Gravesham NHS Trust Page 11 of 16

Eligibility/Conditions All staff who works in clinical areas will be eligible for a uniform. In addition, administrative and clerical staffs that are in regular contact with patients and the public will also be eligible. Number of Uniforms for ALL staff All staff are able to have one full set of uniform per day/shift they work per week. Nursing and support staff will be able to choose a combination of dresses and tunic/trousers or polo shirts where approved. Some nursing uniforms are also available in lightweight material, (please refer to the uniform colour guide and lead times). N.B. Cargo style trousers are no longer allowed for nursing and allied professional staff. Only uniform issue trousers should be worn. Administration and clerical staff Female staff have a choice of 3 different styles of blouses, 2 styles of skirts (one style in different lengths) and trousers. Male staff will have navy short sleeve shirts and navy trousers (no ties required). Administration and clerical staff working in a clinical environment must also be bare below the elbows for infection prevention purposes. Recycling Uniforms In order to save costs, it is Trust policy to recycle uniform which is less than 3 years old but is deemed to be in good condition. New staff may be issued with second hand uniforms in good condition. This will be laundered beforehand. Type/Description of Uniform Uniform will be provided according to the contract specification (see poster displayed in the Uniform Room, Level 2, DVH) and throughout the Trust. Uniforms which fall outside the contract specification will not be ordered by the Uniform Room and must not be worn. All uniform will be marked with a Dartford & Gravesham NHS Trust logo. No additional embroidery with Department names etc. will be ordered. All staff should wear a name badge with the department they work in and there job role. Authorisation for Uniform Please refer to uniform supply and ordering. Uniforms for new starters On appointment, Human Resources will provide the new employee with a letter of authorisation. The new employee will visit the Uniform Room to be fitted/measured. Please refer to - Supply and Ordering of uniform for opening times and guidance etc. Once fitted for uniform, this WILL NOT be ordered until a start date has been issued from the Trust. It is the new member of staff s responsibility to contact the uniform room via e-mail DVHelpdesk@carillionplc.com to advise them of their start date so that uniform may then be ordered. An information sheet will be given to the new staff member with clear instruction on the process for ordering your uniform. When the new uniform is received the Uniform room will contact the staff member- please refer to Supply and Ordering of Uniforms. Replacement uniform (wear & tear/damaged/size change uniform) Uniform may be replaced after three years if its condition becomes worn. The Trust also recognise that staff may require intermittently require replacement uniform for size changes. The Uniform room will keep records on the age of all uniforms in the Trust. Staff are responsible for requesting new uniforms after three years/size changes if the uniform is worn/not fitting. The Uniform Room will check the uniform and if it is still in good condition Dartford and Gravesham NHS Trust Page 12 of 16

will inform the manager to check if a uniform is still to be ordered. If the issue is wear & tear, request early to allow time for new uniform. If uniform is damaged during the three year period, replacement may be ordered. If it is damaged a second time then staff may be required to pay for this but it will remain the property of the Trust. This must be authorised in the usual way. For Security reasons old uniform must be returned in exchange for new uniform. Replacement Uniform (change of post/grade) Where staff are promoted or change position in the Trust, they will be entitled to new uniform commensurate with their new post. Authorisation for new uniform under these circumstances will be on completion of an authorisation form (on Adagio). Again for security reasons, staff are required to return old uniform in exchange for their new uniform. If the new uniform is unsuitable for any reason, it must be returned to the Uniform room unworn and unwashed within one week. Maternity Uniform Staff requiring maternity uniform should present an authorised form to the Uniform room as soon as possible to obtain maternity uniform. Maternity uniform will be provided according to grade as long as sufficient notice is given (6 weeks). Maternity uniform must be returned to the Uniform room at the time the staff member goes on leave - please refer to the return of your uniform as below. Return of uniform (cessation of employment) Staff are responsible for returning uniform to the Uniform room on their last working day. Staff will ensure that they give their name and receive a receipt for this- otherwise charges may be incurred. This should also include any damaged uniform. If a member of staff leaves and the Uniform Room is not open i.e. over a weekend etc. the uniform should be returned to the senior manager on duty at the time and they should give the staff member a receipt (available on Adagio) they need to ensure that the uniform will be returned to the Uniform Room with the member of staffs name so that the records can be up dated accordingly, failure to do this could result in staff being chased for the return of this and potentially being charge. This will also include Maternity Uniforms. 12. Equality Impact Assessment The Trust aims to design and implement services, policies and measures that meet the diverse needs of our service, population and workforce, ensuring that none are placed at a disadvantage over others. In order to meet these requirements, a single equality impact assessment is used to assess all its policies/guidelines and practices. This policy was found to be compliant with this philosophy. Dartford and Gravesham NHS Trust Page 13 of 16

13. Monitoring Compliance with this Procedural document All managers and professional heads (including consultant medical and surgical staff) within the Trust are responsible for ensuring compliance with this policy and are responsible for taking reasonable appropriate action when the policy is breached. What will be monitored Dress code Infection Control How/Method Frequency Lead Reporting to Deficiencies / gaps recommendations and actions Observational audit Board Reports Weekly Monthly Ward sisters/ charge nurses/ Department al managers/h eads of service Infection Control Department Ward Matrix/minuted departmental meetings Discuss with staff member escalate if necessary. Reports reviewed and presented to the appropriate departmental meeting. Trust Board Reports reviewed and presented to the appropriate departmental meetings. Audit data can on request be provided to outside agencies such as the PCT, SHA and DoH. Implementation of any required change Required actions to be implemented by Ward sisters/charge nurses/managers within a specific time frame Actions to be implemented by Ward sisters/charge nurses 14. Associated Documents/Further Reading This Policy should be read in accordance with the following Trust document. Infection Control Manual 2009 15. References Uniforms and work wear: Guidance on uniform and work wear policies for NHS employers 2010 Department of Health. Uniforms and work wear: An evidence base for developing local policy. 2007, Department of Health. Dartford and Gravesham NHS Trust Page 14 of 16

Appendix 1 Religion in relation to staff dress code Hindi staff See advice regarding bracelets above (infection control section). Christian staff See advice under Section 7 regarding badges and necklaces. If staff members in clinical areas wish to wear a Christian cross, a small and discreet lapel badge may be worn, or a necklace (the necklace should be kept under the uniform for the reasons described in the main policy). Advice from Muslim Spiritual Care Provision in the NHS (MSCP) Exposure of the forearms is not acceptable to some staff because of their Islamic faith. In response to this and other concerns, the MSCP convened a group including Islamic scholars, chaplains and multi-faith representatives as well as Department of health policymakers and experts in infection prevention. Based on these discussions, the MSCP prepared the below list of recommendations, which this Trust has chosen to adopt, to ensure that this dress code policy is sensitive to the obligations of Muslims and other faith groups whilst maintaining standards of hygiene. Uniforms may include provision for full length sleeves that can be full length when staff are not engaged in direct patient care, or have three quarter length sleeves. Any full or three-quarter length sleeves must not be loose or dangling. They must be able to be rolled or pulled back and kept securely in place during hand-washing and direct patient care. Disposable over-sleeves, elasticated at the elbow and wrist, may be used but must be put on and discarded in exactly the same was as disposable gloves ( a small amount of over-sleeves are stocked by infection control and should be reordered on Integra). Strict procedures for washing hands and wrists must still be observed. The wearing of full or partial face veil (sometimes known as a 'Niqab') is not acceptable when in face to face clinical contact with patients, i.e. on wards and other clinical areas including outpatient clinics. Wearing a face veil is not religious but cultural. This can detract from open communication with patients. (For more information see advice from the Health Education England). Use of hand disinfection gels containing synthetic alcohol does not fall within the Muslim prohibition against natural alcohol. The hand gel used within this Trust contains synthetic alcohol and therefore is suitable for use. Other religious or belief systems The information in this appendix is not exhaustive and we acknowledge that there may well be other considerations on religion and belief. If such a situation arises, please discuss the issue with your line manager in the first instance. Cited: Uniforms and work wear: Guidance on uniform and work wear policies for NHS employers 2010 Department of Health. Dartford and Gravesham NHS Trust Page 15 of 16

Equality Impact Assessment Tool for this Policy To be completed and attached to any procedural document when submitted to the appropriate committee for consideration and approval Policy Name: Dress Code and Uniform Policy Name of Assessors: 1. Does the policy/guidance affect one group less or more favourably than another on the basis of: Race Yes/No/P ossible No Comments (Positive/Negative) Religion or belief Possible The Trust have chosen to adopt a dress code policy which is sensitive to the obligation of Muslims and other faith groups whilst maintaining other standard of hygiene. Disability learning disabilities, physical disability, sensory impairment and mental health problems Gender No Sexual Orientation No Age No Marriage / Civil Partnership No Pregnancy No 2. Is there any evidence that some groups are affected differently? No 3. If you have identified potential No discrimination, are any exceptions valid, legal and/or justifiable? 4. Is the impact of the policy/guidance No likely to be negative? 5. If so can the impact be avoided? No 6. What alternatives are there to achieving No the policy/guidance without the impact? 7. Can we reduce the impact by taking different action? No If you have identified a potential discriminatory impact of this procedural document, please refer it to the PPI Manager, together with any suggestions as to the action required to avoid/reduce this impact. Dartford and Gravesham NHS Trust Page 16 of 16