Uniform and Dress Code Policy Approved By: Policy and Guideline Committee Date Approved: 17 th September 2010 Trust Reference: B30/2010 Version: Supersedes: Author / Originator(s): Name of Responsible Committee/Individual: V2 A number of individual policies listed in section 1.4 of this policy Deb Baker, Service Equality Manager Claire Agnew, Senior Nurse Clinical Practice Development Executive Team Review Date: September 2013
Contents Section Page 1. Introduction 3 2. Equality and Diversity 3 3. Policy Aims and Scope 3 4. Roles and Responsibilities 4 5. Policy Principles 5 6. Uniform and Dress Code Standards for ALL Staff who have Regular Patient Contact 5 7. Uniform Specific Standards 5 8. Corporate Uniform A Recognised Identity 6 9. Uniform Laundering 7 10. White Coats 7 11. Theatre Clothing 7 12. Non Uniformed Staff Corporate Standards (for staff who have little or no patient contact) 7 13. New Staff 8 14. Termination of Contract 8 15. Process for Monitoring Compliance 8 16. Development, Consultation and Dissemination Process 9 17. Document Control, Archiving and Review of the Policy 9 18. References and Associated Polices 9 Appendix One: UHL Uniform Descriptions and Issue Levels 10 Uniform and Dress Code Policy - Trust Ref: B30/2010 Page 2 of 12
1 Introduction 1.1 University Hospitals of Leicester NHS Trust (UHL), Leicester Partnership Trust (LPT), Leicester County and Rutland PCT (LCRPCT) and Leicester City PCT (LCPCT) (hereafter referred to as the Trusts ) worked in partnership to ensure a consistent approach to standards of uniform and dress that underpins both infection prevention and control policies and increases public confidence. The policy has been produced jointly but will be amended by each Trust to suit their specific requirements. 1.2 This policy has been formulated in the context of: Infection Prevention and Control policies and guidelines and bare below the elbow Health and Safety requirements Good equality practice 1.3 The possibility of transmitting infections via staff uniform / dress is an important issue for employers, staff and patients. Staff have a responsibility to minimise the potential to spread healthcare associated infections. Staff also have a responsibility for their own health and safety at work and that of their colleagues and patients. 1.4 This policy is an amalgamation of the several uniform and dress code policies which currently exist within the Trusts. This Policy replaces the following: Nursing and Midwifery Uniform Policy UHL (INsite Document no 17153) Local Uniform Policy Physiotherapy UHL (INsite Document no 20850) Imaging Services Uniform Policy UHL (INsite Document No 25059) Uniform Policy Occupational Therapy UHL (INsite Document No 39726) Staff Dress Code 2007 UHL (INsite Document No 37200) Infection Control Guidelines for the management of Uniforms and work clothing for staff working in Community Hospitals or Primary Care (LCR- CH/PC109) 2 Equality and Diversity Careful consideration has been given to the religious needs of staff. Every attempt has been made to accommodate these, however, there are some areas where the need to fully comply with infection control guidance has overridden religious requirements. The Equality Team however are aware of this and are endeavouring to find appropriate solutions through the Impact Assessment process. The policy has been subjected to an Equality Impact Assessment. 3 Policy Aims and Scope 3.1 This policy aims to standardise uniform and dress code practices across the Trust. 3.2 This policy applies to all clinical and non-clinical staff (including temporary staff, bank, agency and students) employed within the Trusts. The policy excludes Volunteers in UHL, please refer to Volunteer Services for further information. 3.3 Some members of staff may require a more individual approach to their work wear, for example pregnant women or staff who have a physical disability. These needs must be discussed and agreed with their line manager. Any variation from the policy Uniform and Dress Code Policy - Trust Ref: B30/2010 Page 3 of 12
however should be addressed through a documented risk assessment. This is to be carried out by a line manager, supported by relevant expertise e.g. Occupational Health, Infection Control and Health and Safety, and a decision made based on the assessment which is agreed at Director level in the organisation. 4 Roles and Responsibilities 4.1 It is the responsibility of all staff to ensure they wear the appropriate uniform or dress at work. 4.2 It is hoped that it will not be necessary to remind people of the appropriateness of the correct dress behaviour. However, it is the responsibility of line managers to ensure that the principles and standards set down in this policy are adhered to by all of their staff. 4.3 All staff must wear the correct hospital identification at all times for security reasons and expect to be challenged if their ID is not visible. 4.4 Managers have the right to request that staff dress appropriately for work and are in turn, required to apply standards consistently. 4.5 The locality / Divisional / Clinical Business Unit Infection Prevention Group will monitor adherence to this policy and report any problems identified to the Divisional Director, Head of Service, Divisional or Clinical Business Unit Manager and Head of Nursing / Lead Nurse or equivalent. 4.6 Staff who disagree with the imposition of a dress restriction will have access to the UHL Staff Complaints, Grievance and Disputes (Differences) Procedure (INsite Document No 13903) or other Trusts local procedures to seek a resolution to this which is consistent with Trust policies and good employment practice 5 Policy Principles All staff are required to appear presentable and smart in the workplace and must be: Safe Protected Professional Corporate Responsible Uniforms and clothing worn are practical, comfortable and meet Health and Safety Manual Handling Operations Regulations (ref. Manual 1992, Working Well Initiative, RCN 1999). Clinical staff uniforms and clothing meet Infection Control recommendations and bare below the elbow (BBE). The aim being to reduce the risk of cross infection and avoid staff contaminating clothes. Laboratory staff have specific PPE requirements. Ensuring that the individual promotes a clean, smart professional appearance, building public trust, confidence and promoting a positive image for the Trust First Impressions Count as stated in the Caring at its Best standards and UHL Values. Promoting a corporate image for uniformed and non uniformed staff that encourages co-operation and a willingness to work together, to achieve goals. It is the responsibility of every member of staff to ensure where applicable that their uniform is worn correctly, the dress for non uniformed staff is of a professional standard and that the image and behaviour presented to the public is of the highest professional standard at all times. Repeated failure to adhere to the standards of this policy will result in disciplinary action. Uniform and Dress Code Policy - Trust Ref: B30/2010 Page 4 of 12
6 Uniform and Dress Code Standards for ALL Staff who have Regular Patient Contact It is acknowledged that not all staff who have regular contact with patients wear a uniform, however there are a set of standards that apply to all staff irrespective of whether they wear a uniform or not. Staff groups that wear uniforms and their descriptions are detailed in Appendix 1. 6.1 All uniformed, clinical staff or those who have regular patient contact will be bare below the elbow in accordance with the Hand Hygiene Policy referenced in section 18. Jewellery must not be worn, with the exception of plain wedding bands and the Kara. (see 6.2) 6.2 Jewellery that is permitted is: 6.2.1 One pair of plain stud earrings 6.2.2 One plain nose stud 6.2.3 Plain wedding band 6.2.4 Metal Kara 6.3 Ties, scarves, and ID badges on neck chords must be tucked away and not allowed to fall onto patients or equipment during patient care/contact. 6.4 Wristwatches and the Rakhi must not be worn when undertaking clinical practice, as bacteria can live on watchstraps and fabric threads. Fob watches have been designed to negate this problem. 6.5 The Kirpan may be worn but must be out of sight and pose no risk to patients. 6.6 Excessive facial piercing is not acceptable, as in some cases it is a risk to both the patient and the staff member. Eyebrow studs and tongue studs must not be worn and any member of staff or student member found to be wearing such will be asked to remove them. 6.7 Extreme hair styling and colouring, ie green, blue, purple etc is unacceptable and staff arriving for duty, sporting such colours will be asked to wear a theatre cap. 6.8 Hair must look tidy and if longer than shoulder length must be tied up 6.9 Nail polish must not be worn, and nails should be kept at a reasonable length, to prevent injury to patients and infection. Nail extensions/false nails are not permitted 6.10 Tattoos must not contain offensive language or crude imagery. 6.11 Beards and moustaches must be clean and neatly trimmed or tied. 6.12 Staff are expected to maintain an acceptable level of personal hygiene. 6.13 Clothing worn needs to be mechanically laundered preferably at 60 degrees centigrade (or at the maximum temperature for the garment). Uniform and Dress Code Policy - Trust Ref: B30/2010 Page 5 of 12
7 Uniform Specific Standards 7.1 Before dressing for duty, the member of staff s hands should be washed before putting on the uniform. 7.2 Uniform sleeves must be short (to comply with bare below the elbow). Detachable sleeves are available for religious reasons. Long Sleeves must be rolled up and remain rolled up when working clinically to enable full compliance with the Hand Hygiene Policy. (INsite Document No 23813). This excludes Laboratory staff who have specific PPE requirements. 7.3 Cardigans may be worn, but not in the clinical area during any care activity that involves patient contact. The cardigan must be black, navy or match the colour of the tunic top. 7.4 Where uniforms are worn outside the hospital, this must be to and from work only and full-length coats must be worn, In the case of tunic and trousers jackets may be worn but it must cover the length of the tunic. 7.5 In clinical areas staff must wear navy or black shoes, (white for fracture clinic only). Maximum 1 heel with rubber/crepe soles, for noise prevention and non-slip reasons. Trainers must not be worn (with the exception of AHPs). Crocs are not permitted. For Health and Safety reasons, shoes should have a closed heel and toe. 7.6 Dark socks should be worn with tunic top and trousers. 7.7 Hosiery should either be black, navy or match your own flesh tone. During the summer months when experiencing extremely hot temperatures, uniform dresses may be worn without tights. 7.8 Female members of staff who for religious reasons need to cover their hair and neck by the wearing of a dark coloured scarf are permitted to do so. The material must be able to withstand a 60 degree mechanical wash. 7.9 The veil is not permitted as part of the uniform. 7.10 Sikh members of staff are permitted to wear turbans. 7.11 Uniforms must not restrict movement at the shoulders, hips and waist. Incorrectly fitting uniforms must be replaced. 8 Corporate Uniform A Recognised Identity 8.1 Staff will have the choice of uniform dresses, tunic tops and trousers or a mixture of both. The colour schemes apply to both male and female staff. 8.2 Shorts are not permitted (with the exception of AHPs). 8.3 Pregnant staff will wear the existing uniform modified with maternity trousers. 8.4 A bespoke uniform may be supplied on religious grounds (currently unavailable). 8.5 The Trusts uniform descriptions and minimum levels of issue can be found in Appendix One. 8.6 Contracted staff such as catering, domestic and porters must wear the uniform as dictated by their contractors Uniform and Dress Code Policy - Trust Ref: B30/2010 Page 6 of 12
9 Uniform Laundering 9.1 Uniforms should be changed daily. 9.2 Where Autovalet on site laundry is available to staff staff should make use of this option as thermal disinfection can be achieved. 9.3 If laundered at home, uniforms should be laundered at the highest temperature the fabric allows and at a minimum of 60 degrees, dried quickly, or tumble-dried and ironed with a hot iron. 9.4 If a uniform is heavily contaminated it must be removed as soon as possible. 10 White Coats 10.1 White doctors coats must not be worn when having clinical contact as they: Have long sleeves which are difficult to roll up Are not a substitute for plastic aprons when required Are not changed/laundered as frequently as own clothing 11 Theatre Clothing Theatre greens / blues are identified as uniforms rather than protective clothing. In light of this they can be worn outside of the theatre environment without presenting an infection risk to patients. However it is imperative that all staff wearing theatre greens/blues adhere to the following guidance: 11.1 Greens/blues must be changed if contaminated with body fluids and on finishing the shift/period of duty. 11.2 All hair must be covered by a clean lint free hat or hood. 11.3 Theatre greens/blues must not be worn outside of the hospital building. Changing facilities are provided by the Trust and should be used to change into personal clothing. 11.4 All protective clothing must be removed after use in the operating theatre and not worn outside the operating theatre, ie gloves, hats, masks. 11.5 Theatre shoes must not be worn outside the theatres to prevent contamination being brought back into theatre. 12 Non Uniformed Staff Corporate Standards (for staff who have little or no patient contact) 12.1 Dress must be smart, professional and appropriate in appearance at all times. 12.2 All staff are required to appear presentable and smart in the workplace; and non uniform clothing should be fit for purpose; some specific examples of what is inappropriate are: Uniform and Dress Code Policy - Trust Ref: B30/2010 Page 7 of 12
T-shirts with offensive slogans Revealing clothing Extreme facial piercing Cropped tops showing midriff Leggings, jeans, jogging trousers, casual shorts, vests, denim, combat trousers 12.3 It is reasonable to expect any member of staff to wear sensible footwear for generic risks commensurate with their work activities. Where it is foreseeable that there may be floor contamination or external factors, ie weather conditions, it is reasonable for managers to introduce local footwear requirements. Risk assessments should stipulate the type of footwear that must or must not be worn by all staff in the interests of preventing slips, trips and falls. This does not place a requirement on managers to provide footwear. The provision of footwear by the employer is only a requirement where safety footwear is necessary as personal protective equipment. 12.4 Staff are expected to maintain an acceptable level of personal hygiene. 12.5 Managers have the right to request that staff dress appropriately for work, and are in turn, required to apply standards consistently. 12.6 The member of staff involved must recognise the potential risks of wearing their own clothes, e.g. not meeting moving and handling regulations and the potential risk of contamination of clothing. 12.7 UHL does not require Clerical staff to wear a uniform for work unless there are Health and Safety and/or Infection Control risks identified by not doing so. However, if the Divisional management team or staff themselves wish a uniform to be worn within their own department, a full discussion should take place between the team and agreement reached before a decision is taken. The responsibility for the purchase of the uniform lies with the Division. 13 New Staff The Uniform and Dress Code Policy will be distributed to new staff during their induction programme. 14 Termination of Contract Employees leaving the service of the Trusts must return the uniforms issued or they may incur the cost of the uniforms. 15 Process for Monitoring Compliance 15.1 The uniform policy is designed to ensure both patient and staff safety. 15.2 Regular audit of adherence to the policy and infection control monitoring of patients and staff complaints will be a performance measure adopted across the Trusts. Uniform and Dress Code Policy - Trust Ref: B30/2010 Page 8 of 12
15.3 In order to maintain standards within the Trusts it will be essential to take a serious view of anybody who consistently deviates from this policy. Any member of staff must be prepared to be challenged at any time. 15.4 Line Managers, Matrons and Surveillance Nurses will monitor and address compliance with this policy across their span of control. In addition compliance will be monitored via the nurse metrics monthly audits. 16 Development, Consultation and Dissemination Process 16.1 This policy has been developed and consulted in partnership with all Clinical and Corporate Divisions and Directorates and staff side. 16.2 This policy will be disseminated via the Clinical and Corporate Divisions and Directorate senior management teams. 17 Document Control, Archiving and Review of the Policy 17.1 This policy will be stored and archived electronically through the Trusts SharePoint system. 17.2 This policy will be reviewed every three years or sooner in response to possible patient or staff safety issues. 18 References and Associated Policies Ayliffe, G.A.J., Lowbury, E.J.L., Geddes, A.M. & Williams, J.D. (2000) Control of Hospital Infection: A Practical Handbook Chapman & Hall. Department of Health (2007) Uniforms and Workwear: an evidence base for developing local policy, September 2007, http://www.dh.gov.uk/publications Department of Health (2010) Uniforms and workwear: Guidance on uniform and workwear policies for NHS employers, March 2010, http://www.dh.gov.uk/publications National Audit Office, Reducing Healthcare Associated Infections In England, (June 2009, HC560). NHS East Midlands (2007) Infection Prevention and Control Uniform and press Guidance The Institute of Environmental Health (1996) Basic Food Hygiene Teaching Package. The Royal Marsden Hospital (2004) 6 th Edition Manual of Clinical Nursing Procedures, Blackwell Scientific. UHL Hand Hygiene Policy (INsite Document No 23813). UHL Personal Protective Equipment Policy (INsite Document No 12536) UHL Staff Complaints, Grievance and Disputes (Differences) Procedure (INsite Document No 13903) Ward, D. (2007) Hand Adornment, British Journal of Nursing,Vol16, Number 11. Wilson, J. (1995) Infection Control in Practice Balliére Tindall. www.rcn.org.uk/mrsa link to RCN uniform standard recommendations July 2005 Uniform and Dress Code Policy - Trust Ref: B30/2010 Page 9 of 12
University Hospitals of Leicester NHS Trust Uniform Descriptions and Issue Levels Appendix One The following uniform descriptions must be worn by the listed staff when engaging in clinical practice/patient contact. 1. Nursing and Midwifery Staff: Heads of Nursing / Lead Nurses and above Matron Specialist Nurses Ward / Department Sister / Charge Nurse Deputy Sister/Charge Nurse Registered Nurse / Midwife Healthcare Assistant Dental Nurses, NNEBs Student Nurse / Midwife Housekeepers Navy blue tunic top / dress with purple trim with navy trousers Navy blue tunic top / dress with red trim with navy trousers Royal blue tunic top / dress with white trim with navy trousers (must be worn unless agreed with Head of Nursing). Navy blue tunic top / dress with white trim with navy trousers Pale blue tunic top / dress with navy trim (navy epaulettes for males) with navy trousers Pale blue tunic top / dress with white trim with navy trousers Grey tunic top / dress with white trim with navy trousers White tunic top / dress with yellow trim with navy trousers as per De Montfort University policy Grey Stripe dress / tunic top with navy trousers (available from GH Sewing Room) Consultant Nurses, Education and Practice Development Nurses, Research Nurses and other registered nurses not normally part of the Ward / Department team but participate in direct patient care for clinical practice experience or part of their job role must wear a royal blue uniform with white trim (so as not to be confused with the Ward Sister / Charge Nurse or deputy). Nursing and Midwifery Uniform Optional Extras: A belt and buckle may be worn with a dress but must be removed when undertaking moving and handling to ensure that there is no restrictions to movement. Arm cuffs may be worn by Deputy Sisters, Ward / Department Sisters, Matrons, Lead Nurses, Heads of Nursing and above Ward Clerks may also be required to wear a uniform, the description of which is currently being agreed upon. 2. Occupational Therapy Staff: Occupational Therapist Occupational Therapy Support Worker Female: White tunic top with bottle green trim and bottle green trousers Male: White tunic top or polo shirt with bottle green trim and bottle green trousers Female: Aqua tunic top with bottle green trim and bottle green trousers Male: Aqua tunic or polo shirt with bottle green trim and bottle green trousers Uniform and Dress Code Policy - Trust Ref: B30/2010 Page 10 of 12
3. Physiotherapy Staff: Physiotherapist Physiotherapy Support Worker Female: Navy Trousers, White tunic top with navy trim or White polo top with navy collar and trim Male: Navy trousers with white polo or tunic top with navy trim Navy trousers, pale blue tunic with navy trim or pale blue polo with navy trim 4. Imaging Staff: Radiographers RDAs Assistant Practitioners Trainee Assistant Practitioners Student Radiographers White tunic top/dress with royal blue trim and navy trousers Female - White tunic top/dress with grey stripe trim and navy trousers Male White tunic top with grey trim and navy trousers White tunic top/dress with burgundy trim and navy trousers Grey and white striped tunic top/dress with burgundy trim and navy trousers White tunic top/dress and navy trousers 5. Facilities Staff Leicester General Hospital Portering White tunic top/dress with navy trousers Domestic Female lilac tunic top/dress with black trousers Male navy polo shirt with black trousers Maintenance Royal or Navy Blue safety shoes, safety trousers, polo shirts, sweatshirts, overalls Glenfield Hospital Security Porters Linen/Post Room Waste Building Department Black trousers, black top with logo, stab proof vests and slash proof gloves Pale blue polo shirt or shirt with logo and navy trousers Pale blue shirt/blouse or polo shirt with logo and navy trousers Navy or black polo shirt, navy trousers Overalls, tee shirts, high visibility jackets, protective aprons/gloves, safety shoes 6. Pharmacy Staff Pharmacists/Technicians and assistants (Bands 1-5) Receptionist (wearing of uniform is optional) Storekeepers Female black trousers/skirt, white tunic top with green trim and pharmacy logo Male black trousers with white tunic with pharmacy logo Navy trousers and navy stand collar tunic Safety shoes and black trousers with white tunic with Uniform and Dress Code Policy - Trust Ref: B30/2010 Page 11 of 12
Distributors pharmacy logo or black polo shirt Female dark green skirt/trousers with pale green short shirt Male dark green trousers with pale green short shirt 7. Minimum Levels of uniform Issue 7.1 Uniform Quota: Full time staff 5 dresses or tunic tops / 3 trousers Part time staff 2 dresses or tunic tops / 1 trousers 1 day per week staff 1 dress or tunic / 1 trousers 7.2 Requirements over and above minimum levels must be discussed at individual Divisional level and should consider the number of shifts worked per week rather than the number of hours. 7.3 Managers must agree the replacement of uniforms and budget for uniform issue for all new recruits Uniform and Dress Code Policy - Trust Ref: B30/2010 Page 12 of 12