DRESS CODE AND UNIFORM POLICY (HRP 26)

DRESS CODE AND UNIFORM POLICY (HRP 26) First Issued Issue Version Purpose of Issue/Description of Change Planned Review Date Review June 2012 Named Responsible Officer:- Approved by Date Director of Human Resources and Corporate Affairs INTEGRATED GOVERNANCE COMMITTEE 22.06.09 Policy File: HR Policies Impact Assessment Screening Complete-Date Full Impact Assessment Required- Yes/No No: HRP 26 Key Performance Indicators (to be audited at review): Number and type of uniforms issued on an annual basis to departments within Wirral Community NHS Trust. Number of grievances or complaints from employees in relation to this policy Number of complaints received by patients or service users in relation to this policy Number of employees investigated or issued with disciplinary sanctions in relation to this policy Linked Policies: HRP1 Disciplinary & Code of Conduct ICP10 Personal Protective Equipment (Universal Precautions) ICP5 Hand Decontamination Policy Chairman: Mrs Frances Street Interim Chief Executive: Mr John South

Contents Page Title 1. Introduction 2. Scope 3. Objectives 4. Principles 5. Clinical Staff 5.1 Specific Garments 5.2 Requirements 5.3 Jewellery, Watches and Badges 5.4 Hair 5.5 Nails 5.6 Tattoos 5. Uniform Outside Wirral Community NHS Trust 5.8 Washing of Uniform 5.9 Clinical Staff without Uniform 6. Non Clinical Staff 6.1 Non Clinical Uniformed Staff 6.2 Non Clinical Non Uniformed Staff. Responsibilities.1 Employees.2 Managers and Team Leaders.3 Head of Service.4 HR Department.5 Director of Human Resources and Corporate Affairs.6 Chief Executive 8. Corporate Identity 9. Particular Individual Requirements 10. Consultation with Stakeholders 11. Dissemination 12. Implementation 13. Approval and Ratification 14. Review 15. Document Control and Archiving 16.. References Page 3 3 3 3-4 4 4-5 5 5 5 5 5-6 6 6 6 6- -8 8 8 8 8-9 9 9 9 9 Appendices 1. Appendix 1 Washing Requirements 10 2

1. Introduction Members of staff employed by Wirral Community NHS Trust are required to adhere to a safe, hygienic and appropriate dress code. Wirral Community NHS Trust has a legal duty under the Health Act 2006 Code of Practice for the Prevention and Control of Health Care Associated Infections to prevent and control healthcare associated infections (HCAI) to both patients and staff; ensuring that uniform and work wear worn by staff when carrying out their duties is clean and fit for purpose. The appearance of employees should always be professional at all times within the workplace and dealing with staff, clients, patients and the public, Individuals should therefore ensure that clothes or uniform, personal protective equipment (if provided) and accessories adhere to infection control and health and safety policies and comply with patient and public expectation. 2. Scope This policy applies to all employed Wirral Community NHS Trust staff, whether contracted on a permanent or temporary basis, through an Honorary Contract, Contract for Services, or via an agency. This includes students and those working for Wirral Community NHS Trust on work placements. Local dress codes may be agreed for specific staff groups/services to clarify the sensible applications of Wirral Community NHS Trust s dress code. Such local priorities must be wholly consistent with the principles contained in this policy and the law relating to protective personal equipment. Any local dress code must be agreed by the appropriate Director. 3. Objectives To comply with infection control principles and health & safety legislation To ensure bare below the elbow is followed for personal care and clinical procedures. Compliance with Duty 4h of the Code of Practice for the Prevention and Control Of Health Care Associated Infections (DoH 2006, The Health Act 2006: Code of Practice for the Prevention and Control of Healthcare Associated Infections) To ensure that staff are familiar with the current evidence available on the wearing and laundering of suitable dress or uniform To project a professional image and contribute to the corporate image Wirral Community NHS Trust would wish to present To promote mobility and comfort of the wearer To allow identification for security and communication purposes 4. Principles The dress and uniform code does not permit the following: Very casual or high fashion trousers, i.e. ripped jeans Low waistband trousers showing the abdomen/lower back or allowing underwear to be visible Cropped, strapless, overly tight or revealing tops i.e. that show the abdomen/lower back/cleavage Casual sportswear i.e. track suits 3

Clothing with inappropriate slogans Very short skirts Flip flops or other very casual shoes Excessive jewellery Other items that do not project a professional image The provision of and ordering of uniforms is dealt with on a local basis by each Head of Service and departmental managers. Individuals who leave the employment of Wirral Community NHS Trust or change roles which necessitates a change in uniform must return all uniform issued to their line manager. 5. Clinical Staff 5.1 Specific Garments Different professions and Grades wear different uniforms and these are agreed at a local level. Staff must wear the appropriate uniform designated for their post. Clinical staff uniforms can consist of any of the following: short sleeved dress in agreed uniform colour short sleeved tunic/shirt and trousers in agreed uniform colour tights or socks should also be worn 5.2 Requirements Whether or not a uniform is worn, shoes and clothing for staff having direct patient contact must meet the following requirements: Provide the wearer with mobility and comfort. Be durable enough to withstand decontamination to minimise cross infection Be clean at the start of the shift. All shoes should support the foot, be closed toed and heeled, and be low noise in clinical areas. Have short sleeves or capacity to roll sleeves above the elbow to ensure the principle of bare below the elbow is adhered to in clinical practice. Be designed with a client or patient group in mind, reflecting the type of work to be undertaken and be appropriate for the post. Be protected as appropriate to the degree of potential contamination following Wirral Community NHS Trust s Infection Control Personal Protective Equipment Policy (ICP10) failure to adhere to this policy may result in disciplinary action. Coats, cardigans or jumpers/sweaters should not be worn in clinical areas due to the possibility of cross infection or contamination and to adhere to bare below the elbow principles. If worn during breaks or in between patient visits they should be removed when returning to duty or on arrival at the next patient. Ties (not bow ties) should not be worn in clinical areas as evidence has shown them to be colonised by pathogens. (DOH 200) Pockets (particularly breast pockets) should be used carefully, bearing in mind that objects can fall from them and cause injury or contamination. 4

Project a professional image to encourage public trust and confidence. Contribute to the corporate image the staff and Wirral Community NHS Trust wish to present 5.3 Jewellery, Watches and Badges 5.4 Hair 5.5 Nails Jewellery is restricted to one plain finger/wedding ring; wedding bands with indentations require additional attention as part of staff hand washing procedure to reduce the potential for contamination with micro-organisms. Wrist watches are not allowed and a fob watch may be worn as an alternative as long as it is a positioned to minimise risk to safety of staff and patients. One pair of plain stud earrings (free from stones) may be worn if ears are pierced. Hoop earrings must not be worn due to the risks to health and safety. Any other visible body piercing including tongue studs must be removed or covered when undertaking patient care. An SOS necklace may be worn to indicate the existence of a medical condition i.e. epilepsy, diabetes etc but this should be worn inside the uniform and no other jewellery is permitted. A maximum of two badges (i.e. denoting professional qualifications or affiliations) may be worn, as long as they are positioned on the uniform so that they do not compromise patient or staff safety. Hair should be neat and tidy at all times and where hair falls below the collar should be tied back with a plain band. Fingernails must be kept clean and short. False nails; nail extensions/wraps or nail varnish must not be worn on duty as these have been shown to act as a reservoir for gram-negative bacteria and can reduce compliance with hand hygiene guidelines. Staff who breach these rules may be subject to disciplinary action. 5.6 Tattoos If visible tattoos are deemed to be offensive they should be appropriately covered in order to maintain a professional appearance as an NHS representative. 5. Uniform Outside Wirral Community NHS Trust Where locker room and changing facilities are available staff should travel to and from work in their own clothes. Staff should be encouraged to change out of their uniform promptly at the end of each shift. For areas where changing facilities are not provided the uniform must be covered discreetly for the journey to and from the workplace or between patients. (Wirral Community NHS Trust acknowledges that community staff may not be able to effectively cover their uniforms between patients in hot weather). Uniform must not be worn in any retail or recreational premises whilst not at work. There is no evidence that this is an infection risk locally when staff 5

members follow universal precaution standards but nationally members of the public have expressed concern over staff wearing uniforms in public places (DOH 200). Wirral Community NHS Trust acknowledges that members of staff may need to visit retail premises whilst at work i.e. petrol stations, sandwich shops/supermarkets etc to purchase lunch, however individuals are urged to cover their uniform with a suitable outer garment i.e. coat or cardigan at these times. 5.8 Washing of Uniform Please see Appendix 1. 5.9 Clinical Staff without Uniform For some clinical staff it is not appropriate to wear a uniform in certain circumstances and the professional group in question should agree this. The rationale for clinical staff not wearing a uniform may include: Where the patient/clinician relationship has the potential to be compromised by the wearing of a uniform. Where the non-wearing of a uniform would not create unacceptable risk to safety and/or infection control. Where a uniform is not a requirement of the role it is essential that staff members dress in an appropriate and professional manner. It is left to the discretion of the member of staff and their line manager to agree what constitutes an appropriate dress code, but the principles outlined in Section 4 and 5.2, 5.3, 5.4, 5.5 and 5.6 of this policy must be adhered to. Staff members who do not wear a formal uniform must dress in a manner that avoids provocative and suggestive messages or that may cause offence or embarrassment to patients or others with whom they come into contact. 6. Non Clinical Staff 6.1 Non Clinical Uniformed Staff Non clinical staff may be required to wear uniform and whilst many of the directives that apply to clinical staff will not apply to non clinical staff groups, certain standards must still be maintained. The Principles outlined in Section 4 of this Policy apply to uniformed non clinical staff. Uniforms must be clean and should contribute to the corporate image the staff and Wirral Community NHS Trust wish to present. 6.2 Non Clinical Non Uniformed Staff Where a uniform is not a requirement of the role it is essential that staff members dress in an appropriate and professional manner. It is left to the discretion of the member of staff and their line manager to agree what constitutes an appropriate dress code, but the principles outlined in Section 4 of this Policy apply to this staff group. Staff members must dress in a manner that avoids provocative and suggestive messages and that avoids causing offence or embarrassment to patients or others with whom they come into contact. The way in which staff dress must also be consistent with an appropriate corporate and professional image. 6

. Responsibilities.1 Employees Employees are individually responsible for their general presentation, appearance and personal hygiene and to consider how others may perceive their appearance. All employees are expected to dress in a manner that is likely to inspire public confidence in them as representatives of the NHS. Employees are responsible for following the standards of dress/uniform and appearance contained within this policy and must understand how this policy relates to their working environment, health & safety, infection control, their particular role and duties, and contact with others during the course of their employment..2 Managers and Team Leaders Managers and team leaders are responsible for the dissemination and implementation of this policy within their teams and must ensure that all new members of staff are aware of the required standards of this policy during the local induction process. This applies to all individuals commencing work within Wirral Community NHS Trust, i.e. students, temporary members of staff and agency workers..3 Head of Service Heads of Service are responsible for the dissemination and implementation of this policy within their directorate or service and must ensure that all members of their management team are aware of the required standards of this policy and the impacts of their teams not doing so..4 HR Department The HR department is responsible for providing accurate and timely advice to managers and employees to ensure the policy is appropriately utilised across Wirral Community NHS Trust. The HR department is also responsible for monitoring the key performance indicators detailed on the front cover of this document..5 Director of Human Resources and Corporate Affairs The Director of Human Resources and Corporate Affairs is the named officer responsible for ensuring the content of this policy is applied consistently and fairly across Wirral Community NHS Trust..6 Chief Executive The Chief Executive has overarching responsibility for ensuring the content of this policy is applied consistently and fairly across Wirral Community NHS Trust. 8. Corporate Identity

The Wirral Community NHS Trust issued identification badge must be worn at all times whilst on duty, unless the member of staff is in situations there the badge may be likely to cause injury to patients, staff or visitors. It is suggested that when not on duty or, if on the community, when travelling between patients, that the ID badge is concealed for personal protection. In clinical situations identification badges on lanyards may compromise infection control practice during clinical care. Clips are available from the Training Department instead of lanyards. If worn, neck lanyards must have a quick release safety clip and should be plain navy or black with no text unless NHS, NNUHT or Trade Union approved. 9. Particular Individual Requirements Wirral Community NHS Trust recognises the diversity of cultures, gender, religions and disabilities of its employees and will take a sensitive approach when this affects dress and uniform requirements. Where compliance with any aspect of this policy may cause difficulties to an individual member of staff this should be discussed with the staff member and their line manager and due consideration given to allowing modifications where necessary. However the basic principles set out in section 4 must be adhered to. Special requirements for uniforms as a result of cultural or religious obligations must comply with health & safety and infection control precautions. Headscarves may be worn but these must be changed daily, be unadorned and shoulder length only. The wearing of facial veils or burkhas is not permitted due to infection control and identification issues. The wearing of turbans is allowed on religious grounds but these must be washed and changed daily. Where it is a requirement for staff members to be bare below the elbow (DOH 200) in order to carry out clinical procedures; consultation with Muslim Imams, including those from the Muslim Council of Britain, has confirmed that if the dress code is a requirement of the job to prevent microbiological related infection, it is permitted. However, in exceptional cases, if an employee continues to insist on religious grounds that they cannot conform to this requirement, due consideration should be given to the use of disposable sleeves. Clinical procedures where staff members are required to wear short sleeves, remove white coats or roll sleeves up to the elbow include lifting patients and assessing them where this is at the bedside or in a clinic. 10. Consultation With Stakeholders In order to achieve publication, due consideration has been made to the stakeholder groups (employees via trade union and professional representatives, managers and HR professionals) who will be using or who will be affected by this policy. They have been consulted with and their comments incorporated into the final version. 11. Dissemination 8

The draft policy has been discussed, amended and approved by the HR policy review group, which consists of members of staff side organisations, senior HR representatives and senior managers 12. Implementation It is not anticipated that this policy will create any training or support issues over and above the provisions currently provided by the HR department to key stakeholders within Wirral Community NHS Trust i.e. mandatory attendance of People Management training and ongoing support from designated HR representatives to directorates within Wirral Community NHS Trust. 13. Approval and Ratification Once the members of the HR policy review group are satisfied that this policy meets all the criteria in order to be publicised, it is escalated for consideration by the Integrated Governance Committee. When the policy is approved by IG, it is considered to have been ratified and is then cascaded to managers across Wirral Community NHS Trust for storage in their policy files and published on the Intranet site. 14. Review This policy is subject to periodic review by the HR Policy Review Group which has delegated authority from the Joint Forum. 15. Document Control and Archiving If, following review, it is decided that this policy should be superseded by another and archived; this version will be removed from the Intranet site and replaced, and stored within the shared files in the HR system. Managers will be requested to destroy their copies of the archived document held in their files and to replace it with the updated policy. 16. References Department of Health (200) Uniforms and Work wear, an evidence base for developing local practice Perry, C. Marshall, R. Jones, E. (2001) Bacterial Contamination of Uniforms Journal of Hospital Infection Vol. 48. 238-241 Department of Health (2006) the Health Act 2006: Code of Practice for the Prevention and Control of Healthcare Associated Infections. London. DH Crown Copyright. 9

Appendix 1 Washing of Uniform Individuals who are required to wear a uniform will be provided with sufficient uniforms by Wirral Community NHS Trust in order to adhere to this policy. Wirral Community NHS Trust, within resources available, will purchase quality clothing that meets infection control and health & safety requirements, and reduces replacement costs. Wirral Community NHS Trust does not have facilities for uniform laundering and therefore staff members are required to wash their own uniforms within domestic washing machines. Employees can claim tax relief in respect of laundry costs by writing to the local Inland Revenue office with their national insurance number and details of costs. It should be noted this is also available against the cost of shoes and tights. Uniforms must be washed at the highest recommended temperature for the garment. Never place work wear in an overloaded washing machine; this reduces washing efficiency. It is the dilution and rinsing of the washing process which contributes to the removal of any contaminants. Uniforms should either be tumble dried or ironed following line drying, to remove any residual contaminants. It is essential the process above is adhered to for work wear washed at temperatures below 60 degrees C. A 10 minute wash at 60 degrees C is sufficient to remove most micro organisms; MRSA is removed following a wash at 30 degrees C. (DOH 200). This procedure applies to all items of clothing worn when administering clinical care to a patient. It is recommended that a uniform is changed immediately if visibly soiled due to the possible infection control risk and the likely negative effect of a soiled uniform on patient confidence (DOH 200). In such circumstances Wirral Community NHS Trust recommends staff to change uniforms at the earliest possible opportunity. Clean and dirty uniforms must not be stored or transported together because of the risk of cross-contamination. Staff members working in a contaminated area should stop any further patient contact and change as soon as possible. Work wear grossly contaminated should be laundered separately for other household items. Specific advice can be obtained from the Infection Control Team as to how to decontaminate their uniform. Managers must take into consideration the washing temperatures of uniforms when purchasing new work wear. Uniforms must be suitable for washing at or above 60 degrees C. 10