Uniform and appearance at work and dress code policy

Contents

1 Introduction

This policy sets out the uniform and appearance at work or dress code principles for Rotherham, Doncaster and South Humber NHS Foundation Trust. This policy is to protect the safety of patients and employees by ensuring the uniform and appearance at work or dress code for employees complies with infection, prevention and control (IPC) requirements, health and safety legislation and to ensure that all employees present as clean and smart.

The policy acknowledges personal and cultural diversity where this does not compromise the safety of patients or employees or does not damage the professional standing of the individual or the organisation. Employees are advised that any proposed deviation from this policy because of cultural, religious and physical considerations., should be agreed in consultation with the employee’s line manager, IPC, the human resources department and health and safety wherever possible.

Repeated failure to adhere to the policy may result in disciplinary action being taken in accordance with the trust’s disciplinary policy.

The use of personal protective equipment (PPE) is dealt with under the trusts personal protective equipment (PPE) policy and the infection prevention and control manual.

The policy describes standards for all employees as well as specific standards for employees directly involved in the delivery of care. As well as the general standards, there are additional, more stringent requirements for employees providing direct care, who may be required to wear uniform, dependant on the activity being undertaken. In order to comply with this policy, all direct care employees must have enough (for example, sufficient for daily changes) sets of uniform to facilitate good practice in the areas of IPC and health and safety.

1.1 Glossary of terms

For the purpose of this policy the following definitions apply:

Definitions

Term	Definition
Patient	This term is used when referring to the NHS population as a whole, also for the purpose of this policy it is used to mean, service user, resident, client etc.
Non-direct care	this term refers to employees that do not provide direct patient care, but may refer to employees who have access to or work with patient equipment or who are in the patient environment
Direct care	This term refers to employees in both clinical and non-clinical settings who give direct hands-on patient care for example, assisting with personal hygiene, giving injections or having face to face engagement with the patient
Infection prevention and control	Is a practical evidence-based approach to reduce the risk to patients and health workers from being harmed by avoidable infection

2 Purpose

The purpose of the uniform and dress code at work policy is to ensure that all employees are clear on the standard of appearance or dress expected whilst working, whether in uniform or non-uniform. The policy details the standards and image which the trust wishes to convey to all patients or carers, partners and members of the public. This policy outlines the legislation relating to dress codes and uniforms within the workplace and will be implemented to ensure that safe practice and a positive corporate identity is adhered to.

In all cases, the following principles should be supported and promoted, in order to adhere to the recognised legal framework:

• health, safety and well-being of patients (see definitions 5.1)
• health, safety and well-being of employees
• infection prevention and control
• public confidence
• professional accountability, as defined by professional bodies or councils

The objectives of this policy are:

• to ensure employees wear clothing in line with the principles of this policy
• to ensure that IPC and health and safety issues are addressed

3 Scope

This policy applies to employees that are directly employed by the organisation and for whom the trust has legal responsibility for. For those staff covered by a letter of authority, honorary contract, a volunteer or apprentice agreement or work experience, this policy is also applicable whilst undertaking duties on behalf of the trust or working on the trust premises and forms part of their arrangements with the trust.  As part of good employment practice, agency workers are also required to abide by the organisation’s policies and procedures, as appropriate, to ensure their health, safety and welfare whilst undertaking work for the trust.

4 Responsibilities, accountabilities and duties

4.1 Chief executive

The chief executive has overall responsibility and accountability for the health, safety and welfare of the workforce. Through delegated responsibility to the director of people and organisational development the chief executive will ensure there is a system in place for establishing and maintaining this policy and for meeting all statutory requirements and adhering to guidance issued in respect of the procedural document.

4.2 Directors

All directors have a responsibility to ensure that the policy is consistently applied across their directorate or care groups.

4.3 Managers

Managers must ensure that the uniform and appearance at work or dress code policy and procedure is implemented within their area of responsibility and that employees in their area are aware of the policy and any other departmental guidance relevant to their area.

Managers must also ensure that:

• a safe and healthy working environment is maintained where dress code, appearance or uniform is appropriate to the duties being undertaken, including the use of PPE or health and safety equipment
• any concerns raised by an employee where they believe that their personal requirements or circumstances are not being met in relation to this policy are addressed, thereby avoiding any discriminatory practices. The manager should meet with the employee, where relevant, supported by a member of the Human Resources team, to discuss their personal requirements. The employee should be offered the right to a companion at the meeting. The definition of a companion is contained in the disciplinary policy. Any deviation from the policy, where possible should be agreed with the employees line manager, IPCT, the Human Resources team and health and safety.
• employees are aware of this policy and local requirements and have access to the correct uniform for their area of work from their start date and throughout their employment
• an initial full set of uniforms is ordered, dependant on job role, hours worked etc
• replacement uniforms are provided as required and in agreement with the line manager and the employee
• immediate action is taken where an employee does not comply with the dress code, appearance or uniform requirements set out in this policy

4.4 Employees

It is an employee’s responsibility to:

• adhere to the standards of dress and personal appearance appropriate to their staff group and job role at all times
• co-operate with the trust in meeting their legal responsibilities in relation to the Health and Safety at Work Act 1974
• ensure PPE or clothing for their safety is worn, stored, used, decontaminated, maintained and serviced as appropriate and in accordance with the manufacturer’s recommendations (the Personal Protective Equipment at Work Regulations, 1992 and 2002)
• inform their manager in a timely manner should their uniforms need replacing
• ensure that their uniforms are clean and presentable at the time their duties are undertaken
• inform their manager of any discretionary reason which may mean they need adjustments to be accommodated under this policy
• comply with this and any other associated policies and procedures
• check with their manager if unsure how this policy may apply or not apply

4.5 Human resources

The human resources department will provide guidance to managers and employees on the policy and procedure.

Human resources will also offer support and advice to both managers and employees who wish to discuss a deviation from the policy due to cultural or religious or medical or personal reasons.

4.6 Sewing room

This section is only applicable to section 5.1.5, uniforms.

Uniforms should be supplied in quantities sufficient to ensure compliance with this policy and to allow for a clean (washed) full set of uniform to be worn each day.

Maternity wear will be loaned for the duration of the pregnancy and the quantity will be dependent on the working pattern of the employee. Following the maternity leave, the maternity wear should be returned to the sewing room.

For new employees, their uniforms will be issued in accordance with the principles outlined above within four weeks of the uniform request being received.

Replacement uniforms will normally be issued within four weeks of receipt of the appropriately authorised documentation.

5 Procedure or implementation

5.1 All staff general principles

5.1.1 Personal hygiene

All employees should maintain a high level of personal hygiene.

5.1.2 Identification badges

All employees must wear or have immediately available their trust identification badges (ID) at all times in all areas of the trust for security and identity purposes. These should be sticker free. Employees can wear their ID and one other appropriate badge. Whilst not on duty, when away from trust premises, taking a lunch break, or at the end of the day, the ID badge should be covered or removed for personal safety reasons.

ID badges must only be worn when undertaking work on behalf of the trust and must not be used by employees who undertake any private work or volunteering outside of the trust.

Employees can either wear safety lanyards or a clip-on badge, as appropriate to the area of work.

Employees who are out in the community with patients should ensure that they have their ID badge with them in the event they are required to formally identify themselves.

5.1.3 Compensation for damage to personal clothing

Employees are required to adopt a common-sense approach with regard to the clothing, jewellery, glasses etc. that they wear to work in terms of expense. Employees must ensure that articles are appropriate to the type of work that they carry out and must also be mindful of any potential for damage to or loss of personal property, which may arise as a result of carrying out their duties.

The trust discourages employees from coming to work in overly expensive or “designer” items and where employees choose to do so and subsequently make a claim for damage to or loss of such items the organisation reserves the right to impose an upper limit of the amount of compensation it will reimburse.

All claims for compensation for damage to or loss of personal clothing will be reviewed by the director of finance and performance and will be considered in line with this policy. Employees will therefore only be compensated for damage to personal clothing or property that was worn in line with the requirements of this policy.

All incidents where personal clothing or property is damaged or lost whilst at work must be reported on an Incident reporting form (IR1). Wherever possible, if a request for reimbursement is to be made this must be clearly documented on the incident reporting form and receipt(s) for the damaged items attached, where available.

5.1.4 Non-uniform staff dress at work

RDaSH is a multi-professional, multi-disciplinary multi-cultural health care provider. Certain services of the trust employ staff who are not required to wear a uniform. All staff groups who are non-uniform wearers must dress in a manner which is presentable and smart in appearance to inspire patient and public confidence.

Employees who wear their own clothes must ensure they are suitable for work purposes; are clean and in a good state of repair at all times and can be laundered appropriately. The following must not be worn:

• clothes that are revealing and may cause embarrassment or offence, (for example, above mid-thigh length; tops that are low cut, backless; show the midriff or underwear or transparent clothing)
• clothes portraying large advertisements; sports clothing; etc. (unless participating in sport related therapeutic activities with patients)
• clothing that could be interpreted as intimidating or threatening, (for example, combat fatigues)
• ripped or torn clothing
• denim clothing

Clothing which poses a health and safety risk due to the length of the garment, for example, maxi dresses

Appropriate footwear should be worn for the environment. Dependent on the service area or corporate area managers can apply discretion in relation to the above points but they would need to ensure equity across their service or corporate area.

Dependent on the job role clothing which covers the face may not be permitted. For example, employees who are in contact with patients, carers or visitors, or where clear face to face communication is essential. In these circumstances, employees in these areas who wish to wear a veil for religious reasons can do so when they are not in contact with patients, visitors or carers.

Where an employee or applicant requests a change to their uniform the manager will adhere to the guidance detailed in section 4.3, managers responsibilities.

When working remotely and taking part in video meetings (for example via Microsoft Teams or Zoom), employees appearance should be in line with the standards of this policy, particularly when attending formal meetings.

Appropriate clothing should be worn during relevant training for example, moving and handling training which allows the learner to move comfortably whilst preserving dignity.  A full flat shoe or training shoe is also required. Employees may be refused a training place and asked to rebook if not dressed appropriately.

5.1.5 Uniforms

All employees who are ‘uniformed’ are required to wear the uniform provided and agreed by the trust, this includes some form of PPE. Most localities in the trust do not have facilities for uniform laundering. Therefore, employees are required to wash their own uniform as detailed in appendix B.

• Employees who are required to wear a uniform will be provided with an adequate number of uniforms by the trust to ensure that they can wear a clean uniform every day. The uniform should not be altered in any way and employees are required to wear the uniform provided. The trust will, within resources available, purchase quality clothing that meets IPC and health and safety requirements and reduces replacement costs.
• Employees are required to ensure all uniforms are clean, ironed and presentable and employees should have access to a spare uniform in case of accidental contamination by bodily fluids or any other noxious or toxic substance.
• Employees must presume some degree of contamination following a shift, even if uniform or clothing is not visibly soiled. Employees wherever possible should change out of their uniform promptly at the end of each shift ideally before leaving the premises (for further clarity refer to section 5.6).
• Trust uniforms should not be altered in any way without permission from an appropriate manager.

5.1.6 Additional requirements for employees working in clinical areas

All employees must apply the ‘bare below the elbow’ principles when providing direct care to patients or when in the patient environment and long-sleeved garments (for example, cardigans) must be removed. Where long sleeved garments cannot be removed (for example, blouses and shirts), it must be possible for the sleeves to be rolled up above the elbow, and for the sleeves to remain up independently throughout the duration of the procedure or time spent in the patient environment. Longer sleeves must not be loose or dangling.

Employees should ideally change into non-uniform clothing before leaving work. Where there are no changing facilities the uniform, wherever possible must be covered discreetly for the journey to and from work, between patients or on an allocated break when the employee is off site (the trust acknowledges that community staff may not be able to effectively cover their uniforms whilst travelling between patients in hot weather).

Employees mustn’t smoke whilst in uniform, irrespective of whether they are on duty, or on trust premises, when the uniform is identifiable as a healthcare worker’s uniform. This principal equally applies to staff wearing an identity badge;

Uniforms must not be worn in any retail or recreational premises while not at work.

Clothing should allow sufficient hip and shoulder movement for the safe moving and handling requirements of the job.

Stockings, tights and socks (blue, black or neutral etc.) should not detract from the overall appearance of the uniform.

Employees must not wear neck ties during any care activity which involves direct patient contact. This includes all clinical settings, such as wards or community settings, outpatient clinics and ward rounds. Ties may pose a strangling or ligature risk, in addition to being an IPC hazard.

Washable cardigans may be worn but not when in care or clinical areas or patient areas and or attending to patients.

Clean and dirty or contaminated uniforms must not be stored or transported together because of the risk of cross-contamination.

Where a headscarf or a veil is worn, as part of religious observance employees must ensure that the flow of the garment does not interfere with work practice. This must be changed and subsequently washed on a daily basis to reduce the risk of cross infection.

Similarly, any employee who has a need for special consideration to be given to their appropriate clothing due to religious observance or having a disability should bring this to the attention of their line manager, seeking support and guidance from occupational health, IPCT and human resources as necessary

Pens or any other sharp instrument should not be carried in outside breast pockets as this may cause injury when moving patients. Such items should be carried in hip pockets or inside breast pockets, and should be removed whilst carrying out clinical duties.

5.1.7 Hair

Hair must be clean, well-groomed and off the collar (for clinical uniformed staff). Keeping hair off the collar reduces the incidence of bacterial growth around the collar area. Uniformed staff must have their hair tied back if longer than shoulder length. Where hair clips are worn, they must be plain and not have the potential to injure employees or patients, and must comply with health and safety and IPC standards.

5.1.8 Jewellery

Care or clinical staff may wear a plain ring with no stones and one small pair of plain stud earrings. No wrist watches, necklaces, bracelets, anklets, or fitness bands are to be worn and these must be removed at the start of the working day or shift when providing patient care or in the patient environment. Ear stretching ‘plugs’ will count as one pair of plain earrings.

Employees must ensure that their permitted jewellery is discreet and appropriate and in clinical areas, follow the bare below the elbows principle, so that it does not pose a risk to themselves or others.

Any piercings or jewellery which may cause an IPC or health and safety hazard must therefore be covered or removed; this also includes dermal piercing jewellery, which is not permitted to be worn below the elbow.

Employees who are required to wear jewellery for religious reasons for example, a Kara (steel bangle) may do so provided that it is pushed up the arm and secured in place prior to all direct patient care activity to enable effective hand hygiene. Alternatively, disposable over sleeves may be worn for single episodes of care. Strict adherence to washing hands and wrists must be observed before and after use of these. If medic alert jewellery needs to be worn, this should be worn off the wrist by securing it to the high or mid forearm area or attached to the uniform.

Employees whose religion requires them to wear a religious symbol may do so provided that they are discrete and comply with IPC and health and safety policies.

5.1.9 Body art

Where these are deemed to be offensive they should be appropriately and discreetly covered. The trust will deem tattoos offensive if they include pictures of naked bodies; pornographic material; depictions of violence; symbols relating to extremist groups; foul language or swear words; and any content of a discriminatory nature for example, incites racist or religious hatred, or homophobic behaviour. New tattoos must be covered with a waterproof dressing until they are healed. While working in an area where bare below the elbows is required the covering of the tattoo must not contravene this principle.

Henna body art is permitted provided effective hand hygiene is undertaken.

5.1.10 Footwear

Shoes must be suitable for the work task and in keeping with any requirement of PPE. For clinical staff they must be made of a material that can be cleaned in the event of body fluid contamination and must have closed toes and closed heels.

5.1.11 Belts and buckles

Nurse belt and buckles may be worn by staff wearing dresses but should be removed prior to manual handling of patients and cleaned regularly as per the instructions.

5.1.12 Changes to uniform in extreme weather conditions

There may be circumstances where the wearing of all, or part of, the uniform may cause difficulties to employees, for example in extremely hot or cold weather. Changes may be allowed at local level following discussion between employees and managers and ensuring that no IPC or health and safety requirements are breached

5.1.13 Failure to comply with this policy

Where there are instances of employees failing to comply with the policy, managers will remind the employee of the contents of the policy and the expectation that they will comply with it. If an employee having failed to comply with the policy on a previous occasion fails to do so on a second occasion, then they may be sent home from that particular shift and not receive pay for the period of time that they did not work due to the failure to follow policy. Disciplinary action may also be considered and in cases of repeated failure to abide by the policy may result in an individual’s dismissal from employment with the trust.

5.1.14 Right to redress

Should any individual object to expectations either set out in this policy or in any supplementary guidance issued at departmental level, this should be addressed in accordance with the trust grievance and dispute policy.

6 Training implications

6.1 Managers

• How often should this be undertaken: On revision of the policy or new appointments or promotions.
• Delivery method: Daily communication or agreed communication channels.
• Training delivered by whom: Line manager.

6.2 Human resources

• How often should this be undertaken: On appointment or revision of the policy.
• Delivery method: On the job training mentoring.
• Training delivered by whom: HR team managers or head of HR.

6.3 Staff side

• How often should this be undertaken: On revision of the policy and at policy forum.
• Delivery method: Daily communication or agreed communication channels.
• Training delivered by whom: Line manager.

7 Monitoring arrangements

7.1 Number of HR processes in relation to the policy

• How: Review of HR processes which link to policy.
• Who by: Employee Relations team.
• Reported to: Trust governance structure.
• Frequency: Annually.

7.2 Number of grievances in relation to the policy

• How: Review of grievances.
• Who by: Employee Relations team.
• Reported to: Trust governance structure.
• Frequency: Annually. 

11.2.1 Uniform descriptions

• Band 2, light blue uniform, white piping.
• Band 3, light blue uniform, navy piping.
• Band 4, light blue, no piping.
• Band 5, hospital blue uniform, white piping.
• Band 6, navy blue uniform, white piping.
• Band 7, navy blue uniform, gold piping.
• Band 8a, navy blue uniform, red piping.
• Band 8b, navy blue uniform, burgundy piping.
• Band 8c, navy blue uniform, grey piping.
• Band 8d, navy blue uniform, green piping.
• Band 8a, corporate, navy with red piping and polka dots.
• Band 8b, corporate or associate nurse director, navy with burgundy piping and polka dots.
• Band 8c, corporate, navy with grey piping and polka dots.
• Director, navy with green piping and polka dots.

Registered AHP profession has white with the following:

• dietetics, turquoise
• occupational therapy, bottle green
• physiotherapy, navy blue
• podiatry, black
• speech and language therapy, brown

Unregistered AHP profession has white with an associated lighter colour of uniform piping as follows:

• dietetics, pale turquoise
• occupational therapy, pale green
• physiotherapy, pale blue
• podiatry, grey
• speech and language therapy, beige

The following advice is given to employees on the laundering of uniforms:

• uniforms must be changed daily
• where the service is available it is recommended that employees send their uniforms to the laundry
• if uniforms are washed at the individual’s home, they must be washed separately from other items and on a machine cycle that reaches 71C (for not less than 3 minutes) or 65C (for not less than 10 minutes), therefore, it is important that when uniforms are being purchased, they can withstand laundering at 65C
• if a uniform becomes contaminated with blood or body fluids, it must be changed for a clean one as soon as possible, the contaminated item must be placed in a red soluble bag, ideally it should be sent to the laundry (if this service is applicable) rather than taken home
• the above principles also apply to the laundering of healthcare workers own clothing if worn for clinical work, therefore, clothing should be worn that can withstand the above laundering temperatures.

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Document control

• Version: 6.3.
• Unique reference number: 256.
• Approved by: Corporate policy approval group.
• Date approved: 11 January 2024.
• Name of originator or author: HR advisor or head of nursing.
• Name of responsible individual: Director of people and organisational development.
• Date issued: 16 January 2024.
• Review date: November 2024.
• Target audience: All employees.

Page last reviewed: April 30, 2024
Next review due: April 30, 2025

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