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Uniform, Standards of Dress and Personal Appearance Policy Version1.1 July 2018

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Document Control

Title

Uniform, Standards of Dress and Personal Appearance Policy

Author

Author’s job title Divisional Nurse

Directorate Unscheduled Care

Department Nursing

Version Date

Issued Status Comment / Changes / Approval

0.1 March 2018

Draft Initial version for consultation

0.2 April 2018

Draft Changes after Consultation

0.3 June 2018

Draft Changes after going to Senior Nurse Forum

1.0 June 2018

Final Approved by Senior Nurse Forum

1.1 July 2018

Amendment

Addition to extreme weather

Main Contact Deputy Director of Nursing North Devon District Hospital Raleigh Park Barnstaple, EX31 4JB

Tel: Direct Dial – 01271 335762 Tel: Internal – 5762 Email: [email protected]

Lead Director Director of Quality, Nursing and Workforce

Superseded Documents Uniform and Dress Code policy April 2014

Issue Date April 2018

Review Date April 2021

Review Cycle Three years

Consulted with the following stakeholders: (list all)

Director of Nursing

Deputy Director of Nursing

Head of Midwifery

Head of Therapies

Head of Communications

Divisional Nurses

Assistant Directors of Operations

Clinical Matrons – Acute and Community

Clinical Nurse Specialist

Ward Managers

Corporate Governance Manager

Equality and Diversity Lead

Staffside

Heads of Departments

Uniform, Standards of Dress and Appearance Policy ver 1.1 July 2018

Trustwide G:\Corporate Governance\Compliance Team\Policies Procedural Documents\Published Policy Database\Uniform standards of Dress and Personal Appearance\Uniform Standards of Dress and Personal Appearance Policy ver 1 1 3rd July 2018.docx Page 2 of 26

Approval and Review Process

Deputy Director of Nursing Collaborative Operational Group Partnership Forum (for consultation purposes, not approval)

Local Archive Reference G:directoratemanagement Local Path Unscheduled care\policies folder Filename Uniform, Standards of Dress and Personal Appearance Policy ver 0.1 March 2018

Policy categories for Trust’s internal website (Bob) Workforce

Tags for Trust’s internal website (Bob) Uniform Dress Code Appearance



CONTENTS

Document Control ............................................................................................................... 1

1. Purpose ........................................................................................................................ 4

2. Definitions .................................................................................................................... 4

Uniform ......................................................................................................................... 4

Dress Code ................................................................................................................... 4

Uniformed Staff ............................................................................................................ 4

Non - Uniformed Staff .................................................................................................. 4

Professional Image ...................................................................................................... 4

Bare Below the elbows ................................................................................................ 5

Direct Patient Care ....................................................................................................... 5

Clinical Setting ............................................................................................................. 5

Outerwear ..................................................................................................................... 5

3. Responsibilities ........................................................................................................... 5

Role of Chief Executive ............................................................................................... 5

Role of Director of Quality, Nursing and Workforce .................................................. 5

Role of Professional Leads, Clinical Leads, Line Managers and Heads of Departments ................................................................................................................. 5

Role of Individual Staff ................................................................................................ 6

4. Uniform, Standards of Dress and Personal Appearance – General principles ........ 6

4.1 All staff – uniformed and non – uniformed must: ...................................................... 6

5 Exceptions .................................................................................................................. 12

6 Monitoring Compliance with and the Effectiveness of the Policy .......................... 13

Standards/ Key Performance Indicators .................................................................. 13

7. Process for Implementation and Monitoring Compliance and Effectiveness .......... 13

8 Equality Impact Assessment ..................................................................................... 13

9 References (Optional) ................................................................................................ 14

10 Associated Documentation (Optional) ..................................................................... 14



1. Purpose

1.1. The purpose of this document is to set the standard that Northern Devon Healthcare NHS Trust (NDHT) staff must adhere to in regards to their standard of uniform, dress and personal appearance.

1.2. The policy applies to all Trust staff.

1.3. Implementation of this policy will ensure that:

All staff employed by NDHCT must present a corporate, clean and tidy image to the patients and public at all times whilst at work.

The NDHT meets it responsibilities with regard to Health and Safety legislation and Infection Prevention and Control.

Staff dress in a manner which inspires confidence, presents a corporate, professional image and safe for staff and patients

As far as possible, subject to the overriding requirements of patient’s safety and public confidence, staff should feel comfortable in their uniforms. This includes being able to dress in accordance with their religious and cultural practices.

2. Definitions

Uniform

2.1. Uniform can be defined as distinctive wear for members of a group.

Dress Code

2.2. ‘ A set of rules specifying the required manner of dress’ (Oxford English Dictionary)

Uniformed Staff

2.3. Staff who are provided with a uniform.

Non - Uniformed Staff

2.4. Staff who wear their own clothes to work.

Professional Image

2.5. Professional Image may be defined as a standard of conduct / demeanour / appearance associated with a professional group



Bare Below the elbows (BBE)

2.6. Clothing on arms worn above the elbow to prevent infection.

Direct Patient Care

2.7. Any activity that involves direct contact with patients and their close environment.

Clinical Setting

2.8. Any area where direct patient care take place.

Outerwear

2.9. ‘Clothes worn over other clothes’ (Oxford English Dictionary)

3. Responsibilities

Role of Chief Executive

3.1. The Chief Executive has overall responsibility for:

All policies in the Trust

Role of Director of Quality, Nursing and Workforce

3.2. The Director of Quality, Nursing and Workforce is responsible for:

Ensuring that the policy is implemented across the Trust.

There are clear organisational Standards for wearing uniforms

The Trust meets its responsibilities with regard to health and safety legislation and infection prevention and control.

Role of Professional Leads, Clinical Leads, Line Managers and Heads of Departments

3.3. The professional leads, clinical leads, line managers and heads of departments are responsible for:

Ensuring that all staff are aware of and comply with this policy



Ensuring that all staff that wear a uniform for work present a corporate, clean and tidy image to the patients and public, thereby, inspiring public confidence.

Role of Individual Staff

3.4. Individual Staff are responsible for ensuring that:

They comply with this policy.

4. Uniform, Standards of Dress and Personal Appearance – General principles

4.1 All staff – uniformed and non – uniformed must:

Appear clean, tidy and smart (i.e. no Jeans) to promote public and patients confidence.

When in a clinical setting must remain ‘bare below the elbows’ ensuring all wrist watches and jewellery around the wrist and on hands are removed (one plain ring, without stones, is permitted). Sleeves should be short or rolled securely above the elbow and ties, if worn, should be tucked in.

Staff have the responsibility to maintain their personal hygiene to reduce

the possibility of offensive body odour. Deodorants and perfume can be used however should not be so strong as to exacerbate a patient’s condition.

NDHT Identification must be worn at all times when at work. Lanyards, if worn should have a triple break point for easy removal and be either white metal chains, NHS logo, hospital charity or plain coloured with role identification on only. Staff working in areas with babies and small children are permitted not to display ID badges when delivering clinical care, but must have it available at request and worn when off the ward without a patient.

Smoking whilst in uniform or on Trust premises is not permitted as per Trusts Smoke free Policy. Any staff witnessed smoking in uniform will be managed under the Trust disciplinary policy.



Staff must not use or have mobile phones for personal use under any circumstance when working in the clinical setting; the use of mobile phones for personal use should be limited to unpaid breaks. Mobile phones for work purposes are permitted – this reflects that for community nurses, consultants and some managers mobile phones maybe the only way of contacting them.

All staff must wear the equivalent standard of dress to (a) fulfil cultural,

religious and ethnic needs and (b) meet the specific needs of staff with disabilities.

Avoid extremes of fashion and avoid excessive exposure of flesh: (a) No

low necklines, (b). Clothes will cover shoulder to knee as a minimum, (c) midriffs covered.

If a new style, colour or type of uniform is required for your team please complete the attached in Appendix 2 for approval by the Deputy Director of Nursing via the Senior Nursing and Midwifery Forum.

4.2 Wearing of Uniform

All uniforms remain the property of the Trust and must be returned to the Sewing Room at Bideford Hospital on termination of contract.

Uniforms should be changed daily or immediately if the uniform becomes visibly soiled or contaminated.

Staff must cover their uniforms when they are worn outside Trust premises, unless the weather is so warm as to make the wearer uncomfortable.

Staff must ensure that they only travel directly to and from work whilst in uniform (unless working in the community), if adequate changing facilities and lockable lockers are not provided

If staff remain in uniform, due to inadequate changing facilities and are refuelling their vehicle or collecting their child from school, a coat must be worn.

Community staff may wear their uniform when purchasing food for meal breaks.

Uniforms must not be worn in a setting other than NHS premises unless it is in the course of carrying out duty in the course of work for example community Nursing / Therapy, cardiac rehab / home visits.

NDHT trust uniform (including name badges) must not be worn when working for any outside agencies.



Any staff wearing uniform when not undertaking their normal clinical duties i.e. off duty, are responsible for their own actions in cases where they become involved in an emergency situation in the public arena.

Full uniform should always be worn; i.e. it is not acceptable to wear a mixture of uniform and non-uniform attire.

In extreme weather conditions particularly cold weather under garments maybe worn but they must not be visible.

In hot weather shorts may be worn but only under the direction of the Director or Nursing, Quality and workforce in line with the Public Heatwave Alerts. These must be knee length, tailored and the same colour as your original uniform trousers to maintain the corporate image. No adaptation to the uniform trousers is permitted.

Tights worn should be flesh, navy or black in colour, not patterned. In very hot weather, it is acceptable not to wear tights.

Theatre Staff will be issued with Scrubs. There will be an ample supply of clean scrubs in various sizes in all theatre change areas.

Type of uniform allocated will depend on role and department. See Appendix 1 for table of uniforms.

Number of uniforms allocated will depend on hours / days worked. Table below shows how many uniforms will be allocated

Days Worked Number of uniforms

2 2 Tunics / tops and 2 Trousers

3 or 4 3 Tunics / tops and 2 Trousers

5 4 Tunics / tops and 3 Trousers

4.3 Care of Uniform

Staff must read and be aware of the Trust Laundry policy with regard to the process used by designated Trust contractors for laundering of Trust uniforms and laundering uniforms at home.

Uniforms must be presentable and in a good state of repair.



Replacement uniforms should be considered after three years unless uniform has visible stains or has been damaged. Or if there has been a significant change in physique. Form to order uniform is available on BOB.

Uniforms must be constructed of materials capable of taking thermal disinfection to the standards laid out in HSG (95) 18.

Security of uniforms is paramount and all staff should have awareness around the threats arising from lost or stolen uniforms. If a uniform is lost or stolen, the employee should inform their line manager as soon as possible and report as in incident in line with the Trust’s Incident reporting Policy.

4.4 Outerwear over a uniform

Must be in a good state of repair.

Tabards can be worn in paediatric areas only. These should be laundered as per the Trust’s Laundry Policy.

A plain Navy or Black cardigan, fleece or hoody may be worn away from the Clinical area.

Community nursing teams may wear coats (hooded if required) and / or waterproofs. In hot weather removal of the coat when traveling between patients’ homes is permitted.

Community staff may wear Hi Vis jackets when travelling at times of poor visibility / dusk / night time.

4.5 Footwear

Health and safety considerations (footwear)

The intention of this policy in respect of footwear is to ensure that sensible footwear is worn at work. With such a variety of styles and considering changes in fashion it cannot prescriptively cover all aspects of footwear. Requirements for footwear at work must take into consideration health and safety requirements associated with the provision of health care in Acute and community settings.

When wearing uniform all footwear must coloured plain black, Navy or white with flat, soft, quiet soles and closed over foot and toes. These must be made of a water resistant material or fully washable.

Crocs® or similar style shoes brands are not acceptable – (see department of health Estates and Facilities Alert Ref EFA/2010/012).



All footwear must be in a good state of repair and easy to clean if splashed with bodily fluids.

All Footwear must enable the wearer to run in an emergency.

Steel toe caps are not permitted unless required for Health and safety reasons. Safety footwear when provided must be worn at all times.

Community staff are permitted to wear winter footwear such as snow boots / walking boots when delivering care in extreme conditions such as ice and snow.

Non uniformed staff must wear shoes appropriate for the individual’s duties having regard for Health and safety considerations. Sandals if worn are to be structured enclosing the heel. Flip flop or sandals without backs are not permitted.

Footwear must be low heeled. Heels must have a broad base (no stilettoes). The Society of Chiropodists and Podiatrists recommend heels are no higher than 40mm (1.5 inches). If worn for prolonged periods or in clinical areas, heel height should be reduced to 20mm (3/4 inch).

Theatre staff will have theatre shoes ordered for them, however, if they wish to order or purchase their own they must meet the requirement for safety and cleanliness. Cleanliness of personal shoes are the responsibility of the individual.

4.6 Hair

Hair for clinical staff should be clean and tidy and worn off the face. Hair must be worn off the collar and in a style that doesn’t require frequent adjustment.

Longer hair must be secured above the collar with hair accessories that are plain and simple.

Facial Hair must be kept neat and trimmed.

Head coverings may be worn for cultural or religious reasons but must be plain and undecorated and laundered as per the Trusts Laundering Policy.

In theatres, hair must be covered. A variety of head coverings are available but must not be worn outside of the theatres department.

4.7 Jewellery



Staff when in uniform should not wear jewellery. One plain ring, and up to two pairs of stud earrings are permitted.

Facial Piercings are acceptable if worn for cultural or religious reasons but should be plain and kept to the minimum as possible. Facial/body piercing for non-religious / non-cultural reasons must be discrete. Staff may be requested to remove these if they are deemed by the manager to be inappropriate.

Any piercing with exudate (a fluid that leaks out of blood vessels into nearby tissues), should be covered with a sterile dressing. If exudate continues then this must be reviewed by the infection control team or Occupational Health

Staff with a ‘stretcher’ in their ear may retain these in situ however they must be covered with a discrete solid plug or plain cover disc.

Wrist watches and fitness bands are not permitted to be worn when wearing a uniform or when working in a clinical area.

4.8 Tattoos, other accoutrements and markings

All tattoos, markings or accoutrements that may be deemed inappropriate or offensive must be covered ensuring that if in a clinical setting ‘bare below the elbows’ is maintained at all times.

If for religious or cultural reasons an individual wishes to display the tattoo, accoutrement or marking then this should be discussed with their line manager in the first instance. If a resolution cannot be found then it can be further escalated to Human resources so that decisions can be made on a case by case basis.

4.9 Makeup and Nails

Make up if worn must be discrete and natural looking. False eyelashes should not be worn in a clinical setting.

False nails and nail extensions are not permitted whilst in uniform. Fingernails must be clean, well-manicured and short without nail varnish (including clear varnish) when in a clinical setting.

4.10 Personal Protective Equipment (PPE)

All required PPE must be worn as per the Trust Infection control policy. This may include masks, visors, footwear, overalls and aprons, according to job role.

4.11 Theatres (see Operating Department Operational Policy)

http://ndht.ndevon.swest.nhs.uk/nddh-operating-department-operational-policy/



Clean Scrubs should be worn every day.

Theatre scrubs worn by clinical staff outside of theatres must be changed on re-entering theatres.

Personal protective equipment is available for all staff and it is the responsibility of every staff member to ensure that they wear the appropriate equipment as and when needed according to the Trust’s Infection Control policy and the Trusts Health and Safety policy.

Masks and eye protection are advised to safeguard both the patient and the scrub team.

Hair must be covered (see 4.6)

Footwear (see 4.5)

5 Exceptions

Catering, Domestic, Housekeeping and portering staff on the NDDH site are directly employed by Sodexo. As such, they are not required to adhere to this policy. However, they do abide by ‘Bare below the Elbows’ guidance.

If an exception is requested for alternative appearance then this should be discussed with the line manager in the first instance. If a resolution cannot be found, then it can be further escalated to Human Resources, so that decisions can be made on a case by case basis.

Where staff perceive that this policy conflicts with their religious or cultural beliefs, this should be discussed with the line manager in the first instance. If a resolution cannot be found, then it can be further escalated to Human Resources, so that decisions can be made on a case by case basis.

Paediatric nurses working in the community setting do not wear a uniform due to the nature of their role, however must adhere to the non-uniform standards. PPE and Bare below the elbow must be adhered to in all circumstances.



6 Monitoring Compliance with and the Effectiveness of the Policy

Standards/ Key Performance Indicators

6.1 Key performance indicators comprise:

The types of uniforms issued to departments should correspond to those specified in this policy. (100%)

Spot check audits of dress, accessories and uniform compliance (100%) Complaints received by patients and service users in relation to this policy

(0%) Employees investigated or issued with disciplinary sanctions in relation to

this policy (0%)

7. Process for Implementation and Monitoring Compliance and Effectiveness

7.1 Monitoring compliance with this policy will be the responsibility of the Deputy Director of Nursing. This will be undertaken by Clinical Matrons walk arounds, review of complaints and feedback.

7.2 Where non-compliance is identified, support and advice will be provided to improve practice.

8 Equality Impact Assessment

8.1 The author must include the Equality Impact Assessment Table and identify whether the policy has a positive or negative impact on any of the groups listed. The Author must make comment on how the policy makes this impact.

Table 1: Equality impact Assessment

Group Positive Impact

Negative Impact

No Impact

Comment

Age X

Disability X

Gender X

Gender Reassignment X

Human Rights (rights to privacy, dignity, liberty and non-degrading treatment), marriage and civil partnership

X

Pregnancy X Uniform available for pregnant workers.



Maternity and Breastfeeding

X

Race (ethnic origin) X

Religion (or belief) X Religious people may perceive themselves from presenting themselves in line with their traditions.

Where staff raise concern, a clear explanation that the policy has been developed to ensure Health and safety and patient safety.

Sexual Orientation X

9 References (Optional)

Department of Health’s best practice guidance ‘uniforms and workwear: Guidance on uniform and workwear policies for NHS employers March 2010 (Archived)

Estates and Facilities Alert Ref EFA/2010/012

10 Associated Documentation (Optional)

Standard infection Control Precautions policy Incident reporting Policy Operating Department Operational Policy

http://ndht.ndevon.swest.nhs.uk/standard-infection-control-precautions-policy/

http://ndht.ndevon.swest.nhs.uk/alerting-appropriate-advisorsmanagers-to-incidents-standard-operating-procedure/

http://ndht.ndevon.swest.nhs.uk/nddh-operating-department-operational-policy/



Appendix 1 Uniforms - Table of uniforms including pictures

Uniform Description

Top Trousers Designation Gender Professional Group

Pale Green Tunic and Navy Trousers

Domestic / Housekeeping staff

Both

Domestic / Housekeeping / Portering/ Catering (Community Hospital)

White Scrub Tunic and Purple Trousers

Allied Health Professionals (AHP’s)

Both

Dieticians / Speech and Language Therapist.

Blue Scrub and Navy Trousers

Allied Health Professionals (AHP’s) Nursing

Both

Therapy Support Workers Support Workers

https://www.workwearexpress.com/tunics/p-lw16-portwest-ladies-striped-tunic/



Navy Blue Scrubs

Nursing

Both

Band 6 - Acute

Sky Blue Scrubs

Nursing

Both

Band 2/3 Support workers.

Royal Blue Scrubs

Nursing

Both

Band 5.



Aquamarine Scrubs

Nursing

Both

Nurse Associate

Black Scrubs

Administration and Clerical staff

Both

Ward Clerks / Receptionists

Magneta Pink Scrub Top and Black Trousers

Administration and Clerical staff

Both

Ward Clerks / Receptionists



Dark Green Scrubs

Medical Staff working in the clinical areas

Both

All Medical Staff (optional For Consultants)

Lilac Scrub top and Black trousers

Discharge Coordinators

Both

All Discharge coordinators

Navy Blue Tunic and Navy Trousers. Navy Blue dresses are also available.

Nursing

Both

Clinical Nurse Specialist – All grades. Community Nursing Band 6



Blue Tunic with white piping and Navy trousers

Nursing

Both

Community Nurse

White Scrub Top and Sky Blue trousers

Nursing AHP

Both

Apprentices / Clinical ward support Therapy Support Workers

Red Tunic with Navy Blue piping

Nursing

Both

Director of Nursing and Deputy. Resus Outreach Team



Navy Blue Tunic with White Spots, White piping and Navy Trousers

Nursing

Both

Clinical Matron – acute and community Lead Nurse

Navy Tunic with Red Piping and Navy Trousers

Nursing

Both

Band 7 Ward Manager (nurse and Midwife) / Community Nurse Team leader

Navy Tunic, White Spots and Red Piping with Navy Trousers

Nursing

Female

Divisional Nurse

https://www.googleadservices.com/pagead/aclk?sa=L&ai=DChcSEwjruqO15ozaAhVMgbIKHT36DugYABAXGgJscg&ohost=www.google.co.uk&cid=CAASE-Roy_SB212_biS25r14K9bwSjY&sig=AOD64_2W0DvidgZmVsPvrLrhdLXlUKGD6w&ctype=5&rct=j&q=&ved=0ahUKEwjp8Z615ozaAhWGIJoKHZlIA2UQ9aACCHE&adurl=

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White Tunic and Navy Trousers

Nursing

Both

Community Support Workers

White Scrub Top and Green Trousers

AHP’s

Both

Occupational Therapist

White Scrub Top and Navy trousers

AHP’s

Both

Physiotherapists



Purple Scrubs

Midwives

Maroon Scrubs

AHP’s

Both

Radiology / Pharmacy / Phlebotomist / Ophthalmology imaging technicians and assistants.

Own Clothes with white laboratory Coat

Pathology Staff

Both

Pathology

White Scrub Top and Black trousers

AHP’s

Both

Podiatrist



Pale Blue Scrubs

Medical

Both

Medical Students

Dark Green Tunic with white piping and green trousers

Medical

Both

Physician Associates

Grey Tunic with red piping and Black Trousers

Nurse / AHP’s

Both

Pathfinder team



White Scrubs with red Trousers

Cardio respiratory – Healthcare Scientists

Both

Cardio Respiratory Team

Amethyst Scrubs

Orthoptists

Both

Band 5 and above

Metro Blue Scrub top and Navy Trousers

Assistant Practitioners

Both

Acute

https://www.bestworkwear.co.uk/media/catalog/product/cache/2/image/9df78eab33525d08d6e5fb8d27136e95/w/l/wl30_re_front.jpg



Metro Blue Tunic and Navy Trousers

Assistant Practitioners

Both

Community

Maroon Shirt and Black Trousers

Technician

Both

EBME department

https://www.google.co.uk/imgres?imgurl=https://a3655836d5c58a086ac2-4e8d43a89f100386d472e9f1a1dc59ca.ssl.cf3.rackcdn.com/images/original/965994593_01.jpg&imgrefurl=https://www.moss.co.uk/moss-london-extra-slim-fit-burgundy-single-cuff-stretch-shirt-965994593&docid=VLqfl7DmFZlvUM&tbnid=ZFaGMMNg96nXrM:&vet=10ahUKEwif3sW57ILcAhWQyKQKHcXJBJkQMwjBAigfMB8..i&w=2000&h=3000&hl=en&bih=752&biw=1440&q=maroon shirt&ved=0ahUKEwif3sW57ILcAhWQyKQKHcXJBJkQMwjBAigfMB8&iact=mrc&uact=8



Appendix 2

New Style / Type of Uniform Request Name of Requester ____________________________ Team requesting new style of Uniform _________________________ Current Uniform ___________________________________________________________ Type of uniform being requested (please give details of colour/style and material)

___________________________________________________________ Reason for New / Change Uniform request ___________________________________________________________

___________________________________________________________ Supplier and Cost of new uniform

Please complete and forward to Deputy Director of Nursing for approval via Senior Nurse and Midwifery Forum.