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Staff Uniform and Dress Code Policy

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Staff Uniform and Dress Code Policy

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									Harrow Primary Care Trust
Staff Uniform & Dress Code

      Staff Uniform and Dress Code Policy

APPROVED BY             DATE
Equality and            29/10/2007
Diversity Group
JSCC                    10/12/2007
Exec Team               18/01/2008

Department: Infection Control & Human Resources
Author: Jane Grove. Lead Infection Control Nurse

Policy Date: Nov 2007. Version 1
Review date:

1. Aim                                              3

2. Target Population                                3

3. Background                                       3

4. General Guidance                                 3

5. Staff Not Required to Wear Uniform               4

6. Wearing of Uniform                               4

       6.1 General Rules                            5

7. Infection Control Issues                         8

       7.1 Protection of Uniforms                   9

       7.2 Wearing of Uniform Whilst Not at Work    9

       7.3 Washing of Uniforms                      9

8. Changes to Uniform Policy                        9

9. Particular Individual Requirements               10

10. Students, Temporary Staff & PCT Contractors     10

11. Serious Breach of this Policy                   10

12. Tax Relief for Laundry of Uniforms              10

13. Review of Policy                                11

14. References                                      11

                              Page 2 of 11
Policy Date: November 2007
Review Date: November 2008
1. AIM

The aim of this policy is to ensure that all Harrow PCT staff are clear on the
standard of dress expected while at work, whether uniform or non-uniform.

In all cases uniform and dress code should support and promote the following

   •   The health, safety and well-being of patients.
   •   The health, safety and well-being of staff.
   •   A corporate and professional image to staff, patients, visitors and
   •   Best practice with safe moving and handling practices.
   •   Reduction in the risk of cross infection.
   •   It’s appropriateness to the clinical area.


All staff employed or working for the PCT.


The PCT accepts that employees have the right to freedom of expression and
as such do not aim to stipulate dress code regulations that infringe on that
right. However, as a matter of health & safety, and the promotion of a positive
and consistent image, there is a need to enforce certain guidelines with
regard to dress.

Inappropriate dress within the work place can have an adverse effect within
the team, and in some cases may put unnecessary risk on staff with regards
to their own personal safety.

Where a manager feels that there is a problem with a member of staff in
relation to his/her attire, then the manager should contact Human Resources
for advice on how to deal with the issue.


Employees should dress in clothes that reflect the respect that they have for
their patients and their understanding of illness and vulnerabilities.

The PCT accepts that appropriate attire will vary accordingly to the area within
which an employee works.

Line managers are responsible for the interpretation of appropriateness within
their area, within this policy.
                                Page 3 of 11
Policy Date: November 2007
Review Date: November 2008

Staff can wear the clothing of their choice, however:

   •   Clothing should not cause offence to colleagues, service users or
   •   Clothes should be clean, presentable and tidy in appearance.
   •   Clothes should not be too revealing or transparent.
   •   Clothing with inappropriate slogans or pictures should not be worn.
   •   Minimal jewellery should be worn
   •   No torn or frayed clothing should be worn.
   •   Clothing should be appropriate to the activity being undertaken. For
       example smart attire should be worn for within formal settings when on
       formal PCT business.
   •   Any tattoos deemed to be offensive must be kept covered at all times
   •   Any perfume or aftershave being worn must be discreet as patients
       and colleagues may have allergies.
   •   Personal hygiene must be of an acceptable level in order that stale
       body odour does not cause offence to colleague’s or patients.
   •   Footwear should be sensible, clean and tidy

Hair should be neat and tidy and minimal hair ornamentation should be used.

PCT identity badges should be worn at all times.


Staff that has direct and personal contact with patients are supplied with
uniform by the PCT. Different uniforms are worn by different professions and
grades. Staff must wear the appropriate uniform for their band, and for which
they have been supplied with.

Some staff may choose not to wear uniform in certain situations. (This should
be agreed locally with their line manager). Whether or not uniform is worn,
clothing for staff having direct patient contact should meet the following
    • Provide the wearer with mobility and comfort.
    • Be durable enough to withstand decontamination, to minimise cross
       infection risks.
    • Contribute to identification for security purpose (for example a security
       coded name badge)
    • Project a professional image to encourage public trust and confidence.
    • Contribute to the corporate image that nurses and their employers wish
       too present.
    • Be designed with a client group in mind, reflecting the type of work
                            (Wipe it out, RCN campaign on MRSA. April 2005)

                                Page 4 of 11
Policy Date: November 2007
Review Date: November 2008
6.1 General Rules

Criteria                              Rationale

All uniforms remain the property of
the PCT and must be returned upon
termination of contract.

(a) Must be worn at all times when at (a) Minimise infection risk
work.                                 (a) Maintains corporate & Public
(b) Dress hemline must rest below the
knee                                  (b) Ensure professional appearance

(c) Uniforms must be changed daily    (c) Minimise infection risk
                                      (c) Ensure professional appearance

(d)Spare uniform to be kept at work to (d) Minimise infection risk.
change into if splashes of body (d) Ensure professional appearance.
should occur to uniform being worn.

(e) If nursing belts and buckles are (e) Maintains professional
being worn, then the buckle must be appearance.
kept cleaned. A disposable apron (e) Minimises cross infection risk
should be worn when providing care.

When    carrying   out    manual This is to ensure that under the H
handling with patients belts that & S guidelines patients are not
have sharp buckles should be harmed
Outer Wear:
Plain navy cardigan/jumper/fleece
may be worn away from the clinical

(a) Not to be worn when delivering (a) Minimise infection risk
direct patient care.

(b) Must be in good state of repair, (b)Ensure professional appearance
clean & tidy in appearance           (b) Maintains corporate and public

Shoes must be kept in a good state of
repair and cleaned daily.             (a) Minimise infection risk
                                      (a) Ensure Health & Safety standards
(a) Black or brown shoes (preferably met.
lace ups ) with covered toes and (a) Maintains corporate and public
heels                                 identity
                              Page 5 of 11
Policy Date: November 2007
Review Date: November 2008
                                       (a) Ensure professional appearance
Trainers are NOT acceptable

(b)Open toed sandals must not be (b)Ensures health & safety standards
worn while carrying out manual are met.
handling or patient care.        (b) prevention of foot/ankle injuries

                              (c) Prevention of foot/ankle injuries
(c) Shoes should have maximum (c) Corporate and public identity
2.5cm heel.                   (c) Ensure professional appearance.

(a) Must be clean and tidy and must (a)Minimise infection risk – hair off the
be off the face and collar.         face & collar reduces risk of
                                    transferring micro-organisms such as
                                    Staphylococcus aureus.
                                    (a) Ensures professional appearance.
                                    (a) Maintains corporate and public

(b) If collar length – must be tied up (b) Minimises infection risk.
off the collar using plain fastening (b) Ensures professional appearance
without adornment.                     Maintains corporate and public

(c) Pony tails are NOT acceptable      (c) Pony tails can swing over the
                                       shoulder and can cause infection
                                       when       providing wound care or
                                       carrying out any invasive procedure.
Facial Hair:

(a) Male nurses should be clean (a) Reduce infection risk
shaven or beards should be kept neat (a)Ensures professional appearance.
and trimmed                          (a) Maintains corporate and public
Personal Hygiene:

(a) Personal hygiene must be of an (a) Maintains Professional standard
acceptable level whereby stale body (a) Maintains patient confidence
odour does not cause offence to
colleague’s or patients.

(a) Must be discreet                   (a) Patients and/or colleagues may
                                       have allergies.
(a) Only one plain wedding band and (a) Rings are reservoirs for infections.
one plain pair of stud earrings to be (a) Rings with stones and sharp
worn whilst at work.                  edges can scratch or tear patients
                               Page 6 of 11
Policy Date: November 2007
Review Date: November 2008
                                       Hand hygiene technique cannot be
                                       properly complied with if rings are
No     other      visible    jewellery being worn.
permitted i.e.
                                          (b) Neck chains can be pulled by a
(b) Neck chains                           patient or caught in machinery
                                          (b) Ensures health & safety standards
                                          are met

(c) Bracelets                             (c) Area beneath bracelet identified
                                          as source of infection.
                                          (c) Can cause injury to patients and
                                          can cause cross infection.

                                          Hand hygiene technique cannot be
                                          properly complied with if bracelets
                                          are being worn

(d) Wrist watches are NOT         to be   (d) Area beneath watch identified as
worn when carrying out clinical duties.   source of infection.
If a fob watch is not being worn then a   (d) Can cause injury to patients and
wrist watch should be kept in the         can cause cross infection.
uniform pocket whilst on duty
                                          Hand hygiene technique cannot be
                                          properly complied with if wrist
                                          watches are being worn.

Fob watches worn on uniforms are Ensures full hand hygiene compliance
Body Piercing:

one pair of plain stud earrings is

(a) Visible body piercing jewellery (a) To prevent injury to staff and
must be removed when on duty        patients.
                                    (a) Ensures professional appearance.
                                    (a) Maintains corporate and public

(a) Any tattoos deemed to be (a) Ensures professional appearance.
offensive must be kept covered at all (a) Maintains corporate and public
times.                                identity

(a) The PCT’s security identification (a) Patient’s/visitors/staff should be
badge to be worn visibly at all times. able to identify staff at all times.
                                       (a) Maintains corporate and public
                                Page 7 of 11
Policy Date: November 2007
Review Date: November 2008
                                           (a) Ensures professional appearance.
                                           (a) maximise security on Trust sites

(b) Maximum of 3             professional (b) Ensures professional appearance.
badges may be worn.

(c) Staff involved in direct clinical care (c) Minimises risk of injury to patients’
to babies & small children should not
wear any badge except trust ID


Studies show that uniforms are frequently contaminated by disease-causing
bacteria, including Staphylococcus aureus, Clostridium difficile and
glycopeptide-resistant enterococci (GRE) which presents a potential source of
cross infection in the clinical setting. (Speers 1969, Babb 1983 & Perry 2001)

Maximum contamination occurs in areas of greatest hand contact, for
example – pockets, cuffs and apron areas (Babb 1983, Wong 1991, Loh
2000) High numbers of organisms have been found on the hands of staff
wearing rings and the presence of rings has also been shown to decrease the
effectiveness of hand washing (Salisbury 1997)

While hand hygiene is well-recognised as the single most important factor in
the prevention of cross infection, contact transfer of bacteria from uniforms
leading to infection has also been described (Hambraeus 1973 & 1977)

7.1 Protection of Uniforms

Protective aprons are a preventative measure against cross infection and
must be worn over uniform for food handling, when undertaking personal
care, aseptic procedures, dealing caring for an infected patient or when
handling soiled linen. Aprons must be changed between patient contacts.

Note: Blue plastic aprons are used when handling food. Clear plastic aprons
are used for all other procedures.

7.2 Wearing of uniform whilst not at work

Where locker room and changing facilities are available, staff should travel to
and from duty in their own clothes. Staff should be encouraged to change out
of uniform at the end of a shift.

For areas where changing facilities are not provided, uniform must be covered
discreetly for the journey to and from the workplace, or between patients.

                                  Page 8 of 11
Policy Date: November 2007
Review Date: November 2008
Uniform must not be worn in any retail or recreational premises whilst not at
work. This not only poses an infection control risk for members of the public
but does not give assurance to the people of harrow that the trust is compliant
with infection control and Health & Safety standards.

7.3 Washing of Uniforms

Staff who are required to wear uniform will be provided with an adequate
number of uniforms by the PCT. The PCT will, within resources available
purchase quality clothing that meets infection control and health & safety

The Trust does not have the facilities for uniform laundering. Staff are
required to wash their own uniforms. Staff can claim tax relief in respect of
laundry costs (Subheading 12).

Uniforms must be washed separately from other clothing at the highest
recommended temperature for the garment, and ironed prior to wearing.
Ironing along with tumble drying proves additional protection for infection

Laundered uniforms must be stored in a plastic bag to prevent contamination
and carried separately from other items. Clean and dirty uniforms should not
be transported together in the same bag.


There may be circumstances where the wearing of all, or part, of the uniform
may cause difficulties to staff.

Changes to uniform may be allowed at a local level following discussions with
staff. Managers have discretion to agree non uniform. However, this must be
professional and not cause offence. ID badges must be worn at all times.
Changes must be reviewed at regular agreed intervals.

All staff are expected to use their discretion and judgement in deciding
appropriate dress for the task they are carrying out.

Any change must be within the basic principles stated in sub-heading 6


There will be circumstances where the wearing of all, or part of the uniform
cause difficulties to individual members of staff.

Any difficulties should be discussed with the member of staff’s line manager
and due consideration given to allowing a modification of the uniform.
However the basic principles in sub –heading 6 must be adhered to.

Circumstances may include:
                               Page 9 of 11
Policy Date: November 2007
Review Date: November 2008
   •   Disabled staff who are not able to wear the standard uniform
   •   Pregnant staff who need to wear different clothing to maintain their own
       safety as the pregnancy progresses.
   •   Staff who have religious or cultural beliefs which require certain dress.

All clinicians regardless of their individual requirements MUST ensure that
they can follow the ‘Bare Below the Elbows’ dress code initiative as outlined
by the DOH in 2007.

NOTE: If staff are unable to wear shortened sleeves, compliance with
infection control becomes compromised and cross infections of micro-
organisms can occur from the sleeve and by the failure of the member of staff
to affectively carry out hand decontamination. This is not acceptable practice
for patient’s well-being and line managers in conjunction with Human
Resources may need to readjust the staff member’s roles and responsibilities
in order to prevent infections from occurring.


Pre-registration students have their uniforms provided for them by their
educational provider. Agency staff are provided with a uniform by their
agency. The principles of this policy apply to all students, agency staff and
PCT contractors alike.


This policy is designed to help guide and inform staff of the expected
standard. Most issues will be resolved at a local level through management
counselling. However, disciplinary sanctions can be considered for serious
breach or negligence of the guiding principles within this policy. The PCT will
consider the consequences of the issue and the individual circumstances that


The laundry allowance was introduced for nurse’s when the local NHS no
longer laundered nurse’s uniforms on its own premises. The allowance
ceased to apply some years ago and was removed on the advice of the Inland

Harrow PCT does not offer its employees cleaning facilities for their uniforms,
therefore members of staff who are required to wear a uniform for their work,
and launder their uniforms from their own funds, can make a claim for laundry
expenses directly to the Inland Revenue.

                               Page 10 of 11
Policy Date: November 2007
Review Date: November 2008
In order to do so, you do not need to have kept details of how much you
spend on washing your uniform, or provide receipts to support your claim.
Please contact your local Inland Revenue office, to obtain a tax relief form.

For more guidance, please see:


The PCT will periodically review this policy to ensure that it is effective and up
to date, in line with current legislation.


Babb JR, Davies JG, Ayliffe GA (1983) Contamination of protective clothing
and nurse’s uniforms in an isolation ward. Journal of Hospital Infection, 4, pp.

Department of Health. (2007) Uniforms and Workwear: an evidence base for
dealing with local policy.

Hambraeus A (1973) Transfer of Staphylococcus aureus via nurses uniforms,
Journal of Hygiene (London), 71. pp. 799-814

Hambraeus A, Ransjo U (1977) Attempts to control clothe-borne infection in a
burns unit. Journal of Hygiene. 79. pp.193-202

Loh W, NG w, Holton J (2000) Bacterial flora on the white coats of medical
students, Journal of Hospital Infection, 45. pp. 65-68

Perry C, Marshall R, Jones E, 92001) Bacterial contamination of uniforms.
Journal of Hospital Infection, 48 pp. 238-241.

RCN. Wipe it out campaign on MRSA. ‘Guidance on uniforms and clothing
worn in the delivery of patient care’ April 2005.

Salisbury DM, Hutfilz P, Treen LM, Solin GE, Gautam S (1997) The effect of
rings on microbial load of health care workers hands, American Journal of
Infection Control. 25. pp 24-7.

Speers R, Shooter RA, Gaya H, Patel N (1969) Contamination of nurse’s
uniforms with Staphylococcus aureus. The Lancet, 2(7614), pp.233-235

Wong D, Nye K, Hollis P (1991) Microbial flora on doctors white coats. British
Medical Journal. 303. pp 1602-1604

                                Page 11 of 11
Policy Date: November 2007
Review Date: November 2008

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