Debate: Uniforms

Patients, families, staff and students in England can find it difficult to identify the different types of health care professionals they encounter, with nurses sometimes being confused with other hospital staff. Some patients with cognitive impairment find the variation in uniforms across NHS and independent health care providers particularly difficult, in both urban and rural communities.

In 2009, Congress debated nationalised uniforms. This passed with 76% in favour and was taken forward in Northern Ireland, Scotland and Wales, but not adopted in England.

Wales has a national nursing uniform that identifies by colour health care support workers, nursing students, staff nurses, ward sisters and nurse consultants. This was introduced in 2009 and the commissioning process for this uniform included frontline nursing focus groups. It was the first time an ethical approach to NHS uniform procurement was used in any of the four countries of the UK.

Since 2012, all staff working for NHS Scotland have been wearing the national uniform, with different levels of clinical staff wearing a dedicated shade of blue. More recently, a burgundy uniform for clinical nurse managers was introduced.

Regional uniforms for nursing staff within the Health and Social Care service in Northern Ireland were introduced in two phases from September 2011. Informed by public research conducted by the Patient and Client Council, the intention was to help patients and members of the public recognise health care staff. Staff also wear name badges stating their role and area of work, enabling patients and visitors to identify who is in charge and who to speak to if they have a concern. The uniforms were also designed to promote the identity of different professional staff groups within the Health and Social Care service across Northern Ireland.

In 2016, a fringe event asked how members would like to see nursing uniforms develop in the future. The majority wanted uniforms to be kept, and thought that a national uniform for England or even a UK-wide standard was needed. These uniforms should be easily identifiable by patients, families and colleagues.

The 2013 Francis Report recommended that: there should be a uniform description of health care support workers, with the relationship with currently registered nurses made clear by the title (recommendation 207); and that commissioning arrangements should require provider organisations to ensure by means of identity labels and uniforms that a health care support worker is easily distinguishable from that of a registered nurse (recommendation 208).

A 2016 study in Denver found increased levels of registered nurse recognition, perception of professionalism and perception of ability when standardised, colour-coded uniforms were introduced.

We do not want to suggest that we revert back to the stiff and impractical uniforms of days gone by, but why is it that we reject the notion of a consistent presentation of our professional image? Other professions wear uniforms that clearly convey their role with nothing short of pride. Think about public reaction if other professions were to present themselves in non-standard outfits – police, military, airline pilots – would they be easily identifiable? Would they evoke the same public trust, confidence or respect