Should we have a national uniform?

NHS Supply Chain, which provides all NHS uniforms, has proposed the 30,000 uniform styles currently available in NHS England is reduced to one shared style for all staff groups.

It is as yet unclear whether all allied healthcare professional (AHP) uniforms will be the same colour with different professional identifiers or if it will be different colours for different AHPs or groups of AHPs.

NHS Scotland and NHS Wales introduced a nationally standardised uniform in 2010 and NHS Northern Ireland followed in 2011. NHS Wales currently has 154 product lines and NHS Scotland has 64.

In NHS Supply Chain’s recent consultation of NHS England staff, to which only 50,710 replied (and only about seven per cent of the physiotherapy workforce), 82 per cent were in favour of a consistent uniform across the NHS.  

The CSP pointed to flaws in the survey, as questions steered respondents to back the introduction of the uniform, and the case for change was not adequately explained in a full and transparent manner.

The CSP and other healthcare professional bodies are in talks with NHS Supply Chain on how their members’ views will be represented as the supplier moves into the design and testing phase this summer. 

Frontline takes a look at arguments for and against the introduction of a consistent national uniform – and the CSP launches its own survey to find out what our members really think.

For

The biggest benefit for the NHS is cost – resources spent on variations on uniforms can be channelled back into frontline services. Fewer suppliers and design will save up to £11 million over a two-year period and reduce the carbon footprint. National uniforms may help make it clear to patients who to ask for help, and who’s in charge. A single NHS brand across the patient care pathway would mean clarity for patients throughout their treatment and rehabilitation. These improvements to patient safety support recommendations made in the 2013 Francis Inquiry. Members of the public will be able to distinguish healthcare professionals at a glance.   

A consistent uniform would project a strong image for NHS staff, underpinning a professional look important for winning the confidence of patients. Should advanced roles, seniority and expertise be reflected in AHP uniforms, this could align with career development. Reducing the number of uniforms means a more streamlined and ethical supply chain, which NHS Supply Chain claims could react to sudden fluctuations in demand such as those experienced during the Covid-19 pandemic.

Against

As the largest group within AHPs, NHS England physios already have a distinct identity, and are well recognised by their ‘uniform’ of white polo shirts or tunics with navy blue piping and navy blue trousers. 

Having a choice of clothing enables physios to wear what’s appropriate for a range of settings, as a uniform can be a barrier to the therapeutic relationship or pose -a safety risk for the therapist or patient. So physios working with children can wear a polo shirt that is less formal than a potentially intimidating uniform. Physios working in mental health and other settings may choose not to wear any kind of uniform.

Unless it’s carefully thought through, one uniform won’t be either practical and adaptable to people of different faiths with different requirements for modesty. Designs must be culturally sensitive and must take into consideration religious beliefs and gender identification.

Though NHS Supply Chain argues a consistent uniform allows patients to identify healthcare workers, members in Scotland report physios regularly being confused with nurses. If the uniform is implemented without proper differentiations, there is a risk physios could lose their professional identity. 

What do you think our uniform should be?

What we wear at work says a lot about ourselves and our profession, not to mention determining how easy it is to physically do our jobs. So whatever way the decision on a national uniform goes, get involved. Sign up for a uniform user trial in your area so you can ensure any mandatory uniform is fit for purpose.

To help us influence what these results mean and how they will be translated into practice, tell us what you think in the CSP Uniform Survey.