Uniform Policy

Human Resources |

Policy Scope

This procedure applies to all staff working on behalf of Coast Medic that are required to wear uniform or work wear. Every effort will be made to cater for staff whose cultural and religious beliefs do not allow them to conform fully to this policy. Reasonable adjustments will be made for employees who have a genuine medical reason, or for reasons of disability. 

First impressions are important and as a form of non-verbal communication, they often determine the attitude which will be conveyed within the staff/patient relationship. A neat, well-groomed appearance will impart an impression of an efficient person representing a professional ambulance service. 

This procedure will cover all areas of the organisation in which staff wear a uniform as part of their working day e.g. Operational front line and other support workers such as Administrators, Fleet department and Scheduling. Dual role Clinicians that work across nonclinical and clinical roles may remain in their clinical uniform. 

This procedure also covers staff that do not wear uniform as part of their job role. 

Procedure

All uniform issued to staff by the organisation will always remain the property of the organisation and must be returned at the end of employment and issued at the beginning or during their employment. Failure to do so could result in delay in payment of monies due or, in extreme cases, police involvement. 

The uniform or any issued Personal Protective Equipment (PPE) must not be worn for any unauthorised activities outside the employment of the organisation, nor may it be worn if working for external private ambulance providers at events etc.

Employees should ensure their uniform is complete and of standard issue only. 

Smoking & E-Cigarettes

Smoking, the use of e-cigarettes, vaping, drinking of alcohol or purchasing these products in uniform will not be permitted in public view. Staff who smoke or purchase alcohol whilst wearing the organisation uniform will be required to cover up with appropriate outer clothing that does not identify the organisation. 

Traveling to and from work

For safety and security staff who are off duty and travelling to and from their place of work should cover up with appropriate outer clothing that does not identify the organisation or should change into civilian clothes. 

Uniform Alternation/Substitution

Staff are not permitted to alter their uniform in any way except for sizing adjustments. 

No visible additional or substituted items of clothing may be worn unless authorised by the individual’s line manager. 

Exchange & Replacement of Uniform

Exchanges and replacement of uniform due to soiling, loss or general wear and tear should be completed on an item for item basis. e.g. 3 worn shirts exchanged for 3 new shirts etc. 

Care of Uniform

It is the responsibility of each member of staff to take appropriate care of all issued items and to follow the manufacturer’s instructions with regard to cleaning and storage in order to minimise the risk of damage or loss. 

Blood or Body Fluid Washing Procedure

It should be noted that blood or body fluid stains cannot be removed by hot washing alone; it must first be soaked in cold salt water, then washed at standard temperature. However, a 10-minute wash at 60oc is sufficient to dilute safely or remove most micro-organisms. Should a garment become so heavily contaminated that it cannot be effectively cleaned and requires disposal, this should be done as hazardous waste and with the authorisation of the individual’s line manager. See ‘Disposal of Uniform’ below.

Spare Uniform

Operational staff should keep a spare set of green clinical uniform at their place of work in case of uniform soiling whilst on duty or requests from the police to take items of uniform. It is not acceptable for staff to have to return home to change. Spare uniform must be stored securely at all times in the member of staff’s locker or out of sight in their personal vehicle. A selection of boots will be kept in the HQ for emergencies. 

Shirts & T-Shirts

Organisation issued T-Shirts (or similar matching garments) may be worn under shirts.  Shirts will be worn tucked inside the trousers/skirt. Staff who are pregnant are permitted to wear their shirts outside their trousers if they can no longer be tucked in smartly. 

Footwear

Only approved organisation footwear is to be worn and should a member of staff be unable to wear this footwear for medical reasons, (supported by a doctor’s letter and signed off by the line manager), the organisation will allow similar suitable footwear, subject to it complying with the required safety standards available from the Health and Safety department. 

If a staff member requires high ankle boots, these may only be ordered following sign off by the line manager giving the reasons. 

Footwear must be maintained in a clean and serviceable condition. Any defects must be notified to the staff member’s line manager. 

Hair and Head Covering

Hair is to be maintained in a clean, presentable and tidy condition at all times. Staff members with hair that reaches below the shirt collar must keep it always tied up. Whilst undertaking clinical duties staff must ensure that it does not fall forward or interfere with patient care. Hair colour must be in keeping with a professional image. 

Any accessories that are used to tie or clip hair in place should be small and discreet, and of a dark colour. Any clips/hair ties worn must not contain any stones/beads etc. and must allow for the correct fitment of the individual’s safety helmet. 

Facial Hair

Beards and moustaches are acceptable providing they are kept neatly groomed and clean. The organisation advises staff that some beards may present a problem with wearing of FFP3 single use, disposable masks by not fitting snuggly. In these cases, they may not give adequate protection whilst performing procedures which may create airborne particles, such as intubation, airway aspiration or nebulising. 

Head coverings

Head coverings required to be worn due to religious beliefs such as, but not limited to, a Turban (Sikh men), Kippah (Jewish men) and Hijab headscarf (Muslim women) should be in a plain green colour, as near to corporate green as possible. These items will not be provided but the organisation. Headscarves should be securely fastened with no trailing ends and should not cover the face. All items must be regularly laundered. 

Jewellery

In the interests of Health and Safety, infection prevention and control and a professional appearance, the following must be adhered to: 

  • Ear jewellery will be allowed in the form of studs only. Hoops, bars or dangling earrings are not permitted. Other visible body piercing jewellery will be limited to studs (these may be worn in the nose (excluding septum), no eyebrow piercings, no lip piercings and no dermal anchors. Ear tunnels must be filled with suitably size plugs. Where there is a recognised cultural need such requirements will be discussed at interview or with the line manager and a note placed on the individual’s record to this effect.
  • Neck jewellery must not be visible at any time while in uniform. 
  • Only a band (wedding ring style) with no raised stones will be acceptable as hand jewellery. 
  • Watches are not to be worn on the wrist whilst in green clinical uniform; and bracelets are not permitted unless they are the approved “medic- alert” type or are worn for medical reasons (supported by a doctor’s letter) or for cultural/religious reasons. These are to be removed whilst performing hand hygiene practices. (Please refer to the Infection Prevention Ready Procedure). 

“Clinically Ready”

 “Clinically Ready” will be adopted by all staff in green clinical uniform, unless wearing clothing issued for health and safety reasons or inclement weather. These sleeved items should be removed whilst performing hand hygiene practices within clinical care settings. For those staff who are required to wear full sleeves (for religious/medical reasons), plastic sleeve covers will be available on request. 

To ensure compliance with the hand hygiene technique, all staff wearing green ambulance uniform will, at all times, adhere to following dress code; 

  • No jewellery to be worn from the elbow down with the exception of one flat banded ring. This includes watches, bracelets and raised stoned rings. 
  • Watches are not to be worn on the wrist and bracelets are not permitted. Anyone requiring to wear an approved “medic-alert” worn for medical reasons (supported by a doctor’s letter) must contact the IPC team for advice. 
  • Fingernails should be short and clean. On no account is nail polish (clear or coloured) and/or false nails permitted when in green clinical uniform. 

There are no known cultural reasons for staff not to comply with “clinically ready”. 

Approved bracelets are to be removed whilst performing hand hygiene practices and clinical procedures. 

Identification

To identify staff, ID cards should be worn at all times whilst operational. Job titles or Clinical grade will be displayed where appropriate. 

Tattoos

To maintain a professional appearance, staff are required to cover tattoos where these may be deemed controversial (i.e. sexual, racist, aggressive etc). 

Personal Hygiene Standards

All staff should adhere to the following personal standards: good hygiene, cleanliness and a neat appearance. Advice can be obtained from Operational Managers. 

Make up may be worn in keeping with professional standards. 

Sharp Objects

Pens and scissors etc. in breast or sleeve pockets may cause harm when moving patients. Such items should be carried away from possible direct patient contact to prevent harm or cross contamination/infection. 

Ribbon bars should be worn for ceremonial purposes only and not worn when providing direct patient contact. These could be an issue for patient safety when moving and handling. 

Personal Protective Equipment (PPE)

The uniform itself is not considered as PPE, and so PPE must be worn in any situation where there is danger or potential danger to the individual e.g. road traffic collisions; other highway incidents; poor visibility; construction sites; and potential blood/body fluid splashing etc. The following list is an example of PPE available to all patient facing staff and is not exhaustive: 

  • Safety helmets
  • Safety footwear
  • Debris gloves
  • Fluorescent jackets, tabard
  • Disposable plastic aprons
  • Disposable medical gloves
  • Disposable face masks
  • Eye protection
  • FFP3 masks. 

Loss or Theft

Uniform including PPE must not be left on show in private vehicles due to the risk of theft and security implications that this would involve. Prolonged exposure of magnified sunlight (through vehicle windows) will fade or damage the high visibility materials or compromise the safety standards of the garment. 

If an item of uniform is lost or stolen, the employee is responsible for informing their line manager as soon as possible. An incident report must also be completed through salus3cloud. Where the loss is substantial, or part of a wider loss of organisation equipment, the organisation’s Directors must be informed as soon as possible. 

In circumstances where theft is suspected, the Police must be informed. This would normally be done by the line manager or out of hours duty manager. This is particularly important when security concerns are heightened, e.g. high-profile events occurring in the Trust. 

Disposal of Uniform

Items that are visually identifiable as the whole or part of our organisation’s uniform (e.g. due to their colour or style), have insignia or are otherwise unique to the organisation and which are not suitable for re-use must be disposed of securely. They must be returned to the line manager for onward passage to Stores for disposal by an approved contractor. 

All uniform that is returned for shedding must be in a clear plastic bag with a card label (in the bin system) stating ‘Old Uniform for shredding’. All returns must be checked for any items that are not uniform (e.g. iPads, ID cards etc), before sending as stores will not open the bags once received. Do not put new exchanges in the bag, please use a separate bag clearly marked ‘Exchanges’ 

Responsibilities

The responsibility for ensuring that the procedure is enforced lies with the Chief Executive Officer. 

Line Managers are responsible for overseeing the implementation and monitoring of this procedure. 

Procurement and Finance Directorates will ensure appropriate resources, facilities and associated supplies for staff to adhere effectively to this procedure are available and maintained. All uniform issued to staff by the organisation will always remain the property of the organisation and must be returned at the termination of employment and reconciled with a list of items issued at the beginning and during the employment. Failure to do so could result in delay in payment of monies due or in extreme cases police involvement. 

All Operational Managers are responsible for ensuring that this procedure is routinely applied by all uniformed staff and that suitable and necessary facilities to support this procedure are readily available in all organisational settings 

All members of staff are individually responsible for adhering to this procedure. 

Audit and Review (evaluating effectiveness)

Staff should receive information and education (as necessary) when there is a change in the uniform supplied. 

Monitoring compliance on a day-to-day basis will be undertaken by the Managers observing staff during duty hours. Remedial action for non- compliance should be part of a personal development plan. 

The Infection Control Team will periodically monitor compliance through auditing of infection prevention and control standards. The reporting of non-compliance and deficiencies will be undertaken through the responsible line managers for remedial action. 

All procedures have their effectiveness audited by the responsible Management at regular intervals, and initially six months after a new policy is approved and disseminated. 

Effectiveness will be reviewed using the tools set out in the Organisation’s Policy and Procedure for the Development and Management of Policies and Procedures (also known as the Policy on Policies). 

All changes made to this procedure will go through the governance route for development and approval as set out in the Policy on Policies. 

Associated Documentation

  • Recruitment and Selection Policy 
  • Equality, Diversity and Inclusion Policy 
  • Health & Safety Policy 
  • Infection Prevention and Control Policy 

References

  • Department of Health (2008) The Health and Social Care Act 2008: (rev 2015): Code of practice for the prevention and control of healthcare associated infections. London: DoH. 
  • Department of Health (2007) Uniforms and Workwear: (rev 2010) An evidence base for developing local Policy. London: DoH.
  • Department of Health (2007) Saving Lives: reducing infection, delivering clean and safe care. London: DoH. 
  • Health and Safety Executive (INDG174 rev 08/05) A short guide to the Personal Protective Equipment at Work Regulations 1992. Suffolk: HSE books. 
  • Health and Safety Executive (2005) COSHH a brief guide to regulations: What you need to know about the Control of Substances Hazardous to Health Regulations 2002. Suffolk: HSE books. 
  • The Health and Safety at Work Act 1974 sections 2 and 3. Section 2 covers risks to employees and Section 3 to others affected by their work e.g. patients. 
  • Health and Safety Executive (1999) Management of Health and Safety at Work Regulations 1999 (Management Regulations), that extend the cover to patients and others affected by microbiological infections, and include control of infection measures. 
  • ‘Securing Health Together’, the Health and Safety Executive (HSE) long term strategy for occupational health that commits HSE/Health and Safety Commission and their fellow signatories (including the Department of Health) to a 20 per cent reduction in ill health caused by work activity by 2010. 
  • Health Act 2006 Code of Practice, Duty 4 to maintain a clean and appropriate environment includes at section (g) that the supply and provision of linen and laundry reflects Health Service Guidance HSG95 (18), as revised from time to time and at section (h) that clothing (including uniforms) worn by staff when carrying out their duties is clean and fit for purpose. Health Professions Council, Standard of Proficiency section 10. 

Glossary

Personal Protective Equipment (PPE): Issued above the standard uniform issue to protect against a specific risk to health and safety e.g. Fluorescent jacket, FFP3 disposable mask, EPD (electronic dosimeter); and helmet. PPE must be worn in any situation where there is danger or potential danger to the individual, e.g. road traffic collisions; other highway incidents; poor visibility; construction sites; and potential blood/body fluid splashing etc. 

Equality Analysis

The Organisation believes in fairness and equality, and values diversity in its role as both a provider of services and as an employer. The Organisation aims to provide accessible services that respect the needs of each individual and exclude no-one. It is committed to comply with the Human Rights Act and to meeting the Equality Act 2010, which identifies the following nine protected characteristics: Age, Disability, Race, Religion and Belief, Gender Reassignment, Sexual Orientation, Sex, Marriage and Civil Partnership and Pregnancy and Maternity. 

Compliance with the Public Sector Equality Duty: If a contractor carries out functions of a public nature then for the duration of the contract, the contractor or supplier would itself be considered a public authority and have the duty to comply with the equalities duties when carrying out those functions. 

Appendix A: Rank Slide Definitions

  • Deputy Director of Operations Cartwheel and 2 x pip 
  • Associate Director of Operations Cartwheel and 1 x pip 
  • Strategic Commander/Heads of Cartwheel 
  • TacticalCommander(OUM)Crownand1xpip 
  • EOC Tactical Commander (OUM) Crown and 1 x pip 
  • Tactical Commander (OM) Crown 
  • EOC (Operational commander training) 3 x pip
  • HART TL 3 x pip 
  • OTL (Operational commander trained 3 x pip 
  • 10.OTL (non-operational commander trained 2 x pip 11.EOC team leaders (EMATL/DTL) 2 x pip