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As NHS England begins to introduce a national nursing uniform, nurses from Scotland, Wales and Northern Ireland explain the benefits of a standardised approach
NHS nurses in England will begin being issued with new uniforms this summer – a move that is aimed at cutting confusion and could even save time in emergencies.
Nursing Standard. 39, 6, 14-16. doi: 10.7748/ns.39.6.14.s7
Published: 05 June 2024
The new national uniform for the whole of England will be different to the standardised uniforms in the devolved nations, however; each country will have its own unique attire.
Here, we ask nurses from Scotland, Wales and Northern Ireland about what has changed for staff and patients since standardised uniforms were introduced.
NHS Tayside nurse hysteroscopist Sarah Huggett says it will make life easier for patients and staff. She works as a nurse in Scotland – where standardised uniforms were introduced in 2010 – but trained to be a midwife in London.
She says before she began her first placement at a trust in England, she asked a few nurse friends to show her their uniforms, so she knew who was who. ‘I thought I was prepared, but they were at a different NHS trust to me. I got confused by my trust’s colour scheme, because I thought it was the same as my friends’ trust.
‘On my first shift, I remember thinking that the healthcare assistants were senior midwives. I did work it out after a while, but it was baffling before that.’
Ms Huggett says that, in emergency situations, this can waste precious time for new or temporary staff who do not know the trust well.
‘Standardising things will help patients who’ve received care in different trusts’
Sarah Huggett, nurse hysteroscopist at NHS Tayside, Scotland
‘You could be grabbing the wrong person at that time when every second counts,’ she says. ‘In the rush of it all, you might just see the colour they’re wearing and think it means something it doesn’t.’
She says the new approach will also make things clearer for patients. ‘Standardising things will help patients who’ve received care in different trusts. If they’ve got ten people standing over their bedside somewhere, that’s intimidating anyway, but at least they’ll know who’s who.
‘In Scotland, I think we’ve had fewer situations where patients feel ignored. Now they understand – that person’s a physio and that’s why they’re not doing something a nurse should do, and vice versa. Before they just saw people and didn’t know who any of them were.’
Ms Huggett adds that another big plus of the Scottish NHS uniform ‘is the comfort factor on a long shift, and two big pockets going down either side’.
In Wales, the standardised uniform has been a similar success, according to RCN Wales associate director of nursing professional practice Sandy Harding. But she thinks the English style may offer less differentiation.
Scotland’s NHS national uniform is worn by all clinical and non-clinical staff groups throughout all NHS Scotland Health Boards
‘Generally, it’ll be good for England,’ she says. ‘But our Welsh colours are quite distinctive, and by comparison some of the English uniforms look very similar. In fact, the only thing setting a few of them apart is slightly different trims.
The new uniforms for NHS organisations in England are available as a two-piece, smart scrub-style tunic or dress
Picture credit: John Houlihan
‘If you’re someone with bad eyesight, elderly or slightly disoriented, it’s not going to be as easy to tell the difference.’
Wales was the first UK country to introduce standardised NHS nursing uniforms and nurses say they save time and money
Picture credit: Jay Williams
NHS Supply Chain (NHSSC), which delivers products to NHS organisations, has said the new uniforms for England – which are available as a two-piece, smart scrub-style tunic or dress – will make it easier for the public to differentiate roles.
Who will wear the uniform? Doctors will not wear the uniform, and paramedics will have their own, but everyone else – nurses, healthcare assistants and all allied health professionals, including pharmacists and physiotherapists – will be part of this new national approach.
What will it look like? The uniform does not consist of scrubs like those traditionally worn in theatres or critical care and laundered in hospitals, but a smart scrub-style tunic or dress that can be taken home and washed. Both the tunic and dress have two waist pockets and a breast pocket, and the trousers also have two cargo-style pockets.
Where will it be worn? It will be worn in all NHS settings where uniforms are typical – so not where disposable scrubs or plain clothes are already in use.
When will it be available? The new uniform will be available in summer 2024, but its adoption will be a trust-led decision. Specific timelines will depend on the NHS trust.
Source: NHS Supply Chain
In some cases, the colour differences are distinct, such as healthcare assistants in lilac. But others are not so easy to tell apart. Nursing associates are in sky blue and staff nurses a hospital blue, while nurse practitioners are in royal blue. Team leaders – although it is not clear whether this means charge nurses, sisters or another role – are in yet another shade of blue, navy.
Overall Ms Harding believes the new uniforms will be beneficial to NHS nurses. ‘You don’t have to iron a scrub style, which saves time,’ she says. ‘You don’t need to use a tumble dryer. I find they’re easy to air dry, and that saves money.’
She says that while the standardised system has made things easier for multidisciplinary team (MDT) colleagues to distinguish different nursing roles, there have been problems in some settings.
‘In some places, MDT colleagues liked the idea so much that they decided to standardise their own uniforms. But that didn’t tally up with the national nursing uniform colours. Now, in some settings, there is overlap between their colours and ours.’
Northern Ireland opted for front-zipping tunic, rather than a smart scrub style, in part for infection control reasons, according to South Eastern Health and Social Care Trust assistant director of nursing and midwifery regulation and workforce planning Roisin Devlin.
‘When we were considering our standardised uniform, we had lots of input from our infection prevention and control teams,’ says Ms Devlin, who is also the chair of Northern Ireland’s Regional Uniform Steering Group.
‘They felt a top that people have to pull over their head isn’t ideal in terms of infection and if fluids are on the uniform, so we opted for the zipped tunic.’
Northern Ireland provides two different uniform weights for staff – a heavier standard version for winter, and a lighter weight for summer, says
Ms Devlin. ‘The material is significantly lighter – it’s also helpful for nurses going through menopause,’ she adds.
NHSSC has no plans for different weights for the English uniform, but is keen to point out the financial benefits. It says the new uniform will save £10 million over two years if it is adopted by all NHS trusts in England. Trusts will choose when they adopt the new uniforms.
Hywel Dda University Health Board consultant nurse for infection prevention Tracey Gauci says opting into a national uniform may not work as well as one big roll out.
Ms Gauci was a nurse at Charing Cross Hospital in London when the last national NHS uniform for English nurses was being used. It was introduced in the 1970s and was used into the next decade, but proved unpopular with nurses.
‘It wasn’t nationally adopted in the end,’ she says. ‘Most of the big London teaching hospitals wanted to stick with their traditional uniforms.
‘I’m watching with interest, especially with the major hospitals that still have a clear identity.’
She says that in Wales, where standardised uniforms were introduced in 2010, a mandatory approach worked better. ‘There was a specific lead-in time to prepare, but it was a clear national change, there was no option.’
The RCN says the most important thing is that the new uniforms are practical for daily work. ‘Nursing staff wear their uniforms with pride,’ says RCN England director Patricia Marquis.
‘It is important that uniforms are comfortable, recognisable to patients and practical for clinical settings. Professional identity is important to nursing staff, and we would like it to be clear that the title of a registered nurse and levels of practice are reflected in the uniform descriptor.’
Standardised uniforms for NHS nurses: your questions answered rcni.com/NHS-uniform
