7 How compliant are national health service (NHS) England uniform policies with regards to religious head coverings and bare below the elbow (BBE) adjustments?

Abstract

Background The ‘2020 NHS England Uniform and Workwear: guidance for NHS employers’ has made clear provision for religious head coverings in theatre and adjustments to bare below elbow (BBE) rules, including disposable oversleeves. We conducted a national audit to assess the compliance of local dress code policies with national guidance.

Methods Freedom of Information requests to access local uniform policies were sent to all 211 NHS England trusts, as listed on the NHS England Provider directory between 29/07/2024 and 05/08/2024. Uniform policies were compared to the ‘2020 NHS England Uniform and Workwear: guidance for NHS employers’. Compliance in three areas was assessed: (1) Provision of religious head coverings in theatre; (2) Allowance of full sleeves when not engaged in direct patient care activity; (3) Provision of disposable oversleeves.

Results Overall, 200 uniform policies were received (95%). Provisional analysis shows that of the trusts with surgical theatres, 30% allowed individuals to wear their own cloth headscarf whereas 8% only allowed disposable scarves/orthopaedic hoods. 62% did not mention any provision for religious head coverings in theatre. Regarding BBE adjustments, 30% allowed both full sleeves and disposable oversleeves. 10% only allowed full sleeves and 12% only allowed disposable oversleeves. 48% did not allow any BBE adjustments.

Conclusion Despite national uniform guidance being available since 2020, there is large variability in implementation across NHS England. There is an unmet need to update local uniform policies to value and maintain the dignity of Muslim female healthcare professionals in the workplace.