Introduction
NHS England trust uniform policies can cause issues for
Muslim female healthcare professionals (HCPs) through
restriction of religious head coverings in theatre and bare
below elbow (BBE) policies. The ‘2020 NHS England
Uniform and Workwear: guidance for NHS employers’
has made clear provision for religious accommodations.
However, there is variability in how this national
guidance is implemented in local uniform policies.
Methods
First a national audit was conducted by sending out
freedom of information requests to all 211 NHS Englan
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’(1). Secondly, a quantitative self-completed
cross-sectional survey was conducted online via
Qualtrics software from 31/08/2024 to 30/09/2024 for
Muslim female HCPs or healthcare students in NHS
England since April 2020.
Results
National audit: 200 uniform policies (95%) were
received. Of the 139 trusts with surgical theatres, 30%
allowed religious head coverings in theatre. 8% allowed
an orthopaedic hood or disposable alternative only. 62%
had no provision for religious head coverings.
Regarding BBE adjustments, 30% of NHS England trusts
allowed both full sleeves and disposable over sleeves.
10% only allowed full sleeves and 8% only allowed
disposable over sleeves. 48% did not allow any BBE
adjustments.
National survey: A total of 430 responses were received.
27% of those that work in theatres were prevented from
wearing their headscarf. 72% of respondents had been
asked to be BBE when not engaged in direct patient care
activity. 47% felt they were treated differently at work
due to the uniform policy and 50% due to their faith.
Due to hospital uniform policies, 46% felt their mental
health had been affected citing stress and anxiety (51%),
feelings of alienation (56%) and low mood (36%).
Conclusion
The lack of, and variation in, accommodations for BBE and religious head coverings in theatres within local NHS England uniform policies is a source of discrimination for Muslim female HCPs.
There is a pressing need to increase awareness and implement national guidance more widely to allow for a more inclusive workplace.
References
NHS England and NHS Improvement. Uniforms and
workwear guidance for NHS employers. 2020 [Available
from: https://www.england.nhs.uk/wp
content/uploads/2020/04/Uniforms-and-Workwear
Guidance-2-April-2020.pdf].
