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What to wear

Is it time to introduce a national uniform for physios, or should local trusts decide what staff wear? Janet Wright and Joanna Lyall investigate

What should physios wear to work? Should their uniforms be decided by local trusts? Or prescribed nationally by the profession? Or laid down by national governments? 

In February the CSP’s Annual Representative Conference in Glasgow carried a motion calling on the CSP to campaign for a nationally recognised uniform for all physiotherapy staff ‘to promote a clear physiotherapy identity easily recognisable for all staff, patients and visitors.’ (Motions passed at ARC are later debated by CSP Council and may inform the Society’s work, but are not themselves policy).

Michael Pearson, for East Midlands stewards, proposing the motion, said many trusts were considering, or had already introduced, generic uniforms for clinical staff in the interests of ‘corporate image’. ‘In trusts where this has occurred physiotherapists and other AHPs have lost their identity and confusion reigns for patients, staff and visitors,’ he said.

The trend threatened physios’ professional identity, he argued. ‘Our uniform is a visual representation of our profession, the training we have undergone, the skills and pride we have in our role,’ he said.

Queen’s Medical Centre, Nottingham,  where Michael Pearson works, has a generic uniform for all nurses and AHPs. It consists of navy trousers/skirts and blue and white striped tunics. This was introduced into QMC in 2006. An evaluation of the new uniforms, carried out in 2007 by Nottingham University’s school of nursing, midwifery and physiotherapy, concluded that the absence of different uniforms to distinguish different professions had led to ‘a sense of loss and  disempowerment.’ Physiotherapists were particularly badly affected, it added. 

One physio kept a record of the number of times she was misidentified over two working days. She was taken for a nurse on a total of 13 occasions. 

‘The introduction of generic uniforms was particularly difficult for physiotherapists and occupational therapists, for whom there is a widely recognised national uniform that has come to symbolise professional identity,’ the evaluation pointed out. 

‘We waste many hours each week with constant interruptions,’ says Michael Pearson. 

‘Patients, visitors, doctors and other staff take us for nurses and ask us to get medications and supply information about a patient’s condition.’

In November 2009 a review of quality and patient care at Nottingham University hospitals trust, which includes Queen’s Medical Centre, conducted by East Midlands strategic health authority, also noted patients’ confusion over the generic uniforms. ‘Patients and visitors reported that the trust’s uniforms were confusing in distinguishing staff from different disciplines or grades. This was also the experience of the review team,’ it noted. 

National uniform in Scotland

NHS Scotland is phasing in a national uniform for all nurses, AHPs, catering, domestic, portering and security staff by 2012. Before the introduction of a national uniform NHS Scotland was buying 250 styles of tunic in 150 colours The new uniforms, launched at Stobhill hospital, Glasgow, in December 2009, will include ‘Mediterranean blue’ unisex tunics, with navy blue trousers for AHPs and pale blue tunics for associates. Each tunic will have the AHP’s profession embroidered into it. The Scottish government also offers AHPs the option of wearing polo shirts but says this is a matter for individual health boards to decide.

‘The uniform will help refresh the visibility of staff as they go about their work while presenting a professional corporate image,’  said Dr Kevin Woods, chief executive of NHSScotland, announcing the proposals in October 2008.

Professional identity

But not all physios welcome moves towards corporate work wear. ‘When you train for three years and are accredited as a chartered physiotherapist you are proud, and proud to wear the traditional uniform,’ says Vicki Barrett, Macmillan physiotherapist at Cynthia Spencer hospice, Northampton. ‘It’s not just a job, it’s an identity. A generic uniform undermines this, and is one step away from generic working and despecialising of skills.’

In a previous job Vicki Barrett was once required, by a newly appointed service lead, to wear the same uniform as other professionals. ‘There was a clear “corporate image” element on her insisting on a generic uniform  a design that she chose,’ recalls Vicki Barrett. ‘The therapists felt that, out in the community, we would be indentified as senior nurses, which could cause confusion, or even pose a clinical risk,’ she says. 

In 2007 Northern Ireland’s Department of Health Social Services and Public Safety established a steering group, including union representatives, to look at ‘the standardisation of uniforms and work wear, in the interests of promoting corporate identity within a corporate framework.’

‘It’s been made very clear that it would not be appropriate to use the term registered AHP on the uniforms, as it does not distinguish one profession from another,’ said the CSP’s Tom Sullivan. 

‘It would not be acceptable to the professional bodies, or individual professionals,’ he said. 

In Wales nurses are going into a generic uniform but no moves have been made to impose something similar on AHPs. fl

Why uniforms matter

‘In the present climate of blurring professional boundaries and working in multidisciplinary teams, it is not surprising that uniform should become a matter of concern,’ said Liz Carrington, author of the CSP guidance paper, Professionalism, Personal Appearance and the Patient Experience. ‘Uniforms carry symbolic meaning. The way staff dress sends messages about standards of care and competence,’ she adds. And visual distinction has always been important for professionals, she points out. ‘Looking at the history of uniform for nurses and AHPs, uniform has always been about professional identity as much as anything else,’ she said. 

SOMETHING TO ADD?...

Would you like a national uniform for all physios? Or corporate workwear decided by your employer? What do you think of your current uniform? email us at frontline@csp.org.uk

 

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Article Information

Author(s)

Janet Wright and Joanna Lyall

Issue date

19 May 2010

Volume number

16

Issue number

9

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