BBCMon, 17 Sep 2007 15:36 UTC
The traditional doctor's white coat is to be changed as part of government plans to tackle hospital infections.
The new style clothing will have short sleeves under guidance to come into effect at the start of next year.
Doctors would also not be allowed to wear long-sleeve shirts, jewellery, or watches as part of the measures.
The Department of Health says cuffs are likely to be "very contaminated", and that other forms of protection such as plastic aprons would be introduced.
It also advises healthcare staff in England against wearing a tie during clinical work.
The new dress code is part of a raft of measures unveiled by Health Secretary Alan Johnson to tackle the spread of hospital-acquired infections such as MRSA and Clostridium difficile.
Bigger role for nurses
Matrons will now directly report their concerns about cleanliness and hygiene to hospital boards four times a year. There had been concern that the views of frontline staff were not reaching higher management.
Hospital managers will also have a legal duty to notify cases of infection to the Health Protection Agency (HPA).
Mr Johnson said: "I'm determined that patient safety, including cleanliness, should be the first priority of every NHS organisation.
"Today's package of measures will give more responsibility to matrons and set guidelines on clothing that will help ensure thorough hand washing and prevent the spread of infections.
"This is a clear signal to patients that doctors, nurses and other clinical staff are taking their safety seriously."
The strategy follows a review of the NHS instigated by the Prime Minister shortly after he took over from Tony Blair in June.
Hospitals are also to receive new clinical guidance about isolating patients who do become infected with C.difficile or MRSA.
More single rooms will be used, and patients with the same infection will more often be nursed together.
Integrated approach
Dr Vivienne Nathanson, head science and ethics at the British Medical Asssociation, said a stricter dress code was only one aspect of preventing and controlling infection.
"A co-ordinated approach addressing all the relevant factors, for example dress code, bed occupancy, hygiene in hospital and isolation policies, is most likely to be successful.
"In addition, any new guidelines on dress code must be practical, realistic, and sensitive to different religious groups."
Dr Peter Carter, general secretary of the Royal College of Nursing, said: "This guidance offers a positive step forward in introducing dress code standards across all health professions to help reduce healthcare-associated infections."
Mike Penning, the Shadow Health Minister, said: "The government has failed miserably to rid our hospitals of superbugs."
He said nurses were fed up with spending time on administrative activities rather than on treating patients and ensuring hospitals were clean.
A HPA review published in July showed hospital MRSA cases had fallen by 10% in the first three months of 2007 compared with a year ago.
But rates for C. difficile, which mainly strikes the elderly, rose by 2%.
Scotland is considering similar measures, and in Wales the health minister is examining Mr Johnson's comments.
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