Expert insight: Changing your organisations uniform

How Livewell Southwest raised both staff morale and patient recognition

Getting people to agree a change of work uniform in a small team where everyone wears the same thing can be a challenge – but just imagine what it’s like when you have over 3,000 staff employed in more than 25 different roles, across 8 grading bands and several different teams and locations. That was the daunting task faced by Lori Ashton, Locality Manager, and her colleague Helen O’Toole, Deputy Locality Manager for Livewell Southwest, based at Plymouth Mount Gould Hospital.

Like many other NHS and healthcare service groups, Livewell Southwest is a collaborative partnership between several hospital and community services covering West Devon, Plymouth and South Hams. By consolidating skills, resources and financial planning, their aim is to offer a best practice service to patients whilst maximising the skills, resources and budget within the group.

Early on in the process, it quickly became apparent that as well as rebranding, they also needed to help the teams themselves feel involved in the process to develop a stronger sense of shared ownership and pride in the new group.

One obvious point of difference was the variety of different uniforms worn across the organisation. For instance, a garment worn in one facility – such as a senior ward nurse, might signify the role of a cleaning auxiliary at another site. Differing dress codes meant that some staff wore completely different garments for the same job. Historically, many staff, such as administration and reception had no uniform at all.

“We had two issues” said Lori, “We wanted to find a way of making our teams feel more united under the new Livewell Southwest ‘brand’, and we also wanted both staff and patients to recognise individual staff status and skill by their uniform. Making sure that everyone felt part of the re-branding, while not increasing overall cost was also a major factor.”

Lori and her team tackled the project with a pragmatic and carefully planned approach. First, a detailed review was made of all workwear worn across the organisation, the costs involved and order history. Then an in-depth questionnaire, designed to gather opinions, experience and expectations was sent to staff. They ran a series of feedback sessions across the sites explaining what was planned so that there was an increased awareness of the project and its importance.

“We received a 98% feedback rate from the survey” said Lori, “…and this really helped inform our selections and recommendations for the final proposal. I think we were surprised how deeply everyone felt about their workwear. Although we had both worn uniforms in previous roles, we had forgotten just how important a uniform is to people – particularly in a highly skilled profession like nursing and clinical practice. You spend years training – so you want that expertise to be recognised. Wearing a set of crumpled, shapeless scrubs just doesn’t give the same sense of pride and confidence! We were also conscious of the findings in the Francis Report*; that patients need to be able to identify those who are responsible for their care and feel confident about them.”

Clinical and nursing staff voted overwhelmingly in favour of traditional nursing garments such as the Alexandra HP298 Women's tunic and D312 Zip front dress, whereas non-clinical roles wanted informal, but smart-looking polos or lightweight suiting. It was felt that appearance at every patient ‘touch-point’ needed to give reassurance and continuity – from the reception desk through to clinics and outpatients.

“We started running wearer trials with the nursing groups first,” says Lori. “Alexandra offered both the widest range of colours and styles in the market, and they could be ordered off-the-shelf in a huge range of sizes, reducing the need for holding stock on-site. Across our staff we have a really wide range of ages, shapes and ethnicity, so we needed garments that would suit everyone, both male and female. We don’t offer laundry facilities any longer, so home washing, wear performance and care of the garments are important factors.”

“Alexandra was an enormous help to us in those initial planning stages, helping us both with the survey questions and the early wearer trials” says Lori. “Obviously, Alexandra have been around for a very long time, so they’re very experienced in handling these types of projects – but for us, it was all new.”

“In any major uniform re-fit like this, cost is always a crucial factor,” says Alexandra Account Manager, Sara Moon. “Before Lori could present her initial proposal to her Board, we had to accurately plan every aspect of the project. We were keen to offer a range of garments to give staff some flexibility of choice, including knitwear and outerwear, where this was important. In every case, we needed to demonstrate why the garments being recommended met the criteria for the role and were broadly acceptable to staff.”

“I did not want to leave anything to chance”, continues Lori. “Presenting a major project like this had to be right, first time. We needed to show that every stage had been carefully considered and that choices had been made on sound principles with proven cost savings.”

“Obviously, there have to be compromises.” says Lori. “You can’t set out on a project like this expecting to please everybody. We developed a set of very clear criteria against which every decision could be sense-checked. We referred back to the findings of the initial staff opinion survey and also the results of wearer feedback.”

Adding full staff names and job roles to the uniform using either embroidery or name badges, was initially a point of contention. “Staff feared that they would get unwanted attention from patients, or that their own privacy would be undermined” said Lori, “but in fact, those fears proved to be unfounded. The policy has helped to engender a more respectful, but friendly atmosphere amongst staff and patients.”

Having received the full backing of the Executive Procurement Board to their initial proposals, Lori and her team swung into full deployment mode. “It was absolutely crucial to have the full support of the senior management team before we embarked on communicating the uniform choices to everybody. They therefore endorsed the uniform decisions from the start and offered consistent support of the project. It also meant that we were able to get help from both our internal communications teams and Alexandra to present the uniforms and wearer guides to staff professionally.”

The issue of sizing and distributing the uniforms to such a diverse number of sites needed to be carefully planned. Yvonne Williams is the manager of Alexandra’s highly skilled ‘Roll-out team’.

“With workwear, it’s really important that it fits correctly. Unlike high-street fashion garments, work uniforms have been carefully designed to be durable and enable the wearer to perform their work comfortably. Hospital and care staff often also have to perform their duties in warm environments, so being able to offer the right choice of fabric composition is as important as the colour.”

“I’ve been with Alexandra 19 years – and although every project varies, over the years we have devised proven processes to ensure we can manage complex sizing and deliveries with minimum fuss to the customer.” Says Yvonne. “With Livewell Southwest, we organised dedicated sizing events on-site – or sent complete ‘sizing kits’ to the smaller, community-based teams. We even have our own online sizing tool called ‘FitsMe’ to enable staff to measure themselves accurately from home.”

In October 2016, the first uniforms were being delivered to staff and by spring 2017 virtually all staff had received their new uniform. Whilst the uniform allocation is fixed for each role, staff are able to purchase additional uniform garments if they choose, at a discount, through an online ordering portal that they can access at home or at work.

“Don’t expect to fit a project like this alongside your day job!” laughed Helen. “This has been an all-consuming task that has taken many hours of preparation and planning. We’ve had a couple of teething problems or unexpected issues to deal with, but Alexandra have worked with us every step of the way to minimise the stress and find a solution.”

“Our teams absolutely love their new look – and they feel proud and empowered by their smart appearance. Patients have really noticed the difference, and we’ve had lots of positive feedback. Many say that they really appreciate being able to see the name of the member of staff on their uniform and can now recognise what they do, by the colour of their uniform.”

But for Lori, one of the most gratifying aspects of the project has been the fact that more staff now get a better, wider choice of uniform for virtually the same overall budget as they spent before. “For me, this project really demonstrates the benefits of pooling expertise and resources across many sites. Our staff feel better about the role they play, their position within the organisation is more easily recognised and patients feel more confident in the service we offer. As part of the Devon Sustainability and Transformation Plan (STP), we are now discussing the benefits of co-ordinating the purchase of uniforms across an even wider area to maximise savings and efficiency.”

Top Tips to help you launch a new staff uniform – stress-free

  1. Review what you currently have in place and the costs involved.
  2. Draw up a list of essential needs for the proposed workwear – such as protective qualities, branding, wearability, costs etc. and have this endorsed by senior management and/or stakeholders.
  3. Select a range of possible garments for further consideration and order in samples etc. to check colour and fit.
  4. Seek feedback from actual wearers via questionnaires or feedback sessions. Perhaps perform ‘wearer trials’ to check that the garments are suitable for the roles under consideration. Keep focussed on ‘needs’ for the uniform and not ‘personal tastes’.
  5. Create a shortlist of garments and score them against your list of essential needs list and budget.
  6. Order a complete set of samples for all roles, including the proposed branding – such as embroidery, print or badges.
  7. Produce detailed projected costs, sizing, production and delivery plans with your chosen supplier. Check that these are agreed before you place the order with them.
  8. Get plans endorsed by senior management/stakeholders.
  9. Run sizing days, staff awareness events and prepare communication collateral.
  10. Roll out garments to staff across sites and make arrangements for recycling old workwear as required.

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