INTRODUCTION

The nursing workforce is predominantly female and richly diverse, encompassing a wide range of ethnicities, religious beliefs, and individuals living with disabilities. It is essential that personal protective equipment (PPE) provided to nursing staff reflects and respects this diversity, ensuring both safety and dignity in the workplace.

The RCN believes that PPE must be designed and supplied with inclusivity at its core. This includes accommodating different facial structures, body types, religious dress requirements or beliefs, and health and accessibility needs. Ill-fitting, or non-inclusive PPE not only compromises safety but can also lead to exclusion, discomfort, and reduced confidence among staff.

Within this position statement we define PPE as that required to protect users from health and safety risks, including respiratory protective equipment (RPE), gloves, eye protection and radiation protection, as opposed to equipment used only to protect others (referred to as source control) e.g. fluid repellent surgical masks to prevent the wearer from spreading infection. However, the same principles of user comfort and useability from an equity, diversity and inclusion (EDI) perspective should still apply.  Uniforms, not classed as PPE, are outside of the scope of this position statement, but we expect employers to consider EDI requirements within their uniform policies and relevant infection prevention and control of infections and related guidance.

Whilst the RCN recognises there may have been a need for pragmatism during a global pandemic causing shortages of PPE supplies in the UK, we do not believe that the safety of nursing staff should be compromised due to poorly designed or poorly fitting PPE.   Furthermore, many nursing staff are currently wearing PPE daily, for example, when caring for patients with high consequence infectious diseases or working with ionising radiation.  We cannot wait for another pandemic to ensure equity of protection.  PPE should fit the nursing workforce rather than the nursing workforce having to fit the PPE. 

LEGAL REQUIREMENTS

Health and Safety Legislation 

Under the respective personal protective equipment regulations, which cover Great Britain and Northern Ireland, every employer shall ensure that suitable personal protective equipment is provided to their employees who may be exposed to a risk to their health and safety while at work.  The exception to this is where and the extent that such risks are adequately control by other means which are equally or more effective.

Suitable personal protective equipment is defined as: 

• Appropriate for the risk or risks involved and the conditions at the place where the risk occurs.
• Takes into account ergonomic requirements and the state of health of the person who may wear it.
• Is capable of fitting the wearer correctly.
• Must comply with relevant manufacturing standards and should, as far as is reasonably practicable prevent or control the risk without increasing the overall risk. 

There is also a legal duty under the Safety Representatives and Safety Committee Regulations to consult health and safety representatives on the introduction of new technology or anything that could substantially affect the safety of members.  This should include consultation on the risk assessment to determine the type of PPE required specific to the hazard, alongside the selection of required PPE.

In organisations where trade unions are not recognised, under the Health and Safety (Consultation of Employees) Regulations, the employer still has a duty to consult workers or an elected representative of the workforce. 

Equality Legislation 

In addition to health and safety legislation, employers need to comply with relevant equality legislation.

Although Great Britain and Northern Ireland have separate legislation on equality in relation to suitable PPE, both share the principle that it is unlawful for employers to treat workers less favourably due to protected characteristics (race, gender, age, disability, religion). Employers must take reasonable steps to remove or reduce disadvantages, including providing alternative PPE. 

Reasonableness is not limited to cost but to meeting legal requirements that PPE adequately protects against identified risks where other controls are insufficient. Failure to consider protected characteristics and provide suitable alternatives may amount to direct or indirect discrimination.