Female Muslim doctors and nurses are to be allowed to wear disposable sleeves in order to comply with NHS rules to prevent the spread of hospital superbugs.
All staff involved in caring for patients should be 'bare below the elbows' to ensure sleeves do not become contaminated and hands can be washed thoroughly to prevent infections passed around the ward.
However female Muslim staff had been concerned about the rule as exposure of their forearms is seen as immodest.
Staff in several hospitals had reportedly refused to expose their arms for hand washing and 'scrubbing in' procedures before surgery.
New guidance from the Department of Health said staff can wear disposable sleeves which are elasticated at the wrist and elbow when in contact with patients.
The guidance also states that using alcohol gel to cleanse hands between treating patients does not contravene strict Muslim rules on alcohol.
The guidance was drawn up following meetings between the Muslim Spiritual Care Provision in the NHS group and Islamic scholars, chaplains, multi-faith representatives and infection control experts.
It said: "Use of hand disinfection gels containing synthetic alcohol does not fall within the Muslim prohibition against natural alcohol (from fermented fruit or grain)."
The guidance added Muslim staff could wear uniforms with full length sleeves when not directly engaged in patient care and that they might not be loose or dangling. The sleeves should be able to be pulled back and secured for hand washing and direct patient care.
The Sikh bangle should also be pushed up the arm and secured for hand washing, the guidance said.
If Muslim women wish to cover their forearms during direct patient care they can wear disposable sleeves but washing of hands and wrists should still be observed.
The guidance also said that staff should not wear wristwatches, white coats, neckties other than bow ties, jewellery other than a smooth wedding band and plain stud earings, or display facial piercings or tattoos.
The document said that although there was no direct evidence that wearing uniforms to and from work increased the risk of spreading infection it was good practice to change at work or cover uniforms when outside as this would give patients more confidence.
Christine Beasley, Chief Nursing Officer at the Department of Health, said: "The revised guidance re-enforces the vital importance of good hand hygiene in the fight against infection.
"Staff need to feel comfortable in their uniforms and should be able to dress in a manner that respects their cultural and religious beliefs. Balancing infection control measures with cultural sensitivities is challenging but this revised guidance provides helpful direction to services in how they can achieve this without compromising patient safety.”
The General Medical Council has said that female Muslim doctors must be prepared to remove their veil to treat patients effectively as religious clothing must not be a barrier to good care.
The guidelines say women can wear the hijab which covers the head and hair but not the face.
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