The claim
“The National Health Service has amended its hygiene rules to allow Muslim staff not to wash before attending to patients.”
BNP News, British National Party website, 11 April 2010

The background
Hygiene guidance for NHS staff has been attacked on the BNP’s website, which claims that it allows Muslim staff not to wash before attending to patients.

The article follows the revision of NHS’s guidance to offer advice on dealing with cultural issues associated with workwear.

According to the party, female Muslim staff will now be exempt from the rule that all staff should be scrubbed and bare below the elbow. It notes that long sleeves have been identified as one of the leading causes of the spread of bacteria responsible for the superbugs and describes the alternative of disposable sleeves as “utterly pathetic”.

The party says “the open display of anti-British bias will now put patients in hospitals at even greater risk of infection by the ‘superbug’ epidemic which has directly paralleled the increasing numbers of ethnic NHS staff.”

So will the BNP’s hygiene claims wash with FactCheck?

The analysis
The BNP does not provide a link to the announcement in question. However, the guidance published on 26 March 2010 on uniform and workwear contains advice on cultural issues.

This revision provides advice for NHS employers on how cultural issues affecting uniform policy should be dealt with. It attempts to minimise the risk of any challenge to uniform and workwear codes.

The policy document supplements guidance from 2007, which advises staff to wear short-sleeved shirts or blouses because cuffs become heavily contaminated and are more likely to come into contact with patients.

It says although exposure of the forearm is a necessary part of hand and wrist hygiene during direct patient care activity, the uniform code should “allow for covering of the forearm at other times”.

It goes on to say that “uniforms and workwear should not impede effective hand hygiene, and should not unintentionally come into contact with patients during direct patient care activity”.

The document adds that where members of staff wish to cover their forearms for religious reasons, “when not engaged in patient care”, they should ensure that sleeves “can be pushed up the arm and secured in place for hand washing and direct patient care activity”.

The guidance says disposable oversleeves can be used to cover bare forearms during patient care, but “strict adherence to washing hands and wrists must be observed before and after use”. Oversleeves must be discarded in exactly the same way as disposable gloves.

The Department of Health added that bare arms covered in disposable sleeves must also be washed between treating patients.

These guidelines were developed in consultation with Muslim Spiritual Care Provision in the NHS, a joint project between the Department of Health and the Muslim Council of Britain. 

Its recommendations – most of which have been adopted in the guidance – makes it clear that hand disinfection gels containing synthetic alcohol comply with Islamic prohibition laws.

We asked the BNP to respond to this FactCheck enquiry. The party said: “The content of the story makes it very clear that reference is being made to the bare and scrubbed ‘below the elbows’ rule which is no longer being applied to female Muslim NHS staff.

“No less than six entire paragraphs make it crystal clear that it is the bare below the elbows and long sleeves to which reference is being made.

“We dismiss your attempts to distort the story and stand by the widely reported reality that Muslim female staff have been excused normal NHS hygiene rules because of their religion.”

The verdict
The BNP is factually correct in highlighting the guidance’s proposed alternative of disposable sleeves for NHS staff on religious grounds, which is mentioned in the policy document.

The party is also right when it points out that staff can now opt for long sleeves. But the guidance states that this only applies when they are “not engaged in patient care”. The BNP fails to make this clear – that long sleeves are allowed when not directly dealing with patients – in its article.

However, the party’s top-line claim that hygiene measures have been relaxed to “allow Muslim staff not to wash before attending to patients” is incorrect. While guidance seeks to accommodate cultural differences, it makes it clear that “strict procedures for washing hands and wrists must still be observed”.