Recommendation 208

Distinguishing between nurses and healthcare support workers

Accepted in principle
Commissioning arrangements should require provider organisations to ensure by means of identity labels and uniforms that a healthcare support worker is easily distinguishable from that of a registered nurse.

We agree that patients should be clear on the role of people caring for them, for example through identity labels, clear job titles and uniforms. Many organisations already do this.

However, the Cavendish Review does not make a firm recommendation that health care assistants and nurses should wear distinct uniforms, because so many trusts already develop their own.  The review does, however, support the need to provide more clarity to patients and relatives about who is looking after them.  The Chief Nursing Officer will take forward work on this.


In November 2013, the National Quality Board published guidance to support providers and commissioners to make the right decisions about the capacity and capability of nursing, midwifery and care staffing. One of the expectations set out in the guidance is that NHS providers clearly display information about the nurses, midwives and care staff present on each ward, clinical setting, department or service on each shift. The information displayed should be helpful and accessible to patients, and could include: the numbers of staff present on the ward, department, service or setting; who is in charge; and what the different roles and responsibilities of staff on the ward are. It could also provide relevant local information, such as the significance of different uniforms worn by staff, and titles used. Through the NHS Standard Contract for 2014/15, all commissioners require providers to have regard to this guidance.