Do uniforms influence perceptions of advanced nurse practitioners? A national survey in Scotland

Background: The NHS Scotland uniform policy, introduced in 2009, standardised colour-coded uniforms to ensure clear identification of NHS staff roles. However, advanced nurse practitioners were not allocated a unique colour, leading to concerns about misidentification and frequent interruptions during critical decision making. Aims: This study aims to provide guidance on potential standardisation of advanced nurse practitioner uniforms in Scotland and explore people's understanding of nursing uniforms. Methods: A national mixed methods cross-sectional survey was conducted across all health boards in Scotland, involving healthcare staff, patients and carers ( n =1017). Results: The survey revealed a clear preference for a navy tunic with red trim, associated with seniority and professionalism, over the current cornflower blue uniform. Implications for practice: The study findings have been shared with key Scottish Government stakeholders and will inform policy considerations, though implementing a new uniform may involve cost, supply renegotiations, resistance to change, and the need to consider impacts across advanced practice roles and professions. Conclusions: The findings suggest that differentiating advanced nurse practitioner uniforms from other registered nurses could enhance public confidence and staff morale.