Scrubs, gowns, alginate bags and linen cages: Letter from Simon Corben


Publications approval reference: 001559 / C0294


Chief executives
Medical directors
Estates and facilities directors
Directors of nursing
EPRR leads
DIPCs and infection control leads

15 April 2020

Dear colleagues

Scrubs, gowns, alginate bags and linen cages

It is important that organisations manage stocks carefully, and organisations should ensure they are not disposing of reusable products or surgical gowns. They should also avoid holding excess linen stock on shelves: this needs to be released back into the system.

It is critical that management of linen is considered as part of surge planning and, where possible, alternative solutions such as sending uniforms to laundries are provided. This will support availability across all trusts where scrubs are required.

Laundry suppliers have confirmed they can launder uniforms in place of scrubs, and organisations should work with their supplier to arrange this where required, ensuring that uniforms are bagged separately for ease of processing.

Current guidance does not require scrubs to be used for outbreaks. If an organisation has moved to all staff using scrubs, they must assure themselves they have adequate supplies and have fully considered alternatives, including use of uniforms. If their laundry supplier cannot guarantee these supplies, this should be escalated back to the incident management team as well as the infection, prevention and control team. They will then need to risk assess their approach to uniforms based on supply.

Please work with your laundry supplier to set up laundering of uniforms where necessary. However, if required, uniforms can be laundered at home in the following way:

  • taken home in a standard bag (not alginate as this may damage domestic machines)
  • emptied out of the bag directly into the drum: no other household items should be included in the wash
  • bag can be disposed via general domestic waste
  • seal and door of the machine wiped before closing
  • washed at the highest temperature the garment allows and at a minimum of 60o C.
  • a weekly mild solution of bleach on a high temperature can be used in the machine to decontaminate it.

A 10-minute wash at 60ºC is sufficient to remove almost all micro-organisms. In tests, microbiologists found only 0.1% of any Clostridioides difficile spores remained. They advise that this level of contamination on uniforms and workwear is not a cause for concern.

There is no requirement for uniforms or scrubs to be changed during a shift unless they become soiled. However, staff should ensure they do not wear uniforms or scrubs outside the workplace and change into their own clothes at the end of each shift. This may not be an option for community-based staff, who should remove their uniform as soon as possible, placing them in their washing machine (following the instructions above) and washing their hands thoroughly.

Regional leads should work with organisations in their area to ensure the distribution of items is fair and excess stock is not held. Organisations should work closely with their linen and laundry supplier to ensure additional stocks are released back into the system, agree correct bagging systems and they order only what they need until the next delivery of clean linen.

Please ensure:

  • Scrubs suits and modesty gowns are bagged separately to flat linen to speed up processing.
  • Scrubs, modesty gowns and surgical gowns are not taken home by staff and are returned into the system for processing.
  • Alginate bags are not used for all linen (only infectious linen) and staff do not take uniforms home to wash in these bags.
  • There is no stockpiling of items.
  • You plan ahead, including the potential use of standard uniforms and putting these through the laundry provider if required in place of scrubs.

Guidance is constantly being updated so always check you have the latest version. It will be published on the Public Health England website and be available on NHS Estates Collaboration Hub. Any NHS trust can join the Hub by emailing to request membership.

For any further information please contact: marking for the attention of Emma Brookes.

Yours sincerely

Simon Corben | Head of Profession | Director of NHS Estates