Read the documents: Hospital dress code | Disciplinary warning to staff over dress

DOCTORS, including senior hospital consultants, have been banned from wearing ties because NHS managers claim they could spread the superbug MRSA.

An NHS trust has told hospital consultants they face disciplinary action if they repeatedly wear a bow tie or neck tie on the wards. Doctors and nurses have even been encouraged to confront colleagues who break the "no-tie" code.

The rules have been introduced by Brighton and Sussex University Hospitals NHS Trust to reduce its rate of MRSA infection, the highest in England.

Managers say neck garments are "superfluous" and that as they are not cleaned as often as other items of clothing could be an infection hazard.

However, doctors say the rules are driven by political correctness rather than scientific evidence. They say their professionalism could be eroded by the dress-down policy and fear patients will have less confidence in open-shirted medics.

One consultant at the trust, who did not want to be named for fear of disciplinary action, said: "If you come to see a consultant in Brighton, you will be greeted by an open neck shirted doctor who will look as if he is the hospital DJ, but will in fact be the consultant."

Dr Michael Dixon, a bow-tie wearing GP and chair of the NHS Alliance, which represents primary care trusts, said research showed patients had more confidence in smartly-dressed doctors. He said: "I certainly would feel less professional if I was not wearing a tie. It is all right if you are an antipodean doctor but not in this country.

"This is political correctness rather than science. Patients need to be able to respect and trust their doctors and going around without ties might damage that relationship."

Professor James Drife, a consultant obstetrician in Leeds, said it might even be sexist. Drife, who wears a bow tie, said: "They wouldn't be allowed to humiliate women by telling them they could not wear a basic item of their clothing."

Earlier this year the British Medical Association (BMA) suggested disposing of functionless clothing such as ties could help reduce MRSA rates of hospital acquired infections.

There are more than 7,000 cases of MRSA bloodstream infection, the potentially deadly form, in British NHS hospitals every year. The number of official superbug deaths, where MRSA is mentioned on the death certificate, has increased dramatically from 51 in 1993 to 1,168 in 2004, the last year for which figures are available.

Brighton and Sussex University Hospitals NHS Trust says tough action is needed for its to move away from the top of the league table for MRSA infections. A memo from trust managers warns: "We would prefer not to have to resort to disciplinary procedures. However, the trust will treat repeated disregard of this policy seriously and take any necessary action. We support all staff in challenging anyone seen not to be adhering to this policy."

Matthew Fletcher, medical director of the Brighton trust, said: "We do know this will involve a culture change because many doctors are used to wearing a jacket and tie, particularly when delivering bad news, and many patients expect doctors to look 'smart'. But reducing the spread of infection is more important than looking smart and both doctors and patients need to accept ties are not essential for the delivery of a professional service and good healthcare."

Claire Rayner, the agony aunt and president of the Patients Association, disagreed. The former nurse and MRSA victim said: "This does seem a very puerile argument to me. If a doctor wears a tie properly, and it does not flop around, then there shouldn't be any problem. Issuing these little edicts sounds like someone is trying desperately to find something to say and do about hospital infection.

"These pernickety little rules make managers feel like they have done something. What is needed is for everyone to wash their hands."

Tie Rack, the high street shop, says ties have enjoyed a come-back after sales fell slightly during the dotcom boom when employees were encouraged to wear more casual attire.

Sara Carter, the company's group marketing director, said: "The tie helps to inspire confidence that the wearer is an educated, capable and authoritative figure."

This article is a fuller version of the page one story in The Sunday Times newspaper.

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