NHS workers who grew beards for religious reasons were sacked after refusing to shave them off so PPE could be fitted, HuffPost UK can reveal.
It is the most shocking finding in a survey of nearly 500 Muslim, Sikh and Jewish medics that found most had experienced pressure to shave, even though in many cases PPE can still be safely fitted to bearded faces.
Newly qualified and locum doctors reported feeling particularly uneasy and reluctantly succumbing to pressure to shave their beards for fear of adversely affecting their jobs.
Dr Amer Hamed, a cardiologist consultant at Stepping Hill Hospital in Stockport, was one of the survey’s authors. He got involved after feeling pressure to shave off his own beard.
More than half of respondents (54%) who had beards for religious reasons felt pressured by colleagues, departments or hospital trusts to shave or trim them during the pandemic. A handful said they had lost their jobs altogether.
“I am a Muslim and have a beard,” Hamed told HuffPost UK. “Beards are part of my male religious duties and the tradition is that it is groomed well.
“Having a beard is part of how I look as a Muslim man. I wouldn’t want to shave it without a clear reason that it is unsafe and there is no other alternative.”
As part of routine measures for all staff, at the start of the pandemic Hamed was asked to undergo a fit test to make sure PPE fitted correctly in case coronavirus levels spiralled out of control and he had to be mobilised to a Covid-19 ward.
Hamed was asked to shave off his beard before having the fit test but refused, asking for the PPE mask to be tried with his beard intact.
“The woman carrying out the fit tests wasn’t happy and left me waiting about half an hour while she went to check. But she eventually returned and said that was fine and I passed the fit test despite my beard.”
As a doctor, Hamed accepts the NHS has a duty to ensure staff and patient safety with adequately fitting PPE.
But he says NHS workers with religious beards should at least be offered the chance of fit testing without shaving. “If you fail the fit test with a beard, then fair enough,” he said. “But my point was I at least wanted to be tested with my beard to see if I passed.”
As an experienced doctor, Hamed was aware of his rights and had the confidence to stand up for himself. But he knows more junior staff, locums and those new to the NHS might feel more uncertain.
“Hospitals have to accommodate faith and customs as best they can,” he said. “If I was less confident, I might have felt pressured to shave off my beard.
“This kind of pressure is unacceptable as you feel your principles, your religion and your way of life, is not tolerated.”
Hamed began researching the issue to discover other people’s experiences during the pandemic and set up a group called Covid and beards.
“This kind of pressure is unacceptable as you feel your principles, your religion and your way of life, is not tolerated.”
- Dr Amer Hamed, a cardiologist consultant and an author of the study
Together with a group of other health professionals and academics, he carried out a survey of 469 healthcare professionals.
The majority of respondents were from Black, Asian and minority ethnic groups (98%), with the remaining 2% being from a white background sharing Muslim, Sikh or Jewish beliefs. In all, 94% were Muslim.
Many revealed they were not offered a fit test for the FFP3 face mask due to having a beard, or did not pursue getting one. And 11% said they had failed the fit test because of their beard.
Of those who passed the fit test, 6% passed with their beard, 5% after trimming and 11% after shaving.
Almost three-quarters of those questioned (74%) said they were not given the opportunity to discuss their concerns regarding PPE and their religious observance of a beard with a senior clinician or manager.
One Muslim junior doctor at a hospital in the north-west told HuffPost UK he eventually gave in to the pressure to shave off his beard after months of resistance as he feared he was jeopardising his job.
The 24-year-old began working for the NHS in May last year fresh out of medical school. He was one of the cohort of emergency doctors who graduated early to help out during the pandemic.
Although he was working as support staff and not on a Covid ward, everyone was fit tested for specialist PPE masks in case they needed to help with procedures such as patients on ventilators.
“To be fit tested, you had to be clean shaven and there wasn’t even the option of trying it with your beard or trimming it.
“I was quite naive as a new doctor who had just joined the NHS so I shaved off my beard.”
The junior doctor said he had worn a beard since the age of 16, but decided to shave it off as he knew the NHS was “falling apart” due to the pandemic. “I felt personal responsibility to step up and help. So it felt less painful to shave off my beard the first time.”
Despite shaving his beard off, the doctor still failed his fit test. “The hospital only had certain sizes of PPE because of the problems with lack of supply at the start of the pandemic,” he explained. “Random sizes of PPE were delivered to different hospitals.”
At the end of July he was moved to a new role in the respiratory department, where he declined to undergo another fit test because he didn’t want to shave again.
“I was there as a proper doctor and they needed me to be on special Covid wards and do procedures,” he said.
“It became an ongoing issue as I kept having to tell consultants I wasn’t fit tested so could not wear the PPE and be in the room when these procedures were carried out. I explained I couldn’t shave my beard for religious reasons.”
Things escalated when the doctor was put on call duty covering more emergency hours. He carried a cardiac bleep and when it went off, he was on a team of five who had to race to help the patient. However, he couldn’t enter the room.
“Things became really messy,” he admitted. “I felt marginalised and looked down upon as a doctor who was either incompetent or didn’t care about his patients.
“People asked: ‘Can’t you just shave it off?’ They didn’t understand and were blase about it.”
Between August and November, the doctor put up a fight against shaving off his beard. He suggested alternatives such as a respirator mask with a specialist air filter. However, these cost around £800 to £900.
“My trust’s excuse was these masks were hard to clean so they couldn’t have them for infection control reasons. But I had friends at other hospitals who were provided with them.
“Bosses just wanted me to shave off my beard and get fit tested.”
“I felt marginalised and looked down upon as a doctor who was either incompetent or didn’t care about his patients."”
- A Muslim junior doctor who felt forced to shave off his beard
He overheard a consultant asking why “any doctor would be stupid enough not to be fit tested during this pandemic” and he became concerned he might lose his job.
“I was fearful for my career and went home and spoke to my parents. They said: ‘Your NHS job is important. Maybe you should shave off your beard.’”
He felt torn.
“For me, my beard is part of the foundations of my religion,” he said. “My dad has a beard and it is something I knew I would have since I was a child. My beard was never really long – just about an inch.
“When I shaved off my beard the second time, I felt sad and guilty. But I felt I’d done everything I could to avoid it and had no alternative.
“I’d worked so hard to become a doctor and was the first doctor in my family. I couldn’t risk ruining that.
“Senior doctors can destroy your career in the NHS and it is a very politicised environment. I didn’t want to come under the radar of my bosses for the wrong reasons.”
Dr Salman Waqar, general secretary of the British Islamic Medical Association, was one of the authors of the study. He said no one was disputing the need for PPE to be worn to keep people safe.
“But there are different types of masks,” he said, “and the real probability is some people might have passed their fit test with a beard.”
Dr Waqar said many doctors who felt compelled to shave off their beards had never shaved them before and felt “emotionally and spiritually hurt”, particularly if it was done under the guise of their job or training being at risk.
“Even if these doctors shaved off their beards willingly, it was a huge thing for them to do emotionally and that sacrifice might not have been recognised.”
If the NHS had more diverse management, he believes, there would be a greater understanding of such issues so people wouldn’t feel so compromised.
The beards study is awaiting publication in a medical journal.
It isn’t just Muslim doctors who feel a beard is important. Dr Gaggandeep Singh Alg, president of the British Sikh Doctors Organisation, says for observant and orthodox Sikhs, their beard is “as important as any of their limbs” and viewed as a “God given gift which should be maintained like any other part of the human body”.
“Observant and orthodox Sikhs should never be put in a position where they have to choose between their faith and vocation,” he said.
“When it comes to the PPE issue, some Sikh healthcare professionals felt they had to choose between their faith and their vocation.
“In the cases the British Sikh Doctors Organisation were involved in, the NHS trusts were extremely helpful to their Sikh healthcare professionals once they understood the importance of the beard.
“We were able to prevent some Sikh doctors from shaving their beards.”
A spokesperson for NHS England and NHS Improvement told HuffPost UK: “All NHS trusts are expected to follow the four nations UK government guidance on the use of PPE, and respirator hoods procured by the government are made available to those who can’t wear respirator masks, while risk assessments should be offered to all staff.”
A Department of Health and Social Care spokesperson said: “There should not be any pressure for people to shave their beard.
“The policies and guidance are clear that individuals should always be offered alternative options.
“Through the NHS, we have made a large variety of masks available in various shapes and sizes to make sure people are equipped with PPE that is right for them.”