Culottes, tunic tops, polo shirts and dresses made from crimped fabric with shoulder and back pleats could be part of the nurses' uniform of the future, according to a guide by the Royal College of Nursing (RCN).

The guide says uniforms need to be safe and comfortable.

The RCN says stiff uniforms can affect nurses' posture and lead to bad backs.

Carol Bannister, RCN adviser on occupational health and safety, said: "Safe uniforms which allow nurses to move freely are essential for the sake of both nurse and patient.

"Restrictive uniforms increase the risk of back injury. We estimate the high incidence of bad backs among nurses costs the NHS a million pounds a week."

The RCN suggests several ways to improve flexibility by using modern fabric which allow stretching and free movement.

Confidence

The guide says nurses' uniforms need to encourage public trust and confidence, be smart and practical and reflect the work they do.

It states: "It is vital to make sure that unauthorised people do not have access to uniforms."

The RCN says uniforms also need to be safe, although there is no evidence to show uniforms can spread infection.

To be sure, it says, uniforms should incorporate disposable aprons and should be properly laundered.

Student nurses held a fashion show on Monday at the RCN's annual conference in Harrogate to show off examples of uniforms of the future and to give ideas to health trusts.

The RCN guide adds that students should always have their uniforms paid for them.