Briefing Note: Slip-Resistant Footwear in the NHS

Summary: Slip incidents are a leading cause of staff injury in the NHS. Where floors cannot be kept consistently dry or free from contamination, footwear must be treated as a safety control. National guidance recommends slip-resistant footwear, but there is currently no defined performance standard and no active rating scheme.

National Context

  • NHS National Standards of Healthcare Cleanliness (2025) recommend slip-resistant footwear as a control measure in environments where floor contamination cannot be fully eliminated.

  • NHS Uniforms and Workwear Guidance (2020) requires footwear to be suitable, enclosed, cleanable and supportive of safety.

  • Despite these requirements, no national specification exists to define minimum slip-resistance performance or how performance should be measured.

Evidence for Slip-Resistant Footwear

  • The NIHR-funded SSHeW trial demonstrated that high-performance slip-resistant footwear can reduce slips and related falls by up to 50% in NHS staff populations.

  • The footwear used in the trial achieved high ratings under the HSE GRIP scheme, which provided realistic 1–5 star ratings based on controlled contaminant testing.

  • The HSE GRIP scheme ended in 2022, leaving the NHS without a live, recognised performance rating system.

Neospire® SoleXT Tribometer

To address the absence of accessible verification, Neospire has developed SoleXT, a compact slip measurement tribometer that replicates established ramp-test methods used in slip performance assessment.

Capabilities of SoleXT

  • Bench-top format replicating ramp-based slip testing principles

  • Repeatable slip performance measurement using relevant contaminants

  • Comparative evaluation of footwear options prior to procurement

  • Ability to monitor performance degradation in footwear in use

  • Supports classification of footwear as PPE where required performance contributes to risk control

Current Gap

Trusts are encouraged to use slip-resistant footwear but lack:

  • a measurable national threshold for performance, and

  • an accessible method for verifying performance before procurement.

As a result, procurement decisions often rely on unverified supplier claims rather than independent testing.

Opportunity for a New Rating Scheme

With the discontinuation of the HSE GRIP scheme, the NHS currently lacks an authoritative rating system.

The SoleXT enables development of a new, affordable, evidence-based slip-resistance rating scheme with the following characteristics:

  • realistic testing based on NHS contaminant and flooring conditions

  • accessible verification without requiring large-scale laboratory facilities

  • defined minimum thresholds linked to risk levels and job roles

  • transparent, repeatable, independently validated scoring

Such a system would allow Trusts to specify measurable requirements and verify supplier claims before purchase.

Proposed Pathway for NHS Adoption

1. Define - minimum slip-resistance performance requirements

Consistent procurement criteria

2. Verify - footwear using SoleXT

Independent, evidence-based selection

3. Classify - required footwear as PPE where performance controls risk

Employer-funded provision, aligned with H&S law

4. Prioritise - implementation in high-risk departments

Cost-effective risk reduction

5. Share - results across Trusts

Supports development of a national standard