Hospitals are among the most complex fire safety environments in the UK. They combine an extremely vulnerable patient population — including those on life support, under anaesthesia, or physically unable to move — with round-the-clock operation across vast and complex buildings, medical gases that significantly alter the fire risk profile, and a workforce numbering in the hundreds or thousands whose fire safety training and awareness varies considerably. This guide brings together the latest verified data from the Ministry of Housing, Communities & Local Government (MHCLG) and recent enforcement cases to show the scale of hospital fire and what effective fire safety in healthcare settings demands.

Key facts and figures

  • 433 fires in hospitals and medical care facilities in 2024/25.
  • 6.5% of all UK workplace fires occur in hospitals and medical care settings.
  • 6th largest fire category among UK workplace settings is hospitals and medical care.
  • £95,000 fine for Cardiff and Vale University Health Board in September 2025 for RRO failures.
  • 79% rise in fire safety prosecutions nationally in 2023/24.
  • 39% of fire-related fatalities in England in 2024/25 involved people aged 65 and over.

Fire safety in hospitals: complexity at scale

No other workplace combines so many fire risks with so little room for evacuation. A hospital operates continuously, houses people who cannot move themselves, stores and pipes flammable medical gases, and runs an enormous and constantly changing electrical estate — all while undergoing near-continuous building work. Fire safety in this setting cannot rely on a simple "get everyone out" plan; it depends on containment, staged evacuation and trained staff who know exactly what to do in their own area of the building, on every shift.

The statistics reflect that scale of risk. With 433 fires recorded in hospitals and medical care facilities in 2024/25 — around 6.5% of all UK workplace fires — healthcare is the sixth largest fire category among UK workplace settings. Behind each of those incidents sits the possibility of harm to patients who simply cannot escape unaided.

The unique fire risk profile of hospitals

Non-evacuable patients. Many hospital patients cannot be moved safely — they are on ventilators, in the immediate post-operative period, connected to invasive monitoring, or simply too critically ill to survive evacuation. Fire safety planning in hospitals therefore cannot rely on full evacuation as the primary strategy. Instead, hospitals use a staged horizontal evacuation approach, moving patients within the fire-affected floor to a place of safety in a different fire compartment before considering vertical or full evacuation.

Medical gases. Oxygen piped throughout hospital buildings significantly increases the flammability of materials in oxygen-enriched environments. Fires in oxygen-enriched atmospheres burn faster, hotter and are harder to extinguish than those at normal atmospheric oxygen levels. Nitrous oxide and other medical gases introduce additional explosion risks.

Electrical complexity. Hospitals are among the most electrically complex buildings in the UK building stock, with multiple critical systems — theatre equipment, imaging machinery, life support systems and pharmacy equipment — all drawing significant power from fixed installations that must be maintained with hospital-grade reliability.

24/7 operations and shift work. Hospitals never close, so fire safety procedures must operate across three shifts, including nights and weekends when senior management presence may be reduced. Fire marshal coverage must be maintained at all times.

Construction and maintenance. Hospitals are in a state of near-continuous refurbishment. Hot work, electrical modifications and changes to fire compartmentation represent a persistent source of fire risk in live hospital environments.

Patient behaviour. Patients who smoke (or attempt to despite restrictions), patients with mental health conditions who may deliberately or impulsively interact with fire safety equipment, and patients who are confused or disorientated all introduce human behaviour variables that do not exist in standard workplace settings.

Enforcement action against NHS trusts and healthcare providers

Healthcare providers are subject to the full range of fire safety enforcement and have faced significant penalties.

Cardiff and Vale University Health Board (September 2025). The Health Board pleaded guilty at Cardiff Crown Court and was ordered to pay approximately £95,000 in fines and costs. The case related to failures to comply with an enforcement notice issued by South Wales Fire and Rescue Service regarding fire safety procedures at Llandough Hospital's Hafan-y-Coed mental health ward — specifically failures to manage procedures to reduce deliberate and accidental fire risk.

Fairfield General Hospital, Bury (2014). The hospital was served with an enforcement notice following a routine inspection that identified fire doors wedged open, storeroom doors left insecure, combustibles in escape routes, the hospital's own fire safety policy not being followed, inadequate emergency routes and exits, an insufficient fire risk assessment, damaged fire doors, and limited evidence of fire drills.

Morven House Care Home, Croydon. The care home was fined £45,000 plus £23,000 costs for similar failures in a care setting — a pattern that extends across the healthcare and residential care sector.

The 79% rise in fire safety prosecutions nationally in 2023/24 signals that fire and rescue services are pursuing enforcement action in healthcare settings with increasing confidence and frequency.

MeasureFigure
Hospital & medical care fires (2024/25)433
Share of all UK workplace fires6.5%
Rank among workplace fire categories6th largest
Cardiff & Vale UHB fine (Sept 2025)~£95,000
Rise in fire safety prosecutions (2023/24)▲ 79%
Fire fatalities aged 65+ (England 2024/25)39%

The RRO in healthcare settings

The Regulatory Reform (Fire Safety) Order 2005 applies to hospitals in its full form. The Responsible Person — typically the Chief Executive of the NHS Trust, with responsibility delegated through the management structure to a designated Estates Director or Fire Safety Manager — must:

  • Conduct a suitable and sufficient fire risk assessment for the entire premises, updated when significant changes occur.
  • Implement and maintain appropriate fire precautions, including detection, alarms, suppression, compartmentation and means of escape.
  • Produce and maintain documented evacuation procedures appropriate to the non-evacuable patient population.
  • Provide fire safety information and training to all staff — including agency and bank staff, who must receive fire safety induction before working in clinical areas.
  • Appoint and train fire marshals at sufficient density to manage fire emergencies across the building at all times of day and night.

The most commonly breached articles in healthcare settings mirror the national pattern: Article 14 (emergency routes and exits), Article 15 (procedures for serious and imminent danger) and Article 8 (the duty to take general fire precautions).

What effective hospital fire safety looks like

Compartmentation. Hospital buildings depend on fire compartmentation — fire doors, fire-rated walls and protected corridors — to contain fires to their origin and allow horizontal evacuation to adjacent compartments. Wedged-open fire doors, the most common single failure in healthcare fire safety audits, undermine this fundamental strategy.

PEEP plans. Personal Emergency Evacuation Plans for every patient who cannot self-evacuate, updated as patient conditions change and communicated to all staff on each shift.

Fire marshal staffing. Sufficient fire marshals to manage fire emergencies across every occupied area at all times, including nights, weekends and periods of high clinical demand.

Staff training. All clinical and non-clinical staff must understand the fire emergency procedures for their specific area of the hospital. Agency and bank staff must receive fire safety induction before beginning work.

Hot work permit systems. Any construction or maintenance work involving heat-generating activities such as welding, cutting or grinding must be managed through a formal hot work permit system, with a fire watch during and after the work.

Sources & references

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Mark McShane
Mark McShane
Fire Safety Training Specialist, Online CPD Academy

Mark writes about workplace fire safety, compliance and accredited training for Fire Marshal Training, part of Online CPD Academy.