Hospitals combine patients who may need help to move with continuous operation, complex equipment and demanding evacuation arrangements. This guide brings together official England fire and audit figures for 2025/26 and explains what they mean for healthcare fire safety. The incident category covers hospitals and medical-care premises; the audit category is hospitals.
Reviewed 15 October 2026. Annual figures cover England, April 2025 to March 2026, unless another period or geography is stated. Historical studies, guidance and court cases are labelled separately.
Key facts and figures
- 475 fires were recorded in hospitals and medical-care premises in England in 2025/26, up from 433 in 2024/25.
- 330 of those hospital and medical-care fires were recorded as accidental in 2025/26.
- 52 non-fatal casualties were recorded in hospital and medical-care fires in England in 2025/26.
- 1,338 hospital fire safety audits were carried out in England in 2025/26.
- 63% of hospital fire safety audits were satisfactory in England in 2025/26 (837 of 1,338).
- 40% of all fire-related fatalities in England in 2025/26 involved people aged 65 and over; this is not hospital-specific.
Fire safety in hospitals: complexity at scale
Hospitals operate continuously, care for people who may be unable to evacuate unaided and use medical gases and electrical equipment that need careful management. Fire safety depends on maintained precautions, an appropriate evacuation strategy and staff who understand the arrangements for their area on every shift.
MHCLG table FIRE0301 records 475 fires in hospitals and medical-care premises in England in 2025/26, up 9.7% from 433 in 2024/25. That was 3.5% of the 13,679 primary fires in other buildings in England. Of the 475 incidents, 330 were accidental and 145 deliberate. The table records 52 non-fatal casualties and no fire-related fatalities in this premises category for the year.
The fire risk profile of hospitals
Patients needing assistance. Planning must account for patients who cannot move without staff, equipment or clinical support. Staged evacuation and movement to another protected compartment may form part of the building’s strategy; staff need to know the specific plan for their area.
Medical gases. Oxygen-enriched conditions can cause materials to burn more readily and intensely. Storage, supply and use of medical gases need to be included in the fire risk assessment.
Electrical systems. Life-support equipment, imaging, theatre machinery and other installations require maintenance and appropriate controls when equipment or building use changes.
24/7 operation. Procedures and trained staff coverage must work on every shift, including nights and weekends. The necessary staffing and roles should follow the site’s emergency arrangements.
Construction and maintenance. Hot work, changes to electrical systems and breaches in compartmentation can introduce risks during refurbishment of occupied areas.
Patient needs and behaviour. Care planning should address smoking, confusion, distress and other circumstances that may affect fire prevention or evacuation, without assuming every patient has the same needs.
Hospital audits and enforcement
The 2025/26 protection tables record 1,338 hospital fire safety audits in England. Of these, 837 (63%) were satisfactory and 501 (37%) were unsatisfactory. Audits follow local risk priorities and are not a random survey of all hospitals; an unsatisfactory result means further action is needed, not necessarily a prosecution.
Hospitals received 22 Article 30 enforcement notices and 26 formal notifications in total. The hospital category recorded no prosecutions in this annual return. These are separate measures: formal notifications include several types of formal action, and a single audit may identify more than one deficiency.
Across all premises in England, 33 fire-safety prosecutions were recorded in 2025/26, compared with 35 in 2024/25. This national comparison provides wider context; the hospital figures above describe the sector’s own audit and enforcement activity.
| Measure | Figure |
|---|---|
| Hospital and medical-care fires (England, 2025/26) | 475 |
| Accidental hospital and medical-care fires (England, 2025/26) | 330 |
| Non-fatal casualties in hospital and medical-care fires (England, 2025/26) | 52 |
| Hospital fire safety audits (England, 2025/26) | 1,338 |
| Satisfactory hospital audits (England, 2025/26) | 63% (837 of 1,338) |
| Fire fatalities aged 65+ (all settings, England, 2025/26) | 40% |
The RRO in healthcare settings
The Regulatory Reform (Fire Safety) Order 2005 applies to hospitals in England and Wales. 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 frequently recorded hospital non-compliances resulting in action in England in 2025/26 were Article 14 (286), emergency routes and exits; Article 17 (228), maintenance; and Article 8 (197), general fire precautions. These FIRE1204 counts exclude prosecutions and can include several articles for one premises. The national ranking across all premises is different.
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 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.
Make sure your healthcare site has trained fire marshals on every shift.
Explore the Fire Warden / Fire Marshal Course →Sources & references
- MHCLG — FIRE0301: primary fires, fatalities and casualties in other buildings
- MHCLG — Fire prevention and protection, England, April 2025 to March 2026
- MHCLG — FIRE1202: hospital audit outcomes and formal notifications
- MHCLG — FIRE1204: non-compliance by article and premises type
- MHCLG — Detailed analysis of fires, England, year ending March 2026
- Regulatory Reform (Fire Safety) Order 2005 — current legislation
Mark writes about workplace fire safety, compliance and online training for Fire Marshal Training, part of Online CPD Academy.