Fire Safety for GP Surgeries and Healthcare Premises
Fire safety in a GP surgery or healthcare premises carries considerations that go beyond the standard commercial setting, from patients who may need evacuation assistance to medical oxygen storage and the particular challenges of premises that were never designed for clinical use. This guide covers the key legal duties, practical priorities, and common gaps for responsible persons in primary and community healthcare.
General practice is, by its nature, a complex environment to manage. The clinical demands on a GP surgery are considerable enough without layering in the administrative and compliance obligations that come with running a physical premises. Fire safety is one of those obligations, and in a healthcare setting it carries a weight that goes beyond the standard commercial context. This guide is intended to help practice managers, GP partners, and responsible persons in primary and community healthcare understand what fire safety compliance looks like in their specific setting, what the common challenges are, and how to approach them practically.
Why healthcare premises deserve specific attention
One of the most significant distinctions between a GP surgery and other commercial premises, from a fire safety perspective, is the occupant profile. A surgery on any given morning may have waiting rooms containing elderly patients with limited mobility, individuals recovering from minor procedures, people with cognitive impairment, and young children. Evacuation in a healthcare setting takes longer, requires more coordination, and benefits significantly from having been thought through carefully in advance rather than improvised on the day.
There are also material differences in the physical environment. Medical oxygen, alcohol-based hand gels, pharmaceutical stocks, and sterilisation equipment introduce hazards that a standard commercial premises assessment will not automatically account for. Electrical infrastructure in older converted buildings — many GP surgeries occupy premises that were never purpose-built for clinical use — can present risks that benefit from periodic review. The relevant NHS technical guidance, HTM 05-03, provides detailed guidance on fire safety in healthcare premises and is the benchmark against which NHS-managed and primary care buildings are assessed; its recommendations inform what good practice looks like even for practices that fall outside direct NHS estate management.
None of this means that fire safety in a GP surgery is unmanageable. It means that a thoughtful, premises-specific approach will serve a practice considerably better than an off-the-shelf solution.
The legal framework
The primary legislation governing fire safety in non-domestic premises in England and Wales is the Regulatory Reform (Fire Safety) Order 2005. Under the Order, the duty to ensure fire safety falls on the responsible person, typically the employer, the owner of the premises, or the person with control of the building. In a GP surgery, identifying the responsible person is sometimes straightforward and sometimes less so: a single-handed practice in its own building has a clear answer, while a larger practice sharing a health centre with a community trust and an NHS Property Services landlord may find that responsibilities are distributed across multiple parties. The legislation accommodates this and allows for shared responsibility between multiple responsible persons, but it is worth being explicit about who is responsible for what and documenting that clearly.
At minimum, the responsible person must carry out or commission a suitable and sufficient fire risk assessment and review it regularly or when significant changes occur; implement any actions the assessment identifies; put in place appropriate fire safety arrangements including an emergency evacuation plan, staff training, and equipment maintenance; and keep a written record of the assessment and arrangements, particularly where five or more people are employed.
Healthcare premises are also subject to Care Quality Commission requirements, and CQC inspectors will look for evidence that fire safety arrangements are in place and up to date as part of the safe environment standards. Practices in older or listed buildings may face additional considerations around the practicalities of implementing fire safety improvements within planning or heritage constraints.
A note on shared premises: where a GP surgery occupies part of a building managed by a landlord or estates team — a health centre, a converted commercial unit, or an NHS-managed facility — the fire risk assessment obligation does not disappear simply because someone else owns the building. The responsible person for the practice's activities within their area of occupation retains duties under the Order, and coordination between multiple responsible persons sharing a building is something the assessment should explicitly address.
The fire risk assessment: what to expect
The fire risk assessment is the foundation of a practice's fire safety arrangements. It informs everything else — the emergency plan, the training programme, the maintenance schedule, and the equipment provision. For a GP surgery, a suitable and sufficient assessment should work through the following areas.
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1Ignition sources
Electrical equipment, heating systems, kitchen facilities, and clinical equipment that generates heat should all be identified and evaluated. Particular attention is often paid to how electrical equipment is managed, including the use of extension leads and the overnight status of devices left powered without a clear operational need.
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2Fuel sources
Paper records, soft furnishings, cleaning materials, clinical supplies, waste, and anything else that could contribute to fire spread should be considered in terms of how it is stored and whether it creates unnecessary risk in corridors or near ignition sources.
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3Oxygen and flammable materials
Medical oxygen, alcohol-based hand gel products, and certain pharmaceutical or sterilisation agents require specific assessment. The storage and handling of medical oxygen in particular should be verified against relevant guidance, as oxygen enrichment dramatically accelerates fire spread and changes the risk profile of an affected area considerably.
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4People at risk
This is the area where healthcare assessments most distinctively differ from standard commercial ones. All categories of occupant should be considered: staff, patients (including those with mobility, sensory, or cognitive limitations), contractors, and visitors. The assessment should address how each group will be alerted in the event of a fire and how they will safely leave the building, with particular attention to those who may not be able to do so independently.
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5Personal Emergency Evacuation Plans
Where individuals, whether patients or staff, may not be able to evacuate independently, a Personal Emergency Evacuation Plan (PEEP) should be in place. In a busy clinical setting this requires some practical thought about how to identify patients who may need assistance on a given day and how that assistance will be provided, since the patient group changes from one session to the next in a way that a fixed PEEP document cannot fully anticipate.
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6Existing fire safety measures
The assessment will evaluate what detection, alarm, suppression, fire door, emergency lighting, signage, and equipment provision is already in place and whether it is appropriate for the specific risks identified. It will also consider whether maintenance records are current and whether any equipment is overdue for inspection or servicing.
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7Emergency plan
The assessment should result in a written emergency plan that sets out clearly who does what in the event of a fire and that accounts for variations in staffing, such as reduced cover during lunch or at the end of the clinical day. A plan that only works when all hands are present is not a reliable plan.
The law requires the assessment to be suitable and sufficient for the specific premises and carried out by a competent person. A generic template is unlikely to meet that standard for a healthcare setting, and an assessment that has not been reviewed since the practice moved premises, significantly changed its occupancy, or took on new clinical services may no longer reflect the actual risk.
Fire doors: a consistent inspection programme
Fire doors are one of the most effective tools in a building's passive fire protection and, in a healthcare setting where evacuation may take longer than in a standard commercial premises, they buy the additional time that can make the difference between a controlled evacuation and a chaotic one. They are also, in practice, one of the most commonly found areas for improvement in fire risk assessments across all building types. The pressures of a busy clinical day mean that fire doors are sometimes held open for operational convenience, or accumulate wear and damage that goes unreported simply because no one has been formally designated to look.
A consistent fire door inspection programme is therefore essential in these settings. Doors on escape routes and within fire compartmentation walls should be checked regularly for damage, for the condition of door closers, intumescent strips, and smoke seals, and for any signs that they are being compromised in day-to-day use. Findings should be recorded and defects addressed promptly rather than deferred to the next maintenance cycle.
Staff training: making it relevant to the setting
All staff should receive fire safety training on induction and at regular intervals thereafter, with annual training widely used as the standard for higher-risk environments. The training should cover the essentials: how to raise the alarm, how to use a fire extinguisher appropriately, how to evacuate the building, where to assemble, and how to assist patients who may need help leaving the building.
The most effective training for a healthcare setting reflects the specific building, the specific escape routes, and the specific patient groups the practice serves. A member of staff who has walked the evacuation routes of their actual building and thought through how they would assist a patient in a wheelchair is considerably better prepared than one who has completed a generic online module with no connection to their working environment.
Practices should also consider the fire marshal role. Fire marshals are those members of staff who take a more active role in fire safety management and emergency response, checking areas, assisting with evacuation, and liaising with emergency services on arrival. Depending on the size and nature of the premises, having trained fire marshals on duty during opening hours is likely to be a requirement of the fire risk assessment, and training for this role is available as a short, practical course. Training records should be maintained, both as good governance and as a straightforward means of demonstrating compliance to a CQC inspector or enforcing authority.
Electrical safety
Electrical faults are a leading cause of fires in commercial premises, and healthcare buildings are not exempt. The combination of high equipment density, older building stock, and the incremental addition of devices over many years means that electrical infrastructure in GP surgeries occasionally warrants closer attention than it receives. Extension leads and multi-socket adaptors, the reliable companions of any overstretched clinical space, are worth reviewing periodically, and equipment left powered overnight without a clear operational need should be identified and considered. An Electrical Installation Condition Report (EICR) carried out by a competent electrician provides a clear picture of where, if anywhere, remedial work is required.
Out-of-hours security and arson prevention
A GP surgery that is well-staffed during opening hours is, outside those hours, an unattended building containing pharmaceutical stocks, valuable equipment, and patient records. This makes it, like many healthcare and public-service premises, a target of some interest to opportunistic criminals, and arson, whether targeted or opportunistic, is a risk that a fire risk assessment should address rather than overlook. Practical measures tend to be straightforward: adequate external lighting, secure waste storage away from the building itself, a monitored alarm system, and periodic review of access controls. None of this requires significant investment, but the risk does need to be recognised and documented in the assessment.
What good fire safety looks like in practice
A GP surgery with well-managed fire safety is not one that has eliminated all possible risk — no building can achieve that. It is a surgery where the risks have been properly identified, where sensible and proportionate controls are in place, where staff know what to do and have practised it, and where the responsible person can demonstrate clearly and with documentation that they have taken their duties seriously. In practical terms, this typically means a current fire risk assessment that reflects the actual premises, a written emergency plan that staff have been trained on, a regular fire door inspection programme, maintained fire safety equipment, and up-to-date training records. These are not onerous requirements; they are the reasonable foundations of a safe working and clinical environment.
The starting point, for any practice that is uncertain about its current position, is a professional fire risk assessment carried out by someone with experience of healthcare settings. That assessment will provide a clear picture of what is working well, what requires attention, and — importantly — in what order those things should be addressed.
Fire safety support for GP surgeries and healthcare premises
We work with GP surgeries, health centres, and healthcare premises across Chester, the Wirral, Cheshire, North Wales, and the wider North West, providing fire risk assessments, fire door inspections, and staff training tailored to clinical settings.
This article is intended to provide general guidance on fire safety considerations for GP surgeries and healthcare premises in England and Wales. It does not constitute legal advice and should not be relied upon as a substitute for a professional fire risk assessment carried out by a competent person in accordance with the Regulatory Reform (Fire Safety) Order 2005. Fire safety requirements vary depending on the specific nature, layout, and occupancy of individual premises. Fletcher Risk Management Ltd accepts no liability for actions taken or not taken on the basis of the information contained in this article.