The LWF Blog

Fire Safety for Healthcare Premises – In-Patient Mental Health & Learning Disability Facilities – Part 8

February 8, 2018 1:15 pm

Fire Safety for Healthcare premises is a blog series by LWF, aiming to give guidance on healthcare-based standards and best practice in fire safety. In part 7 of this series, we looked at health centres and GP surgeries which may have facilities for minor invasive procedures and how that should impact upon the safety provisions and protocols in place. In part 8, those facilities which provide inpatient mental health care and accommodation for people with learning disabilities are looked at from a fire safety point of view, with reference to HTM 05-02.


An inpatient service is one where hospital beds and 24-hour care is provided. Such facilities can be found in NHS premises or may be the provision of one of the independent private sector providers.


An inpatient bed service differs from placements registered for the provision of care as provided by local authorities and independent sector providers, registered with the CQC. A placement may involve accommodation in a multiple occupancy facility with a care and support package funded by social services. In this circumstance, it is not an inpatient service and so is not a part of the guidance given in HTM 05-02.


Inpatient mental health services can be categorised as follows:

Acute inpatient beds comprise wards for working-age adults which provide support for patients through intensive medical and nursing provision. Such facilities are for patients who are experiencing acute psychiatric illnesses.


A psychiatric intensive care unit is typically a secure psychiatric ward. Secure in this instance refers to the ward being locked, with the entry and exit of patients controlled. Such units have higher levels of staff, sometimes with one-to-one clinician/patient ratios. The patients on a psychiatric intensive care ward could not be cared for on an acute ward due to the level of risk they may pose to themselves or other people. There is a potential for some patients to have been transferred from prisons or rehabilitation wards, although it is likely all patients will be detained under the Mental Health Act.


Forensic Services is related to criminology and covers high, medium and low-security units. Only medium and low-security units are covered by HTM 05-02.

Low secure services provide care to patients with long-term and complex issues which cannot be catered for on an acute ward. Patients in low secure services wards are often detained under the Mental Health Act.


Medium secure services are provided for those adult patients with a severe mental illness who require their treatment in a secure environment. The secure management of medium secure services patients is necessary for their own safety and that of others and in most instances, the occupants will have committed a criminal offence. As well as the provision of security for protection, the potential for escape is also a concern.


Part 9 of this series will continue to look at the categorisation of inpatient mental health services. In the meantime, if you have any queries about fire safety in healthcare premises or wish to discuss this blog series, please contact Peter Gyere in the first instance on 0208 668 8663.


Lawrence Webster Forrest is a fire engineering consultancy based in Surrey with over 25 years’ experience, which provides a wide range of consultancy services to professionals involved in the design, development and construction and operation of buildings. 


While care has been taken to ensure that information contained in LWF’s publications is true and correct at the time of publication, changes in circumstances after the time of publication may impact on the accuracy of this information.




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