The LWF Blog

Fire Safety for Healthcare Premises – Types of Patient Dependency – Part 5

January 18, 2018 2:13 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 4, the use of vertical escape practices after horizontal escape had already been completed was discussed. In Part 5, we’ll look at how Firecode classifies patient dependency for the purposes of successful evacuation.


Firecode separates patient dependency into three distinct classifications, as follows:


Independent – An independent patient is one whose mobility is unimpaired and they would be able to leave the premises without assistance, or a person who is slightly mobility impaired but would be able to negotiate stairs unaided or with minimal assistance. It would also be important for this category of patient to be able to see, read and understand the emergency signage provided.


Dependent – All patients who do not fall into the ‘Independent’ category above or the ‘Very high dependency’ category below.


Very high dependency – These patients may be in Intensive Care, operating theatres, be undergoing cardiac care or other potentially life-threatening care situations. Patients in this category require clinical treatment or have a condition which means they are highly dependent on staff care.


When considering the categories of patients and their dependencies, it is possible to see that areas of the hospital or healthcare facility designed for that dependency might have different requirements in terms of fire safety.


An area which contains independent patients will not be so reliant on horizontal evacuation (which is designed to provide the least possible interruption to patient care) and so compartmentation requirements are reduced, both horizontally and vertically.


Approved Document B (pdf) provides standards sufficient for an area containing only independent patients and further guidance can be sought under purpose group 2a or 5 depending upon the type of premises under consideration. It is, however, important that clinicians’ advice is sought in cases where there may be any doubt about the ability of a patient to quickly respond in the case of fire.


While it is possible to classify an area as independent, consideration should be given to the potential for horizontal or vertical evacuation to that area of patients who fall into the dependent or very highly dependent categories. In such cases, the means of escape provision should reflect the measures required for the higher dependency patients.


For areas containing patients who are dependent or very high dependency, the guidance provided in HTM 05-02 should be used in addition to Approved Document B.


In Part 6 of this series, LWF will look at some of the additional precautions which must be undertaken in areas containing very high dependency patients. 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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