The LWF Blog

Fire Safety for Healthcare Premises – Very High Dependency Patients – Part 6

January 23, 2018 11:12 am

In LWF’s fire safety blog series for Healthcare professionals, we have been looking at the basic principles of fire safety in healthcare premises. In part 5, the different types of patient dependency were laid out and in Part 6, the particular requirements of Very High Dependency Patients in a fire situation will be explored.


The premise that independent patients are ambulatory and therefore can assist with their own evacuation and dependent patients can be moved while their treatment continues cannot be applied in the case of Very High Dependency Patients (VHDP), where any attempt to move them from an operating theatre or intensive care could be life-threatening.


The serious nature of VHDP care means that additional precautions are necessary where there is a fire and smoke in an adjacent compartment, or where there is a fire situation in the compartment containing VHDP.


The design of areas which will contain VHDP must, therefore, be created in order to take into account the additional needs of the patient and the pre-planning of moving such patients to a safer area. For example, ventilators are provided with an electrical back-up supply but as they must be moved with the VHDP, double doors must be provided in order to allow for large machinery to pass through alongside the bed.


Extended fire-resistant construction of departments is essential, along with adjacent compartments, to allow additional time for preparation and evacuation of the VHDP, all relevant equipment and staff to move from that area all at once.

However, more time isn’t the sole aim of the fire safety design. The main objective is to prevent fire in any adjacent compartment, to either side, above or below, which when successful, avoids the necessity to evacuate VHDP at all. Compartmentation and HVAC systems (heating, ventilation and air-conditioning) are designed to allow an appropriate period of time for the fire to be detected and extinguished before occupants of the area are threatened.


HVAC systems in intensive care areas are designed so that air pressure is kept very slightly elevated above that of surrounding compartments. This assists with preventing smoke and fire debris from entering the area through the systems.

While some VHDP should not be moved due to their condition or current treatment being ongoing, plans for how to evacuate externally must be made. A vertical evacuation strategy must be put together with supportive measures in place to reduce the risks where possible.


Risk assessment may indicate that protected lobbies are required in areas of the premises needing additional protection against smoke movement. A lobby should be large enough to accommodate the patient bed, any associated equipment such as a ventilator and nursing staff, along with sufficient floor space to allow manoeuvring.


In premises where there is no hospital street and the area containing VHDP may be at risk of smoke moving in, each door opening into the compartment wall must also have a protected lobby with each door providing a minimum of 30 minutes fire resistance.


It should be noted that future changes in dependency will impact on the fire precautions available.


In Part 7 of this series, LWF will look at those healthcare premises falling into purpose group 5. 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.


Share this post