In January, SDS welcomed NHS estates teams, contractors, architects and industry leaders to the SDS London Hub for the NHS Estates Fire Safety Forum 2026, bringing together sector professionals for a timely and candid discussion on the realities of fire safety in healthcare environments. If you missed the recent NHS Estates Fire Safety Forum held at the SDS Hub in January, we've put together this summary of the key themes and topics discussed.
With over 100 attendees joining in-person and online, the forum explored regulatory updates, sector-wide challenges, and the practical realities of managing fire safety in live hospital environments. The central theme was clear: fire safety in healthcare must move beyond box-ticking compliance and towards competence, collaboration and risk-based decision-making.
Recent updates to HTM 05-03 reinforce a critical shift: maintenance must be risk-based, not schedule-driven.
While British Standards may suggest fixed inspection intervals (such as six-monthly fire door checks), the legal requirement under the Fire Safety Order is outcomes-based. Fire safety systems must be maintained in an efficient state, in efficient working order and in good repair. How this is achieved is down to the Responsible Person and must be justified.
Trusts are encouraged to:
Assess fire doors based on risk, usage and likelihood of damage.
Develop documented, evidence-based maintenance regimes.
Avoid defaulting to contractor-led inspection schedules without scrutiny.
The introduction of Primary and Secondary Fire Risk Assessments under HTM 05-03 Part K further strengthens accountability:
Primary FRA – covering building-wide elements such as compartmentation, fire alarm systems and common areas.
Secondary FRA – covering wards and departments, placing ownership with local managers.
This structure embeds fire safety into operational management, rather than leaving it solely within estates teams.
The forthcoming update to HTM 05-01 (Managing Fire Safety) will clarify fire safety management structures, including:
The role of the Independent Expert Advisor (Fire).
Expectations around Fire Safety Committees.
Clearer accountability frameworks.
For Trusts, this means governance will be under increased scrutiny and documentation, competence and structure must be demonstrable.
Now in development, HTM 05-02 will focus on fire safety in the design of new hospitals and extensions. Architects and designers are encouraged to engage early, particularly around evolving guidance such as water suppression systems and water mist technologies.
The message is simple: design decisions today determine maintenance challenges tomorrow.
A recurring theme throughout the forum was professional competence — particularly around fire doors.
Nine years on from Grenfell, concerns remain around:
Misunderstanding of what constitutes a fire door (leaf vs assembly).
Inappropriate modification of certified doors.
Poor installation standards.
Over-reliance on certification badges without technical understanding.
A NAHFO-led working group is now reviewing third-party certification schemes and barriers to applying existing reference guidance. The aim is to address systemic weaknesses and ensure that competence, not just paperwork, underpins compliance.
Because a certified product incorrectly installed is not a compliant system.
One of the most powerful contributions came from Trust-level experience.
In acute environments and mental health areas, doors are subjected to constant impact — from beds, trolleys, wheelchairs and, in some cases, deliberate damage. In some Trusts, dozens of fires are managed each year.
This is not a theoretical risk. Fire doors are active life safety systems.
Practical strategies shared included:
Developing Trust-specific fire door specifications.
Standardising seals and components to simplify maintenance.
In some cases, pragmatic risk decisions are required — for example, documented acceptance of threshold gaps based on L1 fire alarm coverage and operational practicality.
The key takeaway: compliance must be maintainable in the real world.
Architects highlighted a critical challenge — working within existing healthcare buildings where full remediation is sometimes operationally impossible.
Examples included:
Missing or outdated fire strategy records.
Snowballing remedial works once intrusive investigations begin.
Situations where shutting down clinical services would pose greater risk than proportionate fire safety deviations.
In some cases, testing of worst-case existing constructions has demonstrated that performance may exceed assumptions — reinforcing the importance of evidence-based risk assessment over rigid interpretation.
Healthcare is not a blank sheet of paper. Fire safety must work within operational realities.
A valuable discussion explored how data and technology could support smarter maintenance strategies.
By monitoring door usage, impact frequency, and operation cycles, estates teams can gain insight into which doors require more frequent inspection, where hold-open devices may help reduce damage, and how predictive maintenance could replace fixed inspection cycles. This approach aligns with the wider shift toward risk-assessed and evidence-based maintenance across NHS estates.
Across all perspectives — NHS England, Trusts, architects and industry — a shared message emerged:
Compliance must be risk-based and justified.
Competence must be demonstrable.
Installation quality matters as much as specification.
Governance structures must be clear and accountable.
Design decisions must consider durability and lifecycle realities.
Patient safety is the unifying objective.
Healthcare fire safety is complex. It involves balancing regulation, operational continuity, infection control, mental health considerations, maintenance budgets and risk tolerance.
There is no one-size-fits-all solution.
But through collaboration and honest discussion of challenges, the sector can move forward.
We would like to thank all the speakers and attendees for their contributions to this insightful discussion.
If you’d like to dive deeper into the discussion, you can watch the full session recording here.
The NHS Estates Fire Safety Forum 2026 reinforced that fire safety in healthcare is not about meeting minimum standards. It is about understanding systems, challenging poor practice, and making informed, defensible decisions that protect patients, staff and services.
As guidance evolves and scrutiny increases, the focus must remain on competence, transparency and practical risk management. Because in healthcare environments, fire safety is never theoretical - it is fundamental to patient care.
If you’d like to join our next event or find out more about how SDS is supporting healthcare partners, please get in touch at sales@specialistdoorsolutions.com.