Recurring concern

Inadequate clarity of fire-safety standards and guidance

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First reported 3 Jun 2014•Latest report 22 Oct 2025

Definition

What this concern includes

Includes deficiencies in explicitly identified fire-safety standards, guidance or regulatory requirements where they fail to clearly define required protections, assessment criteria, implementation expectations or assurance arrangements across a named fire-safety setting or hazard.

Not included

  • Excludes failures to implement, maintain or enforce otherwise clear fire-safety requirements where the standards or guidance themselves are not deficient.
  • Excludes physical fire hazards or missing fire-safety measures when no deficiency in the clarity, completeness or specificity of the governing standards or guidance is identified.
  • Excludes generic regulatory, governance or guidance deficiencies unrelated to fire safety.
  • Excludes product, workplace, housing or operational standards unless the assertion explicitly concerns fire-safety requirements or guidance.
Reports
5

Distinct published reports

Individual concerns
10

A report can raise multiple concerns

Date range
2014–2025

First to latest report issue date

Stated actions
6

Described in published responses

Reports over time

Reports over time

Reports about this concern issued each year.

* 2026 is projected from reports observed to 7 Sep 2026.

Most frequent recipients

Most frequent recipients

Reports about this concern sent to each recipient.

Ministry of Housing, Communities and Local Government2
Birmingham and Solihull Integrated Care System1
Care Quality Commission1
Health and Safety Executive1
Home Office1
Ministry of Defence1
NHS England1

Concerns and responses across reports

Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.

  1. Birmingham and Solihull

    AI-generated summary

    Ricky James MONAHAN · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Ricky James MONAHAN, a resident of a rehabilitation unit detained under section 37 of the Mental Health Act, died after falling from a height on 18 March 2025. The report identified an unprotected fire escape accessible from the garden and roof, no environmental risk assessment of this access, reliance on individual risk assessments, and a lack of guidelines for protecting fire escapes in rehabilitation settings.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Lack of guidelines specifying required fire escape protections in rehabilitation settings

    Wider context from the report

    “1. Mr Monahan was in a 10 bedded rehabilitation unit and was detained under S37 of the Mental Health Act. There was an unprotected fire escape at the rear of the building which could be easily accessed from the garden which in turn gave easy access to the roof. No environmental risk assessment had been completed regarding how accessible the fire escape was and how it easily provided access to the roof due to inadequate railings at the top of the staircase. The trust relied on individual risk assessments when considering what controls were required for individual patients when accessing the garden. 2. The inquest heard how there are no current guidelines setting out what protections are required for fire escapes in rehabilitation settings. The lack of any guidelines presents a risk of future deaths and in my view, action should be taken. ”

    Source location

    Ricky James MONAHAN · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Signpost registered providers to fire-safety and environmental-premises guidance through the CQC website.

    Verbatim wording from the response

    “Your concerns relate specifically to the availability of national or local guidance. We are unable to comment directly on this point due to it being outside the remit of our regulatory scope. We are currently not aware of guidelines regarding fire escapes specifically in rehabilitation settings. However, the CQC signposts registered providers to information regarding fire safety and the environmental safety of their premises on our website.”

    Source location

    Response from Care Quality Commission
    Page 2 · response
    Published 23 October 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Scope revisions to HTM 05-02 fire-safety guidance for healthcare-premises design.

    Verbatim wording from the response

    “NHS England’s Estates Team are currently scoping HTM 05-02, fire safety in the design of healthcare premises, which will be revised imminently.”

    Source location

    Response from NHS England
    Page 3 · response
    Published 23 October 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Escalate and monitor the development of national guidance on fire-escape protections in rehabilitation settings.

    Verbatim wording from the response

    “The inquest also heard how there are no current guidelines setting out what protections are required for fire escapes in rehabilitation settings. The lack of any guidelines presents a risk of future deaths and therefore action should be taken.”

    Source location

    Response from Birmingham and Solihull NHS
    Page 2 · response
    Published 23 October 2025

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    National or local guidance on fire-escape protections is outside the regulatory scope and cannot be directly addressed.

    Verbatim wording from the response

    “Your concerns relate specifically to the availability of national or local guidance. We are unable to comment directly on this point due to it being outside the remit of our regulatory scope. We are currently not aware of guidelines regarding fire escapes specifically in rehabilitation settings. However, the CQC signposts registered providers to information regarding fire safety and the environmental safety of their premises on our website.”

    Source location

    Response from Care Quality Commission
    Page 2 · response
    Published 23 October 2025

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Existing guidance and provider risk-assessment arrangements are considered appropriate to manage fire-escape and roof-access risks.

    Verbatim wording from the response

    “Whilst none of the documents mentioned above specifically refer to fire escapes, secure access to fire escapes should be embedded within the provider’s risk assessments. The clinical risk assessment should cover the patient’s current level of risk (absconding, self-harm etc) and the patient should be supervised according to the level of risk posed.”

    Source location

    Response from NHS England
    Page 4 · response
    Published 23 October 2025

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    NHS England is responsible for developing national guidance on fire escape protections in rehabilitation settings.

    Verbatim wording from the response

    “We have carefully considered this issue and feel that NHS England are most appropriately placed to provide a response. While the development of such guidance sits with NHS England, the ICB will take proactive steps to escalate and monitor this issue.”

    Source location

    Response from Birmingham and Solihull NHS
    Page 2 · response
    Published 23 October 2025

    Open published response
  2. Suffolk

    AI-generated summary

    Ruth Ann PINGREE · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Ruth Ann Pingree died after an accidental fire engulfed the caravan in which she was holidaying with her family. The caravan door became jammed, the smoke detector did not activate, and she was unable to escape before being overcome by fire fumes. The report raised concerns about a lack of clear standards for fire safety measures, risk assessments, and assurance and enforcement for businesses providing paid accommodation.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Lack of clear standards for achieving required fire-safety standards

    Wider context from the report

    “The Inquest heard evidence concerning the operation of the Regulatory Reform Fire Safety Order 2005 (FSO). In assessing the actions by owners/proprietors of businesses such as Happy Days Retro Vacations for compliance with the FSO, there is a general test of suitability and sufficiency applied in relation to measures undertaken by the relevant responsible person/entity (proprietors) to comply with the FSO. This does not require that the proprietors: . keep any written records; . set a specific interval of maintenance inspections; or . provide any signage or safety notices in caravans indicating escape routes or actions in case of emergency. There would not appear to be any set guidance or format for the conduct of a risk assessment, what this must cover nor how often they should be conducted. Proprietors, who under the FSO, are responsible for carrying out risk assessments are provided within the FSO with a general set of requirements that need to then be considered as to applicability to any given activity. The means to understand and interpret the requirement is reliant upon the research ability of those charged with undertaking the risk assessment. Guidance documents such as the Paying Guest Guide do exist and outline best practice steps, however these are not included in the FSO as minimum standards a responsible person/entity is required to take. The potential for short cuts and misunderstandings are substantial. This is within a framework of assurance and enforcement that would appear to be ad hoc. This is in the context of businesses providing accommodation to the public on a paid basis. There is a lack of clear standards concerning what fire safety measures are required, how to assess what is to be applied, how to achieve that standard, and the assurance and enforcement mechanisms beyond this. ”

    Source location

    Ruth Ann PINGREE · Prevention of Future Deaths report
    Page 3 · concerns

    Open source report

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Lack of clear standards for required fire-safety measures

    Wider context from the report

    “The Inquest heard evidence concerning the operation of the Regulatory Reform Fire Safety Order 2005 (FSO). In assessing the actions by owners/proprietors of businesses such as Happy Days Retro Vacations for compliance with the FSO, there is a general test of suitability and sufficiency applied in relation to measures undertaken by the relevant responsible person/entity (proprietors) to comply with the FSO. This does not require that the proprietors: . keep any written records; . set a specific interval of maintenance inspections; or . provide any signage or safety notices in caravans indicating escape routes or actions in case of emergency. There would not appear to be any set guidance or format for the conduct of a risk assessment, what this must cover nor how often they should be conducted. Proprietors, who under the FSO, are responsible for carrying out risk assessments are provided within the FSO with a general set of requirements that need to then be considered as to applicability to any given activity. The means to understand and interpret the requirement is reliant upon the research ability of those charged with undertaking the risk assessment. Guidance documents such as the Paying Guest Guide do exist and outline best practice steps, however these are not included in the FSO as minimum standards a responsible person/entity is required to take. The potential for short cuts and misunderstandings are substantial. This is within a framework of assurance and enforcement that would appear to be ad hoc. This is in the context of businesses providing accommodation to the public on a paid basis. There is a lack of clear standards concerning what fire safety measures are required, how to assess what is to be applied, how to achieve that standard, and the assurance and enforcement mechanisms beyond this. ”

    Source location

    Ruth Ann PINGREE · Prevention of Future Deaths report
    Page 3 · concerns

    Open source report

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Reliance on individual research ability to interpret fire-safety requirements

    Wider context from the report

    “The Inquest heard evidence concerning the operation of the Regulatory Reform Fire Safety Order 2005 (FSO). In assessing the actions by owners/proprietors of businesses such as Happy Days Retro Vacations for compliance with the FSO, there is a general test of suitability and sufficiency applied in relation to measures undertaken by the relevant responsible person/entity (proprietors) to comply with the FSO. This does not require that the proprietors: . keep any written records; . set a specific interval of maintenance inspections; or . provide any signage or safety notices in caravans indicating escape routes or actions in case of emergency. There would not appear to be any set guidance or format for the conduct of a risk assessment, what this must cover nor how often they should be conducted. Proprietors, who under the FSO, are responsible for carrying out risk assessments are provided within the FSO with a general set of requirements that need to then be considered as to applicability to any given activity. The means to understand and interpret the requirement is reliant upon the research ability of those charged with undertaking the risk assessment. Guidance documents such as the Paying Guest Guide do exist and outline best practice steps, however these are not included in the FSO as minimum standards a responsible person/entity is required to take. The potential for short cuts and misunderstandings are substantial. This is within a framework of assurance and enforcement that would appear to be ad hoc. This is in the context of businesses providing accommodation to the public on a paid basis. There is a lack of clear standards concerning what fire safety measures are required, how to assess what is to be applied, how to achieve that standard, and the assurance and enforcement mechanisms beyond this. ”

    Source location

    Ruth Ann PINGREE · Prevention of Future Deaths report
    Page 3 · concerns

    Open source report

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Lack of clear standards for assessing applicable fire-safety measures

    Wider context from the report

    “The Inquest heard evidence concerning the operation of the Regulatory Reform Fire Safety Order 2005 (FSO). In assessing the actions by owners/proprietors of businesses such as Happy Days Retro Vacations for compliance with the FSO, there is a general test of suitability and sufficiency applied in relation to measures undertaken by the relevant responsible person/entity (proprietors) to comply with the FSO. This does not require that the proprietors: . keep any written records; . set a specific interval of maintenance inspections; or . provide any signage or safety notices in caravans indicating escape routes or actions in case of emergency. There would not appear to be any set guidance or format for the conduct of a risk assessment, what this must cover nor how often they should be conducted. Proprietors, who under the FSO, are responsible for carrying out risk assessments are provided within the FSO with a general set of requirements that need to then be considered as to applicability to any given activity. The means to understand and interpret the requirement is reliant upon the research ability of those charged with undertaking the risk assessment. Guidance documents such as the Paying Guest Guide do exist and outline best practice steps, however these are not included in the FSO as minimum standards a responsible person/entity is required to take. The potential for short cuts and misunderstandings are substantial. This is within a framework of assurance and enforcement that would appear to be ad hoc. This is in the context of businesses providing accommodation to the public on a paid basis. There is a lack of clear standards concerning what fire safety measures are required, how to assess what is to be applied, how to achieve that standard, and the assurance and enforcement mechanisms beyond this. ”

    Source location

    Ruth Ann PINGREE · Prevention of Future Deaths report
    Page 3 · concerns

    Open source report

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure to establish relevant fire-safety guidance as minimum standards

    Wider context from the report

    “The Inquest heard evidence concerning the operation of the Regulatory Reform Fire Safety Order 2005 (FSO). In assessing the actions by owners/proprietors of businesses such as Happy Days Retro Vacations for compliance with the FSO, there is a general test of suitability and sufficiency applied in relation to measures undertaken by the relevant responsible person/entity (proprietors) to comply with the FSO. This does not require that the proprietors: . keep any written records; . set a specific interval of maintenance inspections; or . provide any signage or safety notices in caravans indicating escape routes or actions in case of emergency. There would not appear to be any set guidance or format for the conduct of a risk assessment, what this must cover nor how often they should be conducted. Proprietors, who under the FSO, are responsible for carrying out risk assessments are provided within the FSO with a general set of requirements that need to then be considered as to applicability to any given activity. The means to understand and interpret the requirement is reliant upon the research ability of those charged with undertaking the risk assessment. Guidance documents such as the Paying Guest Guide do exist and outline best practice steps, however these are not included in the FSO as minimum standards a responsible person/entity is required to take. The potential for short cuts and misunderstandings are substantial. This is within a framework of assurance and enforcement that would appear to be ad hoc. This is in the context of businesses providing accommodation to the public on a paid basis. There is a lack of clear standards concerning what fire safety measures are required, how to assess what is to be applied, how to achieve that standard, and the assurance and enforcement mechanisms beyond this. ”

    Source location

    Ruth Ann PINGREE · Prevention of Future Deaths report
    Page 3 · concerns

    Open source report

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Publish updated fire safety guidance for small paying guest accommodation, including caravans and recommended fire precautions.

    Verbatim wording from the response

    “The Government published an update to this guide titled “Making your small paying guest accommodation safe from fire” which superseded the older paying guests guide in March 2023 and is available as a free download on GOV.UK. The new guide tends to be more stringent in relation to the fire precautions it recommends.”

    Source location

    Response from Ministry of Housing, Communities and Local Government
    Page 2 · response
    Published 15 April 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Enhance the legal status of fire safety guidance under Section 156 of the Building Safety Act.

    Verbatim wording from the response

    “Since the tragic death of Mrs Pingree, the Government has enhanced the status of guidance issued under Article 50 through Section 156 of the Building Safety Act, which now means that in any proceedings on a breach of the FSO, the court can consider whether failure to comply with guidance tends to establish if there was a contravention (with the converse point that compliance with guidance may be relied upon to establish there was no contravention).”

    Source location

    Response from Ministry of Housing, Communities and Local Government
    Page 1 · response
    Published 15 April 2025

    Open published response
  3. Manchester South

    AI-generated summary

    James Golds · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    James Golds was rescued from a flat fire on 28 September 2020 after sustaining significant fire-related injuries and later died in hospital from complications of smoke inhalation. The report raised concerns about limited guidance for managing and escalating fire risks in supported accommodation, the absence of a statutory requirement for sprinklers, and smoke detectors not activating until a cigarette-related fire was well established.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Lack of guidance on management and escalation of fire risk in supported accommodation

    Wider context from the report

    “1. From the evidence before the court it was clear that Mr Golds presented a significant risk of accidentally starting a fire. He resided in accommodation occupied by vulnerable members of the community who needed some support to live independently. The Court heard that there was little guidance for facilities such as his about how the risk of fire should be managed and escalation of such risk. ”

    Source location

    James Golds · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report
  4. Surrey

    AI-generated summary

    JJ Wilson · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    JJ Wilson died instantaneously after a racing car he was driving during a shakedown test left the track and collided with a tree, causing serious head and neck injuries. The report raised concern that fire-retardant overalls were not required for test-track drivers, creating a potential risk of death or serious injury in a similar crash.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure to require fire retardant overalls for test track drivers

    Wider context from the report

    “The Court heard evidence that whilst there are regulations regarding clothing to be worn during race events, set by the FIA, there are no regulations for clothing to be worn whilst testing a racing car on a test track. The Court heard evidence that JJ was wearing racing boots, gloves and a new Schuberth race helmet, but was wearing ordinary combat trousers. The Court heard evidence that racing overalls were available had JJ wanted to wear these. Whilst ████████ for the Surrey Police Collision Investigation Unit confirmed in her evidence that JJ’s clothing would not have made any difference to the sad outcome in this case, I am concerned that fire retardant overalls are not a requirement to be worn by all test track drivers. - It is not obligatory for fire retardant overalls to be worn by test track drivers which creates a potential risk of death or serious injury in the event of a crash in circumstances similar to that which caused the death of JJ Wilson; Consideration should be given to whether any steps can be taken to address the above concerns. ”

    Source location

    JJ Wilson · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Existing UK law requiring foreseeable-risk assessment, including fire-retardant overalls, addresses the concern when requirements are implemented and instructions followed.

    Verbatim wording from the response

    “Having reviewed the information and legislation in place, regarding the need for assessment of foreseeable risk, it is concluded that there is no gap when the applicable legislation in relation to duties and the workplace if the current requirements are implemented and instructions followed. HSE considers that no action is required because existing UK law includes the requirement to assess, along with many other risks surrounding the activity, the need for wearing of fire-retardant overalls.”

    Source location

    2019-0243-Response-by-HSE
    Page 2 · response
    Published 12 September 2019

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    FIA clothing requirements fall outside HSE’s remit for comment.

    Verbatim wording from the response

    “The requirements within the FIA Regulations are outside the comment of the HSE but as said earlier FIA Sports rules and regulations are required to have notice and compliance to health and safety law and where there is a gap it is for them as the sport’s governing body to close this gap and ensure compliance.”

    Source location

    2019-0243-Response-by-HSE
    Page 2 · response
    Published 12 September 2019

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Any gap in FIA requirements must be closed by FIA, as the sport’s governing body, to ensure compliance with health and safety law.

    Verbatim wording from the response

    “The requirements within the FIA Regulations are outside the comment of the HSE but as said earlier FIA Sports rules and regulations are required to have notice and compliance to health and safety law and where there is a gap it is for them as the sport’s governing body to close this gap and ensure compliance.”

    Source location

    2019-0243-Response-by-HSE
    Page 2 · response
    Published 12 September 2019

    Open published response
  5. Wiltshire and Swindon

    AI-generated summary

    Private Robert WOOD and Private Dean HUTCHINSON · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Private Robert Wood and Private Dean Hutchinson died on 14 February 2011 from inhalation of products of combustion and severe burns. The report raised concerns about fire risk assessments, training on electrical appliance overloading, identification of sleeping in office accommodation, and the effectiveness of random overnight checks.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Fire Diary failing to prioritise fire risk assessment reviews before changes of use or structural alterations

    Wider context from the report

    “(1) In evidence from ████████ from the Defence Fire Risk Management Organisation, I looked at the modification to the Fire Diary on the subject of fire risk assessments. I have attached a copy of the relevant extract marked “B” and the relevant section is already highlighted. It talks of a review of the fire risk assessment where there has been or there is planned to be a change in use or structure alteration. In evidence a number of witnesses, in particular ████████ who carries out fire risk assessments, agreed that advice should be sought quickly before any change of use or structural alteration. I appreciate that there will be incidences whereby a change of use can take place extremely quickly however I considered that this section did not weight a preference in favour of a review prior to a change of use or any structural alteration taking place. It is my view that the current version gives equal weighting to the 2 options available when the evidence I heard was in favour of advice being sought before a change of use was carried out or any structural alteration taking place. In this particular case the alterations were phased alterations over a period of time and whilst I formed the view that it was speculative on the facts of this particular case that such a review before the change would have made a difference that cannot be said for future incidences. As the evidence I heard supports a preference for such reviews to be undertaken before a change of use or structural alteration takes place I would ask that this be reviewed insofar as the wording is concerned. ”

    Source location

    Private Robert WOOD and Private Dean HUTCHINSON · Prevention of Future Deaths report
    Page 1 · concerns

    Open source report

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Fire Diary lacking guidance on contacting expert advice about electrical overloading concerns

    Wider context from the report

    “(2) Instruction and training is now given specifically to Junior Fire NCOs as regards recognising the possibility of overloading in relation to electrical appliances. In my decision I found that the absence of such training was a systemic failure contributing to the deaths of both Rob and Dean. In evidence from Captain Hamilton from the Royal Engineers he explained insofar as the chiller cabinet that was used inside the Transport Troop tent was concerned that whilst that may have a specific amperage in relation to the draw of current, he commented that at the start of a cycle when the compressor becomes activated that figure can be multiplied by a factor of between 6 to 10. For example a 2 amp appliance suddenly draws a current of between 12 and 20 amps. He commented that in order to recognise such an issue that this required quite specific training and knowledge attributable to the qualifications of an electrician. As the Fire Diary is the guide to any Junior Fire NCO I would be grateful if you could please confirm that this document includes guidance to relevant Fire NCOs as regards who to contact if they have a concern as regard overloading in order to seek expert advice on the matter. What became very clear during the course of the Inquest is that such matters sometimes have to be explained in very clear terms and levelled so as to be understood at the lowest level of service men/women. ”

    Source location

    Private Robert WOOD and Private Dean HUTCHINSON · Prevention of Future Deaths report
    Page 1 · concerns

    Open source report

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Amend the DFRMO Fire Diary to require competent fire-risk assessment advice before premises changes or when assessments may be invalid, and strengthen electrical-overloading guidance.

    Verbatim wording from the response

    “In response to your first two concerns, the Defence Fire Risk Management Organisation (DFRMO) Fire Diary has been amended to make it clear that the advice of a competent fire risk assessor must be sought before any changes take place within a premise or if there is a suspicion that the fire risk assessment is no longer valid; and to provide additional guidance and advice on the risks of electrical overloading including the need to contact a competent electrician if there are concerns. The revised Fire Diary is enclosed for your information. The Fire Non-Commissioned Officer (NCO) course content has also been amended and now allocates more time and emphasis on the fire risks associated with electrical overloading. A copy of the PowerPoint presentation delivered on this course is also enclosed for your information.”

    Source location

    2014-0556-Response
    Page 1 · response
    Published 3 June 2014

    Open published response
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Data last updated 7 September 2026