Fire Safety Journal, 7 (1984) 145 - 153

145

The Development of a Points Scheme to Assess Fire Safety in Hospitals

PAUL STOLLARD

Department of Fire Safety Engineering, University of Edinburgh, The King's Buildings, Edinburgh EH9 3JL
(U.K.)

SUMMARY

The improvement of fire safety standards

m existing buildings requires a systematic
evaluation of both the present deficiencies
and the options for improvement. A "points"
scheme offered a simple and repeatable
method of performing such an analysis o f the
patient areas within hospitals, and the Department of Fire Safety Engineering at the University of Edinburgh was sponsored by the
Department of Health and Social Security
(DHSS) to produce such a scheme. The
authority of a points scheme derives from the
experience of those producing it and the use
of the "Delphi" technique to produce this
scheme is described.

INTRODUCTION

Fire safety in hospitals is a very sensitive

topic; sensitive both morally and politically,
as the very existence of hospitals controlled
by a national system suggests t h a t the nation,
through government, has taken the responsibility to care for people who are ill in some
way. If patients or staff are to be injured by
some external agency, such as fire, then this
is a direct reflection on the quality of the
management of the total health care system.
The need to develop an evaluation scheme
came after attempts to apply to hospitals the
relevant parts of the Fire Precautions Act
(1971). A trial survey of 365 hospitals was
carried out around 1976 and 45 were selected
for a detailed fire safety appraisal by the fire
prevention officers of the local authorities'
fire services. These detailed surveys included
recommendations for improving the hospitals
to some "acceptable standard" and t h e y were
costed for the DHSS by independent consultants. As a result of these surveys, it was con0379-7112/84/$3.00

sidered that the costs would be prohibitive if

improvements were to be made t h r o u g h o u t
the National Health Service, and as hospitals
have a good record with respect to fire loss, it
was decided to develop an evaluation scheme
which would identify those areas of greatest
risk. This would enable the available m o n e y
to be spent to the best advantage.
An evaluation scheme for health buildings
was already being developed in the U.S.A.
[1] and it was hoped t h a t this might serve as
the basis for the DHSS evaluation scheme.
Tests of the U.S. system, conducted in the
Edinburgh hospitals, revealed that none of
these hospitals would comply with U.S.
standards. The reasons behind these poor
results related to the differences in the spatial
design of hospitals in the U.S.A. and U.K.,
and the unsuitability of m a n y of the detailed
definitions in the American evaluation system
for British buildings. However, it was obvious
that there was some virtue in the concepts
of a flexible rating system which compares
existing buildings in a consistent manner
against an accepted standard.
Having accepted the need for an evaluation
scheme designed to assess the patient areas
within hospitals, five developmental problems
were identified.
(A) The selection of a 'norm' against which
assessment can be made.
(B) The identification of the safety factors
contributing to the norm.
(C) The calculation of the relative values of
the safety factors.
(D) The development of a m e t h o d of surveying the patient areas to provide factual information.
(E) The formulation of a succinct way to
present the results and make comparisons.
To solve these five problems, a group of
specialists was invited by the DHSS to assist
in the preparation of a scheme which would
Elsevmr S e q u o i a / P r i n t e d in The N e t h e r l a n d s

146
simplify the implementation of the Fire
Precautions Act (1971) and facilitate the
evaluation of relative levels of fire safety in
existing hospitals.
The group was led by members of the Department of Fire Safety Engineering at
Edinburgh University and used the "Delphi"
technique to achieve an agreed system. In this
technique, experts from a variety of related
fields are assembled and their opinions to
various questions recorded. The divergences in
opinion are then repeatedly discussed until
c o m m o n agreement is reached as to the solution. In determining the basis for the evaluation scheme and the details of its application,
the "Delphi" m e t h o d was used and the validity of the scheme lies in the membership of
the "Delphi" group. The ironical name
"Delphi" is taken from the ancient Greek
oracle at Delphi which was famous for the
ambiguity of its answers.

(A) THE SELECTION OF A 'NORM' AGAINST

WHICH ASSESSMENT CAN BE MADE
The American evaluation scheme t o o k the
NFPA Life Safety Code [2] as the standard
against which fire safety was to be assessed.
Unfortunately, in the U.K. there is no document whose provisions can be expected to
apply equally to all geographical locations and
to all types of hospitals. The application of
the standards contained in the Building Regulations may be possible, but those for England
and Wales contained no requirements relating
to escape routes in hospitals. The only document in existence was the draft o f " T h e Fire
Precautions Act 1971 -- A Guide to Fire Precautions in Hospitals (1976/79)", and it was
agreed that this should serve as the norm, for
if hospitals were to be designated under the
Act, then this, or a similar document, would
form the basis of all advice on the upgrading
of existing buildings. This d o c u m e n t has now
been published by the Home Office in a
slightly revised form [3].
(B) THE IDENTIFICATION OF SAFETY FACTORS
CONTRIBUTING TO THE "NORM"
Having accepted the Draft Guide as the
standard for assessment, seventeen factors
within it were identified. These covered the

principal areas of fire safety in hospitals, and

the Delphi group were asked to grade each of
these between 0 and 5 on the basis of importance, and to list any they felt had been
excluded. Against each factor were listed the
elements within the Draft Guide which collectively described the 'perfect' attainment of
the factor. For example, "detection/warning
systems" is described in terms of "call points"
and "power supplies"; while "compartmentat i o n " is described in terms of "fire resistance",
"protected areas" and "self-closing doors".
The seventeen factors were:
fire resistance of floors
fire resistance of walls
compartmentation
surface flame spread
travel distance
corridors
staircases
inter-room access
lifts
direct external access
fire/smoke spread
signs
emergency lighting
detection/warning systems
firefighting equipment
staff training
evacuation drills.
To these the Delphi group added an additional three, and regrouped others. The three
new ones (staff; patients and visitors; fire
brigade) were only implicit in the Draft Guide
but were felt to be significant enough to be
made explicit in the revised list.
Having identified t w e n t y components of
fire safety, it was essential to determine their
relative importance, but before this could be
done it was necessary to determine "importance for what?". To this end the Delphi
group was next asked to consider a hierarchy
of fire safety:
Level 1 Fire Safety Policy
Course or general plan of action adopted by a
government, party or person, to achieve
security against fire and its effects.
Level 2: Fire Safety Objectives
Specific goals to be achieved.
Level 3: Fire Safety Tactics
Independent fire safety alternatives, each of
which contributes wholly or partly to the
fulfilment of the fire safety objectives.

147

Level 4. Fire Safety Components

Major parts of fire safety as defined in conventional fire codes and standards. The t w e n t y
components already agreed b y the Delphi
group.
Level 5 Subcomponents
Essential parts of components which can be
readily identified. Some of these had already
been identified in the Delphi group's list of
additional factors.
Much discussion t o o k place on the meaning
of the objectives, and on the division and
definitions of the tactics. This resulted in
agreement on the following four objectives
and five tactics in the hierarchy:

(5) Rescue. Saving of persons in danger due to

fire or accident. Assistance given to persons in
danger who cannot help themselves.
The t w e n t y components already identified
form the next level (Level 4) and are the
major independent parts of fire safety. Each
contributes to a different degree to each of
the five tactics, and through them to the
objectives and the overall policy. Individual
elements of each of the t w e n t y components
can be identified as subcomponents and these
form a fifth level of the hierarchy. In the
assessment of each c o m p o n e n t these subcomponents formed a checklist and are included
on the worksheets.

Fire Safety Objectwes (Level 2):

(1) Life safety. Preservation and protection of
life from the hazards of flame, heat and
smoke.
(2) Mission continuity. Maintenance of the
supply of health care with minimal disruption.
(3) Property protection. Avoidance of the
diversion of funds to replace essential equipment and/or facilities.
(4) Other consequences. Avoidance of mental
anguish, unnecessary time-consuming inquiries, and post-fire public anxiety.
Fire Safety Tactics (Level 3)
(1) Ignition prevention. Preventing the initiation of destructive and uncontrolled burning.
(2) Fire control. Retarding the development
and/or m o v e m e n t of fire and fire products.
(3) Refuge. Any portion of a building relatively safe from fire danger into which people
can move. A space not involved in fire and
not affected by smoke, toxic gases, or otherwise hazardous to human life and safety.
(4) Egress. Continuous path of travel from
any point in a building to the outside at
ground level.

(C) THE CALCULATION OF THE RELATIVE

VALUES OF THE S A F E T Y FACTORS

Following agreement on the t w e n t y components and on their relationship to the hierarchy of fire safety, it was agreed to use
matrices to establish the contribution of each
c o m p o n e n t to overall fire safety policy. The
Delphi group was therefore asked to give
values to an objectives-to-policy vector, a
tactics-to-objectives matrix and a components-to-tactics matrix. The matrices agreed
by the Delphi group are shown in Tables 1 - 3
and, by the multiplication of these matrices, a
vector for the contribution of components to
overall policy was produced. Each number in
TABLE 1
Contributory values of objective to policy
Life safety
Mission continuity
Property protection
Other consequences

TABLE 2
Contributory values of tactics to objectives

Ignition prevention
Fire control
Refuge
Egress
Rescue

Life
safety

Mission
continuity

Property
protection

Other
consequences

0.96
0.82
0.74
0.74
0 56

0.84
0.78
0.46
0.26
0.26

0.84
0 88
0.14
0.04
0.06

0.54
0.58
0.54
0.54
0.50

0.94
0.78
0.50
0.44

148
TABLE 3
C o n t r i b u t o r y values o f c o m p o n e n t s to tactics

1 Staff
2 P a t i e n t s a n d visitors
3 Factors affecting smoke movement
4 P r o t e c t e d areas
5 Ducts, s h a f t s a n d cavities
6 Hazard p r o t e c t i o n
7 I n t e r i o r finish
8 Furnishings
9 Access t o p r o t e c t e d areas
10 Direct e x t e r n a l egress
11 Travel distance
12 Staircases
13 Corridors
14 Lifts
15 C o m m u n i c a t i o n s y s t e m s
16 Signs a n d fire n o t i c e s
17 M a n u a l firefighting e q u i p m e n t
18 Escape lighting
19 A u t o m a t i c s u p p r e s s i o n
20 Fire brigade

Igmtlon
prevention

Fire
control

Refuge

Egress

Rescue

0.98
0.88
0 04
0.12
0 34
0.66
0 50
0.96
0 04
0.00
0.02
0.14
0.12
0.14
0.12
0.24
0.04
0.02
0.08
0 04

0.90
0.30
0.82
0.66
0 72
0.88
0 72
0.86
0.48
0 44
0.42
0 58
0.58
0.48
0.92
0.22
0 90
0.40
0.82
0.90

0 72
0 70
0 80
0 96
0.50
0 56
0.42
0 24
0.82
0.50
0.78
0.58
0.68
0 38
0 52
0 60
0 28
0 62
0 30
0 30

0 86
0 80
0 86
0.68
0.38
0 60
0 44
0.22
0.72
0.88
0 92
0 88
0 82
0 52
0 52
0.78
0 14
0 82
0 10
0.34

0 86
0 68
0 78
0 76
0 14
0 62
0.28
0 20
0 52
0.86
0.76
0.72
0.72
0 40
0.38
0 42
0 10
0 60
0 10
0 78

TABLE 4
Values o f c o m p o n e n t s . C o l u m n 1: relative values b y m a t r i x m u l t i p l i c a t i o n
C o l u m n 2" revised values o f c o m p o n e n t s a f t e r c o n s i d e r i n g i n t e r a c t i o n s .

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

Staff
P a t i e n t s a n d visitors
Factors affecting smoke movement
P r o t e c t e d areas
Ducts, s h a f t s a n d cavities
Hazard p r o t e c t i o n
I n t e r i o r finish
Furnishings
Access t o p r o t e c t e d areas
Direct e x t e r n a l egress
Travel d i s t a n c e
Staircases
Corridors
Lifts
Communications systems
Signs a n d fire notices
Manual firefighting e q u i p m e n t
Escape lighting
Automatic suppression
Fire brigade

this vector
fraction of
values for
(see Table

0.0866
0.0646
0.0586
0.0565
0 0443
0.0676
0.0500
0.0592
0.0448
0 0436
0.0478
0.0509
0.0511
0.0356
0.0487
0 0401
0.0328
0.0411
0.0316
0.0445

0.0889
0.0643
0.0656
0.0555
0.0400
0.0649
0.0497
0.0625
0.0407
0.0412
0 0488
0.0488
0 0509
0.0342
0 0506
0.0406
0.0302
0 0462
0.0329
0 0435

1.0000

1.0000

was then considered as a decimal

the whole, to give a set of relative
the contribution
of components
4, column 1).

In addition, the group was asked to consider if any pair of components

interacted
and if such interactions were an enhancement
of the purpose of the two components

Staff
P a t i e n t s a n d visitors
Factors affecting smoke
movement
P r o t e c t e d area
Ducts, shafts a n d cavities
Hazard p r o t e c t i o n
I n t e r i o r finish
Furnishings
Access t o p r o t e c t e d areas
Direct e x t e r n a l egress
Travel distance
Staircases
Corridors
Lifts
Communications systems
Signs a n d fire notices
Manual firefighting
equipment
Escape lighting
Automatic suppression
Fire brigade

Components B

<

0.8

0.78

0.54
0.94

0.44

0.54

0.86
0.72

0.76

0.54
0.6

0.62
0.66

0.84

-~

0.64

0.72

0.72
0.74
0.68
0.6
0.76

0.32

0.44

0.62
0.8

09

09

09

0.6

0.44

0.72
0.74
0.74

C o n t r i b u t o r y values o f c o m p o n e n t i n t e r a c t i o n m a t r i x

TABLE 5

0.54

0.84

0.58
0.42

0.58
0.72
0.66

0.76

0.58

0.66

0.6

0.68
0.88

0.52 0.54
0.66 0 . 6 6

0.58

0.52
0.56

0.4
0.34

~..

0.62
0.62

,~

0.7

0.6
072

0.6
0.48
0.8

0.58 0 . 6 4

0.4

0.6
0.46

0.34

0.72
0.8

0.56

0.48

0.5

0.6
0.6
074

0.58

0.46
04
0.66

0.88

0.44

0.78

07

0.72
062

0.5

0.72

0.42

0.4
0.4
0.2

0.52
0.48

0.4

078

~.-~

E
.-~

09

0.54

0.54

0.62
0.52
0.6

0.44
0.4

0.44

0.64
0.64

09

0.34

0.62

0.26
0.68
0.56
0.46

0.6

09

09

0 46

0.58

0.52

0.28

0.68
0.52

e~

'7.

"O

.O

150

concerned. A matrix expressing these interactions (Table 5) was developed and used to
m o d i f y the c o m p o n e n t c o n t r i b u t i o n vector to
give a new set o f values (see Table 4, c o l u m n
2).
It is i m p o r t a n t to not e t ha t m all calculations of interactions, each c o m p o n e n t was
assumed to be making the m a x i m u m possible
c o n t r i b u t i o n to fire safety. The assessment of
how far short o f t h a t m a x i m u m c o n t r i b u t i o n
c o m p o n e n t s actually fell, required the develo p m e n t o f a survey m e t h o d .

(D) THE DEVELOPMENT OF A METHOD

OF SURVEYING THE PATIENT AREAS TO
PROVIDE FACTUAL INFORMATION
In parallel with the de ve l opm ent o f the
theoretical basis o f t he evaluation scheme,
t h o u g h t was given to the design o f the survey
d o c u m e n t s themselves. To facilitate a survey,
the patient areas of each hospital must be
considered as one or m or e survey volumes; an
individual survey volume being a self-contained
and physically defined area which will normally comprise a single nursing unit.
The surveyor is asked to make an assessm e n t o f each survey volume by considering
the deficiency in each of the t w e n t y components and selecting t he appropriate grade on a
six-point scale; 0, 1, 2, 3, 4, 5. This grade
indicates the deficiency of the c o m p o n e n t
c o mp ar ed to th e "i deal " outlined in the Draft
Guide to the Fire Precautions Act (0 represents 100% deficiency, 1 - - 8 0 % deficiency,
and so on, to 5 which indicates no deficiency).
This 0 - 5 grading gives a level of accuracy o f
+0.5 on each o f t w e n t y c o m p o n e n t s (i.e.
-+10% on the total score). A 0 - 10 grading
would obviously give an increase in t he level
o f accuracy to +-5%, but it assumes t hat the
surveyor has been able to assess the building
with this level o f precision. It is felt unlikely
that such a level would always be obtainable
so a 0 - 10 grading would only introduce a
false appearance of accuracy. However,
should a surveyor feel t hat he can be m or e
specific than a 0 - 5 assessment, he is quite at
liberty to introduce halves into the system
w i t h o u t affecting the required calculations.
Field trials o f the survey were c o n d u c t e d
during 1981 on twenty-eight different survey
volumes f r o m seven Regional Health Author-

ites in England. The surveys were c o n d u c t e d

either by representatives of the Regional
Works Officers or by the local Fire Prevention
Officers in the hospitals concerned. Survey
volumes varied from Victorian built Nightingale wards to hospitals built during the last 15
years. The results were carefully analysed to
determine any ambiguities in the worksheets
and to test that this form of assessment was
viable.
Various modifications to the form and layout of the worksheets were subsequently
agreed by the Delphi group and this modified
version was t hen used in a series of repeatability tests. This was t o ensure that different
people assessing the same survey area would
award the same values to each c o m p o n e n t .
Eight survey volumes taken from three hospitals in the South Lothian District Health
A u t h o r i t y (Edinburgh) were used, four being
evaluated by four pairs o f assessors and four
by two pairs of assessors. The results for each
survey volume were then carefully c o m p a r e d
to highlight any problems in the interpretation of the worksheets.
The worksheets were t hen modified and
two of the eight survey volumes were reassessed by four local Fire Prevention Officers
(three from the three hospitals concerned and
one from North Lothian District Health
Authority). Each of these four surveyed the
same two survey volumes and the results
obtained showed a marked i m p r o v e m e n t in
repeatability.
The results of the second series of repeatability tests and the revised draft of the worksheets used, were presented to the final Delphi
group meeting and as a result of the discussions at this meeting, a definite set of worksheets were drawn up as part of the proposed
Health Technical Memorandum.
F o u r forms of assessing the c o m p o n e n t s
had proved satisfactory under trial and are
used in the final set of worksheets. The first
form relies on initially assigning an approximate grade t o the d o m i n a n t s u b c o m p o n e n t
(e.g. for 'staff', this is the staff-to-patient
ratio), and t hen m odi fyi ng this depending upon the assessor's evaluation of the remaining
subcomponents. If t h e y are all average t hen
the initial approxi m at e grade is unchanged,
but if t h e y are better than average it might be
raised by one or two points, while, if t h e y are
worse than average, it could fall one or two

151

points. Components assessed in this manner

are 'staff', 'patients and visitors', 'factors
affecting smoke movement', 'staircases',
'escape lighting', 'automatic suppression' and
'fire brigade',
The second type of assessment is by simple
addition of values awarded to relevant subcomponents (e.g. for 'protected areas', values
are assigned to floors and to walls). Components assessed in this manner are 'protected
areas', 'ducts', 'shafts and cavities', 'hazard
protection' and 'interior finish'.
The third type of assessment is by simple
comparison of the condition in the survey
volume with a list on the worksheet from
which the appropriate grade can be read.
Components assessed in this fashion are
'furnishings', 'access to protected areas',
'direct external egress' and 'travel distance'.
The final form of assessment used in the
worksheets is based upon a comparison of
each subcomponent with an established measure of adequacy derived from the Draft
Guide to the Fire Precautions Act, though it
is expected that the assessor will also be familiar with the other DHSS recommendations
and standards relevant to the component. If
the c o m p o n e n t is found to be completely
adequate in every respect, it is rated as grade
5, but the further it is from the measure of
adequacy, the lower the grade, until if it is
totally inadequate then it is rated as grade 0.
The components which use this form of
assessment are 'corridors', 'lifts', 'communications systems', signs and fire notices', and
'manual firefighting equipment'.

(E) T H E F O R M U L A T I O N O F A S U C C I N C T W A Y
T O P R E S E N T T H E R E S U L T S A N D M A K E COMPARISONS

The grades for each of the components in a

survey volume need to be combined together
to achieve an overall score which reflects the
relative importance of each c o m p o n e n t and
the interactions between them. The m e t h o d
used for making such an overall assessment of
a survey volume is determined by the accuracy
of the survey data available. The simplest
m e t h o d is based on the multiplication o f the
grade for each c o m p o n e n t by the percentage
contribution of that c o m p o n e n t to the overall
fire safety policy. This percentage contribu-

tion must include some assessment of the

interactions and so is based on the revised
values of the components (see Table 4,
column 2). This m e t h o d assumes that the
components with which the c o m p o n e n t under
consideration interacts have all been rated as
grade 5, rather than considering their actual
grades. The degree of inaccuracy introduced
by this simplification is fairly small and the
coarseness of the survey (between 0 and 5 at
integer intervals) suggests that any more
intricate or detailed mathematical use of the
survey grades would be inappropriate and
would only give a misleading sense of accuracy.
By this method, a single score of between 0
and 500 is calculated for each survey volume
which measures how far short of the requirements of the Draft Guide to the Fire Precautions Act the survey volume falls. It is this
m e t h o d which is used in the proposed Health
Technical Memorandum and Table 6 shows a
completed example of the summary sheet
provided using this method.
However, if a finer system of grading was
to be developed for the survey volume, it
would be worthwhile to calculate the score
for the volume by a direct application of the
mathematical manipulation. This is modified
by the grades for every interacting c o m p o n e n t
and gives a score between 0 and 1192. A comparison of the overall scores obtained by these
two methods (for 32 sets of survey grades)
from the repeatability tests showed that the
use of the simpler m e t h o d resulted in only a
small decrease in accuracy.
Having determined a figure which measures
safety against a c o m m o n standard for an
individual survey volume, it is possible to
compare them with each other to determine
which are most in need of improvement. To
provide an approximate indication of the level
that could be termed 'acceptable', the Delphi
group was asked to place each of the eight
survey volumes used for the repeatability tests
into one of the following four categories:
Good
Acceptable
Unacceptable
Definitely unacceptable.
Their estimates of 'acceptability' were made
within the c o n t e x t of the current state of the
National Health Service in the United Kingdom; the term 'acceptable' does n o t imply
perfect fire safety.

152
TABLE 6
Sample summary sheet
Health A u t h o r i t y '
Building: Victoria Hospital
Survey Volume' Ward 1
Date of Survey: 1/4/83
Surveyor' A. N. Other
Number of Bedspaces: 30
Component

Grade*

01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20

012@45
01~345x
012~45X
01234~X
0123@5X
01234~X
012~45
012@45
0123@5
0123~5X
012~45
01234~X
01234~
01234~X
01~345X
012~45X
0123~5X
01~345X
@12345X
01234~X
Totalscore(outof500)

Staff
Patients and visitors
Factors affecting smoke movement
Protected areas
Ducts, shafts and cavities
Hazard protection
Interior finish
Furnishings
Access to protected areas
Direct external egress
Travel distance
Staircases
Corridors
Lifts
Communmations systems
Signs and fire notices
Manual fire fighting equipment
Escape lighting
Automatm suppression
Fire brigade

Percentage
contribution
9
6
7
6
4
7
5
6
4
4
5
5
5
3
5
4
3
5
3
4

= 27
= 12
= 21
= 30
= 16
= 35
= 15
= 18
= 16
= 16
= 15
= 25
= 25
= 15
= 10
= 12
= 12
= 10
= 0
= 20
=350

Additional comments:
*Grades given by assessor are encircled
By comparing their estimates with the
scores from the repeatability tests, it was possible to set the level of acceptability at 70%,
with scores greater than this being considered
as a c c e p t a b l e . A s c o r e o f 7 0 % o r less w a s c o n sidered indicative of an unacceptable level of
f i r e s a f e t y a n d a s c o r e o f 5 6 % o r less w a s
definitely unacceptable. Only a score of over
9 0 % c o u l d b e c o n s i d e r e d ' g o o d ' as o n l y t h i s
represents compliance with the 'norm' (the
Draft Guide).
Three of the components ('staff', 'patients
and visitors', and 'fire brigade') were not dealt
w i t h e x p l i c i t l y w i t h i n t h e D r a f t G u i d e , a n d as
the evaluation scheme only compares survey
v o l u m e s w i t h t h i s n o r m , it w a s u n f a i r t o
p e n a l i s e s u r v e y v o l u m e s w h i c h f a i l in t h e s e
components. Therefore a survey volume had
t o b e g r a d e d as 5 f o r e a c h o f t h e o t h e r c o m p o n e n t s , b u t n e e d o n l y b e g r a d e d as 2 . 5 o n
these three. In this way, particularly high
scores for 'staff', 'patients and visitors' or

' f i r e b r i g a d e ' c o u l d c o m p e n s a t e in s o m e m e a s u r e f o r a d e f i c i e n c y in o t h e r c o m p o n e n t s .
W h e n d e t e r m i n i n g in w h i c h c a t e g o r y a surv e y v o l u m e s h o u l d b e p l a c e d , i t is i m p o r t a n t
t o b e a r in m i n d t h e c o a r s e n e s s o f t h e g r a d i n g
system within which the survey will have been
conducted (the 0 - 5 grading giving an accuracy of +0.5 on each component). The
repeatability studies indicated a margin of
e r r o r o f a b o u t 5%, a n d so s c o r e s o f 51 - 6 1 % ,
6 5 - 7 5 % a n d 8 5 - 9 5 % m u s t b e r e g a r d e d as
indicative of borderline situations. The scale
o f a c c e p t a b i l i t y is i l l u s t r a t e d in F i g . 1.
When considering the improvements necess a r y t o a s u r v e y v o l u m e w h i c h is ' d e f i n i t e l y
u n a c c e p t a b l e ' , i t c a n b e s e e n t h a t i t is i n s u f f i c i e n t t o s i m p l y r a i s e i t a b o v e 5 6 % a n d so
into the unacceptable category. Any planned
improvements must ensure that it would score
above 70% and so fall into the 'acceptable'
z o n e . A f t e r t h e c o m p l e t i o n o f o n e o r all
a s s e s s m e n t s o f s u r v e y v o l u m e s , i t will b e p o s -

153
. . . . . . . . . . . . . . . . . . .

100%

. . . . . . . . . . . . . . . . . . .

500

450

GOOD
45(~

90%

ACCEPTABLE

70%

35q

350

UNACCEPTABLE
280

. . . . . . . . .

DEFINITELY

. . . . . . . . . . . . . . . . . . . .

56%

280

UNACCEPTABLE

O~o

. . . . . . . . . . . . . . . . . . .

Fig. 1 Scale of acceptability.

sible to identify the components within one

volume, or volumes, within a building which
need improvement so that their scores will
become 'acceptable'. It is possible also to
identify those components whose improvement would give the best overall increase in
the survey score b y considering their percentage contributions to fire safety. The grades
obtained b y the t w e n t y c o m p o n e n t s indicate
those which are particularly deficient, and the
relative values attached to each c o m p o n e n t
show which will offer the greatest potential
for increase in fire safety. For example, a
one-point increase in the grade for 'staff' is
equivalent to a three-point increase in the
grade for 'manual fire fighting'.

CONCLUSIONS

The prime objective of this evaluation

scheme was to give local assessors a systematic
technique which is simple to operate, so that
the level of fire safety existing in any survey
volume can be assessed and compared with a
level of acceptability. The highest standard of
fire safety that could be expected would be
complete compliance with the Draft Guide,
this representing what could be expected by
the application of the Fire Precautions Act
(1971) to existing hospital buildings. The

evaluation scheme offers a uniform m e t h o d

of assessing fire safety relative to this standard.
If adopted it would enable Health Authorities
to easily identify those hospitals where a low
standard exists, and be reasonably sure that
an acceptable standard has been achieved
after improvements have been completed.
The authority of the scheme lies in the
ability of the members of the Delphi group
who between them evaluated the different
objectives, tactics and components, and
established what they regarded as the 'acceptable' level of fire safety. Any points scheme
can only be as good as the material on which
it was based, either statistical research or, as
in this case, the experience of the specialists
involved.
It is hoped that the t w e n t y worksheets
mentioned in this article, along with an
explanatory description of the scheme, will
be published in the form of a Health Technical Memorandum on behalf of the Department of Health and Social Security, by Her
Majesty's Stationery Office, during 1983.
A full report of the project, including all
survey data, is available for circulation from
the Department of Fire Safety Engineering,
Edinburgh University.

ACKNOWLEDGEMENTS

The sponsorship and financial support of

the Department of Health and Social Security
have been invaluable. Thanks are also due to
Dr Eric Marchant (Head of the Department
of Fire Safety Engineering at the University
of Edinburgh) who directed the overall project, Dr J o h n M Watts, Jr., who worked on
the matrices, and to all the members of the
Delphi group.
REFERENCES
1 Report NBSIR 78-1555-1, National Bureau of
Standards, 1978.
2 Code for Safety to Life from Fire in Buildings
and Structures, NFPA 101-1973, National Fire
Protection Association, Batterymarch Park,
Quincy, MA 02269, 1973.
3 Draft Guide to Fire Precautions in Hospitals,
Home Office/Scottish Home and Health Department, 50 Queen Anne's Gate, London SWlN
9AT, 1982.