Co-ordinating support for firefighter health and wellbeing

The UK government has recently announced an agreement aimed at improving the long-term health and wellbeing of firefighters. This agreement will be complemented with investment for future research projects to better understand the risks associated with the role.

The role of a firefighter is complex. The symbolic imagery of the occupation captures only a small part of what the job demands. In reality, it is a multi-faceted occupation that requires skills and knowledge in emergency operational work and community engagement. It therefore requires physical strength, aerobic conditioning, sustained psychological resilience, self-regulation, and social support.

Firefighters respond to fires, road traffic collisions, water rescue, animal rescue, medical emergencies, and chemical incidents. Additional elements of the role include prevention and protection through educating children, home safety visits with vulnerable adults, business inspections, and enforcing safety regulations.

Consequently, firefighters are confronted with dynamic and adverse situations, characterised by physical demands, heat stress, moral dilemmas, and critical incidents involving fatalities and deeply disturbing events. They regulate their emotions under challenging conditions and research confirms the cumulative effect of this in terms of developing sleep disruption, depression, post traumatic stress disorder (PTSD), and elevated suicide risk compared to the general population.

This is further reflected in the significant number of working days lost each year due to both physical injuries sustained in operational duties and the growing impact of mental health challenges across the workforce. The psychological dimension is perhaps the least visible.

Understanding and supporting health inequalities

Whilst research in the UK is limited, US studies have found significant health inequalities across uniformed public services including the fire and rescue service (Harding & Coley, 2026). There are further, more nuanced health inequities in relation to specific demographics.

Women make up just 10% of the UK firefighter operational workforce and experience different risks that, to date, the fire service has been slow to address. Firefighting has been deemed a cacogenic occupation, with contamination exposure carrying physical consequences. Personal protective equipment (PPE) has traditionally been designed for men, which can lead to mobility problems, compromised protection, increased injuries, and elevated cancer risk. The consequences extend beyond physical issues and into welfare and confidence, which can, in turn, impact employee engagement and performance.

Women firefighters encounter additional occupational risks. Rates of PTSD are two-thirds higher than their male counterparts. Divorce rates are higher than the national average. Miscarriage rates are elevated, with contaminant exposure further associated with infertility and low birth weight.

Similarly, experiences and impacts of bullying and harassment continue among Black and minority ethnic firefighters. Likewise, specific health and wellbeing risks among on-call firefighters who perform their duties alongside other primary employment or responsibilities remains under studied. These are not individual concerns. They, as with other uniformed services, require transformational, not symbolic, organisational and systemic change.

Learning from other uniformed public services

The Armed Forces Covenant was made statutory through the Armed Forces Act in 2011. It is based on two principles: (1) service personnel should face no disadvantage compared to other members of the community, and (2) special consideration should be given to those who have sacrificed the most. A legal duty was placed on public bodies, such as the NHS, to have due regard to Covenant principles in healthcare, housing, and education. Whilst implementation is inconsistent, there is at least, a framework and recognition of its need.

Similarly, The Police Covenant, part of the Police, Crime, Sentencing and Courts Act (2022), acknowledges the inequalities faced by police officers and staff. It focuses on health and wellbeing, physical protection, and family support. Although less developed than the military version, it will, once standardised, create accountability structures for the police.

Critically, no equivalent currently exists for the fire, ambulance, or prison service workforce, despite these professional experiencing comparable occupational risks and exposure to trauma. This represents a significant equity gap. Findings from a recent Home Office consultation in the fire reform white paper identified that 75% of respondents were either in favour or strongly in favour of creating a college of fire to co-ordinate research, ethics, and professional standards.

Therefore, the government’s recent announcement of bespoke health support for firefighters represents a significant and welcome development in the evolution of occupational health provision across the fire and rescue sector. This reflects growing recognition that firefighter wellbeing requires approaches tailored to the specific demands of the profession, and that long-term workforce resilience is strengthened through sustained investment in prevention, rehabilitation, and evidence-informed support.

This national approach has potential to raise awareness around occupational risks, focus attention, connect and align different parts of the system around a shared goal, and co-ordinate action among multiple stakeholders. It should also enable monitoring and a consistent approach of support through governing bodies such as the National Fire Chiefs Council (NFCC) both during and after service. Hopefully, in time, and in line with the Armed Forces Covenant, this firefighter concordat will prioritise the health and wellbeing of non-operational staff and firefighter families.

Creating, sharing, and applying new knowledge

If bespoke health support is to deliver its full potential for firefighters, its impact will depend not only on policy intent, but on the availability of evidence-informed approaches capable of supporting implementation in practice. Research has an important role to play here.

The relationship between policy and implementation is often strongest when supported by robust research capacity, collaborative partnerships, and mechanisms for translating evidence into operational settings. In this regard, the opportunity presented by the current government announcement is not simply to expand support provision, but to strengthen the infrastructure capable of informing and sustaining that provision over time.

This is an important announcement, not simply because of the commitment itself, but because of the opportunity it creates to build on a growing body of applied research and sector-led innovation already contributing to these ambitions.

Importantly, this is not a policy agenda emerging in the absence of evidence. There is already substantial momentum across the sector, supported by collaborative research, practitioner-informed innovation and increasing recognition that health support is most effective when considered across the continuum of injury prevention, recovery, return to work, and operational readiness.

Seen in this context, the announcement can be understood not as the start of a new conversation, but as an opportunity to consolidate and strengthen progress already underway.

Leveraging collaborative, applied, and equitable research

This is where the role of research and knowledge mobilisation becomes especially important. CEEUPS reflects the type of interdisciplinary and collaborative environment increasingly needed to support this agenda across sectors and services. Through its focus on wellbeing, equity, and evidence-informed transformation across the employment journey of uniformed services, the Centre is contributing to a broader understanding of how workforce support can be strengthened through applied research and practitioner involvement.

The CEEUPS research agenda lies not only in the research it undertakes, but in its capacity to support practical application, connecting policy priorities, operational challenges, and evidence-based solutions. This matters because sustainable improvements in occupational health provision rarely emerge through policy commitments alone. Development is strengthened through investment in research capacity, partnerships, and innovative systems capable of informing study design, implementation, impact evaluations, and continuous improvement.

Viewed in this way, the government’s announcement, alongside insights emerging through research should not be seen as separate developments. Rather, they represent complementary components of a broader system of support.

CEEUPs benefits from several scholars and research projects related to firefighter health and wellbeing. These include developing an evidence-informed screening tool to support firefighters returning to operational duties following musculoskeletal injury. Another explores women’s experiences of PPE within the UK Fire and Rescue Service, focusing on how ill-fitting equipment can affect comfort, safety, and physiological performance.

A PhD project by Charlotte Allen uses creative, playful and participatory methods – such as Barbie-based prototyping and textile protest garments – to enable women firefighters, designers, and manufacturers to radically reimagine PPE and production. Another collaborative study aligned with national research priorities investigates the departure of on-call firefighters in the UK, focusing on people’s experiences in post, reasons for leaving, and transition process. A final project is transporting a perinatal mental health toolkit for new parents from Policing and testing implementation in the fire service.

If the ambition to support firefighter health and wellbeing is to translate into enduring improvement, there is a strong case for continuing to support the research environments capable of informing, evaluating, and strengthening implementation. The government’s announcement is therefore encouraging not only for what it signals in policy terms, but for opportunities it creates to strengthen the relationship between research, practice, and strategic delivery.

Prof Emma Williams, Director, CEEUPS, Dr Liam Noll, Practitioner Fellow, CEEUPS, and Dr Chris Webber, Research Fellow, CEEUPS