Background Each year the Fire and Rescue Service (FRS) deliver approximately 670,000 Safe and Well visits (SWVs) in people’s homes. SWVs target fire safety in addition to a range of health-related issues including falls, social isolation and winter warmth. SWVs have the potential to reduce the risk of fire, help prevent avoidable hospital admissions and excess winter deaths, and improve quality of life, particularly for older adults. The study aims to explore the perspectives of service leaders and those delivering SWVs, including the role of the FRS in delivering SWVs as part of wider health and social care services.

Methods Semi-structured interviews were conducted remotely with firefighters and safe and well advocates who deliver SWVs (n=18), and service leaders (n=11) who were key informants representing stakeholder groups (e.g. the FRS, primary care services) involved in the design and implementation of SWVs. Interview topics included barriers and facilitators to delivering the SWVs and integration with health and social care services. Interviewees were based across two counties in England. Data was analysed using reflexive thematic analysis.

Results Trust: Service leaders and firefighters/advocates believed the FRS is perceived as a trusted service. They felt this allowed the SWVs to provide a comprehensive service to people who are unreceptive to other agencies, such as social services and the police. Reaching underserved populations: Interviewees identified difficulties accessing more vulnerable groups such as those dealing with mental health issues and domestic abuse, and those experiencing language and cultural barriers. Greater training in these areas was desired by some firefighters/advocates. Culture change: Service leaders and firefighters/advocates commented on the changing role of the FRS, identifying a shift from response towards fire prevention, in addition to broader health and safety issues. While firefighters/advocates generally felt well supported, there could sometimes be a mismatch between firefighters’ expectations and the reality of their role. A minority of service leaders and firefighters felt that the increased remit of the FRS meant that the FRS was sometimes expected to fill gaps in other services, though lacked the time and resources to do so.

Conclusion SWVs address a range of health-related needs relevant to fire safety. The status of the FRS as a trusted service may facilitate delivery of SWVs. However, whether the FRS should be expected to fill gaps in other health and social care services is an issue that needs further exploration. Supporting underserved groups via SWVs is an important issue that warrants further resources.