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Grenfell Inquiry Report: Host of lessons for industry, building managers and emergency services

Phase 1 of the Inquiry report confirms non-compliance with building regs and offers recommendations for improvements in the way in which high-rise residential buildings are “designed, constructed, approved and managed”

The first part of Sir Martin Moore-Bick’s report of the Grenfell Tower Inquiry has confirmed many of the allegations of failures of compliance to regulations, training and policy that emerged during the Inquiry hearings, as well as highlighting a range of particular factors that either helped accelerate the spread of fire or hindered the rescue.

Sir Martin ended the report with a series of recommendationsm which the HVAC and construction industry will need to take on-board as a matter of urgency, along with the other organisations involved, if further high-rise tragedies are to be avoided. He said: “The evidence put before me in Phase 1 is already sufficient to demonstrate that a number of improvements can be made, both in the way in which high-rise residential buildings are designed, constructed, approved and managed, and in the which fire and rescue services respond to fire in such buildings.”

In over 900 pages of analysis, Sir Martin confirms the principal reason for the rapid development of the fire - ’the presence of aluminium composite material rainscreen panels with polyethyene cores, which acted as a source of fuel’, along with the presence of PIR and phenolic foam insulation…’which contributed to the rate and extent of vertical flame spread’ - as well as citing ‘compelling evidence’ that the external walls didn’t comply with Requirement B4(1) of the Building Regs, in that they didn’t adequately resist the spread of fire in regard to the height, use and position of the building. “On the contrary,” Sir Martin states, “they actively promoted it.”

There are also a range of criticisms of the management of the rescue efforts, with Sir Martin particularly taking the London Fire Brigade to task for not fully appreciating the nature of the fire at Grenfell, described as ’gravely inadequate preparation and planning’ and resulting in poor advice on evacuation (and the belief in ’stay put’ in the face of conflicting evidence); poor communication on the ground; lack of basic information; and lack of adequate equipment and resources. This, he concluded was due both to an overarching lack of training in high-rise fire risk. limited understanding of the behaviour of high-rise façades and to what he deemed, most damningly as potentially an institutional failing: ”Some may question whether [the LFB’s] training is adequate in the light of experience; others may question whether it is capable of learning from its mistakes.”

Beyond this, there are a host of further issues for the HVAC and construction industry to take note of. These include:

  • That compartmentation was often rendered inadequate by gaps in fire barriers and by combustible insulation and other materials
  • That a key failure of compartmentation was the extractor fans deforming under heat
  • That other fire protection measures failed, either through lack of repair, or through inadequate design
  • That leakage in the smoke-control shafts may actually have worsened the spread of smoke

It is Sir Martin’s recommendations that perhaps will offer most for the industry to reflect on. There are 20 pages of them, covering all aspects, but for those involved with tall building construction, these include:


  • The minimum height of high rise buildings should be reviewed - in England it is 18m, but in Scotland it is 11m.
  • While compartmentation is likely to remain the core strategy for high-rise buildings, building owners will need to consider other approaches for some tower blocks, with appropriate evacuation strategies.
  • ‘It would be sensible,’ Sir Martin says, for all building owners to check whether there is proximity of combustible materials to windows, and similar cladding to Grenfell, and that where the cladding contains ACM panels, remedial work ’should be pursued as vigorously as possible.’


  • Sir Martin elects not to recommend changes to regulations regarding combustibility in view of the fact there is a government consultation ongoing, not to recommend an immediate moratorium on use of A2 class materials
  • The inquiry will investigate the adequacy of materials testing in Phase 2

Building Owners

  • The owner and manager of every high-rise residential building should be required by law to provide local fire and rescue with information about the design of exterior walls and their materials, updating on any changes to them
  • Owners and managers should ensure that their building contains a premises information box with up-to-date floor plans and safety systems
  • Owners and managers of any multi-dwelling building should urgently inspect fire doors and then be required by law to inspect them every three months

Sir Martin also recommends that fire and rescue personnel at all levels should understand the risks of fire taking hold in external walls of high-rise buildings. It is for the HVAC industry now to debate whether this should apply equally to all levels of the construction supply chain.

Executive summary and recommendations can be viewed here

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