Nominated medical practitioners resources

This page links to information and resources necessary for NMPs conducting firefighter health screening.

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FRNSW Health Standard

The FRNSW Health Standard has been developed by the appropriate medical specialists, taking into consideration the unique physiological and physical demands required of FRNSW firefighters. As a resource, the Health Standard is designed to clearly outline the inherent requirements for firefighters in FRNSW, the associated health attributes and the subsequent health standards required to be met to ensure as far as practicable the firefighters’ safety and that of those who rely on them. It also seeks to ensure consistency and transparency in the assessment of health conditions in the context of high-risk firefighting work. 

Click here to download the FRNSW Health Standard for firefighters (PDF)

Summary of operational tasks for firefighters:

FRNSW Health Standard provides an in-depth outline of the following operational tasks:

  • Driving the fire appliances are medium rigid class (or above) vehicles. They are driven in emergency mode at high speed while exercising exemptions to normal road rules provided to drivers of emergency vehicles.
  • Structural firefighting work includes rapidly entering buildings and climbing stairs, rescuing victims, hauling hoses, extinguishing fires, and salvage, ventilation and overhaul activities. Rescued victims may be unconscious, burnt, deceased or distressed. Work is conducted in hot and densely smoky conditions.
  • Wildfire firefighting differs from structural firefighting in that the fire front is rapidly moving through bush or grasslands. The ambient environment is extremely hot. The work requires extensive walking and carrying of hoses and other equipment across difficult terrain, and vigorous use of hand tools.
  • Hazmat work involves the containment and clean-up of dangerous goods and other hazardous materials. The work may require the firefighter to wear a fully encapsulated hazmat suit, which is resistant to external fluids and gases, but limits the ability for sweat to evaporate.
  • Rescue work involves rescuing victims who are trapped in cars or on cliff faces, involved in industrial accidents, and so on. The work varies greatly with the situation. It involves applying first aid to the victim and using a wide range of equipment for freeing and transporting the victim – often in awkward situations and on difficult terrain. The work is conducted in variable environmental conditions. Victims may be unconscious, injured, deceased or distressed.

What is my role as the NMP conducting a firefighter Health Screen:

Step 1: Provide a referral to the firefighter to complete pathology and 12 lead ECG (Appointment 1).

Step 2: Book an appointment with the firefighter 7-10 days later to review the pathology & ECG results (Appointment 2).

Step 3: Review the pathology and ECG results with the firefighter. Conduct a physical examination to complete the Health Screen Report (Appointment 2). When completing the Health Screen Report, please make sure all sections are completed; that you have provided as much detail as possible; and that you and the firefighter have signed and dated the last page.

Step 4: If indicated make subsequent referrals in accordance with the FRNSW Health Standard. Referrals required as part of usual medical care, such as consultations for treatment or management of a condition, should be made through usual patient care mechanisms such as Medicare. Please contact FRNSW, details below, if clarification is required. Fire and Rescue NSW will not be liable for any payment relating to unauthorised referrals made by you or your medical practice. Please invoice Fire and Rescue NSW for the cost of the Health Screen consultation; please note this cannot be charged to Medicare.

Step 5: Provide a determination to the firefighter and FRNSW via the Fitness for Duty Advice Form.**

Step 6: Retain a copy of the pathology, ECG and Health Screen Report for the firefighters file. Please ensure you also provide a copy of all paperwork, including the Fitness for Duty form, to the firefighter. If you have provided a Fitness for Duty Determination the firefighter will be responsible for submitting the Fitness for Duty Form to FRNSW.

** If you are unable to issue a determination for the firefighter, they can give their consent for their Health Screen Records (pathology, ECG, Health Screen Report and any subsequent results or reports) to be sent to the FRNSW Occupational Physician for review and determination. If the firefighter consents to this, please send the relevant documentation to FRNSW via

Questions and Feedback

If you have any enquiries relating to the Health Screening process, please speak to the Health Check Coordinator on (02) 9265 2800 or email 

Identification of Medical Restrictions

Please note, if you recommend restrictions on the tasks the firefighter can undertake in their role to ensure their safety, and these restrictions are not already detailed on the Ordinary Duties Form provided, a category three (3) determination must be issued.

If restrictions are noted on the Ordinary Duties Form, and these restrictions should remain, please ensure you provide a category two (2) determination and confirm in writing the restrictions required for the firefighter’s safety.

With the consent of the firefighter, relevant health information already held by FRNSW (e.g., existing Fit Subject to Review information) will be provided to you to assist with the firefighter’s Health Screen.

Such requests should be sent via email to by either the firefighter or yourself as the Nominated Medical Practitioner.

FRNSW Background

Fire and Rescue NSW (FRNSW) is one of the world’s largest urban fire and rescue services and is the busiest in Australia. Our overriding purpose is to enhance community safety, quality of life, and confidence by minimising the impact of hazards and emergency incidents on the people, property, environment and on the economy of NSW. Our capabilities extend far beyond fighting fires. FRNSW firefighters are among the most highly trained in the world. Our teams provide fire prevention, they respond to hazardous materials incidents, natural disasters and medical emergencies. Our teams also undertake counter terrorism and urban search and rescue operations. We are prepared for anything – helping anyone, anywhere, anytime.

Fire and Rescue NSW (FRNSW) delivers essential emergency services to the community throughout NSW.

  • FRNSW is responsible for protecting 90% of the state’s population from fire,
  • 100% of the state from hazardous materials emergencies,
  • While performing more than 75% of all rescues in NSW.

FRNSW also assist other agencies including the Rural Fire Service at bushfires outside FRNSW districts; the State Emergency Service with floods and storm damage, and the Ambulance Service of NSW with emergency medical responses.

FRNSW currently has an operational workforce of approximately 6, 800 firefighters. The FRNSW organisation comprises of:

  • Permanent Firefighters,
  • Retained Firefighters,
  • Operational Support Firefighters,
  • Administrative and trades personnel and;
  • Volunteers in Community Fire Units.

Permanent Firefighters:

All firefighters hold a rank which gives them lawful authority to command others who hold a lower rank. The table below outlines the various PFF ranks within FRNSW from the highest tier to recruit level. The majority of responses by PFFs are from FRNSW Stations, however senior officers are on call for IMT duties.

Rank - Abbreviation

  • Commissioner - Com
  • Deputy Commissioner - DCom
  • Assistant Commissioner - ACom
  • Chief Superintendent - CSupt
  • Superintendent - Supt
  • Inspector - Insp
  • Leading Station Officer - LSO
  • Station Officer - SO
  • Leading Firefighter - LF
  • Senior Firefighter - SF
  • Qualified Firefighter - QF
  • Firefighter - FF
  • Recruit - RecF

On-call (Retained) Firefighters:

On-call Firefighters provide a high standard of response to fire and emergency situations. On-call Firefighters are essentially on-call to respond to fires and a variety of emergency incidents in their local community. They may respond from home, other workplaces or from other locations within the local community.

Rank - Abbreviation

  • Captain - Capt
  • Deputy Captain - DCap
  • Retained Firefighter - RFF

Operational Support Firefighters:

  • Approximately 4% of the operational workforce are situated in operational support positions.
  • While these positions are not routinely working operationally these persons are technically firefighters and can be called on to perform active firefighter duties if the need arises or in the event of a major incident.
  • Therefore, operational support firefighters are still required to maintain an acceptable level of health and fitness and are eligible to undergo mandatory periodic health checks in line with all other operational staff.

Examples of Operational Support Roles in FRNSW:

  • Fire Investigation & Research Unit
  • Community Safety
  • Education and Training
  • Operational Capability