Firefighter eyesight and medical standards UK: what is tested

When and how medical checks happen

Medical assessment normally follows the fitness and interview stages, after a conditional offer. Section 60 of the Equality Act 2010 generally prevents an employer from asking about a job applicant’s health until they have been offered a job (conditionally or unconditionally) or included in a pool of successful candidates, with exceptions such as arranging reasonable adjustments in the recruitment process and finding out whether the applicant can undertake a function intrinsic to the job. This is why the medical is a late stage in most campaigns.

Nottinghamshire Fire and Rescue Service describes a process starting with a health questionnaire completed with GP sign-off, then assessments by occupational health professionals and an occupational health doctor. Other services use their own combinations, so read your candidate pack. If you are worried about a condition, ask the service what evidence it needs and at what stage rather than guessing. Our entry requirements guide puts the medical in context with the other stages.

Eyesight standards

Vision standards are set by the recruiting service. Nottinghamshire’s process describes distance vision corrected to 6/9 binocularly and a minimum of 6/12 in the worse eye, and near vision of N12 at 30cm. Some services’ published eyesight documents also state uncorrected minimums (for example 6/18 in the better eye and 6/24 in the worse eye), and different near-vision expectations for applicants under and over 25. Treat those as examples of how the wording varies, and check your own service.

Glasses and contact lenses are common. Nottinghamshire’s process says contact lenses are allowed and rigid lenses are prohibited. Some services say that laser eye surgery must be a set period in the past before appointment, with 12 months quoted in one summary, but check the current pack. Bring an up-to-date optical prescription if asked and avoid relying on someone else’s campaign result: standards and testing methods change.

Colour vision

Colour perception matters because operational tasks can involve interpreting signals, markings and equipment. Nottinghamshire’s process describes an Ishihara test with a Farnsworth D-15 test possible for those who do not pass, and other services describe a functional test as a further step for those who fail. What counts as an acceptable Ishihara result is service-specific: one published standard allows no more than two errors, but you should check your own service’s wording.

If you know you have a colour vision deficiency, tell the service early, ask what further tests exist and when they are used, and do not assume a result from one service applies to another. Where there is doubt, an optometrist can explain the type and severity of a deficiency, which helps you understand the questions you may face.

Hearing

Hearing is tested by pure tone audiometry. Nottinghamshire’s standard is H2, described as a military hearing standard, and it says hearing aids are permitted if the required standard is met. Because hearing standards relate to communication on the incident ground and use of breathing apparatus and radios, services take them seriously, but individual assessment applies.

If you have had ear surgery, tinnitus or noise exposure, keep any audiology reports and discuss them with occupational health. A reduced hearing result does not always end an application, particularly if the standard is met with an aid, but the decision rests with the service’s occupational health clinician using its standard.

Respiratory, cardiovascular and general health

Spirometry measures lung function, and the Nottinghamshire page says asthma is assessed case by case, considering how often symptoms occur, triggers and exacerbations. The cardiovascular assessment includes blood pressure, pulse and a treadmill test. The page says Stage 2 hypertension prevents the physical assessments, so if your blood pressure is high, seek treatment before applying and get it reviewed by your GP.

General checks include height, weight and waist measurement, urinalysis, alcohol and substance misuse testing and a physical examination. The page says medical conditions causing collapse or sudden incapacitation, impaired judgment or substantially increased occupational risk are likely to be unacceptable. These are principles, not lists of banned diagnoses, so what matters is how a condition affects you in the role.

Mental health

Mental health conditions are not an automatic bar. Nottinghamshire’s page says that mental health issues do not automatically disqualify applicants and that cases require a confidential discussion. Firefighting involves exposure to distressing incidents, and services take wellbeing seriously for both applicants and serving staff, so the assessment looks at stability, treatment, support and risk.

Be honest on the health questionnaire and bring supporting evidence from your treating clinician, such as a letter describing diagnosis, treatment and prognosis. Concealing information can create problems later, whereas openness allows the clinician to consider adjustments and safeguards. Our guide to firefighter mental health support covers the support available in service.

Reasonable adjustments and disability

The Equality Act 2010 places duties on employers to make reasonable adjustments, and Section 60 allows health questions to arrange adjustments during recruitment. If you need an adjustment to take part in a test or interview, tell the service early and ask what is available. Adjustments to the operational standard itself are a different matter because safety-critical requirements are determined by the role.

If you are refused on medical grounds and you disagree, ask for the reasons, the standard applied and the review route. Take advice from your GP, a specialist or a representative body, and record the dates. A rejection at one service does not always mean the same result at another because standards and assessments vary, though you should be prepared to explain any earlier outcome honestly.

How to prepare before your medical

Good preparation reduces surprises. Use the checklist below in the months before a campaign opens, and remember that fitness and health improve with time. If you are managing a condition, aim to be stable and well-controlled before you apply, with clear evidence from your clinician.

1. Read the service’s medical guidance and any published eyesight standard.
2. Book an eye test and ask for your prescription and colour vision result.
3. Check your blood pressure and address any high readings with your GP.
4. Gather letters for any condition you manage, such as asthma, describing control and treatment.
5. Build fitness with a structured programme and record your results.
6. Avoid alcohol and substances that could show on testing, and follow instructions on the day.
7. Complete the health questionnaire fully and honestly, including GP sign-off if required.

Ongoing health and fitness in service

Health and fitness matter throughout a career, not just at entry. The Home Office’s modern firefighter fitness guide sets out how services assess and support fitness, and services run their own health surveillance. Career length can be affected by health, and if a condition changes, occupational health may consider adjustments, redeployment or, in some cases, ill-health retirement. See our ill-health retirement guide for the pension side.

If you are planning a career, think about longevity. Our age limit guide explains why there is no national upper age limit but fitness standards still apply, and the shift patterns guide explains the duty systems that shape recovery.

Related requirements: fitness, age and the selection stages

The medical is only one part of a wider assessment. Physical tests come earlier and are covered in our fitness test guide and the bleep test standard guide, and the full route is set out in how to become a firefighter. Our age limit guide explains why there is no national upper age limit but the standards still apply.

If you are unsure which standards apply to you, use the fitness readiness tool and the selection process guide to see how the stages fit together. Ask the service’s recruitment team about specific medical questions rather than relying on general websites, including this one, which can explain process but cannot make an occupational health decision.

Common mistakes with medical assessments

The most common mistake is relying on someone else’s result from another campaign or service. Standards, test methods and clinicians differ, and the current pack is the reference. The second is concealing a condition or medication on the questionnaire, which can lead to problems later, whereas a well-managed condition with good evidence is often manageable. The third is leaving high blood pressure or poor control of a condition untreated before applying.

Also avoid last-minute preparation. Book an optician appointment and any specialist reviews early, allow time for GP sign-off if it is required and prepare for the physical tests separately. If the outcome is a refusal, ask for the reasons and the standard applied, and consider whether a later application after treatment or a change could succeed. Keep records of all communications and dates.

Frequently asked medical questions and where to find answers

Applicants often ask about specific conditions such as diabetes, epilepsy, allergies, previous surgery, back problems or medication. This guide does not list conditions because standards are set by each service and applied to individual evidence, and the answer can depend on control, treatment and the demands of the role. The reliable route is your service’s published medical guidance or a direct question to its recruitment or occupational health team.

When you ask, describe the condition, its control and treatment and any relevant reports, and ask what evidence the service needs and at what stage. Record the answer. If you receive different answers from different sources, rely on the written response from the service that will assess you.