The fire that broke out in the Royal Marsden Hospital is a wake up call for the NHS, says the head of the body which oversees London's fire service.
NHS Trusts are now responsible for risk assessments
Valerie Shawcross, chair of London's fire and emergency planning authority, told File On 4 that the NHS does not give enough priority to fire safety.
Since October 2006, 22 NHS trusts have received notices they are breaching fire safety laws, File On 4 has found.
Ms Shawcross said she was shocked the enforcement notices had to be served.
An investigation is continuing into the cause of the 2 January 2008 blaze at the Royal Marsden, which is not one of the trusts served with an enforcement notice.
About 350 staff and patients had to be evacuated from the world renowned centre in West London.
"I think it's very important that the rest of the health service looks at what's happened with the Royal Marsden and says well if you can get such a dramatic and dangerous fire in what is regarded as a relatively safe and well-managed hospital, what would happen in an institution which was in an older or less well-managed building?", said Ms Shawcross.
New regulations introduced in October 2006 gave responsibility for fire risk assessments to NHS trusts with the fire service taking on an inspection and enforcement role.
The File On 4 investigation has learned that 22 enforcement notices have been served to NHS trusts since firefighters were given this responsibility.
The fire service has the power to close premises which do not comply with these enforcement notices.
"I think it is shocking actually that the Fire Brigade does have to get the position of serving enforcement notices on hospitals," said Ms Shawcross.
"You'd think that management would be worried enough about the potential safety impact of being told that they have got a problem in the way they are running their hospital, without us having to take legal steps and I think it does show that we do have a particular problem dealing with the Health service when people are distracted by so many other pressing issues and financial demands.
"They are very difficult environments to manage and we find it very difficult to get adequate attention paid by hospital management."
She added: "I think Fire Brigades up and down the country feel that they have been grappling to get the attention of the health service to improve their fire safety records and this really is the last chance warning to get on with it."
A Department of Health spokesperson said the NHS had an excellent fire safety record and the number of deaths and injuries from fires in the NHS is very low.
The DoH added: "The department continues to work with stakeholders including the Chief Fire Officers' Association, to assess the need to update Firecode guidance in light of experience from fire incidents in both the NHS and wider environment to reflect best practice."
Hear the full story on Radio 4: File on 4 Tue 29 Jan 2008 GMT, repeated Sun 3 Feb 1700 GMT or online at File on 4 website