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Preplacement Assessment & Compliance with the Equality Act


The Equality Act makes it clear that employers have to be very careful about asking health related questions either prior to or in interview.  This is due to the fact that there remains some prejudice and ignorance about health conditions and the effect on work especially in relation to mental health.  The pre-placement health screening process can now only be undertaken AFTER a job offer has been made.  Failure to comply with this could result in charges of discrimination if the candidate is subsequently not offered a post.

Pre Placement Health /Baseline Assessment
The purpose of pre-placement/baseline health check is:

1. To ensure that the prospective employee is medically fit to fulfill the duties and responsibilities of the post, with a view to making such adjustments as may be necessary

2. To assess whether the proposed post may adversely affect the prospective employee’s health and make recommendations to reduce the risk if necessary

3. To record health information as a starting point for monitoring exposure to health hazards e.g. a hearing test on an employee working in a noise hazard area.  This type of test is called a baseline test as it is establishing health levels before exposure.

4. For some specific work activities there is a legal duty to carry out pre-placement assessments of an individual’s fitness for work, for example, those working with lead or compressed air. Although not legally designated as such, for the purposes of the CBH standards it is recommended that workers classified as ‘safety critical workers’ require pre-placement screening also.

After the job offer employers can use 3 methods of assessing pre-placement health:
1. A basic ‘open’ questionnaire which asks 3 general questions and acts as a pre-screening device and serves to ‘fast track’ those who have no health issues likely impact on work or the employee (category 1 and 2 above, not appropriate for category 3 and 4).  Any health issues identified with a ‘yes’ on the questionnaire should trigger a confidential pre-placement questionnaire to be completed and sent directly to Occupational Health by the employee. Pre-screening questionnaires may be checked by non qualified medical staff if suitably trained and the applicant is aware of the process.

2. A confidential pre-placement questionnaire for screening by an occupational health service provider (OHSP) for those in any category but specifically for categories 3 and 4.  The completed questionnaire should be sent directly to the OHSP for screening as appropriate. The OHSP, on receipt of a completed questionnaire, will conduct enquiries into health issues that may affect work or prove difficult for the prospective employee due to health issues.  The first step is usually a telephone discussion where information received will clarify the situation and enable the OHSP to provide management information back to the employer.  Occasionally a report may be required from the prospective employees’ GP, in which case written consent must be given by the prospective employee.

3. A full health check which would incorporate completing risk specific questionnaires, discussion, examination by OHSPs to gather baseline information and to undertake medical tests e.g. drug and alcohol testing.

OHSP Process
In order to make a fully informed assessment, OHSPs will consider:
• The job requirements (it may be necessary to see a copy of the job description and obtain further clarification about details of the post from the manager or HR)
• A relevant medical history which may include information from: 
    o The health questionnaire 
    o Consultation with the prospective employee (usually over the telephone, occasionally in person) 
    o Further information (with informed written consent) from the prospective employee's GP, hospital specialist or previous employer.  

Determining the Outcome
A professional judgement will be made by the OHSP on the suitability of the applicant to the proposed post by reviewing the questionnaire, making an assessment of the potential employee’s health and functional capacity based on the information provided, ensuring there is a clear understanding of pertinent medical conditions, in line with the potential job tasks/demands, working environment and fitness to work issues. If the OHSP is unable to determine the suitability of the applicant for the proposed post or the applicant has declared a condition that requires a medical examination, a face to face consultation with an OH Physician may be required.

The OHSP should also establish any requirements for baseline health surveillance or whether a health assessment is required due to the nature of the role, i.e. safety critical worker. 
Advice to Employee

If any health condition is highlighted which causes concern for work purposes, the employee should be advised of the process of informing the employer of the outcome. Should anything that requires specific recommendation be identified, the individual should be advised by the OHSP i.e. regarding use of personal protective equipment.  Individuals may also require information sheets or tool box talks which are available from the CBH website.
Advice to Employer

Subject to the arrangement between the OHSP and the employer, a fitness for work certificate should be supplied; this will not include any clinical information unless specific consent has been obtained from the employee, but generally the fitness of the individual for the proposed work and whether any restrictions or adjustments are recommended.

Baseline health assessments e.g. for hearing will provide the opportunity for starting the health record and this should accompany the fitness for work notification.

Preplacement health screening by the OHSP will be based on objective, informed assessment of all the available relevant information. It will be carried out in line with the requirements of the Equality Act 2010 and good occupational health practice.

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