Occupational Health

by Anna Harrington

Pre-employment screening and fitness to work

In general, it is now unlawful to enquire about an applicant’s health and/or disability before a job offer is made. This includes questions relating to sickness absence. Therefore occupational health will not normally screen individuals before an offer of employment has been made. For more details on permissible questions and the circumstances in which they can be asked, see Pre-employment medical questions.

The purpose of screening, when permissible, would be to enable the individual to do the job to the best of his or her ability, perhaps through the employer making reasonable adjustments in the workplace. Assessments of this type are therefore used to form an opinion on whether the job role, requirements, processes or methods of work may need adaptation to enable an individual to perform the role to the best of their ability and to the standards required by the employer. They are also used to form a baseline measure of health and to consider if the individual is ‘disabled’, as classified under the Equality Act, 2010, and would require special attention to enable them to do the job.

Fitness to work standards


There is no published definition of fitness to work standards.

Fitness to work medical standards may be advisory or statutory. They may be applied prior to employees entering environments which have risks inherent to them, such as mining and other work in confined spaces. Standards are also given when the work is safety critical: for example, jobs involving transport or food handling.

The standards have to be transparent and equitable. Guiding legislation for equality and fairness is the Equality Act, 2010 (which replaced the Disability Discrimination Act 1995). In addition, health and safety and employment legislation will also guide the detail and procedure for the screening. The requirement to undertake a medical examination is justifiable only where the risk assessment demonstrates its necessity. Questions contained in an assessment process must relate to the risks associated with the job.


Fitness to work screening

A set of criteria used to undertake an objective and non-discriminatory assessment of an individual’s psychological and physical ability to carry out requirements and cope with the demands of a specified job.

An opinion would be given to the individual and manager, which may also include recommendations for changes to be made in the workplace to facilitate optimal performance from the individual.

100 per cent fit

No-one is 100 per cent fit all the time: our health and wellbeing fluctuate daily. Individuals with a chronic health condition will find this of more significance. However, 100 per cent fitness is unachievable; therefore variable levels of performance will be achieved with varying levels of fitness.

Occupations requiring specific fitness standards

Employees in jobs that are safety critical, such as pilots, rail workers, seafarers, food handlers and oil and gas workers have standards of fitness which individuals have to achieve and maintain. The purpose is to prevent a major accident or occurrence due to ill health in an employee. People in these jobs have industry-set standards; other workers, such as forklift truck drivers, do not have industry-set standards, but a business may decide to develop standards and to use them in assessing individual fitness

Setting non-discriminatory fitness to work standards

It is necessary, when setting fitness to work standards, that they are non-discriminatory and justifiable. Standards should be linked to the assessment of risk and are often set by a governing body, industry body or the organisation themselves.

Fitness to work assessments should assess an individual’s function in relation to the tasks and requirements of a particular job. The functional assessment should include the physical and psychological aspects of an individual. In addition, consideration should be given to the effects of treatments and/or medication on the individual’s ability to carry out tasks.

In order to carry out an appropriate and effective assessment, it is necessary to have the details of the job requirement: what the person is expected to do; in what conditions; when, and for how long. A job description or person specification is suitable for this purpose. The assessment is designed to determine what the individual can do and where adjustments may need to be made.

It could be argued that the employer should carry out fitness to work assessments as part of their duty to take proactive steps towards ensuring the safety of their employees (health and safety common law and Section 2 HASAWA, 1974) and to show that they are doing all they reasonably can to find out if an individual has a disability (Equality Act 2010). In addition, they can gather information to form a baseline of health from which future measures can be compared. This would be particularly relevant if the fitness to work standards relate to the employee’s exposure to certain hazards, such as noise and asthmagens (substances causing asthma).