How to get pre-placement health assessment right

A pre-placement assessment tells you whether someone is fit for the role they have been offered and what adjustments would help them do it safely. Done in the wrong order, it creates legal risk rather than removing it.

Make the offer first

Under the Equality Act 2010, an employer must not ask about health or disability before offering work, apart from a few narrow exceptions — such as establishing whether an adjustment is needed for the selection process itself, or where a function is intrinsic to the role. The practical rule is simple: make the offer, then ask. An assessment run before the offer invites a claim that health information influenced the hiring decision.

Ask health questions only where they relate to the role

The questionnaire should follow the demands of the job. A driving role and a desk role need different questions. A single generic form used for every vacancy collects information you have no reason to hold, which is a data protection problem as well as a fairness one.

Send the questionnaire through a secure route

Health information should go to the occupational health provider, not to the line manager and not by email attachment. A secure portal keeps the clinical detail with the clinicians and gives you a defensible audit trail. Managers need the outcome, not the underlying medical information.

Escalate to a clinician where the answers need it

Most questionnaires clear without further contact. Where an answer raises a question about fitness or adjustments, it should go to a clinician for a call or a face-to-face assessment — not to a manager for interpretation. That escalation route needs to exist before you need it, or new starters wait.

Record the outcome, not the medical detail

What comes back to the business is a fitness outcome and any recommended adjustments. The diagnosis stays with the clinical record. Keeping that boundary is what allows employees to answer honestly, which is the only way the process works at all.

Make the adjustments before day one

If an adjustment has been recommended, put it in place before the person starts. An adjustment agreed and then forgotten is worse than none: it undermines trust immediately and, if the person is disabled, may leave the duty to make reasonable adjustments unmet.