TY - JOUR
T1 - Audit of pre-employment assessments by occupational health departments in the national health service
AU - Whitaker, S.
AU - Aw, T. C.
N1 - Funding Information:
The authors are grateful to the Department of Health for financial support, the Association of NHS Occupational Physicians (ANHOPS) for participation and guidance on this project, Mr Ian Calvert for statistical support, and all the occupational health units who took part in the audit exercise for their commitment to the audit process.
PY - 1995/4
Y1 - 1995/4
N2 - Pre-employment health assessment of applicants to the National Health Service (NHS) is one of the functions of occupational health departments in the NHS. This paper describes the results of a process and outcome audit of this activity, concentrating on the current practice of occupational health departments. The audit was carried out by 40 NHS occupational health units who provided information on a standard questionnaire on all pre-employment assessments undertaken over a three-month period. This produced 9139 questionnaire returns. The analysis showed that the most common method of assessment was the use of a self-administered questionnaire alone (49.4%). A self-administered questionnaire followed by a nurse interview as standard practice was the next most common method (34.1%), but referral to a physician was uncommon. The outcome of the assessments for 98% of all applicants was 'fit for work'. A total of 120 individuals (1.3%) were assessed as 'fit to work, but with some restriction' and 65 individuals (0.7%) were considered 'unfit'. The most common reasons for rejection were abnormal body mass index (40%), skin conditions (21.5%) and psychiatric conditions (10.8%). The most common reasons for restriction were musculoskeletal conditions (27.5%), skin conditions (15%) and abnormal body mass index and psychiatric conditions (both 10.8%). The audit identified wide variation between occupational health departments in the NHS in the practice of restriction and rejection. A decision on the value of pre-employment assessment in the NHS must take into consideration the ability of the process to achieve its aim, the time and manpower involved in the process, and the probability of low restriction and rejection rates. These factors should be balanced against the potential risk to the employee, colleagues and the public if allowed into employment. A common standardized approach to pre-employment assessment should be considered by occupational health departments in the NHS.
AB - Pre-employment health assessment of applicants to the National Health Service (NHS) is one of the functions of occupational health departments in the NHS. This paper describes the results of a process and outcome audit of this activity, concentrating on the current practice of occupational health departments. The audit was carried out by 40 NHS occupational health units who provided information on a standard questionnaire on all pre-employment assessments undertaken over a three-month period. This produced 9139 questionnaire returns. The analysis showed that the most common method of assessment was the use of a self-administered questionnaire alone (49.4%). A self-administered questionnaire followed by a nurse interview as standard practice was the next most common method (34.1%), but referral to a physician was uncommon. The outcome of the assessments for 98% of all applicants was 'fit for work'. A total of 120 individuals (1.3%) were assessed as 'fit to work, but with some restriction' and 65 individuals (0.7%) were considered 'unfit'. The most common reasons for rejection were abnormal body mass index (40%), skin conditions (21.5%) and psychiatric conditions (10.8%). The most common reasons for restriction were musculoskeletal conditions (27.5%), skin conditions (15%) and abnormal body mass index and psychiatric conditions (both 10.8%). The audit identified wide variation between occupational health departments in the NHS in the practice of restriction and rejection. A decision on the value of pre-employment assessment in the NHS must take into consideration the ability of the process to achieve its aim, the time and manpower involved in the process, and the probability of low restriction and rejection rates. These factors should be balanced against the potential risk to the employee, colleagues and the public if allowed into employment. A common standardized approach to pre-employment assessment should be considered by occupational health departments in the NHS.
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U2 - 10.1093/occmed/45.2.75
DO - 10.1093/occmed/45.2.75
M3 - Article
C2 - 7718823
AN - SCOPUS:0028913366
SN - 0962-7480
VL - 45
SP - 75
EP - 80
JO - Occupational Medicine
JF - Occupational Medicine
IS - 2
ER -