Pre-placement Assessment: What an OH Provider Has to Capture After the Offer

Pre-placement assessment will normally begin after a job offer has been made.

That timing is not a software preference. In Great Britain, section 60 of the Equality Act 2010 generally restricts health questions before an offer of work. Pre-employment screening and pre-placement questionnaires are therefore typically arranged after a conditional or unconditional offer, subject to the limited exceptions in the Act.

Once that offer exists, the occupational health provider has a different problem from HR. The hiring process has already selected a candidate and a role. Occupational health now has to capture enough of that situation to give defensible advice, and to preserve it after the questionnaire, the clinician and the template have all moved on.

The work is often described as pre-employment screening. That label is familiar, and a pre-employment health questionnaire is frequently how the pathway starts. The more precise occupational health term is pre-placement assessment: advice about fitness for a specific offered role, with any recommended adjustments, further review or restrictions.

A questionnaire can start that work. It cannot stand in for it.

The record has to outlive the questionnaire

A completed pre-employment questionnaire is evidence that somebody answered a set of questions on a particular day, using a particular form version. That is necessary. It is rarely sufficient.

Later, a clinician, auditor, client or court may need to know who the person was, which Client and role the offer related to, whether an offer had in fact been made, what the job demanded, which questionnaire was used, what was answered, whether clinical review was required, what was escalated, which supporting Documents were supplied, what the assessment status was, what advice was issued, and how that history was kept from being rewritten.

If those facts live only in an inbox, a spreadsheet column or the latest version of a form, the assessment becomes harder to explain than it was to complete.

Software can make that capture reliable. It should not be asked to decide fitness.

What has to be captured after the offer

The following are not a product feature list. They are the operational facts a pre-placement assessment has to hold together.

Employee or candidate identity

The person being assessed needs a stable identity in the occupational health record. Name, date of birth and unique identifiers matter, but so does the distinction between a candidate who is not yet an employee and an Employee already known to the service.

If identity is retyped into every questionnaire, later matching depends on spelling. If identity lives only in the Client's recruitment system, occupational health cannot reconstruct the assessment without that system remaining available.

Client and role

A pre-placement assessment is not generic health advice. It belongs to a Client, meaning the employer or contracting organisation, and to a particular role.

The same person can be offered different work with different demands. The record has to retain which Client requested the assessment and which role was offered at the time. A later change of job title should not silently rewrite the context in which the advice was given.

Offer status

The pathway exists because an offer has been made. The occupational health record should be able to show that this was post-offer work, not an informal pre-application health screen.

Offer status is easy to lose when the request arrives as “please screen this starter”. Without it, the service may be unable to show that health questions were asked at the lawful point in the process.

Job demands and role requirements

Fitness is relative to work. Hours, lone working, driving, manual handling, safety-critical tasks, exposure, immunisation requirements and any regulatory constraints are part of the assessment, not background colour.

If job demands are missing, the clinician is left scoring a questionnaire against an imagined role. If they are pasted into free text and then discarded, a later reader cannot tell what the advice was about.

Job demands belong with the request. They should travel with the assessment, not be reconstructed from memory when the report is written.

Questionnaire and questionnaire version

A pre-employment questionnaire is a published instrument. Wording, answer options and conditional questions change.

Each submission needs to remain bound to the version the candidate completed. A later revision of the template should improve future work. It should not change what an earlier candidate was asked.

That is the same versioning problem seen in health surveillance forms. Historical meaning depends on the relationship between answers and the exact questions that produced them.

Responses

The answers themselves need to be retained as submitted. Clinical review may interpret them, ask follow-up questions or record additional findings. Interpretation should not overwrite the original response.

A candidate's “no” is not improved by a later user editing it to “not applicable” because the form changed. The response is evidence. Commentary belongs beside it.

Clinical review requirements

Some questionnaires can be reviewed through a configured route. Others require a clinician to look at the answers, the job demands and any previous occupational health history.

The record should make that requirement visible. A flag buried in a completed form is easy to miss. A stated need for clinical review is work that still has to be done.

Escalation

Escalation is what happens when the questionnaire is not the end of the assessment. It may mean an appointment, further information from the candidate or Client, a more detailed clinical examination, or discussion of adjustments.

That step needs an owner, a status and a connection back to the original request. Otherwise the service has a pile of completed questionnaires and a smaller, less visible pile of people who still need to be seen.

Supporting Documents

Job descriptions, risk assessments, offer letters, previous reports, immunisation evidence and other files often arrive with the request or during review. They are not decorations on the Employee record.

Each Document should retain provenance: what it is, which assessment it belongs to, who supplied it and whether it informed the advice. A filename in a shared folder does not do that.

Assessment status

The operational question is not only “has the form been submitted?” It is whether the assessment is awaiting information, under review, escalated, awaiting a report, complete or closed.

Status has to describe the pre-placement assessment as a whole. If submission of the questionnaire is treated as completion, exceptions disappear. If every later activity overwrites the same status field, nobody can tell what is outstanding.

Outcome and advice

The authorised occupational health outcome is advice about the offered role. It may support starting work, recommend adjustments, identify restrictions, or say that further assessment is needed.

It is not a software-generated pass or fail. Employment decisions remain with the employer. The record should preserve the advice that was issued, to whom, and in relation to which role, without exposing confidential clinical detail to the wrong audience.

Immutable audit and history

People will later ask when the questionnaire was sent, who reviewed it, when an appointment was booked, whether the report was released, and whether anything was changed afterwards.

A useful history records those events in occupational health language. “Questionnaire submitted”, “clinical review required”, “Case created”, “Report released” explain the work. A list of database edits does not.

The history also needs to be immutable in the sense that later activity adds to the record rather than quietly replacing it. Corrections happen. They should be visible as corrections.

A questionnaire submission is not a clinical Case

This is the distinction that keeps pre-placement work intelligible.

The questionnaire is a structured capture. Submitting it is an event. It may be enough for a routine review. It may not.

A Case is the operational and clinical work created when that review, or the original request, requires more than a completed form. Appointments, further Forms, Documents, Tasks and the Report belong to the Case. The questionnaire remains evidence within it.

Collapsing both into one “screening record” recreates a familiar mess. Completing the form looks like completing the assessment. Escalation has nowhere obvious to live. The outcome becomes a field on the questionnaire rather than authorised advice with a lifecycle of its own.

The same pattern appears in occupational health referral management. A Referral holds the request. A Case holds the work created once the request is accepted. Pre-placement assessment uses that model, whether the request arrived as a management referral, a recruitment request or a pre-employment screening pathway.

Software should facilitate the workflow, not decide fitness

It is tempting to ask a system to score answers and declare somebody fit for the role. That misunderstands both the questionnaire and the professional task.

Questionnaires can route work. They can make exceptions visible. They can prevent incomplete submissions. They cannot weigh job demands, clinical history, uncertainty and the possibility of adjustments. That is occupational health judgement.

Software earns its place by keeping the facts above connected: identity, Client, role, offer, demands, versioned questionnaire, responses, review, escalation, Documents, status, advice and history. Occentra's pre-placement assessment workflow is built around that capture, using the same Referral, Case, Form, Document and Report model as other occupational health work. The pre-employment screening pathway is often how the questionnaire enters that model.

The useful test is not whether the system can produce a traffic-light result. It is whether, a year later, somebody can still see what was asked, what was known about the role, what the clinician advised, and why the questionnaire alone was never the whole assessment.