Well, I declare

What is the best way of dealing with a job applicant’s health declaration
form and who should be privy to the sensitive information it may contain?

Q Last month we asked what
readers would do when faced with the following problem: One of our departments
has been upgrading its recruitment processes in recent years. It provides
information about the risk profile for jobs, for example. But it also asks
short-listed candidates to complete a health declaration form prior to

The reason I came to hear of this was that I fielded one
enquiry from an unsuccessful candidate about whether an item in the medical
history might have influenced the decision. The department is clear that there
were professional reasons for the decision but I have suggested to the
department that this practice could be regarded as against the spirit of the DDA.
The response is that the department has worked hard on its procedures and
believes they are fair and non-discriminatory.

It seems to me that a health declaration should be limited to
the candidate who is offered the job. An alternative might be to ask the
short-listed candidates to complete the form and place it in a sealed envelope.
When a job offer is made the sealed envelope for that candidate is sent to the
OHS, the envelopes of any candidates on a reserve list being retained pending a
decision, and the envelopes of unsuccessful candidates are shredded, ideally by
the OHS.

Winning answer

A The pre-employment health screening is an important and integral
part of the employee recruitment and selection service. The purpose of this
screening is to ensure that applicants are assessed prior to and for employment
to ensure that they are fit for the position they are applying for and are
placed in appropriate work.

A pre-employment health questionnaire or a health declaration form is an
important tool for the occupational health nurse and/or the occupational health
team. This tool helps to assess the applicant’s fitness from the answers given
in the form in determining the physical and psychological suitability to
perform the job applied for.

The OHN, in determining the fitness of the applicant, must take into
consideration that the final decision rests within the spirit of the legal
aspects of employment:

– Equal opportunities policy

– Health and Safety at Work Act

– The Management of Health and Safety at Work Regulations

– Disability Discrimination Act

– Working Time Regulations

The OHN must operate within the guidelines and professional code of ethics
set out by the UKCC and the GMC and be consistent with the guidance published
from time to time by the Department of Health and the HSE.

The pre-employment health screening process must be strictly confidential
between the assessing occupational health nurse or medical practitioner and the
applicant. The sharing of health information must be limited to the health care
professionals and the applicant. The appointing person is informed of the
outcome of health screening.

Systems should be in place for safe storage of health records such as health
declaration forms and for employees to access health records as laid down in
the Access to Health Records Act and Regulations under the Data Protection Act.

Therefore the best and most acceptable practice is following the interview
to ask the successful candidate to complete the health declaration form in
complete confidence and enclose it in a sealed envelope addressed to the
occupational health nurse.

The sealed health declaration form must only be scrutinised by the
occupational health nurse and a decision is given to the appointing person in
writing in the strictest confidence. In a health declaration form resulting in
a negative decision, the decision must only be to state that the named person
is considered unfit for the position applied for. The appointing person should
not be given any reasons for the decision.

In line with the DDA, if reasonable suitable adjustments could be made to
the job in order to accommodate the applicant’s disability then the OHN should
make such recommendations.

The final decision to appoint a person rests with the appointing manager.

I do not wish to subscribe to the idea of holding a reserve list of
candidates and completed health declaration forms as individuals’ health
conditions may change in a space of time. It is imperative to assess the
applicant’s fitness at the time of employment.

R Pathmanathan
Occupational health and safety adviser, Quantum Care

A When I worked for an NHS trust in the locality, it occurred to me
during screening that they were interviewing candidates and sending a number of
short-listed individuals for screening, as part of the selection process.

We explained that this wasn’t acceptable, and that it wasn’t cost-effective.
We advised that they provisionally book a time on the day of interview for the
selected candidate to be screened. If the chosen candidate wasn’t
"medically" suitable, they then had time to ask the second choice to
attend for screening without wasting too much time, prior to sending out the
regrettal letters. This also saved time if the first choice declined the job
offer, which happened occasionally.

In addition, we had to work quite hard to impress on them that it was not
acceptable to inform the candidate that the job was theirs, as long as they
passed the medical. I haven’t had this experience with any other employer.

Another "dilemma" I’ve encountered during pre-employment screening
is that of an individual who has applied for a post, been selected, attended
for screening and then informed me she is pregnant. The job she applied for was
a crucial post, which had taken a lot of time and effort to fill. In these
circumstances, I passed the individual fit for employment, as there was been no
medical reason not to do so. In this situation I would advise/persuade the
individual to inform the proposed manager of her pregnancy, but if she declined
to do this, I would be unable to breach the confidentiality issue. What would
others do in these circumstances?

Ann Roberts
Senior occupational health adviser/ business development manager, Corporate
Medical Management

A I read with interest your dilemma in this month’s magazine. As a
company we provide pre-employment assessments to certain companies via a paper
scrutiny method from our remote HUB centres in Scotland and Manchester.

When we enter into this type of contract with the clients we specifically
outline the procedure that should be followed, this includes putting the health
declaration or pre-employment health assessment form in the job offer pack for
successful applicants. We include a printed stamped addressed envelope and the
forms are sent directly to our department with no risk of breach of
confidentiality from the client companies. This allows us to give a fair and
impartial response on the individual’s fitness for work and because we outline
the confidential nature of the process on the form which they can be sure comes
directly to us, we have found that the respondents are more open and honest.
Acceptability for the job is then judged on the references and the "fit for
work" certificate produced by the OH staff.

As an OH nurse in an inhouse department, surely this type of suggestion
could be made to management using stamped addressed envelopes to reduce costs.
This would prevent having unnecessary paperwork from candidates who do not make
it through the recruitment process. This could be presented as an effort to
raise the quality and cost-effectiveness of a pre-placement programme while
protecting them from the ever-increasing threats of litigation, a fact that
none of them can afford to ignore.

Margaret Murray RGN RM BA SPOHN
Regional occupational health manager (Scotland), Bupa Wellness

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