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H04 - Health Screening & Management Referral

The Health Screening Procedure outlines the basic requirements for adopting a health screening programme. The implementation of this procedure will involve the input of an occupational health specialist.

The procedure informs of the reason why a health screening programme is desirable, who requires health screening, what should be included in a pre-employment assessment, and what should be undertaken on an on-going basis. It outlines directors’ and responsible managers’ responsibilities.

Additionally, there are two template documents that can be used to help an occupational health specialist gain access to an employee’s medical records.

What is this?

This is a written procedure which outlines the basic requirements for adopting a health screening programme. The implementation of this procedure will involve assistance from an occupational health specialist. A PDF of the procedure is available to download (see attached), please use it in conjunction with the attached Access to Medical Reports Act 1988 Consent Form and Employee Guide.
Why is health screening undertaken?

Health screening is undertaken to:

  • Ensure new employees are not placed in a situation where a pre-existing condition is aggravated.
  • Ensure existing employees are not put at risk by new starters.
  • Monitor and improve the overall health of company employees.
  • Monitor the effectiveness of control measures used to prevent occupational diseases, conditions and ill health.
  • Assist in the development of systems of work and procedures which improve the health of company employees.

Note: There are also a number of items of legislation that require health screening to be undertaken.

Who requires health screening?

All new employees will require health screening on commencement of their employment, and existing employees will require it at regular intervals depending on their exposure to certain substances. Each employee should be screened at intervals not exceeding 3 years.

What is included in pre-employment health screening?

Pre-employment screening provides a documented record of an employee’s health which is evaluated by trained medical personnel at the time when the employee joins the company.  This record may help to prevent an employee being put at risk due to his/her state of health. Furthermore it can be used if any compensation claims arise as a result of ill health in the future.

Prospective employees are typically made job offers subject to satisfactory health assessment and references. The process works as follows:

  • All prospective employees are sent a pre-employment health questionnaire to complete. They are also provided with a pre-addressed envelope to be sent direct to the occupational health specialist to ensure confidentiality.
  • The occupational health specialist will review the questionnaire and if the employee is declared fit, issue a ‘fit to work’ clearance form.
  • If the occupational health consultant decides further investigation is necessary, they will contact the company to arrange for a medical report and/or an independent medical assessment.     
    • A ‘medical report’ is a report obtained from either the employee’s GP or specialist and will require prior completion of a consent form.
    • Note: See appendices on Access to Medical Records Act 1988
    • An ‘independent medical assessment’ is carried out by a local doctor who will obtain the employee’s consent at the time of the appointment.
  • Finally, on receipt of the clinical findings, the occupational health consultant will determine the outcome and send a letter of explanation to the company. A final decision regarding employment is made by the responsible manager.

What is assessed as part of the on-going health screening programme?

The health screen is tailored to each individual and is based upon his/her exposure (or potential exposure) to those hazards in the workplace that can cause occupational health problems.

At least every three years each employee will be subjected to a comprehensive set of health surveillance tests. As a minimum the tests will include lung function, eyesight, audiometry, ‘vibration white finger’ and dermatitis checks.

In intervening years, for high risk activities, a questionnaire and if appropriate lung function tests will be carried out. If the lung function tests show signs of deterioration then chest x-rays may be carried out. The records of health surveillance tests are sent to the company health professional for his/her analysis and advice where appropriate.

It may be appropriate to undertake Post (or leaving) employment medicals if employees have worked in particularly hazardous environments. The main purpose would be to help defend any future claims.  

What does the responsible director need to do?

The responsible director must:

  • Continuously review the specification for health screening in conjunction with the company's medical advisor.
  • Monitor the results of the health screening and report these to the senior directors.
  • Ensure that a health screening programme is in place and progress with implementation is being monitored.
  • Ensure that confirmed cases of notifiable diseases listed under RIDDOR (Reportable Injuries and Dangerous Occurrences Regulations) are reported to the HSE.

What does the responsible manager need to do?

The responsible manager must:

  • Make facilities available for the mobile health screening units to visit sites.
  • Ensure all employees undergo the health screening programme.
  • Make available to the occupational health nurse:
    • Results of any personal dust sampling
    • Calculations of daily personal exposure to noise.

What do employees need to do?

Employees must co-operate with the responsible manager and take part in the health screening programme.

What if an employee needs to be referred to an occupational health specialist?

Managers may request that an employee is assessed by an occupational health specialist, so that appropriate medical advice can be given to both the manager and the employee. Before referral takes place, the employee must be informed and if a medical is required the consent form must be signed.

Referrals could be due to the following:

  • An employee has been, or is likely to be, off sick for longer than 28 days or there is no specified return-to-work date.
  • An employee has had an accident at work and an accurate appraisal of his/her injuries is required.  
  • An employee fails a health surveillance assessment or concerns are highlighted in a health surveillance assessment.
  • A manager believes that an employee’s health is being adversely affected by his/her work (e.g. stress, RSI or back pain, etc.).
  • An employee’s performance at work may be compromised because of ill health.
  • An employee is diagnosed with a critical illness such as psychiatric ill health, cancer or heart disease.
  • An employee is thought to be suffering from alcohol, drug or substance misuse.
  • An employee has notified the responsible manager that he/she is concerned about his/her own ill health, particularly if he/she believes his/her health is being affected by work.
  • Advice is required on rehabilitation programmes for sick or disabled employees.

On receipt of the clinical findings, the occupational health consultant will determine the outcome and send a letter of explanation to the company.


  • If a medical report is required, the consent form gives the occupational health specialist legal rights to obtain one from either the employee’s GP or consultant.
  • If an independent medical assessment is required, the occupational health specialist will arrange for this to be carried out by a local doctor.  If, for medical reasons, the employee is unable to travel to the premises of the examining doctor, a visit to the employee’s home may be arranged.   

How long do records need to be held?

All records of health screening shall be retained by the company for a minimum of 40 years, except screening for radiation where records must be kept for 50 years.

Note: Records may be passed to the HSE if a business ceases to trade.


  • Management of Health and safety at Work Regulations
  • Quarries Regulations 1999
  • Control of Substances Hazardous to Health Regulations 2002

Associated documentation

  • Access to Medical Reports Act 1988: Consent form
  • Access to Medical Reports Act 1988: Employee guide
  • The Mineral Products Association occupational health guide

This workplace procedure forms part of a Health & Safety Risk Management System for employers in the quarrying industry. The procedures, which cover a wide range of workplace risks and hazards, can be viewed here

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