Health questions after a job offer: what employers can ask and do

Under section 60 of the Equality Act 2010, an employer must not ask you about your health or disability before it has offered you the job. The offer can be conditional. Once you have one, a health questionnaire or occupational health assessment is normal in public sector hiring, and the employer has to deal with the result fairly.

The rule before an offer

At application and interview stage, an employer should not ask whether you have a health condition or how much sick leave you took in your last job. The Act lists narrow exceptions. They include questions needed to arrange adjustments so you can take part in an interview or test, and questions about whether you can do a function that is intrinsic to the work. Monitoring the diversity of applicants is also allowed.

Acting on health information given at the wrong stage can itself be a problem. If you complain to a tribunal that an employer relied on it, the facts you set out are treated as evidence from which a breach could be found, and the employer then has to explain itself. The Equality and Human Rights Commission enforces the rule against asking the question itself. For the wider rules, see Discrimination at work.

What happens after a conditional offer

NHS Employers’ standard says health assessments should take place after an offer of employment and before you start. The health declaration form goes out with the conditional offer letter. On it you tick one of two statements: you know of no health condition that would affect the role, or you have a condition that may need adjustments. The form goes to occupational health, which decides whether to ask for more information or invite you for an assessment.

Schools, councils and the Civil Service run their own versions, and the detail varies by employer. The occupational health check guide describes what the appointment involves.

The outcomes

According to the NHS Employers standard, occupational health sends HR a clearance certificate. It confirms one of the following:

• you can start work
• you can start work with reasonable adjustments in place
• you have the immunisation or exposure prone procedure clearance the role needs

Occupational health advises you and the employer. The decision to appoint stays with the recruiting manager. If the manager appoints despite occupational health concerns, they are expected to record why.

Reasonable adjustments come first

The Equality Act puts a duty on employers to make reasonable adjustments for disabled applicants and employees. Examples in the NHS standard include changed hours, equipment, time off for treatment and extra training or supervision. The Access to Work scheme may help pay for some of them. Reasonable adjustments at work has more.

An employer should not conclude you cannot do the job until it has looked at what adjustments could make it possible. An offer withdrawn without that step is the most open to challenge. If you need help asking for adjustments during recruitment itself, see asking for reasonable adjustments in recruitment.

If the offer is withdrawn

Acas says an employer is not required to give a reason for withdrawing an offer, though giving a valid one is good practice. You can still ask why, in writing, and which condition was not met. You can explain how the decision affects you, share evidence and say what outcome you want.

Withdrawing an offer because of a protected characteristic, such as disability or pregnancy, could break discrimination law whether the offer was conditional or unconditional. If you think that is what happened, the Acas helpline can talk through your options. Time limits for tribunal claims are strict, so ask early. The wider conditional offer guide covers other reasons offers fall through.

What to check

Public sector employers differ on who runs the assessment and how long it takes, so ask HR for the expected timescale when you return the form. A delay at occupational health holds up your start date in the same way a slow reference does, and chasing politely is reasonable.

Expect the health form with the offer, not before it. Keep a copy of what you submit. If you need adjustments to start, say so on the form so occupational health can record them. If you were asked health questions at interview that were not about adjustments, you can raise it with Acas, a union or the EHRC.