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"Without a robust pre-employment assessment the employer's liability is potentially compromised"  

The pre-employment assessment is particularly important.  The purpose of this assessment is not only to identify an individual's fitness for work but also to determine whether there are any on-going medical issues which need to be taken account of in the working environment, and particularly when they might be covered by the Disability Discrimination Act where reasonable adjustments need to be considered.

The assessment will normally be carried out by clinical staff screening a pre-employment health questionnaire completed by the prospective employee.  Experience has shown that in approximately 10% of applicants further investigation is required.  Preferably this would be done by a Pre-employment  Medical Assessment for expediency although a number will require GP and Specialist reports.

For employee groups where there is a significant health risk during employment, it is advisable to carry out a Medical Assessment to determine not only their clinical fitness for the role but also their physical fitness for the role, eg musculo-skeletal assessments.  Such assessments would also provide base-line information for future reference.