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Occupational health · London

Pre-employment medical - London.

The statutory fitness-to-work assessment before starting a new role. Executive, factory, healthcare and safety-critical medicals, same day where the role allows, with a clean split between the clinical report you own and the fitness letter your employer sees.

From £80, fitness letter in 24 to 72 hours.
A private pre-employment medical in a London occupational health clinic

What it is

A statutory occupational health assessment

A pre-employment medical is a fitness-to-work assessment carried out before you start a new role. It looks at the specific physical, mental and cognitive demands of the job and gives the employer a short letter confirming whether you are fit, fit with adjustments, or not currently fit for that role.

It is distinct from an insurance medical or a private health screen. The scope is limited by consent to what the job actually requires, and the split between the clinical report (yours) and the fitness letter (the employer's) is written into the Access to Medical Reports Act 1988 and SEQOHS occupational health standards.

Types

Three tiers, matched to the role

  • Health questionnaire only

    A signed self-declaration form for low-risk desk roles. Reviewed by an occupational health adviser, escalated to a clinician only if flagged. Turnaround 24 to 48 hours.

  • Basic clinical examination

    A 30 to 45 minute consultation for physical roles. History, medication review, BP, urine dip, BMI, vision and hearing screen, MSK assessment. Fitness-for-role letter same day.

  • Safety-critical bespoke

    Built around the industry standard: transport, healthcare, security, food handling, construction, driving. Adds cardiovascular workup, drug and alcohol screen, night vision, colour vision or bloodborne virus status as required.

What is checked

The panel is built around the role

A desk role needs a questionnaire. A safety-critical driver or a nurse needs a much fuller workup. A typical panel picks from the following.

  • History and medications

    Past illness, hospital admissions, current prescriptions, over-the-counter drugs and mental health history relevant to the role.

  • Vision

    Distance, near, colour and, for drivers and safety-critical roles, night vision. Corrected acuity tested where glasses or contacts are worn.

  • Hearing

    Whisper or audiometry screen for noise-exposed roles under the Control of Noise at Work Regulations 2005.

  • Musculoskeletal

    Spine, shoulders, knees and grip strength for manual handling, construction and warehousing roles.

  • Cardiovascular and BP

    Resting BP, pulse, heart sounds. ECG added for safety-critical, executive and older applicants.

  • Urine and bloods

    Urine dip for glucose, protein and blood. Bloods added for healthcare (bloodborne virus status) or executive tier.

  • Drug and alcohol screen

    Point-of-care oral fluid or urine sample for safety-critical, transport and construction roles. Chain-of-custody where required by the employer.

  • DBS and clearances

    Not part of the medical, but often required alongside. We can point you to the right route: standard DBS, enhanced DBS, police vetting or right-to-work checks.

Employer-defined criteria

Industry standards vary

Every industry sets its own baseline. The commonest UK employer standards are below.

  • NHS occupational health

    Bloodborne virus status, varicella, MMR, TB history and full vaccination check are standard for clinical roles. Exposure-prone procedures need additional documentation.

  • Food industry

    Health questionnaire per Food Standards Agency guidance. Screens for infections that could contaminate food and confirms the applicant is fit to handle food safely.

  • Safety-critical roles

    Vision, cardiac risk, drug and alcohol screen and, where relevant, a medication review. Standards set by the employer, industry body or regulator.

  • Teachers and education

    Enhanced DBS alongside a health questionnaire or clinical medical. Fitness to teach and any workplace adjustments recommended.

  • Care workers

    Fit and Proper Person declaration, right to work and a health questionnaire. Enhanced DBS required for regulated activity.

  • Police and security

    Extensive physical medical, vision and hearing standards, cardiovascular workup and a structured psychological screen.

Your rights

Reasonable adjustments under the Equality Act 2010

Any offer of employment made conditional on a medical is subject to the Equality Act 2010. An employer must not discriminate on the basis of a disability, and reasonable adjustments have to be considered before an offer is withdrawn on medical grounds.

The occupational physician's job is to describe the specific functional limitations and recommend workplace adjustments, not to make the employment decision. Where an adjustment is workable, the report should say so, and the employer should take that recommendation seriously before withdrawing the offer.

Cost in London

£80 to £850 depending on scope

Questionnaire-only screens run £80 to £180. A basic clinical medical is £150 to £280. A comprehensive medical with drug and alcohol screening is £280 to £450. An executive tier with full cardiac workup and cognitive screening runs £450 to £850. Bulk employer contracts sit outside this range and are quoted per person.

Where it is done

London occupational health providers

  • Randox Health

    Central London clinics with drug and alcohol screening and rapid turnaround.

  • Nightingale Occupational Health

    SEQOHS-accredited provider with bespoke corporate contracts.

  • Nuffield Health Occupational Health

    National network with on-site delivery for larger employers.

  • LondonDoc

    Same-day private medicals across central London locations.

  • InstantMedics

    Same-day pre-employment medicals and drug screens.

  • Same Day Doctor

    Harley Street and City clinics with next-day fitness letters.

  • HCA Occupational Health

    Consultant-led medicals with imaging and cardiology add-ons.

  • Occupational Health International

    Nationwide coverage, SEQOHS-accredited, employer contracts.

Related medicals

Statutory and industry medicals

Frequently asked

Pre-employment medicals, without the jargon.

  • What happens if I fail a pre-employment medical?

    A failure is rare. Most reports are either fit, fit with adjustments, or need further information. Where an applicant is genuinely not currently fit for the specific role, the employer must consider reasonable adjustments under the Equality Act 2010 before withdrawing the offer. If the offer is withdrawn on medical grounds, the employer should give a clear reason and any right to appeal set out in the offer letter.

  • What does my employer actually see?

    A short fitness-for-role letter: fit, fit with adjustments, or not currently fit, plus any workplace adjustments recommended. Employers do not receive the underlying clinical findings unless you explicitly consent. This split is set out under the Access to Medical Reports Act 1988 and is standard SEQOHS practice.

  • Do I have to disclose a mental health condition?

    You are asked about anything relevant to the role. You do not have to volunteer a diagnosis that has no bearing on the specific job. The Equality Act 2010 protects you from discrimination on the basis of a disability, including many long-term mental health conditions, and the employer must consider reasonable adjustments before withdrawing an offer.

  • Is a DBS check part of the medical?

    No. A DBS check is a separate criminal-records check, arranged through the employer or a registered DBS body. Many safety-critical, healthcare, teaching and care roles need both a DBS and a pre-employment medical, but they are run in parallel, not as one appointment.

  • How long is the waiting list for a private pre-employment medical?

    Private appointments are usually available same day or next working day at the walk-in providers, and within 3 to 5 working days at the consultant-led clinics. Bulk employer contracts can run on-site clinics for teams of 20 or more with two to three weeks notice.

  • What happens if I fail the drug test?

    A non-negative point-of-care result is confirmed by a laboratory test with chain of custody. If the confirmation is positive, the result is shared with the employer per the consented scope. Prescribed medications are declared up front and cross-checked so a legitimate prescription is not misread as a positive.

Ready when you are

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