Objectives Ascertain the provision of pre-employment/pre-entry health assessment (PEHA) and the processes used for undergraduate nursing, midwifery and medical students. To compare the beliefs of the service provider and purchaser (university/college) about PEHA.

Methods Postal survey targeting the providers (occupational health services) and the purchasers (university/college) with descriptive and non-parametric tests for analysis.

Results The response rates were 82% and 81% from the providers and the purchasers respectively. 96% of courses screened their students. 74% providers were NHS services and 24% university-based services. One provider may serve more than one group of students. All providers use some form of health questionnaire. All students are routinely contacted by 49% of the providers, 21% of providers ask for GPs to verify completed health questionnaires and 21% also obtain a GP medical report for all students. 81% providers have agreed the process with the purchaser and only 9% have never evaluated their procedure. There are differences in opinion between the purchasers and the providers as well as within the two groups about PEHAs.

Conclusions Other than the use of a health questionnaire, there is no single accepted PEHA process. The varying opinions between and within the providers and the purchasers imply that both parties need to be clearer about the aims and boundaries of PEHA for these students. A checklist of the main issues to consider when commissioning or reviewing a PEHA is suggested.