Reasonable adjustments during professional placements

Legal framework

The duty to make reasonable adjustments comes from the Equality Act 2010. It applies where someone has a disability, meaning a physical or mental impairment that has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities. Some conditions, such as cancer, HIV and multiple sclerosis, are treated as disabilities from diagnosis.

Professional placements are common in courses such as nursing and other healthcare fields, teaching, social work, law and psychology. What makes placements legally distinctive is that more than one duty holder can be involved at the same time. The way the law applies depends on your status during the placement.

If you are a student and the placement forms part of your course, the further or higher education provider owes you a duty to make reasonable adjustments under the education provisions of the Equality Act. That duty extends to arrangements for placements that are part of your studies. The provider cannot simply pass responsibility to the placement host.

If the placement makes you a worker, or something close to it, the placement provider may itself owe employment-type duties, including the duty to make reasonable adjustments, and the anti-discrimination protections that apply in the workplace. The Act also contains specific provisions covering work experience arrangements and people seeking or undertaking vocational training.

In practice this often means both the education provider and the placement host have overlapping responsibilities, and good practice is for them to coordinate rather than leave gaps.

What the duty actually requires

The core duty has three limbs. Where a provision, criterion or practice, or a physical feature, or the absence of an auxiliary aid, puts a disabled person at a substantial disadvantage compared with people who are not disabled, reasonable steps must be taken to avoid that disadvantage. The duty is anticipatory in the education context, meaning providers should think ahead about the needs of disabled students generally and not just react once a problem arises.

Two important points shape what can be offered. First, adjustments must be reasonable, and what is reasonable depends on factors such as effectiveness, practicability, cost, resources and the disruption caused. Second, adjustments cannot remove a genuine core competence standard. Competence standards, meaning the standards a person must meet to demonstrate a particular level of competence or ability, are not subject to the reasonable adjustment duty, although the way competence is assessed can be adjusted. This distinction matters heavily on professional placements, because regulators such as the Nursing and Midwifery Council, the General Medical Council, Social Work England and teaching bodies set proficiency standards that all entrants must meet. You can adjust how a student demonstrates a competence, but you cannot waive the competence itself.

Examples of adjustments on placement

Adjustments are always assessed case by case, but common and often reasonable examples on professional placements include the following.

Adjustments to hours and pattern of work, such as altered start and finish times, avoiding or reducing night shifts where clinically appropriate, additional rest breaks, or a phased or part-time placement pattern.

Adjustments to the physical environment and equipment, such as accessible workstations, specialist seating, height-adjustable equipment, assistive technology, screen-reading or speech-to-text software, coloured overlays, or ergonomic aids.

Adjustments to support and supervision, such as a named mentor or contact, additional structured supervision, clear written instructions to supplement verbal ones, regular check-ins, or a support worker, note-taker or communication support professional such as a British Sign Language interpreter.

Adjustments to how tasks and assessment are carried out, such as extra time to complete tasks, breaking tasks into smaller steps, allowing more time to build up to a full caseload, or adjusting the format of placement paperwork and reflective logs. Assessment methods can be adjusted even though the underlying competence standard cannot.

Adjustments relating to location and travel, such as choosing a placement closer to home, ensuring accessible transport routes, or allocating a placement whose physical layout suits the student.

Adjustments for mental health conditions, such as a graduated return, protected time for medical or therapy appointments, a stress or wellness action plan, or adjustments to how feedback is delivered.

Funding for some individual support during study, including in some placement contexts, may come through Disabled Students’ Allowances rather than from the provider itself, so it is worth clarifying the funding route.

Who is responsible and how to secure adjustments

Because responsibility can be shared, one of the most important practical points is that the education provider should not treat the placement as outside its control. Good practice, reflected in guidance from the Office of the Independent Adjudicator, is for the provider to discuss the practical arrangements for the placement with you in advance so that potential obstacles are identified and effective adjustments are put in place before you start. The provider should keep an open mind about possible adjustments and discuss them with you rather than deciding unilaterally.

Information sharing is governed by consent. The provider may need to share information about your condition with the placement host in order to arrange support, but it should not do so without your consent, and it is good practice to agree in advance exactly what will be shared and with whom. It is also good practice to put a written placement support plan in place and to monitor the placement to make sure the agreed support is actually delivered.

Practical next steps

1. Get an up-to-date assessment of needs, for example through your provider’s disability or student support service, and if relevant a needs assessment linked to Disabled Students’ Allowances.

2. Disclose to the right people early. You are not obliged to disclose, but the anticipatory duty aside, a provider or host is only expected to make specific adjustments once it knows, or could reasonably be expected to know, of your disability and the disadvantage. Early disclosure gives the best chance of adjustments being ready before you start.

3. Ask for a written placement support plan that names the adjustments, who is responsible for each, and how they will be reviewed. Agree in writing what information will be shared with the host.

4. Raise problems promptly if adjustments are not delivered or a placement proposes to withdraw or fail you. Ask for the reasons in writing and for the decision to be reconsidered.

5. Use internal routes first. Complain through your provider’s formal complaints procedure, and where a fitness to practise or placement withdrawal is involved, engage fully with that process and put your case in writing.

6. Escalate externally if internal routes fail. For higher education students in England and Wales, once you have a completion of procedures letter you can bring the matter to the Office of the Independent Adjudicator for Higher Education. A disability discrimination claim under the Equality Act can be brought in the County Court, though there are strict time limits, so keep the dates clearly recorded and take advice quickly if you are approaching them.

Where the outcome could change

Several missing facts would affect the answer. Whether you are formally a student, a worker, or both during the placement changes which duty holder is primarily responsible. The precise regulator’s proficiency standards will determine which requirements are genuine competence standards that cannot be waived. The cost, practicability and safety implications of a specific adjustment, particularly in clinical settings, will affect whether it is reasonable. And whether a placement can be adjusted or must instead be substituted with an alternative depends on the nature of the course requirements. If you tell me your course, your professional regulator, the specific difficulty you face and what has been offered or refused so far, I can give a more focused answer.