Some of the NHS’s best‑known teaching hospitals are reserving the limited clinical work‑experience places they run for pupils from local state schools, effectively shutting out many applicants who attend independent schools — including those on full bursaries — according to a Mail on Sunday investigation. The report names trusts such as Barts Health, University College London Hospitals (UCLH) and King’s College Hospital as operating schemes that prioritise or restrict placements to partner state schools or local pupils.

Trust publicity and web pages confirm the approach. UCLH’s online guidance states that placements for 16–18 year‑olds are offered through partnerships with the Social Mobility Foundation and selected local schools, and warns demand is high so it cannot accommodate students outside those programmes. King’s College Hospital’s published scheme specifies eligibility by borough and school‑type, saying priority will be given to applicants not attending private schools. Barts Health describes a Healthcare Horizons programme delivered through a network of participating secondary schools and asks students to apply via those schools because of capacity constraints. Trust spokespeople have told the Mail on Sunday that the measures reflect very high demand for a small number of placements.

Trusts frame the policies as targeted widening‑participation measures designed to steer scarce opportunities to young people from lower‑income families and communities that historically have had less access to healthcare careers. South London and Maudsley NHS Trust’s published criteria, for example, link priority to residency in particular boroughs and indicators such as receipt of free school meals or other widening‑participation markers. Nationally, Health Education England says placements are organised locally and that trusts run bespoke schemes while HEE provides toolkits and quality standards; it also notes that roughly 15,000 prospective healthcare placements are arranged across England each year, underscoring the mismatch between demand and capacity.

Those policies are colliding with a reality highlighted by medical‑school admissions guidance: the British Medical Association now advises prospective applicants that hands‑on or observational healthcare experience is an essential part of a competitive application. The Mail on Sunday describes several students from independent schools who say they were refused or deprioritised when applying for hospital placements, including one pupil at Emanuel School told she could not join the local trust’s programme and another on a 100 per cent bursary who reported repeated rejections despite applying widely. Gordon West, head of careers at Stowe School, told the Mail on Sunday that blanket priority rules risk excluding students from very modest backgrounds who attend independent schools on bursaries.

Trusts have defended their policies with practical explanations. A King’s College Hospital Trust spokesman said that in 2024 the trust facilitated 396 placements, the majority for students from state schools; Barts has pointed to the size of its partnership network — dozens of participating schools across several east London boroughs — and says individual placements are allocated through those links; UCLH’s information reiterates that its scheme is delivered through formal partners, while also noting limited capacity for ad hoc requests. NHS England has told newspapers that allocating work placements is a matter for individual trusts.

Critics say the effect is discriminatory in practice. Opponents argue that by excluding or deprioritising pupils on the basis of school type, trusts risk entrenching a new form of indirect disadvantage — particularly for pupils at independent schools who are nonetheless economically disadvantaged. Supporters of the trusts’ stance counter that the measures are temporary triage to direct scarce supervised clinical experiences to young people from backgrounds the NHS sees as under‑represented in the workforce and face‑to‑face with local health‑service priorities.

For applicants who cannot secure hospital observation, guidance from the BMA and HEE points to alternatives. The BMA recommends a broad portfolio of caring and service roles — such as GP placements, hospices, care homes, volunteering and paid care roles — and urges students to use school careers services, personal contacts and persistent applications. HEE and many trusts also promote virtual placements, mentoring schemes and pipeline programmes intended to widen access without relying solely on in‑hospital shadowing. UCLH and other trusts signpost national NHS careers resources and virtual options for those outside partner schools.

The dispute underlines a wider tension in late‑stage school careers: how to balance a legitimate public policy goal — widening participation into medicine and allied professions — with fair access for individuals whose circumstances do not fit simple categories. Trusts and national bodies face a practical choice: expand capacity and central coordination, or sharpen exemptions so that pupils on bona fide bursaries and other disadvantaged independent‑school students are not inadvertently penalised when applying for the very experiences that make medical‑school entry possible.

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Source: Noah Wire Services