Although clinical placements are an integral part of health-profession education, in contrast to university settings where education is a primary focus of activity, the health services that host these placements are primarily configured for clinical services. As a result, health-service staff supervise students in an environment where work priorities are centred on patient care rather than on student learning. Moreover, health services are complex and dynamic environments where student-learning opportunities vary greatly. As part of a project to identify and build leadership capacity for quality student learning within clinical teams, a model for team development was tested in three different health-service teams. The process of identifying and enrolling the selected teams permitted some observations to be made by the project team regarding the ways in which the organisation of health services shaped student-learning opportunities. The more complex the health service in terms of size, clinical team composition and patient or client care responsibilities, the fewer opportunities staff had to come together as a team to discuss and plan student learning. In addition, the more complex the health service, the greater the number of universities placing students and the greater the number of different programmes and levels of study represented, rendering the task of planning more difficult. It is proposed that what is required are negotiations across institutions that are sensitive to the complexities of clinical practice and also mindful of the need for students to be supported and engaged in ways that allow them to contribute and learn effectively in doing so.