Play as a pathway to health

What better environment to explore the benefits of play than in the design and installation of play facilities in hospitals? asks Adam Steiner of the Association of Play Industries

Hospital play under the NHS has a long and diverse history of working to improve the hospital experience for child patients as well as providing a recovery activity that should be a part of every child’s daily life. Hospital wards and corridors can be scary places for children suddenly injured or suffering from long-term illness. There is a relative degree of shock at being thrust into a strange new place, away from friends and family. Therefore the design and facilities of a hospital, as well as the contributions of its staff, must be geared strongly towards the needs and requirements of the child, not solely from an adult perspective.

While there is little to be done in making an operating theatre or hospital bed a less functional or more comfortable place, play provision can make a big difference and comes in many forms, all of which can make hospital a better place for children.

Play facilities have long been a part of hospital life under the NHS. The first hospital play schemes were established in 1957 at St Bartholomew’s and St Thomas’s Hospital in London, followed by the Brook Hospital in London in 1963. But the hospital play movement really gained force in the late-1970s, with a particular emphasis on outdoors play in 1991 after the then Conservative government’s Department of Health introduced guidelines recommending that every major hospital introduce high quality indoor play facilities with the aim to provide one specialist play specialists for every child hospital bed in order to improve patient care and recovery times.

Playable Space
So, how is a playspace created in a hospital? Generally speaking, the size and content of each area changes depending upon the nature of the ward, how able the children will be to use the facilities relative to their condition and what age group the space will cater for. This enables hospitals to allocate space for play according to those child patients who have the greatest need or would benefit most.

A key part of the process is consultation and using an experienced and safety-qualified play company to visit the site and assess the most appropriate equipment. For example, outdoor play spaces have become increasingly popular with larger hospitals as they enable patients to escape the closed internal space of the ward and spend time in a more natural open space; to help them briefly forget the artificiality of the hospital environment. However, due to the rough and tumble nature of outdoor play, not all hospitals and their patients will require such a space and as such outdoor play is often cited as a strong accompaniment to the more common indoor facilities and generally make the hospital grounds feel more welcoming.

API members
The advantage of using an Association of Play Industries (API) member company is that their long line of experience and knowledge of children’s play and play specialists’ needs, qualify them to isolate the level and nature of play provision required for a particular ward and offer a wide range of equipment options.

A popular movement in some hospitals is to divide a space between hard and soft play appropriate to different children’s abilities. This offers a progressive play system for child who are gradually recovering and can move on to more advanced equipment as their condition improves, it also allows child visitors to play, often supervised by hospital play specialists, while their family members move on to the adult wards. Or, if the child is a patient, they can be assisted to work with the soft equipment, depending upon their condition.

At Victoria Hospital in Blackpool, there are several indoor play spaces, including a crèche, designed and installed by API members, including an outdoor playground, all of which cater for children across several ages ranges. These facilities are backed-up by a six person play specialists team who work to support the children at play by helping them to use the play equipment. There are possible plans to expand the hospital’s play facilities to make more space for children of wider age ranges.

Graham Robinson, an API member, commented on the work done at Victoria Hospital: “We are always excited to explore how play can be integrated in hospitals and the health benefits that can be derived from it. It is the hospitals themselves and the staff caring for children who are the most important influence, firstly, having play accepted within the environment and then advising us on how to find new ways for the children to benefit from its inclusion.”

Making Play Happen
Hospital play specialists play a vital role in encouraging patients and visiting children to play which is carried out at several stages. Firstly, there is what is described as normal play, where child patients, particularly those just admitted to hospital, are given the opportunity to forget about their condition and focus on the natural child activity of play.

This is carried out with all child patients, especially those who are unable to leave their beds as play specialists come to them directly and spend dedicated time helping to improve their hospital experience. Another play stage for children is pre and post-procedural play where the play specialists use play and photographs to explain a forthcoming operation to a child, or to detail their post-op recovery plan. This enables the child to relate to the procedure but also helps to remove much of the anxiety and fear that might arise from it.

Therapeutic Value
Play can become an important part of hospital life and one of the most valuable contributions it can make is for child patients with special educational needs or a disability. Sensory experience rooms offer these children a quiet space away from the hustle and bustle of a busy ward and enable them to relax with calming music and light effects that give an added dimension to their recovery.

Play is a highly inclusive form of therapy and can provide a calming effect both for patients and their families visiting hospital, as play is such a natural activity for children it helps to ground the hospital experience and provide some sense of normality. 

The key benefits of creating better play facilities and more play opportunities for child patients in hospitals is that it eases their journey through the healthcare environment. Reducing the shock of being thrust into what can be a very disorientating environment and lessening the level of trauma a child may have had through illness or injury leaving them with a positive experience of the modern healthcare system and that is certainly something worth investing in for the future of children’s health.

Further information

To read more about the value of hospital play, HPSET and the CPIS have produced a useful factsheet:


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