This has been the first survey since 1985, when there were 678 respondents to a nation wide questionnaire (68% of those mailed) carried out by Save the Children Fund. ¹

In 1985, just 82 of the play staff employed in the hospitals responding for the whole of the UK, held the Hospital Play Specialist (HPS) qualification; 33% of wards with salaried play workers (251 in UK hospitals). In 2000, 63% (462 of the 734 hospital play staff employed in England,) hold the qualification. It is essential that the development of the service is supported by a professionally trained staff group.

The original Department of Health 2 recommendation that one Hospital Play Specialist be employed for every 10 beds appears to have been met and even exceeded in some regions, with an average of one qualified HPS for every 14 beds for the UK. However, as Table 5 (below in results section) indicates, not all those HPS are working full time and their responsibilities may include more than one ward or clinic. What is valuable to note is the variation in the average number of HPS employed around England. (Table 10)

No equivalent survey has been carried out in other countries where there is a significant hospital play service (Holland, Sweden, USA, Canada). However, it is clear, from both professionals in the field and personal reports, that the employment of qualified HPS is greater in the UK than elsewhere. The numbers of those employed in the UK to lead play schemes in hospitals as a proportion of in-patient beds is also greater in the UK than elsewhere in the world. For example, Boston Children’s Hospital has 300 beds and employs 18 Child Life Specialists (the title given to HPS in USA), whereas Great Ormond Street Hospital with around 300 beds employs 41 HPS.

Full analysis of the survey information defining the quality of the play service provided has not been completed. Tables 7 and 8 indicate the mix of wards responding and the rich diversity of environments in which Play Specialists operate. HPS are part of a flexible and adaptable NHS, capable of responding to the particular needs of young patients.

From the comments made by senior nursing staff, it is apparent that the role of the play specialist is well recognized and appreciated. Most ward managers would welcome an increase in the number of qualified play staff. Some hospitals already have staff undertaking the Edexcel Professional Development Diploma in Hospital Play Specialism and many more would like to be able to release and fund staff to undertake this training.

Access to training varies across the UK. There are now 15 colleges validated to offer the EDEXCEL Diploma in Hospital Play Specialism recognised by the registering body, the Hospital Play Staff Education Trust. Table 2 shows that only 32% of the hospital play staff employed in the Northern and Yorkshire region hold the relevant qualification compared to 78% in London.

Table 10 above demonstrates further regional inequalities with Northern and Yorkshire and the West Midlands having far fewer qualified HPS per bed than the other regions.

In this survey, 5 of the hospitals responding claimed there was no play provision in their hospital. This means that 5 wards in England alone are not prepared to meet one of children’s basic rights; the right to play enshrined in Article 31 of the UN Convention of the Rights of the Child. It is of great concern, given the commitment demonstrated by the other 138 hospitals to meeting this requirement, and the number of documents published on the subject (e.g. Audit Commission, Dept of Health, PHLC), to find even one such children’s ward.

There was considerable variation in the amount of play provision provided in hospitals. In some cases, there was one HPS for the whole hospital (for example for 44 beds). In others, at least one hospital play specialist for every ward or area where children are being cared for. In some hospitals, the “play provision” described in the questionnaires returned, was the responsibility of members of staff such as Nursery Nurses and Health Care Assistants, for whom play provision is just one part of their role. So, while it is likely that the 462 qualified HPS employed in England, and 21 in Wales have play provision as their primary responsibility, we cannot guarantee that the 272 unqualified staff in England or 20 in Wales will be in a position to put the play needs of the hospitalised child first.

Play provision and number of beds

8. Location of hospital play specialists in the hospital and the community

Hospitals without a qualified hospital play specialist*

Most of these hospitals have only one or two children’s wards

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