Nicky Everett

When a child is particularly unwell, they are likely to be admitted to hospital and they will be treated in a paediatric ward or outpatient department. During this admission, children will be looked after by trained and qualified paediatric staff. As for adults, they will be admitted to a specific or specialised adult unit, and this will be staffed with trained and qualified adult nurses, doctors, physiotherapists, dieticians, etc. However, if you are a teenager/adolescent where do you go? This chapter will explore how young people need the opportunity to access a ward or unit with professionals who understand them and the importance of this because why should it be any different for teenagers.

This chapter is structured around a question-and-answer session between a young lady who spent time in hospital as a teenager and her youth support coordinator, examining the perspective of both sides … the patient (Sarah), and a member of staff (Nicky). Sarah shares her experience and journey through her treatment and what it was like as a teenager undergoing chemotherapy and an amputation. While Nicky explores her role as a youth support coordinator and how support is put in place for young people, because sometimes young people are just too scared to ask or do not know how.

This chapter is based on the concluding thoughts derived from the preceding chapters, it analyses the importance of play and the role of the Health Play Specialist. There is a real lack of understanding about the importance of play for children in healthcare settings and the work of health play staff themselves. Within healthcare, play becomes a powerful and effective tool for helping children navigate their way through this new and potentially traumatic environment. Often under immense pressure from those around them, the Health Play Specialist is there to support and help children and their families through challenging times.

The Starlight HPS Impact project is a three-year project, providing Health Play Practitioners (HPPs) in three different healthcare provisions to offer time, space, and opportunity to play, as well as therapeutic play interventions. The overarching ambition is to have a positive impact on the health outcomes and experiences of children and young people dealing with serious illness and life-limiting conditions and their families. The report highlights various institutional and attitudinal barriers that the HPPs have experienced during year one of the project. Whilst some data already captures the commitment of settings to enabling children to experience quality play in their healthcare, this is not universal across all three settings.

Adolescents often fall into a gap within healthcare systems that are traditionally structured around paediatric and adult services. While children are typically treated in paediatric wards and adults in specialised adult units–both staffed by professionals trained for their respective patient groups–the question arises: where do teenagers fit in? This article explores the unique needs of adolescent patients and the challenges they face in accessing appropriate care. It highlights the importance of dedicated adolescent services and the value of healthcare professionals who are equipped to understand and support this transitional age group. Adolescents are not merely older children or young adults, but a distinct population requiring tailored approaches to ensure effective, empathetic, and developmentally appropriate care.

Exploring how practitioners make use of play’s developmental benefits and therapeutic healing properties to aid the child’s healthcare journey, this reflective book expands and enhances the knowledge base underlying the practice of play in hospitals. The work of health play specialists and child life specialists in hospitals in the UK and around the world requires a deep level of clinical knowledge, so that preparing children for procedures can be done with skill and precision. It builds on an understanding of both child development and the impact of traumatic experiences so that children’s deepest fears and biggest emotions can be faced without flinching. It also relies on an acceptance that play is the foundation of everything – the child’s safest, most natural space – and from this trust, strength and resilience can grow and be nurtured. This new edited text explores the breadth, depth and skills of these trained healthcare practitioners providing play for babies, children, young people and adults, and places the power of play squarely at the centre of most clinical settings. Its starting point of the theory that underpins practice is explored and developed through a combination of reflective essays, case study chapters from the UK and around the world, and the newly emerging use of play in diverse settings. Drawing on the collective work of over 30 play specialists, child life specialists, play service managers, lecturers and researchers, this book is unique in all it offers to paediatric practitioners and settings, in training and in practice. It is an important resource for healthcare play specialists, playworkers, children’s nurses, occupational therapists and more.

Playwork is a profession that focuses on enabling and enriching children’s play experiences, creating a space for spontaneous, self-directed play. The application of playwork principles to dementia care holds promise and resonates with a relational approach to care. However, this area of practice has not yet been explored. This study aimed to explore if and how playwork approaches could be applied with people living with dementia and their impact on residents and those delivering the programme. A five-week playwork programme, delivered by undergraduate playwork students and lecturers, was piloted in a care home, with residents living with dementia. Interviews were conducted with care home staff, students, and playwork lecturers, and reflective diaries of the playwork sessions were maintained by students and lecturers. The findings indicate that playworkers can feasibly adapt their approaches so they are appropriate for older adults living with dementia. Playworkers can encourage agency and support free expression and exploration for residents. The sessions were perceived as having a positive impact on residents’ emotional wellbeing, sense of recognition, social interaction, and engagement, as well as on some staff members’ assessments of residents’ abilities. The study also highlights the crucial role of care staff expertise during the sessions, particularly in addressing the medical and physiological needs of residents. However, engaging care staff proved challenging, resulting in a lack of continuity after the project concluded.

This chapter reflects on a therapeutic playwork project in post-Ceaușescu Romania. The project aided the recovery of a group of abandoned and chronically abused children living in a Romanian paediatric hospital. The playworkers worked in a specially allocated playroom, using a combination of groupwork and one-to-one techniques. The speed and quality of the developmental changes within the group was quite unexpected, because it contradicted standard child development theory. The chapter makes the case for these changes being due to the approach of the playworkers and the opportunities for playful interaction afforded by the design of the playroom, i.e., the children in effect healed each other.

This chapter serves as an Introduction to the book. It includes a reflection on the significance of play in a child’s life, especially their time in a healthcare setting. Play may be used to prepare a child for a medical procedure and as a distraction during such interventions. It may also be offered as a normalising function, especially where a child is likely to be in hospital for an extended period. The chapter also includes a brief preview of the chapters to be found in the book. It culminates in a plea for hospital authprities to take the child’s right to play seriously.