Integrating Play into Pediatric Care: A Key Component for a Child-Friendly NHS

According to a recent report from academics at the University of Cambridge, play should be a fundamental aspect of pediatric health care as the NHS plans for its future. The report, commissioned by the charity Starlight, asserts that incorporating play into children's health care can 'humanize' the experiences of young patients.

In the publication titled Playing with Children's Health?, the authors advocate for integrating play, games, and playful methods into a comprehensive model of pediatric health care. This model emphasizes the importance of addressing emotional and psychological factors alongside physical health needs.

Globally, health care systems have increasingly acknowledged the significance of play in pediatric care over recent decades. Evidence suggests that making health care environments more welcoming and child-friendly can significantly alleviate stress and enhance the experiences of younger patients. Despite this recognition, play is frequently undervalued and inconsistently applied across various health care settings.

This report consolidates findings from over 120 studies to bolster the argument for a more systematic integration of play into pediatric health care. The authors highlight an important opportunity presented by the UK government's upcoming 10-year health plan for the NHS, which could facilitate the incorporation of play into a more holistic vision for child health.

Dr. Kelsey Graber, who led the report, noted that child-centered activities and play have a distinctive ability to support the emotional and mental health aspects of children's healthcare experiences, whether they are in a hospital or visiting a general practitioner for routine treatment. While play may not directly alter the course of an illness, it can substantially enhance the overall experience by mitigating stress and anxiety and fostering understanding and comfort.

Adrian Voce, the Head of Policy and Public Affairs at Starlight, emphasized the timeliness of the report's findings as the government aims to create the healthiest generation of children ever. He urged NHS leaders and government ministers to make play teams an essential part of pediatric care.

The report synthesizes evidence from 127 studies conducted across 29 countries, with most published after 2020, reflecting a heightened interest in children's health care interventions in the wake of the COVID-19 pandemic. Some studies focused on medically relevant play, where hospital staff utilize role-play and toys to introduce children to medical procedures, thereby reducing anxiety.

Other studies examined the impact of non-medical play, including social games, video games, arts and crafts, music therapy, and storytelling, all aimed at enhancing patient comfort. Certain hospitals even provide 'distraction kits' designed to help children relax during medical appointments.

The report identifies five primary ways that play contributes to improving children's health care:

• Reducing stress and discomfort: Evidence shows that play can lower physiological markers of distress, such as heart rates and blood pressure, and can alleviate pain and anxiety during medical procedures.
• Emotional expression: Play provides an outlet for children to express emotions, helping to mitigate feelings of fear, anxiety, boredom, and loneliness in health care settings.
• Fostering dignity and agency: Play empowers children, offering a sense of control in an environment where they may often feel powerless.
• Building connections: Play fosters relationships among patients, families, and health care staff, improving experiences for children, particularly those in long-term or palliative care.
• Preserving childhood: Engaging in play allows children to maintain their identity as children rather than reducing them to mere patients, providing vital moments of joy and emotional relief.

While the benefits of play are widely recognized, the report cautions that its impact can vary significantly from child to child. This variability underscores the importance of adopting informed, child-centered strategies for implementing play in health care environments. Unfortunately, expertise in play facilitation may often be lacking, as only 13% of the reviewed studies examined the work of health play specialists. Most reported activities were directed by adults rather than allowing children to define their own experiences.

The report also points out a significant gap in research concerning the use of play in mental health care, with only three of the 127 studies addressing this area. Given the rising rates of mental health challenges among children and adolescents, the authors call for increased focus on play as a tool for mental health support.

Incorporating play more thoroughly into health care as part of broader government reforms could help reduce trauma associated with health care experiences and improve long-term health outcomes for children. The authors stress that it is crucial for both health care professionals and policy leaders to recognize the value of play, ensuring that children's developmental, psychological, and emotional health needs are met alongside their physical health requirements.