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How to make a surgery child-friendly

A play area in the surgery helps create a relaxed environment for all patients.

Making the surgery child-friendly is good for young patients, their parents and other patients. According to the results of patient surveys by Islington PCT in north London, older people can find young children running around the waiting room difficult to cope with. This prompted the PCT to send out guidance to local practices about how to keep children happy at the surgery.

Give children their own space
Many modern surgeries have a play area for children in the waiting room.

If you don't have enough space for this, a few books and toys on a low table are better than nothing. Make sure the children's area is visible to parents.

'If a parent can't sit and see their child, that's not very safe,' says Jenny Singleton, the PCT's head of patient and public involvement and equalities.

Letting parents bring buggies into the waiting area may mean there is no space a children's corner. A buggy park outside the building with lockable compartments is one way of avoiding this. Alternatively, ask parents to fold up buggies and leave them in an allocated place away from the waiting area.

Consider age, gender and language
Under-fives are easily occupied with activity tables. These will also suit children aged five to nine who also like books, crayons and scrap paper to draw on.

Children over nine and teenagers need something to read. Ms Singleton says that teenagers tend to be forgotten but may have long-term conditions so spend quite a lot of time at the surgery. While teenage girls are happy to read women's magazines, practices tend not to cater for teenage boys.

Providing magazines on music and sports is the answer.
Try also to provide reading material in ethnic minority languages for children whose first/only language is not English. Contact the local Sure Start programme or the local library for advice on books in other languages.

Ask staff and parents to help
Put up a notice inviting patients to devote old toys and books but make sure toys are safe for children of all ages.

And be creative: mobiles and posters at child's eye level can help to distract.

'Noisy children are an issue,' says Ms Singleton.

'Have wall posters aimed at children, children's books and toys each consulting room. And don't forget to put a potty in the patients' toilet, along with a notice asking parents to rinse it out, she advises.

Choose appropriate toys
Wooden toys last longer than plastic and are easier to clean. Bigger toys are harder to mislay and less likely to walk off with a child.

'Spaghetti' tables are popular. These wooden tables have looped wires with coloured beads on them and can keep children occupied for a long time. If buying plastic toys, make sure they are sturdy.

Ms Singleton says: 'It's better to pay a bit more and get something that's very hard wearing.'

Soft toys are not off limits, but they get grubby and need to be washed.

Avoid small toys that can be swallowed and noisy toys.

Look after toys and books
Normally the practice manager or lead receptionist will take responsibility for ensuring toys and books are maintained, replaced and kept clean. Toys can get broken and quite dirty, while reading materials will get old and worn.

Books especially will 'walk', so there will be a constant need to replenish them.

For a copy of Islington PCT's guidance on child-friendly GP surgeries email jenny.singleton@islingtonpct.nhs.uk

Case study: Whitley House Surgery
An enclosed play area in the waiting room is keeping children occupied at the Whitley House Surgery in Chelmsford, Essex. The kit provided includes a table with beads to move on fixed wires and a box of plastic bricks (similar to Lego) and books. Each consulting room also has a beads-and-wires table and box of toy bricks. Shops in Chelmsford donated all the toys and books.

The play area is a safe environment as it is away from the surgery entrance and visible from reception. Receptionists are able to ensure that children do not wander off when parents are not watching. 'We always have to be careful about children running out,' says one of the partners Dr Elizabeth Towers (pictured left).

She adds that parents are often preoccupied when they come to the surgery.

Dr Towers says that the surgery's facilities for keeping children occupied are a big improvement on those at the premises the practice occupied four years ago. There, the children's area was a small space under the stairs and sometimes a child would stray into the path of a patient. 'From a health and safety point of view, it was quite dangerous,' says Dr Towers.

'Whereas here we have a self-contained unit, so we don't have to worry that patients are going to fall over toys.' Or children.

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