Space to Care: Children's Perceptions of Spatial Aspects of Hospitals

Dr Penny Curtis, Professor Allison James, Dr Jo Birch

Space to Care project background

Although recent National Health Service documents have emphasised the need to make hospitals more child-centred, up until now, for the most part, it is adults who have been consulted about what this might mean. There has been little research that has explored what children think about hospitals and how, as patients, they experience them. We have responded to this omission by considering: the physical characteristics of the different spaces provided for children within different hospital settings; the kinds of social interactions and health care practices that are facilitated or prohibited in those spaces; children’s use of different spaces in hospitals and the meanings and values that they attribute to them; and the extent to which age, gender or medical conditions work to vary children’s perceptions and use of different hospital spaces.

The research was carried out in a variety of hospital settings. Using a repertoire of child-centred research tools, we worked directly with 255 children and young people between the ages of 4 and 16 years, to enable them to describe and reflect upon their experiences in hospital wards and out patients’ departments.

Dissemination Event: Wednesday 21st March 2007

We enjoyed a highly successful and stimulating day, sharing findings and recommendations from our 27-month ESRC project. A diverse audience attended, including architects, those working in children’s healthcare settings and other professionals and academics working with children and young people. Thank you to all those who attended and offered valuable thoughts and feedback on the project.


PowerPoint presentations from the dissemination day are now available here:

Welcome and background
The hospital as a physical space: children's perspectives
The hospital as a social space: children's perspectives
Being ill in hospital: children's perspectives
Concluding comments

A major outcome of the project was the production of a set of tools to be drawn on in the evaluation of existing and planned-for hospital spaces used by children and young people. These tools are in leaflet format and are aimed at three groups: healthcare professionals; architects, planners and policy makers and children and young people within hospitals.

Leaflet for healthcare professionals:

Advice on how to use:


The leaflet/tool is designed to be used by multi-disciplinary teams in settings used by children and young people.


The tool is not designed to be used at the level of a whole institution. Separate assessments should be carried out for specific areas.

Examples might be:


The leaflet/tool takes you through a logical process in which users are able to reflect upon what children and young people have told us is important to them and compare this with current provision. This is the starting point for moving on to consider how improvements could be made. Specifically the tool enables users to:

Leaflet for architects, healthcare planners and policy makers:

Advice on how to use:


This leaflet is aimed at a range of people who might be involved in the design of a new hospital building or area or in the refurbishment of existing areas which are used by children and young people. Architects, planners, interior designers, those working in estates and buildings departments and those involved in policy decisions regarding hospital spaces might find this tool useful.


The tool is designed to act as a starting point for evaluation of a whole institution or of a children’s healthcare environment which is in the planning stage. There may be occasions when the tool may be useful to assess specific areas of healthcare environments such as a children’s or young people’s ward.


The tool is best used in conjunction with the original Department of Health ASPECT tool (A Staff and Patient Environment Calibration Tool) which is available on the web:

Building on the original tool, the new tool: ACE (ASPECT: Children’s Environments), describes, with evidence, 10 components of the healthcare environment which children and young people find important to various degrees. The tool then enables users to score how well a healthcare space or building caters for, or might cater for, children and young people.

Leaflets for children and young people:

Advice on how to use:


There are four individual leaflets aimed at children and young people, of different ages, in their assessment of specific hospital spaces, a leaflet for:


These tools are designed to be made available to children and young people who are using specific spaces, for example:


The leaflets reflect what children have already told us about how hospital spaces may best meet their needs. Straightforward questions are asked of children and young people who are invited to use pictures or words to agree or disagree with statements. There are blank boxes, within the leaflets, for children and young people to offer ideas for improvements for particular spaces, for example around:

The links below take you to summaries of the findings:  

Research briefing

Research briefing for children