Bruce Lindsay

‘A 2-Year-Old Goes to Hospital’: A 50th Anniversary Reappraisal of the Impact of James Robertson‘s Film

James Robertson’s film, ‘A 2-year-old Goes to Hospital’, premiered in November 1952, is seen as a seminal influence on the development of hospital care for children. Its importance is amplified by a belief that Robertson’s work represented a wholly new perspective on such care, challenging an orthodoxy that had remained unchanged over the previous 100 years and that completely excluded parents from hospital wards. In this article I support the importance of Robertson’s film, but challenge the belief that its content was a radical departure from contemporary thinking. I argue instead that the film’s importance lies in the way that it communicated ideas to professionals and parents, and discuss the development of changes in thinking about the care of hospitalized children that had begun some years before ‘A 2-year-old Goes to Hospital’ was released.

Development and implementation of psychological care in a children's hospice

Background The Department of Health recently offered funding to support childrens palliative care projects, one of which addressed the provision of psychology services within specific childrens hospices. The aims of the project were to review best practice in the current provision of psychological support for children with palliative care needs and their families, identify methods of assessing need and evaluating outcomes, and determine how psychological services might link with and enhance the model of supportive care already provided by the hospices. Methods A mixed methods approach was adopted, involving focus groups with family members and hospice staff, individual face-to-face or telephone interviews with family members, hospice staff and external staff and a web-based survey for parents. Topics covered included the assessment of psychological need and how need is met, the provision of specialist services and any gaps in provision, and the use of assessment and outcome measures. Interviews were recorded and transcribed verbatim and analysed using thematic coding. Results Ninety-five hospice staff, 28 external staff and 74 family members participated. All staff currently provide psychological support at level 1 (NICE 2004), some provide support at levels 2–3 but there is no provision at level 4. However, there is an untapped and unrecognised resource of existing staff skills within the hospices. Validated tools are not used for assessment or evaluation and some concerns were raised about the mechanisms for families and staff to provide open and honest feedback. Particular areas of need for specialist intervention included the management of challenging behaviour and supervision for staff managing complex situations. Conclusion Provision of specialist psychology services would be of benefit to the hospices, their patients and families, and external staff. Such a role needs to be embedded in a systemic model of working and have strong links with other professional groups.