Our Impact

Seriously ill children and teenagers face months, if not years, of treatment and hospital stays. Research has shown that play is a vital coping mechanism at this time and the lack of opportunities to socialise and communicate can lead to heightened feelings of anxiety, stress and loneliness.

We work in partnership with play specialists and medical professionals in all our partner hospitals to support the wellbeing of children and their families by delivering our Hospital Entertainment Programme. This aims to address the negative impact of prolonged hospital stays, increase communication and spread smiles.

Our services aim to make a lasting and positive impact on the lives of two key groups:

Our 2023 Impact Report

Take a look at our Impact Report 2023

Why we exist

  • To support seriously and terminally ill children and teenagers by providing distraction therapy and play interventions during invasive treatment and long term hospital care
  • To provide age and developmentally appropriate entertainment and play for potentially frightening and/or painful treatment
  • To help create safe, welcoming and less frightening environments to paediatric and young person patients
  • To provide therapeutic interventions to support patients throughout their hospital journey
  • To provide a wide variety of entertainment and play activities to paediatric and teenage patients
  • To provide parental, sibling and extended family support
  • To be an advocate on behalf of the children and young people

All of our services aim to make a real and positive difference to the wellbeing of seriously and terminally ill children and their families throughout their treatment and hospital stays.

The current climate and strained budget of the NHS means priority must be given to medical and procedural support. Play and youth services are therefore increasingly vulnerable to funding cuts.

Spread a Smile works closely with its partner hospitals to support and extend developmental play and entertainment services. Our entertainers and play activities bring joy and laughter and create strong, positive memories of a child’s time in hospital that support their coping mechanisms and build their self-esteem whilst reducing feelings of loneliness, anxiety and fear.

New Research

In 2020, we commissioned Oxford Brookes University to conduct independent research into the impact of our work.  A summary of the results can be found in our latest annual report (pages 16-19) HERE.


  • Creating hope – by replacing the heartache and pain associated with diagnosis and treatment with joy, laughter and fun, the patient and their family is able to feel normal again. It brings hope for the future if only for a short time
  • Helping understanding through play – play is an essential part of childhood and adolescence and is at the very heart of a child’s mental, social and emotional growth and well-being. From the earliest age, playing helps children to learn, to relate to other people and to have fun. This does not stop when they are admitted to hospital when children are at their most vulnerable. They are not only ill, but also they are separated from their friends and familiar surroundings. Having fun with our entertainers can really make a real and positive difference to their acceptance of their illness and treatment. Through our interactions they feel supported as they prepare for hospital procedures and treatment
  • Alleviating the monotony of the hospital environment – hospitalisation means that young people miss out on day-to-day childhood activities with very few reasons to smile. For all children confined to hospital beds, time passes very slowly; they lack stimulation from endless days of inactivity and struggle with separation. Our visits bring joy, entertainment and laughter and help to show the hospital environment as a welcoming, safe and secure space for young patients.  Knowing the Spread a Smile visit date ahead of time gives patients and families something to look forward to and, over periods, the children build a rapport with their favourite entertainers
  • Distracting from treatment and reducing anxiety – by reducing children’s and young people’s anxieties and fears our entertainment can increase their co-operation of hospital treatments. Engaging in play, music, laughter with our entertainers reduces anxiety levels and releases endorphins that can reduce pain, discomfort and stress. Our entertainers are often on hand to provide a distraction during difficult procedures and help reduce the need for sedation and medication to manage pain and thus speed recovery and improve the overall patient experience
  • Improving well-being – our visits help a young person gain confidence and self-esteem and provide an outlet for feelings of anger and frustration. Improved well-being speeds recovery and rehabilitation
  • Supporting for siblings, parents, carers and grandparents – there is pressure on parents and carers to be a constant source of entertainment and our visits help to alleviate that burden and provide a welcome break from the monotony of a hospital stay. Siblings can be deeply affected by their brother or sister’s illness. Our visits also facilitate opportunities for patients and families to meet others in a similar situation and we provide many activities that enable families to enjoy regular experiences together
  • Providing positive memories – creating happy memories is an important part of our work, particularly for parents whose children have conditions that cannot be cured. Many parents cherish the photos and videos taken during our visits and report back to us how valued those memories are. For the children who do get better, our visits help them see their time spent in hospital in a more positive light