Research and Insights

Children unnecessarily anaesthetised for medical procedures

Thousands of children are anaesthetised or sedated for medical procedures that could be done while awake, according to new findings released by our charity. 

In two surveys of health professionals we conducted 70% said they had seen general anaesthesia being used during medical procedures which could have been avoided if play and other support had been available  82% said they had seen sedation methods used for the same reasons. 

General anaesthetic can have many common side effects such as sore throat, headaches, sickness and bruising. On rare occasions it can even result in death.   

Play reduces anxiety and even lessens pain

There is substantial evidence that therapeutic play can mitigate the need for general anaesthesia because it prepares children for their procedures, reduces anxiety and even lessens pain. 

MRI scans are just one example where children are given general anaesthetic because of concerns they will not tolerate the noise, feel claustrophobic when inside or will not stay still long enough as scans are 30 to 90 minutes long. 

Significant cost savings

General anaesthetic also involves significant costs and resources, including an anaesthetic room, additional staff including an anaesthetist, and longer recovery times which can have a knock-on effect on bed capacity and waiting lists.  

With an average cost-saving of £1,000 per MRI if done awake, we estimate the NHS in England could save £5.85 million a year by reducing the need for general anaesthesia for MRIs alone. A Freedom of Information request we submitted to NHS England revealed that there were 6,501 MRIs for children aged 0 to 17 undertaken with general anaesthetic in the 12-month period from April 2024 to March 2025. Studies have shown that when a health play specialist is available to prepare and support with therapeutic play, the need for general anaesthetic is reduced by 90%.

Senior health play specialist Zoe Keates, Royal National Orthopaedic Hospital, London

Zoe’s pioneering and highly-praised work has led to an 88% reduction in general anaesthetic use in children having MRI scans since she introduced play preparation in 2015. 
 
For many years, under-12s were routinely given general anaesthesia but Zoe now uses a 3D printed interactive model she designed to help avoid this. It has lights and sounds and children can put a doll inside. The model is used to prepare children aged 4-14.  

One ten-year old boy who had MRI scans regularly under general anaesthetic at his local hospital was sent to the Royal National Orthopaedic Hospital (RNOH) for an MRI scan for scoliosis (curvature of the spine). Zoe talked to him and his family about trying the scan awake. As well as letting him play with her model she also practiced a relaxation technique with him and accompanied him to the scan. Her approach was successful and he can now manage any future MRI scans awake.  

“I’ve heard so many stories from parents of children who come to us for scans that have said the child could not go through with their MRIs at other hospitals where play was not used to prepare them.” - Zoe

The RNOH scans around 1,500 children a year awake and around 90 with a general anaesthetic. Almost all children referred to Zoe have the scan awake. She said: “We still carry out around 10 a month under general anaesthetic but that is for children with additional needs or conditions such as cerebral palsy.” 

Cathy Gilman, CEO of Starlight

"Hospitals and medical procedures are often scary and traumatising for children. Whether it’s a one-off visit to A&E or regular hospital appointments because of a chronic condition, there is an imperative and a duty to ensure children have an experience which does not hinder healing or harm their mental health.  

“Health play helps children understand why their treatment is necessary and helps them cope. It isn’t a luxury. It’s a necessity. 

“There’s also the economic value of play – it saves resources and staff time, not just for MRI scans but for all the other procedures that children may have. And yet play, and the health play professionals required to support it, rarely receive the recognition or funding they deserve. This needs to change to protect children and to protect the NHS.”