Snakes and Ladders


Great Ormond Street Hospital wanted to create a drama programme called Snakes and Ladders to draw on the experiences and challenges faced by patients, their families and the professionals involved in their care.

The aim of this project was to create a successful interactive learning programme over a 7-month period that would provide good practice for both users and providers of healthcare.

Project Goals and Objectives

  • Creating a story which asks difficult questions about how the NHS can be improved.
  • Tackling topics such as:
    1. Practical, ethical, resource and financial dilemmas
    2. Trust, management of clinical errors, communication, consent, shared decision-making and bereavement
    3. Realities of fragmented care, bed shortages, uncertain diagnosis and difficult treatment choices


PRP collaborated with GOSH, creating roles for what is called sequential simulation. This is where the same patient is seen across different episodes of care.

Each month would follow the medical pathway of a family, with a child suffering from Cystic Fibrosis up to the age of 16.


PRP planned, prepared and translated the family’s 7 topics into a forum theatre style production which raised awareness and stimulated debates. The following issues were handled:

  1. Breaking Bad News
  2. Building Trust and Relationships
  3. Saying Sorry
  4. Hospital Management
  5. Shared Decision-Making
  6. Consent
  7. Terminal Care

A core group of our specialised medical role play team were prepared and briefed to highlight the important issues that needed to be raised, making it a real life journey for everyone involved. 


By the end of the course participants took away:

  • An understanding of how communicating is central to service delivery
  • Understanding the context in which they work
  • Understanding the relationship between evidence-based practice and real clinical effectiveness
  • Understanding how context, communication and evidence-based practice are brought together to generate the improvement in delivery of care

Due to the success of Snakes and Ladders, another leading teaching hospital embarked on a similar project; Snakes and Ladders II.