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Alex Coulter Director of Arts & Health South West
www.ahsw.org.uk
Chair of the Culture, Health and Wellbeing Alliance
www.culturehealthandwellbeing.org.uk
Secretary and Project Manager
All-Party Parliamentary Group
on Arts, Health and Wellbeing
http://www.artshealthandwellbeing.org.uk/appg-inquiry/
“The mind is the gateway through which the social determinants impact upon health, and this report is about the life
of the mind. It provides a substantial body of evidence showing how the arts, enriching the mind through creative and
cultural activity, can mitigate the negative effects of social disadvantage. Creative Health should be studied by all
those commissioning services.” Professor Sir Michael Marmot, Director, Institute of Health Equity, University College
London
“The therapeutic value of art is an asset we must use. A partnership between arts organisations and health
organisations has the power to improve access to the arts and to health services for people neglected by both.
Through our Creative Minds programmes in Yorkshire, I also know these partnerships can both save lives and make
lives.” Robert Webster, Chief Executive South West Yorkshire Partnership NHS Foundation Trust; Lead Chief Executive, West
Yorkshire and Harrogate Sustainability and Transformation Partnership
“At least one third of GP appointments are, in part, due to isolation. Through social prescribing and community
resilience programmes, creative arts can have a significant impact on reducing isolation and enabling wellbeing in
communities.” Dr Jane Povey GP, Director, Creative Inspiration Shropshire Community Interest Company
“Artistic self expression gives participants an identity beyond illness. I have seen the arts build confidence and
community and provide hope in the midst of suffering.” Eva Okwonga, Peer Support Advisory Board Member for Mind and
Music Workshop Leader at Music In Mind
“Art helps us access and express parts of ourselves that are often unavailable to other forms of human interaction. It flies below
the radar delivering nourishment for our soul and returning with stories from the unconscious. A world without art is an inhuman
world. Making and consuming art lifts our spirits and keeps us sane. Art like science and religion helps us make meaning from our
lives, and to make meaning is to make us feel better.”
Grayson Perry, Artist
The Art Room, Oxfordshire Photographer: C. Silver Lewis
Key messages
• The arts can help keep us well, aid our recovery and support longer lives better lived.
• The arts can help meet major challenges facing health and social care: ageing, long-term conditions, loneliness and mental
health.
• The arts can help save money in the health service and social care.
RECOMMENDATION 1
We recommend that leaders from within the arts, health and social care sectors, together with service users and academics,
establish a strategic centre, at national level, to support the advance of good practice, promote collaboration, coordinate and
disseminate research and inform policy and delivery. We appeal to philanthropic funders to support this endeavour. We hope that
the centre will also have the support of Arts Council England, NHS England and Public Health England as well as the Local
Government Association and other representative bodies.
RECOMMENDATION 2
We recommend that the Secretaries of State for Culture, Media and Sport, Health, Education and Communities and Local
Government develop and lead a cross-governmental strategy to support the delivery of health and wellbeing through the arts and
culture.
RECOMMENDATION 3
We recommend that, at board or strategic level, in NHS England, Public Health
England and each clinical commissioning group, NHS trust, local authority and
health and wellbeing board, an individual is designated to take responsibility for the
pursuit of institutional policy for arts, health and wellbeing.
RECOMMENDATION 4
We recommend that those responsible for NHS New Models of Care and
Sustainability and Transformation Partnerships ensure that arts and cultural
organisations are involved in the delivery of health and wellbeing at regional and
local level.
RECOMMENDATION 5
We recommend that Arts Council England supports arts and cultural organisations in
making health and wellbeing outcomes integral to their work and identifies health
and wellbeing as a priority in its 10-year strategy for 2020–2030.
RECOMMENDATION 6
We recommend that NHS England and the Social Prescribing Network support
clinical commissioning groups, NHS provider trusts and local authorities to
incorporate arts on prescription into their commissioning plans and to redesign care
pathways where appropriate.
Arts Council England Sector Support Organisation Website holding page: www.culturehealthandwellbeing.org.uk Monthly bulletin – 2548 signed up so far
Live Music Now and Creative Inspiration Shropshire CIC; Claudia Phipps, Ripples, Cambridge University Hospitals; Dance for Parkinson’s, Pavilion Dance South West
#glosSTP
Commissioning Arts & Culture in the NHS
in Gloucestershire
#glosSTP
Shifting our focus to include a psychosocial/non-medical model of care
Contributing factors to our health (McGinnis, 2002). The determinants of health
#glosSTP
Why prevention & self-care?
“We stand of the cusp of a revolution in the role that patients and also communities –will play in their own health and care. Harnessing what I’ve called this renewable energy is potentially the make it or
break-it difference between the NHS being sustainable or not.”
(Simon Stevens, 2015)
“Our health services must evolve from dealing with acute problems through more effective control of chronic conditions to promoting the maintenance of good health.”
(Derek Wanless, 2002)
#glosSTP
Gloucestershire STP
•Prevention and Self Care strategy
•Asset Based Community Models
•Focus on carers and carer support
•Social Prescribing / Cultural Commissioning
Enabling Active Communities
•Transforming Care: Respiratory and Dementia
•Clinical Programme Approach developing pathways and focus towards prevention
•Mental Health FYFV
Clinical Programme Approach
•Choosing Wisely: Medicines Optimisation
•Reducing clinical variation
•Diagnostics, Pathology and Follow Up Care
Reducing Clinical Variation
•Urgent Care Model and 7 day services
•People and Place - 30,000 Community Model
•Devolution & Integrated commissioning
•Personal Health Budgets / IPC
One Place, One Budget, One System
System Enablers
Joint IT Strategy Primary Care Strategy Joint Estates Strategy Joint Workforce Strategy
System Development Programme
Countywide OD Strategy Group
Quality Academy STP Programme
Development Governance Models
Car
e an
d Q
ual
ity
Gap
Hea
lth
an
d W
ellb
ein
g G
ap
Fin
ance
an
d E
ffic
ien
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ap
STP Gloucestershire: Joining Up Your Care
Prevention & Self –Care, Social
Prescribing & Cultural
Commissioning all positioned
within one programme in the STP
#glosSTP
Arts & culture an aspect of social prescribing
Arts & Culture
Environment &
horticulture
Physical activity & lifestyle
Welfare, benefits &
employment
Social Groups & support
Place-based in local communities
Bio-psycho-social model of health
& wellbeing
A route to deliver evidence based
supportive approaches:
• Peer Support
• Self-management education
• Health Coaching
• Group activities to support health
& wellbeing
• Asset-based approaches in a
health & wellbeing context
Realising The Value (2016)
#glosSTP
Clinical intervention
Social Prescribing Plus
Social Prescribing Universal
Clinical intervention for clinical need
Targeted non-clinical intervention for diagnosed clinical need
e.g. Singing for breathing; Allotments for cardiac rehab; Circus for Type 1 diabetes
Universal non-clinical intervention for non-clinical need e.g. Community Wellbeing Service; Community based
groups and activities
Gloucestershire’s Social Prescribing Model
– a universal and a targeted offer
#glosSTP
Enabling reach across health conditions
#glosSTP
Self-management
Adult mental health
Cancer Recovery
Paediatric Diabetes
Advanced Dementia
Children’s mental Health
COPD
Chronic
pain
Paediatric Epilepsy
Embedding arts on prescription
within clinical care pathways
• Increasing the breadth of
interventions for people living
with long term conditions
• Shifting the balance of power
through
co-production with
patients, providers &
commissioners
• Growing the ‘provider market’
and increasing the
opportunity to engage local
VCSE sector
#glosSTP
Case Example – Children with Type 1 Diabetes
• Two projects – one urban dance & street rap. The other circus
and choreography
• Offered to young people at risk of medical complications from T1
diabetes due to body image peer pressure & social media
• Referred by hospital paediatric team
• Improved HbA1c (glycoslated haemoglobin) post intervention
(small sample)
• New friendships made and improved confidence to self-manage
condition
• Links to community youth arts opportunities established
https://www.youtube.com/watch?v=7VV3fP1iF94
#glosSTP
Case Example – Adults living with Chronic Pain
• Co-produced intervention by artist, patients, clinicians & commissioners. Called themselves “The Producers”
• Mixed media arts for men of working age unable to work due to pain. Most on benefits. Referred from NHS
hospital pain management service
• Outcomes: reduction in opioid use; increase in mental
wellbeing; improved family relationships and
social connectedness
• Now self-run by patients with own community bank
account
• The Producers are now steering development of a countywide arts on prescription offer for living well with
chronic pain - alongside commissioners, clinicians & VCSE arts org
Leadership for a purpose – we develop and sustain diverse system leaders
across health and social care, to improve people’s well-being
Our vision
More than 200,000 people work to provide free health and care in
Thames Valley and Wessex.
They face constant change, cutbacks and complexity. Together they
must transform the NHS, making the Five Year Forward View a reality
in every community.
Our Academy exists to empower people by developing compassionate,
inclusive leaders at every point in the system, and a culture of great
evidence-based leadership.
We equip current leaders to be more effective today, we grow the next
generation to lead and we promote leadership mind-sets-helping
people apply their skills in working together, innovating and making
change happen.
Professor Marion Lynch
Leadership for a purpose – we develop and sustain diverse system leaders
across health and social care, to improve people’s well-being
Leadership for a purpose – we develop and sustain diverse system leaders
across health and social care, to improve people’s well-being
Medical Humanities
Leadership for a purpose – we develop and sustain diverse system leaders
across health and social care, to improve people’s well-being
Find out more about how art improves our health at
paintingsinhospitals.org.uk
Leadership for a purpose – we develop and sustain diverse system leaders
across health and social care, to improve people’s well-being
Michael Billington Theatre Critic The Guardian 29/05/18 “Much taken with Dry by Gaye Poole, which I caught in the basement of St James’s Piccadilly and which offers a salutary warning about the dangers of middle class alcoholism. Presented by a lively Oxfordshire company.“
