CF12/013

ARTS in HEALTH & WELLBEING

Annual Report 2010-2011

Introduction This is the second Arts-in-Health and Wellbeing Annual Report of the Betsi Cadwaladr University Health Board and captures activity during 2010-2011. The range of work undertaken has included Artists-in-Residencies, Community Arts projects, hospital in-reach arts workshops alongside the established Arts Therapies practitioners in mental health services. Work continues to promote the benefits of artists, arts therapists, musicians, writers, and photographers working directly with patients and families to utilise the therapeutic value of participating in creative activity and to create attractive and welcoming healthcare environments. The core focus of the programme has been the continuation of two Artists-in-Residence based at Ysbyty Gwynedd delivering hospital and community projects. This was the final year of a three year funded project with partners Arts Council of Wales, supported by the health board`s charitable funds. This final year saw specific clinical services identified for residencies. These were Elidir Renal Unit, Alaw Unit and Rheumatology Clinics at Ysbyty Bangor and Llandudno. There was a strong collaboration with service users, family and staff, with activity in both hospital and community settings. Alongside the artists residencies BCUHB has, in partnership with Local Authorities, been busy getting broader community based work underway and developing a number of `in-reach` projects, where members of the local arts community have worked with young patients and families during their stay in hospital. With increasing emphasis on Primary Care, Public Health and the Service Users Experience, the AIHWB programme is motivated toward developing partnerships Building on regional contacts between Arts Council of Wales, local authorities arts, museums and galleries the North Wales Arts in Health & Wellbeing Stakeholder Group was established. This group will continue to forge partnerships and shared funding opportunities to deliver high quality inputs to health and social care. It will also develop mechanisms to integrate evaluation and research into all activities, which will provide an evidence based approach. Exhibitions and related events have helped inform about the role that the arts can play within a modern health care service, and as an integral element of the health boards Improving Service User Experience (ISUE) agenda, has developed projects which can bring benefits to patients, staff, visitors and local communities. As BCUHB Clinical Programme Groups are now established, in collaboration with Planning and Estates, there will be opportunities to progress pro-actively across the whole of North Wales (within and away from the hospital) with a wide portfolio of arts activities, therapeutic contacts and capital arts works contributing toward improving the patient experience making timely, strategically relevant, value added interventions with positive and identifiable outcomes.

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BCUHB Arts in Health & Wellbeing

Strategy 2011-2016 launched ARTS IN HEALTH & WELLBEING PROGRAMME SBAR `Creativity for Health and Well-Being` Strategy 2011-2016

Situation There is now an overwhelming body of evidence demonstrating that participation in the arts and access to a range of arts and creative opportunities can dramatically improve health outcomes and increase wellbeing. By complimenting medicine and care, the arts can improve the health of people who experience mental or physical health problems and support those with chronic ill health toward a more socially inclusive access to the arts, whether that be whilst in hospital, rehabilitative care, supported residential accommodation or in local communities. Background Accessing Arts Therapies (HPC Art, Music, Drama or Dance therapy) and involvement in participatory community and hospital based arts programmes provide opportunities for people to engage with each other and their own creativity, directly improving their sense of wellbeing. The arts (inclusive of all forms - Music, Drama, Dance, Writing, Visual Art, Photography/film) can reduce stress and increase social engagement as well as provide opportunities for self-expression, self empowerment and realising potential. Studies have shown that creative expression affects peoples’ sense of control over ill health and reduced reliance on analgesics. The continuum of arts and health initiatives is wide, ranging from people who are fit and well, through to people who are vulnerable to illness from stress, social isolation or difficult family circumstances, to users of primary, secondary and community based health and social care. Initiatives have also been used successfully to engage with members of society who are at risk of social exclusion e.g. substance misuse, ex-offenders, the homeless and those recovering from serious mental illness. Assessment The value of creativity can be gained whether directly `hands on` or as a spectator/visitor to our health care venues and the benefits afforded by a well designed and welcoming environment. Engaging in the arts can promote prevention of disease and build well being by playing an active role in delivering public health education messages and the regeneration of local communities toward a more positive and healthy region. Activity can be delivered in a wide range of settings, from hospital based workshops, within community or residential settings to museums and galleries.

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There are many successful examples of local initiatives that can be utilised simply and effectively that can be shared and built upon further.

Working with internal and external partners we aim to deliver:

• Arts events and projects that contribute to a lively and stimulating atmosphere for services users and staff

• Partnership projects that engage our wider community with the work and values of the Trust

• Environment and buildings projects that enhance the healthcare environment

• Strong links with external Arts professionals and meaningful partnerships with external funders

Recommendations 1. Recognise the role of all Creative Arts activities and interventions in

promoting, supporting and protecting health, social care and well-being. The arts are a key agent in the delivery of holistic care and treatment which puts the service user at the heart and enhances the work experience for staff.

2. Encourage strategic and co-ordinated partnership approaches to engagement with the arts to enhance health and well being, for example, via the North Wales Arts in Health and Well Being Stakeholder Group.

3. Clinical Programme Groups develop their own arts in health micro-strategies enabling the delivery of relevant and timely interventions and be benefactors and host recipients of external contributions, for example: • MHLD CPG -`North Wales Museums for Better Mental Health` pilot 2011/12

-WAG/CyMal Museums & Galleries Strategy • Women’s CPG -`Stitching the Community Together` - community arts for

maternity, health visiting & Sure Start. 4. Links with HE academic departments to support action based research and

evaluation of outcomes which will inform and develop best practise in the field, including potential partner providers of AIHWB training and supervision.

5. Contribute toward the Improving Service User Experience and supporting agendas such as Patient Stories, 1,000 Lives Plus and the volunteer ethos of both public and staff.

`Creativity for Health and Well Being` will also support the delivery of a number of key National and Local Policies: • BCUHB – Strategic Direction 2009-12 & Annual Operating Framework • Our Healthy Future – Public Health Wales • Setting the Direction – Primary & Community Services Strategic Delivery

Programme • Arts in Health & Wellbeing: An Action Plan for Wales – Arts Council

Wales/WAG • The National Programme for Adult Mental Health • Children & Young People’s Single Plan • Older People’s Strategy • Community Strategy

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• National Service Frameworks • Fulfilled Lives, Supportive Communities • One Wales. One Planet • Improving Service User Strategy • Rural Health Plan • North Wales Health, Social Care & Well-Being Strategies 2011-14

*Full Strategy document available on request

Governance The umbrella Arts-in-Health & Health Wellbeing Programme and the Arts Therapies service sit within the Therapies & Clinical Support Clinical Programme Group. Executive briefings are provided to the Executive Director of Therapies and Clinical Support for purpose of informing the Board and relevant other forums in regard to progress and developments. The programme is managed from within the arts therapies service which provides both management and supervision. Inter-Clinical Programme Group working and in partnership with the local authorities Arts and Social Care and Wellbeing portfolios, the Arts Council of Wales, local arts organisations, 3rd sector and higher education institutions are key to appropriate delivery and success. The volunteer sector and staff volunteers is an aspiration to be pursued. Main drivers are: safe value added interventions, promoting best outcomes for the patient, with supporting research & development activity. A range of governance issues have been put in place which includes; Leadership: Identified Executive Lead – AIHWB Design Champion & Improving Service User Experience (ISUE) Identified Leadership of AIHWB Programme and projects management Ensure effective reporting mechanism to Executive Team and relevant CPG`s Ensure effective convening and function of AIHWB Strategic Steering Groups within localities. Be high quality ambassadors of the organisations AIHWB objectives Communicate effectively within the organisation and to the wider public Risk Assessment: Establishment of Risk assessments and management of activities Undertake CRB checks and HPC Registration (as relevant to arts therapists) Employ high calibre arts practitioners with recognised skills and interest in health care environment Provide Supervision of arts practitioners

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Provide corporate management and supervision of partner agencies staff (ie service level agreements/CPG Terms of Reference) Communication: Reports have been provided to the Trust Board/Executive Team and Charitable Funds Committee throughout the year, and have included the minutes of the Trust’s AIHWB Strategic Steering Group and AIHWB Summary of Activities (see below). Regular communication takes place with Executive members and senior managers. All Wales - regular communication with Arts Council of Wales (ACW), WAG Arts Policy Branch, Welsh Therapies Advisory Committee and with other colleagues at regional level. Continuing Professional Development (CPD) Artists-in-Residence and Arts Therapists have attended a range of CPD opportunities and individual study. Audit, Evaluation and Outcome Measures: Each project undertaken is supported by a detailed final report, which by and large captures qualitative and anecdotal evidence. Future developments are to be made regarding audits and evaluation methods, which are much needed to support both future funding proposals/bids and build an evidence based practice.(Individual reports are available on request).

Language: The AIHWB team attempts to make it possible to carry out its projects through the medium of both Welsh and English. Every effort is made to match practitioners to appropriate client groups working in their preferred language.

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Public Exhibitions `Creative Voices` (Yr 2 Ysbyty Gwynedd Residencies) Venue: Bangor Museum & Gallery Artists involved: Karen Brett & Alison Mercer Staff involved: various from teams/departments where residencies held Date: April 23rd – May 14th 2010

`Visualising the Invisible: Artists working in Mental Health` Venue: Wrexham Science Festival, Durber Gallery, North Wales School of Art and Design Artist/s involved: Karen Heald & Susan Liggett Dates: Exhibition/launch of website 2nd – 10th July 2010

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Website launch at `Visualising the Invisible: Artists working in Mental Health exhibition` http://www.karenheald.co.uk/ablett-residency/

Research in partnership Successful BCUHB/Glyndwr University Research and Development funding application “In-between-ness: Using art to capture changes to the self during antidepressant treatment” (Heald, Liggett, Tranter & Poole), October 2010. Research in April 2011. Artist Karen Heald worked in collaboration with the Ablett Unit (Ysbyty Glan Clwyd), Arts Council Wales and University Glyndwr on a year long residency during 2009-2010 and continues this year 2010-11 on a collaborative research project entitled `In-between-ness: Using art to capture changes to the self during antidepressant treatment`- collaborators: Karen Heald & Susan Liggett (artists) Dr Richard Tranter & Prof. Rob Poole ( BCUHB.). This research project has received funding from Arts Council Wales and the North Wales Research Committee. Karen is currently working toward her PhD (Leeds University).

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Activities review: April 2010 -March 2011 Arts Therapies Service Art and Music Therapy sits within the Therapies & Clinical Support CPG and currently exclusively in mental health settings, i.e. acute in-patient unit, forensic secure unit and child and adolescent mental health service, delivering specialist psychotherapeutic interventions and offering supervision and in-house educational sessions. A second pilot community adult art therapy group is being run at Holyhead during the period outcomes from this are helping inform the need and effectiveness of this provision. Emphasis here will be on the possible developments within community and primary care/psychological therapy context and improved access to arts interventions and social inclusion for mental health service users. Participation and partnership collaboration has been a key development within the Bangor CAMHS Art Therapy over the past year, working in collaboration with 3rd sector and education. Partnership with Bangor University Music Department, arts organisations and charitable sector has initiated in-reach musical activity to the forensic secure unit, which further enhances and supports the Music Therapy provision. There is no current Arts Therapies provision in the Central and East areas and none in Learning Disabilities, CAMHS T4, Older Persons Mental Health, Substance Misuse, Cancer/Palliative Care or Stroke Rehabilitation. A need has been identified and supported by service users, that an Arts Therapies provision be provided in the new Heddfan Unit, Wrexham. The service looks forward to developing subject to funding opportunities.

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Artists-in-Residence 2010-2011 (Yr 3 Ysbyty Gwynedd) Artist Nichola Goff and writer/curator Michael McMillan were appointed to Year 3 residencies. These residencies were integral to partnership funding with Arts Council for Wales. During the year ACW were subject to organisational reviews, which delayed some processes of their business. The residencies commenced six months later in November 2010 (running through to October 2011). A public exhibition will be held in January 2012 at Bangor Museum & Gallery and a more detailed report on these residencies in next years annual report. Nichola Goff

Michael McMillan

“I would like to work with patients, carers and staff who are interested in sharing and or writing stories about their lives and experiences. With your consent this material might be used in an art project at the end of the residency in 2011. If you are interested and want more information I will be available in the Cancer/Palliative Care Unit (Alaw Ward) every Tuesday & Wednesday until Christmas 2010.” http://howis.wales.nhs.uk/sitesplus/documents/861/Talk%20About%2006%20-%20April%202011.pdf

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Partnership projects Project Title: Gwanwyn at Ysbyty Eryri Funding source and amount awarded: £500 Gwanwyn Festival, Age Cymru. Venue: Speech and Language Service, Ysbyty Eryri. Artist/s involved: Eleri Jones. Participants (age group, approx numbers): Over 50’s, approx 8 participants. Date: May 24 & 26 / June: 2, 7 & 9 2010

More info available at www.gwanwyn.org.uk Visual artist Eleri Jones was appointed to stage a mini art residence at Ysbyty Eryri during the Gwanwyn Festival 2010 following the success of her 2009 project at Eryri. Gwanwyn is an annual arts festival which celebrates creativity in older age. The project was funded by Gwanwyn and supported by the Community Arts Unit, Gwynedd Council and BCUHB’s Arts in Health and Wellbeing programme.

Eleri delivered a total of 5 art sessions which were held on 24 and 26 May and on 2, 7 and 9 June 2010. She worked in partnership with the Speech Therapy Unit, working mainly with people who had had strokes. Eleri also involved staff and patients’ family members in the art sessions. Project Title: Renal Unit Ysbyty Glan Clwyd Artist-in-Residence Funding source and amount awarded: Friends of Renal Care £3,200 Coleg Harlech received £700 contribution from Friends of Renal Care £650 (materials and National Renal Conference presentation (Birmingham 2011) Venue: Renal Unit Artist/s involved: Jan Gardner & Dawn Oliver (Transplant Nurse Specialist) Participants (age group, approx numbers): treatment unit numbers/open participation Date: April 2010- March 2011

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Project Title: Hafan Gwydir Art Introduction Week and Conwy Elder Abuse Awareness Day workshops A week of introductory visual art workshops at Hafan Gwydir Extra Care Housing Scheme. Funding source and amount awarded: £1,000 Conwy County Borough Council Art Service and £250 Conwy HSCWB Partnership – Conwy Well Being Activity Grant Venue: Hafan Gwydir, Extra Care Housing scheme, Llanrwst and Elder Abuse Awareness Day Eirias Park and Glasdir Artist/s involved: Eleri Jones and Alison Mercer Participants (age group, approx numbers): Residents at Hafan Gwydir aged 60+ (30 - 40 estimate) Date: 14 – 18th June 2010

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Project Title: Summer Creative Play 2010 Gwynedd Council Community Arts Service worked in partnership with the Betsi Cadwaladr University Health Board on a Creative Play Scheme at the Children Unit, Ysbyty Gwynedd during July and August 2010 following the success of the pilot scheme held during the summer of 2008 and subsequent programmes. The aim of the project was to provide an opportunity for patients, their friends and families to participate in creative and playful activities. The aim was to enable children to access facilitated play activities during their hospital stay as means of contributing towards their health and wellbeing.

The project was funded by Gwynedd Council’s Summer Play Scheme (Cymorth Fund) and in-kind contributions were received from Gwynedd Council’s Community Arts Service in the form of staff time and resources. Also, a similar contribution was received from Betsi Cadwaladr University Health Board staff who administered the project funding and supervised and offered support for the artists working on the project.

Funding source and amount awarded: £6,000 Gwynedd Council Play Scheme Fund (Cymorth Funding). Venue: Children’s Unit at Ysbyty Gwynedd and CAMHS – activities held at Gwynedd Museum & Gallery, Bangor. Artist/s involved: Eleri Jones, Rachel Rosen, Owen Davies, Pauline Down and Sian Hutchinson. Participants(age group, approx numbers):Patients between 0 and 18 yrs of age plus parents etc., approx 280 participants. Date: School Summer holidays 2010

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Project Title: Creative Skills Group The Specialist CAMHS Art Therapy Service identified the need to pilot an art based group for a limited period, and the Art Psychotherapist considered how best to support service users. The Creative Skills Group was then developed as the result of a collaborative partnership that took place between Gwynedd County Council and Specialist CAMHS. Funding source and amount awarded: part of £6,000 Gwynedd Council Play Scheme Fund (Cymorth Funding) Venue: Gwynedd Museum & Art Gallery Lead: Tiffany Care, Lead Art Psychotherapist – Specialist CAMHS (BCUHB West) Artist: Sian Hutchinson, Community based Artist Practitioner/ State Registered Art Psychotherapist. Facilitator support: Esther Roberts, Gwynedd Museum & Gallery Curator Participants: (age group, approx numbers): 12-17yrs of age Date: Jan-Feb 2011 (six consecutive weekly workshops)

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Project Title: Conwy Sure Start (Llanrwst & Llandudno) Alison Mercer delivered a series of textile workshops with new and young mothers and staff associated with Sure Start group and healthy living scheme Funding source and amount awarded: £2,960 Conwy Council Venues: Llandudno and Llanrwst community venues Artist/s involved: Alison Mercer. BCUHB AIR Participants (age group, approx numbers): aged 16-30 years, 24 participants Date: June 17th – 27th September 2010

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Project Title: Dolgellau Birth Unit Artwork Project Alison Mercer delivered a series of textile workshops with new and young mothers and staff in Dolgellau. Working with local community groups, several pieces of work were made for permanent display in the new Birth Unit. Funding source and amount awarded: £2,500 Health Challenge Gwynedd Venue: Dolgellau Birth Unit Artist/s involved: Alison Mercer. BCUHB AIR Participants (age group, approx numbers): 0-50+ years old, 74 participants. Date: Jan 5th –March 4th 2011

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Forward work plan and programmes values • To improve experiences through the delivery of high quality arts activity projects, with a

focus on access by all as an aspiration.

• To support staff to gain the knowledge and skills to deliver useful and successful arts

projects, including improving access to existing arts resources, providing opportunities

for staff to develop their arts based skills and increasing staff knowledge of best

practice examples of Arts in Health & Wellbeing activities.

• To use participatory arts projects and creative approaches to support service users to

engage fully in decision making processes.

• To enhance the healing environment – inpatient/outpatient and public spaces.

• To identify solutions to ensure long-term sustainability of arts provision – people want

regular and ongoing arts activities.

• To improve experiences through the delivery of arts performances/events (not

exclusive to visual art).

• To improve access to and clarity of information about our services, including the

possible benefits of engagement with arts programmes.

`The arts can help make it `safe, better, sound, work and making it happen`

Programme Values matched against BCUHB core values

BCUHB CORE VALUES AIHWB CORE VALUES

Making it safe - Making it better

1. We enrich the services already available and provide greater choice to the people who use them

Making it sound

2. We enable staff opportunity to contribute to better working environments through engagement in the creative arts

Making it work - Making it happen

3. We develop partnership working across the organisation and region to widen access to and promote the arts programme

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Contact: Ms Elizabeth Aylett

Head of Arts Therapies & Arts IN Health & Wellbeing Programme ManagerI

Cartref Celf

Ysbyty Bryn-y-Neaudd

Llanfairfechan

Conwy LL3 3OHH

Tel: 01248 682567

Email: Elizabeth.Aylett@wales.nhs.uk