Arts in Hospitals: a synthesis of insights

In NHS Trusts across the UK, we are increasingly seeing the integration of roles responsible for arts delivery and development – whether this be named a Hospital Arts Manager, an Arts Coordinator, Arts Lead, or Creative Health Manager. In the Midlands, 18 of these roles spread across 12 Trusts and 8 Integrated Care Systems (ICS). Representatives from these Trusts join together to create the Midlands Regional Arts in Hospitals Network – a subset of the National Arts in Hospitals Network (NAHN).

In this article, we hear from three members of the Midlands network to better understand their roles and context: Laura Waters, Head of Arts at University Hospitals of Derby and Burton NHS Trust, Emma Linnane, Arts Coordinator at University Hospitals Coventry and Warwickshire NHS Trust, and Sallie Varnam, Creative Health & Heritage Manager at University Hospitals of Leicester NHS Trust and Development Manager for BrightSparks Arts in Mental Health CIO (a charity supported by Leicestershire Partnership NHS Trust). Their contribution has been synthesised by Jane Hearst, during her time as Midlands Creative Health Associate at NCCH. 

Our contributors offered a wide range of responsibilities that make up their roles. These included:

• Curating
• Facilitating
• Managing budgets
• Fundraising for activities
• Improving staff wellbeing
• Visual art around the hospital
• Developing an evidence base
• Setting and delivering strategic aims
• Improving patient and visitor experience
• Developing a participatory arts programme
• Providing both artistic resources and activities
• Recruiting artists/ musicians/ volunteer support
• Developing partnerships, particularly with universities
• Advocating for- and communicating- the benefits of arts in hospitals
• Working with wards/ departments and Estates to deliver site specific commissioned works for both small and capital projects
• Responsibility for the Trust's art and museum collections, and the building which houses these
• Developing opportunities, through strategic partnerships, to advance the notion of creative health across the organisation and partnerships
• Working across the Integrated Care System (ICS) network to advise on creative health approaches to meet strategy - particularly in inclusion and diversity, prevention of deconditioning and community engagement contexts

The relationship with others

The relationships that Arts in Hospitals staff hold are different across Trusts. In places like Derby there are five people in the arts team, whereas elsewhere it is not unusual to have only one arts representative in the Trust. Collaborating departments/partners include:

• Patient experience teams
• Staff wellbeing teams
• The hospital charity (funder)
• Estates and Facilities
• Equity, Diversity and Inclusion
• Communications and Engagement
• Clinical teams across the Trust, such as Dermatology
• Capital projects teams
• Medical education centre
• Library services
• People services
• Research department
• Transformation team
• Corporate nursing team

The key enablers and challenges for this work

According to our contributors, key enablers include:

• Charity support and funding
• working closely with other departments (like those listed above)
• The Trust CEO and Chair (board) offering mutual support
• Being the only post in the organisation with this remit means you have a relatively blank canvas on which to develop work
• Being able to work across partner organisations

Challenges include:

• Proving value for money
• Lack of resource – both financial and working capacity
• Constantly raising funds (which is getting harder to do)
• Size of arts staff compared to the size of the Trust and its workforce
• Lack of awareness of creative health and finding ways to increase visibility
• Developing a consistency of approach
• Trusting creative practitioners to deliver the work appropriately 

Commenting on the final point, Sallie explains: “There is a lot at stake when bringing an artist into a hospital setting and no room for mistakes. I have tried to work with a range of creative practitioners but get the best results when I work with people I know to be highly experienced in working in the field. BrightSparks Arts in Mental Health CIO are developing training for creative practitioners who want to work in health settings to address this issue.”

How artistic provisions are shaped by the NHS context

Adding to the enablers and challenges, Laura provided context of how the delivery of artistic provisions are shaped by the NHS. Much of this was related to the prioritisation of workstreams. That is:

• The team attend steering group meetings to find out where the ‘hotspots’ are in the hospital
• They align their priority areas with the Trust’s areas of concern and where work is requested
• They align their work with the charity objectives, as their main funder

This shifting of priorities is visible in concerns such as staff wellbeing, which until recently was not a major focus within NHS Trusts

The policies and procedures that support the embedding of an arts role in an NHS Trust

Working dynamically with different areas of the Trust, Arts Teams are able to draw upon a number of policies and procedures to embed themselves into healthcare. This way of working draws upon:

• Person-centred care models
• EDI policies
• Pastoral support for medical students
• Occupational Therapy, which is very aligned to arts programmes and is often a good route into patients
• Estates Strategy, as a way of improving environments in the hospital
• The Charity’s Strategy, often with a focal point of enhancing patient Care  
• The Trust’s Arts Strategy – where one exists – which aligns with Trust and Charity mission, values and objectives

It is also important for Arts Teams to create policies around their work. For example, they benefit from having policies around donating artwork, to mitigate against having unsuitable work to deal with. They also benefit from a collections policy, to guide the development of on-site museums and art collections (where applicable). 

Heartwarming takeaways

With a solid understanding of how Arts in Hospitals roles function, I moved on to ask our contributors, ‘What are some of the biggest or most heartwarming benefits you have recorded from your work?’

Laura explained that the feedback they have received about their programme has been ‘incredible,’ literally saving lives or changing them significantly. ‘The arts can have a truly profound effect when emotions and tensions are running so high.’

Emma recalled a moment involving an unconscious patient who had suffered a major stroke and had not been responsive since admission. ‘Through the power of live music their fingers and toes wiggled. Staff were in tears with joy!’

Sallie stated that her favourite part of the work was offering live music for end-of-life patients. ‘It is difficult to find anything more affecting than that.’ She added that her one of the biggest benefits is the use of dance for patients preparing to return home. Notably, this included ‘a patient who had broken his neck and was able to walk for the first time in three months following a dance workshop.’

What other NHS Trust - and wider stakeholders - can learn from the progress our contributors have made locally

Many NHS Trusts across the UK are starting to consider the introduction of Arts in Hospital roles following the successful implementation of pioneering Trusts. For those looking for guidance, here are some top tips and take-aways from our contributors:

1. It is possible to make a significant difference to people’s lives by providing positive distraction at the right time and in the right places.
2. It is important that arts programmes are embedded into the system, making it crucial that Arts Teams are included in capital projects, patient experience projects, wellbeing initiatives.
3. Through better integration into NHS services during the design phase, Arts in Hospitals can co-create projects and become fundamental to their lasting success, rather than be considered a ‘nice to have’ add on. Integrating the arts from the very beginning is crucial as it allows teams to help shape ideas and areas for change, supporting the ability to secure funding and buy in.
4. Arts Teams and their NHS collaborators need to assemble effective comms about the impact of creative health.
5. Finally, it is important to ensure professional artists and musicians are understood as funded and valuable staff, rather than the common perception that they are volunteers who are there doing a nice thing. By helping the public to understand artistic facilitators as skilled and instrumental staff members, with distinct health benefits attached to their work, it can be demonstrated that this work cannot be sustained through voluntary provision, thereby impacting the sustainability of this work in the long-term. 

This Blog has been written and synthesised by Jane Hearst, during her time as Midlands Creative Health Associate at NCCH.