Commissioning Creative Health: What to Ask, What to Expect
The benefits of creative health programmes are clear; they support mental health and wellbeing, help prevent illness, and can strengthen community connections.
At NCCH, we define creative health as creative approaches and activities which have benefits for our health and wellbeing. Activities can include visual and performing arts, crafts, film, literature, cooking and creative activities in nature, such as gardening. Approaches may involve creative and innovative ways to approach health and care services, co-production, education and workforce development. Creative health can be applied in homes, communities, cultural institutions and heritage sites, and healthcare settings, and can contribute to the prevention of ill-health, promotion of healthy behaviours, management of long-term conditions, and treatment and recovery across the life course.
However, commissioning creative health programmes requires collaboration, flexibility, and an understanding of the sector’s unique ways of working. This blog explores the key questions to ask, and what to expect when commissioning creative health initiatives and programmes; helping commissioners design initiatives that are more person-centred, evidence-informed, and impactful.
Laying the Groundwork for Commissioning Creative Health
Commissioning creative health programmes starts with understanding the opportunities in your local area and building the partnerships that will help you deliver them. Using local data sources such as the Joint Strategic Needs Assessments (JSNA), Health Needs Assessments, and national tools such as the digital.nhs.uk/dashboards and fingertips.phe.org.uk can help to identify local priorities and population needs. Commissioners are encouraged to draw on the growing evidence base of creative health by referring to resources such as the Creative Health Review (2023) and the Creative Health Toolkit’s Illustrative Examples, to demonstrate impact and strengthen the case for investment. Developing relationships with voluntary, community and social enterprise (VCSE) partners is also vital for understanding existing creative capacity and ensuring programmes reflect local communities.
Our guidance recommends adopting a co-design approach, involving service users in commissioning decisions, and applying the Creative Health Quality Framework to ensure programmes are safe, effective, and grounded in lived experience. By following these principles and actions, commissioners can embed creative health as a high-impact approach that contributes to more preventative, equitable, and responsive health and care systems.
These recommendations are taken from the NCCH’s Commissioning a Creative Health Programme resource, which outlines practical steps for commissioners to understand local need, build partnerships with VCSE providers, and draw on existing evidence to shape effective programmes.
Strategic Commissioning Framework and Creative Health
The recently published Strategic Commissioning Framework (NHS England, 2025) sets out a shared vision for the future of commissioning, one that is evidence-based, preventative, and focused on improving population health and reducing inequalities. In the framework's foreword The Model ICB Blueprint establishes a shared vision for integrated care boards (ICBs) by setting out the direction of travel for their role and functions.
While creative health is not specifically referenced, its principles align closely with the framework’s ambition for ICBs to adopt a biopsychosocial approach and work in partnership to address the wider determinants of health. As ICBs strengthen their strategic commissioning capabilities, there is a key opportunity to embed creative health as part of this shift, supporting prevention, community wellbeing, and more person-centred models of care across systems.
Creative Health and NHS Commissioning
In March 2025, the NCCH commissioned a report from North of England Care System Support (NECS) (De’Ath, 2025) exploring NHS commissioning and creative health, looking at how funding decisions are made, the sort of evidence that is required, and barriers to the commissioning of non-clinical services.
The report highlights that success depends on strong partnerships, adaptability, and understanding NHS processes. It also calls for more flexible, long-term commissioning and better collaboration between the NHS and creative providers. Focusing on evidence, engagement, and adaptability, the recommendations provide a practical roadmap for embedding creative health more meaningfully within NHS structures.
What to Expect: Identifying Resources, Investment & Funding and Understanding & Developing the Market Place
Under the personalisation and social prescribing agenda, commissioners of creative health programmes act as market stewards, shaping and supporting the local creative health landscape. Their role is to bring partners together, foster collaboration, and ensure new programmes complement existing provision. To do this effectively, commissioners need a clear picture of local creative health activity and where further investment or support is needed. The Creative Health Toolkit recommends mapping both targeted and universal provision to identify gaps, strengths, and opportunities for sector growth.
Investing in creative health requires a joined-up approach that unites local partners, funders, and communities. Commissioners can pool resources, develop joint bids, and use mechanisms such as the Social Value Act or micro-commissioning to create targeted solutions. Establishing community grant schemes can also enable grassroots groups to deliver locally relevant projects. Above all, taking a longer-term view of investment helps ensure creative health is sustainable, stable, and impactful across local systems.
What Works in Community-Based Creative Health Provision
The University of Huddersfield’s Policy Briefing on Developing Creative Health Provision (2023) highlights that effective commissioning of community-based creative health depends on strong local partnerships and inclusive, place-based approaches. Commissioners can strengthen impact by supporting programmes that use trusted community spaces such as libraries, community centres, and cultural venues, making activities accessible and rooted in local life.
Commissioning creative health programmes that prioritise co-design with communities ensures interventions are relevant, engaging, and responsive to local needs. Flexible funding models and sustained investment can also help providers build long-term relationships and deliver consistent and trauma-informed practice. Commissioners can also encourage collaboration across cultural, VCSE, and health sectors, fostering shared goals and clear communication. By investing in locally led, partnership-driven approaches, commissioners can embed creative health as a core part of community wellbeing and integrated care delivery.
Barriers to Commissioning Creative Health
Our NCCH Creative Health Commissioning by Health and Social Care Systems: Findings from Three Integrated Care Systems and Torbay (January 2022) report identifies several barriers that continue to hinder the commissioning of creative health initiatives within health and social care systems.
Commissioners tend to undervalue creative health: Creative health activities are often perceived as peripheral or “nice to have” rather than essential to improving health and wellbeing. The report notes that health commissioners are far more likely to take creative health proposals seriously when they come from within the health system rather than from cultural organisations or local authority cultural teams. This perception is reinforced by current funding structures, since most creative health activities are financed outside the health system, there is an expectation that they will continue to be funded elsewhere. As a result, creative health is often viewed as an add-on rather than a legitimate, evidence-based component of health and social care delivery.
Contracting structures are often unworkable: Existing contracting processes are complex and not designed to accommodate the diverse nature of creative health providers, from freelance practitioners to small community organisations, making it difficult to secure sustainable and long-term agreements.
Commissioning and Co-production in Health and Care
The exploratory literature review Commissioning and Co-production in Health and Care Services in the United Kingdom and Ireland (Scott et al., 2024) found that complex commissioning systems, rigid governance, and short-term funding cycles continue to limit meaningful co-production in health and care. While policymakers increasingly promote co-production to design services that reflect local needs, existing commissioning frameworks often make this difficult to achieve. Commissioners who champion co-production can help create the conditions for collaboration, but wider political and financial constraints often restrict their ability to embed it in practice.
Creative health initiatives are gaining recognition as an essential part of person-centred and preventative care
Creative health is increasingly recognised as a vital part of person-centred and preventative care. While barriers around funding and contracting remain, progress across health systems, local authorities, and communities shows that meaningful change is already underway. The publication of NHS England’s Strategic commissioning framework (November 2025) reinforces this direction of travel. It sets out a vision for integrated care boards (ICBs) as strategic commissioners, using evidence, population health intelligence, and a biopsychosocial approach to improve outcomes and reduce inequalities over the longer term. Creative health offers a practical way of realising this ambition in neighbourhoods, places and systems – drawing on VCSE and cultural sector partnerships, co-production with communities, and interventions that address the wider determinants of health.
As ICBs develop integrated needs assessments, population health improvement plans and new models of neighbourhood health, there is a clear opportunity to embed creative health within strategic commissioning. Doing so can help systems invest more in prevention and commission in ways that value lived experience alongside quantitative data.
With stronger partnerships, clearer evidence, and more flexible commissioning models, creative health can continue to grow as a sustainable part of how we care for people and communities not as an add-on, but as a core component of compassionate, effective health and care, aligned with the future of strategic commissioning.
Author:
Radhika Poojara, Communications Specialist, NCCH
