Embedding Creative Health in Integrated Care Systems: Insights from Gloucestershire
As part of the Mobilising Community Assets to Tackle Health Inequalities programme, NCCH has partnered with University College London (UCL) to conduct ‘deep dives’ into health systems across England.
The deep dives entail qualitative investigation, in collaboration with systems leaders, to better understand the enablers and barriers of integrating creative health into workstreams. Information is then triangulated with systems reports and data infographics to form a comprehensive understanding of what works and why. We are particularly interested in how data is prioritised and presented internally to make the case for creative health, as well as what systems infrastructure has been created, to understand how advocacy is translated into workable and sustainable creative health solutions.
In our first deep dive report, Embedding Creative Health in Integrated Care Systems: Insights from Gloucestershire, we present findings from our investigation of Gloucestershire Integrated Care Board (ICB). Gloucestershire offers one of the most mature examples of Creative Health integration anywhere in England, demonstrating how long-term commitment, structural clarity, and cross-sector collaboration can embed creative approaches firmly within health systems.
The full report is available here.
Key findings of the report
The county’s journey shows that system change begins with early champions who hold both vision and influence. In Gloucestershire, the foundational work of a single GP champion demonstrated proof of concept. Consistent advocacy and the development of clinical credibility, through externally funded test-and-learn pilots, created the conditions for Creative Health to not only integrate into ICB care, but also to sustain through multiple healthcare restructures.
A key enabler in Gloucestershire is the way that Public Health thinking is embedded directly within NHS commissioning architecture. Supplementing the targeted public health work of local authorities, this broader approach entails a culture of prevention, inequalities reduction, upstream thinking, and cross-sector problem solving, which naturally aligns with Creative Health.
This internal alignment was reinforced by the adoption of a Clinical Programme and Population Health approach, with Creative Health placed within the same governance structures that oversee disease-specific workstreams. By using population data, marginal analysis, and inequalities metrics to determine where creative interventions could have most impact, Gloucestershire made Creative Health a legitimate, evidence-led response to clinical priorities rather than a discretionary wellbeing initiative.
What also stands out is the system’s deep commitment to partnership-building and co-design. Gloucestershire’s creative and clinical partners consistently developed services by bringing together artists, volunteers, clinicians, commissioners, and community members at the same table. This creates trust, generates solutions suited to the strengths of local assets, and allows the ICS to mobilise rapidly during periods of high system pressure.
A pivotal structural innovation in Gloucestershire was the formation of the Creative Health Consortium, which brought together five organisations with diverse artforms, delivery models, workforce configurations, and target groups. The consortium model addresses several long-standing problems faced by health systems who are interested in integrating creative health, such as burdensome commissioning pathways and inconsistent data collection. By adopting an informal consortium approach, using a Lead Provider Model, and developing a clear consortium agreement with defined roles, data governance, dispute resolution processes, and shared policies, Gloucestershire created a single, coherent interface for the ICB. This enabled multi-year commissioning, increased confidence among NHS partners, supported coordination, and preserved organisational autonomy while building collective strength. Crucially, a dedicated consortium programme manager ensures ongoing fairness, communication, and data flow.
An important technical achievement is the creation of NHS-compliant data infrastructure to track the impacts of creative health. A shared ‘minimum dataset’, co-designed with providers, incorporates validated measures such as ONS4, WEMWBS, GBOs, and the MICA scale. Crucially, it collects NHS numbers, which enables creative health data to be linked to wider NHS datasets. Submissions flow through the NHS Data Landing Platform, are anonymised, stored in the data warehouse, and then analysed via SQL. This makes Creative Health visible within the same analytical frameworks used for other clinical programmes. The resulting Power BI dashboard allows commissioners to explore demographic reach, inequalities, referral trends, service use changes, and wellbeing outcomes, giving Creative Health a compelling cost-and-impact narrative grounded in NHS-recognised metrics.
A key enabler of Gloucestershire’s sustainability has been the shift from short-term pilots to long-term programme funding. After years of test-and-learn activity, the ICB agreed to three years of programme funding based on a robust, evidenced business case and the strength of the consortium’s minimum dataset. This enabled providers to spend more time on delivery and outcome tracking, over short-term financial planning.
Overall, the Gloucestershire model demonstrates that Creative Health can be embedded at scale when systems combine long-term leadership, prevention-based commissioning, cross-sector trust, structural coordination, multi-year funding commitments, and NHS-grade data infrastructure. The county shows that Creative Health is a system asset capable of reducing demand, improving outcomes, addressing inequalities, and complementing clinical pathways when the right enablers are in place. Other ICSs seeking to build similar capability can adapt these lessons to their own contexts, using Gloucestershire as a blueprint for what sustained, integrated, evidence-led Creative Health can achieve.
Webinar Recording: Launch of the Gloucestershire Creative Health Report
This webinar marks the launch of the report Embedding Creative Health in Integrated Care Systems: Insights from Gloucestershire. The session features presentations from Hannah Gorf, Senior Programme Manager at NHS Gloucestershire, who offers an inside view of how creative health has been integrated across the Integrated Care Board, and Dr Jane Hearst, Research and Policy Manager at the National Centre for Creative Health, who shares the key findings and insights from the report.
The recording provides a clear overview of the local system conditions that enabled this work, the practical steps taken in Gloucestershire, and the lessons that may support other Integrated Care Systems exploring similar approaches.
You can watch the full recording below or on YouTube here.
