Navigating Creative Health Advocacy at ICB Board Meetings

Navigating Creative Health Advocacy at ICB Board Meetings

For advocates of creative health who want to champion the role of cultural and heritage provisions within healthcare settings, connecting with their local Integrated Care Board (ICB) can be an effective strategy. By attending ICB board meetings and raising targeted, evidence-backed questions, advocates can spark conversations that lead to meaningful action.

In this blog post, I will provide a guide to understanding and leveraging ICB board meetings for creative health advocacy. The key take-aways are as follows:

1. Conservation focus: ICBs primarily focus on maintaining local NHS services amidst financial constraints. For creative health advocacy to be meaningfully considered, it cannot be positioned as something which threatens this conservation. Cultural change is desired, but via manageable changes and ongoing monitoring of risk. So, it is important to identify meaningful and readily actionable first steps.

2. Transformation requires alignment: Boards prioritise innovations that meet pressing local needs and promise long-term resource savings or risk reductions. There is a plethora of evidence on the benefits of creative health, so it is becoming increasingly easy to identify quality papers that align to local priorities and reduce the perception of risk through evidence-backed data.

3. Creative health needs integration: Many board conversations discuss the need to be tighter and tighter with their priorities in order to make large-scale and sustainable change. Without a direct link to ICB priorities, creative health risks being sidelined below a long list of other health concerns awaiting their turn for prioritisation. To achieve success, advocates must present proposals tied to pressing board concerns.

If this is the type of advocacy that aligns well to your goals, then read on to find out about the format of ICB board meetings, examples of how to make questions relevant to agenda items, and tips for effective advocacy.

The Format of ICB Board Meetings

ICB board meetings are meetings held in public, not public meetings. This distinction is key as members of the public can attend as observers but cannot actively participate in discussions or add items to the agenda.

What to expect:

• The setting: Board members sit at a circular table, and are sometimes joined by guest presenters. Name tags help identify participants. Members of the public - usually a small number - sit to the side, silently observing proceedings.

• The agenda: A detailed document, filled with progress reports, is available online ahead of the meeting. These reports are usually ‘taken as read’ and only summarised during discussions.

• Discussion format: Board members comment on agenda items and ask questions to achieve decisions or assurances.

• Timeline: The publicly accessible sections of ICB board meetings typically last between 2.5 – 3 hours. Occasionally, topics of a sensitive nature are then discussed in private, following a break.

• Public involvement: While public attendees cannot raise new topics, they can submit questions about agenda items in advance (typically at least two days prior). Depending on the ICB, meetings can either be held in-person, online, or through a hybrid structure. Information is available via the ICB website.

Examples of How to Make Questions Relevant to Agenda Items

In November 2024, I attended ICB board meetings across the Midlands to better understand how to engage with them. Below I outline three examples of questions I asked and what resulted, to give you a flavour of what is possible.

Derby and Derbyshire ICB:

- Agenda items: Staff survey, workforce retention and capacity.

- Question: ‘Matters relating to workforce satisfaction and retention have been discussed in today's meeting. Are the ICB aware of the work that the Arts Team at University Hospitals of Derby and Burton NHS Foundation Trust is pioneering in relation to workforce wellbeing? Their work will be shared with the National Arts in Hospitals Network, demonstrating a great opportunity for Derby/shire to become national leaders in this space.’

- Outcome: The Chief People Officer, Lee Radford, requested a meeting with Laura Waters, the head of the UHDB Arts Team, stating: ‘The health and wellbeing of our people is a key cornerstone of attracting, developing and retaining our system workforce. Whilst the ICB is not directly aware of the Art Team's work at UHDB, it would be really helpful to arrange an induction meeting with the new ICB CPO who is currently strengthening the ICB's People and Culture Committee who have responsibility for the 10 ICS mandated people functions, one of which is the wellbeing of the system workforce. It would be great to understand the opportunities that creative health has to offer, which could support wider system integration work.’

Coventry and Warwickshire ICB:

- Agenda item: Voluntary, Community, Faith, and Social Enterprise (VCFSE) Alliance.

- Question: ‘It's fantastic to see such a commitment to VCFSE engagement at the ICB. So far in your work, have you found that the arts sector are making up a reasonable portion of the VCFSE Alliance/ commissioned partners? Typically, they do not consider themselves part of the VCFSE sector, yet the health benefits of arts engagement is well evidenced and could have a significant impact on ICB priorities.’

- Outcome: In the meeting, the Chief Medical Officer, Angela Brady responded: ‘Our collaborative for the VCFSE is still forming, and we do need to make sure it's representative of the breadth and depth of voluntary sector charities and community groups which are across Coventry and Warwickshire. We do recognise the value of the arts, particularly in mental wellbeing and social isolation, but we need to bring that into our work in our Prevention Network. At the level of place, we need to make sure that we are inclusive of all viewpoints. The other element that we have is the VCFSC portal. This launches in December and it's important to highlight that any group will be able to register to be a member, so we would urge all third sector groups and organisations to consider signing up to be part of that, because that portal will connect you through to some of our Prevention Network work that we're doing at place.’ Following the meeting, I was also able to connect with the consultancy group that are developing the portal, to consider how artists can be best reached and included.

Nottingham and Nottinghamshire ICB:

- Agenda items: Citizen Story (experience of autistic people and citizens with a learning disabilities) + the Finance Report.

- Questions: 1) ‘Have the ICB considered the place of Creative Health in neurodiversity personalised care? (See this resource for another citizen story/exploration of Creative Health - https://ncch.org.uk/blog/the-place-of-creative-health-in-lgbtqia-personalised-care)’

2) ‘Have the ICB considered the place of Creative Health in reducing the costs associated with core/major health priorities? (See this 'At a Glance' resource for key stats - https://ncch.org.uk/uploads/Creative-Health-at-a-Glance-_-Booklet.pdf)’

- Outcome: The ICB chair, Kathy McLean, thanked me for providing the ‘At a Glance’ resource and commented that it was a succinct guide that may be of use to numerous members of the board - including the Director of Finance, Marcus Pratt. She pointed towards the Director of Nursing, Rosa Waddingham, to follow up in the first instance. Rosa expressed interest in the place of creative health, particularly in relation to the ICB’s neurodiversity pathway and pledged to review the linked resource.

Conclusion: Tips for Effective Advocacy

By strategically engaging with ICBs, creative health advocates can position cultural and heritage provisions as valuable, actionable solutions to local healthcare challenges. To do this well, advocates can follow these top tips:

• Do your homework: Review the agenda in advance and identify items that align with creative health.

• Submit precise, targeted questions: Connect creative health solutions to the board’s priorities and provide evidence to support your case.

• Be specific: General advocacy for creative health may not resonate or even be accepted as a question that is relevant to their agenda. Frame questions to align with immediate healthcare challenges or opportunities for innovation that appear in the agenda.

• Provide resources: Include links to evidence or case studies that bolster your argument.

Acknowledgements

This article was written by our Midlands Creative Health Associate, Jane Hearst. It was published in December 2024. For more resources and insights from our associates, visit our news and blogs page, at: https://ncch.org.uk/news