Ruth Davey © Mindsong Music Therapy

In Health and Care Settings

Creative health in nursing and care homes, hospitals and hospices and in specialist mental health settings

Key areas of focus

Hospitals and Hospices

Since the early 2000s it has been standard practice to consider the psychosocial properties of healthcare environments.  The King’s Fund’s Enhancing the Healing Environment programme, involving more than 250 health and care settings, put patients at the heart of design and highlighted the role that the physical environment can play in supporting innovation in service delivery and in improving patient experience.

The WHO Scoping Review provides evidence that artworks in hospitals can reduce stress whilst participatory ats activities in a hospital setting improve patient experience. Where artists are involved in design teams they can form connections between communities, patients and the hospital, helping create spaces and activities in which people can gather, reflect and connect.  Art and design in buildings can provide a positive distraction and increase a sense of calm. Bringing music, dance and poetry into clinical spaces can reduce anxiety. There is also evidence of increased retention of staff and reduced aggression towards them. Sacred spaces in hospitals and hospices provide respite from the medical, allowing stillness, reflection and contemplation, with artistic environments that provide a shelter for the spiritual aspects of humanity.

In support of the role of hospitals as anchor institutions, hospital arts programmes can connect with the wider community, form partnerships and provide patients with routes to social prescribing once discharged.

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Of the 226 NHS Trusts in England, more than 100 have arts programmes. There is an NHS National Arts in Hospitals Network (NAHN) hosted by NHS Charities Together.

The Dyson Cancer Centre at Royal United Hospital Bath will open in late 2023 and will include commissioned artworks to contribute to creating a nurturing and therapeutic environment, reducing stress and anxiety and promoting health and wellbeing.

North Bristol NHS Trust, Fresh Arts, provides arts on referral for patients with chronic conditions: cancer, chronic pain and chronic breathlessness. On completion of the six week programme they refer patients to activities in their local community to support wellbeing.

In Partnership with Calderdale and Huddersfield Foundation Trust and Theatre Company Blah Blah Blah, Creative Minds have been awarded £92,000 from Youth Music to develop new music making infrastructure that can be installed in individual rooms on children’s wards in Calderdale and Huddersfield hospitals.

Specialist mental health settings

The reform of the Mental Health Act aims to provide for the protections and support for people with severe mental health needs, which will strengthen their voice, choice and rights, support the increased use of community alternatives to hospitals, limit the use of the Act for people with learning difficulties or autistic people, improve support for offenders with acute mental disorders, and reduce the racial disparities that have too long been part of the way the Act has been used.

Significant inequalities exist in experiences and outcomes of mental health services, which the NHS Advancing Mental Health Equalities Strategy aims to tackle, including the development of culturally appropriate advocacy through a competency framework aimed to improve ethnic minority community experiences of care in mental health services. There is significantly more use of the Mental Health Act for some ethnic minority groups, which is in part the result of barriers to seeking help at an earlier stage. 

Culturally-specific and targeted Creative Health programmes have been shown to be successful at engaging particular groups, enabling early intervention. A three-year study of an arts-based collaboration with Avon and Wiltshire Mental Health Partnership NHS Trust found that that the arts enhanced valued features and diminished negative aspects, and created opportunities for service users and staff to assert control and affirm non-stigmatised identities.

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The transition from inpatient services to the community can be smoothed through the arts. Raw Material is a youth-led music organisation in Brixton. 75 percent of referrals to its Raw Sounds mental health programme come from a Black or ethnic minority background, providing evening access from hospital wards (primarily SLaM) and the community.

Core Arts, which promotes mental health through the arts in Hackney, particularly among Black and ethnic minority males, estimates savings through avoided hospital admissions of up to £2.58 for every £1 invested.

Hospital Rooms commissions contemporary artists to make artworks to enhance mental health inpatients across the UK. Examples include working with artists, patients and staff to create artworks for the Hellingly Centre, a forensic mental health unit in Sussex.

The Midlands Partnership Foundation Trust has developed Arts for Health, using creative activity to support the recovery of service users, both as inpatients and in the community.

Nursing and Care Homes

The Care Quality Commission encourages care homes to provide meaningful activity, in recognition of the need for older people to spend time purposefully and enjoyably. Creative activities can support many of the Skills for Care check list for achieving outstanding care, from introducing innovative ways to involve people and voice their opinions to embracing cultural difference, promoting independence and autonomy.

The report Arts and Culture in every care home? by the National Activity Providers Association notes that creative expression is essential in the lives of care home residents and integral to wellbeing. For instance during Covid-19 the creative arts were used to encourage connection and express loss and grief. In a report by the Baring Foundation: Creative Homes: How the arts can contribute to quality of life in residential care, the participatory arts were seen to help maintain physical health and flexibility as well as cognitive functioning and a sense of identity. A large number of museums and galleries deliver programmes with care homes to use heritage objects to engage people in reminiscence and tactile story telling, including for people with dementia. Arts organisations work with care homes to deliver training to staff to deliver creative activities with confidence, also benefitting staff wellbeing and retention.

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A Choir in Every Care Home is a resource to support every care home to become a musical care home.

Equal Arts HenPower programme is now in more than 40 care homes and creatively engages older people in arts activities and hen-keeping to promote health and wellbeing and reduce loneliness.

Celebrating Our Beautiful Planet, a partnership between Paintings in Hospitals and Four Seasons Healthcare, will provide digital access to artworks for 8,800 care home residents.

Music in Care is an interactive ‘Musicians-in-Residence’ project in which care staff work with early career professional musicians to deliver engaging music sessions for older people in care, empowering staff to develop new skills and confidence to use music as part of their daily care routine. The project is currently working in 25 care homes across Calderdale and Wakefield, and in all acute wards across South West Yorkshire Partnership Foundation Trust.