Understanding Need

So called ‘wicked problems’ are described as such because they are challenging and complex issues outside of the control of one organisation or profession.

Bringing people together in cross sector teams to discuss local population health, system priorities, areas of high spend and unmet need can create better understanding of those wicked issues and create energy about where local solutions can be found to combat them.

Opening out those discussions to include local people and patient representatives, particularly those with lived experience and people from under-represented groups deepens understanding and can shape innovative solutions to which people will best respond.

Actions to take

Support mechanisms that learn from the local population and listen to what they have to say.

Set up cross sectoral teams made up of health, care and VCSE anchor organisations that promote health and wellbeing with a focus on identifying population need and identifying gaps in support and provision.

Involve people with lived experience in identifying need and planning.

Establish networks and knowledge exchange opportunities to help build a creative health eco-system.

Understanding & Developing the Market Place

Under the personalisation and social prescribing agenda the role of a commissioner could be compared to market stewardship. Commissioners have a responsibility for developing the local market and bringing key stakeholders together to create the right environment in which collaboration between providers can flourish. Understanding what is already in place is important to ensure that new approaches are supportive and complementary to existing provision and do not create division, as well as identifying where there is step down, or step up from universal community projects to targeted creative health interventions. Each area will be at different levels of maturity in their non-clinical interventions; some may have a rich sector of providers with developmental potential and in some there may be a disparity of resources where investment is needed.

Map both targeted and universal creative health delivery in your area to learn what practitioners do and what they can offer.

Commissioners actively promote opportunities for commissioning, particularly where there are gaps in delivery.

Establish the gaps in skills and knowledge of creative health providers and how they can be developed to meet local health and wellbeing needs.

Identifying Resources, Investment & Funding

Mapping creative health supports the process to identify what resources already exist within communities and how value can be added. Often creative health activities are delivered with financial support from a wide range of sources within the eco-system. Many projects are seeded through short-term ‘test and learn’ pilots with external funding and support in kind through partnership that can be helpful in supporting the growth of creative health. Utilising levers such as the Social Value Act and micro-commissioning can support development. However cultural change and embedding creative health within a system takes time and those areas that have secured longer term investment in creative health are those consolidating a more mature offer.

Work with local partners to pool resources, develop joint funding bids and offer in-kind support to projects to add value.

Consider how levers such as the Social Value Act or Micro-Commissioning could support the development of targeted Creative Health solutions.

Establish community grant schemes to enable community groups to easily access funding to deliver Creative Health.

Take a longer-term view on Creative Health investment planning to support sustainability and stability.

Workable Commissioning

The Creative Health marketplace is diverse, from freelance individual artist providers to large national organisations. Commissioning a small organisation or multiple organisations in parallel can represent a disproportionate administrative and financial burden for a commissioner.

Similarly, individual artists and small organisations do not have the capacity, infrastructure or resources to tender for contracts. Commissioners can orchestrate partnership working by establishing local forums to bring interested sectors together who can then develop and deliver services in partnership to an agreed set of principles with the option to establish a legal entity on a more formal basis to be contract ready.

Creative Health providers come together in Creative Health consortia around a set of principles or legal identity.

Creative Health providers make it clearer to commissioners how their work supports key local priorities.

Commissioners work with procurement colleagues to identify the most appropriate contractual framework for level and type of contract needed.

Illustrative Examples