Although there is increasing interest from health and social care providers in engaging older people in arts activity, a huge challenge is paying for it. Damian Hebron and Karen Taylor summarise a report they have written on this issue.
Despite all the changes being implemented to the NHS, no long-term solution has yet been found to the crisis around the provision of care for a rapidly aging population. A number of health and social care providers are looking to the arts as a potential tool in tackling some of the health and wellbeing issues facing this demographic. New opportunities for artists are emerging but there are also new challenges, not least the challenge of paying for proper and meaningful arts engagement.
Arts work with older people is not a homogeneous area of work. It is diverse and includes many dedicated and experienced artists working in a range of artforms. Some of this work is targeted at specific health outcomes, such as working with the symptoms associated with dementia or Parkinson’s disease. Other work has broader aims – building social inclusion, challenging stigma, tackling loneliness – what might be generalised as work to improve wellbeing. All are linked by the underlying belief that the arts can positively impact on people’s lives, particularly in older age.
The health service is currently undergoing a radical overhaul which may well offer fresh opportunities to secure health service funding
Over the last 30 years, health provision has slowly evolved from simply treating illness to include health promotion, improving wellbeing and tackling health inequalities. Loneliness, for example, although not a recognised medical condition, has been rated as a higher health risk than lifelong smoking or obesity. In recent years, there has also been a relatively large number of community health programmes (often focused in areas with high levels of deprivation) which have sought to work with community, voluntary and arts organisations to change lifestyles and behaviours.
Michael Marmot’s 2010 review ‘Fair society, healthy lives’ set out in dramatic fashion the links between social and economic status and health. This review also made clear the economic benefits to society of reducing health inequalities.
In the last five years there has been a concerted effort to provide proof of the positive impact of the arts in this area. There is now a growing body of evidence demonstrating that both participation in the arts and access to a range of arts opportunities can dramatically improve health outcomes and increase wellbeing at both individual and community levels. In this context, health and social care providers increasingly view assisting older people to live longer, healthier lives as an important priority. However, as was made clear in the ‘Agenda for later life 2012’ (Age UK’s policy conference in March 2012),there is a lack of coherency generally in age-related policy-making. An overarching strategic framework promoting active ageing is desperately needed to tie together a disparate range of policies.
Around the country there are many organisations which have been delivering work for older people for many years. Much of this work is targeted at the reduction of loneliness, increasing older people’s social capital and levels of community cohesion and dementia, all of which are clearly identified age-related concerns. While many of the concerns and issues facing those working to deliver arts with older people are similar to the wider arts and health sector, it is this focus on participatory work and the targeting of issues around social capital, as well as the NHS’s focus on the challenge of a growing older population, which distinguishes this work from the broader arts and health sector.
This work has traditionally been supported by a mosaic of funding from trusts, foundations, Arts Council England, the National Lottery and NHS sources. Too often this funding has been project-based and short term, rather than long term or strategically applied. Organisations working in this field struggle constantly for security, to raise their profile, prove the value of their work and build relationships.
Funding from the health and social care sector is patchy and not all organisations demonstrate a clear understanding of the health sector’s need to fund work that delivers against health outcomes. Even where the need is understood, the knowledge of how to reach potential commissioners and to ‘speak their language’ may be lacking. There is a tendency to conflate health and wellbeing outcomes and many organisations feel isolated in their work. The health service is currently undergoing a radical overhaul which may well offer fresh opportunities to secure health service funding. Personal budgets and new clinical commissioning groups are potential sources of future income as would be a wider take-up of arts-on-prescription schemes. Perhaps more promising still are the opportunities presented by collaborations with private partners, such as care home providers, although some unease is tangible as to the compromises involved in such partnerships.
The scale of the changes the NHS is currently undergoing has created a climate of uncertainty and shaken-up personnel. In some cases these changes have jeopardised the personal relationships between arts providers and commissioners, which still so often form the basis of much health funding for this work. However, relying still on a mosaic of funding, many arts organisations are continuing to deliver a range of creative opportunities for older people, countering isolation, combating ill health and improving lives.
Damian Hebron is the Director of London Arts in Health Forum.
Karen Taylor is an Associate at London Arts in Health Forum.
This article is an edited extract from ‘A new age’, a paper examining funding for artwork with older people commissioned by the Baring Foundation (www.baringfoundation.org.uk/NewAgeLAHF.pdf).