Commissioning art for hospitals

With increasing pressure on NHS budgets, it can be hard to justify funding for an art commission unless it delivers ‘added value’. The value of art in a health context is often explained in instrumental terms: an artwork might be commissioned to act as a landmark or to help with wayfinding; it might be designed to encourage patients with mobility issues to walk further each day; or it might aim to prompt reminiscence and engagement for people living with dementia.

Sometimes the artist’s brief is to animate a space and in other cases there are more functional requirements. For example, we commissioned Heinrich and Palmer to create a work for a corridor linking a new part of a hospital with the old. Free to approach the commission in any way they liked, the artists decided to photograph the site from the roof of the tower block of the old hospital, turning the camera every hour over a 24-hour period to capture a 360 degree panorama. The resulting photographic work runs from floor to ceiling along the 24-meter corridor. The brief was open and the artists were given freedom to respond to it in any way they liked.

Input from patients, clinical teams and estates staff is a sign of effective partnership-working and will ensure that an artwork is appropriate

We also commissioned Studio Weave to create a suspended sculpture for the atrium of Bristol Royal Infirmary’s new ward block (see photo above). As well as animating the space, welcoming and inspiring visitors, the work needed to be made from a material that would deliver acoustic baffling equal to building design requirements for the space. It also needed to let light through to the ground floor of the atrium, while providing privacy and protecting sight lines from the floors above. The resulting work looks and functions as an artwork. Most people would see it as an artwork. However, I would argue that it was, in fact, a design commission.

There is scope for both approaches – an open brief as well as a more design-led approach. However, perhaps the first and most important issue to address when negotiating a commission in a healthcare context is to be clear about expectations as to the role of the art and the degree of freedom that the artist will have.

Having established this, the design process that follows will encompass many practical requirements. Perhaps the most onerous of these are around safety and durability. Works commissioned for healthcare need to be hard-wearing and long-lasting as hospitals have thousands of people passing through on a daily basis. Healthcare commissioners will demand artworks that need minimal maintenance and any cleaning or maintenance that cannot be carried out in-house will cause concern.

As well as durability, artworks may also need to comply with infection control criteria. In clinical areas, anything soft or textured that cannot be wiped clean or anything with ridges or ledges that can harbour dust will be problematic. Likewise, the risk of legionella is such that sculptures incorporating water are possible but fraught with problems. Some health contexts will not consider them at all. Others might consider them but the design risk assessments and requirements will be stringent.

Notwithstanding these restrictions, one of the joys of commissioning work for healthcare contexts is that there is often a strong sense of ownership and engagement. Input from patients, clinical teams and estates staff is a sign of effective partnership-working and will ensure that an artwork is appropriate to its context in every way. Such input is often managed through arts steering groups with broad stakeholder representation. However, it is vital that the steering group helps guide and direct an artist in ways which are helpful and constructive, avoiding a ‘design by committee’ approach that erodes an artist’s vision. Likewise, artists needs to know when to listen and adapt their ideas to ensure that they are appropriate and when to hold firm to their vision. The best process involves a partnership approach where there is genuine mutual respect for each party’s professional expertise, whether this is artistic, clinical or estates related.

Working in this context, artists often need to collaborate – with clinicians, architects, developers, engineers, interior designers – to ensure that their work integrates appropriately and seamlessly. Artists need to have appropriate insurances, comply with construction design and management (CDM) regulations, and provide detailed drawings, costings and installation method statements before being allowed to fabricate and install their work. They will often need the support of others within a design team in order to realise their vision. They may need enabling provision such as power, foundations, wall or ceiling strengthening or more complex technical assistance to solve engineering or design challenges.

Public art commissioned for healthcare settings must also be sensitive to the needs of patients who might be upset, anxious, frightened and in pain. While disturbing or challenging work will not be appropriate in this context, neither will anything bland or sentimental.

Laura Ford’s Patient Patients are a series of bronzes of injured animals sited at Southmead Hospital Bristol. A series of three monkeys – one with an injured arm, another with a leg in a cast and a third with a sore head – sit outside the entrance to the emergency department. Staff feared that the injured monkeys would upset or disturb patients. While listening to people’s fears about the work, the arts steering group decided to support the artist’s vision, and once installed the monkeys became instantly popular. Embodying a universal empathy, their open and soulful faces remind everyone of the care and compassion needed in hospitals.

It is possible to deliver artwork in a healthcare setting that is appropriate, authentic and meaningful as well as safe and durable, artwork that people feel a sense of connection to and ownership of. And when this is achieved, it not only transforms experiences of healthcare environments, it can also transform people’s relationships to their own wellbeing.

Jane Willis is Director of Willis Newson.
www.willisnewson.co.uk