A substantial new income stream for the arts sector can go hand in hand with significant savings to the health budget, says Tim Joss. But first we need to move beyond some widespread assumptions that are holding back progress.
Now is the time to think big, find the early wins and prepare for long-term growth in the new normal post-Covid. If we make common cause with other sectors, such as health, we can dramatically improve people’s lives and the financial fortunes of the arts. There are three key opportunities, but there are pitfalls too – ones that the arts sector needs to address quickly.
The first opportunity is that health sector interest in working with the arts is growing. Aesop commissions annual GP surveys. Last year 74% agreed that public engagement with the arts can make a significant contribution to the prevention agenda (up from 66% in 2018). 54% agree that arts-based interventions can be a cost-effective way to deliver primary care to the public to improve health outcomes (44% in 2018). 72% agree arts-based interventions can make a significant contribution to improving the health and wellbeing of the NHS workforce (62% in 2018).
This last statistic reminds us that arts contributions to health can be far-reaching. Much current discussion is about social prescribing – referring people to local, non-clinical services including the arts. This is an exciting development, but it would be a mistake to stop there. The new normal must plan and grow artistic contributions in a much wider range of contexts, including health workforce wellbeing and training, the built environment of hospitals, GP surgeries and care homes, public engagement and education, and health system restructuring and large-scale change.
Dr David O’Flynn, Consultant Rehabilitation Psychiatrist at Lambeth Hospital, spoke at Aesop’s first national arts conference for health decision-makers. He praised Raw Sounds’ music work with patients with severe mental health conditions: “It gets people out of my very expensive beds much quicker. It’s about reducing length of stay. My beds are £500 a night. It doesn’t take many shortened admissions to pay for Raw Sounds.”
On system change, Phil Hanlon, Professor of Public Health at Glasgow University, and Sandra Carlisle have written “we will need new art, stories, myths, symbols, and much else to help us make the inner and outer transformations that will be needed.”
A Sheffield Hallam University evaluation of Dance to Health, Aesop’s programme for reducing older people’s falls, concluded that “Dance to Health offers the health system an effective and cost-effective means to address the issue of older people’s falls‘ and a potential annual cost saving of £79 million for the NHS.”
Significant health savings and a substantial new income stream for the arts can go hand in hand.
To realise this, we must grasp a second opportunity: to work with specialist health and arts researchers on the practical questions that health partners will need answers to – essential for speeding up health’s collaboration with the arts.
It starts with ‘does my arts programme improve health?’ We have to be careful here. For example, Aesop now knows that Dance to Health’s special dance practice reduces older people’s falls by 58%. However, the wider statement ‘dance reduces falls’ is not true. A major research study found social dancing such as folk and ballroom did not prevent falls.
Other key questions need answers. Is my arts programme cost-effective from the health system’s point of view? How can it fit in with a complex health system where on average it takes 17 years for research evidence to reach clinical practice? How can we ensure a supply of excellent artists across the country? How can the activity be place-based, culturally sensitive and involve local people while, at the same time, become a national service and not just for the lucky few?
Getting the right evidence in place will open the door to health. There are funds to support this research, starting with the National Institute for Health Research (with its budget of over £1 billion).
The third opportunity is to find the sweet spot where artistic excellence and health improvement meet. It’s a place where artists have the chance to make work and develop their creative practice, and health professionals can best fulfil their calling; and where health and arts professionals can spark off each other to achieve even better things and build mutual understanding and respect. Making common cause between the health and arts sectors is not just about high-level partnership. It’s about daily collaboration.
It’s also about moving beyond some widespread assumptions in the arts sector that are holding progress back. These are the pitfalls mentioned at the start.
The first is that it’s just the health sector that needs to change. The ‘Creative Health’ report of the All-Party Parliamentary Group for Arts, Health & Wellbeing had 10 recommendations. The majority were for the health sector. None were addressed to arts organisations doing arts-and-health work. And yet, there is so much to be done, starting with equipping busy artists and arts organisations to work with a complex health system. Aesop now has an accredited course with Canterbury Christ Church University.
The second assumption is that arts-and-health work is a compromise: the more you engage with health issues, practices and systems, the less artistic scope there is. This is a false tension. At its best, artists and clinicians collaborating on arts-and-health programmes set up virtuous circles between high-quality artistic practice and health improvement.
And lastly, there is a reticence about growing arts-and-health programmes into services available to all who need them. The fear is that it means a large bureaucracy, remote from beneficiaries and a one-size-fits-all approach, insensitive to local culture and not involving local people. Both are unjustified. The health sector now uses the concept of ‘universal personalised care’. The arts can learn from this.
Covid-19 is a tragedy: deaths, traumatic illness, job losses and increased domestic violence. Good is coming out of it too: a reminder of the power of collective action, a new determination to achieve a green economic recovery, new forms of digital collaboration. Let’s make sure that the arts sector grows, offering unforgettable artistic experiences and improving the nation’s health – and not just for the lucky few, but for everyone.
Tim Joss is a social entrepreneur and Chief Executive & Founder of Aesop
Aesop’s vision is for a future when arts solutions for society’s problems are valued and available for all who need them. Aesop shares learning through the Aesop Institute, a university-accredited course in partnership with Canterbury Christ Church University, and evaluations and other resources on its website.