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Dedicated arts and health co-ordinators, together with a commitment to measure impact, are pushing culture into the mainstream of the country’s health policy, writes Nesta Lloyd-Jones.

A close up photo of an older woman
A participant in The Remote Choir

The arts community has been ahead of the game in recognising how culture can have strong benefits for mental health and wellbeing. But in healthcare, we’ve been slightly off the pace – until now. If we’re being honest, it’s taken a long time to embed arts-based health initiatives within NHS organisations: not just in Wales, but right across the UK.

There are a few reasons why it has taken so long to pilot and implement this type of scheme in health and care settings. One of the most significant has been finding a robust way to measure results. With cancer, for example, we can pinpoint which treatments have been working and which haven’t with a fair degree of precision. It’s also possible to see where and why people in Wales might be more at risk of developing cancer. What was missing was a similar in-depth approach for arts-based interventions that could map and measure where people might be able to benefit.

Memorandum of understanding

That’s why in September 2017, the Welsh NHS Confederation signed a Memorandum of Understanding (MoU) with the Arts Council of Wales (ACW). The primary aims of the MoU were to raise awareness around the impact that arts interventions can have on people’s health and wellbeing, to share best practice and support proactive relationships between the arts and healthcare communities.

Those with legislative power in Wales are now treating the arts and health as a priority.

One significant development since the agreement was signed is that ACW have supported the appointment of Arts and Health Co-ordinators in all seven Health Boards in Wales (this was a key recommendation within the funder’s report last year, ‘Arts and Health in Wales: A Mapping study of current activity’). The co-ordinators help build bridges to arts practitioners across their regions.  They cultivate projects, broker links across sectors and fundraise for arts and health initiatives which could have a positive impact on the health and wellbeing of people in Wales. In this way, they are a vital part of the cross-sector push towards embedding the arts into traditional clinical and social care environments.

We’re now starting to see the rewards of this work, with growing momentum behind arts-based health initiatives in Wales. There are successful examples of arts-based interventions in areas such as loneliness and social isolation, mental health and wellbeing, and supporting people living with dementia and other long-term conditions.

Another aim of the MoU was to develop a standardised approach to measuring the impact interventions are having on health and wellbeing across Wales. Through methods such as surveys and interviews, we are now able to measure the impact on health and wellbeing from a wide variety of case studies to understand more about which initiatives have had the greatest effect.

Tackling loneliness through singing

Projects such as The Remote Choir, led by Span Arts and supported by the Pembrokeshire Association of Voluntary Services and others, are a direct response to the increasing evidence that 440,000 people report living with loneliness and isolation.

Through technology and a shared passion for singing, this choir brings together older people with a wide variety of health conditions that make it difficult for them to get out and engage in their local community.

The crucial thing for health organisations to consider is not the form this project has taken, but the huge impact it is having on people’s lives and the potential that is evident in the results. All participants reported they “felt better” for taking part in the scheme, and there was an average of 11% improvement in participants’ wellbeing over the course of the project.

Interventions like this are working – and we’re finally moving towards a position where we can clearly demonstrate it. The evidence gathered from projects such as The Remote Choir and the work achieved through our MoU with the Arts Council of Wales has led to the revival of the National Assembly for Wales’ Cross-Party Group on Arts and Health.

This group, established in 2016, has already considered issues like how arts and health can impact on loneliness and social isolation, the importance of social prescribing, and how the arts can prevent falls. Those with legislative power in Wales are now treating the arts and health as a priority.

A time of transition

We’re also at a time of significant transition for health and care organisations in Wales. The Welsh Government’s long-term plan ‘A Healthier Wales’, published in June last year, has set a clear direction of travel which fundamentally changes the way we work.

For 70 years we’ve treated people almost exclusively on hospital wards and in GP surgeries. ‘A Healthier Wales’ represents a sea change, transforming us from an acute service into a wellness service. Early interventions, prevention and collaboration across health, social care, local authorities, the third sector and voluntary sectors are a necessity if we are to deliver on this ambitious vision. Social prescribing, including the arts and physical activity, will be a significant part of this.

Challenges

But there are going to be challenges. Despite achieving so much, there is no stable source of funding for these types of initiatives. And it would be too restrictive on health and care organisations to ringfence money when they are dealing with ever-increasing demands on services as a result of an ageing population with more complex needs.

We also need to consider how arts and health projects can be made available to everyone in Wales. This cannot simply be about turning local projects into national projects. We need a more sophisticated approach that can consider the needs of individuals and then signpost them towards relevant interventions, to help keep people in their communities and their homes for as long as possible. We’ve by no means finished our journey yet – but I’m confident that the recent shifts in Wales’ arts and healthcare policy landscape are moving us in the right direction.

Nesta Lloyd-Jones is the Assistant Director at the Welsh NHS Confederation, the membership body representing all the organisations making up the NHS in Wales: seven local Health Boards, three national NHS Trusts and Health Education and Improvement Wales (HEIW).

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