Will the NHS count the cost if it doesn’t harness healing power of the arts?
The second Arts in Health conference will showcase programmes designed to take the burden off the health sector. Amber Massie-Blomfield explores the initiatives that some believe should be available on prescription
As the pressure of funding cuts and spiralling demand continues to take its toll on the NHS, a movement is growing that believes the arts can play a significant role in helping shoulder the burden.
New schemes are being trialled. These include classes designed to stop older people from falling, theatre companies supporting recovering addicts and singing programmes to ward off lung damage. The hope is to roll out similar schemes across the country. The savings, experts say, could be huge.
Tim Joss, who runs the charity Aesop, is at the forefront of the movement. He believes the arts have the power to transform the health sector in the UK and, moreover, that they should be available on prescription from the NHS.
“I’m trying to make arts interventions national services within the NHS,” he says. “This isn’t about pockets of activity. It’s about creating something all patients can use.”
Joss has been convinced of the positive effects that the arts can have on health since the start of his career, when he attended the launch of a Gulbenkian Foundation report on arts in health. “I was blown away,” he says. While working at charitable funding body the Rayne Foundation, and when setting up Aesop in 2014, he “became determined to find out why progress had been so limited. I wanted to achieve breakthrough for the arts – into the health mainstream”.
The second Arts and Health Conference and Showcase, organised by Aesop, which begins on April 19, will show how the arts are reducing demands on the health sector, addressing mental health issues, supporting an ageing population and tackling inequalities.
There is a groundswell of support for the movement, with the conference including senior figures from both sectors. Former ballet dancer Darcey Bussell will speak alongside the NHS’ associate national clinical director for mental health Mike Hunter and Martin Vernon, its national director for older people.
The event will present 24 case studies of arts and health programmes, with the idea that they, and similar ideas, could be rolled out across the country.
Aesop will outline its flagship project, Dance to Health, a falls prevention dance programme for older people. The British Lung Foundation will demonstrate its singing for lung health initiative. Other examples will include English National Ballet’s Dance for Parkinson’s and Historic Royal Palaces’ Sensory Palaces programme for people with dementia and their carers.
Aesop’s work is already gaining significant traction within the health sector. Dance to Health has the financial support of numerous health organisations including Norwich Clinical Commissioning Group, Oxford CCG and Sheffield CCG.
The charity is supported by an advisory group that includes figures from Public Health England and the Wellcome Trust.
The importance of arts in health was highlighted by the All-Party Parliamentary Group on Arts, Health and Wellbeing, which published a report stressing the benefits in July. It also referred to several “arts-on-prescription” services.
While not a new idea, the report pointed to research that found there was still an “absence of emphasis on the arts within current thinking”. It pointed to schemes such as that developed in Stockport in the 1990s offering creative activities on prescription to improve mental health.
In 2010, several GP practices made arts participation integral for patients experiencing depression and anxiety. Evaluation by the University of Gloucestershire on one such scheme found a 37% drop in GP consultation rates and a 27% drop in hospital admissions – saving the NHS an average of £216 per patient.
Joss says that while services have long been trialled, “we’ve now shifted the focus, concentrating on major health challenges and creating arts interventions that address them”. It’s time, he says, to take them “to scale, ie to become national services”.
Among this year’s case studies is dance company Akademi’s Dance Well. The three-year programme of south Asian-inspired movement sessions engages older people living with dementia, isolation or poor heart and lung health.
The scheme’s project officer Claire Farmer says: “There is potential for increased balance and coordination, as well as cognitive function. With heart and lung disease, it helps to improve lung capacity. But the biggest thing is social impact. It’s decreasing loneliness and improving mental health.”
Gillian Leng, deputy chief executive of the National Institute for Health and Care Excellence – an organisation that advises on improving health and social care – hails the benefits of using arts in health. “If you want someone to do something, you’ve got to make it easy for them and you’ve got to make it enjoyable. If you enjoy something, that’s probably one of the best motivations,” she says.
She adds: “It is good to see that alongside the traditional prescribing of drugs there is now a movement around social prescribing, so when a clinician is addressing issues such as loneliness, isolation, and the need to exercise more, they’re now being empowered to issue what’s called a ‘social prescription’, some of which will be arts based.”
Leng is calling for more comprehensive research to support widespread adoption of arts-led approaches across the NHS. “You need evidence that says: ‘Invest in these arts-based treatments as they will save you money on admissions to hospital or on the amount you need to spend on drugs.’ Until you’ve got that sort of hard evidence, [arts interventions are] probably not going to get much of a route in.”
Farmer adds that Dance Well has led to people’s well-being improving “but there’s not a huge amount of quantitative evidence at the moment”.
Joss believes that’s about to change and now organisations like Aesop have “found major bits of knowledge that were missing and we’ve addressed them”.
The charity has set up what it calls the Aesop Public Health England framework, the first programme for properly evaluating arts in health programmes. The framework document has been downloaded more than 3,600 times. Aesop has also worked on connecting the arts in health programmes with health economists, Joss says, “so the arts think about cost-effectiveness from a health point of view”.
Pauline Tambling, chief executive of Creative and Cultural Skills, and previously a senior figure at Arts Council England, has identified the potential impact of the charity’s work. “Until Aesop came along there was no way of taking the benefit and spreading arts and health beyond small project groups. Aesop has initiated new thinking on how we can make this work available to a much wider group of participants,” she says. Joss also points to arts consultancy Nesta’s Standards of Evidence Framework as an important tool for those wishing to measure arts’ impact.
Arts in health
Established by Aesop, Dance to Health is a nationwide falls prevention programme, in which evidence-based physiotherapy exercises are ‘smuggled’ into older people’s lives through regular dance classes. The model is designed to combat a problem that costs the NHS an estimated £2.3 billion a year.
In Breathe’s Breathe Magic camps and workshops, young people with hemiplegia work with Magic Circle magicians to learn magic tricks containing occupational therapy exercises, leading to improved motor skills and confidence.
ENB’s Dance for Parkinson’s has been running for a decade. It introduces Parkinson’s sufferers to the themes, choreography and music of the ballet, in a programme proven to develop confidence and strength, and temporarily relieve symptoms. It is marking World Dance for Parkinson’s Day with international partners on April 29.
Outside Edge Theatre’s mission is to change the lives of people affected by addiction through theatre and drama. Unfinished Business is a performance and workshop designed specifically for those in early recovery from addiction, exploring co-dependency and teaching relapse-prevention techniques.
Sensory Palaces is an enterprise that sees those with early-stage dementia undertake storytelling workshops in heritage sites such as Kew Palace and Hampton Court Palace, with the aim of increasing the health and well-being of participants and encouraging new learning opportunities.
The role of arts in the health sector isn’t limited to working with patients directly. Clod Ensemble’s Performing Medicine is another case study to be featured at this week’s conference. The programme, which has been running for more than 15 years, works with undergraduate medical students and healthcare professionals, using theatre practices to help them improve communication. At the conference, vocal coach Patsy Rodenburg will talk about her work improving health practitioners’ ‘presence’ with patients.
Arts organisations also realise the potential of widening their remit to those who might not necessarily be engaged with what they do. “One experience with a dance artist in a hospital can inspire them to explore the arts in general,” says Farmer.
“It’s a major opportunity to increase access and engagement. It can also be a new income stream for arts organisations,” believes Joss. “This isn’t about small-scale projects. This is about the power of the arts to transform health.”