Arts Enterprise with a Social Purpose
Now is the Moment The case for a new consortium to support the next stage of arts and health development in England
STRICTLY CONFIDENTIAL
Version for existing and potential partners and funders
December 2016
Sir Peter Bazalgette, Chair of Arts Council England:
‘We’ve won the argument about how arts and culture power the creative industries and regenerate our cities. Now we need to act on the growing and compelling evidence of how arts and culture are part of the solution to our health crisis.’ [26 October 2016 personal communication to Aesop]
Pauline Tambling, former Executive Director of Research and Development, Arts Council England (and now Chief Executive of Creative & Cultural Skills, the sector skills council for the creative industries):
‘In 2007 I was involved in commissioning this joint Arts Council England/Department of Health prospectus. I am sure many of the organisations in the 30 or so case studies still run arts and health projects today. But until Aesop came along there was no way of taking the benefit and spreading it beyond small project groups. Aesop has initiated new thinking on how we can make this work available to a much wider group of participants.’ [Keynote speech on 28 October 2016 Aesop/Canterbury Christ Church University conference on arts and health training]
CONTENTS 02
INTRODUCTION AND SUMMARY
04
SETTING THE SCENE
04 05 06
The arts Health Arts and health
08
PROBLEMS AND POTENTIAL
08 11 12 14 15
Why now? Previous moments Arts – still on the periphery of health Aesop’s experience and contributions Making now a breakthrough moment
16
PRACTICAL PROPOSALS FOR A NEW NATIONAL CONSORTIUM
16 16 17 18 18 19
The consortium’s mission Programme co-designed by health and the arts Effective leadership and delivery team Top level Mid-level horizontal push and pull Grassroots pull from the public, artists, health professionals and arts professionals Sustained communications activity
19
20
GOVERNANCE, FINANCIAL MODEL AND CHECKLIST FOR SUCCESS
22
NEXT STEPS
01
Arts and health has had a number of moments in the sun. Yet each time, the moment passed, only for arts and health to remain in the shadows once again. Thanks to the efforts and energy of many in a still small arts and health community, we’re in the sun again. Is it going to be just another moment or can broader alliances and new ideas be fashioned to make a long season of growth? If the latter we have the chance to create a powerful and productive relationship between health and arts, benefiting patients, artists and wider society.
Breathe Magic adapted magic tricks for hemiplegia at the Aesop national conference and showcase. Photo: Helen Murray
INTRODUCTION
Now is perhaps the brightest moment that the arts and health community has ever had. If we do not capitalise on these opportunities not only could arts and health return to the shadows but, much more importantly, the benefits that we could bring to patients and the health system will not be realised. We owe it to them to seize this moment.
02
Dance to Health pilot programme in Abingdon. Photo: Helen Murray
This thought leadership essay makes the case for a new national consortium to support the development of arts and health. It surveys the current landscape and its problems and potential. Practical proposals follow.
SETTING THE SCENE
The Arts The UK’s world-class arts have a powerful contribution to make to the nation’s health. The health sector has plenty of choice. The arts cover popular, folk, classical and contemporary forms across combined arts, crafts, dance, digital arts, design, environmental arts, film, games and interactive media, literature, music, photography, puppetry, theatre and visual arts. Experience can be live or through recordings or broadcasts. One’s role can be as active creator, viewer/listener or just have it in the background. The experience may be at home, in everyday surroundings, or in a dedicated space such as a cinema, music venue, gallery, museum or theatre. The UK is blessed in having three strong arts sectors. ‘Voluntary arts’ are those that ‘people undertake for self-improvement, social networking and leisure, but not primarily for payment.’1 Research in 2011 identified over 49,000 local arts groups involving 9.4 million people. The publicly funded sector helps the arts to innovate, widen access and raise quality. Local government and the Arts Councils for England, Scotland, Wales and Northern Ireland are important advocates, development agencies and investors in the arts. The creative industries cover arts activities with developed commercial aspects. The Department for Culture, Media and Sport identified nine groups: advertising and marketing; architecture; crafts; design (product, graphic and fashion); film, TV, video, radio and photography; IT, software and computer services; publishing; museums, galleries and libraries; and music, performing and visual arts.2
1 www.voluntaryarts.org/take-part/about-the-voluntary-arts-and-crafts/ 2 www.gov.uk/government/uploads/system/uploads/attachment_data/file/394668/Creative_Industries_Economic_ Estimates_-_January_2015.pdf
04
Health For the World Health Organisation health is more than the absence of ill-health. ‘Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’3 . Though repeatedly contested, this definition has never been amended. Although facing many challenges, the health system in England remains world-class. It constantly evolves in response to the changing health of the nation, medical advances, government policy and financial pressures. A major restructure took place following the 2012 Health and Social Care Act (the ‘Lansley Reforms’). This transferred responsibility for approximately two thirds of the total NHS England budget (or £71.9 billion in 2016/17)4 to 209 local Clinical Commissioning Groups and responsibility for public health to local authorities. Note that these reforms applied to England only. The devolved nations have different structures. Changes have continued with, for example, sites of innovation called NHS Vanguards, the Better Care Fund to encourage integration between health and social care, and Genomics England spearheading the development of genomic medicine. A new overall NHS strategy, the Five Year Forward View, was published in 20145 . Of greatest relevance to arts and health is the commitment to prevention6 . Rising demand and falling budgets mean that prevention is now a necessity not an aspiration. Also of relevance is the commitment to parity between mental and physical health7 . The most recent structural development has been the advent of Sustainability and Transformation Plans [STPs] across England8 . The country is divided into 44 areas called STP footprints. The STPs are charged with bringing all local health players together to deliver changes such as increased prevention in an integrated way. Other trends include a growing willingness to look beyond the medical model. Approaches such as social prescribing9 , ‘empowering people and communities’ and ‘social movements’ are being embraced. The health system distinguishes between individuals’ health (the responsibility of GPs, hospitals and a vast range of specialist NHS services), the health of communities and that of the whole nation. Responsibility for the latter is held by Public Health England [PHE]. With local authorities also holding a public health brief, the Local Government Association is another important actor. It is PHE that is tasked with tackling the obesity epidemic for instance.
3 Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946 (Official Records of the World Health Organization, no. 2, p. 100) 4 www.nhscc.org/ccgs/ 5 www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf 6 www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf pp9-13 7 www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf Box 3.2 p26 8 www.england.nhs.uk/ourwork/futurenhs/deliver-forward-view/stp/ 9 See Social Prescribing Network for a definition and more details
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The Arts and health
Work is under way to distinguish different arts in health activities. Aesop uses nine types. Here they are with a few examples. 1 ARTS THERAPIES:
++
SETTING THE SCENE
++
The Health and Care Professions Council defines an arts therapist as ‘a psychological therapist who has arts-based experience plus training in psychological interventions using drama, music or art as their primary mode of communication.’ 10 Arts therapy is the most established arts in health activity. There are 3,922 arts therapists registered with the Health and Care Professionals Council and the protected titles are Art Psychotherapist, Art Therapist, Dramatherapist and Music Therapist. 11
2 PARTICIPATORY ARTS PROGRAMMES TO DELIVER SPECIFIED HEALTH OUTCOMES:
++ ++
Singing for Better Breathing choirs to help people with chronic obstructive pulmonary disease (COPD) to manage breathing difficulties. South London Gallery’s early intervention visual arts programme to improve mental wellbeing for parents and their children.
3 TECHNOLOGY-BASED ARTS ACTIVITIES TO DELIVER HEALTH OUTCOMES:
++
Music and Memory which trains care home staff to set up personalised music playlists on iPods for people with dementia to reawaken residents, enabling them to socialise and stay present.
4 ARTS FOR PUBLIC HEALTH ENGAGEMENT AND EDUCATION:
++ ++
Creative Health’s use of film and theatre to support children to ask people to keep smoke away from them. Maslaha’s film-based resources for mental health in Somali, Pakistani and Bangladeshi communities which have no word for depression. Here, there are barriers to recovery such as entrenched stigma and concerns that support won’t be appropriate.
06
5 ARTS FOR IMPROVING THE HEALTH ENVIRONMENT:
++
Willis Newson’s programmes of artworks integrated into the architecture, landscape and interiors of new health buildings to create a welcoming and reassuring patient environment.
6 ARTS TO IMPROVE STAFF WELFARE AND CONTRIBUTE TO STAFF DEVELOPMENT:
++
7 ARTS TO SUPPORT SYSTEM CHANGE:
++
Health professionals have written: ‘If we are to create widespread change, we will need new art, stories, myths, symbols, and much else to help us make the inner and outer transformations that will be needed.’ 12
8 ARTS FOR EXPRESSING AND CRITIQUING THE EXPERIENCE OF HEALTH AND SOCIAL CARE SERVICES:
++ ++
Dame Barbara Hepworth’s Hospital Drawings. Bobby Baker’s ‘Diary Drawings – Mental illness and me’.
9 EVERYDAY ARTS ACTIVITIES WITH GENERAL HEALTH BENEFITS
++ ++
Learning a musical instrument to support cognition. Joining a pottery class to improve self-esteem.
10 www.hcpc-uk.co.uk/aboutregistration/professions/index.asp?id=1 11 www.hcpc-uk.co.uk/aboutregistration/professions/index.asp?id=1 12 Clift, S ad Camic, P ed, (2016), Oxford Textbook of Creative Arts, Health, and Wellbeing, Oxford: Oxford University Press p23
07
SETTING THE SCENE
++
Performing Medicine – building a resilient, caring workforce through practical and reflective exercises taken from drama, photography and other art forms. Porter’s Poems – hospital porters creating and performing their own poetry to raise their profile and communication skills.
PROBLEMS AND POTENTIAL
Why now?
Aesop sees new energy and interest in arts and health. Sir Peter Bazalgette says now is the time for arts and culture to help address the crisis in health. In February 2016 at the Royal Festival Hall, Aesop presented a national arts in health event aimed at health decision-makers. Whilst there have been other national arts and health conferences this was the first to target health professionals specifically and it succeeded in attracting over 200 health professionals and commissioners. It showcased 24 leading arts in health programmes. All are now promoted on the Aesop Marketplace 13. The event sold out and trended on Twitter for seven hours. Speaking that day, the Secretary of State for Health said:
‘I think the timing for this debate [about the relationship between health and the arts] is very good because inside the health world we are now thinking about prevention much more seriously than we have ever done before. … We have fantastic arts in this country. We have fantastic healthcare. But we want to link them together, and understand healthy mind and healthy body, and the power of creativity. … The time is right.’ Research and the evidence-base is growing. The international journal, Arts and Health, launched in 2009. A second journal, Applied Arts and Health appeared shortly after. An Oxford University Press Public Health Textbook on Creative Arts, Health and Wellbeing was published in 201514. A UK Network for Arts and Health Research was founded in 2012. Two years later it was given a home by the Royal Society for Public Health as one of its special interest groups15 . In addition, Arts Council England has funded a number of substantial arts and health research projects, which will report in 201716.
08
The Special Interest Group’s collegiate approach has led to both arts and health national alliances joining its steering group: the National Alliance for Arts, Health and Wellbeing and National Alliance for Museums, Health and Wellbeing 18. The former, begun in 2012, is an alliance of nine regional organisations in England. The latter is a new consortium largely of museum organisations. An All Party Parliamentary Group for Arts, Health and Wellbeing was launched in 2014. Its first major initiative has been a two year Arts, Health and Wellbeing Inquiry with King’s College London, Guy’s and St Thomas’s Charity and the Royal Society for Public Health Special Interest Group as partners. Charitable foundations are increasingly involved. The Baring Foundation has led on the arts and older people and the arts and social care. The most recent project supported by them has explored the idea of ‘a choir in every care home’ 19. Guy’s and St Thomas’ Charity focuses on health innovation and has an energetic arts strategy. The Wellcome Trust funds arts programmes which help the public engage with health and science. Arts and health is having a moment in the sun.
13 www.aesopmarketplace.org 14 www.global.oup.com/academic/product/oxford-textbook-of-creative-arts-health-and-wellbeing9780199688074?cc=gb&lang=en& 15 www.rsph.org.uk/resources/special-interest-groups/arts-health-wellbeing.html 16 www.artscouncil.org.uk/research-grants-programme-2015-2018/research-grants-programme-round-1-successful-applicants 17 www.artshealthandwellbeing.org.uk/recent-developments/national-alliance-arts-health-and-wellbeing 18 www.museumsandwellbeingalliance.wordpress.com 19 www.choirineverycarehome.wordpress.com
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Dance to Health opening Aesop’s national conference and showcase. Photo: Helen Murray
But this is not the first.
The Windsor Declaration of 1999 was the culmination of work led by the Nuffield Trust ‘to raise the importance of the humanities in medicine and emphasise the place of the arts in health and wellbeing.’20 It made wide-ranging recommendations on professional education, arts therapies, creative environments and arts in community development and health. A further push came in the mid-2000s. Arts Council England commissioned its first literature review of arts in health.21 This helped lead to the Prospectus for Arts and Health jointly published by the Department of Health and Arts Council England22. The following year the Secretary of State for Health, Alan Johnson, gave a speech23 at the Wallace Collection in which he said:
‘Music, poetry, dance, drama and the visual arts have always been important to our mental and physical wellbeing, and collective participation and engagement in the arts is a fundamental element of any civilised society.’ He surveyed the importance of high quality health buildings and the arts’ role in supporting mental health service users and concluded ‘projects up and down the country that involve partnerships between arts and health professionals are demonstrating real benefits’. Further development came with the RSPH Beyond the Millennium report24, leading up to the 2013 Bristol Culture, Health and Wellbeing Conference 25. The RSPH has played a substantial role profiling the vibrancy of the arts and health sector through its Arts and Health awards, which will celebrate its tenth year in 2017. Since the early 2000s, there has undoubtedly been progress, and yet wide-spread adoption of arts for health interventions is still to happen.
20 www.nuffieldtrust.org.uk/publications/arts-health-and-well-being 21 Staricoff, R. (2004) Arts in health: a review of the medical literature, London: Arts Council England 22 Department of Health and Arts Council England (2007) A prospectus for arts and health, London: Arts Council England 23 www.artsforhealth.org/news/alan-johnson-speech.pdf 24 www.rsph.org.uk/resourceLibrary/arts-health-and-wellbeing-beyond-themillennium-how-far-have-we-come-and-where-do-we-want-to-go-.html 25 www.culturehealthwellbeing.org.uk/conference2013
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PROBLEMS AND POTENTIAL
Doctor Michael Dixon, Chair of College of Medicine attending Aesop’s national conference and showcase. Photo: Helen Murray
Previous moments
PROBLEMS AND POTENTIAL
Arts – still on the periphery of health There continues to be a lack of awareness of the value of the arts for health and continuing reluctance to commit health budgets to arts programmes. Many health professionals view the arts as ‘fluff’. The arts are a nice-to-have extra, incapable of delivering robust health outcomes and therefore not a suitable use of NHS funds. Take Norfolk and Norwich University Hospitals NHS Foundation Trust as an example of this view. It acknowledges that the arts can contribute: ‘Our Hospital Arts Project plays an important role in providing a positive health care setting and healing environment for our patients, staff and visitors through a wide-ranging programme of arts.’ 26 But then it adds that the arts are not important enough to merit NHS funding: ‘All our projects are funded by grants from organisations and charitable donations, no money is taken from healthcare budgets.’ NHS funding of the arts is very low. No-one knows exactly how much is spent but Aesop has made an informed guess. We run an action learning set for arts organisations already commissioned by health or social care. There are 25 members ranging from small, specialist arts and health organisations to large companies such as English National Ballet, National Museums Liverpool and Royal Philharmonic Orchestra. The group shared its financial data. Their total combined income from the NHS was just 0.002% of the NHS England budget (£2,502,360). Very few arts and health programmes have a sustainable financial model. This condemns them to a hand-to-mouth existence, dependent on securing the next grant. This fails the very people arts and health wishes to help.
26 www.nnuh.nhs.uk/departments/hospital-arts-project
12
These projects are commissioned not because they are nice to have. They are commissioned because they work for patients and for the health system. The lack of scaling therefore is a double concern. It is certainly a business failure by the arts sector. More importantly, it is a failure of duty and a matter of social justice. If we accept that the arts have a powerful contribution to make to the nation’s health, then a failure to scale condemns patients to a ‘postcode lottery’. It is not enough to run one-off projects in collaboration with health staff who already ‘get’ the arts. Scalable models, flexible enough to work in different health, social and artistic contexts, are essential. No established continuing professional development exists for the arts to work with health or vice versa. There are pockets of important activity. As well as National Museums Liverpool, examples include Green Candle Dance’s dementia courses for dance artists and the Clod Ensemble’s Performing Medicine programme for health professionals and students. Lastly, arts and health events attract few health professionals. Arts in health specialists understandably need opportunities to meet with peers. The arts sector more generally is interested in opportunities to widen their engagement with audiences and participants, and to diversify their income streams. It is also understandable that a health sector, hard-pressed and largely unaware or unconvinced of the value of the arts, will stay away.
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PROBLEMS AND POTENTIAL
No arts in health programme has yet gone to scale in the health system so that all patients who could benefit have access to the programme. The two leading contenders are both Liverpool-based. The Reader Organisation runs Shared Reading groups for good mental health and wellbeing. It works in Liverpool and Wirral, London, the South West, the South East, the North East, Scotland, North Wales, and also in criminal justice settings across the UK. It has sister projects in Australia, Belgium and Denmark. National Museums Liverpool has trained more than 10,000 carers across England, through its House of Memories dementia awareness training programme.
Aesop’s experience and contributions Aesop’s mission is to create a thriving health market for arts-based social enterprises. Many foundation blocks for that market are missing.
PROBLEMS AND POTENTIAL
There was no marketplace where health decision-makers could connect with excellent arts programmes. The Aesop Marketplace was launched at the February conference and showcase. Like an online dating site, this matches health commissioners and other decision-makers with relevant arts in health programmes in an attractive and time-efficient way. For the first year, the site is exclusively for the 24 arts in health programmes featured in the showcase. Each profile offers a quick and easy way to get to know the programme. Basic tools were missing. There was no evaluation framework for arts in health programmes. The Aesop Public Health England Framework now exists27. Other tools have been created including a planning tool for linking artistic quality and social impact, an artistic outcomes framework and standards of evidence28. We need more scalable exemplars like the Reader Organisation and National Museums Liverpool’s House of Memories. Aesop has created Dance to Health (www.dancetohealth. org) as a scalable dance-based solution to the challenge of older people’s falls. It incorporates evidence-based falls prevention exercise for older people into high quality, creative, sociable and engaging dance sessions. A pilot programme has revealed Dance to Health’s potential as an effective, cost-effective and enjoyable means to reduce falls. Continuing professional development is essential for helping health professionals understand the arts sector, the language of arts management, how to create effective partnerships with the arts and how to evaluate arts in health programmes. Arts professionals (including artists) are in a similar position with health. Aesop’s next major initiative is the Aesop Institute, a partnership of continuing professional development providers. This is being developed with Canterbury Christ Church University’s Faculty of Health and Wellbeing. Three of its centres are partners: the Centre for Work-based Learning and Continuing Development, England Centre for Practice Development and Sidney De Haan Research Centre for Arts and Health. Key to the Institute’s success will be quality assured, accredited programmes co-designed by the health and arts sectors.
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Making now a breakthrough moment Speeding up adoption and diffusion is a priority for the NHS. This is against the background of it taking 17 years on average for a research finding to be translated into patient benefit29. Resistance can come from any or all of the following: the media, legislators, hospital administrators, physicians, health academics and medical supply companies30 . Particularly valuable for understanding scaling are the Carruthers report31 and publications by the Health Foundation 32, 33, 34 , What Works Scotland 35 and Nesta 36, 37. Based on this it is possible to identify seven drivers for success of a new national arts and health consortium:
3. 4. 5. 6. 7.
A clear mission. A financially sustainable programme which is co-designed by health and the arts. Effective leadership and delivery team. Top level advocacy. Mid-level horizontal push and pull. Grassroots pull from the public, artists, health professionals and arts professionals. Sustained communications activity.
27 www.ae-sop.org/toolbox/phe-framework/ 28 www.ae-sop.org/toolbox/aesop-toolbox/ 29 Morris, Z.S., Wooding S. and Grant, J. (2011), The answer is 17 years, what is the question: understanding time lags in translational research, Journal of the Royal Society of Medicine. 104, 12 510-520 30 Fuchs, V.R. and Milstein, A. (2011), The $640 billion question — Why does cost-effective care diffuse so slowly?, New England Journal of Medicine. 364, 1985-1987 31 Department of Health, NHS Improvement & Efficiency Directorate, Innovation and Service Improvement (2011), Innovation Health and Wealth, Accelerating Adoption and Diffusion in the NHS, London: NHS 32 De Silva, D. (2014), Spreading Improvement Ideas, London: Health Foundation 33 Randall, S. (2015), Using Communications Approaches to Spread Improvement, London: Health Foundation 34 Health Foundation, Communications in Health Care Improvement – A toolkit www.health.org.uk/collection/ communications-health-care-improvement-toolkitaccessed 7.9.16 35 Shiell-Davis, K. (2015), Evidence Review: Scaling-up innovations, Glasgow: What Works Scotland 36 Burd, H. and Michael Hallsworth, M. (2016), Supporting Self-management A guide to enabling behaviour change for health and wellbeing using person- and community centred approaches, London: Health Foundation and Nesta 37 Burd, H. and Michael Hallsworth, M. (2016), Spreading Change: A guide to enabling the spread of person- and community-centred approaches for health and wellbeing,London: Health Foundation and Nesta
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PROBLEMS AND POTENTIAL
1. 2.
PROPOSALS FOR THE NEW CONSORTIUM
The consortium’s mission Three elements are proposed: ++ ++ ++
Capitalise on the new energy, interest and opportunities in arts and health. Help health harness the power of the arts. Help the arts to deliver health outcomes.
Programme co-designed by health and the arts It is vital to engage the wider health and arts sectors and involve both in co-designing the collaboration’s programme. We propose these areas of activity as essential: ++ ++ ++ ++ ++ ++ ++ ++
A membership scheme addressing the interests and needs of health and arts professionals with subscription rates sensitive to different individuals’ and organisations’ ability to pay. A research development plan for expanding the evidence base, achieving better dissemination and increasing the adoption and diffusion of results. A growing Aesop Institute operating as a partnership of providers of quality assured, accredited continuing professional development programmes leading to qualifications, and co-designed with the health and arts sectors. A web-based information service. Events including conferences, seminars and webinars. A support programme for the creation, growth and scaling of arts in health enterprises. Policy research and development. Advocacy.
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Effective leadership and delivery team Aesop is willing to play its part in delivering these proposals. Only some are on-mission for Aesop, however. This table lists on- and off-mission activities and possible partners who might contribute.
ON-MISSION FOR AESOP - WITH…
OFF-MISSION LEAD PARTNER OPTIONS
GRASSROOTS MEMBERSHIP
OFF-MISSION
College of Medicine Royal Society for Public Health
RESEARCH DEVELOPMENT
OFF-MISSION
Royal College of Physicians Royal Society for Public Health Royal Society of Medicine
CPD
Canterbury Christ Church University Royal Society for Public Health
INFORMATION SERVICE OFF-MISSION
EVENTS
Culture, Health & Wellbeing Alliance
OFF-MISSION except events for market development
ENTERPRISE DEVELOPMENT
Health Foundation Improvement Science London Aesop’s action learning set
POLICY DEVELOPMENT
OFF-MISSION
ADVOCACY
Arts and Health South West Culture, Health & Wellbeing Alliance London Arts and Health Forum
King’s Fund APPG on arts, health & wellbeing
Top-level advocates/partners/ membership
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Top level The new collaboration should involve these key England bodies:
PROPOSALS FOR THE NEW CONSORTIUM
HEALTH
THE ARTS
PRACTICE
NHS England Public Health England Skills for Care Skills for Health
Creative and Cultural Skills Creative Industries Federation Voluntary Arts
RESEARCH
National Institute for Health Research
Arts & Humanities Research Council Economic & Social Research Council
Department of Health Local Government Association
Arts Council England DCMS Local Government Association
GOVERMENT/ FUNDING
Mid-level horizontal push and pull Both health and the arts have a wide range of professional bodies who could be partners for developing mid-level engagement and practical programmes. The bridge between health bodies and arts bodies needs building, helped by examples such as the Royal Society of Medicine’s involvement in founding the National Institute of Dance Medicine and Science.
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Grassroots pull from the public, artists, health professionals and arts professionals
Sustained communications activity The challenges here are: ++
++ ++ ++ ++
Attitude change. The health sector’s lack of awareness of the potential role of the arts in health is certainly a problem. There is also a concern in the arts about arts in health programmes offering artists insufficient opportunity for creativity and development of artistic practice. This can be the case but Aesop’s experience of running Dance to Health has shown that artistic development and delivery of health outcomes can be achieved simultaneously. The Aesop Marketplace has other examples. A shared understanding of the terminology used by the health and arts professionals and the values underpinning practice. Both sectors have their daunting jargon. Up-to-date market intelligence about both sectors. Effective advocacy. A strong communications dimension to all the collaboration’s activities.
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PROPOSALS FOR THE NEW CONSORTIUM
A buzzing membership will be vital for success. It is key to fostering dialogue, mutual understanding and successful collaborations between health and the arts. Subscriptions will provide essential core funding.
GOVERNANCE, FINANCIAL MODEL AND CHECKLIST FOR SUCCESS
Governance Aesop would be willing to lead the collaboration, chairing an executive board of all delivery partners. Each partner would hold full responsibility for their contribution. The board would coordinate the collaboration’s efforts and oversee strategy development, implementation and review. An advisory board drawn from the top level national bodies listed above would support, challenge and advise.
Financial model Several proposed activities should not need long-term grant funding. Pump-priming over three to five years should be enough and, as this tapers off, earned income will take its place making the activity self-sustaining and able to grow. Examples include the membership scheme and events. A second category is activities which could be subsidised by membership income. Examples are policy development and advocacy. A third category is activities which will need funding in the long-term. Examples include research and enterprise development. Activity in any of these categories could be boosted by project funding. The table below applies this approach to the collaboration’s essential activities. FIRST FIVE YEARS
LONG-TERM
GRASSROOTS MEMBERSHIP
Pump-priming
Self-sustaining and providing funding for essential activities
RESEARCH DEVELOPMENT
Pump-priming + funding of research
Funding of research
CPD AND INFORMATION
Pump-priming
Self-sustaining
EVENTS
Pump-priming
Self-sustaining
ENTERPRISE DEVELOPMENT
Funding of support and of exemplars
Grants and social investment for enterprises
POLICY DEVELOPMENT
Pump-priming
Funded from membership income
ADVOCACY
Pump-priming
Funded from membership income
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Checklist for success There are many successful support organisations working in health and in the arts. They point to the following success factors:
SUCCESS FACTORS ++ ++ ++
Active membership – not just reliant on efforts from the centre Regular consultation on the collaboration’s future strategy Receiving annual reports including strategy delivery reports
++ ++ ++ ++
Realistic strategies for research development and dissemination Productive partnerships with NIHR, AHRC, ESRC and Wellcome Trust Research agenda devised and delivered in partnership with practitioners and beneficiaries Research to include health outcomes
++ ++ ++ ++ ++ ++
Training curricula co-designed by health and the arts Programmes positively evaluated by attendees Independent quality assurance Qualifications for health and arts professionals Information service positively evaluated by health and arts users Self-sustaining within 5 years
++ ++ ++
Events with target audiences and planned outcomes clearly identified, measured and reported High production values for live and on-line events Self-sustaining within 3 years
ENTERPRISE DEVELOPMENT
++ ++ ++
Exemplars identified Means for sharing lessons on how to grow and scale Funding of support and of further exemplars
POLICY DEVELOPMENT
++ ++
Evidence-based policy proposals Proposals which are relevant, realistic and appropriately targeted
ADVOCACY
++ ++ ++
Strong networks in health and the arts Active communications activity Relevant, realistic and appropriately targeted campaigns
GOVERNANCE
++
Good governance as recommended by the Charity Commission
GRASSROOTS MEMBERSHIP
RESEARCH DEVELOPMENT
CPD AND INFORMATION
EVENTS
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Next steps Aesop will first discuss the proposal with potential partnership and funders. A second version will then be produced. Aesop will be using social media and hosting events around England to consult on these proposals and, if momentum begins to build, move on to a co-design process to shape the consortium’s first three-year strategy.
Arts Enterprise with a Social Purpose
info@ae-sop.org
@AesopHealth