Participate participatory arts programme evaluation report may16 v02

Participatory Arts Programme Evaluation Report May 2016

CONTENTS Section

1. INTRODUCTION Page

1. INTRODUCTION

3

2. pARTicipate PATICIPATORY ARTS PROGRAMME

4

3. EVALUATION METHODOLOGY

10

4. GLOW MOMENTS

12

5. OUTCOMES

14

6. RECOMMENDATIONS

24

7. CONCLUSIONS

25

8. REFERENCES

27

This report presents the evaluation findings of pARTicipate, an ongoing participatory arts project at the Royal United Hospitals Bath (RUH). The project was developed by the Art at the Heart team (AATH) and for the past two years funded by Arts Council England, Bath and North East Somerset (B&NES), RUH charitable funds and the Medlock Trust. The report details the projects aims, objectives, outcomes, the activities that have taken place and the project outputs. It also describes the evaluation approach and data collection methods. The role of 5x5x5=creativity included working alongside the creative team, the underpinning philosophy of patient-led practice, mentoring and the production of this evaluation report. Most importantly it evaluates activity completed between May 2014 and April 2016.

Delivery partners: Art at the Heart RUH 5x5x5=creativity Live Music Now Bath Folk Club Bath Spa University Creative Team: Hetty Dupays, Arts Manager, Art at the Heart RUH Diane Samways, Marketing and Audience Development Manager, Art at the Heart RUH Edwina Bridgeman, Artist in residence, Participatory Arts Programme RUH Frankie Simpkins, Musician in residence, Participatory Arts Programme RUH Participants: Patients, Visitors, Play workers, Education staff, Musicians Volunteers: Anna Hurwitz, Lucy Bell, Lydia Williams, Ida Mauro-House Mentor: Penny Hay, 5x5x5=creativity Evaluation team: Penny Hay and Louise Betts, 5x5x5=creativity

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2. pARTicipate PARTICIPATORY ARTS PROGRAMME ‘By improving the patient experience to reduce the level of agitation improved the experience for the patient.’ John Willis Combe Ward Manager Art at the Heart (AATH) is the charitably funded, arts programme for the RUH and was first established in 2000. A dedicated and highly skilled arts team is overseen by The RUH Arts Strategy Group which has a committee comprising of ten members drawn from the clinical, patient and staff community and also members of the local arts and business community. The RUH delivers acute health care to a catchment population of 500,000 residents across Bath & North East Somerset, North Wiltshire and South Gloucester. The RUH is a major employer in the Bath area, as a Foundation Trust Hospital it strives for excellence in its innovation and research. pARTicipate is a programme of creative engagement led by Art at the Heart (AATH).

The programme has emerged from over ten years’ experience of organising and delivering art and music workshops, exhibitions and commissions within a major acute-care hospital.

Artsparks, Soundbite and Stitch in Time are existing programmes which provide year round opportunities for patients and their families to engage with the arts. pARTicipate attempts to combine these strands in order to establish models of working that improve outcomes for patients through developing the patient environment, encouraging and supporting social skills and increasing self-esteem and confidence.

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Artsparks

pARTicipate aims to improve the time in hospital for older and younger patients at the RUH, their patient experience and opportunities for physical and mental stimulation during the recovery process through a regular and continuous programme of creative activities. Committed to excellence and innovation, the pARTicipate programme provides creative opportunities to the whole community through partnerships, participation and collaboration to create stimulating and uplifting spaces for patients, staff and the wider hospital community. It includes workshops, residencies, installations and public and ward music performances that support the RUH’s Five Year Plan and medical goals.

Objectives a) Deliver arts projects to support the healing of patients. b) Give patients, staff and visitors the opportunity to be creative and showcase their work. c) Promote a widespread understanding of the important of arts in healthcare. d) Establish good working relationships with clinical staff and patients. e) Develop and innovative service with exceptionally high standards. f) Encourage younger people to take part in arts and cultural activities, for example through student placements and involvement with schools. g) Increase recognition of our quality service by external organisations and the community that we serve.

‘The arts and cultural sector has huge potential to positively impact on the health and wellbeing of the population and provide innovative and creative pathways to reducing inequalities in England, but the sector, and commissioners, must be more effective at collecting and using data to demonstrate this in real time.’ Dr Justin Varney, National Lead for Adult Health and Wellbeing, Consultant in Public Health Medicine, Public Health England

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Activities

Key Projects

•

Soundbite brings a varied programme of live music and creative activities to RUH wards and public areas, delivering high quality live music and creative reminiscence interactive workshops for older and younger patients. Frankie Simpkins, musician in residence, provides an on-going and fully inclusive music service for the hospital with weekly interactive performances, tailored to all ages and tastes. The Soundbite Performance Programme brings a diverse range of live music to communal areas of the hospital and wards, working with young musicians from Live Music Now and Bath Spa University, as well as local musicians and staff from the RUH including the RUH choir.

• • • • •

• •

Regular/weekly participatory workshops and live music performances in the children and older patient wards led by the artist and musician in residence.

Live music performances in different spaces in the hospital.

Residencies and projects based on particular themes.

A programme of exhibitions and installations in the RUH and the city of Bath.

Placements for students of local universities and colleges so that they can gain first-hand experience of the use of arts in healthcare.

Developing relationships with designated members of staff on each ward who refer people to the service, allowing us to work more closely with the clinical staff.

Mentoring by 5x5x5=creativity for artists, staff and participants in the process of creative enquiry and participant-led work.

Training for artists and students working in a hospital environment.

Stitch in Time is a weekly creative textile reminiscence workshop based on Combe Ward, a recently re-furbished award winning dementia friendly ward for older patients which features a spacious and homely Dayroom large enough to accommodate a range of activities. The workshops are entirely patient-led by Edwina Bridgeman and co-produced by textile students and volunteers.

The workshops aim to incorporate a range of images and creative processes, taking elements from one-to-one and group conversations and paying homage to our heritage through the involvement and the sharing of memories.

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3. EVALUATION METHODOLOGY Evaluation runs through all projects and is particularly important when working at close contact with vulnerable patients. The Creative Team have been engaged in a collaborative and ongoing evaluation process, reflecting on practice and collecting significant and illuminative moments (‘glow moments’) that helped us gain a deeper understanding of our individual roles and how we can improve these alongside patients and the staff team. This approach has been developed by 5x5x5=creativity over 16 years. Activity took place between May 2014 and April 2016 and has involved the creative team at Art at the Heart in the delivery of the project, reflection and evaluation.

The Participatory Arts Programme Evaluation Framework is formative and allows the creative team to: • • • • •

Develop a reflective approach.

Support creative practice in action.

Develop the ability to analyse and evaluate different approaches to creative practice.

Gain personal and professional insights.

Make changes to and develop creative practice.

• •

• •

Log books containing number of sessions and number of participants (including the percentage of those with dementia).

Postcards used as a space for participants to provide comments about the workshops.

Observations recorded in artists’ reflective journals about how the patients responded to the workshops.

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• •

Observation and documentation of the activities and the resulting participant responses by creative team and clinical staff Questionnaires and interviews, feedback forms, informal conversations Monitoring, tracking information from hospital systems

The following challenges of collecting data in a hospital setting were discussed and are recognised throughout this report:

•

• • • • • • • •

5x5x5=creativity team has mentored the pArticipate team, to develop the potential of imaginative and creative learning of all involved and to:

Participant engagement in evaluation process Non-biased data Respecting participants’ needs Participant disabilities Dementia awareness Time – data collection and dissemination Resources – data collection and dissemination Skills – data analysis

Methods of delivery and data collection with the creative team: • •

The outcomes and outputs were monitored using: •

Discussions with clinical staff to determine the ongoing benefits of the project.

Visitors comments on how the patients engaged with the workshops.

• • •

An enquiry framework and action plan with creative practitioners.

Reflection in action: through dialogue, email, professional development events and provocations, punctuated with regular meetings to give an overview of progress as well as to raise issues that would benefit from the support of the team.

Each artist/team member kept a reflective journal.

A project blog shared ‘glow’ and ‘low’ moments.

Artists contributed to pre- mid- and end-project analyses and outcomes, face-to-face and in writing.

Methods of evaluation and data collection with participants:

•

•

•

•

Support creative practitioners in generating new ideas and to facilitate the development of genuinely innovative practice that is disciplined and has a clear sense of purpose and value.

Maintain integrity, quality and rigour in all of the work: to embed creativity in the RUH’s daily activities and exemplify imagination, curiosity, playfulness, kindness, generosity and sensitivity as key processes.

Support the wider RUH artist team in their own creative professional learning, to develop innovative approaches to excellence, sharing these widely through thorough evaluation processes.

Provide a safe space for reflection with confidentiality.

‘pArticipate marked a new direction for the programme, which was fueled by new learning and a reflective ‘team’ process. Not only did it unite the strands, but it united the team, with cross department working being introduced for the first time.’ Diane Samways, Marketing and Audience Development Manager

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4. GLOW MOMENTS 5x5x5=creativity has developed an approach to evaluation processes over 16 years (Bancroft et al. 2008). More recently it has begun using ‘glow moments’ to focus on significant examples of outstanding creative experiences. It was agreed by the creative team that they would test this approach in this project and have added to this with the documentation and recognition of ‘low moments’ when practice can be found to be difficult or challenging.

Glow moments emerge from deep, critical reflection on powerful and transformational experiences at the heart of the work with 5x5x5=creativity. These glow moments help us as a team to reflect on the powerful creative thought and action of children and adults and have affected a positive shift in the work that we do. Sometimes these ‘glow moments’ present themselves vividly and intensely as they happen, other times they emerge slowly through close and sensitive reflection and critical thought processes.

Each ‘glow moment’ has developed through collaborative discussion, recollection and debate.

They are a product of multiple perspectives, brought together in a process of crystallisation through which we come to see that there is more than one way in which to see the world. Through this collaborative reflection and evaluation of our work we come to recognise those moments that are truly transformational in the work that we do.

The creative team established a blog to share their thoughts, draw out common themes, recognise challenges and in turn identify the ‘glow moments’ from the project which can then be shared with a wider audience. The blog also considers specific ways of disseminating the evaluation results, cases 12 | pARTicipate Participatory Arts Programme Evaluation Report | May 2016

studies and stories from the project. Reflection is at the heart of this approach.

Case studies The role of the arts was recognised and valued by children, patients and staff in a variety of contexts.

Children’s and Adolescents Mental Health Service (CAMHS): there has recently been a significant rise in admissions to the ward and these young people are extremely vulnerable; often their treatment is complex and entails lengthy stays.

Artists have visited the ward twice weekly so that there is continuity of care and the ability to build strong relationships and tailor specific projects to individuals. Together with her grandmother, a young patient with a serious eating disorder spent time making creatures for the World War 1 Hospital tapestry. Initially she talked about her inabilities but on completion of her work she said how proud she was of what she’d achieved and how unexpected the experience had been. The patient has since moved to a specialist hospital and has requested a session with the artist to create a textile figure to take with her. Recently a 17 year old CAMHS patient remarked with real pleasure ‘How lucky am I?!’ when being told that she could continue her making and talking with the artist the following day’ Cancer: impacts on the entire family, it can entail lengthy stays and repeat shorter visits that entail invasive procedures including transfusions and chemotherapy. We are very mindful of the whole family in these acute situations and provide opportunities for the family to share and work together where they are supported and nurtured in a safe environment.

“The workshop made a big difference to my 5 year old niece who was crying and scared of surgery before she started doing the art work. She said afterwards: “I feel so much better now” Family Member Long term chronic illness including Cystic Fibrosis: some long term patients require treatment throughout their childhood and adolescence.

Edwina is able to build long-term relationships with these young people and involvement in art workshops is often the highlight of their lengthy stays. Recently Edwina transformed a hospital single bedroom into a studio which was used daily and became a hive of activity. It was no longer a clinical room but a space that reflected the child’s personality and imagination.

‘Martha (7) came in for a blood test which she has regularly. She has developed a strong fear of having the tests. Today was very different because we came and worked with Edwina first. Martha was relaxed and enjoyed exploring the materials and making a scene with characters and scenery. She turned it into a computer game! The blood test was quicker and easier than it’s been for months and she recovered quickly. She was very keen to return to working with Edwina and playing with her creation. The whole process was much more relaxing for us as parents too.’ Parent Patients with learning and physical disabilities (autism, sensory loss, brain injuries and acute physical disabilities including paralysis and Cerebral Palsy) are frequent in-patients who benefit from continuity and attaining a sense of achievement.

Older patients with dementia: being engaged in creative activities has enhanced the quality of patients’ time in hospital and understanding of their needs. Providing stimulating activities has reduced stress and the patients’ perception of pain - often leading to a reduction in the level of medication required and shortened lengths of stay in hospital.

These creative activities have also opened up a forum for discussion and communication, making people feel more relaxed and calm and more likely to voice anxieties, fears, recall memories and form networks within the group. By encouraging and supporting social skills and interaction between patients, their self-esteem and confidence is increased.

‘An elderly gentleman with severe learning difficulties and little speech was a frequent visitor to the Combe Ward Dayroom; sometimes his presence upset fellow patients with one man commenting that the atmosphere had changed in the room and was no longer friendly. We went on to discuss friendliness, familiarity and kindness and how there is actually room for everyone.

The following week the elderly gentleman was brought into the Day Room and all the patients in the room cheered, he responded by saying their names which was very rare for him. The incident demonstrates a greater understanding and acceptance of fellow patients; we learn through ongoing and shared experience’ Edwina Bridgeman, Visual Artist in Residence

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5. OUTCOMES Artsparks workshops: 96 Stitch in time workshops: 60 (Started in September 2014) Frankie’s Interactive Performances: 510 hours over 2 years (255 hours per year, 5.5 hours a week (rounded up).

Lunchtime performances from visiting musicians: 44 pARTicipate Participants engaged from April 2014 – April 2016 No. of participants engaged Artsparks

2339

Soundbite

6307

Soundbite Lunchtime Performances

8276

Stitch in Time

342

Total:

17,264

Artsparks Participants engaged from April 2014 – April 2016 No. of participants engaged Children

1013

Siblings

105

Parents

869

Visitors

179

Staff

173

Total:

2339

Stitch in Time Participants engaged from April 2014 – April 2016 No. of participants engaged

Soundbite (numbers exclude *lunchtime performances) Participants engaged from April 2014 – April 2016 No. of participants engaged Patients (Children)

107

Sibling

23

Patients (Adult)

3077

Visitors

590

Staff

2510

Total:

6307

Soundbite Lunchtime Performances Participants engaged from April 2014 – April 2016 No. of participants engaged Atrium

5354

Lansdown Foyer

310

Friend’s Cafe

110

Wards

2502

Total:

8276

Reached 1010 in total (almost 30% of the total audience reach per year) Awards • Arts and Health South West Award: Highly Commended • Bath Life Arts Winner 2014 • Bath Life awards 2016: Shortlisted • A&HSW Awards 2016: Shortlisted OBJECTIVES ACHIEVED a. To deliver arts projects to support the healing of patients.

No. of Participate Student Placements and Volunteers April 2014 – April 2016 Students

Volunteers

Artsparks

0

2

Soundbite

3

0

Stitch in Time

0

6

Total:

3

8

In-kind Student and Volunteer hours April 2014 – April 2016

By encouraging and supporting social skills and interaction between patients, their self-esteem and confidence is increased.

‘I enjoy the social side of sitting and chatting with other people. It helps pass the time and it makes you forget about your troubles. It makes the experience of being in hospital much better.’

Patient

‘Since I have been working at the hospital we have talked about having musicians on the children’s ward but it had never been possible. Earlier this year it was agreed that I would spend an hour on the children’s ward with my ukulele under the guidance of the play specialists and see how it goes. My visit was hugely successful, and I was received in the best possible way, and I have been returning weekly since.’

Frankie Simpkins. Musician in Residence Using feedback from the live musical performances it is evident that staff, patients and visitors appreciate listening to live music and it has been noted that the music helps calm nerves and anxiety for patients having treatment or visitors waiting for a relative.

‘The music playing was a calming and relaxing influence for the patients. So much, that I noticed one of the patients that is normally very vocal and agitated, became calm, smiling, and was dancing to the music with her fingers and legs’ Staff Member This resource supports sustained and in-depth work with patients which is responsive to their needs and supports healing.

The regularity of the artists’ visits has enabled the team to realise long-held aims and develop new work.

Hours

Patients

273

Visitors

11

Artsparks

40

Staff

58

Soundbite

75

Total:

342

Stitch in Time

240

Total:

355

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Bath Folk Festival 2015 5 acts, 15 performances in total

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‘In August I spent time working closely with families, responding to individual needs and interests. Patients often had their siblings present which extended the work and enabled the whole family to feel involved together. Serious illness in the family is difficult for all. I noticed the huge value to families of being able to work together. Siblings, parents and grandparents were less anxious and felt comfortable in the safety of the playroom given the opportunity to work creatively and to support each other.’ Edwina Bridgeman, Visual Artist in Residence The collaboration between the artists has also been an important element of the success of the programme.

‘There is a great energy and atmosphere of camaraderie between all participatory projects and the cross over between Artsparks and Soundbite is certainly helping to create this.’ Hetty Dupays, Arts Programme Manager ‘I was delighted to be asked to join Frankie the Musician in Residence and the volunteers on the ward to consolidate their work with the elders.

Frankie and the volunteers all have an easy, respectful way of working on the ward and an excellent understanding of the needs of the patients.’ Edwina Bridgeman, Visual Artist in Residence

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b. To give patients, staff and visitors the opportunity to be creative and to showcase their work.

The AATH team have ensured that there are suitable spaces and places to showcase the work created during the work- shops and sessions with the artists alongside the exhibition programme at the hospital.

This gives participants a sense of achievement and moment to celebrate themselves as artists which develops confidence and self-esteem.

‘We started the year creating work for a commission for Paediatric outpatients, it commemorate the life of one of the Paediatricians.

A day outdoors was the theme and we made a series of boats and animals in a large box frame.

This led to creating work for the 4 large wall mounted cases in the Art- sparks corridor. The work was installed in the corridors [with the help of a two of young patients] in early August and has been greatly admired.’ Edwina Bridgeman, Visual Artist in Residence ‘Recently a young adult from Haygarth ward told me that when she was able, she was wheeled around the hospital to look at the artwork, the Artsparks corridor and the Four Seasons boxes had a huge impact on her. She was inspired to start her own work again, illness had curtailed her textile degree at Central St Martins a few years ago.

Although she is unable to access the Children’s ward she sought us out on Combe and successfully took part in the Stitch in Time workshop.’ Edwina Bridgeman, Visual Artist in Residence

The sharing of work also promotes the work of the hospital in other settings. In December 2014 work created by children working with Edwina Bridgeman was exhibited as part of the Ship of Fools, Edwina’s exhibition at the Victoria Art Gallery in Bath.

‘It was an excellent project with many patients and staff at the Private View (for the Ship of Fools exhibition at the Victoria Art Gallery), for some it was their first visit to a gallery. The children’s work was an integral part of the show and prompted lots of questions and interest about our work at the Hospital. Most importantly it was a way of showing children how much their work is valued.’ Edwina Bridgeman, Visual Artist in Residence ‘Participants of the programme are encouraged to explore creative ways of disseminating evaluation results and stories and sharing them with the group. So far we have had the following ideas; a glow worm interactive cave, the glow jar, immersive theatre small set design, The Playroom Book, fantasy acrylic paintings taken from glow stories, a 45” vinyl package and a series of short films and animations.’ Diane Samways, AATH Marketing and Audience Development Manager

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The environment of the ward has been enhanced by creating artworks with patients that reflect the happy and positive environment of the playroom, encouraging children to play, be creative and add something of themselves to the ward.

‘The Playroom is the ideal environment. Children are absorbed in the activities on offer which help them relax, make friends and use their imaginations. The Playroom is a special place and I believe plays an important role in children’s recovery, it is also unique in being the place where Children can really be themselves and play. It is for this reason that I wanted to make the Playroom Book, not only to celebrate it but to use it as a resource for Children and their families prior to them visiting the Children’s Ward.’ Edwina Bridgeman, visual artist in residence c. To promote a widespread understanding of the importance of arts in healthcare.

The team have used a number of methods to meet this outcome and promote and reflect on the work of AATH within the creative team, with the hospital and wider community.

The concept of ‘glow moments’ has had an impact on how the team are sharing their work with different audiences.

‘A refreshing development is the way that we are now pushing the ‘glow moment’ format to general documentation and audience development. For example, the new Arts Map will help patients and visitors to find their way around the RUH and will include interesting facts presented in an imaginative way and illustrations by young patients

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can be used to depict an artwork in the hospital just as well as a photo can. It will be informative but also fun.’ Hetty Dupays, Arts Programme Manager The music offer has been promoted to all ward managers in the hospital: ‘Our Soundbite programme has recently been promoted and publicised around the hospital. It came to our attention that outside of the wards we visited, many members of staff did not know about the music programme. Despite the small numbers, it is encouraging that the wards are interested in the Music programme, and the survey does show that we need to do more to raise awareness around the hospital of Soundbite.’ Frankie Simpkins, Musician in Residence

d. To establish good working relationships with clinical staff and patients The creative team all speak about the good working relationships they have with the each other and the staff on the Children’s ward and Elders’ Ward which have developed over time and which have been strengthened and developed as part of this programme.

‘Patients that are involved in the sessions carry the benefits with them all day. Lively conversations are struck up... patients delighting in stories that they have in common.’ Ward manager, John Wills

the ward is a sensitive environment and good relationships have to be built slowly. The good relations are now well established and are based on mutual trust, respect and kindness. The outcome is that the work feels embedded within the hospital, I am familiar to staff and regular patients.’ Edwina Bridgeman, Visual Artist in Residence New and unexpected relationships have sprung up as a result of the artists’ presence on the wards, unearthing hidden creative talents and interests.

‘Over a couple of months a relationship was built up between myself and one of the ward cleaners.

He would always clean the floor wherever I was singing, and would sing along with me in harmony. Every week I would sing and he would mop around me and we would sing together.

It was so lovely and a number of patients used to laugh and comment on it.’ Frankie Simpkins, Musician in Residence ‘Between September and December we created Sea Monsters from junk that were to become part of my exhibition Ship of Fools at the Victoria Art Gallery Bath. Each week I bought a large bag of materials that within minutes were being transformed into octopus, alien fish and monsters.

Some of the clinical staff became very interested and donated rubber pipes and other medical equipment to be incorporated. It is unusual to see interest from the clinicians on this level.’ Edwina Bridgeman, Visual Artist in Residence

‘This has been a very successful and busy year for Artsparks. We have been building relationships with the Children’s ward over a number of years,

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e. To develop and innovative service with exceptionally high standards The creative team recognise the elements of their practice that are innovative and high quality and also where the work needs development or support to improve this. For example, the blog has supported the team to share their developing practice and other projects or examples of good practice and alongside regular meetings with the team and staff on the wards this feeds into the reflective cycle and development.

The Arts Manager, who leads the programme, articulates her aspirations for the programme and its impact on the wider arts programme within the hospital, in particular she identified reflective practice as an area for development and the value of external evaluation and mentoring in the project.

‘One of our aims was to bring a more measured approach to projects and adopt a more critical and reflective understanding. External evaluation and mentoring has been helpful; an external observer can take an objective overview, without which I suspect that progress and learning would not be captured in such a coherent and measured way.

It is in fact, very reassuring to have this outside viewpoint; that can pick up on our strengths and weaknesses and help to unpick why something works or doesn’t. Mentoring has been very helpful, because of the quick expansion there has been a lot to take on board for all of us and again having someone who has the experience and objective viewpoint means that we can take a more outward looking approach to the way that we work as a team.’ Hetty Dupays, Arts Programme Manager

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The artists clearly articulate their practice where they respond to the needs, interests and skills of the participants and how they are changing the perception of arts activity in the hospital. Key themes based on values of the programme are kindness, change, transformation, unexpected moments of joy and playfulness.

‘When the facilitator truly follows the child’s lead and becomes immersed in their story and their ideas, transformations take place. The playroom is a safe place where children have the opportunity to be themselves. It is not unusual for patients to request a Wednesday visit giving them the opportunity to take part in a workshop. The value of process over outcome is beginning to be more recognised and understood.’ Edwina Bridgeman, Visual Artist in Residence ‘The sometimes forgotten joy of creating things is revived and taken home to be continued and there is lots of laughing.’ Edwina Bridgeman, Visual Artist in Residence

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hospital environment, but seeing the positivity of the pARTicipate project and the potential for creative programmes has opened my eyes. I have learnt a lot from the outcomes of this film and I would collaborate with the hospital on creative projects in the future if the opportunity arose.’

Georgie Epps, student, Bath Spa University School of Art and Design ‘I’ve learnt things that I didn’t know I needed to learn’ Lucy, Volunteer g. To be recognised for our quality service by external organisations and the community that we serve.

Continued Professional Development Staff training and development has been prioritised for the creative team, artists and volunteers the following ways: •

• • • •

The team has built a strong relationship with Chelsea & Westminster Hospital arts programme and they are interested in collaborating further.

The team is undertaking research into arts participation, dementia and the environment.

The manager prioritises a budget for specialist training clinical and artistic CPD. The team has attended Arts & Health courses and conferences.

The team were given opportunities for professional development with leading researchers including Francois Matarasso.

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f. To encourage younger people to take part in arts and cultural activities, for example through student placements and involvement with schools.

The programme has engaged 13 volunteers through links with Bath Spa University and Bristol College. The programme has had an impact on their development and given them valuable experience. The AATH team has also established a new volunteering programme for people from the local community which has given the creative team valuable support and additional expertise.

‘All round, this live brief opportunity proposed by the hospital has been a completely invaluable experience for me, and further more a great beginning to my design career. As a designer I would have never thought that of working in a

There have been a number of opportunities to share the work with external organisations and the wider community to date. These opportunities have arisen through networks and relationships developed by the creative team.

• • •

• • •

Artwork created by children in the play room was exhibited as part of Edwina Bridgeman’s exhibition Ship of Fools at Victoria Art Gallery.

RUH Central Gallery: April-June: pARTicipate Exhibiton A glow moment and textiles were included in Glow, a 5x5x5=creativity exhibition at 44AD Art Space in March 2015 and in the House of Imagination exhibition in April 2016.

Organisations (i.e. Bath Folk Festival/Club) collaborate on AATH programmes.

Paper Birch was a project set up by two MA Textile students at the Royal College of Art pARticipate Film

‘Live Music Now and Bath Folk Club musicians perform around 12 times per year as part of the Soundbite programme .. activities enable participants to access the many therapeutic, social and emotional benefits of engaging with live music. This connects directly with the pARTicipate programme, so working together helps us both to achieve our aims .. It’s a pleasure to work with such a committed and professional team.’ Ursula Crickmay Live Music Now Partnerships Alongside the need to further embed the work within the RUH it is also important to raise the profile in the community. The profile of the work has expanded by strengthening existing and developing new partnerships: UNICEF Bath Child Friendly City campaign through the ongoing partnership with 5x5x5=creativity (to link with Bath’s Child Friendly City pledge).

B&NES Arts Development as strategic partners to meet the themes for the B&NES joint health and wellbeing strategy: • Helping people to stay healthy.

• Improving the quality of people’s lives.

• Creating fairer life chances.

Bath Spa University and Bristol City College placement opportunities and mentoring for music and visual arts students.

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6. RECOMMENDATIONS Bath University: Public Engagement RUH Dementia Strategy Group and the RUH’s ambitious pledge to become a leading Dementia Friendly Hospital by 2020 (including visual arts and music).

Bath Folk Club who have been performing for several years Arts & Health Southwest networking Cultural Forum for the Bath Area advocacy ‘In a broad context, the embedding of the programme has helped to raise the profile internally at the RUH and also externally; not only through arts related contacts but also the Care Quality Commission who observed an Artsparks workshop and when they asked a consultant what made the Children’s Ward special, she replied - the artist’ Hetty Dupays, Arts Programme Manager

Working closely with the creative team the recommendations are to: • • • • • • • •

• •

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engage directly with patients, managers and healthcare staff to support everyone’s sense of being well and their overall quality of life. further embed the work on the children’s and OPU wards and work more closely with Dementia Coordinators. prioritise continuity to ensure confidence and familiarity between artists, patients and staff. work with clinical staff to support a full understanding of the role of the artist on the ward and how best to support patients. set up a clear referral service with attached costs. include professional development for clinical students, young doctors and nurses. continue to develop the volunteer and student placement programme. raise awareness of the programme through publications (specifically the Playroom Book) as a resource for clinical staff and a celebration of the art programme. promote feedback from patients and families to demonstrate the impact of the project. share best practice from the sector with the wider RUH community.

Future opportunities include: • • • • •

linking with further city-wide opportunities. creating a public blog to promote the work. improving the environments of the wards in consultation with patients and families. considering the gender balance in the programme, offering equal opportunities for male and female patients. involving local schools in the development of the arts programme.

‘The most significant change has been the embedding of the programme. Having the continuity of three years funding will have many benefits. The mutual understanding of roles between the artist and clinicians has really developed over the past two years and will continue to strengthen. I am often asked to visit patients that the clinicians feel would particularly benefit from a creative session. These sessions allow young and old patients to talk and express themselves in a way that is unexpected but very helpful in a hospital setting.

The work is always patient led; responding to individual’s needs and these might range from encouraging a parent to let small child paint to working very closely with an adolescent who may be struggling with feelings of isolation, an eating disorder or a long term stay for mental health treatment. These golden opportunities can’t just happen; it takes time and is possible only through the gaining of trust.’ Edwina Bridgeman: artist in residence

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7. CONCLUSIONS ‘High levels of agitation, anxiety stress and even physical violence has substantially reduced and I am sure that the music and art is a significant part of that. Ultimately it’s good for the patient good for the carers and good for the hospital as it means that someone gets home better and more active than they were before they were in hospital which is always a challenge for our population.’ Dr Chris Dyer pARTicipate programme creates a safe and supportive space for patients to enjoy and express themselves through the arts. For vulnerable patients, adapting to a stay in hospital can be a very difficult experience. Young people are separated from family, friends and school, are often much less active than they are used to being and can find themselves feeling vulnerable and isolated.

This work has demonstrated clearly that creative arts experiences can provide an emotional outlet, enabling patients to make friends and strengthen relationships with peers and clinicians in a creative environment of mutual support.

The programme of work has shown that engagement in the arts helps young and old people to feel more at home, reduces stress and anxiety and aids recovery and wellbeing. These ‘unexpected’ creative opportunities enable social interaction, which can be lacking in an acute clinical setting, more often seeming to be a threatening and alien experience. The focus on embedding the importance of creativity into the daily routine of the wards and building strong relationships with the staff has resulted in a mutual understanding of each other’s roles.

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Through participating in the arts workshops patients are often delighted to discover new skills and usually experience a sense of pride and achievements in work that they have made with the artist - the impact on confidence and self-esteem is effective and long lasting, impacting far beyond the clinical setting. Staff have witnessed how the artists’ presence impacts positively on ward environment and routine. Carers, staff, visiting students and volunteers have participated in the workshops and this sense of community and getting involved raises everyone’s spirit. Patients, visitors and families have witnessed the artwork created in public exhibitions.

Evidence and feedback from young patients as well as from parents and carers of elderly patients underlines the importance of art and music to effect a direct change on the patient experience helping them to realise some of their creative potential and aspirations. Children are reassured by the process of creating and making alongside others that care.

‘ ..It just makes the place happy – happy people get better quicker’ John Willis Combe Ward Manager

The Art at the Heart team has developed a signature approach to working alongside patients, visitors and staff characterised by kindness, creativity and empathy. The artists really listen, observe and respond the different needs of each individual. The invitation to experience and participate in the arts has shown clear evidence of improved motivation and engagement of those involved. An improved sense of wellbeing through participation in the arts is a vital aspect of this work. The pARTicipate programme has shown the potential of positive hospital experiences to inform ‘being well’ and enhanced all areas of the hospital experience.

1. A demonstration of creative, compassionate care and the role of the arts in supporting health and wellbeing.

The creative team has grown through working together, with professional development, mentoring and creative approaches to evaluation, deepening their understanding of their roles and their effect on patients. The film is a testament of this (see www.ruh.org.uk/participate). All the participants have been engaged in a shared enquiry that values everyone’s contribution. The team have developed new networks and shared opportunities for supporting each other’s work. The legacy of this work is far-reaching.

The pARTicipate programme highlights the importance of the the arts in promoting a sense of value and well-being among patients, staff and visitors. In summary the key learning outcomes are as follows:

2. Creating a safe space for effective, empathetic and creative interventions.

3. Valuable one-to-one time for artists to work with patients and their families, giving patients a choice and a voice in forms of expression.

4. Distinctive working approaches of artists and play specialists and mutual support from clinical specialists.

clinical staff; an improved understanding of working with colleagues, helping patients and supporting their families, friends and other hospital visitors.

6. Transparent ethical practices especially in relation to Dementia awareness.

7. Involving family members in the creative process.

8. The importance of group engagement and integrated professional development.

9. The value of on-going reflection, evaluation and mentoring, the documenting and collation of stories and ‘glow moments’ via the blog and with regular meetings.

10. The ripple effect: long term effects of this work on wider working practices.

‘Use of the arts in healing does not contradict the medical view in bringing emotional, somatic, artistic, and spiritual dimensions to learning. Rather, it complements the biomedical view by focusing on not only sickness and symptoms themselves but the holistic nature of the person. When people are invited to work with creative and artistic processes that affect more than their identity with illness, they are more able to “create congruence between their affective states and their conceptual sense making.” Through creativity and imagination, we find our identity and our reservoir of healing. The more we understand the relationship between creative expression and healing, the more we will discover the healing power of the arts.’ (Staricoff et al 2003)

5. Time to invest: establishing relationships with

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8. REFERENCES Bancroft S, Fawcett M, and Hay P. (2008) Researching Children Researching the World:5x5x5=creativity Trentham Books MacLure, M. (2010) The offence of theory Journal of Education Policy, 25:2 Schon, D. (1983) The Reflective Practitioner: How professionals think in action. Basic books.

Staricoff R.L. (2003) Arts in health: a review of the medical literature www.thesah.org/doc/music%20 and%20science.pdf.

www.ruh.nhs.uk

www.5x5x5creativity.org.uk