Sunday, December 28, 2014

Use the arts to boost the nation’s health

A scene from The Nutcracker by English National Ballet at the London Coliseum. The company has run several programmes, including one for people with Parkinson's. Photograph: Tristram Kenton for the Observer

There’s a growing understanding that we cannot afford our health service as it’s currently constituted. A rising birth rate increases demand while every technological or pharmaceutical breakthrough spells a new waiting list. A rapidly increasing elderly population puts a strain on acute services and social care alike. And at the sharp end, visits to many GP surgeries and A&E departments have doubled in a decade, with patients routinely demanding antibiotics and anti-depressants.
The new chief executive of NHS England, Simon Stevens, set out last month how much more money the service will need just to stand still. Significantly, Stevens also pointed out that we spend more on curing obesity than preventing it. The implication is clear: we urgently need to explore new ways to promote wellbeing – a theme picked up by John Ashton, president of the Faculty of Public Health in his essay for the Arts Council’s recent publication, Create. He wrote: “Unhealthy people cost the taxpayer much more than investing in the kinds of activities, facilities and public environments that help prevent or ameliorate illness.” As it happens, quietly and with increasing effectiveness, medics and carers, health authorities and local councils alike are turning to the arts as one way to help boost the wellbeing of the nation. This is about prevention rather than cure. And, as ever with the arts and culture, it’s about enriching lives, too.

In Cornwall, the Baring Foundation and Arts Council England are funding everything from theatre and textiles to dance or drama in care homes. The director of arts for Health Cornwall, Jayne Howard, says: “Creative engagement for older people has been linked to greater mobility, greater social interaction, stronger appetite and a generally better quality of life.”

In Liverpool, local museums have developed House of Memories, an inspiring history project to help dementia sufferers capture and savour their past. And the South Staffordshire and Shropshire NHS Foundation Trust is promoting professionally led singing for people with Alzheimer’s. The Birmingham and Solihull Mental Health NHS Foundation Trust has partnered with the Birmingham Rep to create the Bedlam Festival of Ideas, involving those with mental health problems in drama and comedy. Walsall council is funding poetry and photography activities in a local hospice. In Kent, the Sidney de Haan Research Centre for Arts and Health has pioneered singing classes for people with respiratory conditions, carefully collecting the evidence of the results. In London, English National Ballet has run a number of programmes with their expert teams, among them is Dance for Parkinson’s, helping researchers investigating treatments for the condition. I’ve visited classes for people wanting to get fit at Dance East in Ipswich, and Dance Cheshire which runs dance and music classes for severely disabled adults in Chester (“Their best moment of the week,” a carer told me). You get the picture.

Some are now referring to this development as “social prescribing”. That may sound somewhat clinical. Perhaps the more elevated way to put it is that we should tend to the spirit as well as the body, and the arts can do both. I have sat recently with the national leaders of health organisations and this is now being taken very seriously. It will feature in future health policy because this is the direction we’re forced to go in. But it happens to be a good direction, socially and economically. Of course, there’s nothing new about the deployment of therapeutic remedies. But what is new is the widespread involvement of arts professionals in formal agreements with health authorities.

In Gloucestershire, Art-Lift is now funded by the local NHS, not the Arts Council. GPs can “prescribe” drama, music or painting to the patients attending their surgeries. One doctor told me, with a wry smile, that there is already better evidence for their efficacy than there ever was for Prozac. Again, in Cambridgeshire, Arts and Minds allows health professionals to refer clients direct to art workshops. University College, London has developed a three-year scheme actually called Museums on Prescription, which is being trialled in the south-east. It connects isolated, vulnerable older people to their local heritage; that is, to their own personal culture.

And there’s now an initiative called Books on Prescription, available across England. Books are recommended by doctors or other health professionals to support patients with particular conditions. In its first year it has reached 275,000 people providing an important source of help, particularly for those with mental health problems. .

If social prescribing is to be more widely and systematically adopted it needs to be seen to work. It needs to demonstrate it can reduce queues in GP’s surgeries and A&E and relieve hard-pressed mental health services and social care. All health spending is quite rightly subject to rigorous evidence testing. But one estimate of the effect of the projects already underway suggests that savings to the NHS alone could have exceeded half a billion pounds. Arts Council England will be funding more research into arts and health next year. And a new organisation, Aesop (Arts Enterprise with a Social Purpose), has been set up to pursue further projects with the requisite evidence bases. Their first is to investigate how dance exercise can help reduce falls among older people. Its founder, Tim Joss, stresses two key things: the evidence must be good and the art must be excellent.

What else needs to happen? In the debate about the NHS running up to the next election let’s make sure the case for arts and wellbeing is heard. There’s also much work to be done helping arts organisations and health authorities speak the same language. To that end the National Council for Voluntary Organisations is being funded by the Arts Council to help artists to secure health commissions, with training and online resources.

Medicine attends to the body, but the arts cares for the person. It’s clear that the health service now has to put greater resources into prevention. But this is a wholly beneficial imperative. The national and local government spend on arts and culture is around one 50th of the NHS budget. But it’s a small sum that does a lot of good. Not least for health and well being.

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