An artistic approach to healthcare delivery

The power of the arts to improve many mental and physical illnesses is well known – we look at two initiatives that are using the arts to transform the delivery of healthcare.

In the United Kingdom an arts revolution is taking place. The NHS is using the arts as a part of treatment and engagement more and more to improve patient outcomes. And arts organisations are starting to enter the world of health as a part of their corporate responsibility.

Decades of research has shown that humans expressing themselves through the arts can help a broad variety of illnesses. According to research from Harvard University, engagement with arts can help people with dementia, depression, anxiety and even physical illnesses such as cancer.

East London Foundation Trust

Fifteen years ago, East London Foundation Trust (ELFT) was a very different organisation. It was a traditional mental health trust covering Hackney, Newham and Tower hamlets. Now ELFT has expanded to Bedfordshire and moved into community healthcare and primary healthcare service.

But it’s also very different to most NHS organisations. It describes itself as an NHS trust that provides out-of-hospital care for people in the community. This followed a conversation consultation with the public to improve the life of patients. The content of this consultation was different to the standard. ELFT wanted to not just engage with patients, but actually improve life for patients, carers and the communities they work with.

From this a trust strategy was developed with four aims: improve experience of care, improve population health outcomes, improve population health outcomes and improve value.

To improve population outcomes ELFT needed to engage with communities and arts has been instrumental to this. It has a big patient engagement department, as service users give so much to improving services and helping to develop them.

Alongside patient engagement, the ELFT team recognised the importance of bringing patients and staff together. They brought an acting improvisation troupe into the trust to bring patients and staff together. Staff became service users and vice versa. The impact has been huge, with ELFT seeing a massive improvement in how people engaged with services and how staff understood and therefore treated patients. The trust is now looking to define what coproduction truly is so it has a defined way of approaching and improving all services for patients.

See me as I am

ELFT doesn’t just use the arts as a part of its services, but also as an ongoing tool for staff, patient and community wellbeing. ELFTin1Voice is its combined staff and patient choir, which last year released an unofficial trust anthem ‘See me as I am’.

Stephen Sandford, the professional lead for Allied Health Professionals at the trust, said the opening lyrics are especially poignant: "See me as I am, step into my world, I'll help you know me, I'll help you help me". It is a reminder that medical professionals are experts but that they don't know everything; care works best when you engage with those you are treating.

ELFT has 50 arts therapists – there are so many because they know it’s an effective tool for helping patients. The trust’s approach is that words are only a part of the journey – the use of dance, drama, visual art and other arts really helps with psychological and therapeutic support.

ELFT has a series of tips to transform the way healthcare is delivered with the help of the arts:

• tap into the tremendous creativity of your senior leaders
• harness the energy and talents of your staff and service users - encourage them to bring all of themselves to work
• use your arts therapists – let in arts and culture partners
• use social media
• make it fun, challenging and stimulating with reflection

Arts supporting health – English National Opera

The English National Opera (ENO) has been a socially driven organisation since it was founded – led by Lilian Baylis, who had a vision of making opera accessible to all.

During the first COVID-19 lockdown ENO realised there may be opportunity to support communities and individuals nationally. ENO’s vocal experts worked with Imperial College Healthcare NHS Trust and, most importantly, with patients, to develop the ENO Breathe programme.

ENO Breathe is a breathing and wellbeing programme for people recovering with long-term COVID-19. Co-designed with respiratory specialists at Imperial, it's designed around de-medicalised tools for self-management of symptoms. The whole point of the programme is that the patient can carry on beyond its initial reach.

Singing is used as the vehicle to help people on their journey to recovery. The programme teaches participants to retain their breathing. Participants get a one-to-one session with a vocal specialist, six weekly group online workshops and access to a broad range of digital resources. These resources empower the patient – one person in the pilot said she had trouble breathing in the night so she accessed the digital resources, which helped her to breathe again without medical intervention. ENO Breathe puts the patient in the driving seat.

To join the programme patients are assessed by medical experts and referred by specialist long COVID clinics, all for free.

Illuminations

• NHS trusts should think beyond patient care and consider how their strategy and approach can help to transform and look after their local communities.
• Tap into creativity – be it with patients, staff or your leadership team. When things get tough, creative solutions can often provide ways to overcome difficulties.
• Arts organisations can and are developing ways of supporting the NHS without the need for medical intervention. NHS could work with local partners to consider how they might tap into these rich artistic resources.

If you have any questions or comments about this briefing, please call us on 07732 681120 or email advice@good-governance.org.uk.

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