AHSW's Director, Trustees, and Members reflect on various aspects of arts, health and wellbeing.

Reflections on Recent National Developments

Alex reflects on recent developments regarding social prescribing.

The Secretary of State for Health’s speech last week, at the King’s Fund Social Prescribing: Coming of Age conference, provided an opportunity for him to expand on his views on Social Prescribing.

He celebrated the role of the arts and culture:

“We know what the NHS does is life-saving. But what the arts and social activities do is life-enhancing. You might get by in a world without the arts, but it isn’t a world that any of us would choose to live in”

He quoted the key messages from the Creative Health report and used several examples from the case studies, such as the Royal Philharmonic Orchestra’s Strokestra project with Hull Stroke Services. Some people will be concerned that Matt Hancock refers to ‘free’ activities in the speech.

Social prescribing, is, of course, not just about the arts and culture and many social prescribing offers can be free, such as volunteer-led walking groups or community gardening, and some activities using an asset-based community development approach are free or low-cost. With professional providers, for example debt or housing advice, or arts organisations, the services or activities aren’t likely to be free to provide, although they are likely to be free to the users. He does mention the more clinical end of the spectrum: “In Gloucestershire, hospitals are now referring patients with lung conditions to singing sessions. Sounds counter-intuitive? But no. Singing helps people, even with chronic lung conditions.” and this is funded by NHS commissioning funds as part of the Gloucestershire Clinical Commissioning Group’s Social Prescribing Plus programme.

Whatever arts and cultural activities cost, we can probably assume they will be cheaper than drugs or attending hospital, and we need to find ways to more consistently prove that such savings are being made. One of the most interesting statements in the speech challenges the dominance and lobbying power of the pharmaceutical industry:

“Because social prescription reduces over subscription of drugs. It can lead to the same or better outcomes for patients without popping pills. And it saves the NHS money, because many of these social cures are cheaper or free. Now, drug companies may not like that. And you can bet this multi-billion pound industry will use every tool at their disposal to lobby for the status quo and convince us drugs are better than free social cures. That’s why we need a National Academy for Social Prescribing to be a champion for non-drug treatments. And it’s the role of the state to sponsor the treatments that are often cheaper, better for patients, and better for society.”

The All-Party Parliamentary Group on Arts, Health and Wellbeing will continue to work with the Department for Digital, Culture, Media and Sport (DCMS) and the Department for Health and Social Care, Arts Council England and other arms-length bodies, to encourage a joined-up approach to national policy, and work towards the acceptance of the recommendations in the Creative Health report. Last week I was at an NHS Providers round table, attended by Chairs and Non-Executives from approximately 30 NHS Trusts from around the country. Lord Howarth talked about the Creative Health report and recommendations; Rob Webster, Chief Executive of the South West Yorkshire Partnership NHS Foundation Trust and Claire Slattery, Cultural Services Manager at Calderdale Council, presented their work in Calderdale, which is part of the place-based approach to services championed by the West Yorkshire and Harrogate Health and Care Partnership, one of the new Integrated Care Systems (formerly STPs just to confuse things further). The response in the room was overwhelmingly positive. Of course, most of those present are already the ‘converted’, but it is becoming more and more the norm that these discussions are being initiated and led by health professionals, and, to my mind, this is a significant shift in the centre of gravity, and one we have long asked for.

Culture, health and wellbeing is not just part of social prescribing, or what happens in hospital buildings and NHS Trusts. The work can contribute to wide-ranging and deep-reaching change in the way we think about health and healthcare. Some of you may have seen the Heart of the Matter exhibition at the Royal West of England Academy in July. More recently it has been at the Copeland Gallery in Peckham. In Bristol I was struck by the physicality of the heart and of the sculptural forms and materials, the extraordinary medical technical skills of 3D printing combined with more ancient craft and making skills which many of us feel a longing for. The project provoked discussion about the control and containment that medical professionals need to provide in the face of complexity and bewilderment, and how this relates to risk, for artists, for patients, for clinicians. But most of all, it was the wonderment, the spiritual, the votive offering and the yearning for health and healing, with the heart as ‘mystical being’, which moved and entranced me.

In Peckham, other thoughts arose, of the Peckham Experiment, the Pioneer Health Centre, which promoted a vision that is very relevant to how we think about and manage health now. It was concerned with empowering people to take control of their own health and wellbeing and with giving them agency, a person-centred and whole person approach. With the creation of the NHS and the extensive centralised bureaucracy that entailed, there was no place for an experiment in Peckham led by independent minded and visionary doctors.

The Heart of the Matter, and much arts and health practice, is part of a current wave of change towards more person-centred rather than illness-based health services. In this space, the most advanced forms of medical technology: 3D printing, genomic medicine, Artificial Intelligence, share a common purpose with the everyday and the grassroots, community development and people-powered health as a social movement. Both allow us to better understand and empower the individual in the system. The Heart of the Matter is the perfect example of marrying the two – the technology that gives us the preciousness of each single heart, celebrating their diversity while advancing knowledge and accuracy of treatment; the participatory arts practice that enables patients and parents to craft their own narratives and find their individual story in the vast scheme of things.

Alexandra Coulter

Director, Arts & Health South West

November 2018

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