Background

This programme is the first of its kind in an acute hospital setting. It is part of the ‘Social Prescribing’ model most often used in GP surgeries, which offers non-medical ‘prescriptions’ that operate alongside existing treatments for health and wellbeing. It links patients with each other and with community programmes to help them manage conditions (see attached document).

Our Pilot Study

A pilot programme at North Bristol NHS Trust (NBT) has demonstrated that participating in arts activity alongside others with similar conditions provides patients with expressive and creative tools to help them better cope with health conditions, improving quality of life and reducing hospital re-admissions. It has also demonstrated that after taking part in this short intervention, patients want to continue to meet to support each other and their own wellbeing.

Evidence indicates that Arts on Referral is particularly effective in helping patients take greater control of managing complex conditions. The combination of participating in an arts activity in a safe group setting eases depression, improves self-esteem and provides tools and motivation to build resilience.

The benefits and impacts might be subtly different for each patient group, but the principle is the same. High quality arts activity, creative expression and play, social support and a new experience lead to improved self-esteem, increased resilience, an ability to reframe ones situation and take greater responsibility or agency for self-management of health conditions. This, in turn, leads to patients wanting to stay connected to support each other.

It is particularly suited to supporting chronic, complex or ‘life style’ conditions and has been shown to help people going through difficult life changes as a result of a health condition.

The pilot study is currently on-going at NBT and a mixed methods evaluation will be delivered to monitor outputs and determine the impact of the project in terms of self-management and peer support.

We are particularly interested in exploring how patients’ stories can be credibly and robustly used as part of the evaluation process.  – how such stories can be ethically and robustly gathered and how they might be shared and disseminate

Sustainability

The support groups will be embedded alongside existing acute services with strong links to community services. Patients from North Bristol NHS Trust will be referred to 8-week arts programmes designed for specific conditions such as chronic pain, cancer, diabetes, dementia, COPD, fibromyalgia, ME and chronic fatigue.  Each programme will be specific to the needs of the particular patient group.

The arts workshops to which patients will be referred will be led by professional artists managed by the Trust’s arts programme Fresh Arts.

Referral leaflets will be produced and handed direct to patients by clinical referrers, be included in patient information packs and be available in waiting rooms.

Once referred, patients will be contacted to ensure that they are able to attend. Patients will be encouraged to visit the Fresh Arts Studio and to meet artists prior to the start. Access issues will be discussed and resolved to ensure there are no physical or psychological barriers to participation. Reminders will be sent to patients ensuring a high level of participation on an ongoing basis.

After taking part, patients will be encouraged to form small peer support groups and will also be referred to community-based arts workshops run by project partners.

Strategy

The programme will work in partnership with Community Navigators and Social Prescribing Signposters, the Southmead Development Trust, the Bristol Arts on Referral Alliance, wellbeing centres and GP services, in order to link groups to existing community services.

The programme supports the Trust’s goals around enabling patients as partners in care and a person-centred approach to health.

It has a strong fit with strategic health priorities locally and nationally. It will demonstrate that participating in the arts has a clinically significant impact on improved health. There is also a likelihood of it resulting in savings through fewer re-admissions, reduced medication or reduced GP visits, which would ensure its ongoing delivery.

As well as developing new clinical partnerships, it will support local partnerships across health the arts and the wider local community.

Co-production is built into the delivery process to ensure that the programme is accessible and appealing. Patients will work with artists to co-design activities to ensure their relevance and appropriateness and will help create publicity and referral materials to ensure they are relevant and enticing.

Strong partnerships will be at the heart of the referral process, supported through a range of activities with clinical staff. We will visit clinical teams and talk to staff, expert patients and volunteers. Artists will deliver taster sessions for clinical and support staff to ensure they understand the project and its benefits. Engaging staff in creative activity will support the project’s delivery and enhance staff wellbeing.