3 Improved effectiveness in delivering and evaluating arts for health programmes
Submitting InstitutionUniversity of the West of England, Bristol
Unit of AssessmentSocial Work and Social Policy
Summary Impact TypeSocietal
Research Subject Area(s)
Medical and Health Sciences: Public Health and Health Services
Studies In Creative Arts and Writing: Performing Arts and Creative Writing
Summary of the impact
's research has improved delivery and evaluation of arts
and health programmes for clinical and non clinical populations. It has
supported the development of arts on referral schemes and has led to more
effective use of arts to benefit patients and staff in mental healthcare
settings. It has enabled arts consultants Willis Newson to deliver much
needed evaluation services and has shaped CPD provision, enabling artists
and commissioners to develop and evaluate arts programmes. Her participation
in national and international policy debates has contributed to the
formulation of policy and strategy of arts organisations, healthcare
providers and third sector organisations.
The underpinning research has generated findings in two areas: benefits
and risks of arts participation; and developing evaluation methodologies
for arts and health. Research undertaken in 2002 at UWE by Norma
Daykin (Senior Lecturer 1993-1996, Principal Lecturer 1996-2001,
Reader 2001-2006, Professor 2006-present) identified benefits and risks of
creativity for professional musicians (ref 1). These can transfer into
therapeutic environments, including negative beliefs about creativity that
shape inclusion and exclusion. From this followed a study in 2004 with
Leslie Bunt, Professor of Music Therapy at UWE, which demonstrated the
high value that patients place on expressive creativity as well as the
complexities of using arts with vulnerable groups (ref 2).
This initial groundwork prompted further research with the UWE research
team of Stuart McClean (Lecturer 2000-2004, Senior Lecturer 2004-present),
Paul Pilkington (Senior Lecturer 2006-present) and Nick de
Viggiani (Lecturer 2001-2002, Senior Lecturer 2002-present) with Daykin.
In the evaluation of ArtLift (2008), commissioned by Arts Council England
and Gloucestershire County Council (ref 3), Daykin, Pilkington
and McClean reviewed an innovative programme of 15 artist residencies in
GP and mental healthcare settings across Gloucestershire. The research
evidenced benefits, including reduced anxiety and social isolation, of
participation in activities such as poetry, ceramics, drawing and
painting. The research showed which patients benefitted most, including
those with mild to moderate mental health problems and physical conditions
such as Parkinson's Disease. The findings included detailed
recommendations for improving quantitative and qualitative evaluation
practice, highlighting the need for training and support for artists and
health practitioners (ref 3).
A long-standing partnership with Willis Newson Arts Consultants has
generated findings to both areas described above. Daykin led the
evaluation of `Moving On', (2005-7), a programme provided by Avon,
Wiltshire Mental Health Partnership NHS Trust. The study, commissioned by
the Estates and Facilities division of the Department of Health, used
qualitative methods to investigate the impact of arts on patients and
staff in mental healthcare environments (ref 4). It revealed the role and
contribution of healthcare environments in enhancing patient care and
staff morale, illuminating best practice in using creative arts to address
stigma. The study demonstrated the value of qualitative methods including
documentary analysis, interviews, focus groups and arts based methods such
as photography (ref 4).
Evaluation methods were the focus of an evidence review led by Daykin
and de Viggiani, commissioned by Youth Music in 2011. This
assessed evaluation practice across a wide range of participatory music
making, identifying a strong need for improved methodological
understanding and appropriate evaluation tools. This has guided the
Knowledge Transfer Partnership (2010-2012) between UWE and Willis Newson,
led by Daykin (ref 5). In this, methodologies from previous
studies have been re-examined for potential relevance to arts and health.
These include consensus techniques developed by Daykin in an
earlier study of best practice in user involvement in cancer services, led
by Avon, Wiltshire and Somerset Cancer Services (ref 6). In this, Daykin
refined the use of Nominal Group and Delphi techniques for engaging
diverse health communities in service evaluation.
References to the research
1. Daykin, N. (2005). Disruption, dissonance and embodiment:
creativity, health and risk in music narratives. Health: An
Interdisciplinary Journal for the Social Study of Health, Illness and
Medicine 9 (1), 67-87. http://dx.doi.org/10.1177/1363459305048098.
oUTPUT FROM fACULTY-FUNDED research: Daykin, N. The impact of
illness on the creativity of musicians. UWE, Bristol, School of Health and
Social Care, September 2002-August 2003.
2. Daykin, N., McClean, S. & Bunt, L. (2007). Creativity,
identity and healing: participants' accounts of music therapy in cancer
care. Health: An Interdisciplinary Journal for the Social Study of
Health, Illness and Medicine 11 (3), 349-370.
Outcome from Faculty funded research: Bunt, L. & Daykin, N.
Survey of music therapy provision and music activity in supportive cancer
care. Funded by the Music Space Trust and the Faculty of Health and Social
Care. December 2004 - December 2005.
3. Daykin, N., McClean, S. & Pilkington, P. (2008).
Evaluation of ArtLift: A Partnership Arts and Health Project. UWE Bristol,
Arts Council England, Gloucestershire County Council. Available from:
Outcome from commissioned research: Daykin, N., McClean, S. &
Pilkington, P. Evaluation of ArtLift: A Partnership Arts and Health
Project. Gloucestershire County Council/Arts Council England, September
2007 - August 2008, £8,000.
4. Daykin, N., Byrne, E., Soteriou, T. & O'Connor, S. (2010).
Using Arts to Enhance Mental Healthcare Environments: Findings from
Qualitative Research. Arts and Health: An International Journal of
Research, Policy and Practice 2 (1), 33-46.
Output from: O'Connor, S., Daykin, N., Soteriou, T. & Willis,
J. Building on the Evidence: Qualitative Research on the Impact of Arts in
Mental Healthcare. Estates and Facilities Division, Department of Health,
September 2005 - August 2007, £107,709.
5. Daykin, N. Attwood, M. & Willis, J. (2013) Supporting Arts
and Health Evaluation: Report of a Knowledge Transfer Partnership. Journal
of Applied Arts and Health. Journal of Applied Arts and Health 4
(2), 179-190. http://dx.doi.org/10.1386/jaah.4.2.179_1.
Output from a Knowledge Transfer Partnership funded by the Department of
Health and the Technology Strategy Board, October 2010 - September 2012.
6. Daykin, N., Sanidas, M., Barley, V., Evans, S., McNeill, J.
Palmer, N., Rimmer, J., Tritter, J. & Turton, P. (2002). Developing
consensus and interprofessional working in cancer services: the case of
user involvement. Journal of Interprofessional Care 16
Output from commissioned research: Barley, V., Tritter, J., Rimmer, J., Daykin,
N. & Turton, P. Developing and evaluating best practice for user
involvement in cancer services. Dept. of Health, 1999- 2001. £381,194.
Details of the impact
The ArtLift evaluation guided new arts on referral services in primary
care. On the strength of it, £200,000 was awarded by NHS Gloucester for
art groups reaching approximately 780 patients up to July 2012. The scheme
is now embedded in clinical practice, funded by the Clinical Commissioning
Group, with up to 60 patients receiving ArtLift `treatment' at any one
time (source 1). The lead GP from Walnut Tree Surgery, acknowledges that Daykin's
research was key to persuading doctors and funders to continue and enlarge
on the work. Because of the evaluation, follow-on activities are targeted
at groups that benefit the most. A wider debate was started about the
importance of art and, `how we need to de-medicalise mild to moderate
mental health issues' (source 2). The research is an acknowledged
influence on work in other localities, such as Bristol's ArtShine inner
city arts on referral scheme (source 3).
The Moving On evaluation brought together a multidisciplinary team of
clinicians, artists and service users who carried out its key
recommendations, securing charitable funds (2009) to establish a
participatory arts project at a large Bristol NHS mental health hospital.
A poet, a musician and two visual artists each delivered successive
residencies for approximately 50 patients drawn from adult acute,
rehabilitation and psychiatric intensive care wards, and an older adult
unit. These patients recorded music and created permanent artworks that
continue to enhance the hospital environment. The team created a toolkit
and resources so that therapies staff could continue with the activities
once the residencies had finished. The patients also took part in public
performances and showcasing events. These reduced stigma, generating new
community partnerships for the hospital. Therapies staff gained new
creative skills and resources, reporting their practice as invigorated by
the project. Senior clinicians and managers observed the positive impacts
of the arts process, being persuaded to maintain three artists' employment
on an ongoing basis. These impacts are documented in the report,
co-authored by Daykin with Barbara Feldtkeller, the Trust's arts
psychotherapy research lead (source 4).
The Director of Willis Newson acknowledges the significant impact of the
KTP research on organisational learning and business development (source
5). By generating a framework for arts and health evaluation and a
supporting library of tools, it supported the launch of a new consultancy
service (source 6) that has evaluated arts and health programmes for NHS
and Third Sector organisations, generating new income of £19,977 up to 31
July 2013. This has enhanced their reputation and strengthened their
eligibility for grant funding, supporting sustainability, with new income
of over £140,000 projected for evaluation services over the three years
from January 2014.
Local impact is acknowledged by LightBox Community Interest Company, a
Bristol based arts on referral project providing workshops to promote
mental wellbeing. Without the research, `we wouldn't have been able to
access the £200,000 funding we were subsequently awarded by BIG Lottery's
Reaching Communities Fund' (source 7). The research also, `enabled us to
critically appraise out achievements and weaknesses as an organization,
and use that knowledge to continually improve how we engage with the
public who access our resource' (source 7).
National level impact is also evidenced by Making Music, which represents
over 3,200 voluntary groups across the UK. The research findings generated
a CPD workshop on arts and health evaluation, well attended and received
at their national conference in September 2011. Consequently, they were
able to successfully launch a `Manifesto for Music and Wellbeing.' The
Head of Development acknowledges the significant influence of Daykin's
research on `the thinking behind many of our recent strategic decisions,
and the drafting of funding proposals ... for projects in this important
and largely misunderstood area' (source 8).
By identifying risks as well as benefits of arts, and linking this with
improved evaluation practice, Daykin's research is widely
acknowledged as encouraging arts organisations to adopt a more considered
approach to their work. This has ensured their sustainability, and has
generated wider benefits for the sector, through dissemination by local
and national advocacy organisations (source 9). Daykin's research
is acknowledged as helping to raise standards and increase effectiveness
of arts in health activity across the UK. Over the last five years, it
has, `influenced the way in which arts in health work is described, framed
and examined.... Over this same period, the field of arts in health ... is
much more widely accepted. This is not coincidental. Improved evaluation
and a better approach to defining the impact of arts activity on health is
a big part of the reason for arts approaches being adopted by clinicians
and healthcare providers' (source 10).
Sources to corroborate the impact
- The Art Lift Project can be accessed by referral by health
professionals as well as self referral. Patients can access it through
the website at: http://www.artlift.org/.
Testimonial available from UWE from a GP at the Walnut Tree
- The ArtShine Project can be accessed by patients through Bristol Arts
and Health Forum, a partnership of statutory and non statutory
organisations set up to promote and disseminate arts and health
information in the locality.
A full description of the programme characteristics can be found in the
evaluation report authored by the ArtShine team. This can be downloaded
- The full report (45 pages) is Daykin, N. & Feldkteller, B.
Arts@Callington Rd Project Evaluation Report. UWE Bristol/AWP NHS
Partnership Mental Health Trust. September 2009. ISBN:
978-1-86043-448-8. Available from:
A summary of the project is available from the Willis Newson website: http://www.artshealthandwellbeing.org.uk/case-studies/arts-callington-road-hospital-bristol.
Testimonial available from UWE from the Director of Willis
- Clients and the public can access information about the evaluation
service through the Willis Newson Website: http://www.willisnewson.co.uk/our-evaluation-service.html.
Testimonial available from UWE from the Head of Business
Development, Light Box Project CIC. Further information about the Light
Box Project can be found on their website:
Testimonial available from UWE from the Head of Development,
Making Music, The National Federation of Music Societies, London. The
Wellbeing Manifesto was launched at the 2011 conference that had health
and wellbeing as its theme and to which Daykin contributed a
practitioner workshop on evaluation. Further details can be found on the
website at: http://www.makingmusic.org.uk/our-work/music-and-wellbeing/conference-2011.
- An example is Arts and Health South West, a regional membership
organization with over 800 members. Daykin's research is
regularly disseminated through their website and has been used to guide
policy and strategy. There is a direct link to UWE's arts and health
research programme: http://www.ahsw.org.uk/research.aspx?id=56.
Testimonial available from UWE from Damien Hebron, Director of
London Arts in Health Forum, CAN Mezzanine, 49-51 East Rd, London, N1