Art in healthcare premises

In reviewing “Rewarding Innovation in the Workplace” in January of this year we closed the article by noting that the Facilities Team at Wolverhampton City PCT included two arts coordinators, who were working on a job share and doing some very innovative work with what could best be described as “tired” premises. I promised then to take a deeper look into their work and the impact this has within healthcare premises. Subsequently the topic came up at a local professional meeting and there was so much interest I decided this warranted bringing the topic forward in my plan of facilities editorials for the magazine.
    
Art in hospitals has long been one of those topics that it appears only lip service is paid to. Over the years we have seen, often politically driven, small schemes to place art work (normally pictures) in hospitals to improve the patient environment. The problem is that the funding has only ever been short term and so the pictures become fixed and/or damaged and the impact is severely diminished and often the end result after several months is that they are removed as an eyesore.

Art projects
I had the privilege in the 1980s of being involved in two schemes to improve the patient environment by the use of art in a rather unusual way. While overseeing the maintenance of two local hospitals (one now closed and the other in the care of Wolverhampton City PCT) I was charged with recovering stained glass windows from two churches that were closing and installing them in the hospitals to make chapels for patient and visitor use. The first scheme was as one church was being converted into the then new Sainsbury’s store in the town centre. Just inside the ring road the site is still in use by Sainsbury with all the original window openings filled in with matching stone. The windows we retrieved (with support from Sainsbury’s if I remember correctly) were overhauled and resized by Maybury Brothers and then installed into the curtain walling of a reception room at the then two-year old Penn Hospital on the outskirts of the town. The transformation was amazing and the room very well used by patients, visitors and staff alike. The roll of colour into the room was superb and because of the internal glazing also spilled into the main entrance and corridor brightening those two rather utilitarian areas.
    
The second scheme was rather more challenging and sadly the building, and indeed whole site, is now in a massive state of disrepair having been dropped from the local health estate by The Royal Wolverhampton Hospitals NHS Trust. While not wishing to get into the whys and wherefores of the decision making process (and there is much local discontent) I really would love to know if they recovered the stains for onward use elsewhere. The Wolverhampton and Midland Counties Eye Infirmary sits on the western side of the city centre in the fork between two main roads as they diverge to their differing locations into Staffordshire. The infirmary was a well loved and respected service provider under the old Wolverhampton Area Health Authority when I worked there from 1979. Just towards the town centre from the infirmary St Marks Church was closed and being converted to offices for a large independent financial advisor who is still there today. We had the opportunity to retrieve some of the stained glass windows and again Maybury Brothers did a superb job of cleaning and refurbishing them ready for our use.
    
A new twin theatre suite was being built behind the main infirmary building and once commissioned I had the unenviable task of overseeing the conversion of the old theatres, including very rusty metal balconies and floor to ceiling metal framed windows, into a chapel. Our in house carpentry team built an alter rail and other furniture custom to the space and also frames for the stains which were installed with stripped, cleaned and painted metal framing. Just off the main corridor, the new chapel was well used by people of all faiths and as the sun tracked across the beautifully clear glass the colours flooded into the room and to say the least the end result was very pleasing – but I would say that wouldn’t I? I only wish I could find the photos and get them scanned to include here but sadly I cannot.

Positive impact
So my own personal involvement in these schemes has engrained in me the firm belief that appropriately used art of all kinds can and does have a very positive impact on the “patient environment” as we now call it. The provision of chapels and chaplains is an ongoing debate in healthcare but because of my involvement in local churches these two schemes were of great personal interest and granted me the greatest job satisfaction. However, this only addresses one area of art and it has been thrilling to see and hear of how art is again being used in my home locality for the benefit of patients and their families.
    
Before taking in some of the more recent schemes in the local area there is some guidance and encouragement in the use of art in healthcare premises and this is worth a look. The King’s Fund has been running a programme entitled “Enhancing the Healing Environment” and between 2003 and 2005 some 23 schemes were undertaken and they are reviewed in a very informative document jointly published in 2006 by King’s Fund and DH1. A series of roadshows were run around the country at the time to propagate the best practice derived from these schemes and some of the outcomes included guidance on colour choices for therapeutic benefit and art involvement for certain classes of patient. At about the same time a report was produced by DH and published in 20072. This report talks about how art in its various forms can positively contribute to key objectives relating to healthcare provision and health improvement. However, it also points out that although there was much being done, a great deal of innovation being shown and some high quality documents and information available through the web, this was not generally well know, publicised or made use of. With my own passion already declared I find it interesting to note that the report states:“When they (the materials and information) are (known about), they save time and effort and provide sound examples for others to use. Many have commented that they were most inspired and convinced of the need and possibilities by seeing live examples, either within their own organisation or elsewhere.”³

Awarding excellence
Within the Healthcare Facilities Consortium we have long been supporters and propagators of best practice within the facilities arena, effecting this through our workshops, day and conference events and our long established Benchmarking Club. This year as part of our drive to encourage innovation in the healthcare facilities arena we are sponsoring a new award in conjunction with Health Business – The Innovation in Facilities Management Award. No doubt more of this later but it is very interesting to note that the report makes the following recommendation: “The Department should establish a national award to promote the use of arts and health.”
    
With all this in my mind I spotted the shortlists for the HefmA Awards being made later this week⁴ and noted that it included the very people that had started my ears twitching in late 2009 when I met with their managers to review the impact that winning awards had on the Facilities Team; the arts coordinators, Natalie Jones and Ruth Harvey-Regan at Wolverhampton City PCT. I already had an interview booked with one of them to go through some of their achievements and aspirations.
    
One particular project that caught my eye was: ‘Snow Hill’ Sexual Health Clinic Refurbishment – Creating a brand identity for Wolverhampton Sexual Health Services. Knowing the building that was being used I knew that this was going to have been a real challenge and it is fascinating to see what has been achieved, but of course that is going to be very difficult to convey in an article like this.
    
Particular points of interest are in the community involvement. Natalie Jones, one of the arts coordinators, told me: “A series of creative consultation sessions with a graphic design company and PCT Consultant in Public Health Medicine enabled young people to participate in developing the ‘Think’ brand. They wanted to create graphic icons to represent each key sexual health service to make it easier to identify what services are available and where. Young people from across the city played a key role in the refurbishment of the Snow Hill Sexual Health clinic alongside creating a brand identity for Wolverhampton Sexual Health Services.”
    
A multi-agency partnership approach resulted in young people taking ownership of the project from the start and through extensive consultation with different stakeholder groups a youthful new brand identity was created. The brand name ‘Think’ was selected by the Youth Council from shortlisted options. The brand identity aimed to increase awareness of sexual health issues and increase access to NHS services available across the city and bring clarity to what is available and where. For me, apart from the brand which now emblazons the front of the building, one of the most striking features is the transformation of what I know to have been a dire corridor which was known by staff as “the walk of death”. This has been transformed with the use of light boxes on the walls containing landscape photography created by students Jon Crump and Mairi Turner from the photography department of Wolverhampton University. This gives the impression of windows in the wall and has made the long, narrow corridor bright and airy and far less depressing for staff and those who have to use it on the way to life changing consultations.
    
Away from this particular project the same principles have been applied to the refurbishment of various clinics and health centres showing a marked improvement in the premises. A partnership has been developed with Wolverhampton Arts and Heritage Service to enable the loan of museum objects from their local history collections to Penn Hospital for display in the main reception. The objects have been chosen by the Clinical Lead for Occupational Therapy for over 65’s. The museum objects will provide a stimulus for conversations in relation to reminiscence work with dementia patients, an example being a display on our local football club, Wolverhampton Wanderers – still in the Premiership. The project included a session at Wolverhampton Art Gallery led by a specialist Art Interpreter, an experienced member of the education team who helped a group of elderly adult inpatients from Penn Hospital to further explore the museums local history collection to encourage communication and sharing of memories – it also provided a day out in a safe environment for everyone involved.

Improving buildings
In late 2008 I wrote a Focus on Facilities Management⁵ and cited our local GP as an example of the future of healthcare premises. They were moving from a converted detached house into a purpose built medical centre and this has been very well received by their patients and the local community. Just after I took the photograph we used in volume 9.1 a piece of sculpture appeared on the walls of the new building and this to me is a shining example of how art can be used on the external of buildings to improve the impact the buildings have and also shows how the local community can be actively involved in such projects. The development project was managed by Primary Asset, part of the MedicX group.
    
An interesting aspect of the project was that as part of the planning requirements MedicX was asked to provide a piece of community art. MedicX commissioned experienced community artists, Karl Lewis and Sam Hale of Bostin Arts to develop the artwork with the Community. The building is located on Windmill Lane and consequently Sam & Karl identified a broad theme of ‘...on a windy day’ as this provided a wide but interesting concept to develop ideas for the artwork.
    
An initial art workshop was held with the pupils in Years 2 & 6 at Castlecroft Primary School, which is very close to the medical centre. Working with a variety of shapes, objects and books, and using a fan to simulate the wind, the children developed lots of exciting ideas. Drawing them on acetate these were projected onto an image of the building to discuss size and scale. Cutting out shapes and images in metallic plastic generated discussion about the different materials that could be used and how these would look on the completed building. Sam & Karl spent a long time considering the ideas generated by the school workshop and then from the images generated by the pupils developed seven designs for further consultation.
    
The seven ideas were presented and displayed at the old surgery waiting room, shown to patients and favourites were picked. The dandelion image was very popular, a familiar refrain was ‘However old you are it’s magical to see a dandelion lose its seeds and then watch them blow...’ A further workshop was held at the Windmill Community Centre with the over 50’s group showcasing the seven designs and again the dandelion emerged as the most popular. Following the workshops, the Castlecroft Doctors, Primary MedicX and the Architects West Hart considered the designs and after much discussion selected the dandelion which was then manufactured and erected on the building by Rowley Engineering of Stafford.
    
The artwork has generated lots of local interest with requests for information at the practice from proud grandparents of children who influenced the design. Craig Lord, development manager at MedicX, commented: “MedicX are very proud to have been part of a project which has enabled the local community to be involved with creating such a tangible and exciting outcome. Not only has everyone come together to provide such a fantastic piece of work, but it will be able to be seen for many years to come and give enjoyment to the local residents.”⁶
    
Sadly for me the senior partner at the practice declined to offer any view on this exciting piece of art on his own place of work.
    
In closing Natalie told me about a creative health education project that they have been running in conjunction with a number of local schools. The interesting thing about this project is that along with promoting exercise and healthy eating in line with the PCT strategic goals, it is also aligned to the “Eat 5 a day” national campaign for healthy eating and so is not just about the “look” of the facilities. Working within the schools the arts co-ordinators discovered that the children sometimes lacked enthusiasm for exercise, didn’t eat breakfast or had little understanding of what a portion of fruit really was. A grape for example was one answer. In helping the children’s understanding about this a series of fruit people were developed, with the children’s involvement, which showed how a handful of a fruit made up a portion. The resulting health promotion artwork has been displayed in the local health centres alongside other improvement works resulting on a much brighter and more welcoming environment. One spin off is that the art work displays draw people into the health centres so that they are now more familiar with the premises and so are more willing to attend when they have medical needs. Art and Health in action: I love it!

Notes
1. “improving the patient experience: celebrating achievement: enhancing the healing environment programme 2003–2005” executive summary available from the dh website under reference 4127234.
2. report of the review of arts and health working group. available from the dh web site under reference 073589
3. page 6 – section 8 of the above report
4. hefma awards: thursday 27th may 2010
5. health business volume 9.1
6. thanks to the team at MedicX for their input to this article