1. 1
Alder Hey Children’s NHS
Arts for Health Programme
2014 Service Evaluation
The Impact of The Arts on Healthcare
By
Sarah Siân Williams
Arts for Health Evaluator
Alder Hey Children’s Hospital

2. 2
Introduction
Alder Hey Children’s Hospital is one of Europe’s busiest hospitals, with over 270,000
patients each year and 250,000 members of staff. The hospital’s charity diligently applies for
funding to spend on projects, facilities, equipment and research. These projects must
adhere to given guidelines and often involve fundraising events and liaising with companies
to develop beneficial partnerships.
The Alder Hey National Institute for Health Research Clinical Research Facility works to
conduct first-class, patient-centred research to improve the health and well-being of
children and young people. This is done by supporting the provision of safe, high-intensity
studies including studies of complex new medications and interventions, including those
requiring inpatient, overnight care.
The Arts for Health Programme provides an extensive variety of participatory arts for
children and young people to engage in. These include music, digital art, dance, storytelling,
poetry and performance. Some of the diverse arts activities implemented by the Arts for
Health team have involved projects which use layered observations of the personal
experiences of those involved. This provides a great insight into the invaluable role of such
projects.
Within the present study, the researcher has measured the effect that Arts for Health
activities have upon hospital patients, their families and hospital staff. More specifically, I
assess their perceptions of their own emotional and physical states.
I have engaged with hospital patients, their families and hospital staff members, to gather
their authentic views of how the Arts for Health activities they have experienced have
impacted their experience of being in hospital.

3. 3
Method
Design
In light of the personal yet quantifiable nature of this study, a mixed method design is
employed. This utilises the features of qualitative and quantitative research and allows a
greater insight into the phenomena involved in creativity and health.
The present study has analysed the qualitative responses from participants using
Interpretative Phenomenological Analysis (IPA). The questions used to gather this data
focused upon the different elements to the participants’ thoughts and feelings and state of
mind and body as a result of participating in Arts for Health activities. Semi-structured
interview schedules were produced for the staff members, whilst questionnaires with a
qualitative section were used to gather responses from the patients and their families.
Materials
Semi-structured interview schedules were used to gather responses from staff members.
These included open-ended and closed-ended questions to obtain data which is both in-
depth data and simple to display.
The researcher engaged with patients and their families on the hospital wards and waiting
areas to develop a dialogue with the participants along with collecting responses using a
questionnaire. The questionnaire included both closed-ended and open-ended questions to
provide a more accessible format for young patients.
Questionnaires were given to patients and patients’ family members to obtain feedback
when medical procedures or practical elements of hospital life limited the ability for the
researcher to engage with these individuals.

4. 4
Participants
Since it is essential to consider the effect of the Arts for Health programme on all individuals
involved, the participants of the present study consist of three distinct groups. These groups
are hospital patients, hospital patients’ family members or carers and hospital staff
members.
This variety of participant allows the research question of how the arts impact healthcare to
be addressed from as many angles as possible.
Data Collection
A semi-structured interview schedule was used to gather data from staff members. This
involved a mixture of open-ended and closed-ended questions.
A questionnaire was utilised for collecting data from patients and their family members. The
questionnaire predominantly consisted of closed-ended questions to provide a more
manageable source of communication for young patients and busy parents. The nature of
hospital life, comprising medical procedures and barriers to communication, meant that a
simple closed-ended question was often advantageous for patients and family members
alike. An open-ended question was also involved for a comprehensive view of their
experience.
Analytic Process
Notes were made with each analysis of the transcript, and themes were then created as a
result of the features that were initially identified. This procedure was also used by
O’Callaghan (2011) who found evidence that The Arts help children through the damaging
experiences of being diagnosed with and dealing with cancer. Connections were then made
between themes to create a clear explanation of each case.
The next stage of analysis involved the creation of a summary table of structured themes.
Quotations from the interview transcripts were added to support each theme. A group label
was given, and within each group separate themes were created, with brief quotations and
references. The summary tables for each participant were integrated into a comprehensive

5. 5
list of main themes that reflect the experiences of the group of participants as a whole.
These main themes were checked against the transcripts to ensure they were grounded in
the data.
From these more general themes that apply to the group of participants, a connection was
made to the original themes and notes were made to the extracts.
All themes were described and their diverse expressions from different participants have
been explained. In order to demonstrate the use of these themes, quotations have been
given along with links between themes to illustrate the participants’ experiences

6. 6
Results
The following commentary outlines the findings of the study. Statistical charts are shown to
display the responses from each closed-ended interview question. Emerging themes from
the open-ended questions are defined, using quotations from the qualitative data
transcripts. All responses were transcribed verbatim by the researcher, which enabled full
engagement with the data.
Patients
Question 1: “Have you liked the arts activities?”
93%
7%
Have you liked the arts activities?
Yes
Don't know
Total patient
responses:27

7. 7
Question 2: “How did the arts activity make you feel?”

8. 8
Question 3: “If you did art with other people, did you feel close to people or
like other people were taking notice of you?”
70.37%
81.48%
64%
66%
68%
70%
72%
74%
76%
78%
80%
82%
84%
close to other people like other people were
taking notice of me
When involved in an Arts Activity, I feel:
close to other people
like other people were taking
notice of me
Total patient
responses: 27

9. 9
Question 4: “Have you enjoyed the arts activities?”
0%
96%
4%
Have you enjoyed the arts activities?
yes
don’t know
Total patient
responses: 26

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Question5: “Please tell us anything else you want to about taking part in the
arts activity?”
Communication
“Even though he was very shy, he loved singing along”
Here we can see how a barrier of shyness has been surmounted, leading to a medium of
self-expression which previously seemed unattainable.
“I sang with Mohammed and it was great”
“I like playing the drums and so does my sister.”
The process of bringing people together is identified here and interacting in a way different
from the verbal communication which we are saturated with in regular hospital life. This
healthy expression and uniting of individuals is valuable in a healthcare environment where
isolation can be an issue.
Happiness
“It was great fun.”
“A lovely way to put a smile of anybody’s face”
“She [the Arts for Health practitioner] was nice, the lady, and made me feel good and
happy”
“The storyteller and characters made me laugh”
These quotes support the importance of adding joy and positivity to the lives of hospital
patients.
Alleviating difficulties
“It made me feel special and happy. It helped me because I was feeling lonely and bored and
then I did the leaves and trees which distracted me”
“A brilliant distraction, thank you.”
Boredom, loneliness and anxiety are only a few of the difficulties faced by those in hospital.
The Arts for Health activities can help to provide an external point of focus and relief from
pain.

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Confidence
“Before my boy was encouraged to join in with this activity, his confidence was low and he
struggled interacting post-op. After the session he was on top of the world, mobile and
super-charged with confidence.”
It is clear that self-confidence can be generated by Arts for Health activities. The observed
shift from lacking to gaining confidence displays the impact of such activities on one’s sense
of self and perception of one’s own abilities. This process of engendering confidence links to
the additional themes of interaction and communication which are core to the Arts for
Health activities.
Improved Hospital Experience
“It has been really fun, I’d like more please. I’d like to listen to more stories by him because
he’s hilarious. Activities like this would be good on the orthopaedic ward where I had to be
for an operation.”
The enthusiasm expressed here by a child patient, highlights the value of Arts for Health
activities within the healthcare system. Child patients conveyed their interest in more Arts
for Health activity which emphasised the important role this can play in patients’ hospital
stay.
Recovery Speed
“He literally changed back to himself. I firmly believe that Arts are essential during
convalescence and with it children will recover quicker than without.”
The power of the Arts for Health activities to alter one’s identity and aid healing is expressed
here.

12. 12
Family Members/Carers
Question1 – “Have you noticedany changes as a result of the Arts for Health
activities?”
97%
0% 3%
Have you noticed any changes as a result
of the Arts for Health Programme?
Positive
Negative
None
Total
parent/carer
responses: 35

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Question2:“If [you answered]yes [toquestion1], please indicate where you
have found changes”
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
84.2%
100%
47.4%
68.42%
26.32%
31.58%
63.16%
68.42%
36.84%
57.89%
Changes observed by parents as a result
of the Arts for Health Activities
Changes
observed by
parents
Total
parent/carer
responses: 35

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Question 3: “Have you found the Arts for Health activities supportive?”
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Yes No Don't know
100%
0% 0%
Have parents found the Arts for Health
Activities Supportive?
Total
parent/carer
responses: 33

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Question 4: “Would you find more arts activities beneficial?”
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Yes No Don't know
100%
0% 0%
Would parents find more Arts for Health
activities beneficial?
Total
parent/carer
responses: 34

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Question 5:
“Please tell us anything else about being involved in the arts activity.”
Pain relief (for patient)
“It plays a very important role in taking children’s mind off pain….I would love more
activities like this please.” (Parent/Carer 1, Arts Activity: stories and music with John and
Georgina, Ward: L2)
Break and rest (for parent)
“…It gave me a break when I don’t normally get them for a very long time.”
(Parent/Carer 1, Arts Activity: stories and music with John and Georgina, Ward: L2)
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
I have found the
Arts Activites
Supportive
100% 100%
Have parents found the Arts for Health
activities supportive and would they like
to see more of these activities?
Parents'
Positive
Responses
I would find more
Arts for Health
Activities beneficial
Total
parent/carer
responses: 35

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Altered concept of time
“…Time goes by much faster than usual when there is music, stories and other activities”
(Parent/Carer 1, Arts Activity: stories and music with John and Georgina, Ward: L2)
“I have found this [the arts activity] supportive as it made me and my son laugh since it was
beginning to get boring on the ward waiting to see the medical team. The activity made us a
lot happier and the time went really quickly when listening to the story. My little boy was
really happy afterwards.”
(Parent/Carer 19, Activity: Storytelling with John, Ward: E3)
Mood change
“The activities really uplift the mood of both children and parents.”
(Parent/Carer 2, Arts Activity: Not disclosed, Ward: K2)
Coping with medical treatment
“They provide really positive experiences for the children who are coping with treatment
and the fears of hospital.” (Parent/Carer 2, Arts Activity: Not disclosed, Ward: K2)
“I think it is great to break up the TV viewing and boredom for your child when receiving
treatment. Anything to take their mind off things is worth it’s weight in gold. Thank you!”
(Parent/Carer 6: Arts Activities: Storytelling with John, Ward: D2
“My daughter was scared whilst having her bloods done on the ward. John did a fantastic
story and helped my daughter to feel better. More is needed in the waiting room on D2
when waiting around for an appointment.”
(Parent/Carer 16, Arts Activity: Storytelling with John, Ward: D2)
Anxiety relief/relaxation
“The one-to-one story telling was good. All of the children listened and joined in. It is a very
good idea. When waiting for a procedure it lowers anxiety levels. It gives you something to
focus on, which was brilliant for him [the patient] because he has a visual impairment.”
(Parent/Carer 5, Arts Activity: Stories with John, Ward: D2)
“It has helped my son to overcome his nerves and made him relax.”
(Parent/Carer 7, Arts Activity: Stories with John, Ward: D2)

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Environment change
“They are a really welcome distraction where you can forget for a while that you are in
hospital”
(Parent/Carer 2, Arts Activity: Not disclosed, Ward: K2)
Interaction/Communication
“I have found it [the arts activity] supportive, it encouraged my child to engage and take
part in the activity.”
(Parent/Carer 4, Arts Activity: Not Disclosed, Ward: C3)
Inclusivity
“We have experienced both the storytelling and the dance. The dance was when my son
was particularly ill and this therapy improved his mood greatly and helped him to attempt
more. The storytelling was great fun and everyone joined in. The dance was particularly
supportive.”
(Parent/Carer 9, Arts Activity: Storytelling and Dance, Ward: D2)
Engaging in Arts for Health activities can act as a channel to more opportunities, bringing
people together irrespective of their condition.
“I feel it lifts the mood on the ward to one of light-heartedness and fun. It includes everyone
and excludes no one. Everyone I have met through the Arts for Health Programme has been
passionate about their art form and wanted to make the patient's and family's stays the
best it can be. Their passion is then shared with the patients, families and staff making a big
difference. More please!”
(Parent/Carer 17, Arts Activity: Not Disclosed, Ward: C3)
Uniting people
“My son and I really enjoyed it and believe it is a brilliant idea.”
(Parent/Carer 10, Arts Activity: Storytelling with John, Ward: D2)
Families can enjoy something together in a time of difficulty.
“Grace has really enjoyed the activity again. She has been very engaged and participated
fully. She enjoys spending time with children who have the same condition as her and she
can share experiences. The activity increased her self-confidence, she enjoys the exercise.”
(Parent/Carer 20, Arts Activity: Breathe, Ward: F2)

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Creating
“[On behalf of child patient] It was really good fun with Georgina and making the song and
playing the instruments. Before this I didn't feel very happy or good but after it changed my
mood very quickly. I loved it! It was a very good laugh.”
(Parent/Carer 11, Arts Activity: Music and Art, Ward: C3)
Health gain
“Very helpful for the children as they are all asthmatics and it seems to put them at ease.
This is the most exercise she gets most of the time. Her confidence is growing due to this
programme.”
(Parent/Carer 24, Arts activity: Breathe, Ward: F2)
Accessibility
“It is brilliant knowing you can easily access the service – e.g. Harry struggling today – [his]
stats [were] down, [he was] given inhaler and support. This is invaluable otherwise [we
would have to go to] A&E. Great being able to chat to other parents in the same situation.
Harry says he now knows there are lots of Asthmatic children, I think it helps him feel
supported and normalises this. Breathe dance is great – two younger siblings join in and it
becomes a family activity, so Harry doesn’t feel the odd one out. This is the second time
Harry has done the programme, he really enjoys it and it is so reassuring to have someone
to come, where you can get checked out if there are any concerns. Thank you!!!”
(Parent/Carer 25, Arts activity: Breathe, Ward: Not Disclosed)
Arts for Health activities can generate closeness between family members, breaking through
isolation and individuals’ roles.
Reassurance and support
“Jack has really enjoyed this project and meeting all new friends with similar problems to
him. Although there has been no change medical wise, Jack has enjoyed taking part. It is
also good the fact that Jack can take part in these activities, knowing if anything was to
happen, he has the medical staff to deal with him straight away which is a God-send to us.”
(Parent/Carer 26, Arts activity: Breathe, Ward: F2)
“My son always enjoys the activities very much as it means he is able to exercise in a safe
environment and under supervision. This provides us with a sense of security and I feel
confident that if there were any complications, that we are in the right place to receive the
immediate attention that he would need.”
(Parent/Carer 29, Arts activity: Breathe, Ward: F2)

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The professional nature of the Arts for Health activities is highlighted here, with the staff
providing reliable and skilled support for parents of hospital patients.
Educational
Opportunity and hope for future
“The musician is brilliant. My baby loves to listen to the music and plays with the small
instruments. There aren't a lot of other Arts we have seen in the hospital so we really look
forward to Georgina's visits.”
(Parent/Carer 18, Arts Activity: Music with Georgina, Ward E3)
“I feel this project/activity was a great opportunity for the children. It gave them something
different to focus on and something to look forward to. It was nice for them to feel part of
something that other children in similar situations were part of. Twin Vision were fantastic
with the children and really involved them with the process teaching them along the way!
Whilst keeping it fun and interesting.”
(Parent/Carer 30, Arts activity: Twin Vision, Ward: Oncology)
A sense of belonging is suggested here, providing hope and educational value for those
involved.

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0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
An invaluable
patient
experience
A necessary
part of healing
A pleasant
addition
100%
83%
58%
Staff members'view of the Arts for Health
Programme within Alder Hey Hospital
Hospital Staff's View of
the Arts for Health
Programme
Total staff
member
responses: 13
Hospital Staff
Question 1: “Please rate how you value the arts within the hospital
environment at Alder Hey:”

22. 22
Question 2: “Please rate, from your own experience, how the arts for health
activities impact upon the patient experience:”
0%
20%
40%
60%
80%
100%
The Arts for Health
activities have
created major
positive changes
upon the patient
experience
It is an invaluable
patient experience
100% 100%
Staff members'experience of the Arts for
Health Programmeat Alder Hey
Staff members' experience of
the Arts for Health Programme
at Alder Hey
Total staff
member
responses: 13

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Question 3: “Please rate how the Arts for Health activities may or may not
support patients, please tick as many as apply:”
86%
88%
90%
92%
94%
96%
98%
100%
Emotional
support
Physical
support
Psychological
support
100%
91%
100%
How staff memberssee the Arts for Health
activities to support patients
Type of support
given to patients
from Arts for
Health activities
Total staff
member
responses: 13

24. 24
Question4:“Please rate how the Arts for Health Programme may or may not
support your own work:”
Total staff
member
responses:13

25. 25
Health
Holism
“The arts help patients to express themselves and release their frustrations, letting them
forget that they are in hospital for a while. Physically - this is huge!!! We have patients who
are anxious about moving and mobilising post op. They take part in sessions and are
mobilising by the end of the session.” (Lorna O’Brien)
The quote above illustrates the connection between physical and mental processes. Arts for
Health activities can promote relaxion of the mind which leads to physical mobility too. The
interconnectivity of every aspect of one’s being is honoured through Arts for Health
activities, with benefits to people’s psychological health, emotional state and physical
ability.
Mental health
“Twin Vision produced a video which produced a positive boost of self-esteem. Complex
needs patients rarely show positive reactions normally but with Georgina they smile. It
focuses on them as a person and not a broken leg. Mental health improved when they got
the boost that they needed, which is very special.” (Teressa Watkins)
Physical health
“The "Breathe Project" provided an opportunity for patients to engage in
activity/exercise/movement in a supported, safe environment with not only improvements
in their physical wellbeing but gaining confidence, making friendships and experiencing
support from other patients/parents as well as health professionals.” (Vicky Worrall)
Recovery and healing process
“At some time in their journey, almost all Alder Hey's patients will pass through the doors of
Radiology. Radiology is a busy department which unlike other areas, do not have any play
leaders. We have been extremely lucky to have on a number of occasions been involved in
the Art for Health Programme, most notably with Georgina Aasgaard the resident musician.
To observe Georgina interacting and involving the children in our waiting room is a delight.
The sheer pleasure on their faces when they get to play an instrument is wonderful. I feel
that this sort of experience should be an integral part of the healthcare environment to aid
the healing process.”(Hilary Stowbridge)
Self-expression
“I have enjoyed being part of the Arts for Health Programmes. The patients gain a lot from
the experience - not only helping to keep them occupied but sometimes experience things
that they may not have done before. It can help some patients express how they feel.”
(Michelle Ball)

26. 26
“I think it is a great way for the children to help with getting better and also they can show
their feelings” (Name not disclosed)
“Patients singing about being happy when they were really down before. It is a good
distraction” (Sue Ashley)
Quality of Life - Holistic
“In co-ordination / collaboration with Arts for Health the Asthma Nurses were able to
provide a dance project "Breathe" with MDI for children with Asthma/ Respiratory
conditions. This was a fantastic opportunity to provide a non-pharmacological approach to
asthma management and improve quality of life for patients who would otherwise struggle
to participate in any exercise/activities.” (Vicky Worral)
Adaptable - Child-centered
“Arts for Health is an invaluable project that I am very happy to access for all of the patients
I work with. It has been a pleasure to watch it grow and see how the children benefit from it
both in health terms and their wellbeing. It is another tool to use as therapy and to observe
the children's and young people's interactions. It is also something to look forward to.” (Lisa
Plews)
The fact that the Arts for Health Programme adapts to provide benefits to all patients,
makes it of huge value. The activites are centered around the child, catering to their
individual needs.
“I have seen it used for developmental aid, rehab patients, complex and special needs
patients. It works as distraction and fun. It is therapeutic and fun-giving, it breaks up the
day, bringing the outdoors in to them.” (Julie Sellers)
A broad range of patients are helped through Arts for Health, displaying it’s relevance to a
spectrum of conditions.
“Arts for Health provides valuable support and makes information accessible. It is child-
friendly, and the outcomes are focused upon the children. It gives lots of opportunities to be
involved in. I find it particularly supportive, especially the Arts Co-ordinator. Children are at
the heart of the Arts for Health Programme and Alder Hey is better for it.” (Sheelaugh
Greenslade, Patient Information Manager)
“It is relaxing and stimulating depending on the activity. It brings something different to
hospital days which are so long. Something external provides a different type of
engagement.” (Teressa Watkins)
Uniting People

27. 27
“Really positive experience, something different for the children. The beauty is bringing a
diverse group together. Music seems to bypass the difficulties and provides a total break,
focusing on something positive. It is really valuable and you can see the impact.” (Teressa
Watkins)
“Benefits to patients and families having the opportunity to meet others as part of the
project/group creating a very safe, supportive environment.” (Vicky Worrall)
Overcoming difficulties
Passion and fun into difficult situation
“The children, parents, carers and families enjoy relaxation and fun that music brings to
their stay in hospital.” (Patsy Ellery, Ward Manager)
“Happier environment, can make hanging around not so tedious e.g. magician/musician in
clinics.” (Lisa Plews)
Aids medical procedures
“It takes the pressure off parents. It is a good distraction for blood tests and other
procedures. A great distraction. More responsiveness as you can see a difference from
unsettled and anxious to relaxed.” (Catherine Taylor)
“Through the arts, patients are doing things they don't even realise they are doing. e.g. post
op patient in bed actually getting out of bed and mobilising. It helps to relieve parents and
staff of stress (calming music/funny stories). It creates a nicer, more relaxed environment.
Patients look forward to the arts visitors on the ward.” (Lorna O’Brien)
“It is part of the therapy programme for rehab, there is a relaxation and emotional element
to it.” (Julie Sellers)
“The Arts for Health projects are something we access when on offer. It is a very positive
experience for all and would be missed if they were to stop. Watching the children interact
and respond in a different manner to how they do in therapy is amazing. The pleasure that
children, families and staff get from the different projects in immense. It is a multi-tool
which can relieve boredom as well as aid therapy.” (Lisa Plews)
Environment
“Previous Arts for Health activities have enhanced the outdoor environment of the unit with
art work on the walls of the building.” (Anna Snelham)
“The lift by the ward to go to theatre - children made their own birds and a big tree so it was
colourful and nice when they go to theatre.” (Name not disclosed)

28. 28
Here are some examples of how the Arts for Health Programme has involved patients in
practical activity, physically changing the environment.
“I have seen children engage and get enjoyment. The impact upon parents in the
environment is clear, it has an interactive effect. The atmosphere lightens because people
look forward to it. It is a much needed distraction for parents.” (Sheelaugh Greenslade,
Patient Information Manager)
Staff support
Morale
“Music brings a smile to many faces and we wish that these music sessions continue for the
benefit to patients and staff.” (Patsy Ellery, Ward Manager)
“It adds variety, which is definitely beneficial for all of us. It is a team approach and makes
you think outside of the box. It is nice to see children in a different light with different
opportunities.” (Teressa Watkins)
“I feel that it can help my work as we can and do work as a team for the benefit of the
patient we can share ideas and thoughts I have also enjoyed being part of programmes I
have taken part in.” (Michelle Ball)
“Arts for Health has facilitated the opportunity for the Asthma Nurses to provide an
approach to managing patients with severe/difficult asthma, as well as giving them another
opportunity to support the patients/families in an alternative way.” (Vicky Worrall)
Practical tool for staff
Manages complex needs
“It is used to encourage children's movement and engage socially. It can be used one to one
and can be tailored to children's needs. It can also be used for groups, progressively and is
especially effective with individuals with Asperger’s.” (Julie Sellers)
“A master-class of getting through to children. Evidence is on Sue’s iPad. Parents join in on
the ward and cleaners dance. Georgina is showing me how to ‘do music’ sessions e.g. we
have ordered chime bars etc. to work with children.” (Sue Ashley)
“We have our own patients and are not ward-based. We work together with musician and
therapists and it complements our physiotherapy work.” (Catherine Taylor)
“It is a pleasure to work with the artists. It makes the patients' hospital experience more
positive!!! I have parents who are anxious visiting the hospital, I will ask the artists to work
with them and this works so well!!! There are times when myself and the artist will work
together to set plans/aims for patients during their stay.” (Lorna O’Brien)

29. 29
“As a play specialist it [the Arts for Health programme] was valuable to me in a practical
sense. Now I am responsible for the calendar of activities, it allows me to ensure a range of
activities take place. It is essential to Alder Hey.” (Julie Sellers)
“It has supported me in patient information, with awards such as the BMA Medical Book. It
allows me to open doors and minds - knowing that Arts for Health can support that person
to do that. Vicky is absolutely invaluable, she is always there and helps make it happen. It
allows realisminto ideas such as graphics, artists and we can support each other.”
(Sheelaugh Greenslade, Patient Information Manager)
Educational
Skills gained, creating, beyond the awareness of patients
“The patients have learnt new skills - developed existing skills. It has created a good
atmosphere on the ward. Calming in some cases and a learning environment in others.”
(Michelle Ball)
“As a class teacher on the Dewi Jones unit, there are limits to what we can provide our
children educationally. We strive to give them a varied and broad curriculum but we can't
replicate the opportunities and experiences that they would be getting if they were at
school. The Arts for Health programme enables us to enhance our curriculum provision
within the hospital environment. Most of our pupils would struggle to access arts-based
activities if they were on other premises and so our curriculum can be enhanced within the
safety and security of the hospital and with nursing and teaching support available
throughout. The on-site provision also means that we can be inclusive as our pupils can dip
in and out of the sessions if they're unable to manage the whole activity.” (Anna Snelham)
Access to culture
“As the people who provide Arts for Health projects are experts in their chosen activity, it
gives me the opportunity to offer the children and young people experiences on another
level e.g. music, dance and storytelling. It supports the work I am doing, being able to
observe the interaction of children and young people in a different way. It can change the
feeling in an environment turning it from tense to calming and relaxing. It has opened me up
to taking on different options and giving it a go.” (Lisa Plews)
New opportunites are created through Arts for Health activities, with people participating to
a degree that they feel comfortable with, creating a more relaxed environmen and a shift in
energy.
Variety of opportunities
“All children in hospital miss out on many opportunities and experiences that their peers
receive on an everyday basis at school. Our children on the Dewi Jones unit really benefit

30. 30
from the Arts for Health Programme. It gives them opportunities that they are missing due
to their, often long term absence from school. The sessions benefit our patients
educationally, emotionally and psychologically.” (Anna Snelham)
“In the case of the dialysis patients it opened up a new world around the chair space - they
were encouraged to move around the space and through photography explore their
environment. It has offered both emotional and psychological support to children who find
it difficult to cope with conditions.” (Michelle Ball)
Here we can see how new opportunities are provided to those involved in Arts for Health
activities. This creates a positive outlook allowing the future to be viewed in an optimistic
way. The creative activities can lead to further prospects as a result of welcoming the new.
External influences
“Georgina [musician]’s visits to the Neurosurgical ward are like a breath of fresh air. She is
an excellent person with a passionate heart for music and she is also someone fun.” (Patsy
Ellery, Ward Manager)
Independence - tool
“Engagement as a part of managing their [patients'] own health, engagement with parents
and clinicians. It can act as a conduit to something else. It gives a lot of patients’ confidence.
It provides a legacy to parents if the child has passed. It is child-centred but everyone
benefits. I would hate to think of not having Arts for Health.” (Sheelaugh Greenslade,
Patient Information Manager)

31. 31
Discussion
Creativity enables a part of the mind to be freed.
The Arts for Health Programme at Alder Hey Children’s Hospital delivers a consistently high
quality variety of interactive creative projects for patients regardless of their condition. This
study has shown the multitude of benefits reaped from the implementation of Arts for
Health activities. These benefits ripple into the lives of not only the patients, but their
families and staff members too.
It is essential to note the holistic nature of the Arts for Health activities. The present study
has found a multitude of benefits from The Arts for Health Programme, thus transforming
hospital life. Mental health, physical ability and emotional state have all been found to be
strengthened through the use of Arts for Health activities. Communication and self-
expression were found to be facilitated, surmounting the issue of isolation and enhancing
social skills. Elevated mood, confidence and relaxation were consistently reported by all
groups of participants. Additionally, physical agility and mobility improved in patients,
illustrating the how The Arts can impact all areas of health and is not restricted to one
capacity. The multiple benefits also show how Arts for Health activities are fully adaptable
and cater to the needs of the individual, including everyone and excluding no one.
The perspective of those involved in Arts for Health activities was shown to widen and
change, as opportunities are provided. An educational value is generated as individuals can
access culture and cope with their condition in a different way through use of the Arts. New
ideas and skills are developed which can provide a tool for patients, staff and parents to
utilise and encourage independence. Providing hope for the future and creating a shift in
energy, Arts for Health delivers support by bringing people together and focusing on
something practical and external to the medical procedures. This improves recovery speed
and helps to engender morale throughout the workforce and an enhanced quality of life for
patients and parents.
Research by Preti and Welch, (2011) found creative interventions to act as a sedative for
paediatric patients undergoing clinical procedures, indicating a less threatening
environment as a result of the creative implementation of The Arts. The findings from the
present study show that the anxiety surrounding medical procedures can be alleviated by
the use of Arts for Health activities. This not only helps patients but assists healthcare staff
by alleviating the tension surrounding conducting medical procedures.
The way that the human brain processes music is opposed to that of language (Koelsch,
2011) and since everyday life is saturated with verbal language, this new wavelength of
interaction creates a distinctive possibility for connection. This facilitates a shared
experience between the patient, staff members and family members.

32. 32
The creation of a new method of communication coupled with a reduction in anxiety levels,
hints at the multitude of effects that the Arts for Health programme has on Alder Hey
Children’s Hospital. The findings from this study also demonstrate how physical mobility is
improved by Arts for Health activities. Staff members report patients to relax mentally and
physically, this clearly displays the link between all aspects of our being and how the Arts for
Health Programme at Alder Hey provides a holistic approach to benefit all areas of the
patient’s health. This supports the array of research displaying the multitude of benefits of
musical interventions (Erkkila et al., 2011; Jones & Van de Eerden, 2008; Kusatz et al., 2005;
Letts et al., 2011; O’Callaghan, 2011; Sherratt et al., 2004).
The emphasis on joy, laughter and the speed of the patient’s recovery as a result of the Arts
for Health Programme, demonstrates how one’s entire being is enhanced. Individuals
concerned are raised to a higher level; not focusing on illness. This improves the hospital
experience for all involved. The interest expressed by patients to have more activities in
wards such as orthopaedics underpins the value of Arts for Health activities. Lazarus’ (1991)
transactional stress theory is substantiated here. His idea that stress depends upon the
meaning of a stimulus to the perceiver comes into play. Participants stated how patients’
altered view of their situation created a more positive outlook. Here, it seems clear the Arts
can change the meaning of a stressor to the individual perceiving it.
Participants in the present study explained how patients gained a new identity through the
use of Arts for Health activities as their confidence in their own abilities grew. It follows that
participants described patients as empowered to exist in a different way without being
associated with their condition or pathology. Winnicot’s (1971) theory of transitional
phenomena upholds the view that The Arts allow one to exist differently and thus the
present study supports this. Williams (2012) found this altered self-perception to be a result
of musical interventions, the present study supports this further by using a wider range of
participants including the patients themselves.
Family member participants of the present study expressed relief as a result of the Arts for
Health activities. The relief identified took many forms; from relieved physical pain to
relieved emotional pain and anxiety surrounding medical procedures, it all enabled a
stronger way of coping. The interconnectivity of physical, psychological and emotional
health is hinted at here, along with the highly treasured break that is provided for parents
by such alleviation of tension. This transformation occurs benefitting the healthcare service
and those who truly benefit from it. Parents and family members of patients also clearly
benefit by seeing their loved ones much happier as a result of the Arts for Health activities.
The support provided by Arts for Health activities was consistently pointed out by all
participants of the study. The uniting of people breaks through isolation often experienced
by patients and their family members. The experience of being in hospital and coping with a
condition is also normalised by this uniting of individuals. Bringing people together in this
way enables true change to take place. Ideas and thoughts can be shared more openly when

33. 33
people are united by such creative activities as that of Arts for Health. Staff members value
the element of teamwork and improved morale evoked by the injection of positivity brought
by Arts for Health activities.
The magnitude of health benefits derived from Arts for Health activities have been drawn
out by the present study. This spans from psychological support and emotional wellbeing, to
physical relaxation and mobility. The practical realismprovided by such activity provides a
tool for patients and staff to utilise. This tool can reveal independence and reduce
dependence on staff members. Since the principles of Arts for Health are child-centred, it
fully adapts to the needs of each individual. Therefore providing each person with a unique
experience tailored to their needs.
The transformation provided by the Arts for Health Programme is clearly phenomenal. It
enhances the health and happiness of those who it encompasses, making the healthcare
service a better experience for all involved. Given the current pressure on healthcare
services, the arts have the power to promote health, healing and happiness in all that it
touches.

34. 34
References
Jones, G. M. M. & Van der Eerden, W. J. (2008). Designing care environments for persons
with Alzheimer’s disease: Visuoperceptual considerations. Reviews in Clinical Gerontology,
18, 13–37.
Koelsch, S. (2011) Toward a Neural Basis of Music Perception – A Review and Updated
Model. Frontiers in Psychology. 2, 110-132.
Kusatz M., Ostermann T., & Aldridge, D. (2005). Auditive Stimulation Therapy as an
Intervention in Subacute and Chronic Tinnitus a Prospective Observational Study.
International Tinnitus Journal, 11(2), 163-9.
Lazarus, R.S. (1991). Emotion and Adaptation. London: Oxford University
Press.
Letts, L., Minezes, J., Edwards, M., Berenyi, J., Moros, K., O’Neill, C., et al. (2011).
Effectiveness of Interventions Designed to Modify and Maintain Perceptual Abilities in
People With Alzheimer’s Disease and Related Dementias. American Journal of Occupational
Psychology, 65(25), 505-513.
O’Callaghan, C., Baron, A., & Barry, P. (2011). Music's relevance for pediatric cancer
patients: a constructivist and mosaic research approach. Supportive Care in Cancer, 19(6),
779-788.
Preti, C. & Welch, G. (2011). Music in a Hospital: The Impact of a Live Music Program on
Pediatric Patients and Their Caregivers. Music and Medicine.
Sherratt, K., Thornton, A., & Hatton, C. (2004). Emotional and behavioral responses to music
in people with dementia: An observational study. Aging and Mental Health, 8, 233–241.
Winnicott, D.W. (1971). Playing and Reality. Routledge, London.
Williams, S. (2012). The healing power of music: An IPA of practitioners’ experiences
towards a unified musical intervention framework. Manchester Metropolitan University.

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Appendices
Appendix 1:
Hospital Staff Interview Transcript
Pat Devine, Play Specialist
“Georgina is a real asset; she has a lovely way about her and glides onto the ward. She
always asks me what the patients’ needs are. There are really poorly children on the wards
and the Arts for Health work that takes place really connects with them. The age of the
patient doesn’t seem to matter, even if they are a teenager, the Arts for Health work has
such a profound effect. When there is music on the ward, movements happen for children
who don’t normally do much.
With the money we have, we have ordered shakers of different sizes, keyboards, chime
bars, rain-sticks and “Soundbeams”, which guide movement in patients.
Parents of patients can be unsure at first, but their persona changes when the music and
arts take place. A child was distressed before theatre and the Cello was brought to her. On
another occasion, the Anaesthetist requested music to relax the patient because the same
noises were so beneficial before.
Georgina is so kind. She shares all of her instruments and cleans everything. Parents join in
too which is great to see. She always adapts the activity to the patients’ level. We are so
lucky to have Georgina, we love her to be here. Three children where in one bed playing the
Cello with their feet. Two pairs of patients were there too. It really brought people together.
Parents really do change their minds as they realise that it is a calming influence. [this shows
how it impacts themselves as well as their patients] It is a non-pharmacological drug. It
breaks barriers of culture and language. I would be lost without her. It supports our work
and helps us get children to theatre.
We have seen children improve. We see movement in long-term patients who know each
other and we don’t normally see movement in them. Patients who don’t normally pay
attention do with music.
[Music is also so useful as a tool to communicate as] A video was made showing a song for
the mother of a patient. There are also photographs for teaching. [Educational value]
There is the power of persuasion without being threatening. [Important tool to alter mind-
set]

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The orchestra has also provided opportunities for patients here and the use of singing bowls
and the patient’s own voice to make sound has a really useful value.
Hospitals should not be associated with negative things, we do what we can for children.
Creative play is how I find out about patients in ways that others don’t. It allows the child to
open up. Parents that don’t normally do things are helped to be more creative with their
own children through the Arts for Health activities.
There is such enthusiasm for the Arts for Health activities. Changes in patients are apparent;
we see children’s muscles relax. Staff and doctors are interested too, as the Cello was
requested by an Anaesthetist. There was a young boy who we had never seen laugh since
his time in hospital, who started playing the guitar in a music session and was laughing for
the first time. Georgina really is an asset to the ward and we would have her every day.
Patients can have a better recovery from music as they need less medication and less time
in hospital. There are brilliant photographs documenting their enjoyment of the arts
activities.”