How creativity and culture are supporting people in institutions during covid-19

A couple waving at care home residents
Vamos Theatre - The Wednesday Wave. Photo: Graeme Braidwood

A new report, recommendations and collection of case studies of work reaching people resident in hospitals, care homes, hospices, prisons and other institutions during the pandemic, led by the Culture, Health & Wellbeing Alliance in partnership with Live Music Now, Music for Dementia, Music in Hospitals and Care, the National Criminal Justice Arts Alliance, the National Performance Advisory Group (NPAG) for Arts, Design and Heritage in Healthcare, Paintings in Hospitals and Performing Medicine. The report was published in April 2021.

Recommendations: for funders, commissioners and policymakers

  1. Celebrate, acknowledge, and learn from this work
  2. Support creative freelancers through the pandemic and its aftermath
  3. Invest in culture, health and wellbeing programmes and the partnerships that underpin them
  4. Support training and research that will help the cultural sector to address health inequalities
  5. Support training and research to help practitioners develop successful digital or blended approaches
  6. Increase flexibility, trust and accessibility in funding systems

You can read the full report here, and see all the case studies below. See coverage in Care Management Matters here.

Key points

Who was this work designed to support?

Most projects served more than one group of participants. The largest proportion of projects were designed for older adults in residential care (37%). Other key groups included people living with dementias (20%); adults in mental health institutions (20%); NHS staff, adults in hospitals, and young people in hospitals (17% in each case); people serving sentences (15%); and care home staff (13%). Most organisations aimed to reach both people they had worked with before the pandemic, and new participants.

How many people took part?

Respondents estimated numbers based on everything from direct one-to-one participation, to YouTube views, so it’s hard to reach a sensible estimate, but it seems likely an average of over 1,000 people benefitted from each project, albeit to differing degrees. Some work deliberately focused on small groups (Theatre for Life worked with 12 young people in Southampton Children’s Hospital, for example) and others aimed for a far broader reach (Live Music Now, for example, continue to reach thousands of people at care homes around the country).

What did the organisations do?

Just under half the projects featured online workshops, just over a third used pre-recorded performances, just under a third distributed activity packs or similar. Just under a quarter developed exhibitions, or coproduced artworks of various kinds with participants. The same number used live, online performance to reach their audiences. A fifth worked on exhibitions and a similar number created co-produced artworks. Other work was hugely varied but included activity packs specifically designed for staff, as well as postcards, radio programmes, phone-based workshops, outdoor performance and, when safe, one-to-one work.

What outcomes were the projects aiming for?

The common thread across all the work is culture and creativity as a social intervention – building on a growing evidence base documenting the relationship between creative practice and health and wellbeing in their broadest senses. The projects can universally be related to the Five Steps to Wellbeing: Connect with other people, Be physically active, Learn new skills, Give to others, and Pay attention to the present moment (mindfulness).

Within this, organisations aimed for a huge variety of outcomes. Just under half specifically aimed to improved participants’ wellbeing; over a quarter aimed to support staff wellbeing in institutions, although this was perceived as a knock-on effect of other projects, too. Over a third of projects were designed to tackle loneliness or isolation; a quarter spoke about supporting social or family connections.

Other outcomes included providing meaningful activity, skills development, challenging boredom, and building participants’ confidence. Much of this could be described as early intervention to prevent the onset of apathy and depression, to build a sense of feeling worthwhile. Some organisations also sought to develop health and care staff’s skill and confidence in delivering creative activities themselves.

Thank you to everyone whose case studies are below: AgeCymru, AirArts, Artfelt, Arts@StAndrew’s, Arts Together / Opera North, Arts Uplift CIC, Beating Time, The Box, Bright Shadow, CARIAD (Cardiff Metropolitan University), Creative Dementia Arts Network, Ex Cathedra, Funder Films CIC, Give a Book, GOSHArts (Great Ormond Street Hospital), Hearts and Minds, Keneish Dance, Key Changes, Live Music Now, Ludus Dance, Heads On (Sussex Partnership NHS Foundation Trust’s charity), Music in Hospitals and Care, Musical Moments, Novus, Odd Arts, Open Eye Gallery, Orchestra of St John’s, Orchestra of the Swan, Oxford Health Arts Partnership, Oxford Hospitals Charity, Oxford Playhouse, Paintings in Hospitals, Performing Medicine, Plymouth Music Zone, rb&hArts (Royal Brompton & Harefield Hospitals), Sing Inside, Southbank Centre, Spitalfields Music, Tyne & Wear Archives & Museums, University of Cambridge Museums, Vamos Theatre, Voices Across Time, and UCLH Arts and Heritage (University College London Hospitals NHS Foundation Trust).

Read our July 2020 report on creativity and culture for people shielding at home here.

Project: cARTrefu
Organisation: Age Cymru
Region: Wales
Designed for: Older adults' residential care

“This was so much fun. I thoroughly enjoyed it. We are going to do this activity tomorrow and build on it within the home. Feeling very emotional and relaxed.”

Project: A Grateful Heart
Organisation: Air Arts, University Hospitals of Derby and Burton
Region: East Midlands
Designed for: Adult acute healthcare

"Being able to include staff performing on the video was a very positive way to give back to them and for other colleagues to see their friends doing something positive and uplifting at a difficult time."

Project: Artfelt Anywhere
Organisation: Artfelt, Sheffield Children’s Hospital Charity
Region: Yorkshire & Humber
Designed for: Paediatric acute inpatients

“The patient packs …have been an incredible addition to our work. They look very professional and are far more entertaining than anything we had hoped for! Most importantly, the children are thoroughly enjoying using them and receiving age-appropriate packs unique to them.”


Organisation: Arts@StAndrew’s, St Andrew’s Healthcare
Region: East Midlands
Designed for: Adult and young people's mental healthcare

“Media production has proved most flexible, shifting from studio to ward working by means of a laptop. As a creative tool this has also proved effective and efficient in terms of managing hygiene in that it is a single piece of equipment that can be cleaned easily before and after each use.”

Project: Arts Together for Care Homes
Organisation: Arts Together / Opera North
Region: Yorkshire & Humber
Designed for: Care homes

“Initiatives like these are hugely appreciated at a time like this when both residents and staff are having to adapt to a complex situation. Having Tessa really brightened up everyone’s day and brought them together. It made such a difference being a live performance, and everyone appreciated being given the chance to enjoy a musical interlude from such a talented singer.”

Project: Love Music
Organisation: Arts Uplift CIC
Region: West Midlands, South West
Designed for: Older adults' residential care

All residents thoroughly enjoyed this afternoon’s choir practice the enjoyment in all their faces was so lovely to see.”


Project: Choirs Beating Time
Organisation: Beating Time
Region: West Midlands, South East
Designed for: People serving sentences in prison

"This project has been made possible by the skills and versatility of our music directors; existing relationships with prison staff which enabled us to discuss, agree and implement alternative services in necessarily very restrictive regimes; the drive of our Insider in HMP Birmingham (and Co-Director of Inside Job) to keep Inside Job going and help his fellow prisoners even when he couldn’t leave his cell; the flexibility and support of our funders to repurpose funds; and HMPPS who allowed flexible/mitigating services to be provided under their contracts and continued to pay suppliers."

Project: The Box on The Box
Organisation: The Box
Region: South West
Designed for: Care Homes

"All the residents immediately started to chat and reminisce following the session. We learned a lot. Some had worked in the victualling yard - it was great because now I know what they are talking about because I have seen it in the old film”

Project: Zest
Organisation: Bright Shadow
Region: South East
Designed for: Older adults’ residential care

This afternoon some of our residents joined in with a zoom workshop from Bright Shadow. The session was so much fun and left those who took part invigorated and excited to talk about what we had done … After the session we sat around the table to have tea and cake, and everyone spoke about it for ages. We have 2 more sessions over the next two weeks, and can’t wait ’til next week…

Project: HUG by LAUGH
Organisation: CARIAD, Cardiff Metropolitan University
Region: Cardiff and Vale of Glamorgan
Designed for: Adult residential care and hospitals

“Findings from the Sunrise Senior Living evaluation show an increase in cognitive and functional ability of half those in the study... Findings from the adapted Bradford Wellbeing Profile indicate that wellbeing improved for 87% of residents who had a HUG for six months.

Project: Creative Connections
Organisation: Creative Dementia Arts Network
Region: South East
Designed for: Older people in hospitals

“CDAN’s partners: Artlink and Creating with Care received and passed on feedback from nurses and nursing assistants in Oxfordshire hospitals. Interestingly responses have come from nurses across all departments / specialities – as older people are as likely to be nursed in trauma as in gerontology wards in general hospitals.”


Project: Singing Medicine & Singing Pathways
Organisation: Ex Cathedra
Region: West Midlands
Designed for: Children in hospital

“…this is absolutely amazing! Really made us smile during this difficult time! — had a little boogie to the video especially when you sang happy birthday! What you do is absolutely fantastic. Thank you so much to all of you who were involved in creating such a special video for my baby — ! Thank you again x”

Project: The History of Ashford in 100 Buildings
Organisation: Funder Films CIC
Region: South east
Designed for: Older adults' residential care

"The funding was provided for the project to reach out into care homes … However, the nature of film is that you can reach other audiences fairly easily so I have also sent the film to schools, the local hospice and a local art club. I’ve also put it on community groups in the borough where it has reached an audience of 15,000."

Project: Prison Reading Groups
Organisation: Give a Book
Region: National
Designed for: People serving sentences in prison

“Prisoners have been happy to receive a book, they are even more grateful when told that they can keep it. Even a few that initially refused changed their mind due to considering the limited time out of cell at the moment due to Covid.”

Organisation: GOSHArts, Great Ormond Street Hospital
Region: London
Designed for: Children and young people’s hospital

“First long weekend on the wards in many years. Things I am grateful for: - colleagues with dry wit - chatty tween patients - the anonymous donors supplying us with barista coffee each day - this beautiful book of poetry from @GOSH_Arts and @ceciliaknapp - that I can go home.”

Organisation: Hearts and Minds
Region: Scotland
Designed for: Children and young people in hospices, hospitals and special educational schools and adults living with dementia

“They make me laugh when I am in hospital when I am not well. They make me forget I’m in hospital so much I want to be a Clowndoctor” (participant, aged 9)

Organisation: Keneish Dance
Region: West Midlands
Designed for: People living in sheltered accommodation

“I loved this, I am going to do some of these exercises in my room before I go to bed”

Project: Studio Connect
Organisation: Key Changes
Region: London
Designed for: Hospitals, care homes & supported housing

"Weekly group online sessions have been particularly successful – prior to the crisis we were delivering weekly centre-based workshop sessions and we initially felt unsure if online sessions would be as engaging. Online sessions have been very well attended and have given people a valuable lifeline for social interaction and peer support throughout the crisis."


Project: Live Music Now Online
Organisation: Live Music Now
Region: England, Wales and Northern Ireland
Designed for: Care homes

“I just wanted to send a message to thank everyone at Live Music Now so much for the wonderful afternoon we had today … It was the best thing that has happened to us in a very long time! It was an absolute breath of fresh air to see them and listen to them sing/play. The residents and staff loved every second! I’m so impressed with how well it all works on zoom. Because we know Emily and James so well already it felt really natural and as if they with actually in the room with us! … It’s such a wonderful thing to watch someone’s day being made like that!”

Project: State of Flux 2.0
Organisation: Ludus Dance
Region: North West
Designed for: Child and Adolescent Mental Health Service

“It helps people, boosts confidence, gets you out of your comfort zone, helps you socialise, gives you structure and routine and helps you learn new things. It gives me hope, thought my drawings weren't good but now it feels like my art can be used for something. I want to be a Freelance Illustrator and Stuart has helped me plan next steps. Gives me the motivation to continue drawing. It's good, it's beneficial and it helps people.” (Inpatient)

Project: Make for Tomorrow
Organisation: Make Your Mark – part of Heads On (Sussex Partnership NHS Foundation Trust’s charity)
Region: South East
Designed for: Adult mental healthcare

"After another difficult week it was very pleasurable to spend time listening to Naomie and Francine chatting; really relaxing - what an uplifting afternoon! Thank you."

Project: Massage & Melodies
Organisation: Music in Hospitals & Care
Region: National (UK) – project in London
Designed for: Neonatal care

“One of the reasons it was so helpful is that when you’ve had a premature baby you’re tied into this really medical model and you become a parent through medicine. It’s not how you are meant to become a parent. Something like massage and lullabies which are typical parenting activities are able to make it a little bit more normal and a little bit nicer but also give the advice and strategies that I wanted everybody to have.”

Organisation: Musical Moments
Region: National
Designed for: Care homes

“We have tried desperately to engage with our clients, but it is proving extremely difficult. We have offered outdoor/garden sessions, virtual sessions and an interactive online/on demand package, but the turnout for these is very low compared with the amount of clients that we have across our UK network.”

Project: A Future I Can Love
Organisation: Novus
Region: North East, Yorkshire, North West, Midlands, London and Wales
Designed for: People in the criminal justice system

“Creative arts and music project are relatively new to me; they have put me in the deep end and stretched me! I have not done anything like it (Creative) in the past, so they are not part of who I am, but they are certainly helping me to define me now – allowing me to Express.”

Organisation: Novus & Open Eye Gallery
Region: North West
Designed for: People in the criminal justice system

"The lack of physical engagement with participants in prison in addition to the updated protocols relating to postal engagement created an opportunity for me to really investigate and develop the form and nature of postal engagement available in prison through creating an introductory experience of photography. ...It seemed that the circumstances created an instant space in which I could experiment within where a vast set of skills which included visualisation processes used in my filmmaking were brought together and whose effectiveness I was always considering in terms of both ‘user experience’ and prison/postal logistics."

Video link – Open Rooms series, interview with Liz Wewiora (Open Eye Gallery, Hafsah Naib (artist) and Sarah Hartley (Novus), 2020 c. Open Eye Gallery

Project: Worth My Wellbeing
Organisation: Odd Arts
Region: North West
Designed for: Young offenders in education settings, and NHS mental health institutions

“Throughout the week, young people discussed the difficulty young people – particularly young men – have in discussing emotions and wellbeing, but themselves engaged in all aspects of discussion despite this.”

Organisation: Orchestra of St John’s
Region: South East, South West & London
Designed for: Schools, mental health wards and acute hospitals

“The staff and patients at Evenlode would like to thank all of your team that turn up every Wednesday to play for us all. We fully appreciate you every week and enjoy the different instruments that you all play. Without fail every Wednesday one of our guys ask are the music people coming today. Thank you all once again you are making a big difference and this difficult time. Please continue with your great work.”

Project: Music Cares
Organisation: Orchestra of the Swan
Region: West Midlands
Designed for: Care homes

“…the numbers are surprisingly good – even though I do think some people are suffering with technology overload – myself included! I think the fact that the next series of videos will be shared via our networks nationally, the reach could be much wider and we will therefore reach a different audience…”

Organisation: Oxford Health Arts Partnership (Artscape / Creating with Care)
Region: South East and South West
Designed for: Community hospital and mental health inpatient wards

“Kingfisher patients (and I!) are full of positive feedback about the musicians from the Orchestra of St John’s who have been visiting. This week’s violinist in particular, they found very engaging and enjoyable, and they were insistent that I pass on their thanks. The effort is very much appreciated, and it’s been lovely to have such a perk in these very strange times.”

Project: Music on Wards
Organisation: Oxford Hospitals Charity
Region: South East
Designed for: Older people and those living with dementia in in hospital

“The ipad concerts went really well today with lots of lovely comments from patients and staff. One of the stand out moments was when I was playing a Beatles song to a patient and I could see the man smiling and laughing ...he told me that the nurses were dancing in the background which he seemed delighted by! I sang ‘Somewhere over the rainbow’ for a patient ...and the nurse told me afterwards that the lady had been feeling really sad earlier in the day and commented on how much happier she looked during and after the music. The lady smiled and waved at me after the song and said how much she enjoyed it.”

Project: Tea Talks
Organisation: Oxford Playhouse
Region: South East
Designed for: Care homes (and people living in isolation

“The success was certainly the participant feedback and the fact that the engagement was overwhelmingly positive. Our aim of reaching older people in uncertain times in a meaningful way was successful. It was a challenge to create a comfortable environment for the elderly people taking part given that we couldn’t see each other face-to-face and had not met before.”

Project: Creative Care Homes guide
Organisation: Paintings in Hospitals
Region: England, Wales, Northern Ireland
Designed for: Older people in care homes

"What a fantastic resource! Very keen to share it with our 180 care homes..."

Organisation: Performing Medicine
Region: London/national
Designed for: Healthcare professionals and
nonclinical hospital staff

“Absolutely vital work from @PerformingMed1 @clodensemble supporting our healthcare workers and frontline NHS staff during #Covid19 #ProtectTheNHS #PPE please share widely with NHS frontline #PPEKit"

Project: Extraordinary Times
Organisation: Plymouth Music Zone
Region: South West
Designed for: residential care, mental health units, domestic abuse refuge, schools, bereavement groups (including hospice partnership) and more...

“If Dave hadn’t been phoning, I would have just given up. I love PMZ so much, particularly as you reach out to people who wouldn’t otherwise get a chance.”

Project: rb&hArts Online
Organisation: rb&hArts, Royal Brompton & Harefield NHS Foundation Trust
Region: London
Designed for: Hospital staff and patients

“We are missing out on opportunities to meet other transplant outpatients at clinic where we’d usually make friends and meet people in the same boat. Now with covid we don’t have that, and we need opportunities to have a laugh and not think about our health. We have lost two transplant friends over the past few months and this has been really helpful”

Project: Singing for Breathing
Organisation: rb&hArts
Region: London
Designed for: Adults with respiratory conditions

“I always really enjoy SFB classes with Elisa [Jeffery]. It’s really beneficial to the breathing and totally uplifting. So you leave feeling fabulous. I thought it was a brilliant replacement for our usual sessions to keep our spirits up in these very trying times. It was a great idea.”

Project: Vocal Beats
Organisation: Royal Brompton & Harefield NHS Foundation Trust; Royal Marsden NHS Foundation Trust
Region: London and the South East
Designed for: Young inpatients and outpatients living with cancer diagnoses or heart and lung diseases

“Something to aim for, lovely sense of community and belonging, amazing song, people and memories”

Organisation: Sing Inside
Region: England & Wales
Designed for: People serving sentences

Although it has been very challenging not being able to access prisons during this time we have worked to provide remote musical learning that helps embed a sense of community and being part of something bigger. Our work repeatedly finds that this feeling of inclusion can be life-changing for people and a huge boost to wellbeing.

Project: Art by Post
Organisation: Southbank Centre
Region: London and national
Designed for: Residential and nursing homes, hospices, hospitals, mental health services and prison services

“With a bleak winter to look forward to, these packs will have a significant impact on the physical, emotional and cognitive wellbeing of some of the most isolated and vulnerable.”

Organisation: Spitalfields Music
Region: London
Designed for: Care homes

“In some respects, keeping the relationship alive with care home staff across lockdown has been a powerful experience for us as an organisation to understand where our impact lies and realign what we are trying to do in the community.”

Organisation: Tyne & Wear Archives & Museums
Region: North East
Designed for: Adults in residential care

“All the residents on the dementia unit still have the postcards and they are displayed on their bookcase and we do talk about the postcards to the residents, it is a nice conversation with a cup of tea.”

Project: Dance and Time with the Museum
Organisation: University of Cambridge Museums
Region: East of England
Designed for: Older adults' residential care

“it’s been really good to keep in touch with the Museum, it’s been very special, as we haven’t been able to do this with any of our other community partnerships. With all the art work you have provided you’ve helped us keep it going and alive and you’ve adapted to our needs brilliantly, it’s been a rich exchange of ideas.”

Project: Relax, Look, Imagine
Organisation: University of Cambridge Museums
Region: East of England
Designed for: Adult acute healthcare

"We are reaching more people within the hospital community, both through the films and the postcards. These lighter-touch forms of engagement mean that we are reaching beyond our targeted partnerships with the Dialysis Unit and older people’s wards to reach a wider range of staff and patients across the hospital community."

Organisation: University of Cambridge Museums
Region: East of England
Designed for: Mothers and children living in emergency accommodation

"Family workers have reported that the families were delighted to receive the packs, and those who had received them as part of the first phase were keen to be involved again."

Project: The Wednesday Wave / Love through Double Glazing
Organisation: Vamos Theatre
Region: West Midlands
Designed for: Care homes

“Love Through Double Glazing made me realise how long it’s been since we laughed so much.”

Project: Bring Me Sunshine / Spotlights / But Once a Year
Organisation: Voices Across Time
Region: South East
Designed for: Hospitals, care homes

"some care homes find it hard to connect digitally, especially with content which is live and responsive. However, our online reach has increased drastically especially due to open access resources."


Project: Creative Comfort
Organisation: University College London Hospitals NHS Foundation Trust, UCLH Arts and Heritage
Region: London
Designed for: Hospital staff

"Support from colleagues, especially the Staff Experience, the Staff Psychological and Welfare Services, the Occupational Health teams was essential in establishing the programme. They had the necessary channels to support the digital offers and were able to share materials on the ground at the hospital."

Logos for the partner organisations detailed above

Image: cARTrefu (Age Cymru)

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