Museums on Prescription: Exploring the role and value of cultural heritage in social prescribing

There is a growing body of evidence which describes the social inclusion role of museums and the role that museums play in improving health and wellbeing, including previous research funded by the AHRC. This research has shown that engaging in museums provides: positive social experiences, leading to reduced social isolation; opportunities for learning and acquiring news skills; calming experiences, leading to decreased anxiety; increased positive emotions, such as optimism, hope and enjoyment; increased self-esteem and sense of identity; increased inspiration and opportunities for meaning making; positive distraction from clinical environments, including hospitals and care homes; and increased communication between families, carers and health professionals.

Given the wide range of benefits it is not surprising that more and more museums and galleries are adapting their access programmes to consider the wider social, health and wellbeing benefits that museum encounters can bring about. From museum object handling to reminiscence sessions, through to interactive exhibitions, tours, talks and participatory arts and creative activities, museums offer a diverse range of opportunities for active engagement. With over 2500 museums in the UK alone, most of which are free, museums offer a largely untapped resource as places which can support public health. Museums, however, are very well placed to address issues such as social isolation, physical and mental ill-health and evidence suggests that museums can help to build social capital and resilience, and improve health and wellbeing.

The Health and Social Care Act (2012) is bringing about considerable changes to the way health and social care services will be delivered in the future. A key part of these health reforms sees a shift towards 'prevention is better than cure', within a model which will require a multi-agency approach with an increased reliance on third sector organisations such as charities, voluntary and community organisations. Part of the reason for the health reforms is the realisation that individuals are living longer but with unhealthier lifestyles, with a significant increase in age- and lifestyle-related diseases, such as dementia and diabetes; this places added pressure on health services (including the NHS) and social services. It has also been shown that there is a 'social gradient' in relation to health, whereby individuals from poorer socio-economic backgrounds experience reduced health, wellbeing and social resilience.

It is easy to see how museums could fit into this new era of health commissioning considering the benefits described above. One of the biggest challenges facing the museums sector is understanding how best to meet these needs; here lessons from arts-in-health could help inform the museums sector. Over the past few decades arts-in-health has gained considerable support, backed up by a robust evidence base. Many arts organisations have developed more formalised relationships with health and social care providers, offering schemes described as 'social prescribing'. Social prescribing links patients in primary care with local sources of support within the community. The proposed research seeks to test a novel 'Museums on Prescription' scheme (MoP). The research will link museums with health and social care providers, and third sector organisations such as AgeUK, and using lessons learnt from arts-based social prescribing schemes, will set up two MoPs, one in Central London and one regional MoP in Kent. By working closely with health/social care service users, and museum, health, social care and third sector professionals, the research will use a range of techniques, including quality of health measures, interviews and questionnaires, to develop a MoP model which can be adopted by the museums sector as a way to provide a novel public health intervention.

Museums on Prescription (MoP) will offer economic, societal and cultural impact across a number of spheres. Economic value for money: In the long term MoP schemes will afford savings to the NHS and other health/social care providers, including Local Authorities. Health and social care services are under increasing pressure to reduce their spending, limit referrals for expensive health interventions (such as some NHS treatments) and encourage their patients to live healthier lifestyles. MoP will offer health and social care professionals, plus those working in allied support groups such as charities, an inexpensive intervention that can help with a number of health and wellbeing challenges. The cost-benefit analysis, which will be undertaken by NEF, will provide tangible, quantifiable, evidence of the economic benefits and potential savings for both health/social care providers and the museums sector. Outcomes from the research can be used by partner museums to help raise their profile and support future funding applications, helping them to secure more income.

Social impact: For the public, those members of the community that are at risk or vulnerable, perhaps due to social isolation, mental ill-health or physical impairment, MoP schemes offer a new way to improve aspects of their health and wellbeing, accessible directly from their source of primary health care. MoP will offer resources and activities that have been shown to be engaging and interactive, offering a source of inspiration and opportunities for cultural as well as social interaction, building new friendships and engendering a sense of community and identity. Specifically, the project will target older adults who have been identified by referrers as being vulnerable, socially isolated and/or lonely. In the longer term other users of health/social care services (e.g. those with physical/cognitive disabilities; mental health service users) will benefit as MoP schemes are rolled out more widely across the UK and beyond, when the full impact of the research is realised via the wider dissemination plan.

Cultural impact: (1) Partner museums will benefit from being involved in a high impact, university led research programme that will (a) provide evidence of the impact of the importance of cultural participation on health and wellbeing and (b), help develop partnership working across sectors. (2) Heritage and museum practitioners will benefit from the research in a number of ways including (a) training and advice regarding audience development and partnerships with health and social care providers and (b), participation in a novel model that will expand their access programmes to meet the needs of their communities in a more practical and strategic way. This is likely to be especially beneficial for publically funded museums, which are under increasing pressure to justify their expenditure and demonstrate value beyond caring for the nation's cultural heritage. (3) Society and the general public will benefit by being made aware of the links between cultural participation in a museum environment and health and wellbeing. Similarly, the practical nature of the model, developed in collaboration with several different museums in urban and regional settngs, means that it will be transferable across a range of organisations from small through to national museums.

Third sector impact: Professionals and volunteers in organisations allied to health promotion, including charities and support groups (e.g. AgeUK) and NGOs, including partners (RSPH, NEF, ACE) and other not-for-profit organisations (e.g. the International Longevity Centre, Scottish-based Wellbeing Alliance) will benefit from the development of a novel public health intervention which has been created through partnership working using a robust mixed-methods research framework.