Therapeutic placemaking as a pathway to improved public health: realising our health and care centres of the future

'Good design' for health and care, and the development of industry and public sector skills to support such improvements in infrastructure, will be key if the devolved governments of the UK are to address the challenges brought about by an ageing society, and the need for clean growth. The aim of this research is to examine and advance an interdisciplinary design innovation piloted by a West of Scotland Health Board NHS Greater Glasgow and Clyde (NHSGGC) over a sustained period of building modernisation that identifies lessons of immediate regional relevance, and for wider future application in other UK regions. 'Therapeutic placemaking' is a bespoke Arts and Health strategy that supports facility functionality through novel design features (including interactive way finding, personalising patient dignity, and positive distraction installations) and promotes wellbeing by bringing a cultural dimension into the healthcare environment. The innovation is delivered by a public artist working at the interface of a built environment team, the health service, local communities, and local authority partners, to develop generative placemaking concepts that will inspire the design of a new-build NHS project.

The Fellowship's programme of research will take place in the post-industrial town of Clydebank, where the development of a new NHSGGC primary care facility is being envisioned as the catalyst for wider processes of urban renewal. Efforts at local regeneration programs have so far struggled to identify solutions to the complex and compounded legacies of industrial decline, including the deterioration of public health, wellbeing and the local environment. Research leadership is required to ask if another approach is possible, and evaluate its effectiveness. Partnering with NHSGGC, Architecture and Design Scotland, and three local authority departments (West Dunbartonshire Health and Social Care Partnership, West Dunbartonshire Libraries and Museums, and West Dunbartonshire Planning and Building), the Fellowship will develop a practice-led therapeutic placemaking approach for the new facility (Clydebank Health and Care Centre), and then evaluate its impact on service-users, service providers and the wider community upon its opening in September 2020. Through the collaborative and iterative development of such an approach, this project will advance research around critical and creative placemaking in the fields of feminist urban studies, arts and health, and heritage futures.

The Fellowship will enable innovative and collaborative research leadership in regional efforts to improve infrastructures and facilities for health provision in NHS Greater Glasgow. It will embed a 'therapeutic placemaking' approach in the health, public and education sectors, and the architecture and design industry. Additionally, it will engage local community representatives in knowledge exchange, and consultative and evaluative processes around the application of novel therapeutic placemaking interventions. Concentrated Fellowship actions at the local-authority level will scale up through research outcomes and skill-sharing, making research Leadership an asset in UK-wide industry settings and regional public sectors. Transferable innovations and insights will be shared via national Arts and Health and design programs, generating improved industrial capacity to deliver renewed spaces of health and care that are health and place improving for our ageing society.

The proposed project will identify the role that TP, as an emerging interdisciplinary innovation, can play in making spaces of health and care that are health and place improving, and futureproofed to face pressing societal challenges. The project design identifies and creates opportunities for maximising impacts in an innovation ecosystem encompassing local community members, and relevant stakeholders in the public sector, and architecture and design industries. Research is embedded in a 'live' capital works project to realise the benefits of TP at the local scale, and this impact is then scaled up with the production of skilling resources and knowledge exchange (KE) activities that harness the potential for nationwide impact. In this way, the project design enables and accommodates emerging opportunities during the project lifecycle for the maximization of impact.

PATHWAY 1 TO TP: DELIVERING IMPROVEMENTS IN INFRASTRUCTURE AND IMPACTING ON CULTURES OF HEALTH AND WELLBEING - This pathway centres on capacity building within a built environment team, a local authority, and local communities, to envision and deliver a health improving and place enhancing NHS primary care facility. Integrated thinking and working is enabled by participatory research that is conducted in the community to identify compelling placemaking concepts, and to create opportunities for knowledge sharing, learning and engagement, around matters of Health and Place, in the run up to the opening of the new facility. The pathway culminates in the coproduction of a TP intervention with an empowered local interest working group that will be embedded in the new facility for the benefit of service-users, service-providers, and elderly users in particular.

PATHWAY 2 TO TP: REGIONALISING IMPACT BETWEEN CLYDEBANK AND GREENOCK - This pathway opens the scope of research to the NHSGGC Health Board region. The impact pathway centres around the coproduction of a TP intervention with the lead artist on an NHSGGC building modernisation project in Greenock, that will enable the exchange of knowledge and creative, resourceful TP techniques between neighbouring post-industrial riverside communities, forging new community resiliencies and solidarities. Capacity building will be consolidated with the delivery of a TP intervention - a 'Healthy Journeys' scheme - that will impact on the clean growth credentials of both facilities, and provide health improving opportunities for service-users, service-providers and wider communities.

PATHWAY 3 TO TP: EVALUATION, CAPACITY-BUILDING AND RESKILLING - This pathway builds on practice-led research, to develop skilling resources, including a TP Portfolio and Guidance Note, that will enable UK Arts and Health leaders, UK design and construction industry (including architects, and public artists) and UK local authorities to take up the TP approach. Resources will be disseminated at a TP KE Symposium, attended by stakeholders from across the UK, and then deposited in the NHSGGC Public Health Resource Unit for future use. Such capacity building will impact on NHS infrastructure development that supports health improvement, and sustainable growth.

Impacts across pathways will be consolidated through regular KE meetings with the director of Architecture and Design Scotland (A+DS), Scotland's leading professional body for excellence in the built realm, to advance A+DS' placemaking objectives in the context of deindustrialisation, and to identify how TP can vitalise design policy for health.

To ensure strategic oversight of impact planning and delivery across the project's lifecycle, and to identify research impact legacies and potential follow-on Leadership Fellowship activities, a TP Impact Advisory Group (IAG) will be established. The P-I's prior experience with socially engaged arts practice and ethnographic research in health and regeneration settings will drive all pathway to impact activities and associated outputs.