Delegates at Building Better Healthcare’s recent “National Patient Environment and the Arts Conference 2009” in London heard how national public arts think tank ixia has appointed Bristol-based arts and wellbeing development agency Willis Newson to write “concise and convincing guidance” on commissioning art for new healthcare facilities.
A key message, during a joint presentation, was that integrating artwork into hospitals and other healthcare premises requires the earliest possible consideration to reap the maximum rewards.
After a brief introduction by director Jonathan Banks to ixia, a public art think tank which describes its main functions as “to provide guidance on the role of art in the public realm”, and to “identify and challenge restrictive practices which result in limited and missed opportunities for artists working in the public realm”, Willis Newson director Jane Willis explained that the ixiacommissioned project’s key goal would be to produce guidance that explains how art can best be integrated into existing health service procurement systems. She told delegates: “We’ve been doing this work for the past eight years; developing the guidance provides an opportunity to step outside our existing practice and consider, if we were given a blank canvas, what steps we would advise organisations such as NHS Trusts to follow to ensure optimal integration of artwork into their buildings.” She explained that the new guidance would be informed by an extensive research process, with significant input from an advisory group on which will sit representatives from organisations including CABE, Building Better Healthare, the Young Foundation, NHS Trusts, and architects. “The guidance will examine how art and artwork can best be integrated into healthcare capital developments, and how we can apply existing good public art practice into the healthcare estate,” she told the conference. “Our aim will not be to try to influence Trusts’ actual choice of artwork, but rather to plot out a route map that will enable art commissioners, such as estates personnel, art managers/directors, and Trust boards, to ask the right questions, get the right support when commissioning, and harness good practice.”
Evidence-based approach
She told the conference the project team would be looking at how the healthcare sector can build an evidence-based approach to artwork commissioning that works effectively, based around a route map that takes into consideration the workings of each of the three existing main healthcare procurement routes, and “raises questions linked to each”. Looking first at the PFI route, Jane Willis noted that, to date, over £10 billion had been invested in PFI projects, with a further £1.93 billion presently earmarked. Currently, there were 36 schemes operational, with 17 under construction, and a further nine left to go forward to the OJEU selection process. Although conceding that the PFI model “may be getting near to the end of its lifespan”, she said that, if the remaining nine schemes do go ahead, and the “illusory” 1% of the total scheme costs (the percentage is generally used as a benchmark for the proportion of capital allocated to incorporating art in publiclyfunded new-build healthcare projects) is indeed provided for artwork procurement, there would still be “a huge opportunity for the commissioning of artwork in the new facilities”. With the PFI procurement route harnessing a “competitive bidding process”, she argued that, if arts professionals get art onto the agenda sufficiently early in such schemes, it will be “taken seriously” by consortia and, accordingly, taken into the contractual relationship process. “If not,” she said, “it will lead to the pitfalls and potential hazards of a process where the building is owned and managed by someone else, and it will then be very difficult for a Trust to make future progress with art installations”.
‘Part of the business case’
The solution with PFI projects was therefore to “get art onto the agenda really early on”. “It should be considered at public sector comparator stage, and should form part of the full business case,” she said. “If art is included in the tender process then the bidders will have to respond, leading to a competitive dialogue around arts integration.” Otherwise, she explained, a building’s users will need, subsequently, to “find a chink in the contractual process of a project where somebody else is undertaking the design and construction.” An excellent illustration of a PFI project where an integrated arts programme had been considered from an early stage discussed by Jane Willis was at the Royal Alexandra Children’s Hospital in Brighton (designed by architects BDP), where arts consultant Lesley Green developed an initial public arts strategy and then recommended a local art co-ordinator be appointed to take forward art in the distinctive new maritime-themed building, which is located close to the Sussex town’s seafront. As a result the hospital incorporates artwork including entrance sculptures by Ally Wallace, and the “Oasis Room” carvings in oak by Walter Bailey, as well as community-based projects such as a mosaic by children from a Catholic school, a Church of England school, and children associated with a synagogue.
Re-thinking healthcare delivery
Moving to discuss art integration within LIFT schemes, normally a joint venture between the Department of Health and the local health community, Jane Willis said there was here, in a broader context, “a major chance for the healthcare providers to re-rethink they whole way they deliver healthcare, providing the opportunity for an integrated arts approach within holistic care models”, as evidenced by the success of the Bromley by Bow Health Centre in London’s East End (see pages 53-58). Jane Willis said that, although LIFT scheme participants – from local authorities to GP surgeries and local companies – might be advised to think about art “really early on”, some unfortunately tended to believe this meant before a building opened, whereas what was actually needed was careful consideration of art’s potential role and optimal integration at the stage when the strategic development of the entire LIFT programme was being planned. She said: “This means strategic health authorities need to build in allowance for art at an early strategic stage. If this is done, funding may be found.” While current guidance for art in LIFT schemes suggested it should be considered “at the end of the design process”, art must, she argued, not simply be “an afterthought” in LIFT projects: “It should instead be a strong tool for cultural change in the way we are delivering services and building partnerships with the local community.”
‘Wayfinding beacons’
Illustrating the benefits to service users and staff alike of successful art integration, Jane Willis described the Guy’s & St Thomas Charity-backed and commissioned artwork installation at Sunshine House in Peckham, South London, home to the new Southwark Child Development Centre. Artwork features include Rotterdam-based artist Milou van Ham’s text-based artwork, and Jacqueline Poncelet’s “architectural interventions”, the latter designed both as artistic features in their own right, and as wayfinding “beacons” for the facility’s young users. Milou van Ham involved, during her creative process, young service users in defining the words for sculpture, deciding on “Hide and Show” for the three internal voids. Her aluminium and steel sculptures, glazed with powder paint, are suspended from the ceilings and attached to the walls, making them visible from the building’s basement, ground and first floors. Jacquie Poncelet, meanwhile, worked with architects Alford Hall Monaghan Morris to develop useful wayfinding beacons for children, their parents and visitors. Outside the building some of the walkway bricks are turned on their sides, revealing their interior holes, which have been filled with bright blue terrazzo. Brightly coloured kick and push plates on doors, linking with the interior design, help make doors leading to key service areas more memorable. In addition, large graphic panels in primary colours are adorned with brightly coloured magnetic dots and squares; children are encouraged to use the magnets to secure their own artwork created in waiting areas. Modus Operandi, the art consultants on the project, liaised with the artists, architects and the Charity to ensure the project fulfilled the creative brief.
Complications possible
Looking next at artwork integration within ProCure21 schemes where, because buildings are owned by the NHS, it is able to select the principal supply chain partner (PSCP) to work with, Jane Willis said art “fitted slightly differently here”. She explained: “While early consideration of art might imply it be set as part of the brief to the PSCP, in practice integration of art is usually led by the NHS.” Complications could, however, arise where artwork was commissioned outside of the contractual agreement with the PSCP, leading to a need for Trust to negotiate “outside the main contact terms”. To date she said there had been “very patchy use” of artwork on ProCure21 projects. Much had depended on the enthusiasm for art of the particular Trust, and whether it considered art “part of its culture”. The type of building being constructed was also, as one might imagine, “a major determining factor”. One successful illustration of ProCure21 art integration was at the Richard Desmond Children’s Eye Centre at London’s Moorfields Eye Hospital, where painter Alison Turnbull was commissioned to work with scheme architect Penoyre & Prasad to create the building’s distinctive external louvres. Here Jane Willis said it could quite reasonably be argued that the louvres were “neither strictly an artwork, nor purely an architectural feature”. The question here was whether the collaboration had, in fact, delivered “more than either the artist or the architect could have brought to the scheme on their own”.
Making commissioners confident
Arguing that one of Willis Newson’s key goals in compiling the new guidance would be to answer the question of “how can we make commissioners more confident in the commissioning of artwork”, Jane Willis reiterated that Willis Newson felt, currently, that artwork was still “too often thought of as an afterthought, rather than as an integral element of a healthcare facility from the outset”. While delivering successful artwork strategies and installations undoubtedly required “more effective partnership working”, she said there was also a need for “better evidence of artwork’s benefits and better use of the evidence we do already have”. She also asked the audience: “Should we be demonstrating the social value of arts as well as its value to individual wellbeing?” Wrapping up the presentation, she explained that the new guidance would be accessible at the ixia website (www.ixia-info.com) by this September, and Willis Newson and ixia also plan to hold seminars nationwide on the topic for organisations including strategic health authorities, NHS Trusts, PFI teams, LIFT companies, PCTs, regional development agencies, local authorities, “local and regional health teams”, and local authority arts officers. She added: “Gathering together as a group people who will be taking art projects forward, the seminars will be structured to enable them to build a shared vision, thereby helping engender success.” To inform the new guidance Willis Newson has developed an online questionnaire which it, and ixia, are keen for as many interested parties, to complete before 1 June. Designed to take only 5-10 minutes to work through, it can be accessed at: www.ixia-info.com/research/health
