Collaborative governance for creative health: initial programme theories for collaborating across sectors and disciplines.

Aims

To understand (1) how collaborative governance for creative health is being enacted in different health and social care systems across the UK and (2) why collaborative governance for creative health was needed in these systems and the factors that enable it to be effective.

Methods

Qualitative interviews with creative health stakeholders within UK health and social care systems (n = 16) to develop realist-informed initial programme theories (IPTs) about the purpose and efficacy of creative health collaborative governance approaches.

Findings

Collaborative governance describes arrangements where one or more public agencies and non-state stakeholders engage in collective decision-making through formal, consensus-oriented and deliberative processes. We identified eight IPTs in relation to collaborative governance for creative health. Two of these IPTs relate to why collaborative governance is needed and are associated with the need to secure buy-in from senior stakeholders within the health and social care system to secure access to the resources needed for creative health provision to be sustainable. The remaining six IPTs cover how participants in the creative governance initiatives suggest it could be effective. These include mechanisms such as building trust between key actors and institutions, providing opportunities to develop the creative health workforce, gathering and disseminating evidence about the efficacy of creative health, being responsive to lived experience perspectives, having clearly defined lines of accountability and ensuring alignment with and between key policies and strategies.

Conclusions

Collaborative endeavours for creative health should focus on relationships, trust building and accountability mechanisms first and foremost. These will provide a platform for further collaborative activities with a focus on sustainability, workforce development, evidence, lived experience and alignment with key policies and strategies. Collaborative priorities should be based on an appreciation of local strengths and gaps and recognise that 'what works' in one area is not guaranteed to work in another.

Creative health is a term used to describe creative approaches and activities which have benefits for health and wellbeing. We undertook qualitative research with people from different sectors and working in a range of roles related to creative health in the UK to understand what factors support effective cross-sector collaboration. Key factors included the need to secure buy-in from senior leaders; funding and financial resources; building trust and accountability; support for the creative workforce; evidence about the effectiveness of creative approaches; meaningfully involvement of creative participants; and having good alignment with key policies and strategies. However, it is important not to take a one-size-fits-all approach and make decisions based on what matters to people locally.