Unintended Outcomes: How the Quality Framework has transformed me and my practice

by Jane Willis

series of colourful icons taken from the Quality Framework designAround 10 years ago, at the end of an evaluation training programme, someone asked whether there was a direct correlation between ‘good’ Creative Health practice and improved health outcomes. Instinctively, I wanted to say “Yes!” but I wasn’t sure there was any evidence of this, and, equally, I wasn’t sure that we, as a sector, had ever clearly articulated what ‘good’ actually looked like.

So, when Richard Ings at Arts Council England asked the same question at a round table meeting back in 2021, I leapt at the opportunity to work with CHWA to co-produce a Creative Health Quality Framework.

Our hope was that, by developing a set of Quality Principles and offering clear guidance on how to use them, The Creative Health Quality Framework would inspire the best possible experiences and outcomes for everyone involved in Creative Health work.

What I hadn’t expected was just how much the process of developing the Framework would impact me and my practice!

Using the eight Quality Principles as a structure for reflection, I have taken a moment to pause and consider what the process of working on this project has meant to me.

  1. Person-Centred

I can, at times, be very goal orientated. This isn’t always a bad thing – it keeps me motivated and helps me get things done. But it also meant that I started work on this project with a clear idea of what the final Quality Framework might look like. However, the process of developing the Framework has helped me reflect on the value of putting my goals to one side in order to listen, be open, and responsive to others. I intend to embed a ‘people-centred’ approach across all my work by always remembering the importance of deep listening.  

  1. Equitable

One thing that has nourished and sustained me throughout this process has been the sense that I am part of a wider community of practice working towards a fairer and more equitable society. However, this has also made me reflect on my own privilege and position within the sector. I have been asking myself where I might unconsciously perpetuate inequalities and how I might be more active in working towards equity. There are no quick answers. These are questions that will shape me and my practice.

  1. Safe

I have never underestimated the importance of social, emotional, and psychological safety. Such safety is, I believe, the foundation of Creative Health work. It enables awareness, acceptance, courage, creativity, expression, and agency. Throughout the process of developing the Quality Framework, I have been struck by how safe I felt. Working with Victoria at the Culture, Health & Wellbeing Alliance, the Steering Group and Reference Group and the many people involved in the wider engagement process, I have never felt anything other than non-judgemental and constructive support and encouragement.

  1. Creative

Such safety enabled conversations around the Quality Framework that allowed for not knowing; conversations that took place at our learning edge. Isn’t this where creativity takes place? When we allow ourselves to step into not knowing and create new knowledge through the process of making and creating? I hope that others also experienced the process of working on the Quality Framework as creative and feel that they too have played a part in inspiring and igniting change. For me, I aim to lean into my own not-knowing as much as possible, giving myself permission to not-know, to try things out, to learn, grow and create.    

  1. Collaborative

I have long known that collaboration is a good thing! Don’t we all? But I don’t think I have felt the value of collaboration as strongly as I have through this process. The Framework is so much more for having been shaped by so many people. There has been deep learning for me in this – in trusting that I don’t have to do things alone. That things are, in fact, richer and stronger when we do them together!

  1. Realistic

The need to be realistic, to not under-estimate what it takes to do this work; to allow enough time and sufficient resources; to not over-extend ourselves, our colleagues, our organisations. This is such a big one for many of us - me included! And it was reflected in this work. We did not apply for enough funding. We under-estimated the complexity of the work and the time required. And, because time is a finite resource, what was given to this work was, inevitably, taken from elsewhere. Learning how to be realistic and how to hold healthy boundaries around time and resources takes practice. The process of working on this Framework has made me more aware of when I am not realistic and when I fail to hold such boundaries. And awareness is the first step towards change!   

  1. Sustainable

This has also made me more mindful of the connection between ‘Realistic’ and ‘Sustainable’. If we constantly think short-term - under-estimating and over-delivering - we will burn out. This is not just about the individual. It applies at every level of the eco-system of practice and the wider environment of which we are a part.  It makes me reflect on the importance of the Quality Framework as a deeply embedded value system supporting us to grow work with strong, interconnected roots that span culture, health, and social change. 

  1. Reflective

For anyone familiar with my practice, you will know that I am somewhat obsessed with the importance of reflection, in particular, the power and potential of using creative tools to support reflection. Reflection, as Gillie Bolton says, “makes the difference between 20 years of experience and merely one year of experience repeated 20 times” (Bolton, 2014). The above notes are some of my reflections on the process of working on the Quality Framework. Following its launch, it will be evaluated by Lizzie O’Halloran of Outskirts Research so that we can all better understand its impact and develop and improve its use and usefulness.

I hope you take time to explore the Quality Framework, and that it supports you to reflect on your practice. I would love to hear your reflections.


Jane writes a monthly newsletter full of ideas and resources to help you reflect, evaluate and practise well, as well as news of the courses and workshops she runs. You can sign up here. Please send us any thoughts and reflections on the Creative Health Quality Framework at victoria@culturehealthandwellbeing.org.uk.


Jane Willis: creative health consultant, trainer, facilitator, and coach.


Drawing on 30 years’ experience, Jane supports people within the Creative Health sector to feel connected, supported, and resourced to practise well. 

Having worked across a range of artist-led spaces, galleries, and museums, Jane’s first role in healthcare was as Director of Arts for Barts Health, where she set up the arts programme, Vital Arts in 1993.  In 2001, she founded award-winning arts and health consultancy Willis Newson which she directed for 22 years, before becoming an independent consultant in 2023.

During this time, she co-directed two academic knowledge exchange partnerships with the University of the West of England exploring how best to evaluate creative health programmes, resulting in the online evaluation resource Creative and Credible.

Most recently, Jane co-led the development of the Creative Health Quality Framework with CHWA and colleagues from across the sector.

Jane practices writing and making as a way of exploring and reflecting on her own experience. She is an accredited coach and creative writing facilitator with master’s degrees in English Literature and Creative Writing for Therapeutic Purposes.