We're delighted to be sharing the Creative Health Quality Framework (CHQF) evaluation conducted by Outskirts Research for the Culture, Health & Wellbeing Alliance (CHWA) across 2023 and 2024.
Thank you to everyone who took part in surveys, workshops and case studies, to help us understand how the Framework is being used and where we should go next. We're especially grateful to Outskirts Research for bringing together such a clear and thorough evaluation and recommendations for how we can take the Framework forward.
The evaluation aimed to assess the framework’s accessibility, appropriateness, and impact within the Creative Health sector.
"The CHQF has fostered unity and confidence within the creative health sector, validating practitioners' methods and reinforcing their contributions, especially in health and community settings." (Creative Health Quality Framework Evaluation, p.18)
Background
The Creative Health Quality Framework: Developed in collaboration with Jane Willis and funded by Arts Council England (ACE), the CHQF is grounded in eight Quality Principles: Person-Centred, Equitable, Safe, Creative, Collaborative, Realistic, Reflective, and Sustainable. It serves as a practical resource to guide practitioners, organisations, policy-makers, funders, and commissioners in embedding quality and good practice across diverse creative health contexts.
The evaluation: The mixed-methods evaluation incorporated six case studies, two workshops, and surveys. Over 200 people from across the sector engaged through surveys, straw polls, interviews, and group reflections. Data was analysed thematically to reveal patterns across stakeholder experiences.
"Such an important and meaningful piece of work for the sector and beyond." Attendee at Launch Event for Policy Makers, Funders and Commissioners
Key Findings
The evaluation revealed the following insights about the CHQF’s impact and use:
Embeddedness of Quality Principles:
Collaborative, Person-Centred, and Creative were the most commonly applied principles, while Sustainable, Realistic, Equitable, and Reflective proved challenging. Time constraints, limited resources, and sector pressures were noted as common barriers to fully integrating these principles into daily practices.
Accessibility and Ease of Use:
The CHQF was widely regarded as flexible, accessible, and thoughtfully designed. Many stakeholders valued resources like the Quality Principles Poster as effective entry points, as the framework’s comprehensive nature occasionally felt overwhelming. Requests emerged for simplified versions, such as easy-read formats and audio and visual aids to support diverse needs.
• Appropriateness and Relevance Across Contexts:
Stakeholders praised the CHQF’s adaptability across varied settings—from creative and cultural projects to partnerships in health and community contexts. This adaptability supported meaningful applications across distinct areas, including advocacy, practice development, and strategic alignment with health partners. Barriers such as limited time, resources, and engagement within the health sector restrict deeper use, while enablers like targeted workshops, case studies, and multicultural resources were suggested to foster broader adoption and sustained engagement across varied audiences.
Observed Changes from Using the Framework:
The CHQF has increased confidence, particularly among practitioners by validating their contributions and providing a shared language within the sector to communicate the value of Creative Health work. It has encouraged reflective practice and continuous learning and highlighted the importance of safeguarding and personal wellbeing. The framework has also supported more intentional planning and fostered open conversations around resilience and self-care, helping create more supportive work environments.
Impact Across Key Areas:
The CHQF has enhanced self-awareness and person-centred approaches, and embedded reflective practice as a core value. It has strengthened partnerships, by building trust and credibility. The framework has improved co-creation, enabling inclusive, participant-driven projects, and has informed responsive, sustainable project planning. It supports skills development in ethical, reflective practices and has redefined evaluation methods, fostering meaningful assessment and continuous learning across organisations.
Recommendations
To enhance the CHQFs' usage and impact, the following steps are recommended:
1. Training and Dissemination
Create a comprehensive training and dissemination package, including foundational workshops, context-specific sessions (e.g., health, community projects), and accessible resources such as easy-read editions, audio guides, and interactive tools. This will support diverse users in integrating the framework effectively into their practices.
2. Shared Responsibility and Sector Engagement
Promote a collaborative model by involving commissioners, funders, health partners, policy-makers, and local authorities in actively endorsing the CHQF. Encourage these stakeholders to integrate the framework into funding and policy criteria, supporting a unified commitment to quality and shared responsibility across the sector.
3. Reflective Learning Tool
Emphasise the framework's role in fostering continuous learning and development by prioritising reflective practice. Provide resources like checklists and peer-sharing prompts to support routine reflection and refinement of practices, ensuring the CHQF serves as a tool for growth beyond evaluation alone.
The evaluation underscores the Creative Health Quality Framework's valuable role in fostering quality and good practice within the Creative Health sector. While widely praised for its flexibility and relevance, the CHQF also faces barriers in adoption. Stakeholders expressed strong support for further resources and training to make the framework more accessible and engaging across diverse contexts. With targeted enhancements and a collaborative sector-wide commitment, the CHQF holds significant potential to drive continuous growth, deepen partnerships, and embed good quality practices throughout Creative Health initiatives.
Case studies
The evaluation also includes six case studies involving 36 participants, aiming to represent a cross-section of stakeholder groups, to capture nuanced, contextualised insights on the use and impact of the CHQF.
This included:
• Jane Thakoordin - Involved as an individual Creative Practitioner.
• Purple Patch Arts - An organisation offering creative and inclusive learning opportunities, primarily for learning-disabled and autistic adults.
• UCLH Arts and Heritage - A hospital-based arts and heritage initiative focused on integrating the arts into healthcare settings.
• Accentuate and its Museum Partners (Curating for Change) - Collaborative projects with museums to enhance accessibility and inclusivity, particularly for people with disabilities and neurodivergence.
• Live Music Now - An organisation that brings live music experiences into healthcare and community settings to promote well-being.
• Barnsley Creative Health Partnership - A collaborative partnership involving Barnsley Metropolitan Borough Council (BMBC) and CHWA, which includes leaders from culture and public health sectors, NHS representatives, and a local Creative Health community organisation.