An evaluation of Unfold the Untold

Context: Health and Society Knowledge Exchange (HASKE), at the University of Cumbria, was commissioned by Healing Arts Cumbria to conduct a service evaluation of the Unfold the Untold project. Unfold the Untold is the Healing Arts project that ran from September 2023 to October 2024, engaging with patients on two wards at Cumberland Infirmary, Beech C and Elm C, and children at a local primary school. The project aimed to enhance wellbeing by bringing together patients, staff and children through shared creativity. Weekly creative sessions on the wards included activities such as puppetry, craft, storytelling and poetry. The evaluation aimed to explore the impact of Unfold the Untold from the perspective of the creative arts practitioners and healthcare providers; and understand and articulate the process of delivering and embedding this type of collaborative practice into ward settings at Cumberland Infirmary. Methodology: This evaluation explored the process of delivering Unfold the Untold on hospital wards from the perspective of both creative practitioners and staff working on the wards, through three stages of data collection: 1) semi-structured interviews with creative practitioners 2) semi-structured interviews of ward managers and ward staff working on Beech C and Elm C 3) secondary data analysis of notes and reflections made by the creative practitioners. Conclusions and recommendations: • The findings show that the ‘creative conversations’ facilitated by the creative practitioners are key to the success of the Unfold the Untold project. Any participation in creative activities or production of creative outputs were perceived to be a means by which the interaction between the creative practitioner and patient could be established, enhanced, or continued. • It was evident that the creative practitioners apply their skills seamlessly and simultaneously throughout their interactions with patients. The findings from the creative practitioner interviews were mapped onto the World Health Organization’s guide to evaluation (2022) with a focus on how the three key elements of wellbeing, trust and social cohesion were incorporated in practice: 1) Wellbeing – the findings demonstrate that the creative practitioners honour the patient through focusing on their life experiences; giving them any artwork created during the project; viewing the interaction as the outcome rather than the art; and sensing to what extent the person might want to engage with the creative conversations. 2) Trust – there was evidence that the creative practitioners work to build and maintain trust with the patients by being aware of the space and the person’s emotional state, establishing autonomy, and being respectful. 3) Social cohesion – although the interactions and creative conversations were brief in nature, the findings show that the creative practitioners were able to create a meaningful connection with each patient, which inspired participation in the creative conversation. This meaningful connection was established through listening, finding common ground, and building a social relationship with the patient. • The main challenges reported by the ward staff were their initial reservations about creative activities and a lack of understanding about the potential benefits of the project. However, these challenges were addressed through the delivery of workshops for ward staff to raise awareness and understanding of the Unfold the Untold project and its benefits for wellbeing. • From the perspective of the ward staff, the most valuable aspect of the Unfold the Untold project was that the creative conversations provided an opportunity for patients to talk about their lives, which enabled the ward staff to better understand and connect with the patients.