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.