Author:
Dawn Holford, Research Lead ReCITE, School of Psychological Science, University of Bristol
Three years ago, ReCITE began as a small experiment in co-production: a handful of community organisations, creatives, health partners, and researchers came together to explore how storytelling and creative practice could support health equity across Liverpool.
As we prepare a new paper reflecting on our early co-production phase , we’ve been revisiting what shaped ReCITE’s design and the lessons that have stayed with us. These lessons reflect not only what we learned from each other, but also what the creative health sector needs if it is to contribute fully to system-wide change.
Below, we share five core insights that guided the creation of the ReCITE programme - now embedded as our theory of change - and what they mean for policy, commissioning, and the future of creative health. We include quotes from stakeholders at our workshops who contributed to each of these insights.
1. Short-term funding limits impact and wastes opportunity
Building a creative health system requires investment in stability, not just projects.
Partners repeatedly raised the challenges of short-term funding. For community and arts organisations, many of whom form the foundation of hyperlocal support, this instability creates a cycle of project-itis: doing impactful work, evidencing its benefits, and then losing the capacity to sustain or grow it.
“Our communities have rich narratives, and the small pockets of funding can be negative as it gives communities insight into inequities but doesn’t give people power. How do we get the people with the power to see this?”
Implications for policy and commissioning
Policymakers and commissioners need to understand why this keeps happening. Frequent breaks in provision disrupt community trust, weaken relationships with healthcare partners, and prevent programmes from developing the depth needed to influence health outcomes. Policy frameworks that rely on short-term funding rounds inadvertently cap the potential of creative health to contribute to prevention, wellbeing, and local economic value.
2. Stories can shift attitudes and mobilise action
Creative storytelling can be as strategic as it is expressive.
Stories have the power to shape public attitudes, influence decision-making, and motivate communities. Although storytelling sometimes unhelpfully reinforces stereotypes or misinformation, it also offers a powerful route in shaping healthier and fairer narratives. What we are missing, we found, were stories that are looking forward: not only stories describing current inequities but helping people imagine what could change.
“[It’s] frustrating because we want to talk about the positives in our communities, but we often end up speaking about discrimination. … Internal stories that are told within communities can maintain inequalities.”
Implications for policy and commissioning
Creative health initiatives should be supported not only as services but also as narrative interventions that help to shift public understanding of inequality, reduce stigma, and highlight possibilities for change.
3. Silo-ed working weakens impact
Cross-sector collaboration is not optional but a structural requirement.
We recognise siloed working prevents promising ideas from gaining traction. To scale-up learning or build strategic partnerships we need ways to link up people from different sectors and consolidate small projects so that we have a greater impact throughout Liverpool.
- “[We should value] learning from each other and creating new knowledge for change/action.”
- [Success comes from] “creating a community where researchers, community groups and individuals work together to drive health equity in the area.”
Implications for policy and commissioning
Commissioners, Integrated Care Systems partners, and funders should prioritise collaborative infrastructure (e.g., forums, exchanges, and shared planning spaces) that allow creative health contributions to align with population health strategies.
4. Unfair societal structures drive poor health
Creative programmes can mitigate harm but lasting change requires system reform.
Participants across the programme spoke openly about how poverty and other structural drivers have an unequal impact on people’s mental and physical health, putting pressure on health systems. We may be able to solve some of the problems with creative hyperlocal solutions, but we need stories that can advocate for structural change too, or else we will only treat the symptoms of inequality.
- “So much focus on individual not structural elements that drive inequity.”
- “How do we get these stories heard and out in the community?”
- “What do we have to do to get these stories acted upon?”
Implications for policy and commissioning
Place-based creative work needs to be paired with advocacy, using stories and lived experience in that same local area to challenge the conditions that produce unfair and avoidable health outcomes.
5. Evaluations need to work for everyone in the system
We need evidence that is rigorous, proportionate, and inclusive.
A clear message from partners was that evaluation must support decision-making and reflect community experience. Commissioners need reliable, robust data to justify investment. Community and arts organisations need evaluation approaches that are realistic, meaningful and aligned with the nature of their work.
“Now more than ever commissioners are expected to show effective, efficient commissioning that is scalable and impactful, strong evidence is needed for this, also interventions that can tackle multiple outcomes will be favourable as value for money.”
“Many [arts and community] organisations are collecting stories using social science approaches [such as ethnography and photovoice], but [these] are not positioned as data or ‘scientific’ evidence.”
Implications for policy and commissioning
Policy frameworks should support mixed-methods evaluation that values both statistics and stories as the data, ensuring decisions capture the full picture of public value delivered by creative health.
How These Insights Shaped ReCITE
Together, these five lessons became ReCITE’s “theory of change”: our shared understanding of how creative health can contribute to reducing health inequalities. They informed the design of each of the five pillars of the programme:
- Our “What’s Your Story” programme looks at how we can use storytelling to highlight what can, and should, change.
- Our Creative Health Exchanges are connecting health providers, community organisations, and creatives to spark new ideas and collaborations.
- Our Community Innovation Teams are connecting health, community, and creative partners to address hyperlocal health disadvantages, and finding ways to evaluate creative community-led interventions.
- Our Advocacy Networks are identifying structural causes of unfair and unavoidable health outcomes so they can challenge the social structures that perpetuate disadvantage.
- Throughout this, our research team works with our community co-researchers to understand what works. Our Learning Events will celebrate what we’ve learned and share good practice across the project.
Looking Ahead: Building Creative Health Infrastructure for the Future
One message came through consistently throughout this work: Liverpool’s arts and community organisations are an essential part of the city’s health infrastructure. They provide inclusive, relational, place-based support that cannot be replicated elsewhere. Moreover, the social value they generate far exceeds the investment currently available to them.
For creative health to fulfil its potential, these organisations need stable, long-term resourcing, not piecemeal project funding tied to research cycles. As ReCITE looks ahead to 2026, one of our core ambitions is to help make that shift: from short-term projects to sustainable partnerships and a long-term Creative Health Strategy that allow creative health to contribute fully to reducing health inequalities.
“The fundamental question is how can we create platforms that can be sustained and that will attract the attention of funding organisations? How can we bring people together?”
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ReCITE is funded by the Arts and Humanities Research Council (AHRC), part of UK Research and Innovation. |
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