The role of arts in health
11 August 2025
Principal Consultant Anna Barnes argues that hospital art is more than just decoration; it communicates care, compassion and competence
‘When money is tight how can we afford this kind on nonsense?’ If I had a pound for every time I’ve heard this objection to enhancing clinical environments with art, I would be doing well...
My interest in this area stems way back to the 1990s. I was project manager for the construction of a new mental health acute unit that was part of the strategy for the replacement of an old Victorian asylum of around 2,000 people with smaller dispersed units.
I decided to seek feedback from service users and staff about how this unit should look and feel. I was struck by the differences in needs expressed by staff and patients. Patients wanted the unit to feel homely, welcoming and therapeutic, while staff were more concerned with safety and containment.
My work in this area fed into a publication at the European Design Health Care Conference in 2023[1] (it had a slow gestation…).
What interested me was that so many patients were practising artists. I felt intuitively that enhancing the environment would promote healing and used their experience and expertise when I set about commissioning several pieces which lifted the space, funded by the percent for art:[2]
- a water feature made of Rhodesian stone
- a carved wooden bench in the garden
- a stained-glass partition.
This was the first time I heard about art not being important, but it wasn’t to be the last. The art there was wonderful, but it was not looked after, so it suffered death by a thousand cuts, and the water feature (for example) was rapidly decommissioned.
Alleviating distress
During my next four capital programmes I fought for arts in health, buoyed by the seminal Kings Fund publication which outlined what I had intuitively known.[3] It’s not just about paintings on the wall; it’s interior design in its broadest sense: how a reception area makes you feel as you walk in, whether the flooring absorbs noise, whether wayfinding is intuitive or labyrinthine, and whether the environment reflects the community it serves by way of its displays or the design of its furniture.
The main reason I have spent so much time thinking about this is that until we are patients or visitors (not staff, who experience the building in a completely different way), we are not aware of the anxiety, sometimes terror, people feel as they enter a hospital.
They are either expecting life-changing news, or their loved ones are patients. Their senses are heightened; anything we can do to communicate care, compassion and competence is helpful to alleviate that distress.
The most powerful example I have for this makes me emotional every time I think about it. It’s about the family of a boy who was killed by a random punch when he was only 15. His family donated many of his organs so his untimely death could benefit others, yet they described the ‘bad news room’ where they heard he would not survive as scruffy, full of random broken furniture, and uncared for. The environment would negatively imprint in their memories. I have heard other similar stories.
I believed then and still believe now that we can do better and it doesn’t have to cost the earth.
We also know that the evidence base for arts in health is still developing; the seminal paper (still referenced) is by Ulrich[4], and the battle is far from over.
Those of us with skin in the game have a dark humour that we fight and fight for our percent for art schemes, even when the schemes are mandated as a planning condition, such as the Louisa Martindale Building in Brighton.
This £500m acute hospital won design awards, including best interior design and best new hospital building over 40,000 sqm, at the European Design Congress 2024.
It features the following:
- Stage 1 welcome space (reception)
- Sky gardens / roof gardens
- The Sanctuary multi-faith space
- An integrated approach to art and interior design across the oncology centre
- Bespoke wallpaper designs for 32 interview rooms / quiet rooms
- Floor-to-ceiling printed illustrated vinyls in all lift cores depicting local landmarks across East and West Sussex to aid wayfinding
- Willis Newson worked with local artists and illustrators to develop an integrated approach to support wayfinding throughout the development by using large-scale feature wall prints to welcome and direct patients and visitors
- A large local history mural which recreates the history of the hospital adjacent to the re-provided Victorian chapel and heritage space.[5]
We created a conceptual design philosophy that was our touchstone: how we wanted the building to look and feel to visitors, guided by the following principles:
- art should be high quality and offer value for the public purse
- art should reflect the human presence (hand-drawn is sometimes the best)
- art should be appropriate (no Rothko, please), using images of nature when possible
- art should be durable and infection control/fire compliant.
The reason for the dark humour is that (as I heard from many other arts practitioners) the schemes had to be fought for all the way – in Brighton’s case, the art schemes were under immense scrutiny and vulnerable to being cancelled on several occasions. Yet on opening, they are almost the first feature to be acclaimed, providing photo opportunities galore.
Reflecting the community
A robust evaluation is needed to assess the effects of these artworks on the experience of those visiting the hospital. We hope they promote healing, but at the very least we know from feedback that patients and visitors feel assured that they are in a stunning, locally specific environment which reflects their history, culture and local reference points.
In Brighton it is very much their hospital, as it referenced their local landmarks, from the playful larger-than-life ceramic seagulls in the roof gardens to the huge mural of Shoreham Airport (or Brighton City, as it is now called) and the detailed re-creation in vinyl of the Palace Pier next to the ground floor lift panel.
Just as important is the multi-faith space known as the Sanctuary. Here, views of the sea out of the window are complemented by a series of photographs of the sea in all its moods and delicate stained-glass panels encased in a robust surround; a space offering solace to people of all faiths or none; so popular that people are asked not to come and eat lunch there every day.
A very different scheme has been implemented in Southwest London and St Georges at Springfield. Here, some internationally acclaimed artists worked with the mental health patients to design the interiors in a way that is culturally sensitive through a series of intensive workshops.
The resulting artworks are truly stunning and reflect the Indian subcontinent, Nigeria and the Caribbean, as befits the patients who use the facilities. Not only is this culturally sensitive, but the high standard of works has been cited in feedback by patients as reducing the stigma they feel when people visit them on the wards.[6]
Questions for new hospitals
Since my time as public art commissioner, the field has moved on. Jane Willis has produced a fantastic resource pack for the commissioning of public art, so no one has to reinvent the wheel [7]. There are still tensions, however, and it is understood that the New Hospital Programme is very focused on Hospital 2.0 and a much more standardised approach to design.[8] The passionate, emotional discussion about the design of a quiet room, or a wayfinding strategy that makes patients smile at local land marks, is unlikely to occur. My final questions remain, though:
- Will the bereaved family find themselves in a room that has been designed with their experience in mind and makes them feel that someone knows what they are going through, or will it be a bland, neutral space?
- Will a patient at the end of their life have a view of nature in some way?
- Will an elderly visitor find echoes of the previous hospital where their grandparent died or where their children were born, recreated in some way to reassure them that their history matters?
Art is by its very nature subjective; some people would say that any money ostensibly taken from clinical care is money wasted. Some people would say they want a hospital to offer clinical excellence and money spent on interior design is money wasted.
The jury is still out, but I think the growing evidence base supports the hypothesis that design matters; the meanings and memories we attach to our public spaces matter and I think the public deserves nothing less than spaces that have been designed mindfully and compassionately.
[1] Healing in Health Care Designs
Towards a New Architecture for Mental Health; Hesse and Barnes European Design Congress
[2] https://publicart.ie/main/comm...
[3] https://archive.kingsfund.org.uk/concern/published_works/000021350
[4] https://pubmed.ncbi.nlm.nih.go...
[5] https://www.janewillis.co.uk/c...
