HARP Hywel Dda Arts Referral Pathway
Authors(s), Creator(s) and Contributors: Kathryn Lambert, HDUHB, Rhian Rees, Amy Campbell
Publication Date: 06/03/2026
Categories: Case Studies, English
Supporter(s)/Funder(s): Arts Council Wales, Hywel Dda Charities
Partner(s): Hywel Dda UHB, PHW, Tri Tech Research & Innovation, Arts4Wellbeing, Arts Care Gofal Celf, PeopleSpeakUp, Span Arts, WAHWN, GP Surgeries Coach and Horses GP Surgery, Taliesen Surgery and Tenby Surgery
Funder(s): Arts Council Wales, HDUHB Charities
The Challenge
Chronic physical and mental health conditions, social isolation, and rising pressure on primary care created a clear need for alternative wellbeing support. With high GP demand and limited non clinical options, Hywel Dda UHB sought a preventative, community based approach aligned with national policy promoting holistic, non medical interventions. HARP was developed to address loneliness, low confidence, and limited access to creative or social opportunities by offering arts based support for people who frequently attend GP services.
The Approach
HARP delivered eight blocks of eight two hour arts sessions across St Clears in Carmarthenshire, Lampeter in Ceredigion and Tenby in Pembrokeshire, led by four experienced arts partners (People Speak Up, Arts Care Gofal Celf, Span Arts and Arts4Wellbeing). Sessions included creative movement, collage, crochet, glass painting and group discussion, with visits from health and wellbeing professionals to signpost further support. A total of 49 patients were referred and 23 took part, with up to 12 participants per group. Artists provided support, accessibility adjustments, and flexible delivery—such as adapting session times, offering transport funding, and allowing family attendance where anxiety was a barrier. Sessions were co produced with health partners, aligned with Hywel Dda’s Arts & Health Charter, and supported through supervision, evaluation involvement, and collaborative planning. Programme costs included artist delivery, venue hire, art materials, transport support and coordination, funded by Arts Council of Wales, Lottery funding and Hywel Dda Charities.
The Impact
HARP was evaluated using mixed methods, combining PROMs (SWEMWBS and SWSWBS), qualitative interviews and focus groups with service users, arts partners and primary care staff. The limited number of full quantative data sets reduced statistical power, so the small wellbeing changes are only indicative. However, qualitative findings demonstrated clear positive impacts. Participants reported reduced loneliness, increased confidence and renewed motivation: “These sessions have helped me with getting out the house” and “We just clicked… and totally relaxed.” Social connections were strengthened, with participants forming friendships and re‑engaging in creative and community activities.
Clinicians saw HARP as a valuable option for socially isolated or anxious patients, with one GP noting it “saved her at a point of crisis.” Arts partners observed improved engagement when sessions were flexible and when health professionals joined in activities. Unintended impacts included increased volunteering interest and improved trust between patients and health professionals.
Overall, HARP quantitative evaluation was hampered by data limitations but qualitative analysis shows HARP delivered meaningful social, emotional and confidence‑building outcomes.
Lessons Learned
Clear lessons emerged from delivering HARP. Flexible delivery, compassionate artists and transport support worked well, helping reduce barriers for participants. Challenges included GP referral numbers, evaluation burden and limited capacity. Next time, simpler referral routes, clearer evaluation language and extended programme length will be prioritised. This learning will guide improved processes, stronger partnerships and more accessible future delivery.
The Legacy
HARP created lasting social connection, improved confidence and renewed engagement in creative and community activities. Participants expressed a desire to continue, with one noting the programme had “saved her at a point of crisis.” and "I am grateful to (my health professional for) guiding me to a brighter life". Learning from the pilot is now informing plans for longer programmes, simpler referrals and broader rollout, helping embed creative health approaches across Hywel Dda and sustain benefits beyond the sessions.
Website and Social Media Links
Health Inequalities in Primary Care - Public Health Network Cymru
HARP-Evaluation-report-FINAL-March-2026.pdf
https://publichealthnetwork.cymru/e-bulletin/health-inequalities-in-primary-care/
(Pages 23 and 24)
https://hduhb.nhs.wales/healthcare/services-and-teams/arts-and-health/
Contact Details
Tags: arts referrals, creative prescribing, complex needs, long term conditions, anxiety, isolation, frequent GP attenders, rural isolation, chronic pain
