'So, this feels very different and, you know, kindly': a mixed methods study of arts on prescription in secondary care.

Arts on Prescription (AoP) programmes occur within primary care and community settings. The aim of this study was to examine the impact of AoP delivered in secondary care, on patient wellbeing, social connection, and experiences of care. A mixed-methods design was used. Quantitative data were collected from 61 patients referred to AoP through secondary care outpatient services for cancer, chronic pain, weight management, breathlessness, or neuromuscular conditions. Wellbeing and loneliness were assessed pre- and post-participation in the AoP programme. Mood and loneliness were assessed before and after each arts workshop. Qualitative methods focused on experiences of AoP and were collected through semi-structured interviews and focus groups (n = 12) and analysed using thematic analysis. Wellbeing scores increased significantly over the course of the programme, alongside reductions in loneliness. Arts workshops increased relaxation, contentment, and social connection. Thematic analysis led to four themes: (i) Connection to others-feeling supported, inspired, and understood; (ii) Making space-providing relaxing, protected time; (iii) Becoming-renewed confidence, and opening to new opportunities; and (iv) Relationships with healthcare-reframing interactions with secondary care, validating referrals, and supporting the management of health conditions. AoP in secondary care demonstrates potential as an effective approach, replicating effects in primary care, including improved wellbeing and social connection. However, additional merits in this context relate to healthcare relationships, and using the arts to manage health conditions. Embedding AoP within secondary care may reduce burden on services by supporting psychosocial needs alongside medical care.