Viewpoint: Evidence-informed policy? Local government needs to know what works

Using evidence to make informed decisions is an essential part of providing the right services; Nancy Hey looks at the wider lessons to be learned from a recent review of the evidence about the effectiveness of music therapy.

There is strong evidence that brief music therapy is an effective way to support wellbeing in palliative care patients in hospitals. And that regular group singing improves mental health-related quality of life and reduces loneliness, anxiety and depression in older people. We also now know that there’s initial evidence that music therapy has a positive effect on mood in post-stroke patients.

We know this, and other music and singing related findings, because we commissioned leading universities – LSE, Brunel London, Winchester and Brighton – to systematically review all the available evidence music and singing for wellbeing benefits.

Surprisingly, despite millions of pounds being spent to deliver community music and singing projects to countless people across the country, our review is the first of its kind. That means everyone from young offenders to older people have been participating in community projects without a full picture of the evidence. How do we know the best way to get impact for those involved, their families and communities?

Our new evidence reviews help local government to improve people’s lives in real and meaningful ways. We already know that the way people are supported to improve their wellbeing can make a huge difference. But, until now, we have only been able to glimpse small fragments of what works, and for whom.

This has to change.

It may seem that we intuitively know that a community choir or calming music at work has positive effects on people’s wellbeing. But a mindset that good intentions equal good results is a luxury when resources are tight and when we want to do the best we can for people.

We need to start taking evidence-informed policy and practice more seriously.

A first step would be to get better at measuring what matters for people – and make sure that policies and decisions are designed to actively improve what is most important for people and communities.

We can get a better picture of what’s working across the country – learn from each other – if community organisations and other public services are better supported to evaluate what they do. And those evaluations need to do more than sit on a shelf. There are many claims that all sorts of things improve wellbeing and we have no way to compare the impact. The findings need to be brought together so learning can be shared and used to improve services.

Knowing what we do know also helps us focus on finding out more about what we don’t and precious research funds can be focused better. For example, our music, singing and evidence review showed that there was initial evidence that when nursing home residents with dementia took part in individual, personalised music listening sessions, they were less anxious and depressed.

‘Initial evidence’ essentially means there may be an effect, but we need to look at whether this will happen consistently and how. If we are able to find more evidence, and use this to create evidence-informed programmes in care homes, it could mean more ways to help older people living with dementia lead more fulfilled and dignified lives. It isn’t just a theory, initiatives like A Choir in Every Care Home – which featured in our Music, Singing and Wellbeing findings – are already working to fill the evidence gap in this area, while evaluating their music projects.

Using any evidence base to inform policy and practice is the next logical step, and one we at the What Works Centre for Wellbeing are committed to making happen. We need more evidence geeks involved with running and measuring our community services, and we need to make sure we capture what is being learnt. Because, ultimately, better evidence leads to better decisions that improve and potentially save people’s lives.

Nancy Hey is director of The What Works Centre for Wellbeing, an independent organisation set up to produce robust, relevant and accessible evidence on wellbeing. The Centre works with individuals, communities, businesses and government, to enable them to use this evidence make decisions and take action to improve wellbeing.