Hospital Broadcasting An impact study

Research undertaken by: On behalf of: 2

The Hospital Broadcasting Association is the national charity which supports and represents a network of over 200 independent hospital broadcasting organisations across the UK. For more information, see www.hbauk.com 3 Executive Summary

The Hospital Broadcasting Association that hospital radio was actually positively Hospital radio has the potential to increase (HBA) commissioned an independent piece in" uencing all of these psychosocial awareness of health and wellbeing by of research into the impact of hospital outcome measures. delivering information and advice in an broadcasting on health outcomes for appropriate and sensitive way. patients. A UK wide study was completed Entertainment is provided by hospital radio involving over 250 individuals including through the playing of music, along with In addition to bene# tting patients, hospital patients, sta! and hospital radio volunteers. other content, that listeners like and that they radio has a positive impact upon volunteers feel is relevant to them. through making them feel like they are doing The study revealed that there was evidence something worthwhile and by creating a of hospital radio stations having an impact Social interaction via hospital radio comes sense of community and belonging amongst on psychosocial health outcomes in the from providing listeners with a virtual friend, radio station volunteers. following ways: and through face to face interaction with volunteers from the station. There is potential social value generated • Boredom reduced by entertainment by hospital radio through the impact it has • Loneliness reduced by social interaction Hospital radio through the approach to upon the psychosocial outcomes, and the • Anxiousness / frustration reduced by broadcasting taken by presenters provides a links between them and both physical health being calming and reassuring distraction and is a calming and reassuring outcomes and organisational priorities • Disorientation reduced by creating a sense form of entertainment. for the hospital, such as a positive patient of belonging experience. • Depersonalisation reduced by making Hospital radio helps create a positive sense one feel like an individual of belonging by familiarising patients with Recommendations are made to increase • Health and wellbeing awareness increased the hospital and allowing them to maintain the impact of hospital radio through raising by providing information a connection with their lives and people awareness and promoting partnership outside. working with hospital partners. More detailed Participants in the research recognised the recommendations have been made to the positive impact of hospital radio on reducing Hospital radio helps people to feel like an member stations and the HBA. boredom, loneliness and anxiousness. individual by focusing on their personality Moreover, insight from the research revealed and music preferences. Written by Dr Jenny Thomas and Steve Coles On behalf of the Hospital Broadcasting Association © 2016 www.hbauk.com 5

1

Approach I have had a really di% cult and hard day. Your visit really cheered 2 me up and I am now looking Literature Review forward to hearing my record. Thank you!

3 – Hospital Patient Impact Measures

Entertainment Social Interaction Calming and Reassuring A big thank you for brightening the Sense of Belonging night when you played requests Feel Like an Individual for all the patients on our ward. Health and Wellbeing Now that I’m home I’m still smiling about the sing-a-long we had!”

4 – Hospital Patient Value of Hospital Radio

5 Conclusions 6 Approach

To gain an insight into the impact of hospital their families was included within the analysis. broadcasting a multi-method approach was The focus of the research was to explore the taken including: activities undertaken by the stations and the impact that these activities • desktop research have upon listeners. • questionnaires 47 hospital radio • station and hospital visits The data, both qualitative and quantitative in volunteers • interviews nature, was analysed to determine the impact of hospital radio in relation to a theoretical Insight was gathered from: model developed from secondary research. The way in which these impacts were achieved • hospital radio station volunteers through the activities of hospital broadcasting • patients and families are presented in the following section, along • NHS ward sta! with evidence of this impact in practice. 60 • senior representatives from the NHS in patients and 25 families indirectly engaged hospitals patients directly All countries within the UK were represented. engaged In addition, a review was undertaken of relevant research and data.

Questionnaire responses were received 111 14 NHS from over 50% of the 209 HBA member questionnaire representatives hospital radio stations in the UK and more responses than 89 individuals were directly engaged by the research team for in-depth exploration of the activity and impact of hospital radio. Some of the people we Feedback from an additional 60 patients and spoke to in our research. 7

Introduction Physiological

• Blood pressure To determine the impact of hospital • Respiration rate broadcasting the Hospital Broadcasting • Pain Association commissioned a piece of • Discomfort independent research. The aim was to • Infection establish whether the activities of hospital • Sleep radio stations are having an impact upon • Deteriorating health • Additional symptoms health outcomes and, if so, how they are • Falls making this di! erence. • Death

Existing research evidence suggests that the Organisational clearest impact of hospital radio can be seen in relation to psychosocial health outcomes • Number of calls to nurse (British Medical Association, 2011). These are • Discharge process non-physical outcomes which include feeling • Length of stay lonely, being bored and feeling anxious in • Pain medication hospital. Psychosocial health outcomes • Infection control • Satisfaction with care are linked to other health measures • Patient experience and govenment healthcare priorities • Patient centred care demonstrating the huge potential of hospital • Re-admission radio to make a di! erence.

Linked to this model are other factors Psychosocial which should be considered: • Loneliness • impact on volunteer’s wellbeing by being • Boredom involved in hospital radio • Anxiousness / stress • # nancial cost and potential bene# t of • Anger / frustration • Sense of control providing hospital radio • Disorientation 8 Literature review

1 2 3 The Patient Experience: Importance of Psychosocial Music as Therapy: Health: Current government policy focuses upon the Research into the therapeutic impact of impact that the patient experience has on Psychosocial health outcomes have speci# cally music is mixed but generally positive. the delivery of healthcare (Black & Jenkinson, been linked to a patient’s experience of There is evidence to demonstrate that 2009). Research shows that how a patient feels hospitalisation. listening to music has an impact upon in hospital can a! ect aspects of their physical physical health including blood pressure, health and have consequences for the NHS, Brown (1963) suggested that hospitalisation heart rate and increased tolerance of pain or HSC in Northern Ireland (Sobel, 1994). for patients was linked to anxiety, boredom, (Allen et al, 2001; Khanna & Kotwal, 2010; loneliness, and frustration. In addition patients Mitchell et al, 2005). Physical health outcomes, measured in had to adjust to an unfamiliar environment. relation to hospital stays, are linked to the NHS A loss of control over their lives and the In terms of the psychosocial health factors Outcomes Framework and include; blood # lling of time were cited as signi# cant issues. identi# ed, music has been found to have a pressure, respiration rate, pain, infection, Patients reported the slow passage of time positive impact upon stress levels, boredom additional symptoms, deteriorating health, which could lead to loneliness, sadness and and mood when being admitted to hospital falls and death (Department of Health, 2014) anxiety (Holloway et al, 1998; Kelly et al, 1999). (Evans, 2002).

“Hospitalisation presents speci# c stresses Organisational outcomes include those Furthermore, having a choice in the music over and above those associated with illness... factors which a! ect the running costs of played was found to have an impact upon When a patient’s needs are not met it may the NHS or HSC such as length of stay. the level of perceived control that patients a! ect their emotional state.” (British Medical felt they had in hospital (Mitchell et al, 2005). These two groups of health outcomes are Association, 2011 p. 4) a! ected by psychosocial health measures of the patient experience including; Sobel (1994) analysed the evidence and found loneliness, boredom, anxiousness, sense of that a positive outlook had a bene# cial impact control, sadness, anger and disorientation upon physical health outcomes. As a result (British Medical Association, 2011). those with positive psychosocial health were less likely to make use of health services. 9

4 5 7 Beyond the Music: Impact on Volunteers Conclusions:

In addition to music, hospital radio stations There can be impacts of volunteering upon There is limited, if any, research speci# cally also broadcast other content and visit the volunteers themselves. Mundle et al conducted previously into the impact of patients on the wards. (2012), found that people are motivated hospital radio on health outcomes. However, to volunteer through self-interest such the existing research does suggest that there There is evidence that engaging hospital as developing a new skill, altruism, or a is potential for hospital radio to in" uence patients in activities which distract them from combination of the two. psychosocial health outcomes in particular. thinking about their time in hospital has a Research demonstrates that being a volunteer positive impact e.g. playing interactive games The research highlights the importance of can have a positive impact upon that individual like bingo (British Medical Association, 2011). psychosocial health in relation to physical through improved self-esteem, wellbeing and Comedy and humour have also been found health. Being hospitalised can have a negative social engagement (Naylor et al, 2013). to have a positive impact on psychosocial impact upon the physical health of patients health (Rotton & Shatts, 1996). if they feel lonely, bored, anxious, and 6 disorientated amongst other things. There is evidence of the positive impact of visiting patients on wards (Casiday, 2008; Value of the Patient Experience: Music, and the other activities associated with hospital radio such as request collecting Fitzsimons et al, 2014; Galea et al, 2013) and Social value, via an improved patient the bene# ts of increased social interaction, on wards and broadcasting other content, experience, can be derived from the activity have been found to have a positive impact including parasocial interaction which is a of hospital volunteers (Hotchkiss et al, 2008). virtual connection with someone (Giles, 2009). upon hospital patients. There are also The Kings Fund estimated the social return positive impacts identi# ed for the volunteers on investment at around 11 times the # nancial themselves. For NHS or HSC partners there cost to the NHS of supporting volunteering is evidence that something like hospital (Galea et al, 2013). radio could generate social value through an improved patient experience. An NHS Confederation report found an improved patient experience could lead to reduced operating costs, shorter hospital stays and improved health outcomes (2010). 10

Impact of 19% of stations have evidence of increasing awareness of Hospital Radio: health & wellbeing 89% Hospital radio stations were asked whether they had evidence of their impact on six key impact measures. 89% The responses were very positive of stations have in relation to social interaction and evidence of their impact on social entertainment however stations interaction were less aware of their impact 19% on the other measures. 21% 21% of stations have evidence that they make patients feel like an individual 26%

26% 92% of stations have evidence 44% that they give patients 92% a sense of of stations have belonging evidence of 44% their impact on of stations have evidence entertainment that they are calming & reassuring 11

Impact Measure Entertainment of stations surveyed rated entertainment 67% as their number one priority when deciding what to Impact and Activities Challenges: broadcast. which Make a Di! erence: Whilst in hospital patients have long periods The impact of hospital broadcasting on of inactivity, and report that time can pass 92% very slowly. There is often little to provide entertainment comes from providing of stations surveyed them with enjoyment or pleasure, particularly listeners with something that they feel is reported having outside of visiting hours. Patients who have relevant and personal, and playing music they evidence of a di% culty sleeping often report that this is enjoy which is chosen by them and fellow positive impact of % worse at night when they cannot talk, and the 99 patients. Beyond the on air content, hospital their activity on light for reading or watching the television broadcasting is able to entertain listeners reducing boredom in disturbs other patients. through engagement in conversations with hospital patients. of stations volunteers who visit wards. surveyed said that Patients now have access to a range of they collect song entertainment media. Most have access to requests. national and local radio stations and television at their bedside, as well as hospital radio. An increasing number of patients are also 76% of stations bringing in their own devices with pre-loaded broadcast interactive content including music and television content such as programmes. competitions and on air games 12

Opportunities: “ We # nd that people want to hear about things in the local area that are relevant to them. Each week we put As a medium, radio is designed to provide together information on about three entertainment for listeners. However, Our mother was in hospital last or four events happening in the next evidence gathered suggests that hospital month and had a request played month that we think our patients radio entertains patients in a way that other for her with a mention on the would enjoy and which they might be forms of radio, etc are not able to through: Wednesday night show. She was able to manage, such as local history absolutely delighted and could • the genre and variety of music played talks. ” talk about nothing else the next • nature and relevance of content broadcast day when we went in to see her. • interactive content e.g. quizzes and – Kerry, volunteer from Hospital Radio Sadly she passed away 2 days later games Plymouth but we’re so pleased that her last Unlike other radio stations where the music Wednesday night was # lled with played is dictated by various requirements such joy thanks to hospital radio. A further di! erentiator of hospital radio is that such as commercial restrictions, set playlists requests are gathered directly from listeners etc, hospital radio stations have the freedom – Family of a hospital patient and then broadcast on live shows. The to play whatever songs they want. This means majority of hospital radio stations broadcast it is generally tailored to suit the preferences request shows in the evening and play of patients. As requests are gathered, the requests gathered that same day. 44% of the particular genres or songs that are popular stations play requests on all live shows. that day are often used to in" uence the rest of the music played. The variety of music Song requests have an impact on played is wide, and songs that are rarely entertainment through allowing people to heard together can frequently be played hear a song or songs that they like. In addition sequentially. As one interviewee commented to this is the enjoyment that people get from “where else would you hear Frank Sinatra hearing their name mentioned on air. When followed by AC/DC”? a request has been made patients are much more likely to listen out for their song and are pleased when it is played. 13

The nature of the content broadcast is important. Having met their audience and being very aware of their situation, hospital broadcasters are able to tailor what they We had an elderly gentleman broadcast to ensure that it is appropriate and patient who was really excited to appeals to listeners. Some presenters do talk to us about George Michael. small but signi# cant things like not reporting He and his late wife had been big the time as they are aware that it can pass fans. He was telling us all about slowly for some people in hospital. Others provide information about interesting local the concerts they’d been to and events that are happening in the future that then asked if he could show us would be appropriate for patients in recovery. something. He got out of bed and started dancing! He just lit up. “ When we think the patients are Various levels of interactive content were It was lovely to be able to bring a up to it we sometimes unplug the reported. This ranged from presenters posing new, more positive engery to him. headphones from the bedside units questions for listeners to ponder on, through and play out radio in the bay. to competitions where people were asked - Nyah, volunteer from All of them put in requests and we to phone in and interactive games such as Radio Harrow have them all singing along and battleships and bingo. Where listeners are sometimes dancing. It gets a good engaged in these activities there is positive atmosphere going which really lifts feedback. It provides entertainment both for those playing and the other patients the patients’ spirits. Its good for the around them who invariably join in. Again, patients and its good for the sta! . interactive elements, providing they are not It makes us feel more human. ” too challenging, engage people in a way that other mediums of entertainment are not able – Sammy, nurse and volunteer from to such as passively watching television. Radio Addenbrooke’s 14

Impact Measure Social Interaction

95 % of the stations surveyed reported that presenters go out to meet patients Impact of Hospital Challenge: on the wards. Radio Activities on Social With lots of people around, hospital might Interaction: not seem a lonely place. However, people frequently report feeling socially isolated. 9 Hospital radio provides patients with virtual They do not know anyone and only see friends who know and understand their friends and family at visiting times, or not at 4.5 visits are made needs and the situation they are in. This all if they have no visitors. to the wards by allows them to communicate e! ectively hrs volunteers per with people over the airwaves. The ward The literature review revealed that social per day is the station per week on visiting and song request collecting are isolation in hospital is a concern as it can have average length average. essential activities to give patients someone a negative impact upon patients’ health. With of time stations to talk to face to face. The programmes families being more geographically dispersed, surveyed broadcast broadcast and visits from volunteers to the and friends and family of patients sometimes live on air. wards facilitate social interaction between struggling to get into hospital to visit, patients patients, with visitors and with ward sta! . can feel more isolated. The increase of single Over 2/3rds of the rooms is thought to be further contributing to stations surveyed had feelings of social isolation for some patients. In received song requests these rooms they do not have other patients from NHS sta! , often to talk to and do not see sta! as often as they with dedications to might in shared wards or bays. patients. 15

Even when in a ward with other patients Semi-passive engagement is important it is sometimes di% cult for them to # nd for patients who feel that they want social common ground to interact with others. interaction on some level but who do not want Equally healthcare sta! are keen to # nd to actively participate. This might be due to As nurses it is sometimes di% cult to ways to promote social interaction with, and them feeling too unwell or wanting something # nd time just to sit with a patient, between, patients to promote wellbeing. soothing to help them sleep. Hospital even if we know they would bene# t broadcasting plays an important role for these from that support. So we’ll put in a Opportunities: people as they perceive that there is someone song request and ask the patient to talking to them on a fairly personal level who Hospital broadcasting was found to be having understands them, and their situation, but to call us when it comes on. We then a positive impact upon social interaction in a whom they don’t have to respond. go and sit with them to listen with number of ways: them at their bedside. To have a Presenters being perceived as similar to reason to spend that time with them • being a virtual friend on the radio patients, e.g. the same age, gender is is invaluable. • semi-passive engagement sometimes seen as bene# cial, particularly • meeting with and talking to patients in if patients feel they can connect through – NHS Ward Sister person something like shared musical tastes. Equally, • encouraging conversations between some older patients reported that it was nice patients and interaction with hospital sta! to hear a young person on the radio and meet them when they were ward visiting. Presenters want to reach out to hospital play to interact with them around something patients and entertain them at, what is for Evidence from patients, and interviews with enjoyable. The radio station can facilitate this. most, a di% cult time. With the vast majority of both volunteers and hospital representatives, The more e! ectively patients are engaged by presenters reporting that they visit patients it demonstrate that visiting the patients the volunteer the more positive the impact. means they are able to visualise them when is extremely important to help combat The music can be of secondary importance they are on air. They can talk to listeners in a loneliness. Patients who want to talk to but is an in" uential tool to engage people. way that presenters on other radio stations someone but have no visitors, or # nd are not able to. This is appreciated by patients themselves alone at certain points of the day, The importance of hospital radio stretches who feel they know the person talking to enjoy having a person to talk to about the beyond interaction between listeners and them and that the radio broadcast is targeted music they like. In children’s hospitals there radio station volunteers. By visiting wards and at them. is an even greater emphasis placed on using asking patients about music, conversations 16

“ A few patients have said they like meeting me as I seem like a nice young man, I’m 17 years old, and some of the older patients say I remind them of their grandson so will happily chat to me. ”

– Andrew, volunteer from Hospital Broadcasting Service (Glasgow) are generated in bays, between the beds, as patients talk to one another about the requests they might make. It also prompts enjoyable conversations between patients and their visitors. In addition, interactive elements of the broadcast can involve groups of patients working together in teams.

Social interaction between ward sta! and patients can also be positive where healthcare sta! are engaged in hospital radio. A considerable proportion of stations surveyed for this research said that hospital sta! had made a request and they often dedicated this to patients on their ward. In some hospitals the “ Often we go into a bay and it is quiet. By the time we leave you’ve got people bedside sets are the only means of listening to chatting from bed to bed about the music they’ve requested. You get a really hospital radio but there are examples of sta! positive atmosphere. Not a party... but almost! ” # nding ways to broadcast the radio in their wards using speakers, etc, and sitting with – Peter, volunteer from Hospital Radio Plymouth patients to listen with them via headphones. 17

of the stations Impact Measure surveyed said 62 % that providing patients with Calming and Reassuring a distraction whilst they were in hospital was a top 3 priority for them. Impact of Hospital Radio Challenges:

Activities on being a People are in hospital because they need to Calming and Reassuring be there to receive treatment or medical care. 30 % Therefore, whilst boredom is clearly an issue, of the stations In" uence this can be coupled with anxiety, frustration surveyed said they and / or sadness for many people. Worrying 71 % Where other radio stations are providing broadcast over about what might happen or the treatment to entertainment, hospital radio has an loudspeakers in be received is common, especially as patients additional, important role which is to waiting rooms, often have time to dwell on these thoughts of stations surveyed distract people from the negative feelings or outpatient areas, when they are not otherwise occupied. Finding o! er content in thoughts they have about being in hospital etc to provide a something to take their mind o! the situation, addition to music or a similar setting. This is achieved through distraction for even just for a short while, is bene# cial. such as news, talk, people who might sensitive presenting, content being relevant sport, spoken be anxious. and engaging for the listeners, interactive word, weather and elements of the programming and visits by comedy. volunteers to talk about music and other things that interest the patient. 92% of stations surveyed reported that they broadcast 24 hours a day. 18

Opportunities: “ Recently we were not able to broadcast a live Saturday morning show for a while. Nursing sta! from As detailed earlier, radio has a bene# cial I was in hospital for a long time last one of the wards asked us to bring impact upon negative feelings through year. It was an extremely stressful it back as the number of call bells providing entertainment. Beyond this it is time for me and I would just lie in they had to respond to dramatically also important to note the additional impact bed from 10pm to 7am worrying and reduced when the show was on air that hospital radio has through being a not sleeping. I discovered hospital distraction and having a calming in" uence. because patients were engaged by radio and found it really helped This is due to the particular situation of the the show. ” at night. To just be able to put on listeners. The morale of healthcare sta! can headphones and listen to non-stop also be boosted by listening to the hospital – Andrew, volunteer from Hospital Radio music was just what I needed at that radio station, which in turn creates a positive Plymouth time. It did ease my frustration and atmosphere for patients. The presenting style of people on hospital radio anxiety during these long nights. is also a contributor to reducing feelings of Many patients in hospital are very ill, however anxiousness. Having a calm presenting style or – Hospital Patient they might still be able to listen to and enjoy being humorous were both cited as e! ective the radio and music played. Having a request at making people feel more at ease. Whatever played has a particularly positive in" uence the style, making listeners feel that they were with the majority of patients we interviewed being connected with on a personal level by saying that when they made a request they someone who understood them was key. listened out for it that evening, which was a As a rule I don’t ask patients what pleasant distraction. Direct reports from healthcare sta! they’re in for. Some volunteer the interviewed indicate that hospital radio information and want to talk to At other times patients need something to take has helped ease anxiety during treatment. a person who will listen to their their minds o! negative thoughts that they are Listening to music can help people relax and concerns. having or to help them sleep. Being able to also gives them something to focus on rather – Phil, volunteer from Causeway tune into hospital radio any time day or night is than the treatment. Healthcare sta! reported positive as patients know it will be something getting patients to listen to music when Hospital Radio they can listen to that is appropriate and receiving some treatments which were not sensitive to them and their situation. very pleasant to soothe them. 19

Knowing that hospital radio was available meant that they had a trusted source of distraction that they could put on for patients. They reported that they had seen patients physically relax as a result, which made the treatment more e! ective and easier to bear.

Distraction is also provided by hospital radio through ward visits. Having something to talk about which is not related to their health or the situation they # nd themselves in provides welcome relief. They can talk instead about music and memories or feelings that those songs might provoke that relate to them as a person and their life outside hospital. Some patients spend time thinking about the requests they want to have played which, again, takes their mind o! their situation for a little while. Conversely some patients do want someone to talk to about their health condition as sharing their concerns can help reduce the anxiety they are feeling.

When content from the radio is also available “ We had a group of ladies on one ward who had been in for a while and were on demand, people have the opportunity to very anxious about going home. We persuaded them to take part in an on air listen to it when they need to be distracted competition together. They got in touch to say they’d not laughed so hard which may not be the time that the show is in ages and were excited about going home now as they couldn’t wait to tell broadcast live. their families about being on air and winning a prize. “

– Peggy, volunteer from Hospital Broadcasting Service (Glasgow) 20

Impact Measure A Sense of Belonging

48 % of stations have received positive feedback from NHS sta! about the impact Impact of Hospital Radio Challenge: of hospital radio on Activities on a Sense of patients. Being in hospital can be a very disorientating 1/2 Belonging: experience. People are in a new and unfamiliar environment and some will have Information provided via hospital radio been taken there with little or no notice to of stations linking patients to both the people and allow them to prepare. Once there, people’s 58 % surveyed meet activity of the hospital, as well as keeping daily routine is completely di! erent and of stations with an NHS them connected in a positive way to the things are happening around them that they surveyed change representative outside world, helps reduce feelings of do not understand. There are also unfamiliar their schedule less more than twice disorientation in hospital. people, both patients and sta! , and they than once per year a year to discuss will not have people there who would and the majority what they are normally be with them e.g. partner, children, keep a # xed doing in the etc. Changes to the way in which care is schedule to provide context of the delivered also means that patients are not consistency. hospital. usually in hospital for as long so do not have the time to become accustomed to their surroundings. The outside world can seem a of stations surveyed long way away. 71 % broadcast national news and information about things happening locally is broadcast by 67%. 21

Opportunities: “ We see hospital radio as part of the wider NHS Trust family and work with them to help bene# t both the Hospital radio helps orientate people within patients and sta! in the hospital.” the hospital and makes them feel less We have launched Team of the Week for hospital sta! . They get a disconnected from the rest of their lives in a – Linda, NHS Representative trophy, chocolates and requests and number of ways: Addenbrooke’s Hospital dedications played on air. It makes • providing patients with information about sta! feel valued and appreciated. way. Members of sta! including directors from the hospital and what happens there the Trusts and Boards are often interviewed by The award also engages patients • connecting patients with people and hospital radio stations and usually talk about from that ward and it helps increase things happening outside the hospital their favourite music whilst also explaining awareness generally of hospital radio. • making NHS sta! aware of the station and what their role is in relation to the hospital. schedule so they can engage patients – Steve, volunteer from Hospital • o! ering a personalised service so patients Whilst local radio is able to provide people Radio Clatterbridge recognise the radio as being something with information about what is happening for them outside the hospital, this could lead to patients feeling more isolated. Hospital radio Hospital radio stations, whilst independent volunteers in the interviews reported that they from the NHS (or HSC), are seen as part of were careful about the content broadcast the hospital and they provide patients with and that they ensured that it was presented it information about what is happening there. in a sensitive way. For example hospital radio Where there is a positive and pro-active stations go out to local places and events relationship between the radio station and and report on them for the bene# t of hospital the hospital, the stations engage with events patients or broadcast live concerts. Others such as carol concerts and broadcast them engage the local football teams, getting to listeners. managers and players to talk on air at half time. Having a live connection to these local Hospital radio is also used as an opportunity to events, and reporters who are conscious of introduce some of the sta! and services that patients listening in hospital, helps people feel patients might not be aware of in an engaging connected in a positive way. 22

Another signi# cant thing which makes people feel isolated and cut o! is not seeing their “ We want to make the station local and for the people who are there in hospital. families and friends as much as they would We’re introducing a feature called Barry Island Discs which is a local play on outside of the hospital. Hospital radio can help Desert Island discs. We’ll say to guests “you’re stranded at the train station in mitigate this by providing a connection on the Barry Island, what 6 songs are you going to play on your ipod while you wait for air. This can come in the form of song requests the train? ” from family and friends which are signi# cant to their relationship and this connects people – Dave from Hospital Radio Merthyr Tyd# l to their loved ones who they are missing. Hospital radio stations which broadcast online or via an FM/AM signal further strengthen this connection as friends and family can listen to their requests being played. On stations where this is possible, on air conversations extend contact between people beyond visiting hours.

The greater the awareness ward sta! have of hospital radio, the more likely they are to promote it to patients and engage them. Generating enough awareness is a challenge that most hospital radio stations face due to other pressures on healthcare sta! time and the potential lack of opportunity to meet with appropriate sta! members. Where there is good engagement with ward sta! they frequently use hospital radio to create a positive, inclusive atmosphere on the wards to make patients and sta! alike feel a sense of belonging to that place at that moment. 23

Stations surveyed reported Impact Measure receiving an average of: Feeling Like 50 requests per week

an Individual Just under half the stations at: Impact of Hospital Radio Challenge: 44% Activities on Feeling Like reported accepting On coming into hospital patients give up requests for all live an Individual: almost all control of what happens to them 1/4 shows. and their daily routine. With the focus of The literature review revealed that there their time in hospital being their health and is a risk of people feeling depersonalised receiving treatment, patients can sometimes Around 1/4 of when they are in hospital. Through hospital feel depersonalised and that their condition stations o! er a broadcasting this is reduced by recognising is the focus rather than them as a person. recording of some people as an important individual, talking Finding ways to give patients a greater sense 4th of their shows that to them about their likes in terms of music of control, and ensuring that they still feel people can play on and playing requests for them. This sense of like an individual, is really important for their demand. identity is further strengthened by creating a health and wellbeing. Giving patients personalised service for patients and o! ering a choice in what them greater control over what they listen to Opportunities: songs are played and when. on the radio was the 4th highest Hospital radio is regarded as being for the priority for stations patients. A personalised service that belongs surveyed when to them. This sense of the radio being for deciding what to the patients was reported by both them and broadcast. 24

volunteers. Feeling part of something and “ You go out and visit your audience in perceiving hospital radio to belong to them, hospital radio so you meet the people the patients, promotes a sense of being you’re broadcasting to. You know important and mattering within the hospital. them, and you can play the music Having the radio station located in the hospital, they like as you visualise them when A lady opposite me on the ward and patients having the opportunity to visit the you’re doing your show. ” requested a song yesterday and also studio, and being invited to request songs all expressed an interest in the tennis. contribute further to patients knowing that the – Joe, volunteer from Northern Air You played her track on air and said radio is provided for them. you’d probably lost her to the tennis. Well she had her headphones on and makes that person feel important. Firstly that An important element of hospital radio is was smiling and chuckling so happily the provision of a service which focuses on they’re important enough to play a song for, to herself when you mentioned her the patients as individuals and their interests but also that they are mentioned on air and name and that she’d probably be outside of the hospital. By focusing on that the presenter refers to them directly for listening to the tennis instead. She what music people like, and their personal everyone else to hear. If they have met the preferences, hospital radio is able to help person actually presenting the request show was alone for a lot of the day and people maintain a sense of self whilst in this is strengthened further. It creates a real I think your dedication made that hospital. As noted earlier it also helps spark connection with the hospital radio station that elderly lady happy. That’s priceless. conversations between them and their visitors, it is not as easy to form with other mediums of other patients or ward sta! about something entertainment or other radio stations. – Hospital Patient other than their health and treatment. Variety was cited as a reason that hospital The opportunity to request a song to be radio was liked and had a positive impact played on the radio also makes a di! erence. upon feeling like an individual. People feel At face value there is an opportunity to with the mix of music, and other content in" uence the music being played on the where broadcast, that there is usually radio and ensure it is something the listener something for them within the schedule. likes. Although many people have access to Most stations broadcast additional content music they like in hospital via mobile phones like sport, comedy, spoken word, news, etc or tablets, the reason that having a request and specialist music programmes, often played on air appears to be di! erent is that it throughout the day when the station is 25

“ Our patients tell us that most of particular programmes that appeal to them. “ It’s amazing how people can pick their conversations, even those with For example, they could choose to listen to a a song that means something to visitors, centre around their health programme of relaxing, calming music when them straight away. They give and what treatment they have had. they are feeling anxious or could listen to a all sorts of di! erent reasons for Someone coming in and asking them recording of a Sunday service during the week choosing a song. Maybe it is a happy what music they like reminds them if their religion was an important part of their memory from outside of hospital or of their lives in a more general sense identity and they wanted that reinforced. sometimes dark humour about their and who they are as a person. That’s situation. But whatever the reason a really important part of the patient the song choice re" ects them and it experience. ” gives them pleasure to hear it.”

– Judy, HSC Trust representative – Susie, volunteer from Radio from Causeway Hospital Addenbrooke’s

not live. If patients are aware of the station schedule they can chose to listen to the shows or programmes they like.

From the research it became apparent that some hospital radio stations are considering ways in which they can o! er listeners further control over what they listen to by providing on demand content, or the ability to listen via mediums such as online streaming or AM/FM broadcast. There are challenges to o! ering these services but the potential bene# ts to listeners are considerable. On demand content means patients can listen to elements of hospital radio when it suits them, and 26

Impact Measure Health and Wellbeing

19 % of stations feel that they are having an impact upon listener awareness of health and wellbeing. Impact of Hospital Radio Challenge: Activities on Health and Recently discharged patients are one of the Wellbeing: most vulnerable groups that Public Health 51% and equivalent bodies deal with. Patients There is opportunity for hospital radio to who have been recently discharged do not have an impact upon the awareness of always follow, or are not aware of, health of stations report health and wellbeing for those who have advice. Whilst the hospitals promote health that they have received treatment in hospital if handled and wellbeing advice, and the majority hold some form of sensitively. Hospital radio is an additional awareness days such as stroke awareness online content and alternative means of communication day, this is not always accessible to or actively 50 % including for health charities, Public Health and the received by patients. of stations report streaming. hospital themselves. that there is some NHS input into the content of their “ We need to work more closely with the hospital radio station to include them broadcast. in our community days. It’s a real bonus having them involved but we are aware that we need to tell them more about what’s happening in the hospital. ” of stations surveyed – Kath, NHS Health Board representative from Prince Charles Hospital 58 % reported broadcasting health and wellbeing information. 27

“ A large number of charities are keen to and also provides patients access to these wellbeing to listeners. With a move towards be involved with our station as we are events who might not be well enough to providing more care within the community, well known locally. We promote the attend in person. Whilst this was reported to self-care and the use of technology to work of a number of charities on the be happening in some hospitals, many radio facilitate virtual wards, those who would Wirral whose work is associated with stations involved in the research, and their traditionally have been thought of as hospital the health park where we broadcast healthcare partners, acknowledged that more patients may no longer physically be in and invite them in to speak on air. ” could be done to involve hospital radio in these hospital. Public Health representatives in events for the bene# t of patients. the research highlighted the vulnerability of – Steve, volunteer from Radio Clatterbridge recently discharged hospital patients and felt There is also an opportunity for hospital that something which enabled them to still radio to engage charities or services which feel a sense of connection to the hospital, Opportunities: would bene# t people in hospital, that they such as hospital radio, is bene# cial. might not otherwise be aware of. Again, if Hospital radio stations are in a positive handled in a sensitive way, this is a bene# cial Some hospital radio stations, with the ability position whereby they have links to the service for patients. to broadcast outside the hospital, engage hospital and other health providers and people within the community and share health patients listening. Whilst the main purpose Broadcasting outside the con# nes of the messages with them as part of their remit as of hospital broadcasting is seen to be hospital also o! ers greater opportunity to a hospital service. Some stations have used the provision of entertainment, there is promote positive messages of health and other methods to enable broadcasting to be opportunity to provide positive health taken to a wider audience requiring health messages in a non-intrusive way. “ We record a request show for four local and wellbeing support, such as people within care homes once a month. Requests residential homes. The majority of hospitals hold awareness are collected from residents and a one days, open days and other events associated hour long programme is recorded. The Whilst not currently a priority for most with health and wellbeing. Where good programme is provided both online hospital radio stations, there is potential for communication and links exist between the and on a memory stick so sta! from the them to have a greater impact upon the healthcare partner and a hospital radio station care home can play it out to groups of health and wellbeing awareness of listeners. they frequently have a presence at these events residents in a day room or for residents This is something that the healthcare and, with the right equipment, broadcast live. individually in their rooms.” partners, and other health organisations, This provides another medium for the hospital are keen to explore further. to communicate health messages to patients – Tony, volunteer from New Forest Radio 28

Impact on: Hospital Radio Volunteers

Introduction Challenges

Volunteers at hospital radio stations had The main challenge facing stations in relation Stations surveyed di! erent motivations for getting involved. to volunteering was recruiting volunteers. 3hrs reported that the average Some were initially interested in radio as Most stations want to recruit more volunteers. number of hours each a medium whilst others joined due to an In particular they want to encourage people volunteer gives per week appreciation of music. For a smaller, but still to join who will enable them to produce high is 3 hours. signi# cant, group of volunteers the motivation quality and relevant content, be that through to join was to work directly with patients in the presenting ability, technical skill or an a% nity The number of volunteers at hospital. The majority of volunteers we spoke for engaging patients. The content produced, hospital radio stations ranges from: to said that whilst it might have been the love and the ability of the station to have a positive of radio or music that # rst attracted them, it impact upon listeners, is heavily reliant upon was actually the positive impact they felt they the quantity and quality of volunteers. were having on people’s time in hospital that 6 to over 100 really motivated them to stay involved. 29

“ If I can make a patient feel a little For the Listeners happier and a little less sad during their time in hospital then it makes Volunteers almost universally reported that what we’re doing worthwhile and has they believe hospital radio is all about the Being able to make a patient chuckle kept me here for 40 years! ” listeners, and in particular patients. They play and brighten their night is extremely music that is not necessarily to their taste rewarding. – Steve, volunteer from Hospital Radio because they know it is what their listeners Plymouth want to hear. They are also sensitive to their – Eric, volunteer from Hospital listeners’ situation when presenting between Radio Chelmsford songs. Volunteers reported that if they could just take people away from the negative feelings that they might have whilst in hospital by providing entertainment and a distraction, then the time they are giving to the station is worthwhile and rewarding. You can see the happy faces of patients and the di! erence you have Family of Volunteers made. They might be quiet and reluctant to interact when you # rst A further bene# t to volunteers observed in meet them but when you leave they the research is the feeling of being accepted are smiling. You really feel you’ve and belonging to a group of likeminded and made things a bit better at a really generally supportive people. When volunteers di% cult time for them. are working alone in the studio is when they are most likely to report being concerned that – Polly, volunteer from Radio no-one is listening to and bene# tting from Lollipop the broadcast. When volunteers get together they are able to share stories of the positive impact they are having as well as discuss their mutual shared interest of radio and music. 30

Cost of Providing Value of Hospital Radio There are over 5,300 volunteers at HBA Hospital Radio member stations who, according to the survey results, are contributing on average 3 hours per week. This equates to over Introduction Whilst further research is required to de# nitively 16,000 hours per year. Even if they were determine the social return on investment paid the minimum wage in 2016 (£6.70) (SROI) of hospital radio, due to the complexity for the hours they work it would equate to Hospital radio, in its steady state, is low cost of the relationship, secondary research and more than £107,000 per year. as all the human resource required to run proxies can be used to establish where hospital it comes from volunteers who give their radio might contribute social value. From data gathered from the Charity own time to operate the stations. Premises, Commission and Scottish Charity Regulator including utilities, are generally paid for by the Overall the impact study reveals that hospital (sample of 101 stations) the average annual hospital. All other running costs are covered radio can contribute positively to the expenditure in 2014 was £4544. However, by stations themselves through fundraising, patient experience through the impact on expenditure is very much dependent grants, etc. psychosocial health outcomes. There is clear upon the size and activity of a station that evidence of a link between a postive patient year, as well as the money available from Financial bene# ts come from the contribution experience and clinical e! ectiveness (Doyle fundraising. Some stations were reporting of hospital radio through impacts on et al, 2013). This means that the patient annual expenditure of less than £250. psychosocial health outcomes. London- experience has a # nancial impact. based think tank Demos de# nes social Premises costs are generally limited to the value as the “wider non-# nancial impacts of If hospital radio contributes to an improved cost of running a space within the hospital programmes, organisations and interventions, patient experience, which reduces the length e.g electricity and heating costs. However including the wellbeing of individuals of stay by one day, the activity of the station there can be higher costs incurred for NHS and communities, social capital and the is contributing to a £400 per patient saving (or HSC in Northern Ireland) partners when environment.” (Wood & Leighton, 2010). which is the average cost of an NHS hospital new space has to be provided or there are bed per night (Georghiou et al, 2014). signi# cant modi# cations that need to be To the extent that hospital broadcasting made to a space. Where space within a positively a! ects the wellbeing of individuals £400 per day, per patient hospital is at a premium it can be valued and families, it is creating social value. highly as it is seen as space that could be used for another, clinical purpose. 31

Social Interaction Entertainment Feeling Like an Individual Social valuation techniques estimate the Using wellbeing valuation techniques Fujiwara There is a # nancial proxy for the value of ‘feeling value of ‘friendships from community et al (2014), on behalf of the government’s in control of life’ which suggests that the learning’ (a group activity, which may be Department for Culture, Media & Sport, put a average amount of social value is £12,470.00 loosely comparable to group dynamics value of £742 per year on being an engaged per person per year (Value Calculator, 2014). stimulated by hospital radio) at $10 per hour audience member at a music event. While To translate that to the social value created by (Global Value Exchange), which equates to listening to hospital radio is not the same as engagement with hospital broadcasting we roughly £7 per hour. going to a music event, we might use the value might suggest that the value per day per person as a rough approximation of the wellbeing is £34.16 and that hospital broadcasting may £7 per hour, per patient value of music. £742 per person equates have contributed to 10% of that (allowing 90% to £2.03 per day of value realised through to be attributable to hospital sta! , chaplains, Calming and Reassuring improved wellbeing. family members, personal circumstances etc), which is a social value per person per day of An SROI report by the social value lab used £2.03 per day, per patient £3.42. If hospital broadcasting contributes to, £35 (the cost of a ‘De-stress and Sleep Well’ say, 1 person in half of the 350 hospitals where course) as a proxy value for change in mental A Sense of Belonging members broadcast across the UK per day to state, including reduced anxiety and distress for ‘feel in control of life’ to that extent, then the individuals (Global Value Exchange). A cautious Hospital broadcasting, it’s family of volunteers social value would be £218,453 per year. calculation, to minimise the risk of over- and their activities can encourage a sense of claiming, might suggest that if a conservative belonging and feelings of community which £218,453 a year nationally estimate of one person in half of the 350 are vital to wellbeing. According to Barry hospitals that members broadcast to had a Schwartz, Professor of Social Theory and Health and Wellbeing better night’s sleep as a direct result of listening, Social Action “what seems to be the most According to Daniel Fujiwara and the Social and this happened every night, then it would important factor in providing happiness is Value Bank, the average value derived by contribute to a social value of £2.2m a year close social relations. People who are married, someone ceasing smoking is equivalent to nationally. who have good friends, and who are close to £4,010.00 (Value Calculator, 2014) which shows their families are happier than those who are potential scale of the value of public health not … Being connected to others seems to be £2.2m a year nationally information, advice and guidance. Hospital much more important to subjective wellbeing broadcasting may well contribute to the than being rich.” (Schwartz, 2005 p. 107) provision and dissemination of that advice and therefore contribute to the value created. 32

Volunteers’ wellbeing is improved by their involvement in hospital radio Conclusions through making a positive di! erence to patients’ stay in hospital and through The most direct impact of hospital radio The focus on people’s condition feeling part of the station family. is through psychosocial health outcomes 5 in hospital can be depersonalising. including; boredom, loneliness, anxiousness, Hospital radio can help people to feel There are some costs associated with disorientation and depersonalisation. like an individual by focusing on their providing hospital radio but much personality and the music they like. resource is provided by volunteers Boredom can be alleviated through who give their time to run the stations. 1 entertainment provided by hospital Hospital radio has the potential to There is potential social value o! ered radio, the playing of music with other 6 increase awareness of health and in return by hospital radio through its content that listeners like and that is wellbeing by delivering information contribution to positive psychosocial relevant to them. and advice in an appropriate and health outcomes. sensitive way. Loneliness and feeling socially isolated From the research there are four main 2 can be reduced by hospital radio conclusions: providing listeners with a virtual friend and through face to face interaction 1. hospital radio has a positive impact with volunteers from the station. upon health outcomes

Anxiousness and frustration can be 2. there is a clear di! erence between 3 reduced with hospital radio being hospital radio and other forms of a calming in" uence, providing a entertainment distraction and o! ering reassurance. 3. the impact of hospital radio is greater Patients in hospital can feel than providing entertainment or 4 disorientated. Hospital radio can help distraction familiarise them with the hospital and help them maintain a connection 4. the success of hospital radio is with their lives and people outside. dependent on patients and sta! engaging with station activity 33

Evidence from the questionnaire data, are also aware that they promote important maximum impact of hospital broadcasting, interviews and patient feedback demonstrates social interaction, both face to face and as a and assist the healthcare partners in their how hospital radio has an impact upon virtual friend via the airwaves. To some extent work, partnership working is important. The psychosocial health outcomes including they are aware that they can help people who impact could be extended with the additional boredom, loneliness, anxiousness, feel anxious by being a calming in" uence involvement of other partners such as Public disorientation, depersonalisation and health and distraction. Beyond this, hospital radio Health and third sector organisations, and by and wellbeing awareness. Therefore, hospital can help people settle more easily within the considering ways of extending broadcasting radio could be expected to contribute a return hospital environment and, at the same time, beyond bedside sets. on investment from social value generated celebrate their personal identity as they are through an improved patient experience. asked about their preference in music and the Where implemented these alternative associated memories. These positive impacts approaches to extend the reach of hospital From deep dive interviews, and other should be understood and embodied further radio were generally contributing to an evidence collected, it is apparent that hospital by radio stations in order to proactively increase in awareness. radio o! ers its listeners something that increase bene# ts to patients. The positive other forms of media generally do not. The impacts of hospital broadcasting are only overriding reason is that hospital radio is a realised if people are engaging with hospital personalised service for patients associated radio. One of the key challenges identi# ed with that particular hospital or facility. This is by most stations involved in the research was manifested through patient song requests, raising and maintaining awareness of their broadcasting in a way that is sensitive to station and activity. their situation, and hospital radio volunteers meeting patients face to face so they know From the research good practice was who they are broadcasting to and are known identi# ed where hospital ward sta! were to their listeners. proactive in encouraging patients to listen. In other instances hospital partners Hospital radio stations recognise that they involved the stations in their activities and provide patients with entertainment and actively promoted them. To achieve the 34

References

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Acknowledgements

Questionnaire Respondents • Radio St. Helier • Radio En# eld • Valley Park Radio • Merthyr Hospital Radio • Radio Frimley Park • Barnsley Hospital Broadcasting • Stoke Mandeville Hospital Radio • Radio North Kent • Radio Craigavon • Hospital Radio Echo • Radio Harrow • Whipps Cross Hospital Radio • Hospital Radio Chelmsford • Jumbo Sound • She% eld Hospital Radio • Cotswold Hospital Radio • Radio West Middlesex • Radio Odstock • Hospital Radio Basingstoke • Radio Warneford • New Forest Hospital Radio • Bath Hospital Radio • Radio Gwendolen • Coventry Hospital Radio • HWD Hospital radio • Evesham Hospital Radio • Radio Wulfrun • Hospital Radio Bedford • Radio Tyneside Network • Hospital Radio Leighton • Chichester Hospital Radio • Radio Nene Valley • Chippenham Hospital Radio • Bedrock • Anker Radio • Radio South Tyneside • Radio Royal • Radio Cherwell • Winchester Hospital Radio • Hospital Radio Bedside • Radio Addenbrooke's • Radio Halton • Radio Grapevine • MY Radio • Phoenix Hospital Radio • Harlow Hospital Radio • Milton Keynes Hospital Radio • Hospital Radio Perth • BHBS - Hospital Radio for Bristol • Radio Redhill • Rookwood Sound Hospital Radio • Durham Hospitals Radio • Scunthorpe Hospital Radio • Radio Allerton • Edinburgh Hospital Broadcasting Service • Seaside Hospital Radio • Radio Fox • Hospital Radio Exeter • Radio Haslar • Causeway Hospital Radio • Hospital Radio Medway • Radio Wexham • Radio Victoria • The Hospital Broadcasting Service • Southend Hospital Radio • Life Care Radio • Grimsby Hospital Radio • Radio Brockley • Basildon Hospital Radio • Jubilee Hospital Radio • Radio Starlion • Ashford Hospital Broadcasting Association • Conquest Hospital Radio • Stoke Mandeville Hospital Radio • Radio Bronglais FM • Hereford Hospital Radio • Radio Sunderland For Hospitals • Inverness Hospital Radio • Radio Marsden We’d like to thank the volunteers, NHS / HSC sta! and patients • Hospital Radio Ipswich • CHBN from the following for their involvement in interviews: • Radio Lollipop (Bristol) • Radio Hillingdon • Bay Trust Radio • Radio General (Warrington Hospital Radio) • Causeway Hospital Radio and Causeway Hospital • Hospital Radio Norwich • Watford Hospital Radio • Hospital Broadcasting Service and NHS Greater Glasgow • Hospital Radio Plymouth • Sunshine Radio and Clyde • Radio Glan Clwyd • Choice Radio • Hospital Radio Chelmsford • Hospital Radio Sta! ord • Radio Camelot • Hospital Radio Plymouth and Derriford Hospital • Hospital Radio Tunbridge Wells • Southside Broadcasting • Merthyr Hospital Radio Prince Charles Hospital • Radio Wey • York Hospital Radio • New Forest Hospital Radio and Lymington New Forest Hospital • Radio Law • Barts & London Chest Hospital Radio • Northern Air and North Manchester General Hospital • Hudders# eld Hospital Radio • Radio Chelsea and Westminster • Radio Addenbrooke’s and Addenbrooke’s Hospital • Radio Horton • Radio Mount Vernon • Radio Clatterbridge • Southern Sound • Hospital Radio Wrightington • Radio Harrow and Northwick Park Hospital • Northumberland Hospital Radio - NHR • Radio Nightingale • Radio Lollipop in Birmingham • Radio Lonsdale • Hospital Radio Reading We’d also like to extend our thanks to the HBA trustees for • ArroweSound • Radio Glamorgan their support. 36

Research undertaken by: On behalf of:

The full report and associated # lm are available at http://hbauk.com/impact For more information please contact the Hospital Broadcasting Association. e: [email protected] t: 0300 121 0525

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