English National Opera is developing a breathing and wellbeing programme for coronavirus patients

The English National Opera (ENO) has joined with medical experts at Imperial College Healthcare NHS Trust to devleop a singing, breathing and wellbeing programme for coronavirus recovery patients called ENO Breathe. A of 28 January 2021 a national rollout of the programme, after a successful pilot in 2020, has begun. More information on ENO Breathe here.

Thousands of patients affected by the COVID-19 virus in the UK have required medical ventilation. The longer-term effects of those people surviving such invasive intervention are being studied. Coronavirus survivors, particularly those that required mechanical ventilation, are experiencing a variety of medium and long-term difficulties – including breathlessness, fatigue, cognitive dysfunction and anxiety.

ENO Baylis (the research and outreach arm of ENO) is helping develop the first programme of its kind being specifically for patients recovering from COVID-19, bringing together medical and musical expertise to create an integrated rehabilitation programme.

This project will take place in three phases:

Phase 1 – ENO Breathe Pilot Project (early September 2020)

Working closely with staff at Imperial College Healthcare, an ENO Baylis Vocal Specialist will deliver a bespoke programme of virtual learning workshops, designed exclusively for patients referred onto the programme by the Trust.

Patients will learn techniques to help them focus constructively on their breathing, using lullabies expressly designed to calm, in a combined approach to train the mind to work with the body mirroring techniques used by opera singers.

The initial six week pilot proved to be successful following independent evaluation, with the participants reporting definite improvements in symptoms and wellbeing, indicating that ENO Breathe has had positive impacts for them both emotionally and physically.

Phase 2 – ENO Breathe National Programme

Following the success of an initial six week pilot, ENO Breathe is to be rolled out nationally, beginning 28 January 2021.

Following an initial six-week trial with 12 participants from September to November 2020, the programme will now be rolled out to up to 1,000 patients by participating healthcare networks across London and the North of England with a view to continuing to work with more post-COVID services across the country over the coming months.

Led by Baylis, ENO’s learning and participation programme, ENO Breathe uses weekly group online sessions and digital resources to empower participants with tools and techniques to help them focus constructively on their breathing. The programme focuses on breathing retraining through singing, using lullabies as its musical starting point. Traditional lullabies cross boundaries of culture, are accessible to all and their very purpose is to calm. Led by professional singing specialists, participants learn breathing and singing exercises, using an approach that mirrors techniques employed by opera singers who achieve the physical coordination required for singing via emotional connection and imagery, rather than by giving their bodies explicit physiological instructions. Participants are then equipped with exercises to practice these techniques in their own time, aided by online resources specifically designed to support their progress.

Jenny Mollica, Director of ENO Baylis said: "The ENO are committed to making a difference to the lives of people and communities recovering from COVID-19, using our unique skills and resources in ways that are relevant and useful – and that matter to people. Following our successful pilot programme, we are hugely proud to be able to roll out ENO Breathe nationally, enabling us to support many more patients in their recovery from COVID and journey back to wellness. Combining cutting edge musical and medical expertise, we look forward to continuing our partnership with Imperial College Healthcare NHS Trust, and to working with post-COVID assessment clinics across the country in this next phase of the programme."

Dr Sarah Elkin, Consultant in Respiratory Medicine & Clinical Director Integrated Care at Imperial Healthcare NHS Trust said: "It has been a pleasure to work with ENO Baylis on this programme. As we continue to respond to the latest surge in COVID-19 cases in the UK, we must also remember those patients who are still suffering with COVID symptoms long after their initial disease. Ongoing breathlessness is debilitating and can be frightening. We hope this programme will support people to improve and help reduce their symptoms. We look forward to widening participation as the programme rolls out across the country."

Culture Minister Caroline Dinenage said: "The success of the ENO pilot has clearly shown how breathing through singing can help those suffering with breathlessness. I am grateful to ENO for partnering with the Imperial College Healthcare NHS Trust to deliver this important programme which provides crucial support to people recovering from COVID-19."

Phase 3 – Online learning course, available worldwide

In conjunction with Phase 2 and pending pilot outcomes, ENO will create a self-guided online learning course led that would be available worldwide to help coronavirus survivors in their recovery.

The pilot programme will cost £12,000 and fund will be gathered through fundraising and donations.

The programme is an example of 'social prescribing' - non-medical interventions with patients that can have a transformative effect on mental and physical health, often reducing the need for medication or valuable medical resources.

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