Case Study: Wellness with WNO

Introduction

In 2021, Welsh National Opera (WNO) established a singing and breathing programme called “Wellness with WNO”, in partnership with Betsi Cadwaladr, Cardiff and Vale and Cwm Taf Morgannwg University Health Boards. The programme aims to improve the physical and emotional health and wellbeing of people, experiencing symptoms of breathlessness, fatigue and anxiety, caused by Long COVID, through a non-clinical expert intervention led by professional singers. Participants benefit from one-hour online sessions held over six-weeks, that involve singing and breathing techniques to improve breath control, lung function, circulation and posture. In 2023, Wellness with WNO was expanded across all seven health boards in Wales, making it the first nationwide service of its kind.

The Challenge

The need for this programme was identified by Long COVID Services, within Betsi Cadwaladr, Cardiff and Vale, and Cwm Taf Morgannwg University Health Boards. They approached us to co-create a programme to support those living with Long COVID symptoms, such as breathlessness, fatigue, and anxiety. This followed ONS data in June 2021 showing that 50,000 people (1.6% of the population) in Wales had Long COVID, which rose to 94,000 people in the year to 5 March 2023. Working collaboratively, we created a joyful environment using singing to enhance people’s health and wellbeing. The programme was extended to all health boards in 2023 to widen reach and reduce the inequalities of access to support people impacted by Long COVID across Wales.

The Approach

From January to December 2023, WNO continued to collaborate with Long COVID services in all health boards across Wales, to deliver a programme that utilised the expertise of opera singers, who are vocal specialists in breath control. To compliment the NHS service model, the WNO programme provides practical support in a de-medicalised environment to help rehabilitate people experiencing Long COVID symptoms. This involved delivering 20 bespoke courses to 170 people (17 in English and three in Cymraeg) that comprised of six sessions held once weekly. During sessions, vocal specialists shared strategies for efficient breathing with participants and empowered them with the resources to continue the exercises themselves. After completing the programme, participants were invited to attend twice-monthly drop-in sessions to get together and sing for enjoyment, whilst encouraging the continuation of breath control techniques. Overall, 23 drop-in sessions were held which were very well attended and appreciated by participants. One participant stated “After the six-week programme you are being looked after and not forgotten. For me it is important emotionally. They are trying to help me.”

The Impact

Alongside Milestone Tweed, we evaluated Wellness with WNO using a variety of research tools including metric scales used by Long COVID Services (the EQ-5D-5L and MRC Breathlessness scale). The evaluation found continued positive outcomes for participants. At the start of the programme, 54% of participants did not understand, were unsure or had a neutral understanding of their respiratory health. A further 64% sometimes or regularly used breathing techniques. Post-programme, 86% of participants understood their respiratory health and 96% used breathing techniques. Mental health outcomes included increased positivity, improvements in emotional wellbeing, reduced anxiety, depression, overthinking and panic, and increased confidence. We evaluated the long-term impacts of the drop-in sessions and explored insights to inform programme development, using interviews and focus groups with participants and partners. Results showed that the drop-in sessions help towards maintenance of the breathing techniques and supporting recovery. These benefits are combined with participants reporting feeling that WNO cares: “Every month someone cares about me. I’m not forgotten. I’m ill and miserable but I’m always looking forward to a really nice hour.”

Lessons Learned

Our evaluation showed that participants health and wellbeing was positively impacted through our programme’s activities. We recognise that there is still more work to be done to improve the programme’s reach into ethnic minority communities to better represent the demographics of local communities across Wales. We will continue active discussions with our partners to promote diversity in referrals, along with continually developing our impact framework to better meet the needs of participants and partners alike.

The Legacy

Our programme has resulted in excellent working relationships with Welsh health boards, that combine the expertise of healthcare and opera professionals in a powerful way that unites arts and health to improve people’s physical health and wellbeing. We aim to build on these partnerships to further develop the programme in 2024, to include support for other long-term conditions, such as ME, CFS and Fibromyalgia. We are working on adapting the programme with other NHS services to help individuals who may benefit from this approach.

Website and Social Media Links

Wellness with WNO news | WNO website:

• https://wno.org.uk/wellness-with-wno

• https://wno.org.uk/news/nhs-at-75

• https://wno.org.uk/news/wellness-with-wno-goes-wales-wide

• https://wno.org.uk/news/wellness-with-wno-the-results-so-far

• https://wno.org.uk/news/wellness-with-wno-innovating-rehabilitation-through-song Social Media links 

WNO:

• https://www.instagram.com/p/CoUmffeMYZd/?img_index=1

• https://www.instagram.com/p/CoPc046ub89/?img_index=1

• Instagram Handle: @welshnat_opera_cencym

• Facebook Handle: Welsh National Opera Cenedlaethol Cymru

• X (previously Twitter) Handle: @WelshNatOpera / @OperaCenCymru

Press links:

• Swansea Bay University Health Board: https://sbuhb.nhs.wales/news/swansea-bayhealth-news/opera-sessions-help-long-covid-patients-hit-high-notes-in-their-recovery/

• ‘It helps so much’: long Covid sufferers aided by sessions with opera singers, The Guardian: https://www.theguardian.com/society/2023/mar/16/it-helps-so-much-long-covid-sufferers-aided-by-sessions-with-opera-singers

• Welsh National Opera expands Long Covid support programme, Arts Professional: https://www.artsprofessional.co.uk/news/newsreel/welsh-national-opera-expands-long-covid-support-programme

• Welsh National Opera Expands Long COVID Program Across Wales, Opera Wire: https://operawire.com/welsh-national-opera-expands-long-covid-program-across-wales/

• Welsh National Opera expands programme to support those with long Covid, Cambrian News: https://www.cambrian-news.co.uk/news/health/welsh-national-opera- expands-programme-to-support-those-with-long-covid-594349 

• Welsh National Opera Teaches Long-covid lessons, Slipped Disc: https://slippedisc.com/2023/01/welsh-national-opera-teaches-long-covid-lessons/

• WNO expands Long Covid Programme, Classical Music: https://www.classical-music.uk/news/article/wno-expands-long-covid-programme 

Contact Details

April Heade, WNO Programmes and Engagement Producer

Email: april.heade@wno.org.uk

Number: 02920 635049

Tags: Singing, Opera, Wales, Long COVID, Health, Wellbeing, Zoom, Breathlessness, Breathing, Anxiety, Fatigue, Mental Health.

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