Cohere Arts – Creative Health and Long Covid
In January 2022, Suffolk-based Cohere Arts were commissioned by East Suffolk and North Essex NHS Foundation Trust (ESNEFT) to provide creative health activities for patients of their long covid assessment service. A 12-week pilot programme was developed in partnership with the clinic, including a series of free online workshops in creative writing, visual art, gentle movement and singing, each led by specialist arts-health practitioners. In sessions which combined practical exercises with social time, participants could rekindle creative interests, nurture new skills and share their experiences with other participants facing similar challenges. At the end of the pilot, participants recorded slight reductions in perceived levels of the measured symptoms; fatigue, brain fog, poor memory, social isolation and anxiety, with social isolation most significantly improved. Those who had engaged most frequently saw the most positive impact.
Following the pilot, the Creative Space programme was extended and redeveloped in response to the changing needs of patients, many of whom were having to return to work despite facing continuing health challenges. The programme currently includes 1-to-1 creative health consultations, online group workshops scheduled at lunchtimes and after working hours, in-person activities held at weekends and pre-recorded online content that can be accessed at any time. One of the most popular activities is Art Cafe sessions, relaxed artist-led art workshops in cafe or cultural settings.
Find out more about the programme here.
Long covid is a multi-systemic, long-term health condition, requiring a multi-pronged and multidisciplinary approach to treatment. NICE guidelines recommend the inclusion of occupational therapy, physiotherapy, clinical psychology, psychiatry, and rehabilitation expertise within multidisciplinary teams around the patient. In the ESNEFT team, social prescribers are amongst the many healthcare practitioners working collaboratively to provide holistic support to patients. For people living with long term and more complex health challenges like long covid, recovery time can vary widely, from weeks to months. Engaging with creative activity during this time can offer many positive health and wellbeing impacts, ranging from distraction and relaxation to skill development, increased confidence and feelings of accomplishment. Group activities can offer connection and peer support as an antidote to the isolation that ill-health can bring. Delivery can also be designed to address specific symptoms; for example breathing exercises for respiratory issues and anxiety, hand-eye coordination tasks to stimulate cognitive function and movement for cardio and physio rehabilitation. The aim of the Creative Space programme is to provide access to all these potential benefits alongside more clinical routes. The range of activities on offer means that participants can choose how and when they engage, and are encouraged to take part in a way that suits their energy levels and how they are feeling that day.
In more recent months as provision has included more in-person events, additional cultural organisations have contributed to the project by providing venue space for ‘art cafe’ workshops. This has encouraged people living with long covid to venture out and visit cultural spaces such as parks, heritage buildings and theatres. The evolution of the programme has been very much a collaborative and cross-sector effort. Cohere artists have been included in clinic meetings, and healthcare professionals have attended creative workshops to experience some of the activities for themselves.
Lived experience is embedded within delivery, with some of the artists and clinical team members themselves living with long covid. Patient feedback is collected on an ongoing basis, and participants have remarked on the ‘kindness and care’ shown by lead artists, which they very much appreciate.
The drop-in nature of engagement in the programme’s various events (people do not have to commit to multiple sessions) and fluctuating content means that beyond the pilot it has been a challenge to track impact on specific symptoms. However, holistic impact is richly evidenced within qualitative accounts.
“The sessions gave me a sense of connection and camaraderieship - knowing that they understand what you are going through. It’s made me feel accomplished, because I’m doing something - I’m doing something that has a purpose. I think it’s reminded me of the possibility that anyone can be an artist. I’ve definitely learned lots of breathing techniques from the singing sessions, which I think is very useful particularly for people with long covid.” - Charlotte, Creative Space participant
Perhaps most importantly, attendees of group events have appreciated the opportunity to connect with other people facing similar challenges. As one participant reflected:
“I have seen a massive improvement in my mood since connecting with others during Creative Space sessions. I feel so happy afterwards and the sessions are relaxed and set at a good pace.”
Other participants have reflected on their experience creatively:
How do I feel Art Cafe?
(Waking)
Heavy
Tired
Yet determined.
(Approaching)
Hopeful
Arriving...
Welcomed
Relaxed
Happy
Understood
Valued
Unburdened
Creative
Uplifted
Artistic
Connected
Leaving
Alive
Still tired
Yet inspired.
By Jacquie Smith
By February 2023, 2154 patients had been referred to ESNFT’s long covid clinic, bringing a steady stream of participants to the Creative Space programme. Wider marketing has also brought in a number of self-referrals. Outside of the long covid clinic, the Connect for Health social prescribing service in East Suffolk is also actively signposting clients to this, and other activities offered by Cohere Arts within their creative health programme, thanks to the strong support of the Suffolk and North East Essex Integrated Care Board.
As NHS provision for long covid evolves, it is likely to combine with other services covering a wider range of long term health conditions and ‘invisible illnesses’, and with continued funding the Creative Space programme will continue to expand and accommodate this change. One of the strongest success factors of this creative health initiative has been its dynamic approach to programme development, which is continually adapted in response to both patient need and emerging knowledge. This is not possible without a co-productive, reflexive approach from both health and cultural partners.
There is still work to be done to legitimise creative health options - particularly in the hearts and minds of clinicians, social prescribers and other gatekeepers to programmes like Creative Space. Patients and healthcare professionals can be sceptical or resistant to the idea that getting creative (particularly alongside others) can help aid recovery, especially if they do not consider themselves to be ‘arty’ or have had negative experiences of arts education. Cohere Arts are grateful to the champions within the health sector who have made this programme possible and continue to support and advocate for this work.
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