Naviation
Examples of evidence
  • Singing support for people with respiratory disease led to significant improvements in COPD Assessment Test (CAT) scores; 45% of participants reported reduced GP visits and 18% reported reduced hospital admissions [2,3]
  • Expressive writing for adults with moderate asthma improves lung function by 14% due to reductions in physiological stress [4]
  • Music therapy lessens paediatric patients’ asthma symptoms, and improves medication compliance, pulmonary function and quality of life [5]
  • Dance-based exercise for COPD improves postural stability and balance scores, pulmonary function, and peripheral muscle strength [6]
Photography by Karla Gowlett, overall image designed and created by ENO's Breathe in-house designers ©
Photography by Karla Gowlett, overall image designed and created by ENO's Breathe in-house designers © 
Creative health in practice

ENO Breathe uses singing techniques to aid people recovering from COVID-19 who are still suffering from breathlessness and associated anxiety. It is delivered online by English National Opera (ENO) in collaboration with Imperial College Healthcare teams. 

No prior experience or interest in singing is required to take part in ENO Breathe. 

ENO Breathe offers participants: 

  • An initial one-to-one online conversation with session leaders
  • Six weekly group online workshop sessions led by a professional singer from the ENO
  • Access to bespoke online digital resources designed to support participants between sessions
  • Access to post-programme weekly drop-in sessions. 

As of December 2023, 3,053 participants from across England had taken part in the ENO Breathe programme. 

  • 80% of participants said their levels of breathlessness had improved
  • 73% of participants said their levels of anxiety were better
  • 87% said that ENO Breathe had a positive impact on their general wellbeing. 

For the full story of this initiative see www.eno.org/breathe/about-the-eno-breathe-programme/ 

For the results of a randomised controlled trial looking at ENO Breathe see www.thelancet.com/journals/lanres/article/PIIS2213-2600(22)00125-4/fulltext

Where next?

The NCCH has worked in partnership with NHS England to develop a Creative Health Toolkit, which includes examples of how creative health can be used to help manage chronic respiratory disease.

Practical strategies for introducing creative health 

The National Centre for Creative Health

NCCH supports health and care sector professionals in organisations and systems to achieve the benefits of creative health approaches for patients and service users.

We publish a monthly newsletter especially created for professionals working across health and care. Please do subscribe here and/or share with colleagues working across Primary Care, Provider Trusts, ICBs, Public Health, Social Care and across the NHS, so they can access the latest news for creative health!

Downloadable information

Download this information sheet in PDF format

  1. House of Commons Library. Research Briefing: Respiratory health. 2024 November. Available from: https://commonslibrary.parliament.uk/research-briefings/cdp-2024-0148/

  2. All Party Parliamentary Group on Arts Health and Wellbeing, National Centre for Creative Health. Creative Health Review: How Policy Can Embrace Creative Health [Internet]. 2023 December. Available from: https://ncch.org.uk/creative-health-review

  3. Lewis A, Cave P, Hopkinson N. Singing for Lung Health: service evaluation of the British Lung Foundation programme. Perspectives in Public Health. 2018;138(4):215-222. DOI:10.1177/1757913918774079 

  4. Smith HE, Jones CJ, Hankins M, Field A, Theadom A, Bowskill R, et al. The Effects of Expressive Writing on Lung Function, Quality of Life, Medication Use, and Symptoms in Adults With Asthma: A Randomized Controlled Trial. Psychosom Med. 2015 May. 77(4):429–37. DOI: 10.1097/PSY.0000000000000166 https://pubmed.ncbi.nlm.nih.gov/25939030/

  5. Zhang D, Yu X, Lin Q, Xia Y, Wang G, Zhang J, et al. Music Therapy in Pediatric Asthma: A Short Review. J Asthma Allergy. 2023 October. Volume 16:1077–86. DOI: 10.2147/JAA.S414060 https://pubmed.ncbi.nlm.nih.gov/37814635/

  6. Kaya M, Gurses HN, Ucgun H, Okyaltirik F. Effects of creative dance on functional capacity, pulmonary function, balance, and cognition in COPD patients: A randomized controlled trial. Heart Lung. 2023 Mar;58:13–20. DOI: 10.1016/j.hrtlng.2022.10.017 https://pubmed.ncbi.nlm.nih.gov/36335909/