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English National OperaENO Breathe

The English National Opera is a world class opera company, based at the London Coliseum.

ENO Breathe is a brand new pioneering programme developed by the ENO and Imperial College Healthcare teams specifically for people recovering from COVID-19. This is the first partnership of its kind between a leading arts organisation and an NHS Trust, and is the first programme of its kind being developed for these patients.

Combining both medical and musical expertise, it offers unique practical exercises and online resources in order for participants to improve their breathlessness. Social prescribing is at the heart of the programme.

English National Opera

ENO Breathe © Karla Gowlett

Target Beneficiaries

The programme is for people recovering from COVID-19 who are still suffering from breathlessness and associated anxiety. It focuses on breathing retraining through singing. No previous experience or interest in singing is required. ENO Breathe is currently only available for patients who have been medically assessed by a specialist long COVID clinic in England.

The aim of ENO Breathe is to empower participants in the management of breathlessness and anxiety post COVID-19. A singing, breathing and wellbeing programme, ENO Breathe combines medical and musical expertise to equip participants with the tools needed for the self-management of their recovery and anxiety.

The pilot of the project took place in October and November 2020 in London, with the intention of expanding it nationwide. ENO Breathe was rolled out nationally on 28 January 2021.  This phase involved up to 2,000 patients in partnership with 50+ NHS post-Covid Assessment Clinics throughout the country including London, Cheshire & Merseyside, Newcastle and Manchester.


The programme uses lullabies as a way into exercises as they are expressly designed to calm and soothe, and have the benefit of being short, memorable and accessible to all.

There is an initial one-to-one online session with a member of the ENO Breathe team to discuss the practicalities of the programme and what the participant hopes to achieve. Following this there are six free weekly group online workshop sessions, led by an ENO Vocal specialist. Workshops encourage participants to take part in exercises and activities especially designed to support breathing control, providing tools for self-management of breath and anxiety.

Additionally, participants have access to bespoke online digital resources, designed to support them between sessions. These include exercises, song sheets and audio and video materials, especially recorded by the ENO for participants on the programme.

Post-programme, participants receive access to digital resources designed to support them to continue the exercises on their own. In addition, all post programme participants have access to fortnightly twilight drop-in online sessions.

The cost of the pilot was £12,000.


A randomised control trial with the research team at Imperial College has just been completed, with data due from that research trial due later this year.

Pre and post programme, all participants are asked to complete a series of short self-assessments using standardised NHS metric scales to help the ENO Breathe team assess their progress.

All participants take part in facilitated mid-point focus group discussions, where the ENO can capture more qualitative feedback.

Participants undertake follow-up surveys 3-6 months post-programme to ascertain the extent to which they have continued to use ENO Breathe tools and techniques beyond the duration of the programme.


Pilot participants ranged from those in their 30s to their 70s




The outcome of the pilot was overwhelmingly positive:




Watch participants video


I never before had an experience like this. I didn’t think things like singing could help me with my breathing and improve my recovery from Covid and it has really helped me emotionally and physically.

Ludmila (participant)

A fantastic tool that has given me my confidence back.

Sheeba (participant)

It has been quite a dark year since I had Covid, and the past 6 sessions with ENO Breathe have been a shining light.



Premier Medical Group and Medicals Direct Group as well as donations from ENO Supporters and Members.