We are delighted that a major new study published today in The Lancet Digital Health, the world’s most prominent digital medical journal, and carried out by Imperial College London, has found that our pioneering ENO Breathe programme significantly improves quality of life for people living with long COVID.

ENO Breathe is an award-winning online breathing and wellbeing programme developed by English National Opera (ENO) in collaboration with clinicians from Imperial College Healthcare NHS Trust. The free online programme, which is available via NHS referral across England, combines breathing retraining, singing techniques and wellbeing support. Delivered through live group sessions led by ENO vocal specialists, it uses singing – particularly lullabies from around the world – to help support patients’ recovery and complement their clinical care.

The clinical evidence shows that the programme delivers measurable improvements to participants’ quality of life, breathlessness, anxiety and other symptoms, and has a long-term positive impact on their respiratory and mental wellbeing.

The newly published study analysed outcomes from 1,413 participants referred through 51 NHS long COVID services across England, making it one of the largest real‑world evaluations of a creative health intervention for long COVID breathlessness to date. Participants who completed the six‑week programme experienced clinically meaningful improvements across multiple validated health measures, with 61% achieving clinically important improvements in breathlessness. Engagement levels were high, and no serious adverse events were reported.

These findings build on earlier evidence from a Randomised Controlled Trial (RCT) published in The Lancet Respiratory Medicine in April 2022, further strengthening the clinical evidence base for ENO Breathe and its potential for integration at scale within NHS services.

Since launching in September 2020, the programme has expanded to take referrals from 85 NHS partners nationally and has supported more than 4,829 participants to complete the programme. The programme continues to reach patients with breathlessness from long COVID and is now also open to people experiencing similar post-viral symptoms.

During 2026-27, we will pilot an expanded version of our ENO Breathe programme in both London and Greater Manchester, supporting people living with chronic respiratory conditions, including COPD and asthma. In Greater Manchester, the programme is part of the Greater Manchester Creative Health Place Partnership led by NHS Greater Manchester and the Greater Manchester Combined Authority.

The programme demonstrates ongoing clinical relevance and capacity to operate at scale.  Clinicians and NHS specialist services working in Long Covid, post-viral conditions, asthma and COPD are encouraged to get in touch to explore partnership opportunities, helping us expand access and support people to manage their breathlessness symptoms, alongside clinical care.