by Author Dan Henchman

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OPUS Music: an organisational case study

Over the last ten years, East Midlands-based arts organisation OPUS Music has grown to become one of the leading UK providers of music-making in healthcare settings.

OPUS’s musicians are experts at engaging patients, visitors and hospital staff in music-making. OPUS also runs training programmes and apprenticeships for musicians in healthcare, and has been central in building a national network of professionals working in the field.

OPUS co-founder Nick Cutts spoke to us about how Youth Music funding has helped the organisation to develop, and the impact he’s seen first-hand.

Taking an interest in music and healthcare

“We started as a community music organisation, but we weren’t initially specialised in music and health,” recalls Nick. “I got interested in what was happening to young people in hospital, and what educational, musical and cultural opportunities were available to them.”

Nick began giving his time to experiment with music-making in hospital play rooms and children’s wards. “Despite staff working hard, it was still a clinical space where it’s hard for cultural encounters to happen,” he continues.

“There was very little practice of music in healthcare in the UK at the time. There were bits of music therapy, but that’s different from what we do.”

New ideas from abroad

In 2009, Nick was selected to take part in an intensive training programme led by Musique et Santé, a French organisation specialising in music in healthcare settings.

Nick had the chance to explore the existing – and potential – role of music-making in hospitals in Paris, Krakow, Dublin and Manchester. The ideas he encountered have had a lasting influence.

“The music sessions we’d previously been doing were quite workshop-based,” says Nick. “The music leader would have an outcome they’re aiming towards, and lead the group in that direction.”

Based on what he’d seen with Musique et Santé, Nick began to develop a new model which gave patients much more ownership of the music-making process. “That fitted really well with the needs of quite vulnerable young people who are in hospital.”

Getting started

OPUS first received funding from Youth Music in 2010. As part of the grant, a trainer from Musique et Santé worked with Nick to deliver a training programme for OPUS colleagues and other musicians across the East Midlands.

The OPUS team then applied what they’d learned, establishing their first programme of weekly music-making sessions at Derbyshire Children’s Hospital. They also set up an exchange with musicians involved in similar work at Manchester Children’s Hospital, who were invited to observe OPUS sessions and vice versa.

“We spent some time exploring the practice, reflecting and developing,” says Nick. “The grant allowed us to initiate a programme that wasn’t just about me taking my learning, but actually starting to share and spread it.”

Building strong partnerships

Nurses, play teams, educational staff and clinicians were among those who soon realised the benefits of music-making on the ward. “As we built partnerships with people across the hospital and they talked to others, there was a real interest in what we were doing,” says Nick.

These connections have enabled OPUS to develop partnerships with several other hospitals across the East Midlands over the following years, with the help of further Youth Music grants in 2012, 2014 and 2016.

“The funding has really enabled us to be an integral part of the team in hospital,” says Nick. “It’s a huge thing to be valued as much as any of the other staff, and seen as an asset to the wellbeing of the young people we work with.

“It’s not something that happens overnight. Things take a long time to get embedded into regular practice in healthcare. The funding has given us time to build those partnerships and invest in making practice happen.”

OPUS’s work in practice

OPUS’s musicians work in pairs, singing and playing instruments (including guitar, violin, melodeon and percussion) on the wards and in communal areas of hospitals. The majority of their sessions take place on children’s wards, although they’ve also begun working in neonatal units and with older patients too.

Patients can choose simply to listen and enjoy, or to get involved with the music-making. OPUS provides instruments for them to borrow, including shakers, xylophones and ukuleles.

Most sessions are one-to-one, tailored to each child’s needs depending on their age and type of illness or injury. And importantly, OPUS’s musicians are highly responsive and encourage young people to take a lead in the music-making – whether that’s by adjusting their tempo to match the young person, playing louder or quieter, or responding musically to a baby’s verbal sounds.

“We’re always responding to the environment, to the patient, and how they react to our initial musical engagement,” says Nick, “making sure we’re in sympathy with the patient and not trying to push them to go somewhere else.

Giving young people a voice

“Something we really try to do is work with the person, rather than the patient. We’re in a unique position of not being there to deal with their condition – and that changes what we’re able to do.

“One young lad picked up the ukulele, and within half an hour he was playing chords and singing songs with us. We work with another charity that donates ukuleles to children in hospital, so we were able to give him one to keep.

“About an hour later we walked past his ward and he was sat teaching a doctor how to play. To see the doctor taking the time and seeing the value in sitting there with this young patient – that says a lot about what this practice can do.

“We’re really keen on giving young people empowerment and autonomy while they’re in hospital because that’s often taken away from them. Often we find that’s what clinicians are looking for as well – getting rid of that hierarchy.”

Transforming the hospital environment

“We see the hospitals get huge benefits from us being there,” Nick continues. “Everywhere we go, staff say to us: ‘can you work with this patient?’, ‘it’s nice to see you’, ‘thank you for being here’.

“Music can really change the atmosphere and the way people relate to each other. We see that a lot in children’s practice, where nurses, doctors, patients and family are singing together.

“Rather than doctors, patients or nurses, people can just be human beings with each other. It facilitates that holistic healthcare that’s such a struggle for clinical staff.”

Training and sharing practice

Alongside day-to-day music-making, Youth Music has funded OPUS to deliver training courses for musicians and healthcare professionals.

OPUS also runs an apprenticeship scheme which has brought through eight specially trained musicians so far, with four more upcoming. Former OPUS apprentices are now bringing music-making to hospitals around the country.

Today, OPUS is one of several organisations nationwide working in music in healthcare, and it’s a field that’s continuing to grow. “There’s a real openness about music in healthcare as a practice,” says Nick. “One of our biggest roles in the last few years has been sharing practice and getting more happening.”

OPUS are helping to achieve this in two ways. Firstly by sharing ideas and learnings with their fellow musicians working in healthcare settings. And secondly by engaging directly with key people in the healthcare system such as consultants, hospital schools and play teams – “strategic players that can really embed what we’re doing” – and showing them the value of the work.

The National Alliance of Musicians in Healthcare

Since beginning its work in hospitals, OPUS has been central in building a network of musicians in healthcare, including hosting a series of conferences which was initially funded by Youth Music.

This network has now evolved into the National Alliance of Musicians in Healthcare (NAMIH). In July 2017 OPUS co-hosted and assembled the committee for the first NAMIH conference, which welcomed a wide group of stakeholders including politicians, NHS representatives and arts organisations from around the UK.

“It’s a real passionate group of people dedicated to doing this work really well,” says Nick. “It’s an instant way of sharing practice much more widely and learning from each other.”

OPUS also gathered evidence for a groundbreaking report by the All-Party Parliamentary Group on Arts, Health and Wellbeing, which makes a number of recommendations in favour of the arts’ role in health and social care.

OPUS and the music in healthcare landscape

“There’s a lot more practice taking place, and more recognition from healthcare staff,” says Nick. “People are starting to see the musician in healthcare as a profession, as opposed to just a nice thing.”

OPUS currently works in children’s hospitals in Derby, Leicester, Nottingham and Mansfield, but as Nick explains: “It’s not about expanding OPUS further and us delivering it everywhere – that’s not sustainable. We’re keen on supporting really high-quality practice taking place elsewhere.

“The practice has got to be quite responsive to the healthcare settings we’re working with. We feel it’s important that the organisation is run by the musicians on the ground.

“It’s about sharing an ethos of working and an approach to partnership building – how you become part of the healthcare team. We feel embedded as teams and so do most of the people we’ve trained and supported in getting their own practice.”

Future plans

“We continue to try new things out, document what we’re doing and capture it in the best way that allows us to share it with funders and partners like Youth Music and NHS England.

“We’ll continue to contribute to NAMIH as much as we can and stimulate what it can do for the sector.

“Keeping the practice going, and continuing to share it as widely as we can with an ever-growing group of engaged stakeholders, is critical right now. We’ve only been doing it 10 years.

“It’s an exciting time to be involved in this work.”

Photos by OPUS Music.

For further reading, see our newly published Music in Healthcare evidence review, which draws together academic research and evidence from Youth Music grantholders delivering music-making projects in healthcare settings.