Thread by @MarkOneinFour

Hello! The next session I'm live tweeting for you from #quality2021 (internationalforum.bmj.com/europe/) is "Creativity as core in QI - using the Arts to empower and build co-production". It will run until 13.00GMT. We're hearing from Polly Bowler and Leanne Sedin about work at @NHS_ELFT

Amy Price is introducing the session. Says we'll be hearing about the East London Foundation Trust's #ELFTin1Voice projects. Polly Bowler is Head of Arts Therapies for ELFT’s Bedfordshire & Luton. Says improving lives is the aim of what they do. #quality2021

Bowler is talking about the 1Voice choir project, which is run in partnership with Sing Tower Hamlets community Choir. She stresses that the project is open to all, and helps to bring together people and provides a way to discuss difficult things #quality2021

Leanne Sedin is now telling us about the song 'See Me As I am', a song co-written with Mandeep Singh, a psychiatry trainee and freestyle rapper #quality2021

Sedin: we're going to take the attendees of this workshop through the process they go through while working alongside people to make music. We're doing a breathing/stretching exercise. Sedin says this is a way of getting out of your head and into your body #quality2021

While we're breathing, here's a bit more background on 'See me as I am' elft.nhs.uk/News/See-Me-As…

We're now doing some singing exercises, so that we can get comfortable with each other singing (Luckily you can't hear me. Sweet harmony from me it is not) #quality2021

Sedin: why sing? Sedin says that there is an increasing evidence base for the wellbeing and physical impacts of singing. Bonding, community, breathing. Says that the arts in general have health impacts #quality2021

Bowler is saying that working with outside arts partners helps their trust make links with the community. Says of working with arts partners: Someone like Leanne only sees a room of potential collaborators, not a room with medical hierarchies. #quality2021

Bowler says that working with the arts and artists is a far more natural set of interactions than the medical mechanisms for interacting with each other. Bowler says that from the outset, arts have buy-in from senior figures at the trust #quality2021

Bowler says that senior buy-in gives license and allows staff to model their enthusiasm and behaviour = leading from the top. Says that in 2020, like so much else 1Voice moved online. Began a project to collaborate on a song. Process began with reflection #quality2021

Bowler says that the process of collaboration began by reflecting: 'what was 2020 like for you; how are things feeling currently; how are you feeling looking towards the future?' She says they want real responses. Workshop attendees are doing the same activity now #quality2021

Bowler and Sedin, importantly, are recognising and witnessing people's contributions. Not a blank response ('thank you for your feedback'), but an emotional and human one ('Yes, it does feel like that, that sounds hard) #quality2021

Bowler says writing their song, they collated people's reflections and divided them into 'hard things' and 'good things' collaboratively using an online tool replicating a fridge door to arrange words and phrases. Said it was important not to sugar coat, even in song #quality2021

Sedin has been putting together a brief song while Bowler has been explaining how songwriting works for them. She's taken reflections from this workshop and formed a song. Says in a workshop, the group would collaborate to find out what a line should sound like #quality2021

Sedin is stressing the ways in which making lyrics and melody is a constant push/pull interaction where each iteration as group can change what is being made incrementally. What something sounds like isn't fixed until it is as people chip in to make and remake a song #quality2021

A song is a place where collaborators can make something that has never existed before; a platform for capturing ideas and feelings. Sedin stresses her role as a trained collaborator as helping to shape and make sense of the musical element; adding not controlling #quality2021

A song made this way is a collaboration or coproduction that those involved can actually process through their bodies and hum on the way home. Their song about the pandemic once crafted, was sense checked with collaborators #quality2021

Their song about the pandemic was done with everyone singing and recording themselves at home and are currently in the process of editing all of these together into one song: a virtual choir. #quality2021

Bowler is stressing that the flattening of hierarchies that comes from making something together improves trust between service users and community and staff. She says that this is a quality improvement intervention, the impact of which could be measured #quaity2021

We're now listening to a clip of the work in progress song they've been working on together. It sounds outwardly uplifting, but there is also a strong wistful undertow of sadness and loss. There's something about massed voices that makes feeling solid #quality2021

A question from the chat asks 'how can we book Leanne for workshops?' The comments are more about how emotionally affecting the session was, and discussion about young people and health settings. Someone asks 'what do you do if someone gets sad in a workshop?' #quality2021

Bowler says that emotions are part of art, and that groups often know how to look after each other. This is not something to be afraid of; don't step in too soon to control or close down but let things be open. #quality2021

And that's the end of the session! I'm back at 1.15GMT with an abrupt change of gear from singing with: "Optimising the medication pathway: Meeting the WHO 2022 target of 50% fewer medication errors and clearing patient backlogs through automation" See you in a bit! #quality2021