Behind the curtain on the modern public health film: “They’re rooted in the power of storytelling to help people walk in others’ shoes”

BFI Player’s NHS on Film collection presents a rich history of filmmaking in and for our National Health Service, from its founding in 1948 across the rest of the 20th century. Much of it was carried out, often by gifted filmmakers, through the auspices of the Central Office of Information, the state communications agency throughout that period. Ironically, the COI’s closure in 2012 came just as digital video and online distribution possibilities for film as a creative medium for information and learning were really taking off.

So did NHS filmmaking cease in 2012? Far from it, but it’s become ever harder to track, as it’s no longer centralised through one agency. Instead, it’s spread across a bewildering range of organisations, from central government to NHS Trusts to NGOs. Across this fragmented landscape, unnoticed by film critics, talented filmmakers have been busily revitalising this public service tradition in film through our own century, as public health faces challenges old and new.

Chris Godwin is among the most impressive of this filmmaking generation, having become an in-demand specialist in health filmmaking over the last decade. Originally a BBC director working on everything from Newsround, Watchdog and the BAFTA-nominated Short Change to multiple travel, food and documentary shows, Godwin moved to corporate filmmaking company White Boat TV where he directed arguably the seminal NHS training film of our century so far: Barbara’s Story, commissioned by Guy’s and St Thomas’ NHS Trust.

Godwin subsequently set up his own company, Inner Eye Productions, consistently producing highly crafted video (often dramas based on factual research) for clients across the world of public health, speaking to issues of today.

I recently caught up with Godwin to ask him about his experiences at the junction between film and our greatest national public service.

How did you get into NHS filmmaking?

After years at the BBC, I was starting to feel institutionalised, finding the work creatively restricting; all the programmes I worked on seemed to become heavily formatted. I wanted to try new things. Voluntary redundancy was offered, and it was time to leave. I then worked in branded content, specialising in advertiser-funded programmes, and for global agencies Havas and McCann as a consultant: a big culture change. Agencies protect creativity in a way broadcast doesn’t. Both approaches have their advantages and impact on the work culture.

In the late 2000s I joined White Boat, a small production company where I worked on corporate filmmaking and branded content. I really enjoyed my time there. Some work was a bit bog-standard, but there were some exciting projects offering a lot of creative freedom, most notably Barbara’s Story, a complete game-changer in my career.

What was the NHS context for the commissioning of Barbara’s Story?

The Francis Report had just been published in response to the Stafford Hospital scandal. A key finding was the importance of compassion and care in patient outcomes. Also, government had made dementia awareness a priority.

It was compulsory for every trust staff member to watch Barbara’s Story and it made a huge difference, verified by an evaluation by South Bank University. Its success led to five more films being commissioned, continuing the character’s story, with similar impact. One surprising outcome was how they sparked the trust’s leadership team to review systems and process, including use of wheelchairs, reconfiguring reception areas and reviewing infection control policy.

The film went on to be rolled out across the whole NHS, then globally. Apparently Barbara is big in Japan!

This lead to you being offered more health-related projects?

Yes. I’ve mainly specialised in this genre ever since. The first film we were commissioned to make was The Deafening Silence for stillbirth charity Abigail’s Footsteps. This very raw film really put the charity on the map and has had a massive impact on bereavement care for families across the country. It’s racked up 470,000 views on YouTube, helping break that ‘silence’ around stillbirth.

Another notable piece off the back of Barbara’s Story was Seen and Heard, about child sexual abuse for the Department of Health. Similarly, this was commissioned in a specific context, following the Rotherham child sexual exploitation scandal, to communicate the insight that healthcare workers had unique opportunities to elicit disclosure of abuse. It was produced in conjunction with the Children’s Society and targeted to every single NHS staff member as part of a training package. Evaluation indicated use of the film in various trusts has led to an increase of disclosures. And it’s had 3.3 million YouTube views.

You’ve covered dementia, sexual abuse, suicide, bullying of trans kids, healthcare for the homeless – all sensitive, potentially harrowing topics. What have you learned about bringing them to the screen?

The critical element is ensuring every film is authentic and based on real experiences. This is where research is key, often involving interviews and focus groups. We always work with an organisation connected with the issue we’re covering. They normally put us in touch with survivors/victims willing and able to talk. We preface meetings with a conversation around safeguarding and what individuals are or aren’t prepared to talk about. Our storytelling is then key to how we sensitively reflect these topics on screen. We’re very careful to only allude to the more harrowing elements of the story. For example, in Seen and Heard we implied the abuse took place in the front seat of a car – so the seat became the metaphor for the abuse.

From a safeguarding perspective we must also be careful when working with actors, particularly child actors. We’ll always make sure support is there if they feel they need it. With child actors a mental health assessment will be done before the shoot. We’ve sometimes shot scenes in unconventional ways to ensure the psychological safety of a child.

On a personal level, I certainly feel the sadness behind the issues. However, I also feel the power of humanity: for individuals to make a difference in the life of a vulnerable person. I’d also like to think all my films leave you feeling uplifted.

Today’s public health world, and its filmmaking, is fragmented. Are there clients you’ve worked with frequently?

I’ve continued making films for Guy’s and St Thomas’, most recently a film on mental health crisis. Another trust I’ve consistently worked with is East London. At White Boat, I made two films for them on dementia and its impact on the South Asian community. Similarly, a film on end-of-life care in the Muslim community, and also a film on self-harm. I’m currently working with them, in conjunction with Bristol University, on a film about autism.

How has the pandemic affected health filmmaking?

As we went into lockdown, I had to delay production of a film for homeless charity Groundswell on difficulties people with lived experience of homelessness have when accessing healthcare. The extended production period presented opportunities to collaborate with different people, so I reached out to screenwriter Jimmy McGovern, who worked with us as a consultant. And until this point I used library music; now I decided to reach out to a composer, and since then all my films have been scored by composer Jonny Colgan.

Lockdown also exposed different issues. I became interested in researching its effects on mental health and came across some from Imperial College on the impact on young people. I approached the academic Dr Lindsay Dewa and we ended up collaborating with West London NHS Trust. Inspired by the co-production approach to research, we continued this into production of the film: working with a group of young people on every stage from development through casting and signing off the final cut. This film, Nexus, is now being rolled out across West London NHS Trust and on a screening tour of the UK and various conferences globally, getting extensive BBC world service coverage. We’re currently seeking funding for a follow-up.

Do you approach projects differently for professional clinical audiences, in the NHS, as opposed to a wider public?

All my films have a primary and secondary audience. The primary audience will normally be an internal clinical one. My focus is making the piece work for them. But for every film we produce a trailer/impact film, which is used to promote the main film but is also often used as a stand-alone impact film within social media.

Some films might touch on sensitive subjects that might be misinterpreted by a broader audience: for example, a video I made for Capital Nurses to help improve nurse retention. It was noted that nurses were leaving the profession due to poor work culture. This film, Ella and Abi, was designed to be a platform for debate and discussion around some of these issues within the nursing profession.

In the 11 years since Barbara’s Story you’ve become a leading specialist in NHS and health films. What have you learned?

The process always starts with finding an insight on which to base the story. Normally this comes through interviews; it can come through research and data. Either way the insight is always the spark for a narrative that not only responds to the brief but is the foundation for a story.

Although the films are sometimes used in a training context, I don’t like to think of them as training films – they’re rooted in the power of storytelling to help people walk in others’ shoes. We’re not trying to show people what to do; we, hopefully, are emotionally drawing them into a story, immersing the audience in the mind of a character, allowing them to work it out for themselves.

How does the character see the world? How does it make them feel? Our shooting and editing technique is often built around big close-ups and point-of-view shots and scenes, combined with sound design, specially composed music and editing, all seeking the emotion in every scene.