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Nobody ever came out of a performance of Wozzeck thinking that what it really needed was an extra layer to make it even more harrowing. Caution against excess, however, is not a feature of the Southbank’s Multitudes festival – gloriously so. Searing playing and singing from the London Philharmonic and a first-rate cast, conducted by Edward Gardner, combined here with Ilya Shagalov’s video art, co-created with Nina Guseva, to make Berg’s opera yet more adrenaline-inducing than ever.

Shagalov’s film, on a big screen behind the players, told Wozzeck’s story in thousands of still photos. The time was today, the place a grey city, and Wozzeck part of the invisible workforce hidden by their hi-vis vests. With a translation of the sung German at the bottom, the images sped by or turned over more slowly, always as stills – except only for the moment after Marie’s murder, when the orchestra joined in a terrifying crescendo on a single note. Then, and only then, did we see Wozzeck’s face moving, and the effect was as spine-chilling as it was brief.

The only thing that didn’t quite work was the absence of Wozzeck and Marie’s child – instead she was pregnant. In the final minutes, when half a dozen children from the Tiffin Boys Choir trooped on stage in smart school uniform to sing the lines Berg gives to Wozzeck’s son and his classmates, it didn’t really join up.

Generally, though, the film was riveting. Faces were sickly, angular and covered in rosacea one minute, pale, plastic and mannequin-like the next; the photos could be a low-quality snap or a high-definition shot, and at times were so beautifully lit and composed that they looked like old-master oil paintings – or Lucien Freuds. There was blood, lots of it, and, in the scene when Wozzeck was being the Doctor’s guinea pig, some stuff not for the squeamish. Nothing, though, felt designed purely to shock.

Below the screen, a concert performance was going on that would have been complete enough on its own terms; if there was a downside it was that we weren’t able to pay enough attention directly to the singers. Peter Hoare was acting his socks off as the Captain from behind his music stand from the start, and the rest of the cast, from Annette Dasch’s incisive Marie and Brindley Sherratt’s self-important Doctor to Callum Thorpe’s resonant First Apprentice, was just as vivid. Stéphane Degout’s singing wrapped Wozzeck’s desperation in velvet, making the character the quiet hero in his own undoing. This performance was billed as a one-off, but festivals worldwide should be queuing up to screen Shagalov’s video – if, like these, they have the musicians to match it.

• The Multitudes festival continues until 30 April