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Objectives The aim of this paper was to explore the experiences and support needs of ethnically diverse healthcare staff and how they were affected by the COVID-19 pandemic.Design A qualitative study using focus groups conducted remotely on Microsoft Teams.Setting The study took place across 10 National Health Service Trusts in England; 5 were Acute Hospitals Trusts and 5 were Community and Mental Health Trusts.Participants 55 participants across 16 focus groups took part in the study. Participants were all healthcare staff members from ethnically diverse backgrounds.Results Seven themes were generated which highlighted issues of negative experiences of discrimination at work, particularly during the COVID-19 pandemic, including participants often finding line managers unsupportive, appearing to lack care and compassion, and not understanding ethnic diversity issues. Participants identified many reasons for finding it difficult to speak up when faced with such experiences, such as feeling unsafe to do so, or feeling too exhausted to keep speaking up. Other staff had more positive experiences and described supportive interventions, and despite workplace difficulties, many participants discussed remaining motivated to work in the National Health Service.Conclusions Negative day-to-day experiences of ethnically diverse healthcare staff, and the difficulty of speaking up about these align with other, international literature on this topic. Progress in the area of staff equality is vital if healthcare organisations are to continue to provide high-quality patient care and retain skilled, compassionate staff who value their place of work. Recent literature suggests that many initiatives to reduce inequalities have not been successful, and there is a call for fundamental, cultural-level change. Future research is needed to understand how best to implement these organisational-level changes and to evaluate their effectiveness.

Objectives The study aimed to understand the psychospiritual experiences and support needs of ethnically diverse healthcare staff during the COVID-19 pandemic.Design A qualitative study using focus groups conducted remotely on Microsoft Teams.Setting The study took place across 10 National Health Service Trusts in England: 5 were Acute Hospital Trusts and 5 were Community and Mental Health Trusts.Participants Fifty-five participants were recruited to the study across 16 focus group meetings. Participants were all National Health Service staff from ethnically diverse backgrounds.Results Psychospiritual concerns were central to participants’ understanding of themselves and their work in the National Health Service. Participants felt there was limited recognition of spirituality within the health service. They described close links between their spirituality and their ethnicities and felt that the psychospiritual support offered within the healthcare setting was not reflective of diverse ethnic and spiritual needs. Improved psychospiritual care was viewed as an opportunity to connect more deeply with other colleagues, rather than using the more individualistic interventions on offer. Participants requested greater compassion and care from leadership teams. Participants described both positive and negative changes in their spirituality as a result of the COVID-19 pandemic.Conclusions Culturally sensitive psychospiritual support is a key aspect of healthcare staff’s well-being, despite identified gaps in this area. Aside from affecting physical, psychological, social and financial aspects of healthcare staff’s lives, the pandemic has also had a significant impact on the ways that people experience spirituality.

Quality improvement (QI) provides a rigorous and innovative approach to improving patients lives in the healthcare system. Still, it can pose challenges in understanding what ethical considerations apply to some projects to minimise the possibility of patient harm or prevent other ethical wrongs and potential staff burden. While many commentaries discuss the extent to which QI ethics should match research ethics, there is minimal literature regarding what QI project teams should do when considering ethics at the planning stage. This paper provides a practical walkthrough of some of the ethical considerations across the breadth of QI projects, starting from some of the key questions when planning a QI project and a guide for the different ethical considerations that may apply.