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ObjectivesThe study aimed to understand the psychospiritual experiences and support needs of ethnically diverse healthcare staff during the COVID-19 pandemic.DesignA qualitative study using focus groups conducted remotely on Microsoft Teams.SettingThe study took place across 10 National Health Service Trusts in England: 5 were Acute Hospital Trusts and 5 were Community and Mental Health Trusts.ParticipantsFifty-five participants were recruited to the study across 16 focus group meetings. Participants were all National Health Service staff from ethnically diverse backgrounds.ResultsPsychospiritual 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.ConclusionsCulturally 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 patient's 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.