Sources of Data:
NACEL collects data from five sources:
1. Bereavement Survey
Formerly known as the Quality Survey, this is an online survey completed by relatives, carers and those important to the person who died in hospital, to report their experiences of the care and support received at the end of life.
2. Case Note Review
This is data collected from patient notes about the care they received during their final admission to hospital. It focusses on 10 elements of care, including recognition of dying and timely review of the dying and deceased patient.
3. Hospital/Site Overview
Questions focus on the specialist palliative care workforce, staff training and quality and outcomes within the hospital/site.
4. Staff Reported Measure
This survey is completed by staff who are most likely to come into contact with dying patients and their loved ones. The survey asks questions about staff confidence and experience in delivering care at the end of life, the support they receive and the culture of their workplace.
5. Annual Death Data Collection
A short collection to gather information on the total number of deaths during the year.
The National Audit of Care at the End of Life (NACEL) is a national comparative audit of the quality and outcomes of care experienced by the dying person and those important to them during the last admission leading to death in acute hospitals, community hospitals and mental health inpatient providers in England, Wales and Jersey.
NHS Benchmarking Network is commissioned by Healthcare Quality Improvement Partnership to deliver NACEL as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP).
Overarching NACEL objectives:
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Improving quality of care by identifying areas for action in relation to delivery and outcomes, and adapting QI priorities in line with evidence and guidance.
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Reducing unwarranted variation through benchmarking of outcome measures as well as identifying and managing outliers using the appropriate guidance.
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Understanding and reducing health inequalities in relation to impact on the specified measures.
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Sharing and adopting best practice including QI examples, and signposting to resources available in the wider End of Life landscape.
By participating in the NACEL it has given us evidence to present to our executive teams about the improvements that are needed across our Trust for end of life care. It has influenced the questions we ask for our Ward Accreditation Scheme in the Trust based on the Gold Standards Framework. It has made us engage with the generalists to elicit their views and look for improvements.
King George's Hospital
Barking, Havering and Redbridge University Hospitals NHS Trust