About the audit
COMMISSIONED BY
Healthcare Quality Improvement Partnership (HQIP), as part of the National Clinical Audit and Patient
Outcomes Programme (NCAPOP)
DELIVERED BY
NHS Benchmarking Network
COVERAGE
England, Wales and Jersey
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.
Overarching NACEL objectives
⭐
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.
📊
Reducing unwarranted variation
Through benchmarking of outcome measures, as well as identifying and managing outliers using the appropriate guidance.
⚖️
Understanding and reducing health inequalities
In relation to impact on the specified measures.
💡
Sharing and adopting best practice
Including QI examples, and
signposting to resources
available in the wider end of
life landscape.
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
Data collected from patient notes about the care they received during their final admission to hospital. It focuses 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 or site.
4.
Staff Reported Measure
Completed by staff who are most likely to come into contact with dying patients and their loved ones. It asks 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.
"Participating in NACEL 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, 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