National Audit of Care at the End of Life (NACEL)

National Clinical Audit

Delivered by:

NHS Benchmarking Network

Website:

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. Hospital remains the most common place of death in England and Wales (2023). Ensuring that individuals are treated with dignity, compassion and respect, and that their final wishes are recognised wherever possible, is fundamental to high quality end of life care and central to the purpose of this audit.

Drawing on over 40,000 case note reviews and bereaved family surveys, NACEL provides one of the UK’s most comprehensive evidence bases on care at the end of life. It offers a clear picture of what good end of life care looks like, highlights variation in practice, and identifies where improvement is most urgently needed.

Data from NACEL has enabled us to tailor education to our own locality, and drive quality improvement.” Tameside General Hospital, Tameside and Glossop Integrated Care NHS Foundation Trust

Supporting improvement

Driving quality improvement (QI) is central to NACEL’s purpose. The audit is designed to not only assess care, but also to help providers maximise the value of their audit data to support meaningful local improvement. NACEL’s QI approach is set out within its Healthcare Improvement Plan, which is reviewed annually. A range of outputs and resources support this work, and these can be found on the NACEL website, including:

Data and Improvement Tool (access is restricted to healthcare professionals)
NACEL QI pages, including a Good Practice Compendium, Community of Practice and other QI resources.
Outlier management: The identification and review of outliers is a key QI activity, supporting shared learning and targeted improvement.

Additional data and resources

In addition to HQIP-published reports below, NACEL has a number of additional resources on its website, including the NACEL Impact Compendium, the NACEL Good Practice Compendium, and the NACEL Patients and Carer Tool.