National Audit of Care at the End of Life (NACEL) 2022/23 report

Reports | Published: 13 Jul 2023

The National Audit of Care at the End of Life (NACEL) has published its latest report. Based on 7,620 case note reviews, 3,600 quality survey responses and 11,143 completed staff reported measures in England and Wales, this report sets out the findings of the fourth round of NACEL, which took place in 2022. Key findings include:

  • The possibility that the patient may die within the next few hours/days was recognised in 87% of cases audited, consistent with 2021, and
  • The median time from recognition of dying to death was recorded as 47 hours (41 hours in 2019), providing a greater opportunity to realise individual wishes for end of life care.

However, results from the quality survey show that 13% of families and those important to the dying patient ‘strongly disagreed’ or ‘disagreed’ with the statement ‘staff communicated sensitively with the dying person’ (this was 11% in 2021). A quarter of cases had a documented discussion about the extent to which the patient wished to be involved in their care, while 62% had no discussion documented but a reason recorded. This suggests earlier action is required once uncertain recovery is identified, to avoid missed opportunities to involve patients and those important to them. As such, the report contains a number of recommendations around advance care planning, patient involvement in decisions, and training for health and care staff, among others.

Read the full report: You can read the report by clicking on the link below.

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National Audit of Care at the End of Life (NACEL) 2022/23 report