End of life care – 2024 State of the Nations report (NACEL)

Reports | Published: 14 Aug 2025

Based on care delivered from January to December 2024, this report from the National Audit of Care at the End of Life (NACEL) found that 83% of deaths were expected by clinical staff during the final admission and, of these, 84% had an individualised plan of care addressing their needs at the end of life.

73% of bereaved people rated the overall care and support given to themselves and others by the hospital as excellent or good

It also found that 97% of hospital providers have access to specialist palliative care services. Yet, of those providers, 61% have access to a face-to-face specialist palliative care service (nurse and/or doctor) 8 hours a day, 7 days a week. As such, the report recommends that services provide specialist palliative medical and nursing cover face-to-face, 8 hours a day, 7 days a week in addition to a 24-hour, 7 days a week, telephone advice service.

Other key findings include:

  • 77% of bereaved people agreed that the dying person received sufficient pain relief during their final hospital admission
  • 62% of clinical notes contained evidence of communication about hydration with those important to the dying person, or a reason recorded why not.

In addition to further key findings, this report contains five recommendations for improvement relating to:

  1. Hospital improvement plans
  2. Access to specialist palliative care services
  3. Personalised care and support planning
  4. Equitable care
  5. Training and support.

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End of life care – 2024 State of the Nations report (NACEL)