Acute and Community Audit

NHS providers are asked to register a submission, or multiple submissions, for NACEL.

A submission determines what data is collected and submitted to NACEL, as well as how the findings will be reported.

Guidance:

• Submissions can be created for each hospital/site within the Trust/Health Board, or a combination of hospital/sites can be included into one submission.

• Separate submissions should be created for acute and community hospital providers. This will allow the findings for acute and community hospital providers to be reported separately.

• The submission should be clearly named, to identify the name of the hospital/site(s) included in the submission.

Mental Health Spotlight Audit

Providers are advised to create a single submission covering all mental health inpatient sites within their organisation. This is due to the low number of deaths typically seen in mental health inpatient facilities, combining all sites into one submission will make data collection easier and the results more meaningful.  

Acute and Community Audit

The key dates for NACEL data collection and reporting can be found here.

Mental Health Spotlight Audit

An overview of the NACEL 2025 Mental Health Spotlight Audit Timescales can be found here

Acute and Community Audit

Each NACEL submission should participate in the Case Note Review data collection, submitting data for patients (18+) who died within the submission location (hospital/site) across each quarter. The target sample size is to review the care delivered to 20 – 70 patients who died within the submission location within each quarter. A maximum of 280 case notes across the year. There are two data collection periods for the NACEL Case Note Review, hence participating organisations can be flexible on when to submit the data within the online data collection pages. Review the key dates to understand the data collection timescales.

Mental Health Spotlight Audit

The request is to submit ALL deaths that occur within the year who are, following the inclusion and exclusion criteria. If there is a reason that it is not possible to review a death within the initial sample (e.g., the person opted out of data processing), please review the next eligible death. Review the key dates to understand the data collection timescales. For more information on the inclusion and exclusion criteria please review the audit guidance.

Acute and Community Audit

The URL link and QR code are available via the NACEL data collection pages on the NHS Benchmarking Network members’ area. The link and QR code can be copied and pasted into an email, ward posters, leaflet, letters or any other Trust/HB communication as an invitation to participate in the Bereavement Survey.

The links and QR codes for NACEL 2024 redirect to the NACEL 2025 survey, so the 2024 links and QR codes can continue to be used in 2025.

For Mental Health Spotlight participants: the Bereavement Survey is not a part of the Mental Health Spotlight Audit.

The data opt out only works for the person who has opted out and their data (the patient who died within hospital). The national data opt out is therefore only relevant for the Case Note Review audit element. The national data opt out wouldn’t be ‘extended’ to the bereaved person(s), therefore isn’t required for the Bereavement Survey.

NHS healthcare providers participating in NACEL should submit their data, for the Case Note Review and the Hospital/Site Overview (or Trust/HB Overview for Mental Health Spotlight participants), via the NHS Benchmarking Network members’ area. A login is required to access the NACEL data collection pages. If you need assistance with log-in details, please contact NACEL support on 0161 521 0866 or nhsbn.nacelsupport@nhs.net.

Data for the Bereavement Survey is to be submitted by the bereaved person via a unique survey link provided to them under voluntary participation. For Mental Health Spotlight participants: the Bereavement Survey is not a part of the Mental Health Spotlight Audit.

MEs ask if the family/those important to the patient are happy with what is on the medical Certificate of Cause of Death (MCCD), have any questions about the cause of death or concerns about care. There is some overlap with the NACEL Bereavement Survey. We encourage Trusts to use this as an opportunity to triangulate data and gather fuller intelligence about the quality of end of life care being provided.

For Mental Health Spotlight participants: the Bereavement Survey is not a part of the Mental Health Spotlight Audit.

NACEL 2023-2025 has only been commissioned to include deaths in acute and community hospitals and, for the Mental Health Spotlight Audit, mental health inpatient providers. However, we understand there is a large appetite to include community deaths in NACEL and we are motivated to respond to this. We are therefore in the process of discussing what a community NACEL pilot could look like with stakeholders. We will keep our website updated for any future developments.

NACEL 2023-2025 has only been commissioned to include adult deaths. There are several other ways in which children and young people’s deaths are assessed for quality of care which means including them in NACEL would potentially be duplication.

There are well established national programmes reviewing the deaths of these patients, including the MBRRACE-UK; a national collaborative programme of work involving the surveillance and investigation of maternal deaths, stillbirths and infant deaths. Inclusion in NACEL would be duplication of this work.

No. NACEL audits the quality of care delivered in NHS funded beds. Private beds are excluded from the scope of NACEL.

We have undertaken the following steps to reduce clinical burden:

o Reduction in the number of questions in the Case Note Review

o Improved efficiency and flow of questions in the Case Note Review and Bereavement Survey

o Removal of the Audit Summary element of NACEL

o Changed the proposal to collect data twice rather than four times a year

o Development of a Data and Improvement Tool to assist interrogation of data and prioritisation of improvement areas

We will support quality improvement with the following means:

o Resources and training signposted by our website

o Development of a community of practice for those who wish to use NACEL data in QI projects

o Development of the data and improvement tool with support to navigate this

o Delivering webinars that are timely to the release of data and responsive to what the data is telling us

Take a look at our Quality Improvement pages for more information and resources.

The NACEL tools are the intellectual property of Healthcare Quality Improvement Partnership (HQIP). To use the NACEL tools for external purposes, a copyright and IPR permission should be sent to communications@hqip.org.uk, copying in the NACEL Support Team, nhsbn.nacelsupport@nhs.net. For more information, go to the copyright and IPR permission page.