For the first time, in 2021, mental health inpatient providers in England and Wales were included as a spotlight audit during the third round of NACEL. The purpose of the spotlight audit was to provide a baseline position for mental health inpatient providers with regard to end of life care delivery, patient and families experience, and compliance with the Five priorities for care and the relevant NICE Standards and Guidelines.

The Mental Health Spotlight Audit was aligned to the main acute and community hospital audit wherever possible, and mental health providers were invited to participate in all four data elements (Organisational Level Audit, Case Note Review, the NACEL Quality Survey and the new Staff Reported Measure). Data was collected from the 1st June to the 8th October 2021. For the Case Note Review data element, deaths were audited between 1st April and 31st August 2021 and Quality Surveys were sent out during this period to the bereaved. Staff were also asked to respond to the Staff Reported Measure during this time.

 Details of each audit element are below:

 •        an Organisational Level Audit covering hospital/submission level questions.

 •        a Case Note Review reviewing deaths over a set time period. 

 •        a Quality Survey completed online, or by telephone, by the bereaved person.

 •        a Staff Reported Measure completed online, by members of staff who are most likely to come into contact with dying patients and those important to them.