NACEL: National Audit for Care at the End of Life
The National Audit for Care at the End of Life (NACEL) is a national quality improvement programme designed to review and improve the care provided to patients in the last days and hours of life. Its purpose is to ensure that every person nearing the end of life (EOL) receives compassionate, personalised, and high-quality care, consistent with their needs and preferences.
At Homerton Hospital, NACEL plays a key role in helping us monitor and enhance the palliative and end of life care services we provide. By participating in NACEL, we are able to benchmark our care against national standards and identify areas where we can improve the experience and outcomes for our patients and their families.
Why is NACEL in place?
Care at the end of life is complex and requires careful coordination, sensitive communication, and timely support for patients and their loved ones. NACEL exists to:
- measure the quality of care delivered to patients in their final days and hours
- highlight good practice and identify where care may fall short of expectations
- encourage reflective learning and service improvement across hospitals nationwide
- promote patient-centred care, ensuring patient’s wishes and dignity are respected
- support families and carers by improving communication and involvement in care decisions.
The audit recognises that dying is a universal experience and that all healthcare services have a responsibility to provide compassionate and effective end of life care.
The purpose of NACEL at Homerton Hospital
At Homerton Hospital, we are committed to providing the best possible care for patients approaching the end of life (EOL). Participation in NACEL allows us to:
- assess the care delivered in our hospital wards and specialist palliative care services
- understand patients’ experiences through feedback from families and healthcare staff
- identify areas for improvement, such as symptom control, communication, and documentation of care preferences
- develop action plans based on audit findings to enhance training, policies, and clinical practices
- ensure compliance with national guidelines and quality standards for palliative and EOL care
By analysing NACEL data, Homerton Hospital can monitor trends, share learning, and implement changes that lead to better symptom management, improved decision-making, and more compassionate support for both patients and their families.
How NACEL contributes to quality care
The audit process involves collecting information about patients who have died in hospital and reviewing key aspects of their care, such as:
- recognition of the dying phase
- symptom assessment and management
- communication with patients and families
- documentation of care plans and patient wishes
- ethnicity, religion or belief, and language spoken
- support for families before and after the patient’s death
The findings from NACEL provide Homerton Hospital with a clear picture of how well we are meeting the needs of patients at the end of life or focus efforts on areas where care can be improved.
Further information
If you would like to learn more about NACEL or the palliative care services at Homerton Hospital, please contact the Palliative Care Team.