NACEL Audit Guidance 2026

Download the National Audit of Care at the End of Life (NACEL) data specifications, audit guidance and promotional resources for the current audit period year below.

Find information about copyright and IPR permission here or see the full list of guidance and outputs here.

Click here for the NACEL 2025 Audit Guidance page (For deaths between January 2025 - December 2025)

Audit Guidance

The audit guidance document is intended to provide guidance on each aspect of NACEL for all acute and community organisations in England, Wales and Jersey.

Download Guidance (.pdf)

NACEL 2026 Mapping Document

This document maps each question and its audit element to the Primary and Secondary Drivers. It also outlines which questions are used as a Key Indicator or for the Management of Outliers Analysis.

*Coming soon*

Example Script for Healthcare Professionals

An example script to help healthcare professionals support patients, carers and bereaved people understand the findings on the quality of care at the end of life.

Download Script

Case Note Review

The Case Note Review collects patient level data on the deaths within the audit criteria, focusing on ten indicators of care, including recognition of dying, timely review of the dying and deceased patient, etc. The downloadable versions below do NOT include SNOMED codes. These will be released later before data collection commences.

Download CNR Specification WITHOUT SNOMED Codes (.xlsx)
*CNR Specification (.pdf) coming soon*

Bereavement Survey

The Bereavement Survey is an online questionnaire to be completed by bereaved person(s) of all eligible patients who died within the audit criteria. For Trusts/Heath Boards: example promotional materials are available here. Survey translations to follow.

Download Bereavement Survey Specification - English (.pdf)
Download Essential Bereavement Survey Questions - English (.pdf)
*Translations to follow*

The following elements of NACEL will be available to complete later in the year. See the audit guidance document or visit our Key Dates page for more detail of timescales.

Annual death data collection

Each submission will complete a small data collection element in early 2027 which will collect the number of deaths that took place in 2026.

Download the Annual Death Data Specification (.xlsx)

Staff Reported Measure

The Staff Reported Measure is a survey aimed at members of staff who are most likely to come into contact with dying patients and those important to them. For Trusts/Health Boards an example promotional poster is available here.

Download SRM Specification (.pdf)