Contractual requirement to participate in NACEL
Under the refreshed NHS Standard Contract, NHS providers are required to:
26.1.2.1 Participate in any national programme within the National Clinical Audit and Patient Outcomes Programme (NCAPOP)
26.1.3 Make national clinical audit data available to support national publication of consultant-level activity and outcome statistics
26.1.4 Engage in national outlier identification and management processes, in line with published outlier guidance
The Welsh Health Circular (WHC) for the National Clinical Audit and Outcome Review Plan outlines that health boards and trusts in Wales are required to fully participate in audits and outcome reviews listed in the annual plan.
What does this mean for NACEL?
All NHS providers delivering adult inpatient care in acute and community hospitals are required to participate in the National Audit of Care at the End of Life (NACEL), as part of NCAPOP.
Non-participation in NACEL will be treated as an alarm-level outlier, with notification shared with audit funders and care regulators.
Partial participation will also be flagged as an outlier. This includes providers who, during 2026:
Do not submit data to the Case Note Review
Do not submit data to the Staff-Reported Measure
Do not provide data to the Key Indicator Metrics
Participation across all NACEL components supports best practice, enables meaningful benchmarking and quality improvement, and is necessary to meet contractual requirements and avoid escalation.
If you have any questions about NACEL participation, please contact the NACEL team.