This staff-reported summary measure includes 11 questions regarding staff confidence in delivering end of life care: I am confident I can recognise when a patient might be dying imminently (within hours to days); I feel confident in my skills to communicate clearly and sensitively to dying patients and those important to them; I am confident I have the skills to involve the dying patient and those important to them in decisions about end of life care in line with their wishes and preferences; I know how to access specialist palliative care advice, if required, when addressing specific end of life care needs for dying patients; I know how to respond to requests to die outside of the hospital setting from dying people and/or those important to them; I feel confident to respond to the practical and social needs of the dying person; I feel confident to respond to the spiritual, emotional and cultural needs of the dying person; I am confident in my ability to discuss hydration options with dying patients and those important to them; I am confident in assessing and managing patient pain and physical symptoms at the end of life; I feel confident to respond to the practical and social needs of those important to the dying person; I feel confident to respond to the spiritual, emotional and cultural needs of those important to the dying person.

All 11 questions include response options on a 6-point Likert-scale. For the summary score method, the following scores are assigned for all questions: Strongly agree=4; Agree=3; Neither agree not disagree=2; Disagree=1; Strongly disagree=zero; N/A/Not sure= zero=2).The maximum possible score for this summary indicator is 44.

Hospices are excluded from participating in the National Audit of Care at the End of Life (NACEL) program. All non-NHS acute sites and community hospital providers of adult inpatient care in England and Wales were ineligible to take part in the audit. For this staff-reported summary measure guidance from the audit program was made available to Trusts/hospitals on which staff groups and which locations ought to be covered. Exclusions were maternity and paediatric inpatient staff, and any wards unlikely to have dying people on them.

None

The national and hospital-level summary scores are not stratified. The proportions of response options to the 11 individual data collection questions contained within this summary indicator are reported. The proportions of strongly/agree responses are stratified by audit year.

Audit participants (based at eligible NHS acute and community hospitals/trusts in England and Wales) were requested to complete the staff-reported survey during the audit data collection period. The survey asked questions pertaining to staff confidence and experience in delivering care at the end of life and was completed for each submission. Staff completed the online questionnaire using a unique link generated for each hospital/site or through a unique QR code.

Public reporting.

National Audit of Care at the End of Life (NACEL) program 2022/23 Report: www.hqip.org.uk/wp-content/uploads/2023/07/Ref.-380-NACEL-2022-Summary-Report-Final.pdf National Audit of Care at the End of Life (NACEL) program 2022/23 Appendices and specifications: www.hqip.org.uk/wp-content/uploads/2023/07/Ref.-380-NACEL-2022-Appendices-Final.pdf

Unable to locate full technical specification details. Some details and methods for scoring available here in Appendix 16 (page 34-40): www.hqip.org.uk/wp-content/uploads/2023/07/Ref.-380-NACEL-2022-Appendices-Final.pdf