This staff-reported summary measure includes 6 questions on the environment in which staff deliver end of life care: I feel able to raise a concern about end of life care within my hospital if I needed to; Staff work in partnership with the dying person and those important to them in planning and making decisions about their health, treatment and end of life care; Priority is given to the provision of an appropriate peaceful environment, that maximises privacy, for dying people and those important to them; Staff actively share information with each other about the individuals' end of life care needs; Deaths are actively reviewed, and action plans are implemented to improve end of life care; We have a culture that priorities care, compassion, respect and dignity as fundamental in all interactions with dying patients and those important to them.

All 6 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 24.

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 6 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