Describing and monitoring quality in value-based palliative and end-of-life care at a population level in Wales: achievements and future direction

Improving and monitoring quality of palliative and end-of-life care is well documented within current and historic literature. However, there is a paucity of evidence around national data-informed approaches to ensure healthcare services are delivering high-quality, equitable care that meets the needs of the population within the last year of life. Wales has a legal 'Duty of Quality' obligation and has taken on the challenge to measure and monitor quality within the healthcare system at a population level within the last year of life, creating a dashboard using nationally held routine data. This manuscript aims to document the progress made in Wales to describe and monitor quality in care for people within the last year of life at a population level against the six domains of quality and discusses requirements and challenges of the approach and its future direction.