Therefore, much of the report focussed, quite rightly, on palliative and end-of-life care provision and with that in mind this response will primarily focus on that too. The Department has already introduced a number of significant changes to improve the provision of palliative and end-of-life care in England in recent years, which we have highlighted in response to the individual recommendations. Additionally, the UK has been considered an international leader in palliative and end-of-life care for a number of years and, in a recent Cross-Country Comparison of Expert Assessments of the Quality of Death and Dying, the UK was ranked no. 1 of 81 countries for high- quality end-of-life care. However, with an increasing ageing population and a growing number of people living and dying with multiple long-term conditions, there is more work to be done.