In 2008 the Department of Health published a report of end of life care in England. The report outlined a series of proposed changes to the way that end of life care is delivered in England (and Wales). This included increased training in end of life care for healthcare staff, supporting people to die where they want to die, a greater continuity between care settings at the end of life and increased support for carers. The VOICES questionnaire is written into the Department of Health report as a way of monitoring whether the changes and suggestions outlined by the report are reflected in the care that patients and their families and relatives receive.