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Duty of Quality

What is a Duty?

A Duty is a legal obligation that Public Health Wales is expected to fulfil to meet Welsh Government standards for health and social care.

What is the Duty of Quality?

In Wales, the Welsh Government has introduced a new law to improve health and social care services. This is called the Health and Social Care (Quality and Engagement) (Wales) Act 2020.

It includes a Duty of Quality which means all NHS organisations have a legal responsibility to continually improve the quality of the services they provide. The Duty also applies to how Welsh Ministers manage health functions in Wales.

The Duty of Quality came into effect in April 2023 as part of the Health and Social Care (Quality and Engagement) (Wales) Act 2020. It applies to everything we do in the NHS in Wales, to help us improve and protect the health, care and well-being of the current and future population of Wales.

What do we mean when we talk about 'Quality?

Welsh Government have provided the following definition of what Quality means for healthcare in their guidance:

‘Quality is considered to be defined as continuously, reliably, and sustainably meeting the needs of the population that we serve.’


What this means for people who use health services.

The Duty of Quality applies to all staff in NHS Wales, whether they work in clinical roles (such as doctors or nurses) or non-clinical services (such as porters and administrative roles). 

The Duty aims to:

  •  Improve the quality of health services
  •  Help people in Wales have more years in good health
  •  Listen more to people and patients and act on what is shared

All health organisations, including Public Health Wales, need to make sure services are safe and reliable for everyone who uses them by meeting 12 new Health and Care Quality Standards (see below). These standards are part of the Duty of Quality which was brought in on 1 April 2023.

The 12 Health and Care Quality Standards of the Duty of Quality

The Duty of Quality has introduced 12 new standards to help health organisations, such as Public Health Wales, understand what good quality looks like. They help us to develop our plans to measure, monitor and deliver quality in our services.  A definition for each of the standards can be found in the Duty of Quality Statutory Guidance which you can find here.

In developing the Duty of Quality Guidance, Welsh Government made the decision that the new Health and Care Quality Standards (2023) replace the previous Health and Care Standards (April 2015).

The twelve standards are made up of six domains of quality (a domain is a particular area or things we want to have good quality health care):

  • Safe
  • Timely
  • Effective
  • Person-Centred
  • Equitable
  • Efficient

The remaining six standards outline what is needed to support  good quality health services:

  • Leadership
  • Culture
  • Learning, Improvement and Research
  • Workforce
  • Whole System Approach
  • Information

This diagram illustrates the six domains of quality supported by the six quality enablers.

You can find out more here about what these standards mean.

Sharing our progress

As part of the new Duty, Public Health Wales is required to report and share our progress on how our services are doing, and how we are fulfilling our obligations to the Duty of Quality.

See the below section on Duty of Quality Reporting for more information.

Under the Duty, all health organisations, including Public Health Wales, need to produce an Annual Quality Report which gives information on our progress to improve the quality of our services. The first report will be published in Spring 2024.

Duty of Quality Reporting

Public Health Wales regularly reports its progress on how our services are doing, and how we are fulfilling our obligations to meet the Duty of Quality. We report this information in a number of ways on our internet pages. The following links can take you to more information:

  • Committee and Board papers – Here you can find our Annual Reports and other papers (such as our Integrated Performance Report) which are presented to our different Committees and at Board level. These papers give details on a wide range of topics related to public health in Wales. They also give updates on how well our services are working and the impact our work is having to help keep people in Wales healthier for longer.

If you are interested in finding out more data and statistics about health in Wales, you can find out more on our webpages. Here you can find up-to-date data on immunisation uptake within Wales, the latest statistics on Covid-19 rates, and information about the different teams in Public Health Wales, including Health Intelligence, Screening, Healthcare Associated Infections, Diseases & Infections and Cancer.

Find out more

This video helps to explain what the Duty of Quality means for all of us.


You can also read more here about the Duty of Quality Guidelines and Standards.