The NAO reported that the mix of funding mechanisms varies between ICB areas, largely comprising a mix of historic grants and block contracts with few examples of activity-based contracts used in a strategic commissioning approach.11 Progress in moving towards strategic commissioning has been slow. NHS England explained that it is a long, complicated process of unravelling how the money is currently connected to services.12 The continued reliance on the current funding arrangements has meant there is little clarity over what ICBs are paying for or the volume of these services.13 Hospice UK highlighted the current financial pressures on the independent hospice sector and informed us that hospices raise and spend £1.2 billion a year on care, but only receive approximately £400 million in statutory funding.14