Professor Murtagh stressed that ICBs need to commission on the basis of activity and outcomes. Professor Murtagh explained that this approach is already used elsewhere in the NHS through a blended payment model that aligns payments with incentives, and questioned why it is not being used to commission care from hospices.32 She drew attention to the loss of mechanisms that captured and reported on hospices’ activity.33 NHS England acknowledged that currently data is very poor, and told us that, over time, ICBs will have more data upon which to base their commissioning decisions.34