We have assumed the hon. Member is referring to Spinraza. The National Institute for Health and Care Excellence (NICE) received a formal ministerial referral for nusinersen (Spinraza) to treat spinal muscular atrophy and this topic has been scheduled into its work programme. The appraisal process is anticipated to begin in January 2018 and the deadline for an evidence submission is anticipated to be March 2018. Although no further details about timescales for the development of guidance are available at this stage, NICE take approximately nine months to develop guidance on new drug depending on the individual product.

Despite rigorous and extensive investigation of this unusual strain of Vero cytotoxin-producing Escherichia coli (VTEC) O55, a single source was not identified. The evidence suggests that the likely source was a local zoonotic (from animals) infection. No further cases of this unusual strain of VTEC with links to Dorset have been seen since late 2015.

Public Health England (PHE) has well established systems to identify new cases of this infection and well-rehearsed operational procedures to respond should any future cases emerge. These systems were last tested in a cross-Government exercise in November 2016. There is extensive guidance and advice on preventing the transmission of VTEC on the PHE website, NHS Choices and the Food Standards Agency website.

The Care Quality Commission (CQC) will move from a budget of £249 million in 2015-16 to a budget of £217 million in 2019-20, requiring total savings of £32 million.

The CQC’s revenue budget for 2016-17 was £236 million and next year (2017-18) it will be £226 million. The proportion of the savings that will be delivered in financial year 2017-18 is 31%. The proportion of the total required savings that will have been achieved by the end of financial year 2017-18 is 71%.

The World Health Organization (WHO) did not ask the Department to provide resources in relation to implementation of the Framework Convention on Tobacco Control (FCTC).

Over the past 12 months, Departmental officials attended the FCTC Conference of the Parties in Delhi, India in November 2016 as part of the United Kingdom obligation to support the FCTC, and have attended meetings with the FCTC Secretariat in Geneva, Switzerland. No countries have received direct country support from the FCTC project over the past 12 months.

The World Health Organization (WHO) did not ask the Department to provide resources in relation to implementation of the Framework Convention on Tobacco Control (FCTC).

Over the past 12 months, Departmental officials attended the FCTC Conference of the Parties in Delhi, India in November 2016 as part of the United Kingdom obligation to support the FCTC, and have attended meetings with the FCTC Secretariat in Geneva, Switzerland. No countries have received direct country support from the FCTC project over the past 12 months.

The World Health Organization (WHO) did not ask the Department to provide resources in relation to implementation of the Framework Convention on Tobacco Control (FCTC).

Over the past 12 months, Departmental officials attended the FCTC Conference of the Parties in Delhi, India in November 2016 as part of the United Kingdom obligation to support the FCTC, and have attended meetings with the FCTC Secretariat in Geneva, Switzerland. No countries have received direct country support from the FCTC project over the past 12 months.

When it was established in 2013, NHS England published a set of so-called ‘generic commissioning policies’ including the policy on “Defining the boundaries between the NHS and private healthcare”. These policies were intended to guide NHS England’s decision-making for its directly commissioned services. The policies were published on an interim basis as it was recognised that they would benefit from further engagement and testing with stakeholders, including patients and the public.

In October 2016 NHS England launched a public consultation on the set of policies, to test whether they were sufficiently clear and effective in supporting decision-making. The consultation followed a period of review and testing with stakeholders. As well as testing the detail of some of the policies, the consultation was intended to test whether the policies would continue to be appropriate in light of other Department of Health or NHS England policy developments, or whether they risked duplication.

NHS England’s response to the consultation is planned for publication shortly. The response will set out the planned changes to the set policies based on feedback received during the consultation.

Co-funding and most forms of co-payment, other than those limited forms permitted by Regulations, such as prescription charges, are contrary to National Health Service policy.

More information on co-payments can be found at the following address:

https://www.england.nhs.uk/wp-content/uploads/2013/04/cp-12.pdf

The Competition and Markets Authority (CMA) has a duty to review mergers and acquisitions involving National Health Service foundation trusts to assess the impact on quality and choice of NHS services to patients. If an NHS proposal has been reviewed and has given undertakings to the CMA relating to its future merger or reorganisation plans, then the NHS foundation trusts can put forward any new proposal to merge services or work jointly for the CMA to consider. The CMA will then consider whether there has been a change in circumstances to justify varying or releasing the undertakings previously given.

This information is not held centrally and I refer my hon. Friend to the answer I gave on 21 November 2016 to Question 53429.

In addition to the information provided in my Answer to Question 53429, NHS Dorset Clinical Commissioning Group (CCG) advises there are 22 inpatient beds at Wimborne Hospital and 22 at St Leonard’s Hospital in the East Dorset locality. Any future plans for these beds are a matter for the local NHS. We understand the CCG is in the process of carrying out a Clinical Services Review, which will be subject to public consultation in due course.

The CCG also advises that Broadwaters residential care home sited in Wick is a local authority facility where 26 beds provide care to Bournemouth people.

The CCG further advises Royal Bournemouth and Christchurch NHS Foundation Trusts, NHS Dorset CCG and the local authority spot purchase with a large range of care/nursing homes a further 18 beds across both Christchurch and Bournemouth localities.

This information is not held centrally and I refer my hon. Friend to the answer I gave on 21 November 2016 to Question 53429.

In addition to the information provided in my Answer to Question 53429, NHS Dorset Clinical Commissioning Group (CCG) advises there are 22 inpatient beds at Wimborne Hospital and 22 at St Leonard’s Hospital in the East Dorset locality. Any future plans for these beds are a matter for the local NHS. We understand the CCG is in the process of carrying out a Clinical Services Review, which will be subject to public consultation in due course.

The CCG also advises that Broadwaters residential care home sited in Wick is a local authority facility where 26 beds provide care to Bournemouth people.

The CCG further advises Royal Bournemouth and Christchurch NHS Foundation Trusts, NHS Dorset CCG and the local authority spot purchase with a large range of care/nursing homes a further 18 beds across both Christchurch and Bournemouth localities.

Further to my reply given to Question 52427, NHS England advises that the correct figure for the number of community beds in Dorset is 347, of which 286 are community hospital beds. This corrects the answer I gave on 14 November 2016.

NHS England advises community hospital beds are located in the following areas:

- 137 beds in East Dorset; Poole Bay; Poole Central; Poole North; and Purbeck;

- 44 beds in Bournemouth North; Central Bournemouth; Christchurch; and East Bournemouth; and

- 166 beds in Dorset West; Mid Dorset; North Dorset; and Weymouth and Portland.

NHS England further advises that the additional 69 community beds are proposed to be located in the following hospitals:

- Bridport Community Hospital;

- Weymouth Community Hospital;

- Blandford Community Hospital;

- Swanage Community Hospital;

- Wimborne Community Hospital; and

- Yeatman Hospital.

Dependent upon the outcome of a public consultation, which NHS Dorset Clinical Commissioning Group (CCG) expects to run in due course, beds will also be located at Poole, Royal Bournemouth or Christchurch hospitals.

Of the 69 additional beds, extra care home beds will be required in four main areas to take account of proposals to consolidate community hospital bed on fewer sites; as well as meeting the needs of people in Christchurch, Bournemouth and Poole. These areas are Wareham, Shaftesbury and Bournemouth, Poole and Christchurch. Until the consultation is concluded the CCG is not able to develop the definitive sites for these beds.

Further to the Answer of 14 November 2016 to Question 52127, planning is now underway for the delivery of support to low- and middle-income countries to implement the World Health Organization Framework Convention on Tobacco Control. The Government will contribute £15 million between 2016/17 and 2020/21 via the Secretariat of the World Health Organization Framework Convention on Tobacco Control to provide this support.

Only those countries that have ratified the World Health Organization Framework Convention on Tobacco Control and are listed by the Organisation for Economic Co-operation and Development as being eligible to receive Official Development Assistance will be eligible to receive support through this project. The process of selecting countries to receive direct support will be undertaken over the next six months.

Information about the proportion of patients attended to by ambulances which are referred to emergency departments is not collected centrally.

However, NHS England does publish monthly information on the number of transported incidents. The number of transported incidents does not equal the number of patients involved as one incident with two or more patients transported is counted as one incident. From April 2013, only incidents with a patient journey to Type 1 or Type 2 accident and emergency (A&E) are included.

Data on the number of transported incidents can be found at:

https://www.england.nhs.uk/statistics/statistical-work-areas/ambulance-quality-indicators/

The following table sets out data for the three ambulance trusts in question for 2015/16.

Number of Transported Incidents

Source: NHS England, Ambulance Systems Indicators Time Series to August 2016, published at:

https://www.england.nhs.uk/statistics/statistical-work-areas/ambulance-quality-indicators/

Notes:

1. ‘Transported incidents’ were previously described as ‘Emergency Journeys’. From April 2013, only incidents with a patient journey to Type 1 or Type 2 A&E are included, and one incident with two or more patients transported is counted as one incident.

2. Type 1 A&E refers to consultant-led 24-hour department with full resuscitation facilities and designated accommodation for the reception of A&E patients.

3. Type 2 A&E refers to consultant-led single specialty services (e.g. ophthalmology, dental) with designated accommodation for the reception of patients.

Information about direct admissions to community hospitals following conveyance by ambulance is not held centrally.

Information about direct admissions to community hospitals following conveyance by ambulance is not held centrally.

The United Kingdom is providing support to low and middle income countries both through direct country support to a select number of countries and through producing training and guidance that will be available to all low and middle income countries. Country projects will be delivered through our delivery partners the World Health Organization Framework Convention for Tobacco Control secretariat and the United Nations development programme.

Robust monitoring and evaluation mechanisms have been put in place to ensure the project delivers maximum value for the British taxpayer.

NHS England advises that there are currently 357 community hospital beds in Dorset. Dorset Clinical Commissioning Group is proposing under its current Clinical Services Review to provide an additional 69 community beds, increasing numbers in the east of the county and reducing numbers in the west. The proposals are based on projected local demand and any changes will be subject to full public consultation.

The Government has engaged with a wide range of stakeholders to inform its negotiating position with other Parties attending the Conference of the Parties for the Framework on Convention on Tobacco Control (FCTC), including users of e-cigarette and other novel products. The Government recognises that e-cigarettes can help some smokers quit and the evidence indicates that they are considerably less harmful to health than cigarettes. However, they are not risk free and it is essential that we do not encourage smoking and continue to protect children from the dangers of nicotine. This is a position firmly grounded on the evidence base.

The United Kingdom is a world leader in tobacco control and as such has already implemented the majority of the FCTC’s provisions and taken further action in line with its non-binding guidelines, for example introducing Standardised Packaging. There are few further guidelines being developed by the FCTC and the focus of the Convention is now on full and comprehensive implementation by all 180 Parties. We therefore do not expect the outcomes of the forthcoming Conference of the Parties to significantly alter our tobacco strategy, but will continue to offer our support and experience to help other countries fully implement the provisions of the Treaty, especially low and middle income countries.

The Government has engaged with a wide range of stakeholders to inform its negotiating position with other Parties attending the Conference of the Parties for the Framework on Convention on Tobacco Control (FCTC), including users of e-cigarette and other novel products. The Government recognises that e-cigarettes can help some smokers quit and the evidence indicates that they are considerably less harmful to health than cigarettes. However, they are not risk free and it is essential that we do not encourage smoking and continue to protect children from the dangers of nicotine. This is a position firmly grounded on the evidence base.

The United Kingdom is a world leader in tobacco control and as such has already implemented the majority of the FCTC’s provisions and taken further action in line with its non-binding guidelines, for example introducing Standardised Packaging. There are few further guidelines being developed by the FCTC and the focus of the Convention is now on full and comprehensive implementation by all 180 Parties. We therefore do not expect the outcomes of the forthcoming Conference of the Parties to significantly alter our tobacco strategy, but will continue to offer our support and experience to help other countries fully implement the provisions of the Treaty, especially low and middle income countries.