Mike Penning

Indoor sports and physical activity facilities play a crucial role in supporting people to be active and the Government is committed to reopening facilities, including snow sports and indoor rock climbing facilities, as soon as it is safe to do so.

We are holding regular discussions with representatives from the leisure sector and national sports organisations to develop guidance that will support them to open their facilities in a timely and safe manner once lockdown measures are eased.

As with all aspects of the Government’s response to Covid-19, we will be guided by the science to ensure that as restrictions are eased people can return to activity safely.

In England and Wales, an organisation is a charity if it meets a number of legal tests; namely that it is established for exclusively charitable purposes for the public benefit and that it falls within the jurisdiction of the High Court regarding charities. Supporting the cost of medical treatment has long been recognised as capable of being a charitable purpose where the benefit and safety of the treatment can be demonstrated

The Charity Commission, as the independent charity regulator in England and Wales, is responsible for determining whether or not an institution is a charity and for registering those that are and which meet the legal threshold for registration

The Commission robustly assesses each application on its merits against these tests, based on the information provided in the application.

The Farm Animal Welfare Committee has reported to us on animal welfare issues concerning live exports and noted that animals should only be transported if absolutely necessary. We are carefully considering the report and recommendations in terms of what they mean for ending excessively long journeys. We intend to launch a consultation on how we deliver on our manifesto commitment later this year.

I refer the Rt. Hon. Member to the reply given to the Rt. Hon. Member for Chipping Barnet on 11 June 2020, PQ UIN 55899.

[questions-statements.parliament.uk/written-questions/detail/2020-06-08/55899]

Sport England is working with partners including the Sport and Play Construction Association (SAPCA), British Standards Institute (BSI), Institute of Groundsmanship and the NGBs to update guidance on artificial surfaces (Artificial Surfaces for Outdoor Sports) to include recommended measures to help minimise the environmental impact of rubber crumb microplastics. We expect the updated guidance to be published this year.

My department has not commissioned research into the environmental effect of the spread of rubber granules from artificial grass playing fields.

Rubber granules used as infill on artificial playing fields have been proved to be hard wearing and able to provide sports performance and athlete protection. Sport England isn’t aware of any acceptable suitable alternative infill materials that can be used to replace the rubber crumb on existing pitches. This is because the alternatives, such as cork and coconut fibre do not equal performance qualities such as shock absorption and density.

Non-filled long-pile artificial grass surfaces have been developed and introduced to the market, but to date, none have been found to satisfy the sports performance and player welfare requirements of FIFA and World Rugby.

The government has regular discussions with the aviation industry on a range of issues. The industry is aware that the Health Regulations relating to the self-isolation requirements remain under constant review and are currently subject to a formal review every 28 days. The next review will be on 27 July 2020.

The destinations airlines fly to are commercial decisions for those airlines. The government’s guidance is clear that those travelling abroad should check Foreign and Commonwealth Office coronavirus advice and travel advice before they travel. This advice states that passengers will have to comply with coronavirus requirements in the country that they are travelling to, and this may include self-isolating.

We have not made such an estimate for the number of British nationals that have booked flights to countries that have not formed reciprocal quarantine-free travel arrangements with the UK.

Our approach to travel corridors has been guided by the science and worked closely with health and policy experts from across government to ensure the steps we are taking will minimise the risk of importing COVID-19 cases, while helping to open our travel and tourism sector.

The Department for Transport is in regular contact with representatives of the road haulage industry to understand the issues the industry is experiencing as a result of COVID-19. The Department is working with the industry to ensure that the appropriate measures are in place to allow for the continued operation of the road freight sector during the pandemic and to identify barriers to accessing the available Government support schemes. ?

The Department continues to collect, receive and assess data about the logistics industry. The Government will continue to gather evidence on the impacts of COVID-19 to establish whether any further support for the sector is needed.

The Department for Transport is in regular contact with representatives of the road haulage industry to understand the issues that the industry is experiencing as a result of COVID-19. Engagement with the industry suggests that delays in payment from customers is an issue for some hauliers.

The Government will continue to gather evidence on the impacts of COVID-19 to establish whether any further support for the sector is needed.?

The Department for Transport is in regular contact with representatives of the road haulage industry to understand the issues the industry is experiencing as a result of COVID-19. The Department is working with the industry to ensure that the appropriate measures are in place to allow for the continued operation of the road freight sector during the pandemic and to identify barriers to accessing the available Government support schemes. ?

The Government has made available £330bn of support through loans and guarantees to support UK businesses. Changes have been made to some of the schemes to ensure that more businesses, particularly those that are SMEs like many road haulage companies, can benefit from them.

The Department is in regular contact with representatives of the road haulage industry to understand the issues that the industry is experiencing as a result of COVID-19. The Department recognises that the sector is going through a challenging time.

Engagement with the industry suggests that delays in payment from customers is an issue for some hauliers.

Engagement with the industry also indicates that some road haulage trucks have been taken off the road. Whilst there are no current plans to introduce a financial support scheme for haulage businesses whose vehicles are idle during the COVID-19 outbreak, we continue to keep this under review.

The Government will continue to gather evidence on the impacts of COVID-19 to establish whether any further support for the sector is needed.

The Government has made available £330bn of support through loans and guarantees to support UK businesses. Changes have been made to some of the schemes to ensure that more businesses, particularly those that are SMEs like many road haulage companies, can benefit from them.

The Department is in regular contact with representatives of the road haulage industry to understand the issues that the industry is experiencing as a result of COVID-19. The Department recognises that the sector is going through a challenging time.

Engagement with the industry suggests that delays in payment from customers is an issue for some hauliers.

Engagement with the industry also indicates that some road haulage trucks have been taken off the road. Whilst there are no current plans to introduce a financial support scheme for haulage businesses whose vehicles are idle during the COVID-19 outbreak, we continue to keep this under review.

The Government will continue to gather evidence on the impacts of COVID-19 to establish whether any further support for the sector is needed.

The Government has made available £330bn of support through loans and guarantees to support UK businesses. Changes have been made to some of the schemes to ensure that more businesses, particularly those that are SMEs like many road haulage companies, can benefit from them.

The Department is in regular contact with representatives of the road haulage industry to understand the issues that the industry is experiencing as a result of COVID-19. The Department recognises that the sector is going through a challenging time.

Engagement with the industry suggests that delays in payment from customers is an issue for some hauliers.

Engagement with the industry also indicates that some road haulage trucks have been taken off the road. Whilst there are no current plans to introduce a financial support scheme for haulage businesses whose vehicles are idle during the COVID-19 outbreak, we continue to keep this under review.

The Government will continue to gather evidence on the impacts of COVID-19 to establish whether any further support for the sector is needed.

The Government has made available £330bn of support through loans and guarantees to support UK businesses. Changes have been made to some of the schemes to ensure that more businesses, particularly those that are SMEs like many road haulage companies, can benefit from them.

The Department is in regular contact with representatives of the road haulage industry to understand the issues that the industry is experiencing as a result of COVID-19. The Department recognises that the sector is going through a challenging time.

Engagement with the industry suggests that delays in payment from customers is an issue for some hauliers.

Engagement with the industry also indicates that some road haulage trucks have been taken off the road. Whilst there are no current plans to introduce a financial support scheme for haulage businesses whose vehicles are idle during the COVID-19 outbreak, we continue to keep this under review.

The Government will continue to gather evidence on the impacts of COVID-19 to establish whether any further support for the sector is needed.

The Government confirmed its intention to review available evidence on whether a more flexible approach might be appropriate to allowing the use of red flashing lamps by road recovery operators.

The Government is committed to improving road safety, and the Department is currently tendering this independent review through a competitive process. It is expected that the contract will be awarded in approximately three months and, subject to the tenders received, the results could be available four months later. The report will be published following completion.

We want our roads to be as safe as possible. That is why the Secretary of State asked the Department to carry out an evidence stocktake to gather the facts about the safety of smart motorways and make recommendations. The Department will present the findings of the stocktake shortly.

While we would not want to pre-judge the results of that work, we will continue to prioritise improving safety – making conditions safer for everyone on our roads. The Roads Minister will write to you as soon as the stocktake is completed to answer your specific question.

We want our roads to be as safe as possible. That is why the Secretary of State asked the Department to carry out an evidence stocktake to gather the facts about the safety of smart motorways and make recommendations. The Department will present the findings of the stocktake shortly.

While I would not want to pre-judge the results of that work, what I can say is that we will continue to prioritise improving safety – making conditions safer for everyone on our roads. The Roads Minister will write to you as soon as the stocktake is completed to answer your specific question.

International passenger rail services provide a number of benefits for passengers, businesses and the wider economy, including environmental benefits. The Government is committed to supporting the future growth and success of international traffic, including potential sleeper services.

Department for Transport officials have engaged with UK and European partners to encourage the future growth and success of international passenger services, providing connectivity between major European cities. The Department also stands ready to engage with any potential operators of new international services, including sleeper services.

In 2019 Highways England’s expenditure cost for retrofitting Stopped Vehicle Detection (SVD) was £289,000.

In 2019 Highways England’s expenditure cost for retrofitting emergency areas was £1.8 million.

The table below includes all breakdown cases where the location has been categorised as being in a live lane or not in a live lane.

Data which has not conformed to these two location descriptions is not included within the table.

The previous Government announced its intention to review available evidence to see if a more flexible approach might be appropriate regarding amending regulations to permit the use of red flashing lights by road recovery operators.

The Government is committed to improving road safety. The Department is commissioning this study, which will involve an assessment of the potential risks and benefits. A decision to review the Road Vehicles Lighting Regulations 1989 will be taken once the study has reported.

Sole traders can apply to the scheme through a Kickstart Gateway. Although if they are not registered with Companies House and/or do not have the systems to pay participants through PAYE, they will need to work with a Gateway which is able to put the participant on the Gateway’s PAYE system.

We are not yet able to break Kickstart data down by sector or employer type.

Significant progress has been made in the delivery of the commissioning policy for transcranial Magnetic Resonance Guided Focused Ultrasound (MRgFUS), published in November 2020 and effective from 1 April 2021.

MRgFUS is used in the treatment of medication refractory essential tremor. It has been estimated that there will be approximately 150 cases a year which, in the first instance, will require two centres to meet the needs of the population of England. A centre at Imperial Healthcare NHS Trust in London has already been identified and it is intended that this service will commence in May.

A second centre in the North of England will be required and discussions are ongoing with commissioners about its possible location. It is envisaged that there will need to be a formalised provider selection process given the number of expressions of interest received. Cross-border discussions have taken place with the devolved authorities in Scotland as to the feasibility of a third centre being commissioned in Scotland, and these discussions continue.

Data on NHS Continuing Healthcare (CHC) eligibility rates is published quarterly by NHS England at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/nhs-chc-fnc/

Data on the number of people who apply and are found ineligible at the initial checklist assessment stage for CHC is not currently collected. NHS England will collect and manage CHC checklist data as part of an upcoming patient level data set. Data on the CHC referral conversion rate is available since 2017-18. However, as the 2019-20 data has been significantly impacted by COVID-19 we do not consider there to be sufficient data points to undertake meaningful trend analysis.

We have interpreted ‘first review’ to mean how many people are found to be eligible following a review at the local resolution stage. Prior to 2018-19 this data was not collected. We have interpreted ‘on appeal’ to mean how many people are found to be eligible in full or partially following a request for an independent review. Data on the number of people found to be partially or fully eligible in England and Herts Valley Clinical Commissioning Group (CCG) is shown in the following tables:

England

Herts Valley CCG

Data on NHS Continuing Healthcare (CHC) eligibility rates is published quarterly by NHS England at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/nhs-chc-fnc/

Data on the number of people who apply and are found ineligible at the initial checklist assessment stage for CHC is not currently collected. NHS England will collect and manage CHC checklist data as part of an upcoming patient level data set. Data on the CHC referral conversion rate is available since 2017-18. However, as the 2019-20 data has been significantly impacted by COVID-19 we do not consider there to be sufficient data points to undertake meaningful trend analysis.

We have interpreted ‘first review’ to mean how many people are found to be eligible following a review at the local resolution stage. Prior to 2018-19 this data was not collected. We have interpreted ‘on appeal’ to mean how many people are found to be eligible in full or partially following a request for an independent review. Data on the number of people found to be partially or fully eligible in England and Herts Valley Clinical Commissioning Group (CCG) is shown in the following tables:

England

Herts Valley CCG

Data on NHS Continuing Healthcare (CHC) eligibility rates is published quarterly by NHS England at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/nhs-chc-fnc/

Data on the number of people who apply and are found ineligible at the initial checklist assessment stage for CHC is not currently collected. NHS England will collect and manage CHC checklist data as part of an upcoming patient level data set. Data on the CHC referral conversion rate is available since 2017-18. However, as the 2019-20 data has been significantly impacted by COVID-19 we do not consider there to be sufficient data points to undertake meaningful trend analysis.

We have interpreted ‘first review’ to mean how many people are found to be eligible following a review at the local resolution stage. Prior to 2018-19 this data was not collected. We have interpreted ‘on appeal’ to mean how many people are found to be eligible in full or partially following a request for an independent review. Data on the number of people found to be partially or fully eligible in England and Herts Valley Clinical Commissioning Group (CCG) is shown in the following tables:

England

Herts Valley CCG

Under the current restrictions a couple who live apart can only form a support bubble if they fulfil the eligibility criteria. We recognise that not everyone who would like to form a support bubble will be able to do so. This is because the formation of a support bubble and therefore the ability to have close contact with those you do not live with, carries transmission risks. As such the eligibility criteria is necessarily limited to smaller households most in need of support that cannot be facilitated by other means and in other settings.

We continue to keep the eligibility criteria under review.

Given the incubation period of the virus and local differences in application of testing protocols, it is not possible to definitively determine the number of people who contracted the virus while in hospital in England state or the number of nosocomial infections amongst National Health Service staff and how many have been infected through contacts outside the NHS. NHS England and NHS Improvement do not hold any data on visitors infected.

Since October 2020, NHS England and NHS Improvement has published data on COVID-19 hospital activity from 1 August including the numbers of people diagnosed in, or admitted to, hospital with COVID-19. NHS England and NHS Improvement also collect data the time between admission to hospital and first positive swab for COVID-19 and the number of patients admitted to hospital after a diagnosis in the community or diagnosed within eight days after admission.

The Government’s Counter Disinformation Unit looks for trends on social media platforms so that we can work with them and other partners to respond to misleading content rapidly., This can range from labelling, downranking, or removal where there is significant risk of harm, in line with platform terms and conditions.

The Department is leading extensive communications activity to reassure the public, providing advice and information to support those who have been prioritised to receive a vaccine and anyone who has questions about the vaccination process.

We have developed the SHARE checklist which aims to increase audience resilience by educating and empowering those who see, inadvertently share and are affected by false and misleading information.

In addition, a range of posters, leaflets and awareness videos have been made available on social media and in public places to help explain more about the COVID-19 vaccine and what the public should expect from the National Health Service.

As hospitals treat COVID-19 patients, trusts continue to offer as many routine services as they can to restore services to the previous levels. To keep operations going, services are being redesigned and priority is given to patients based on clinical urgency and those who have been waiting the longest. Interruptions to routine services should only occur when they are absolutely unavoidable and these decisions are taken locally based on operational needs. In addition, the Nightingale hospitals continue to support services by offering extra capacity and bed numbers, which are being utilised upon the decision of local clinicians when needed.

All tests have been assessed as performing to manufacturers’ specifications before being used. The current tests are very specific and the risk of false positives, where the test is reacting to other viruses, is extremely low. Like any diagnostic test however, there is always the small possibility of a false negative or a false positive result.

Eighty three laboratories have applied for COVID-19 testing with the United Kingdom Accreditation Service, of which 27 are accredited. The remainder have either been assessed or are in the process of being assessed due to a very recent application. Those that have been assessed and not accredited will be working through any actions required to meet the International Organization for Standardization’s accreditation standards.

Pooled testing is an important part of the National Testing Programme allowing laboratories to test more samples. It is a safe and effective way of testing swab samples from several people at the same time providing quicker testing of asymptomatic people. However, pooled testing should only be used for samples from people who do not have COVID-19 symptoms. If an individual has COVID-19 symptoms, they should be tested individually. Samples from those who have tested positive in the past should not be used in pooled testing

The Specialised Commissioning Oversight Group last met in June 2019. This is because the meeting structure has since changed, and NHS England now have a Strategy and Policy Group meeting on a monthly basis and a Delivery Group meeting on a monthly basis instead.

Although there is no specific agenda for the next meeting, the Strategy and Policy group considers the recommendations made by the Clinical Priorities Advisory Group (CPAG) relating to clinical policies and service specifications. The CPAG looks at NHS England’s approach to commissioning services, treatments and technologies, and considers which of these should be prioritised for investment.

The Specialised Commissioning Oversight Group last met in June 2019. This is because the meeting structure has since changed, and NHS England now have a Strategy and Policy Group meeting on a monthly basis and a Delivery Group meeting on a monthly basis instead.

Although there is no specific agenda for the next meeting, the Strategy and Policy group considers the recommendations made by the Clinical Priorities Advisory Group (CPAG) relating to clinical policies and service specifications. The CPAG looks at NHS England’s approach to commissioning services, treatments and technologies, and considers which of these should be prioritised for investment.

The Specialised Commissioning Oversight Group last met in June 2019. This is because the meeting structure has since changed, and NHS England now have a Strategy and Policy Group meeting on a monthly basis and a Delivery Group meeting on a monthly basis instead.

Although there is no specific agenda for the next meeting, the Strategy and Policy group considers the recommendations made by the Clinical Priorities Advisory Group (CPAG) relating to clinical policies and service specifications. The CPAG looks at NHS England’s approach to commissioning services, treatments and technologies, and considers which of these should be prioritised for investment.

The National Health Service Nightingale hospitals are an unprecedented response to an unprecedented challenge and created additional capacity to ensure the NHS can respond to demand if needed.

The Nightingale hospitals are available to support the NHS when needed. Local clinical leaders are working to determine how this is done whilst considering the needs of all patients requiring NHS care.

No assessment has been made.

Observational studies would not provide robust evidence to inform future commissioning decisions and would delay a more useful and scientific study. The best course of action is to develop evidence via safe and robust clinical trials supported by the National Institute of Health Research (NIHR).

A programme of two randomised controlled clinical trial are being developed by the NIHR. These trials will be critical in ensuring that evidence for cannabis-based medicinal products can be developed to plan future National Health Service commissioning decisions for the many hundreds of patients in the United Kingdom with refractory epilepsy. Industry also needs to step up and invest in robust clinical trials to improve understanding of how patients might benefit from these products.

I refer the Rt. hon. Member to the answer I gave on 15 May 2020 to Question 43850.

No assessment has been made.

Our aim is to enable residents to be reunited safely with their loved ones. This guidance will be updated as the risk posed by COVID-19 continues to change.

On 22 July 2020 the Government published updated guidance on visiting arrangements for care homes during the COVID-19 pandemic. This guidance is available at the following link:

https://www.gov.uk/government/publications/visiting-care-homes-during-coronavirus

Our first priority is to prevent infections in care homes and therefore visits should be carried out with caution.

Care homes can develop their visiting policies based on a local dynamic risk assessment, taking into account the circumstances and needs of the individual care setting, including both residents and staff, and the external COVID-19 environment. The process of considering visitors should be led by the relevant local Director of Public Health.

Whilst it is mandatory to wear face coverings on public transport, we recognise that reasonable measures are necessary for some people on health or disability grounds. In the guidance published, we have listed cases in which exemptions could apply.

The guidance published online states that you do not have to wear a face covering on public transport if you have a physical or mental illness or impairment, or a disability that means you cannot put on, wear or remove a face covering. In addition, you do not have to wear a face covering on public transport if putting on, wearing or removing a face covering would cause you severe distress.

Whilst it is mandatory to wear face coverings on public transport, we recognise that reasonable measures are necessary for some people on health or disability grounds. In the guidance published, we have listed cases in which exemptions could apply.

The guidance published online states that you do not have to wear a face covering on public transport if you have a physical or mental illness or impairment, or a disability that means you cannot put on, wear or remove a face covering. In addition, you do not have to wear a face covering on public transport if putting on, wearing or removing a face covering would cause you severe distress.

National Health Service trusts are responsible for establishing their own corporate governance arrangements, including arrangements for public access to Board meetings. The NHS Leadership Academy, now part of NHS England and NHS Improvement, published ‘The Healthy NHS Board’ in 2013 which sets out principles for good governance. These include the principle that Board meetings should be held in public except where there is a compelling reason for confidentiality and is available at the following link:

https://www.leadershipacademy.nhs.uk/wp-content/uploads/2013/06/NHSLeadership-HealthyNHSBoard-2013.pdf

The Government continues to be led by the evidence in our response to COVID-19. Following Scientific Advisory Group for Emergencies advice, we think there will be some benefit for people wearing face coverings in enclosed public spaces where social distancing is not possible or where they are more likely to come into contact with people they do not normally meet. This is most relevant on public transport or in some shops.

Comprehensive guidance can be found at the following link:

https://www.gov.uk/government/publications/our-plan-to-rebuild-the-uk-governments-covid-19-recovery-strategy/our-plan-to-rebuild-the-uk-governments-covid-19-recovery-strategy

No assessment has been made.

All health and social care staff who have symptoms of COVID-19 are eligible for testing and have been since 17 April. This includes National Health Service staff, those employed by local authorities, and those working for private providers. Health and social care staff can book a test through the Government’s online self-referral portal, which allows them to register for a home test kit or book a drive-through test at a regional test site. Testing is also available through mobile and satellite test centres that are placed where need is greatest, including to NHS hospitals or care homes. Testing within an NHS facility, such as a hospital, is available for NHS workers.

As part of our concerted national efforts to respond to the COVID-19 outbreak, the Department is working closely with industry and others in the supply chain to help ensure patients can access the medicines they need, whether on the National Health Service or privately. The supply of unlicensed cannabis-based products is no different. The Government has also recently changed its policy on imports, so that patients can access their prescribed medicines more quickly and be better assured their treatment will not be interrupted.

No assessment has been made of the effect of the COVID-19 outbreak on the ability of this patient group to maintain funding to private prescriptions for unlicensed medicinal cannabis, and no additional funding is being provided beyond the financial package to provide additional support for public services, individuals and businesses experiencing financial difficulties during COVID-19.

For those who rely on fundraising events to access private medicines, events which do not involve people gathering in one place may still go ahead provided they comply with Government policy and guidelines which is available at the following link:

https://www.gov.uk/government/news/charities-act-2016-new-fundraising-rules

And further advice on fundraising is available at the following link:

https://www.fundraisingregulator.org.uk/more-from-us/news/coronavirus-covid-19-advice-fundraising

As part of our concerted national efforts to respond to the COVID-19 outbreak, the Department is working closely with industry and others in the supply chain to help ensure patients can access the medicines they need, whether on the National Health Service or privately. The supply of unlicensed cannabis-based products is no different. The Government has also recently changed its policy on imports, so that patients can access their prescribed medicines more quickly and be better assured their treatment will not be interrupted.

No assessment has been made of the effect of the COVID-19 outbreak on the ability of this patient group to maintain funding to private prescriptions for unlicensed medicinal cannabis, and no additional funding is being provided beyond the financial package to provide additional support for public services, individuals and businesses experiencing financial difficulties during COVID-19.

For those who rely on fundraising events to access private medicines, events which do not involve people gathering in one place may still go ahead provided they comply with Government policy and guidelines which is available at the following link:

https://www.gov.uk/government/news/charities-act-2016-new-fundraising-rules

And further advice on fundraising is available at the following link:

https://www.fundraisingregulator.org.uk/more-from-us/news/coronavirus-covid-19-advice-fundraising

As part of our concerted national efforts to respond to the COVID-19 outbreak, the Department is working closely with industry and others in the supply chain to help ensure patients can access the medicines they need, whether on the National Health Service or privately. The supply of unlicensed cannabis-based products is no different. The Government has also recently changed its policy on imports, so that patients can access their prescribed medicines more quickly and be better assured their treatment will not be interrupted.

No assessment has been made of the effect of the COVID-19 outbreak on the ability of this patient group to maintain funding to private prescriptions for unlicensed medicinal cannabis, and no additional funding is being provided beyond the financial package to provide additional support for public services, individuals and businesses experiencing financial difficulties during COVID-19.

For those who rely on fundraising events to access private medicines, events which do not involve people gathering in one place may still go ahead provided they comply with Government policy and guidelines which is available at the following link:

https://www.gov.uk/government/news/charities-act-2016-new-fundraising-rules

And further advice on fundraising is available at the following link:

https://www.fundraisingregulator.org.uk/more-from-us/news/coronavirus-covid-19-advice-fundraising

As part of our concerted national efforts to respond to the COVID-19 outbreak, the Department is working closely with industry and others in the supply chain to help ensure patients can access the medicines they need, whether on the National Health Service or privately. The supply of unlicensed cannabis-based products is no different. The Government has also recently changed its policy on imports, so that patients can access their prescribed medicines more quickly and be better assured their treatment will not be interrupted.

No assessment has been made of the effect of the COVID-19 outbreak on the ability of this patient group to maintain funding to private prescriptions for unlicensed medicinal cannabis, and no additional funding is being provided beyond the financial package to provide additional support for public services, individuals and businesses experiencing financial difficulties during COVID-19.

For those who rely on fundraising events to access private medicines, events which do not involve people gathering in one place may still go ahead provided they comply with Government policy and guidelines which is available at the following link:

https://www.gov.uk/government/news/charities-act-2016-new-fundraising-rules

And further advice on fundraising is available at the following link:

https://www.fundraisingregulator.org.uk/more-from-us/news/coronavirus-covid-19-advice-fundraising

NHS England is in the process of developing a national clinical commissioning policy for MR-guided focused ultrasound for essential tremor. The policy will determine whether the intervention will or will not be routinely commissioned and contain criteria to guide clinical decision making about the patients able to benefit.

A draft policy was returned to the Specialised Commissioning Clinical Panel in November 2019 and is now progressing to stakeholder engagement and public consultation. After public consultation is completed, the policy proposal will be considered by the Clinical Priorities Advisory Group. If a decision is taken to commission the intervention, funding will be required to implement the policy. This will be considered alongside other proposals for new treatments for funding through a relative prioritisation process which takes place twice a year, and is next due to take place in May 2020.

NHS England is in the process of developing a national clinical commissioning policy for MR-guided focused ultrasound for essential tremor. The policy will determine whether the intervention will or will not be routinely commissioned and contain criteria to guide clinical decision making about the patients able to benefit.

A draft policy was returned to the Specialised Commissioning Clinical Panel in November 2019 and is now progressing to stakeholder engagement and public consultation. After public consultation is completed, the policy proposal will be considered by the Clinical Priorities Advisory Group. If a decision is taken to commission the intervention, funding will be required to implement the policy. This will be considered alongside other proposals for new treatments for funding through a relative prioritisation process which takes place twice a year, and is next due to take place in May 2020.

NHS England is in the process of developing a national clinical commissioning policy for MR-guided focused ultrasound for essential tremor. The policy will determine whether the intervention will or will not be routinely commissioned and contain criteria to guide clinical decision making about the patients able to benefit.

A draft policy was returned to the Specialised Commissioning Clinical Panel in November 2019 and is now progressing to stakeholder engagement and public consultation. After public consultation is completed, the policy proposal will be considered by the Clinical Priorities Advisory Group. If a decision is taken to commission the intervention, funding will be required to implement the policy. This will be considered alongside other proposals for new treatments for funding through a relative prioritisation process which takes place twice a year, and is next due to take place in May 2020.

Guidelines published by the National Institute for Health and Care Excellence (NICE) demonstrate a clear need for more evidence to support prescribing and funding decisions of cannabis-based medicines (whole-plant extract or otherwise) across all conditions covered in the report. We are working hard with the health system, industry and researchers to improve the knowledge base available.

Central to this, NHS England and NHS Improvement are working closely with partners to deliver all recommendations from the NHS process evaluation report entitled ‘Barriers to Accessing Cannabis Based Products for Medicinal Use’. The following progress has been made:

- On 20 December 2019 a letter was published reminding prescribers of General Medical Council guidance on the prescribing and use of unlicensed medicines – and to clarify the procedure for prescribing and supplying cannabis-based products for medicinal use;

- The National Institute for Health Research has run two research calls for applications on medicinal cannabis. Following these, a workshop was held including applicants, NHS England and NHS Improvement, the Department and other research experts. We expect this to have halved the time required to design and gain funding agreement for a safe and high quality clinical trial. Researchers are expected to involve patients in both the design and delivery of the research;

- Funding has been fast-tracked by NHS England and NHS Improvement and is available from 6 January 2020 for patients who fulfil the criteria for the recently published NICE Technology Appraisals for the use of cannabidiol in conjunction with clobazam for adjuvant treatment of seizures associated with Lennox-Gastaut and Dravet syndromes. This will improve access to licensed cannabis-based products for appropriate patients. NICE guidelines on the prescribing of cannabis-based medicines also recommend Sativex to treat moderate to severe spasticity in adults with multiple sclerosis;

- A new Refractory Epilepsy Specialist Clinical Advisory Network is being established and will launch shortly. This will make a positive addition to the current well-established clinical networks; and

- A patient registry is being developed with input from specialist clinicians and other advisory bodies.

NHS England and NHS Improvement are using existing systems to monitor use of the newly rescheduled unlicensed cannabis-based products for medicinal use in England. In England, these systems monitor the number of items dispensed and associated costs in primary care and the volume of products used and associated cost in secondary care.

The NHS Business Services Authority is only able to provide information on prescriptions for cannabis-based medicines that have been prescribed and submitted to the NHS Business Services Authority. It does not hold information on prescriptions for cannabis-based medicines which have been issued but not fulfilled.

Between November 2018 and October 2019, 19 items for unlicensed cannabis-based medicines that were prescribed on a National Health Service prescription, dispensed in the community and submitted to the NHS Business Services Authority for reimbursement.

The NHS Business Services Authority does not collect data on whether an unlicensed cannabis-based medicine is a whole-plant extract. The licensed cannabis-based medicines Sativex, Nabilone and Epidyolex are not whole-plant extracts, so no data has been provided on these products.

Guidelines published by the National Institute for Health and Care Excellence (NICE) demonstrate a clear need for more evidence to support prescribing and funding decisions of cannabis-based medicines (whole-plant extract or otherwise) across all conditions covered in the report. We are working hard with the health system, industry and researchers to improve the knowledge base available.

Central to this, NHS England and NHS Improvement are working closely with partners to deliver all recommendations from the NHS process evaluation report entitled ‘Barriers to Accessing Cannabis Based Products for Medicinal Use’. The following progress has been made:

- On 20 December 2019 a letter was published reminding prescribers of General Medical Council guidance on the prescribing and use of unlicensed medicines – and to clarify the procedure for prescribing and supplying cannabis-based products for medicinal use;

- The National Institute for Health Research has run two research calls for applications on medicinal cannabis. Following these, a workshop was held including applicants, NHS England and NHS Improvement, the Department and other research experts. We expect this to have halved the time required to design and gain funding agreement for a safe and high quality clinical trial. Researchers are expected to involve patients in both the design and delivery of the research;

- Funding has been fast-tracked by NHS England and NHS Improvement and is available from 6 January 2020 for patients who fulfil the criteria for the recently published NICE Technology Appraisals for the use of cannabidiol in conjunction with clobazam for adjuvant treatment of seizures associated with Lennox-Gastaut and Dravet syndromes. This will improve access to licensed cannabis-based products for appropriate patients. NICE guidelines on the prescribing of cannabis-based medicines also recommend Sativex to treat moderate to severe spasticity in adults with multiple sclerosis;

- A new Refractory Epilepsy Specialist Clinical Advisory Network is being established and will launch shortly. This will make a positive addition to the current well-established clinical networks; and

- A patient registry is being developed with input from specialist clinicians and other advisory bodies.