New best practice guidelines for prescribing UK medical cannabis released
4 min read
Emily Ledger
What are the rules for medical cannabis in the UK?
On the 1st of November 2018, it became legal for doctors on the GMC specialist register to prescribe cannabis-based medicinal products (CBMPs).
While there were some restrictions on these prescriptions, this meant medical cannabis could be prescribed for a wide number of health conditions for the first time since the introduction of the Misuse of Drugs act 1971. Since then, more than 160 specialist consultants across around 40 private clinics have begun prescribing CBMPs across the country.
However, with no mandated training required for clinicians interested in prescribing CBMPs, reports have indicated significant differences in prescribing practices. This was highlighted in the CQC’s annual update of the safer management of controlled drugs report, published in July this year.
Contents
What did the CQC’s report say?
The Care Quality Commission is the independent regulator of health and social care in England.
The body is responsible for inspecting, monitoring, and rating health services and making recommendations to ensure they meet safety and quality standards, including in the management and use of controlled drugs. As part of this requirement, the CQC publishes an annual report highlighting their findings.
Medical cannabis prescriptions
Prescriptions for medical cannabis are processed manually, creating a time lag in the data available for analysis. As a result, the most recent report analysed prescribing data from the period between 31 March 2023 and 31 March 2024.
This data shows that there was an increase of 130% in the prescribing of unlicensed CBMPs in independent services, increasing from 150,527 in 2022/23 to 346,600 items in 2023/24.
Furthermore, industry sources indicate that around 75,000 patients are now accessing these medications. The vast majority of these patients access CBMPs through private clinics, while the number of NHS prescriptions remains extremely low.
Measures needed for improving UK medical cannabis prescribing practice
In addition to general figures highlighting the extent of medical cannabis prescribing, the report covered a number of concerns relating to CBMPs and their prescription, and made several recommendations, including the need for:
- Strict regulatory compliance and professional accountability.
- More robust clinical justification for the prescription of CBMPs.
- Appropriate multidisciplinary peer review and oversight.
- Transparent reporting and responsible communication with patients and regulators.
- Strict measures on the advertising of CBMPs and their potential uses.
Shortly after the publication of the CQC’s annual report, the Medical Cannabis Clinicians Society (CMMS) published its updated edition of the Good Practice Guidelines for Prescribers of CBMPs.
However, with no mandated training required for clinicians interested in prescribing CBMPs, reports have indicated significant differences in prescribing practices. This was highlighted in the CQC’s annual update of the safer management of controlled drugs report, published in July this year.
Medical cannabis guidelines from the MCCS
The MCCS states that the revision of its flagship Good Practice Guide offers “a clearer, more detailed framework for safe, lawful and patient-centred prescribing”. The guide covers recent developments in clinical practice, prescribing patterns, and regulation to provide detailed guidance on best practice prescribing.
The guide covers various aspects of prescribing practice, including the requirements of initial and follow-up consultations, responsibilities of prescribers, setting and recording outcome measures, appropriate dosing and selection of medical cannabis products.
Measures included in the guidance include:
- A multidisciplinary approach: The Chief Medical Officers expect both NHS and non-NHS prescribers to base prescribing decisions on a multidisciplinary team discussion. This should ideally include fellow clinicians with experience in prescribing CBMPs and at least one clinician from the same discipline.
- Appropriate terminology: The MCCS recommends that producers should not use recreational names when referring to CBMPs (for example, Girl Scout Cookies, or Northern Lights). Clinicians should also move away from reliance on the terms “Indica” and “Sativa” when describing/selecting strains, as this cannot accurately determine the effects of different cultivars.
- Flower prescribing guidelines: Prescriptions of medical cannabis flower exceeding 2 grams daily, or of flower products containing more than 25% THC, should be subject to approval by a peer panel.
- Training for prescribers: There are currently no mandated training requirements for prescribers. The MCCS guidelines recommend that prescribers should undergo a recognised training programme, with due certification, before starting to prescribe CBMPs.
Releaf’s commitment to safe prescribing
At Releaf, we are dedicated to the safe prescribing of cannabis-based medicines. We will always strive to meet best prescribing practices to ensure our patients receive the best standard of care.
To learn more about cannabis-based medicines and how they may help with your health needs, head to our fast and free medical cannabis eligibility checker. It takes just 20 seconds to complete, and once done, you will have a much clearer idea of your potential eligibility for medical cannabis in the UK.
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Emily, an accomplished content writer with a specialisation in cannabis and alternative health, leverages her five years in the sector to enhance education and diminish stigma around medicinal cannabis use.
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