Cannabis-based products for medicinal use
Cannabis-based products for medicinal use (CBPMs) are Schedule 2 controlled drugs under the Misuse of Drugs Regulations 2001. They can be prescribed by, or under the direction of, a doctor who is on the specialist register of the General Medical Council to treat patients on a case-by-case basis to meet an unmet clinical need.
During 2023, we continued to register clinics in the independent sector that provide treatment with CBPMs. At the time of publishing, 22 providers that prescribe unlicensed CBPMs were registered with CQC.
Over the last year we have seen instances where providers have not always communicated treatment plans and information on prescribed products in a timely way with other healthcare professionals involved in a person’s care. It is vitally important to share information effectively with people’s regular prescribers (normally their GP) to keep them safe. In some cases, this may also include liaising with secondary care and other independent services.
As in previous years, almost all prescribing continues to be for unlicensed CBPMs in the independent sector (figure 1).
Figure 1: Private unlicensed CBPM prescribing in England, October 2019 to June 2023
Note: Figure 1 does not include data before October 2019 because of low numbers.
Prescriptions for CBPMs are processed manually because CBPMs are not included in the Dictionary of medicines and devices. This means there is a time lag in the prescribing data available to present day. The most current available prescribing data for independent services has shown an increase of 118% across the following periods:
- 1 July 2021 to 30 June 2022: 81,476 items dispensed
- 1 July 2022 to 30 June 2023: 177,566 items dispensed.
This data relates specifically to prescriptions dispensed in a community setting.
Some non-medical prescribers can prescribe CBPMs under the direction of the specialist doctor. We have seen that most of the non-medical prescribing for CBPMs is undertaken by pharmacist independent prescribers, who work in clinics in the capacity of shared care with specialist doctors.
We are not able to publish the data for NHS prescribing of unlicensed CBPMs. This is because the number of items prescribed in the NHS is so small that this could potentially breach patient confidentiality.
It has been over 5 years since the change in legislation that permitted the prescribing of CBPMs. This change allows specialist clinicians to prescribe unlicensed CBPMs on a case-by-case basis, to meet an unmet clinical need. We have since seen a significant increase in prescribing to treat a wide range of medical conditions, as well as changing models of care, including those involving non-medical prescribers. People can also find it difficult to access joined-up care from all their healthcare providers. The number of unlicensed CBPMs prescribed each year continues to increase by at least 100% annually. A multi-agency review of the impact of this change would be beneficial.
https://www.cqc.org.uk/publications/controlled-drugs/2023/issues
