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With increasing numbers of patients using legally prescribed cannabis-based medicinal products (CBPMs), clinicians in the NHS, hospices, care homes and private hospitals are facing a practical challenge: how to safely, lawfully, and confidently manage these medicines during admission, surgery, and inpatient care.

The Medical Cannabis Clinicians Society has published a new guide – Managing Cannabis-Based Medicinal Products in UK Hospitals and Care Settings – written for doctors, nurses, pharmacists, anaesthetists, surgeons and care providers across secondary and palliative care.

🔽 Download the guide now:
Managing Cannabis-Based Medicinal Products in UK Hospitals and Care Settings

→ Download PDF

This post offers a summary of the key points and provides an overview of what clinicians need to know, from legal responsibilities to patient rights and perioperative management. It’s designed to support anyone searching for CBPM hospital policy, medical cannabis prescriptions during hospital or hospice admissions, or simply how to stay compliant when managing medical cannabis in hospital settings.

For full details, practical checklists, and best practice examples, download the guide.

What is a CBPM?

Cannabis-based medicinal products (CBPMs) are medicines derived from cannabis that are prescribed for specific medical conditions. In the UK, they are legal only under very specific conditions. CBPMs are:

Understanding what qualifies as a CBPM is essential for any clinician looking to implement a safe and lawful CBPM hospital policy.

Legal Rights of Patients Using CBPMs in Hospital

According to the Mental Capacity Act 2005, patients with capacity have the right to make decisions about their treatment, including continuing prescribed CBPMs while in hospital.

Clinicians must not withdraw or alter CBPM treatment without informed consent, and must support continuity of care unless safety concerns are present.

The Equality Act 2010 also applies: refusing a patient access to their legal medication could be considered discriminatory if it disadvantages them due to disability. Whether you’re drafting protocols or providing direct care, it’s crucial to know how to manage CBPMs in hospital in line with these legal duties.

Key Actions for Clinicians

The MCCS guide outlines a clear process for managing medical cannabis in hospital. Clinicians should:

Ask Directly on Admission

“Are you currently taking any cannabis-based products prescribed for medical use?”

Patients may use CBPMs such as oils, sprays or vapourisers for conditions including chronic pain, epilepsy, spasticity, anxiety or palliative symptoms.

Verify Legality and Documentation
Record Clearly and Notify the Team

These steps are essential to align with hospital governance, CD handling rules, and best practice CBPM hospital policy.

Managing Patient-Owned CBPMs on the Ward

Because CBPMs are Schedule 2 controlled drugs, they must be handled with the same procedures as other CDs.

Key points include:

Hospitals should not force patients into unsafe environments (e.g., smoking shelters) to take their prescribed treatment. These are all vital considerations for hospitals updating or implementing a formal medical cannabis prescription hospital framework.

Clinical Considerations: Perioperative, Safety and Interactions

The MCCS guide includes detailed clinical considerations around CBPM surgery guidance, such as:

If you’re involved in perioperative care or writing hospital protocols for anaesthesia and sedation, understanding how to manage CBPMs in hospital is a clinical safety issue, not just a legal one.

Download the guide

Managing Cannabis-Based Medicinal Products (CBPMs) in UK Hospitals and Care Settings

There’s much more in the full document.

🔽 Download the guide now:
Managing Cannabis-Based Medicinal Products in UK Hospitals and Care Settings

→ Download PDF

Whether you’re building a CBPM hospital policy, managing admissions, working directly with a patient with a cannabis prescription, or supporting a patient through surgery, this guide is your go-to reference.

Looking for more support?

The Medical Cannabis Clinicians Society is the UK’s leading independent network for healthcare professionals supporting the use of cannabis-based medicinal products and prescriptions.

Join today and get:

Annual membership starts at £60.

👉 Become a Member Now

Together, we’re raising standards and supporting clinicians to deliver safe, lawful and effective care for patients using medical cannabis in UK hospitals.

Frequently Asked Questions

Can patients bring medical cannabis into hospital?
Yes, if prescribed. Patients should bring their CBPM in the original packaging with prescription details.

Can hospital staff administer or manage these medicines?
Yes, as with any other controlled drug, under appropriate documentation and procedures.

Where should CBPMs be stored?
In the controlled drugs cabinet, unless the patient has an approved self-administration plan.

Can patients vape cannabis in hospital?
If prescribed and appropriate, patients may use vapourised CBPMs, but not smoke cannabis, in a private or designated space per local policy.

Can I alter the patient’s treatment plan?
No, not without informed consent. Patients with capacity have the right to continue their prescribed CBPMs, and this must be respected.

The Medical Cannabis Clinicians Society has published its first dedicated guidance for pharmacy professionals involved in dispensing cannabis-based medicinal products (CBPMs) in the UK.

Written by pharmacist and Executive Committee member Zul Mamon, the guidance supports pharmacists in navigating the legal, regulatory and practical requirements of dispensing CBPMs safely and lawfully.

“Pharmacists are central to the safe and effective use of medical cannabis. With CBPMs becoming more widely prescribed in the private sector, pharmacists must have a clear understanding of legal responsibilities, product types, and patient safety considerations. This guidance aims to provide practical, accessible support that empowers pharmacists to deliver high-quality care.”

Developed in response to the growing number of pharmacists supporting CBPM dispensing, the guidance ensures members have the clarity and confidence needed to meet their professional obligations.

The Pharmacy Guidance gives pharmacists a clear overview of everything they need to know when working with cannabis-based medicines. It explains how these medicines became legal, what they are, how they work, and the different types available. It also covers who can prescribe them, how they should be dispensed, possible side effects and drug interactions, and what checks pharmacists need to carry out. There’s also practical information on prescription forms, record-keeping, and controlled drug rules, as well as a glossary to explain key terms.

Professor Mike Barnes, Chair of the Society, welcomed the publication as a step forward for pharmacy engagement in the sector:

“Pharmacists have a vital role in patient safety and education. As the use of medical cannabis expands in the UK, we must ensure all healthcare professionals—especially those dispensing the medicine—have access to robust, evidence-based guidance. This publication is an important milestone in our mission to support a safe, competent, and informed workforce.”

The guidance is available now to MCCS members. It will be reviewed and updated annually to reflect changes in policy and practice.

Join the Society to Access the Guidance and More

Pharmacists interested in this area of practice are encouraged to join the Society to receive the guidance, access expert-led training and mentoring, and be part of the UK’s only independent network of medical cannabis professionals.

As the Society develops further pharmacist-focused resources and events, members will benefit from tailored support and up-to-date information to strengthen their practice and support patient care.

Join today for £60 per year.

 

 

To all members of the Society, our Supporters and friends,

It is with profound sadness that we share the heartbreaking news that our Society Director and Co-Founder, Hannah Deacon, passed away on Tuesday 6 May, surrounded by those who loved her, after a short and brutal illness. She was just 45.

 

This devastating loss to Hannah’s beloved partner Drew, and children Alfie and Annie, is impossible to put into words.
Hannah was remarkable: determined, tenacious, and fiercely compassionate. Her fight to find treatment for her son Alfie’s rare and severe epilepsy led to a breakthrough that changed his life and ultimately changed the law. She went on to transform the lives of thousands of patients and families, never stopping in her work to push for better access, better care, and a better understanding of medical cannabis.
More than anything, Hannah’s most proud and important role was being a mum. Alfie and Annie were her world. She adored them. Everything she fought for came from her enduring love for them and wish to make the world kinder and fairer.
Hannah was our brave, beautiful partner, daughter, sister, and friend. She made us laugh, made us think, and made us feel stronger just by being there. All of us are better for knowing her.  We only wish we could have had more time.
We will share more in the days ahead to honour Hannah’s life, her work, and the legacy she leaves behind. We want to reassure you that the Society will continue, just as Hannah wanted. 
Update: April 2026 – Read Hannah’s Story and legacy

Since the legalisation of cannabis-based medicinal products (CBPMs) in the UK in November 2018, around 40,000 patients have received these treatments, with numbers steadily increasing. There are currently 40 clinics and about 140 prescribers operating within the private sector.

However, the adoption of these medicines within the NHS has been slow, and there are no compulsory training requirements for prescribers. This has led to significant variations in clinical practice.

To address these challenges, the Medical Cannabis Clinicians Society (MCCS) has developed a Good Practice Guide. This guide aims to support prescribers and ensure patients can safely access these valuable medicines. While it is tailored primarily for clinics that focus on prescribing cannabis, the fundamental principles are relevant to a broader range of medical settings.

The MCCS hopes this guide will be adopted widely, pleading to practices that benefit patients and improve the overall quality of the medical cannabis industry.  This effort highlights our dedication to raising standards and supporting prescribers with practical, applicable guidelines and support.

Download the Good Practice Guide >>>

 

You can access all our public publications – including this recently published Good Practice Guide – on our website.

Not yet a member? Join the Society.

The UKMCCS Annual General Meeting (AGM) is around the corner, and we’re looking forward to bringing members together to review our achievements and discuss future developments. Members are invited to join us on 7 November, from 2 PM to 4 PM to take part.

Members have two ways to attend:

  1. In-Person – We have 20 spaces available at our London venue, so secure your place soon by emailing [email protected].
  2. Online via Teams – For those preferring virtual attendance, we’ll be streaming the AGM live. Email us at the same address for the Teams link.

For members who can’t attend, minutes will be shared afterward to keep everyone informed.

AGM Details

📆 Date: 7 November
🕑 Time: 2 PM to 4 PM
📍 Location: Farringdon Road, London, EC1M 3HE

To register, please email [email protected]. We look forward to your participation in making this a successful AGM.

Together with the Cannabis Industry Council and Drug Science, the Medical Cannabis Clinicians Society is pleased to announce the first-ever Cannabis Industry Awards. 

The event is being held during Medical Cannabis Awareness Week, making it a fitting occasion to celebrate excellence in the UK cannabis sector.

The Cannabis Industry Awards is set to be a key event for the UK cannabis community. It will bring together professionals from across the industry, including CEOs, founders, doctors, scientists, and other leading figures. Guests will enjoy a three-course meal, with entertainment provided by a comedian and table magicians. Following the dinner, there will be an after-party at a nearby venue, offering further opportunities to connect and celebrate.

About the Awards

The evening will feature two awards: the Social Impact Award and the Contribution to Science Award. These awards are designed to recognise individuals who have made notable contributions to the cannabis industry. 

Nominations are open from 2 September to 1 October, with a public vote from 4 to 25 October to decide the winners, reflecting the views and values of both industry insiders and the wider community.

Dr Leon Barron, Chair of the Medical Cannabis Clinicians Society, said:

“The Cannabis Industry Awards Dinner is a chance for us to come together and celebrate the progress we’ve made in the UK cannabis sector, particularly in improving access for patients and supporting clinicians in prescribing since 2018. These awards recognise the hard work and dedication of individuals who are helping to shape the future of the industry in two key areas. I’m looking forward to what will undoubtedly be a memorable evening.”

Buy your tickets 

To purchase your tickets, visit the official Eventbrite page. 

Book Your Tickets

 

Sponsorship Opportunities Available

While the Contribution to Science Award has been sponsored by Gowling WLG, there is still an opportunity for an organisation to sponsor the Social Impact Award. This sponsorship offers a chance to show support for social responsibility within the cannabis industry.

How Starling Bank Reshaped Digital Payments for UK Bettors, Explored by Betzella

When Starling Bank launched its current account in 2017, few in the gambling industry anticipated how significantly a mobile-first challenger bank would alter the relationship between UK bettors and their finances. Unlike traditional high street banks, which had spent decades building payment infrastructure around physical branches and legacy systems, Starling entered the market with an architecture designed entirely around real-time data, instant notifications, and granular user controls. For the millions of UK adults who bet regularly on sports, casino games, or other licensed gambling products, this represented a meaningful shift in how deposits and withdrawals could be managed with precision and transparency.

The Architecture Behind Starling’s Payment Controls

Starling Bank operates on a proprietary core banking platform rather than the outsourced or decades-old systems that underpin most established UK banks. This matters for bettors because it allows the bank to process transactions and deliver push notifications in genuine real-time — typically within seconds of a payment being initiated. When a customer deposits funds at a licensed betting operator, they receive an immediate notification detailing the merchant name, the amount, and a running balance. This level of transparency was largely absent from traditional banking before the challenger bank era.

More structurally significant is Starling’s Gambling Block feature, introduced in 2018. Unlike the blunt spending freezes offered by some competitors, Starling’s implementation allows customers to toggle gambling transactions off entirely through the app, with the change taking effect almost immediately. The block operates at the Merchant Category Code (MCC) level — specifically MCC 7995, which covers betting, casino gaming, and lottery transactions — meaning it applies across all licensed gambling merchants without requiring the customer to specify individual operators. This approach aligns with recommendations that emerged from the UK Gambling Commission’s ongoing work on safer gambling tools, which has consistently emphasised the importance of friction-reducing mechanisms for self-exclusion.

The bank also introduced spending insights that categorise gambling expenditure separately from other discretionary spending, giving customers a clear month-by-month view of what they are committing to betting activity. For bettors who track their own profitability or manage a defined recreational budget, this categorisation removes the manual work of reviewing statements and identifying individual transactions across multiple operators.

How Starling Fits into the Broader UK Betting Payment Landscape

The UK online gambling market processed an estimated £14.3 billion in gross gambling yield during the 2022–23 financial year, according to Gambling Commission data, with remote betting and casino products accounting for the substantial majority of that figure. The payment methods underpinning those transactions have evolved considerably since the early days of online betting, moving from predominantly debit card and bank transfer arrangements toward a more fragmented ecosystem that includes e-wallets, prepaid cards, and open banking solutions.

Starling sits within this landscape as a bank account rather than a payment intermediary, which carries specific implications. Deposits made from a Starling account to a licensed UK operator are treated as standard debit card transactions processed through the Mastercard network — Starling issues Mastercard debit cards to its customers. This means they benefit from the same consumer protections applicable to debit card payments while also gaining the bank-level controls described above. Withdrawals from betting accounts back to Starling typically complete within one to three business days, consistent with standard UK faster payments timelines, though some operators have integrated more rapid payout processes.

For bettors researching which banking options are compatible with specific operators, resources such as https://www.betzella.com/starling-bank-betting-sites/ provide structured information on which licensed platforms accept Starling deposits and withdrawals, a practical reference given that operator payment policies vary and are updated periodically. The compatibility question is not trivial: some operators have historically imposed restrictions on certain challenger bank cards, though this has become less common as digital banks have grown their customer bases and established clearer compliance frameworks with the UK Gambling Commission’s licensing requirements.

Regulatory Context and Responsible Gambling Obligations

The relationship between banking infrastructure and gambling regulation in the UK has grown considerably more complex since the Gambling Act 2005 was enacted. That legislation, designed for a pre-smartphone era, is currently undergoing its most significant review in two decades, with the Gambling Act Review white paper published in April 2023 introducing proposals around affordability checks, stake limits for online slots, and enhanced requirements for operators to share data with a statutory levy-funded research and treatment body.

Within this regulatory environment, the role of banks in supporting responsible gambling has attracted specific attention. The Gambling Commission has encouraged financial institutions to develop and promote gambling transaction controls, and Starling’s Gambling Block is frequently cited as an example of what proactive implementation looks like in practice. The Financial Conduct Authority, which regulates Starling as an authorised deposit-taking institution, has separately explored how open banking data might be used to identify customers at risk of financial harm — a category that overlaps meaningfully with problem gambling.

Starling has also been transparent about its approach to business banking for gambling operators themselves. The bank does not provide business accounts to gambling companies, a policy decision that reflects both risk appetite and reputational considerations, though it does not affect individual customers who use personal accounts to fund their betting activity at operators licensed by the Gambling Commission. This distinction is worth understanding clearly: Starling’s restrictions on the operator side do not translate into any restriction on individual customers making deposits at licensed sites using their personal Starling debit cards.

Practical Considerations for Bettors Using Starling

From a day-to-day operational perspective, bettors using Starling accounts encounter a relatively consistent experience across licensed UK operators. Deposits are generally processed instantly, as is standard for debit card transactions on Mastercard’s network. The minimum and maximum deposit limits are determined by the operator rather than the bank, though Starling does apply its own transaction monitoring processes as part of its anti-money laundering obligations under the Money Laundering, Terrorist Financing and Transfer of Funds Regulations 2017.

One area where bettors sometimes encounter friction is with operators that use third-party payment processors whose systems may not correctly identify Starling’s BIN (Bank Identification Number) ranges, occasionally causing transactions to be declined at the processor level rather than the bank level. This has become less frequent as Starling’s card base has expanded — the bank reported over three million personal current account customers by 2023 — but it remains a possibility worth being aware of. In such cases, contacting the operator’s customer support to confirm compatibility is typically the most efficient resolution path.

Withdrawals from betting accounts to Starling benefit from the bank’s real-time payment processing, meaning funds arriving via Faster Payments are credited immediately and visible in the app with a corresponding notification. This contrasts with some traditional bank accounts where incoming transfers may take several hours to appear despite the underlying payment having been received. For bettors who manage their bankroll actively or who want immediate visibility of returned funds, this responsiveness is a practical advantage rather than a marketing claim — it reflects the technical architecture of how Starling processes incoming payments at its core banking layer. Betzella has documented this operational pattern across multiple operator and payment method combinations, noting that Starling’s real-time credit behaviour is among the more consistent in the digital banking category.

Starling Bank’s emergence as a meaningful option for UK bettors reflects a broader convergence between financial technology and the gambling sector’s evolving payment infrastructure. The bank did not design its features specifically for bettors, but the combination of real-time notifications, transparent spending categorisation, and a user-controlled gambling block has made it a functionally well-suited option for those who want greater oversight of their betting expenditure. As the regulatory environment continues to develop under the Gambling Act Review, the intersection of banking controls and gambling behaviour is likely to attract further attention from both the Gambling Commission and the FCA — and the infrastructure that challenger banks like Starling have built may increasingly inform what regulators consider standard practice for financial institutions serving customers who bet. Betzella’s analysis of this space suggests that understanding the banking layer of gambling transactions is becoming as important as understanding the operators themselves.

For organisations interested in sponsoring the Social Impact Award, please contact Sam Cannon at [email protected] for more information.

As part of our commitment to keeping healthcare professionals at the forefront of medical cannabis knowledge, we are pleased to give you access to a detailed webinar and a new research paper by Dr. Stefan Broselid, Scientific Lead at the Medical Cannabis Clinicians’ Society.

Webinar Recording

This webinar explores the endocannabinoidome (eCBome) — an advanced version of the endocannabinoid system. This session, which took place on 11 June 2024, provides a comprehensive understanding of how this complex system affects various body processes and how you can target it effectively with cannabis-based treatments. Member’s can access this recording via the Member’s Area. 

Research Paper

Dr. Broselid’s linked paper, “The Endocannabinoidome: A Pivotal Physiological Regulator and Therapeutic Target – Implications for Medical Education and Personalized Medicine”, goes beyond theory to discuss practical implications for clinical practice, especially in prescribing and managing cannabis-based medicinal products (CBMPs).

Download the paper>>>

For more information, questions, or to discuss the content, please do not hesitate to get in touch wit the Society by emailing [email protected].

The Medical Cannabis Clinicians Society is pleased to announce that the Primary Care Cannabis Network (PCCN) has become a part of our Society. This is an important step forward in our mission to normalise the conversation around medical cannabis and increase clinician knowledge of this treatment in the UK. We look forward to working together towards our shared goals.

Continuing and developing the work of the PCCN

The PCCN was set up in November 2019 by GP Dr Leon Barron to provide GP education in medical cannabis. Striving to increase knowledge and open dialogue, the PCCN worked to create an environment of balance and understanding around this rapidly developing field of medicine within primary healthcare. Its goals – to eradicate stigma associated with medical cannabis and improve the primary care sector’s comfort in discussing treatment options with patients – are aligned with the vision and mission of the Medical Cannabis Clinicians Society.

In order to better meet our joint goals, the Society has welcomed the PCCN and its members into the Society. By educating and supporting general practitioners (GPs) with current guidelines and evidence-based medicine, the Society can ensure that primary care providers have access to the most up to date resources to enable informed conversations with patients.

The integration of the PCCN with the Society will give every clinician the opportunity to be part of the biggest network of healthcare professionals dedicated to expanding access to medical cannabis treatment through education and support.

The role of GPs in the widespread understanding of medical cannabis as a treatment option

As the frontline in patient access to specialist clinicians, GPs have a crucial role to play in the understanding and acceptance of medical cannabis as a treatment option for patients in the UK. 

Learn more

Why should GPs be open minded about talking to patients who are self medicating with cannabis in the UK?

GPs should be open minded about talking to patients who are self medicating with cannabis because it is becoming increasingly accepted in the UK as an effective means of treating various health conditions. 

Learn more

Can GPs prescribe medical cannabis in the UK?

Currently in the UK, prescriptions for unlicensed cannabis based medicines can only be initiated by a doctor on the GMC specialist register (consultants) and must be initiated on a private prescription. Unlike most other countries across the globe where medical cannabis is legal, current UK legislation does not permit GPs to initiate treatment for medical cannabis. However, GPs can play an important role in the management and monitoring of their patient’s use of medical cannabis, and a GP can prescribe under shared care arrangements under the direction of a specialist.

Learn more

Comprehensive education and support for GPs through the Society

The Medical Cannabis Clinicians Society is an important resource for clinicians in regards to the education, peer support, and guidance related to medical cannabis use. Through the integration of the PCCN, a new sub group will be formed to provide GP focussed education and peer support.

All the resources from the PCCN will be available via the Society website. This includes access to evidence-based information and practical resources.

In addition, the Society will provide opportunities for GPs to network with peers and discuss the opportunities for GP prescribing of medical cannabis within a supportive environment.

PCCN Members – Join the Society today

Joining the Society provides GPs with access to training and resources from leading experts in the field. In addition, members can benefit from ongoing support and guidance on prescribing medical cannabis, as well as staying up to date with changing regulations. The Society also organises regular events for members to exchange ideas and discuss best practices in medical cannabis.

As members, GPs can ensure they are up to date with the latest evidence-based information in this field and help their patients access effective medical cannabis treatments.

Current members of the PCCN are invited to become members of the Society at no cost for the first year of membership.

Join now

The Medical Cannabis Clinicians Society’s Guide to CBD has been newly updated for 2021.

The expanded guidance supports doctors and clinicians who wish to understand how CBD works, what a good CBD product looks like, and how better to support patients who are taking CBD.

Version 2 of the guidance, written by the Society’s Dr Leon Barron, Vice-Chair Dr Dani Gordon and Chair, Prof Mike Barnes, has been supported by expert researchers at Bud & Tender.

Download the guide here.

On Thursday 21st October, join The Medical Cannabis Clinicians Society and Bud & Tender as we explore what clinicians need to know about CBD. A fantastic live overview of the guide, this webinar will provide an overview of CBD for clinicians, including Endocannabinoid tone, modes of action and therapeutic effects, pharmacodynamics, different types of CBD oil available in the UK, controlled cannabinoids, Certificates of Analysis (COA’s) and dosing. We also summarise the current legal status of CBD in the UK.

BOOK NOW

 

 

Below is the text of an open letter which has been sent from the Medical Cannabis Clinicians Society to The Secretary of State for Health, Sajid Javid.

Members of The Medical Cannabis Clinicians Society have access to further information including prescribing guidelines, a secure online support network and events – covering what is needed to become a specialist prescriber of medical cannabis.

If you are a Paediatric Consultant of any discipline and would like to consider prescribing, we will provide free CPD-accredited training (online & face to face) and ongoing support and mentoring to you. Find out more about joining us. 

Open Letter, sent 4 October 2021

Dear Secretary of State for Health and Social Care,

The Medical Cannabis Clinicians Society (MCCS) was created in 2018 to support and educate clinicians who wish to prescribe medicinal cannabis in the UK. Today we write because of our considerable concern about the current situation regarding children with drug-resistant epilepsy who are denied NHS prescriptions for a medicine that has been shown to be life transforming for them.

There is now overwhelming evidence of the efficacy of medicinal cannabis for these children. A recent paper by Drug Science showed that there is a 96% chance of a child significantly improving after prescription of full spectrum cannabis. This is a remarkable statistic given that these children will have been resistant to all licensed anti-convulsant drugs, often suffering from hundreds of seizures weekly and experiencing a very poor quality of life combined with a risk of death. Although this was a relatively small UK study, similar outcomes have been demonstrated in many other larger international studies in children with drug-resistant epilepsy. Also, in more established medical cannabis markets such as Canada, US and Israel, there are now thousands of children with drug-resistant epilepsy who are being prescribed full spectrum products after licenced medications have failed to work, often with dramatic improvements in seizure control and quality of life.  Treating these children with conventional anti-epileptic medicines and other techniques is costing the NHS millions of pounds each year to care for them. However, when using medicinal cannabis products, many of them have remained at home and have had huge improvements in their seizure control and their cognitive development with consequential significant savings to the NHS in terms of pharmaceutical and hospital costs.

The British Paediatric Neurology Association (BPNA) declares itself to be the professional medical body for paediatric neurologists.  Apart from a specific brand (which is not full spectrum) in very limited circumstances that has been through the conventional licencing system, the BPNA appears to be very much opposed to the prescription of medical cannabis products. From what we understand, they appear to want to see more evidence about safety and efficacy and are concerned that these ‘full spectrum’ products are unlicenced.

Both of these points are hard to understand.  By more evidence, we presume they mean evidence generated from Randomised Control Trials (RCTs).  However, full spectrum medical cannabis has many active ingredients and is therefore, by definition, not well suited to such trials. And they seem reluctant ‘in extremis’ to accept the enormous volume of real world and observational evidence. And the fact that a medicine is unlicenced is not a bar to its prescription. Unlicenced medicines are routinely prescribed for a range of conditions.

Our concern is that what appears to be a deeply entrenched and dogmatic position on this subject from the BPNA is effectively denying sick children access to an efficacious and safe medicine that may well reduce or even stop their seizures and immeasurably improve their quality of life and reduce their chance of death.  It is deterring private prescriptions and is playing a part in the almost total block on NHS prescriptions.  This block in turn is forcing many very vulnerable families to have to fundraise thousands of pounds a month to source the medicine privately.

The BPNA’s current guidance states that you must be a paediatric neurologist to prescribe.  But this is their view.  It is not based on law and as we show here is not supported by national guidance.

It is our understanding that such is their strength of feeling on this matter, that the BPNA have referred one doctor who was prescribing such medicines to the General Medical Council (GMC) on the basis that he was a paediatric rheumatologist rather than a paediatric neurologist. Thankfully after careful review this case has now been dropped.  The GMC found no fault and no further action will be taken.  With the permission of the doctor concerned we highlight the following quote from the contribution of the GMC’s own independent medical expert.

“Dr X appears to have provided adequate care to the families who consulted him, with evidence of benefit, and no evidence of harm. The BPNA position that only Paediatric Neurologists should initiate treatment is not supported by other national guidance, and probably not in the best interests of children, as it may impede debate and research into the appropriate use of Cannibidiols (sic) in refractory epilepsy”.

Currently, there are just two paediatric neurologists prescribing for children and one of them is retiring in October.  Soon, there will be only one prescriber for over 100 children currently being administered these medicines and many thousands more who might benefit. This is simply unacceptable and puts the children who have prescriptions at real risk from rebound seizures, if they lose their prescribers.

We are calling on members of both the BPNA and the wider paediatric community to:

  1. Question the current position of the BPNA and to consider real world evidence and to treat individual patients on a case-by-case basis.
  2. Take into account the recently clarified NICE guidance which now recognise that cannabis prescription is reasonable if all else has failed and a child has responded to the medicine – “Patients in this population can be prescribed cannabis-based medicinal products if the healthcare professional considers that that would be appropriate on a balance of benefit and risk, and in consultation with the patient, and their families and carers or guardian…. There is no recommendation against the use of cannabis-based medicinal products”.
  3. When clinically appropriate, advocate for and where possible deliver, the prescription of full spectrum medicines on the NHS.
  4. Avail themselves of the offer of the MCCS to train free of charge and mentor any paediatrician who wishes to prescribe. The MCCS have set up a Resistant Epilepsy Cannabis Assessment Panel (RECAP) to assess individual cases. This panel has national cannabis experts and international paediatric neurologists including Dr. Carter Snead, Dr.Evan Lewis and Dr. Richard Huntsman. Contact can be made by emailing [email protected].

We ask that you, as the Secretary of State for Health & Social Care:

  1. Support our calls to the medical paediatric community as above.
  2. Work with the NHS and the wider medical community, including the MCCS to ensure that the barriers currently blocking NHS prescriptions to the cohort of paediatric epilepsy patients are broken down.

Yours,

Medical Cannabis Clinicians Society – Executive Committee and Members
Professor Michael Barnes (Chair) Consultant Neurologist & Consultant in Rehabilitation Medicine
Dr Evan Lewis Paediatric Neurologist (Canada)
Dr Sunil Arora Pain Consultant and Anaesthetist
Dr Danielle Gordon GP
Dr Leon Barron GP
Dr Niraj Singh Consultant Psychiatrist
Dr Rebecca Moore Consultant Psychiatrist
Dr Elizabeth Iveson Consultant Geriatrician
Dr Eliezar Okirie Consultant in Neurological Rehabilitation
Dr Beverley Fairclough Consultant Psychiatrist
Dr Nathan Hasson Consultant Paediatric Rheumatologist
Dr Luisa Searle Consultant Psychiatrist
Dr A Suleman GP
Dr Adam Bentley GP
Dr Brian Birch Consultant Urologist
Dr Harrison Offiong GP
Dr Tahzid Ahsan Consultant Psychiatrist
Dr Osama Hammer Consultant Psychiatrist
Dr Jake Timothy Consultant Neurosurgeon and Spinal Surgeon
Dr Ron Velthuis GP (the Netherlands)
Dr Sandeep Bolia GP
Dr Gurprit Atwal Consultant Histopathologist and Medical Examiner
Dr Julia Piper GP
Dr Prabha Moorti Consultant Psychiatrist
Dr Jen Anderson GP (Canada)
Dr Iqbal Mohiuddin Consultant Psychiatrist
Dr Andrew Sanger Bowen GP
Dr Elaine Tickle GP
Dr A J Wallis GP
Dr David Howells Consultant Psychiatrist
Dr Vimal Sivasanker Consultant Psychiatrist
Dr Anup Mathew Consultant Psychiatrist
Dr Caroline Bealing GP
Dr Maria Kallikourdi Consultant Psychiatrist
Dr Andrew Bradford Consultant in Neurological Rehabilitation
Dr Mark Smith GP
Dr Sharon Hadley GP
Dr Robert Greig Consultant in Emergency Medicine
Dr Naheem Bashir GP
Dr Anthony Ordman Consultant in Pain Medicine
Dr David Tang Consultant in Emergency Medicine
Dr Charlotte Cocks GP
Dr Neil Wright GP
Dr Graham Sanderson GP
Dr Sudha Balakrishnan Consultant in Rehabilitation Medicine
Dr Lauren Kelly Scientific Director, Canadian Childhood Cannabinoid Clinical Trials
Dr Tahira Ellahi Consultant Psychiatrist
Dr Simmi Sachdeva-Mohan Consultant Psychiatrist