The Care Quality Commission has published an important update on cannabis-based products for medicinal use (CBPMs).
The update clarifies what the CQC expects from medical cannabis prescribers and providers, particularly around treatment initiation, multidisciplinary review, specialist oversight, shared care and communication with other healthcare professionals.
It also confirms that the CQC has begun an engagement programme with CBPM providers to understand how services operate, manage risk and identify good practice.
What is the latest CQC medical cannabis guidance?
The CQC’s update references the growth in private prescribing of unlicensed CBPMs, reporting that 833,525 items were prescribed between April 2024 and March 2025, an increase of 134% on the previous year. As prescribing increases, it is clear the CQC requires services to demonstrate that decisions are clinically justified, properly reviewed and supported by effective clinical governance.
The Medical Cannabis Clinicians Society is pleased to be specifically referenced in the latest CQC controlled drugs update. The CQC notes that the Society has strengthened its guidance for CBPM prescribers. Although it does not formally endorse external guidance, it describes principles within the MCCS Good Practice Guide as helpful and says they align with its expectations.
The CQC highlights two MCCS principles:
- A specialist consultant should be involved in the patient’s first follow-up appointment before care is fully transitioned to a shared-care arrangement.
- Written treatment plans or policies should establish clear parameters within which follow-up prescribers may adjust dose and formulation in response to the patient’s clinical progress.
What does the CQC expect from CBPM providers?
The CQC states that providers must have a process to scrutinise and ratify every decision to initiate a CBPM. This process should confirm that the decision is patient-centred, clinically appropriate and supported by a clearly established unmet clinical need.
Independent providers may manage this through a multidisciplinary team, clinical governance board or another proportionate governance process. Providers must maintain an effective audit trail showing who reviewed the case, what information was considered and how the decision was reached.
CBPM multidisciplinary team requirements
Services must ensure that their processes allow at least two doctors on the GMC Specialist Register to participate in scrutinising and ratifying prescribing decisions.
The prescribing specialist must practise in the clinical specialty relevant to the condition being treated. Other specialists taking part must have sufficient knowledge of that clinical area to provide meaningful scrutiny.
Reviews may take place in person or through an appropriate asynchronous process, but they must involve genuine clinical review rather than administrative sign-off.
Specialist oversight and shared care
The CQC has seen examples of care being delegated entirely to non-specialists, with little continuing involvement from the initiating specialist. Services must be able to demonstrate that the specialist retains oversight and remains practically involved in the patient’s care. The level of involvement should reflect the patient’s condition, response to treatment and individual needs.
Where supplementary prescribers are involved, treatment must follow a thorough, patient-specific Clinical Management Plan. This should set out the agreed treatment, monitoring arrangements, permitted adjustments and when the specialist must be consulted again.
Communication and registration
Medical cannabis prescribers need complete and accurate clinical information before making a prescribing decision. Relevant healthcare professionals should also be informed about treatment. Depending on the patient, this may include their GP, specialists, mental health services, other independent providers and the dispensing pharmacy.
Providers already registered with the CQC for the regulated activity of Treatment of disease, disorder or injury must update their statement of purpose if they begin offering CBPM treatment. The CQC must be notified in writing within 28 days of the change.
What is the CQC CBPM engagement programme?
The CQC has begun an engagement programme with CBPM providers. The programme will help the regulator understand the services being provided, how risks are managed and where good practice is taking place. Information gathered will also inform its ongoing monitoring activity.
The CQC is requesting information on:
- numbers of patients and prescribers
- definitions of high-volume and high-strength prescribing
- management of higher-risk prescribing
- processes for receiving and acting on safety alerts
- wider clinical governance arrangements.
Supporting medical cannabis prescribers
Medical cannabis is a developing area of clinical practice. Prescribers must navigate unlicensed medicines, controlled drug regulations, changing regulatory expectations and a growing evidence base. Specialist consultants, GPs, pharmacists, nurses, allied health professionals, medical students and other clinicians can get much-needed support from the Society.
MCCS membership provides access to:
- practical prescribing guidance and templates
- CPD-accredited medical cannabis training
- an up-to-date clinical evidence database
- peer support and case discussion
- webinars, events and professional development
- regular clinical and regulatory updates.
Whether you already prescribe medical cannabis, are preparing to prescribe or support patients in another clinical role, the Society can help you practise safely and with confidence. Join the Medical Cannabis Clinicians Society and become part of the independent clinical community working to improve CBPM care.
Is your clinic committed to good practice?
Clinics can demonstrate their support for high standards by joining the MCCS Clinics Committed to Good Practice initiative.
Participating clinics complete an annual voluntary declaration confirming their support for specialist-led prescribing, appropriate MDT oversight, structured monitoring, clear documentation, transparency and continuing professional development.
The initiative is based on voluntary self-declaration and annual renewal. It is not an accreditation or inspection scheme.
If your clinic has not yet signed up, speak to your clinical and governance teams about taking part.