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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:

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:

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:

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.

Find out more and complete the declaration.

Cannabis-based medicinal products (CBMPs) have been legal to prescribe in the UK since November 2018. Since then, an estimated 95,000 patients have received prescriptions, supported by around 160 prescribers across approximately 40 private clinics. Despite this growth, NHS prescribing remains extremely limited. At the same time, the absence of mandatory training and consistently applied clinical standards has led to variation in practice across the sector.

The Medical Cannabis Clinicians Society (MCCS) has today published an updated version of its Good Practice Guide for Prescribers of CBMPs. This guidance is intended to support clinicians in making safe decisions and strengthen consistent prescribing in a developing area of medicine. It draws on the collective experience of the Society’s multidisciplinary membership, committee and executive, reflecting real-world prescribing across a wide range of clinical settings.

➡️ Download the new Guidance

The Society’s position 

Medical cannabis can be a safe and effective treatment option for selected patients, particularly where conventional therapies have been unsuccessful, when prescribed within a structured clinical framework with appropriate assessment, decision-making and follow-up.

Prescribing must meet the same standards expected of any other unlicensed medicine. Consistent application of these standards is essential to minimise risk for patients and maintain confidence in the sector. This guidance aims to define good practice, based on real-world clinical experience and supported by existing regulatory expectations.

Central to this is clinical responsibility. Prescribing decisions sit with the clinician. They must be justified, based on appropriate assessment, and always remain in the patient’s best interest. This includes independent decision-making and full accountability for documentation, monitoring and outcomes.

This guidance does not replace clinical judgement or existing regulatory frameworks. Medical cannabis remains an individualised treatment, and decisions must be made on a case-by-case basis. The aim is to support safe access to treatment while ensuring prescribing remains clinically appropriate, accountable and evidence informed.

A structured approach within existing regulation

The Good Practice Guide provides a practical framework covering:

These are standard principles of medical practice. The purpose of the guide is to apply them clearly and consistently to cannabis-based medicines. It reflects established principles already recognised by the Society, including careful patient selection, multidisciplinary input where appropriate, and thorough documentation of prescribing decisions.

This guidance sits alongside existing regulatory frameworks. Clinicians must continue to work within the standards set by the General Medical Council, Care Quality Commission, MHRA and NICE. CBMPs remain unlicensed “specials”, and prescribing carries the same responsibilities as any other unlicensed medicine.

The role of the Good Practice Guide is to translate these high-level requirements into practical, day-to-day clinical application, providing clarity on how regulatory expectations apply in the context of medical cannabis.

The Society is committed to working with regulators to support alignment, share clinical expertise and contribute to the development of clear, proportionate and workable oversight as the sector continues to evolve.

Safety in context

Medical cannabis has a favourable safety profile when prescribed appropriately. However, it is not risk-free and requires active clinical oversight. The updated guidance places clear emphasis on risk identification and management. Clinicians are expected to assess, monitor and manage:

Prescribing should follow a cautious, structured approach. This includes starting at low doses, titrating gradually, and maintaining regular follow-up to assess response and tolerability, consistent with established prescribing principles.

What the Good Practice Guide (V4) covers

Raising standards in a developing field

“Prescribing cannabis-based medicinal products requires careful clinical judgment, a strong understanding of the evidence, and a clear grasp of professional responsibilities. This guide provides the structure and support clinicians need to practise safely, lawfully and in the best interests of their patients.”
— Professor Mike Barnes, Chair, Medical Cannabis Clinicians Society

Medical cannabis remains a developing area of medicine. The evidence base continues to evolve, clinical experience is expanding, and expectations around governance are becoming more defined.

The updated guidance provides clinicians with a clear framework for safe, accountable prescribing, and offers reassurance to patients, regulators and the public that medical cannabis is being prescribed within a structured, professionally governed system.

As the sector matures, consistent standards matter. This guidance sets a clear direction for safe, responsible prescribing across the sector.

The MCCS expects this Good Practice Guide to be adopted by prescribers and across clinics, supporting a consistent approach that prioritises patient safety and quality of care. This will help raise standards across clinical practice and the wider sector.

Access the Guide

The Good Practice Guide for Prescribers of CBMPs is available now for all.

If you’re not yet a member, join today to access our growing library of practical tools, prescribing guidance, training, and peer support.

➡️ Download the new Guidance

👉 Find out more and join the Society

Date: Thursday 20 November 2025 |  Time: 7:00pm (UK) | Register: Click to register now via Zoom

In this practical session, Professor Mike Barnes, Chair of the Medical Cannabis Clinicians Society (MCCS), will walk through the key principles of the Good Practice Guide for Prescribers of Cannabis-Based Medicinal Products (CBPMs) – the definitive framework for safe, ethical, and compliant prescribing in the UK.  In this webinar, explore the updated guidance, including best practice in consultations, peer review, prescribing protocols, and follow-up care.

Developed by clinicians for clinicians, the Guide brings clarity and consistency to an evolving field. Professor Barnes will explain why the framework matters, how it aligns with GMC and MHRA expectations, and how prescribers can apply it to strengthen clinical practice and protect patients.

A must-attend for clinicians and clinic managers who want to ensure they meet professional standards and deliver safe, defensible care.

What you will learn
Who should attend?

Open to all professionals working in or around medical cannabis prescribing, including:

Register for Free
This 45-minute session will be followed by a 15-minute open Q&A with Professor Barnes, giving attendees the chance to ask questions and discuss real-world applications of the Good Practice framework.

Places are free but limited – register now to secure your spot and join the conversation on raising standards in medical cannabis prescribing.

The Medical Cannabis Clinicians Society (MCCS) is pleased to announce the publication of the updated edition of the Good Practice Guide for Prescribers of Cannabis-Based Medicinal Products (CBMPs), an essential resource for clinicians working in this fast-evolving field.

Since CBMPs were legalised for prescription in the UK in November 2018, more than 75,000 patients have received treatment, supported by around 160 prescribers across 40 private clinics. Despite this growing demand, NHS prescribing remains extremely limited, and clinicians face a lack of consistent training, standards, and support.

In response, the Society has revised and expanded its flagship Good Practice Guide to offer a clearer, more detailed framework for safe, lawful and patient-centred prescribing. The updated guide is part of MCCS’s broader mission to raise standards across the sector and safeguard both patients and practitioners.

What’s inside?

This updated guide reflects the latest developments in clinical practice, prescribing patterns, and regulatory expectations. It includes detailed guidance on:

Who should use this guide?

While developed with specialist cannabis clinics in mind, the guide is relevant across all settings where CBMPs may be prescribed or supported. That includes:

Access the Guide

The Good Practice Guide for Prescribers of CBMPs is available now for all.

If you’re not yet a member, join today to access our growing library of practical tools, prescribing guidance, training, and peer support.

👉 Download the Good Practice Guide

👉 Find out more and join the Society

“Prescribing cannabis-based medicinal products requires careful clinical judgment, a strong understanding of the evidence, and a clear grasp of professional responsibilities. This guide provides the structure and support clinicians need to practise safely, lawfully and in the best interests of their patients.”
— Professor Mike Barnes, Chair, Medical Cannabis Clinicians Society

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.