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By Zul Mamon, Pharmacist and MCCS Executive Committee Member

The General Pharmaceutical Council’s (GPhC) recent thematic review into the supply of cannabis-based products for medicinal use (CBPMs) has revealed an uncomfortable truth: seven years after legalisation, pharmacy practice in this sector remains inconsistent, fragmented, and in some cases unsafe.

As a pharmacist with over 40 years in the profession, including senior roles in medicines distribution, I believe this report is one of the most important regulatory interventions to emerge since CBPMs became legal in 2018.

This review exposes long-standing weaknesses that many of us working in this area have recognised for years, and it sets out changes that are now essential if CBPMs are to be supplied safely.

Below, we outline the core issues highlighted by the GPhC and why the Society supports the reforms proposed, as well as advocating for an additional recommendation.

What the GPhC found

The findings are clear.  Inspection across 25 pharmacies revealed significant problems across governance, safety, training, and clinical oversight, exposing a “postcode lottery” of care, putting many patients at risk. Without better systems, clearer standards, and appropriate clinical information, pharmacists cannot discharge their responsibilities safely, and patients will continue to be put at risk.

Poor governance

The review identified widespread gaps in governance, including pharmacies operating without formal risk assessments for supplying unlicensed cannabis medicines. In online settings, these risks were amplified by a lack of  oversight.

Safeguarding concerns

CBPM patients commonly live with complex and chronic health needs. Despite this, many pharmacies lacked appropriate safeguarding processes, audits, and staff training. In one case, a pharmacist issued a controlled drug to a patient with a known history of drug misuse.

Inconsistent competence

Training provision varied significantly. Some pharmacies relied on unverified or outdated materials. Others allowed unqualified staff to participate  in the dispensing process.Fragmented and siloed care

One of the most serious findings was the absence of shared information between clinics and pharmacies. Many pharmacists were asked to dispense CBPMs without any access to patient records, making safe clinical checks impossible.

Real-world harm

These failures had real consequences for patients, including:

What needs to change: Three urgent reforms

The GPhC recommends three practical and urgent reforms needed to protect patients and build a reliable medical cannabis framework. These findings will inform a larger review by the Advisory Council on the Misuse of Drugs (ACMD). The  Society fully supports these recommendations.

  1. Connect the System: Create shared data systems so that doctors, clinics, and pharmacists can communicate effectively and share information. This is essential for providing joined-up, safe care.
  2. Give Pharmacists the Full Picture: Grant all pharmacies, including private ones, access to patient records. This would allow them to conduct proper clinical checks and prevent harmful drug interactions.
  3. Strengthen Cross-Regulator Cooperation: All regulatory bodies must work together to enforce high standards consistently across the sector. A unified approach is the only way to ensure quality and safety for every patient.

A fourth reform the sector now needs: Specialist training and clear guidance for pharmacists

Alongside the GPhC’s three urgent reforms, there is a fourth requirement that must now be recognised: specialist education for pharmacists dispensing CBPMs.

Pharmacists are responsible for supplying unlicensed Schedule 2 cannabis medicines safely and lawfully. Yet there is no national training standard for this area of practice. This gap contributes directly to the inconsistencies highlighted in the GPhC review.

The Medical Cannabis Clinicians Society has already taken steps to address this and many pharmacists already rely on our guidance to navigate this fast-moving and often poorly defined area of practice. 

In April 2025 we published Guidance for Pharmacists Dispensing CBPMs, developed specifically for pharmacy professionals. This detailed resource gives pharmacists the essential information they need, including:

This guidance is already supporting pharmacists across the UK to build confidence, strengthen clinical checks, and ensure patients receive safe and consistent care.

To build on this foundation, the Society is developing a dedicated online training module for pharmacists, launching in December. This structured, CPD-aligned course will offer the practical, regulator-aligned training that is currently missing from the national landscape.

Together, the guidance and upcoming training form the pharmacy-standard pathway the sector urgently needs, and the fourth reform we believe should sit alongside those recommended by the GPhC.

A turning point for the sector

The UK’s medical cannabis system is at a turning point, and the GPhC review should act as a catalyst for long-overdue change. The evidence shows it is currently failing many of the vulnerable patients it was designed to help. As someone who has worked across community pharmacy, medicines distribution, and specialist practice, I believe these reforms, combined with clearer education and stronger professional support, can finally bring consistency, accountability, and safety to this area of care.

Patients deserve a system that is safe, consistent, and professionally robust. Pharmacists deserve the tools, information, and clinical access required to carry out their duties. And the wider sector needs coherent standards across all regulators and providers. The Society remains committed to supporting pharmacists to meet these expectations and to strengthening standards across the UK. The hope is that these findings will drive meaningful change, leading to a system that is not only legal but also safe, reliable, and effective for all.

Join the Society

If you are a pharmacist working with CBPMs, or seeking to build confidence and competence in this area, we invite you to join the Medical Cannabis Clinicians Society.

Membership provides access to guidance, training, expert commentary, and the UK’s largest peer network of medical cannabis professionals.

By Zul Mamon,  Expert Committee Member

This article summarises the crucial insights shared during my presentation “The Role of the Pharmacist: Best Practices for Dispensing CBPM” at the Cannabis Health Symposium on 25 November 2025, which explored how pharmacists can optimise patient outcomes and drive clinical excellence, offering a roadmap for pharmacists navigating this complex and growing area of practice.

Sarah’s Story

Let’s consider Sarah’s story. Like many patients, Sarah experienced confusion and delays when trying to access her CBPM prescription.

Sarah is a 45-year-old mother of two, living with chronic pain that has made even the simplest tasks unbearable. After years of trying traditional treatments with little success, Sarah was told by a friend to try cannabis, which is now legally available on prescription.

Sarah did some research, as we all do, using Google and found a clinic which could help her, and proceeded to complete an online form She managed to get an appointment during which an independent prescriber triaged her. The appointment lasted around 15 minutes to confirm her eligibility. Shortly afterwards, she had an appointment with a Specialist Prescriber. This lasted around 10 minutes.

She was prescribed medication, and after a wait of around a day, Sarah received a payment link from a pharmacy that was connected to the clinic. Sarah was hopeful, but she had to wait to receive her prescription medicines.  There was hardly any communication from the pharmacy or the clinic.

When she contacted the online pharmacy by email, it took several days to receive a reply. This left Sarah feeling frustrated and uncertain about her treatment.

Eventually, the medication arrived by secure post.  Unsure how to use her medication, Sarah contacted the pharmacist again by email as it was the only mode of communication available. The pharmacist was unable to provide comprehensive guidance.

This scenario is more common than we’d like to admit, and something the MCCS is working hard to ensure becomes a thing of the past. 

In this article we explore how pharmacists can ensure patients like Sarah receive the guidance, support, and care they need to achieve the best outcomes.

Pharmacists are often the last point of contact in a patient’s journey for CBPMs and are responsible for providing the proper guidance and support. By implementing best practices, we can transform the experience for patients like Sarah, ensuring they receive the high-quality care they deserve.

The Pharmacist’s Pivotal Role in the CBPM Pathway

The pharmacist’s function in the CBPM clinical pathway is multifaceted and vital. It extends far beyond simply dispensing medication. It begins with a prescription assessment to ensure legality and accuracy, followed by safe dispensing protocols.

However, the role doesn’t end there. Patient education is a cornerstone of adequate care. Pharmacists must provide clear guidance on dosage, administration methods, and potential side effects. Finally, ongoing monitoring enables tracking of therapeutic outcomes and the prompt management of issues that arise during treatment. Without access to clinical data and direct patient contact, significant gaps can emerge, leading to reduced patient education, ineffective safeguarding, and missed opportunities for clinical intervention.

Insights from the GPhC 2025 Report

The General Pharmaceutical Council (GPhC) 2025 thematic report served as a critical reference point, providing a snapshot of how CBPMs are managed across the UK. The report highlighted significant gaps in governance, safeguarding, and clinical oversight, serving as a wake-up call for the industry.

The GPhC brought two critical issues to the forefront:

1.Lack of Access to Clinical Records

Many pharmacies operate without access to a patient’s medical history. This severely limits the ability to perform meaningful safety checks for potential drug interactions, contraindications, or therapy duplications, thereby increasing the risk of adverse events.

2. Inappropriate Prescribing

The report noted instances of inappropriate prescribing, such as providing controlled drugs to individuals with a history of substance misuse. Access to clinical records would empower pharmacists to identify and flag these risks and to take appropriate action to safeguard patients.

These findings underscore the need for systemic changes to ensure pharmacists have the tools required to meet the highest standards of care.

A Framework for Best Practice in CBPM Management

To address the identified challenges, a robust best-practice framework is essential. This framework should be built on four key pillars:

This involves more than just a standard check. It means confirming the prescriber is on the Specialist Register and ensuring the prescription is appropriate and complies with the Misuse of Drugs Regulations 2001. Pharmacists must document all such checks.

Dispensing CBPMs requires a deep understanding of patient safety. This includes assessing medical history and monitoring for side effects.

Patients need clear, non-technical information about their medication. Pharmacists should explain dosage, administration, storage, and handling. It’s also vital to manage expectations and clarify the difference between medicinal and recreational cannabis.

Seamless communication and coordinated efforts across the healthcare team are non-negotiable. This ensures a holistic approach to patient care, reducing the risk of errors and miscommunication.

Navigating Common Challenges in CBPM Practice

The path to optimising CBPM dispensing is not without its obstacles. Three common challenges frequently impact patient care:

Many CBPMs are imported, leading to limited availability, variable product quality, and complex procurement processes. These factors can disrupt consistent patient access to medication.

Knowledge gaps among pharmacy teams, coupled with the stigma surrounding cannabis, can create significant barriers. The GPhC report noted that many pharmacies were using unverified sources for training, highlighting a need for standardised education.

Complex dosing regimens and poor side-effect management can make it difficult for patients to adhere to their treatment plans.

Practical Solutions for Real-World Problems

Overcoming these challenges requires practical and proactive solutions.

For supply chain management, pharmacists should establish robust supplier relationships, identify backup procurement sources, and implement digital inventory-tracking systems. Developing clear communication protocols to inform patients of supply disruptions is also crucial.

To improve education and training, regular team training on CBPM knowledge is essential. Working with industry partners to develop standardised patient information resources and counselling aids can help bridge communication gaps and empower patients with clear, accessible information.

Building Confidence: The Three Pillars of Professional Development

Building confidence in CBPM practice is a continuous journey. A professional development strategy grounded in the following three pillars can help pharmacists enhance their competence and provide the best possible care.

The field of CBPMs is rapidly evolving. Pharmacists must stay current with emerging research, regulatory changes, and new clinical guidelines.

Engaging with specialist groups like the Medical Cannabis Clinicians Society (MCCS), attending symposiums, and participating in peer support forums are excellent ways to share knowledge and learn from others. These networks provide a platform for collaboration and discussion.

Implementing systematic quality measures is vital. Conducting regular audits, seeking patient feedback, and refining protocols are critical steps to ensure the highest standard of care is not just met, but exceeded.

A Call to Action for Pharmacists

Let’s return to Sarah. Imagine if her pharmacist was well-trained in CBPMs, had access to her clinical records, and could offer clear, confident guidance. She would feel supported and reassured, knowing she is in capable hands. This is the tangible impact we can have.

By embracing our role in the clinical pathway, implementing best practices, and collaborating effectively with the wider healthcare team, we can ensure that every patient receives the care they deserve.

Let’s work together to raise the standard of CBPM practice and make a real difference in our patients’ lives.

If you’re a pharmacist working with CBPMs – or want to build your confidence in this area – now is the ideal time to join the Medical Cannabis Clinicians Society. Membership for pharmacists is just £60 a year and gives you access to peer support from pharmacy colleagues, specialist guidance, practical dispensing resources, and CPD-accredited training designed for busy clinicians.

Join today and strengthen your role in safe, effective CBPM care.

About the author

Zul Mamon is a member of the Expert Committee at the Medical Cannabis Clinicians Society, a pharmacist and a Responsible Person with extensive experience across community pharmacy and the medical cannabis sector. As the founder of Pharma Experts and co-founder of both Amber Green Clinics and Blue Angel Care, he has developed a unique perspective on the evolving landscape of modern healthcare.

Driven by a passion for advancing the profession, Zul focuses on navigating the complex challenges and identifying key opportunities within the field. He is committed to sharing his insights to help enhance patient care, improve clinical governance, and support the professional development of his peers.