Intended for healthcare professionals

Feature Access to Medicines

Medical cannabis: patients turn to private clinics because of NHS void

BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l5290 (Published 02 September 2019) Cite this as: BMJ 2019;366:l5290
  1. Elisabeth Mahase, clinical news reporter
  1. The BMJ
  1. emahase{at}bmj.com

How will private clinics start seeing patients who request medical cannabis based products when NHS doctors seem unable to? Elisabeth Mahase investigates

The only thing stopping two private clinics in London dedicated to issuing prescriptions for medical cannabis is the final sign-off from the regulator, the Care Quality Commission, which all healthcare services need.

The Sapphire Medical Clinic1 and the Medical Cannabis Clinic2 expect to get this any day now, and as soon as they do they will be making appointments for the 180 patients who have already joined their waiting lists in the hope of accessing medical cannabis based products.

The clinics, which charge about £250 (€275; $306) for an initial consultation and £150-£175 for follow-up appointments, take referrals from GPs and hospital consultants. They offer to treat patients for pain, cancer, and gastrointestinal, neurological, and psychiatric conditions. They have also created registries to collect evidence on outcomes, drug efficacy, and adverse events.

But why are these patients being left to seek treatment from the private sector?

Any UK doctor on the specialist register has been able to prescribe medicinal cannabis since 1 November 2018. A change to the Misuse of Drugs Regulations 2001 moved cannabis from a schedule 1 drug (having no unique medical benefit) to schedule 2 (which doctors can prescribe in certain situations). However, since the law change the number of patients able to access medical cannabis is very small, activists have said.

One of the UK’s main suppliers is Grow Biotech, which is involved in about three quarters of all medical cannabis imported into the UK. The company told The BMJ that it had fulfilled roughly 80 prescriptions so far: all were for patients who came through private healthcare.

Guidelines advise against prescribing

A major barrier to patients accessing medicinal cannabis is guidance that largely advises against …

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