Cannabis Based Products for Medicinal Use (CPBM)

I am registered with ScriptAssist which enables independent practitioners to prescribe medical cannabis in their existing clinics and is subjected to Streamlined Clinical Governance Data Lead Formulary and involves Doctor/ Patient Goal Setting.

The whole process is led by Multidisciplinary Team Review and Peer Support.

All regulatory considerations with respect to this process have been followed including:

  • General Medical Council (GMC): Issued guidance on CBPMs, prescribed by a Specialist within their scope of practice and agreed with MDT - I am a Specialist and this is within my scope of practice.
  • Department of Health: rescheduled into a Class B product; recognising therapeutic benefit.
  • Care quality Commission (CQC): Clinician must be associated with a private CQC recognised organisation and I have my practising privileges at the Nightingale Hospital London and I'm also a member of the Independent Doctors Federation.
  • National Institute for Health And Care Excellence (NICE): Issued Clinical Guidance on prescribing but not yet officially recommended for reimbursement and so prescribed off license.
  • Home Office: Regulated as a Schedule II Controlled Substance
  • Medicines & Healthcare Regulatory Agency (MHRA): regulated the same as any other unlicensed medicine.

I am a member of the MedicalCannabisCliniciansSocietyand the MedicinalInstituteofEducation

I have had expert medical cannabis training specifically for UK doctors - this includes an extensive knowledge and understanding of the endocannabinoid system and understanding of the current evidence based for cannabis (taking into consideration some of the limitations around availability of evidence for some conditions and lack of RCT studies), an understanding of UK regulations regarding prescribing and choices of products in the marketplace and specifically the practicalities of how to safely integrate medical cannabis into my existing clinical practice.

Cannabis-based products for medicinal use (CBPM) are classed as a schedule 2 controlled drug so prescriptions must be completed on an FP10PCD form.

NHS England have stated that in addition to a specialist on the GMC registry only prescribing within their own area of practice and training; the decision and final validation of the chosen prescription plan must be agreed upon by a multidisciplinary team (MDT).

CBPM prescription guidelines in the UK recommend that patients should only be considered for a prescription of medical cannabis if there is sufficient evidence supporting the application of CBPM in this condition.

Additionally, guidelines recommend CBPM should not be used as a first-line medication and instead should only be considered after the patient has tried at least two first-line medications and found them to be ineffective.

There are the three licensed cannabis-based medicines in the UK

  • Epidyolex is a purified CBD oral solution used in addition to clobazam for children (from the age of two) and adults with epilepsy.
  • Sativex is a mouth (oromucosal) spray containing both THC and CBD, in a 1:1 ratio and is licensed in the UK for people with MS-related muscle spasticity.
  • Nabilone is a capsule containing synthetic THC and is prescribed for chemotherapy-induced nausea and vomiting.

Products such as Epidyolex, Sativex and Nabilone are classed as licensed cannabis-based medicines as they have all received marketing authorisation from the MHRA which allows them to be prescribed by any GP in the UK.

Cannabis-based products for medicinal use (CBPM); such as dried flower, oils and capsules, are all classed as unlicensed controlled drugs as they have not received marketing authorisation from the MHRA and so have to be prescribed as a controlled drug by a specialist on the GMC's registry.

TheScriptAssistpatientapp allows you to learn about medical cannabis and find an experienced doctor. Through the app, you can also keep track of your symptoms, prescriptions and medications, and work towards bespoke goals agreed with your doctor.

Please refer to CannabisBasedProductsforMedicinalUseFees for more information.

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