NHS England expects that cannabis-based products for medicinal use should only be prescribed for indications where there is clear published evidence of benefit or UK Guidelines and in patients where there is a clinical need which cannot be met by a licensed medicine and where established treatment options have been exhausted. In addition, a Specialist doctor on the General Medical Council Specialist Register should only make the decision to prescribe within their own area of practice and training and the decision to prescribe should be agreed by the multidisciplinary team.
To support specialist clinicians’ prescribing decisions, NICE has been asked by the Department of Health and Social Care to produce a clinical guideline on the prescribing of cannabis-based products for medicinal use. This guidance is expected by October 2019 at the latest. In the interim, the British Paediatric Neurology Association has produced clinical advice on the use of cannabis-based products for medicinal use in paediatric patients with certain forms of severe epilepsy and the Royal College of Physicians has developed additional advice around prescribing of cannabis-based products for medicinal use in intractable chemotherapy induced nausea and vomiting and chronic pain.
The MHRA has updated its guidance on manufacturing, importing, distributing and supplying specially manufactured or ordered products ('specials') to include cannabis-based products for medicinal use in humans.