Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if he will clarify guidance on the ability for a prescription for medical cannabis given by a specialist to subsequently be taken over by a GP under a shared care arrangement.

The law requires that unlicensed cannabis-based products for medicinal use (CBPMs) be supplied under either the prescription or direction of a clinician on the General Medical Council’s (GMC) Specialist Register. As with all areas of clinical practice, the GMC’s guidance states that all doctors must recognise and work within the limits of their competence. This is supported by the National Institute for Health and Care Excellence’s guideline ‘Cannabis-based medicinal products’, which states that after the initial prescription, subsequent prescriptions of CBPMs may be issued by another prescriber as part of a shared care agreement under the direction of an initiating specialist prescriber, if:

- shared care is appropriate and in the person’s best interest;

- the person's clinical condition is stable; and

- the other prescriber is confident to make a fully informed prescribing decision about cannabis-based medicinal products.

If a general practitioner (GP) accepts ongoing shared care responsibilities and continues prescribing once a patient has been initiated and stabilised on CBPMs, they must be confident to accept the associated legal and professional responsibilities associated with doing so, which are increased in the case of an unlicensed product. This includes accountability for the quality of the product prescribed. Treatments initiated privately would not usually be prescribed by a GP under shared care unless the requested treatment is approved under existing National Health Service policies or there are exceptional circumstances. This remains the case even if that privately funded treatment has been shown to have clinical benefit for the individual patient. This applies to all treatments.