Medical Cannabis Clinics Should Create a Code of Practice
Professor Trevor Jones makes the case for medical cannabis clinics collaborating on industry best practice
With three exceptions, cannabis-based products for medicinal use (CBPMs) are not generally available through the NHS. For the most part they are prescribed privately by specialised physicians, mostly via newly-established medical cannabis clinics, 16 of which now operate in the UK.
These clinics are subject to inspection by the Care Quality Commission (CQC) and their operations must comply with medicines legislation. But for more patients to access the benefits of medical cannabis, the industry must demonstrate it is operating ethically, responsibly and to the highest standards.
It’s therefore the ideal time, I believe, for clinics to come together and agree to a common, self-regulating Code of Practice (CoP). Earlier this year, in partnership with our friends at the Cannabis Industry Council (CIC), the Centre for Medicinal Cannabis (CMC) convened a meeting of all clinics operating in the UK.
A common approach to developing such a code was developed with leaders from within the CIC in the months that followed. Unfortunately the CIC was unable to secure the required agreement of its members to proceed to full implementation of the CoP.
Since then four leading clinics have continued the process, in partnership with the CMC, to develop the scope of a CoP. Together we are now seeking input from a wider array of leaders within clinics to complete this process
Our clear intention is to ensure that clinics operate in a professional, ethical and transparent manner to guarantee the appropriate and rational use of medicines and support the provision of high-quality healthcare – complementing compliance with applicable laws and regulations.
Critically, as part of this process clinics will also be expected to conduct their marketing, prescribing and dispensing in a legal and socially responsible way that does not take advantage of medicinal cannabis patients, many of whom are extremely vulnerable.
By setting a gold standard for regulatory and scientific best practice, expanding knowledge and the evidence base, the CoP will contribute to improving patient health and well-being outcomes, as well as maximising access to the benefits of medical cannabis.
Among the initial principles suggested for the draft code are:
That the clinic is registered with the CQC and maintains compliance with all CQC requirements
That the clinic is adequately staffed with persons with expertise in the potential therapeutic use of medicinal cannabis products and specific condition areas to ensure the appropriate prescribing of CBPMs
That before prescribing medicinal cannabis products, the GP records of the patient are assessed to ensure that they have had access to current accepted standards of care for their condition
That arrangements for the dispensing of prescriptions are such that the patient has access to the most appropriate medicinal cannabis product relevant to their condition
That the clinic has established that the products that they prescribe are of acceptable standards of purity, quality and reproducibility
That adequate clinical records for the patient are maintained and can be accessed by their prescriber, GP or other authorised persons.
That confidentiality and GDPR concerns are taken into account and clinics have clear consent policies so that patients understand how, why and to what end their data is being used and who can access it
That clinics must follow MHRA guidance on the advertising and promotion of medicines
Current champions of the code are also seeking to agree a formal procedure through which patients and others can raise issues with their experience and medication.
They now invite others to join them in this endeavour.
Clinics must make every effort to resolve complaints quickly and fairly, treating them in confidence and ensuring patients are not disadvantaged as a result. This could be overseen by an independent arbitrator appointed from outside the sector.
Complementing this, our intention is that a public list is maintained of clinics that subscribe to, meet and continue to demonstrate their commitment to the CoP. A clinic’s presence on this list would indicate to patients, prescribers and the general public that the named practice is working to high operational and ethical standards.
With medical cannabis in the UK still in its early stages, building a consensus around best practice would go some way to showing that the industry is operating in good faith and putting patient well-being at its heart.
We now invite all clinics to come on board and help shape the future of the sector.
Professor Trevor Jones is well known internationally for his activities in the pharmaceutical industry, biotech industry and academia. His extensive resume includes: Board Director for Research & Development at The Wellcome Foundation Ltd (Wellcome plc), Director General of the The Association of the British Pharmaceutical Industry (ABPI), Vice Chair of King’s College London Council and Commissioner at the World Health Organisation (WHO).
Subscribe to the Medical Cannabis Journal for to hear more from the industry’s leading voices