General Medical Council Guidance on Cannabis Prescribing

GMC Good Medical Practice and Controlled Drug Prescribing

• GMC Good Medical Practice requires prescribers to prescribe only when clinically appropriate
• Prescribers must be satisfied they have adequate knowledge of the drugs they prescribe
• Cannabis-based medicines should be prescribed in accordance with evidence and clinical judgement
• Off-label and unlicensed prescribing carries additional professional responsibilities

The General Medical Council’s guidance underpins the professional obligations of every doctor prescribing medical cannabis in the UK. Good Medical Practice requires prescribers to work within their competence, to prescribe only when it is appropriate to do so, and to take particular care when prescribing outside licensed indications. These obligations apply with full force to cannabis-based medicines.

The GMC’s Position on Unlicensed Prescribing

• The GMC permits unlicensed prescribing where there is sufficient evidence and clinical need
• Doctors must be able to justify their prescribing decisions and document them clearly
• Informed consent must include information about the unlicensed status of the product
• Doctors should have access to relevant clinical information and review patient outcomes

The majority of medical cannabis prescribed in the UK is unlicensed, meaning it has not undergone the standard clinical evaluation process required for a full marketing authorisation. The GMC acknowledges that unlicensed prescribing can be clinically appropriate but places the burden of justification firmly on the individual prescriber. Clear, contemporaneous documentation of the clinical rationale is essential.

Continuing Professional Development and Competency

• Doctors must maintain and develop their knowledge of cannabis-based medicines
• CPD should include awareness of emerging clinical evidence and changing guidelines
• Specialist training in cannabis medicine is available through a range of providers
• GMC revalidation requires demonstration of updated knowledge and skills

Medical cannabis is a rapidly evolving field. Evidence from clinical trials and real-world data studies is accumulating, professional organisations are developing clinical guidelines, and the regulatory landscape continues to develop. Clinicians prescribing cannabis-based medicines have a professional obligation to remain current with this evidence and to reflect changes in their prescribing practice accordingly.

Patient Safety Reporting and GMC Obligations

• Doctors have a duty of candour to be open and honest with patients about adverse events
• Serious adverse events related to cannabis prescribing should be reported via Yellow Card
• GMC concerns about a doctor’s cannabis prescribing practice can lead to fitness-to-practise proceedings
• Proactive engagement with clinical governance processes provides a degree of professional protection

Patient safety is the lens through which the GMC evaluates all prescribing decisions. For medical cannabis, this means taking adverse events seriously, reporting them through appropriate channels, and being willing to review and revise prescribing in response to patient outcomes. Doctors who can demonstrate a consistent, evidence-informed, patient-centred approach to cannabis prescribing are in the strongest professional position.