Bridging the Gap: Medical Cannabis, Regulators, and the Reality of Clinical Accountability

In her bi-weekly series for Cannabis Health, Dr Sue Clenton, Consultant Oncologist and Medical Director at Releaf Cannabis Clinic, shares her insight from the front line of an emerging field of medicine, taking readers inside the clinic and offering a doctor’s perspective on what it really means to prescribe cannabis medicines in the UK today.

Opinion on medical cannabis and CPBMs is very polarised among the public and the medical profession. 

This can lead to the assumption that those responsible for regulatory oversight, such as the General Medical Council, are hostile towards this field of medicine. In my experience, that is not entirely accurate. 

When the GMC becomes involved in any prescribing matter, the focus should not be on the medication in isolation, but on whether the correct processes were followed. 

Their role is to assess whether the clinician’s decision-making was sound, evidence-informed, and appropriately documented.

Clinical oversight has always been about professional judgement, patient safety, and defensible practice – and medical cannabis should not be treated differently simply because it is unfamiliar.

Who is responsible for regulating medical cannabis?

Medical cannabis sits within a well-established framework of professional oversight. 

The prescribing of cannabis-based medicines is governed in much the same way as any other area of clinical practice. Clinicians remain accountable to their professional regulator, specialist colleges help shape standards within disciplines, and medicines fall under the oversight of the MHRA. 

The Care Quality Commission is responsible for regulating the clinics themselves and expects strict standards to be followed around safety, prescribing practice, record keeping, and patient monitoring. 

Clinics may also be guided by professional organisations such as the Medical Cannabis Clinicians Society, the Cannabis Trades Association, and others working to establish best practice.

The multidisciplinary nature of cannabis care also means pharmacists and nurses are guided by their own professional bodies, reinforcing that this is not an unregulated space, but one that is increasingly structured, monitored, and held to the same expectations of safe, evidence-informed practice as the rest of medicine.

Each of these regulators and bodies play their own part in guiding members of the clinical team. 

However, these organisations do not always collaborate and communicate effectively, which can leave clinicians feeling uncertain. 

Exercising caution and accountability

We must be honest about the fact that the evidence base for cannabis-based medicines is not yet as extensive as it is for many other treatments. 

This can lead to scepticism among some clinicians, caution among others, and often allows misinformation to fill the gaps. The people who shout the loudest are often those who have strong opinions but little knowledge about the use of cannabis as a medicine.

In the vast majority of cases, medical cannabis is a remarkably safe treatment when prescribed appropriately, often with fewer side effects than traditional medications. 

Compared to other common treatments such as opiates, cannabis has been shown to have significantly fewer risks.

That does not mean cannabis is without risk — no medicine is — but the fear surrounding it is often disproportionate to its clinical reality. Clinics are CQC-regulated with strict governance procedures and safety measures in place.

Prescribers should not be guided by polarisation or noise, but by clinical reasoning, evidence where it exists, and transparency where uncertainties remain.

Ultimately, clinical accountability should not be something prescribers fear. It is something we practise every day.

If we want medical cannabis to sit properly within modern UK medicine, we must ensure clinicians will feel confident enough to engage with it responsibly, and allow informed practice to lead the way.