Should the NHS Provide a Better Service for Medical Cannabis Prescriptions?

How the UK's National Health Service is operating on a unequal basis

We note that the subject contained in this article represents illegal activity in certain jurisdictions. Whilst we do not condone any acts which are contrary to any such laws, we understand that readers in those jurisdictions which have decriminalised cannabis may find this article of interest.

It's been one year since the UK officially legalised the use of medicinal cannabis, in hopes of bettering the lives of those needing the treatment. However, it's still just as difficult to get a prescription as it was when the plant first got legalised.

Cannabis still remains the most used illegal drug in the UK. On 1st November 2018, UK lawmakers moved to legalize medicinal marijuana, acknowledging that it is a drug with clear medical value. This allowed doctors to prescribe cannabis as a treatment where they deem necessary.

And while the regulations surrounding medicinal cannabis are still tightly controlled, other cannabis products—that have low concentration versions of CBD oil—are more widely used in the UK.

These products may not have the same medicinal benefits as the ones that are prescribed by doctors. But, they can promote other general health and wellness benefits. These over the counter products are most commonly sold in pharmacies and wellness stores, and can include oils and supplements that help regulate sleep and reduce stress.

NHS and Cannabis

The National Health Service, otherwise known as the NHS, is known as the UK's crown jewel. For 71 years, the NHS has been running as a government funded medical health-care service using tax-payer money.

Residents of the UK are not required to make any payments for medical services including consultations with general practitioners, urgent medical attention using ambulances and hospitals etc. 

With the many benefits medicinal cannabis can provide, campaigners have long sought to have the drug added as a treatment within the NHS.

Progress was already made in aid this goal, when medicinal cannabis products were moved from the "Schedule 1" category—meaning that they were not of any medicinal value—to "Schedule 2", which means that they are now allowed to be prescribed to patients under certain circumstances.

This change was the result of an evidence review by the UK Government's Chief Medical Officer, who concluded that some medicinal cannabis products were an effective form of treatments for certain conditions. 

Unfortunately, despite the significant hype around medicinal cannabis products, the NHS is still proceeding with a fair bit of caution. Guidelines have been produced for clinicians to follow, setting out expectations of how and when doctors—within the NHS as well as those working in private practice—should supply healthcare advice involving the use of cannabis-based products.

According to the NHS, medicinal cannabis treatments are being acknowledged as "specials", which means that they are a last resort form of treatment if nothing else seems to be initially effective. This itself is a major roadblock for patients, as waiting to find out their eligibility can substantially slow down the progress of their treatment.

There is also a possibility that, despite patients being eligible, they still find themselves denied cannabis treatment by the NHS. Even with a prescription from a consultant, the patient's case is still put into review, and can be denied  by NHS Trusts if they believe that the patient's case is not worth the money that will be invested for treatment.

Private Healthcare

At this point, there is still a high chance that patients will be denied when they attempt to secure a prescription for medicinal cannabis through the NHS. As a result, many UK patients are now turning to private healthcare as a second option.

However, going the private route can be a costly pathway to cannabis prescription. Patients seeking medicinal cannabis from private clinics will first have to arrange a consultation with a private consultant, with the initial consultation often costing up to £250 (AUD 466). And the prices of follow- up appointments are no better, as they average to be around £150 (AUD 280) per appointment.  

As of March 2019, the UK's first specialist medicinal cannabis clinic, The Beeches, has already opened in Manchester.

A typical appointment will cost patients £200 (AUD 370)—which is then followed by up to £700 (AUD 1300)  a month for their prescriptions—with the decision to prescribe cannabis only being made by doctors after the initial appointment.

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Clinics like The Beeches are certainly a step in the right direction, and one can only hope that with time—and greater competition—they will lower their prices for treatment.

This will be an important step as the UK cannabis industry continues to mature, as the current cost model is unviable for long term patients. If cannabis is showing signs of helping a patient's treatment, then to continue treatments for a year could cost the patient a minimum of £8000 (AUD 14,900) for repeat prescriptions.

While private healthcare is a viable option, it does mean that access to medicinal cannabis for UK patients is unequal and unfair to those who cannot afford private treatment.

If these financial burdens—along with the struggles of getting NHS prescriptions—aren't addressed, then it may lead to patients considering other options, such as the black market, where cannabis products are illegally sold at lower than market rate prices.

The future of cannabis in the NHS

While it's no secret that medicinal cannabis provides great flexibility as a treatment pathway for multiple conditions, there is still much work to be done for the NHS to actively promote it, rather than providing it as a last-resort option.

Parliamentary debates have been held discussing this issue, with multiple MPs pushing the idea that patient access to cannabis should be prioritised over the need to provide further evidence for its effectiveness.

At this stage, taking the correct steps in this process is crucial, as the UK needs a responsive medicinal cannabis system for its patients, whilst also complying with medical practices and standards. Without this, the UK might see more delays in this process.

Luckily, the UK is slowly and gradually making progress in integrating cannabis products into both the NHS and privatised healthcare systems.

However, it seems that the pace at which the UK is making progress is simply not quick enough. The costs of medicinal cannabis products are obstructively high, simply because these products are currently so hard to come across.

The demand for the NHS to incorporate medicinal cannabis products is getting greater by the day, as pressure mounts from all angles.

Hopefully, the UK will speed up this process to accommodate to the needs of the many, rather than just the needs of the few.

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Niki Mohazeb
Niki Mohazeb

Niki is a Sydney based writer, with a passion for promoting the health benefits of medicinal cannabis. Niki also enjoys researching and writing about the future of cannabis along with the many other benefits that the plant provides, such as the diverse utilities of hemp.

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