The UK’s medical hashish market has lengthy been a locked field on the subject of dependable knowledge. The truth that it’s nearly totally non-public implies that the info is basically proprietary, forcing us to piece collectively and mannequin the market from snippets given to us by particular person clinics or to parse massive, unreliable knowledge units attained by way of Freedom of Info requests.
Regardless of guarantees of a central ‘affected person registry’ spanning over 4 years, no such official database but exists. A number of unofficial registries, such because the UK Medical Hashish Registry, established in 2019 by Curaleaf Clinic physicians, have tried to fill this hole, however in the end depart analysts to make educated guesses.
The opposed impression on not solely trade gamers, however on the broader healthcare system and each present and potential sufferers shouldn’t be understated. It inhibits analysis into the broader impression of readily accessible medical hashish, retains the trade largely within the shadows, and means the patches of information which are made public are extra susceptible to being misunderstood or misrepresented.
Slowly, this dynamic is starting to vary. With every fragment that’s launched, one other brick within the wall is eliminated, and the image turns into clearer.
In March, The Occasions printed a narrative based mostly on knowledge obtained by way of an FOI request, shedding some mild on prescription practices within the UK for the primary time. We’ve now had the chance to look at that very knowledge set, and under we’ll try to clarify precisely what it may possibly reliably present us, and maybe extra importantly, what it can not.
What the info exhibits
Enterprise of Hashish obtained the NHSBSA’s FOI-03587 dataset and subjected it to our personal impartial evaluation. The next findings are drawn immediately from that knowledge. For every, we set out what the figures present, the caveats the NHSBSA attaches to their interpretation, and the extra context offered by the Medical Hashish Clinicians Society.
Speedy progress
Between 2019 and 2024, the amount of cannabis-based medicinal merchandise disbursed privately in England grew from 278 objects to 663,130, a 2,382-fold improve over 5 years.
*2025 provisional Jan–Might solely. Supply: NHSBSA FOI-03587
Month-to-month volumes mirror this development. In early 2020, fewer than 400 objects had been disbursed each month. Within the first 5 months of 2025, this month-to-month common had reached roughly 85,000. The 2024 whole exceeded the mixed whole of each previous yr.
Month-to-month prescribing quantity, Jan 2020 – Might 2025
Supply: NHSBSA FOI-03587
The NHSBSA states in its FOI response that the info is captured for monitoring functions and is explicitly unvalidated. CBPM prescriptions are recognized by way of a guide evaluation of prescriptions filed as ‘unspecified medication,’ not by way of an automatic system, and completeness can’t be independently verified.
Moreover, the 2025 figures are more likely to change. Prescriptions are logged in opposition to the date written reasonably than the date submitted, and in our expertise, these figures change considerably as reporting delays are realised.
Recognising the ‘vital progress in prescribing’, the MCCS says it sees this as a mirrored image of ‘sustained affected person demand’, reasonably than a supply-driven phenomenon.
This, it says, is probably going prevalent in ‘individuals with continual, treatment-resistant situations similar to ache, anxiousness and kids with resistant epilepsy who haven’t discovered satisfactory aid from standard therapies.’
It added: “Many sufferers are turning to personal care as a result of they’re unable to entry well timed assist by way of the NHS, with lengthy ready lists, together with round 1.7 million individuals ready for psychological well being providers, contributing to this shift. Clinicians are responding the place normal therapies haven’t labored, reasonably than as a first-line strategy.”
Concentrated prescribing to a handful of Medical doctors
Since 2019, 9 prescriber identifiers have collectively accounted for greater than half of all CBPM objects recorded in England. The highest ten mixed account for 805,255 objects, 52.2% of the all-time whole of 1.54 million.
Thirty-seven identifiers account for 80% of all objects ever disbursed. On the different finish of the distribution, 121 of the 314 identifiers within the dataset have issued fewer than 100 objects in whole throughout your complete interval.
Lifetime focus: prime 10 prescribers vs relaxation (all-time)
Prime prescriber 11.2%
Prescribers 2–10: 41.0%
Remaining 304: 47.8%
Supply: NHSBSA FOI-03587 (2019–Might 2025)
In 2024, the focus was extra pronounced nonetheless. Three identifiers every disbursed 50,000 objects or extra, accounting for 31.6% of that yr’s whole between them.
Eleven additional identifiers within the high-volume tier (10,000–50,000 objects) contributed 37.5%. The 113 identifiers on the lowest tier, every shelling out fewer than 500 objects throughout the total yr, collectively accounted for underneath 2% of 2024 quantity.
Moreover, this concentrated prescribing dynamic, typically attributed by the trade to the extreme lack of specialists in a position to prescribe, has been declining since 2022.
The Gini coefficient, a measure of inequality throughout the prescriber base, peaked at 0.861 in 2022 and fell to 0.850 in 2024 and 0.775 within the first 5 months of 2025. The highest single identifier’s share of annual quantity fell from 14.9% in 2023 to 12.2% in 2024 and 10.8% within the provisional 2025 knowledge. The variety of lively prescriber identifiers rose from 116 in 2022 to 200 in 2024, with 77 new entrants recorded that yr alone.
Market focus (Gini coefficient), 2019–2025
Greater = extra concentrated. *2025 provisional. Supply: NHSBSA FOI-03587, evaluation by Enterprise of Hashish
There are two vital limits to what these figures can present. First, it stays unclear whether or not every prescriber identifier represents a single particular person clinician or whether or not an identifier could in some circumstances correspond to a bunch observe or organisational account.
The NHSBSA advised Enterprise of Hashish: “Typically, a singular PIN is issued to a person clinician and so a singular PIN ought to characterize a single particular person clinician.
“Nevertheless, there are some group PINs in existence. We have now not carried out any evaluation on whether or not any of the PINs disclosed as a part of FOI-03587 relate to a bunch.”
As such, the place a bunch PIN seems within the knowledge, objects attributed to it can not reliably be taken to characterize the prescribing exercise of a single particular person.
Second, the info captures whole merchandise quantity however can not distinguish between preliminary assessments and ongoing repeat prescribing for established sufferers.
For instance, a high-volume identifier could also be issuing massive numbers of routine repeat prescriptions inside established care relationships, a sample that appears similar within the knowledge to high-volume new affected person exercise.
For that reason, the MCCS cautions in opposition to ‘drawing conclusions in regards to the high quality or security of care from prescribing quantity knowledge alone,’ including that ‘mixture or anonymised figures don’t seize the scientific context, fashions of care, or governance processes in place.’
The society is unambiguous that ‘item-level prescribing quantity just isn’t a dependable indicator of scientific exercise, workload, or whether or not applicable requirements are being met.’
The dimensions of main prescribers
The best-volume identifier within the dataset has issued 172,755 objects since first showing within the knowledge in early 2020, 11.2% of the all-time whole.
Prime prescriber: month-to-month merchandise quantity, 2020–2025
Supply: NHSBSA FOI-03587. Prescriber identification anonymised.
Within the first 5 months of 2025, that identifier recorded 45,947 objects, averaging roughly 9,189 objects monthly. The height single month within the dataset for this prescriber was April 2025, when 9,697 objects had been recorded.
As soon as once more, it’s price noting that the 2025 figures are more likely to change resulting from reporting delays, with the newest months more likely to see the biggest modifications.
Energetic prescribers and new entrants by yr
Complete lively
New entrants
*2025 provisional Jan–Might. Supply: NHSBSA FOI-03587
A vital caveat right here is that an merchandise is the variety of instances a product seems on a prescription type, not the variety of prescriptions issued and never the variety of affected person consultations.
“The time period ‘objects’ refers back to the variety of instances a product seems on a prescription type, not the amount prescribed. One merchandise shouldn’t be learn as one prescription issued. We don’t maintain any knowledge on affected person consultations,” the NHSBSA advised us.
A single appointment producing a prescription for 3 hashish merchandise would produce three objects on this dataset. The uncooked merchandise totals in FOI-03587 can’t be used to estimate what number of sufferers acquired therapy, what number of consultations befell, or how incessantly any particular person was seen.
The MCCS added: “Prescribing knowledge reported as ‘objects’ doesn’t equate to the variety of sufferers handled or consultations delivered. On common, that is round two objects per affected person, per prescription, although this varies.
“Some clinicians present one prescription containing a number of objects; others situation separate prescriptions for every merchandise. These variations can considerably have an effect on how prescribing quantity is recorded and interpreted.”
At two objects per affected person per prescription, the MCCS’s said common, the main identifier’s 45,947 objects within the first 5 months of 2025 would suggest roughly 22,974 patient-prescriptions over that interval, or roughly 4,595 monthly.
The NHSBSA has confirmed that the supplementary calculations circulated alongside the dataset — together with the methodology be aware describing an assumed working week of 20 days and eight hours — weren’t a part of its FOI response. The authority that collects and holds the info didn’t produce them and is unable to confirm them. Any arithmetic extrapolating a per-minute or per-hour prescribing price from the merchandise totals is subsequently a third-party calculation, not one the NHSBSA has validated or endorsed. The tempo implied by these figures ought to be learn in that mild.
On whether or not that quantity is according to applicable evaluation, peer evaluation, and monitoring underneath MCCS steering, it stated noting that the ‘duty for guaranteeing secure and applicable prescribing sits with the person prescriber and the clinic.’
Evaluating medical hashish and avenue hashish
The Occasions reported that the strongest medical hashish obtainable within the UK, a product named ‘House Cake’, incorporates 34% THC, greater than double the 14–16% sometimes present in avenue hashish. The comparability is introduced as an indicator of danger.
Requested whether or not the NHSBSA holds knowledge at this stage of granularity for CBPM prescribing, it advised Enterprise of Hashish: “This knowledge has been beforehand printed in response to FOI-03623. Nevertheless, this knowledge can’t be validated. It’s because, as a part of our guide processing train, we seize product descriptions as they’re written on the prescription type.
“Hashish-based merchandise for medicinal use are unlicensed and usually are not included within the NHS Dictionary of Medicines and Gadgets. This implies there is no standardised naming conference for the product names, energy or quantity. This may increasingly result in duplication of some product names, energy or quantity relying on variations inside how the product was prescribed and/or recorded.”
On the comparability itself, the MCCS notes that medical hashish and illicit hashish function in totally completely different scientific contexts. Prescribed doses are titrated from low beginning factors underneath specialist supervision, merchandise are quality-controlled, and cannabidiol can mitigate a few of the psychoactive results of THC.
The MCCS Good Observe Steering, up to date in Might 2026, addresses this immediately, recommending that prescribers keep away from ‘terminology derived from leisure hashish markets’ on the grounds that such names ‘have very restricted scientific that means, don’t assist skilled communication and will undermine acceptance of CBMPs as reliable medicines.’ The steering notes that ‘it’s good to see a discount on this observe over the past 12 months throughout many elements of the sector.’
Past the info
Inside 48 hours of The Occasions article publishing, two additional FOI requests had been submitted to the NHSBSA. The primary, FOI-03715, requested the authority to substantiate whether or not a named physician was among the many ten high-volume prescribers and, in that case, to call the opposite 9, or failing that, to call the clinics concerned.
The second, FOI-03716, requested for the names, GMC registration numbers, and prescriber codes behind the ten pseudonymised identifiers within the dataset.
Each had been refused by the NHSBSA on the grounds of non-public knowledge safety underneath Part 40(2) and prejudice to the efficient conduct of public affairs underneath Part 36.
“The information that NHSBSA holds exhibits volumes of prescriptions issued by named prescribers. By itself, the info we maintain can not present any wider context in regards to the prescribing and/or its appropriateness.”
The authority that collected the info and owns its caveats concluded that it couldn’t pretty be used to establish people publicly. That place is according to each limitation we’ve set out within the knowledge part above,
The Advisory Council on the Misuse of Medicine has been commissioned to evaluation the use and availability of cannabis-based merchandise for medicinal use, a course of referenced by the NHSBSA in its FOI refusal letters and one that may, in time, produce suggestions that carry regulatory weight.
The MCCS’s newest Good Observe Steering acknowledges that ‘the absence of obligatory coaching and persistently utilized scientific requirements has led to variation in observe throughout the sector.’
Whether or not that interprets into enforceable requirements, and on what timeline, is the query the sector is ready for the ACMD evaluation to start to reply.
