Bridging the Gap: Helping GPs See the Evidence Behind UK Cannabis Care

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.

In her latest edition, Dr Clenton discusses the dynamic between specialist prescribers and GPs, and explores what both sides can do to help prioritise patient outcomes. 

One of the questions I am asked most frequently is ‘why can’t my GP just prescribe cannabis for me?’

For patients, especially those new to treatment, this is an understandable question. After all, GPs have been their first port of call for any health issues for their entire lives. 

Currently, GPs in the UK cannot initiate cannabis-based prescriptions; only clinicians on the specialist register can start a patient on their treatment journey, and they can only continue the prescription once it’s been initiated. 

However, even if GPs had the ability to prescribe cannabis medicines, it doesn’t necessarily mean they would. 

Medical education in the UK still does not cover cannabis-based medicines. I have been qualified for nearly 30 years, and although the endocannabinoid (ECS) system was discovered while I was a student, it still does not feature in the curriculum, even though it plays a role in major systems throughout our bodies. 

Unless a doctor actively seeks out information about cannabis and the ECS, they may simply never encounter it. 

From my experience before moving into medical cannabis, and from my friends and colleagues in the healthcare sector, I know that many practitioners still have concerns about the safety of cannabis for their patients. 

Some still think it is dangerous or will lead to other, more harmful, drug use, while some are concerned that it will interact dangerously with other drugs, or that they could overdose, when actually, the converse is true. There is no evidence that cannabis leads to further drug use, and there is no known lethal dose of cannabis in humans. 

At Releaf, one of the UK’s leading cannabis clinics, we are working to help address these misconceptions through training sessions with GP networks and online communities. We also engage with the palliative care clinicians, where there is a lot of interest in alternative treatments for symptom management. 

Every conversation with a curious GP, every webinar delivered to a hospice team, helps chip away at the historic stigma that surrounds cannabis. 

Real-world evidence is also critical to helping dispel many of these concerns, especially considering that by nature, doctors are evidence-based practitioners. 

At Releaf, we use patient-reported outcome measures, internationally recognised tools that track progress across pain, sleep, anxiety, and quality of life. When we can show colleagues that patients are reporting reduced pain and improved function, we are no longer asking them to take our word for it.

In many ways, Releaf works much like a familiar GP surgery. Our team of clinicians have a diverse range of specialisms in everything from neurology to psychology to endocrinology, and we refer patients between ourselves according to their individual needs. 

We have robust incident reporting, clinical governance meetings, and a dedicated clinical director overseeing audits and guidelines. We are not simply writing prescriptions, but working to build the infrastructure of a recognised clinical service.

As our practice has grown, we’ve worked hard to ensure that our quality of care maintains our rigorous standards. We do not try to see 19,000 patients. We try to see one patient really well, 19,000 times. 

Key to this is empathy and ensuring each patient feels listened to. When I listen to our patients’ feedback or read our reviews, it’s rewarding to see that this is recognised and welcomed. 

If you pinched everyone in a room, they would all feel it differently and describe it differently. Our job is to interpret, to understand, to put the pieces together.