FOI-03771

Thank you for your request for information about the following: ##Request I request the following data relating to private prescriptions for unlicensed cannabis-based medicines (CBPMs) dispensed in the community in England: 1. The total number of prescription items for private unlicensed cannabis-based medicines, broken down by individual prescriber code, for each calendar year from 2019 to 2024 inclusive, and for the period January to May 2025. 2. For each prescriber code provided in response to question 1, please also provide the prescriber organisation name and, where held, the prescriber's specialty or registered title. 3. The total number of prescription items for private unlicensed cannabis-based medicines that were recorded as "unspecified drug" or captured in an "other" category during initial data processing, before the secondary review process identified them as cannabis-based medicines, broken down by calendar year from 2019 to 2024. 4. The total number of prescription items for private unlicensed cannabis-based medicines that remain unassigned to a named prescriber code, broken down by calendar year from 2019 to 2024. 5. A description of the data collection and entry process for private Schedule 2 and 3 controlled drug prescriptions submitted to the NHSBSA, including whether data is entered manually from physical prescriptions, and what quality assurance processes are applied to prescriber code attribution. The NHS Business Services Authority (NHSBSA) received your request on 22 April 2026. We have handled your request under the Freedom of Information Act 2000 (FOIA). ##Our response ##Question 1 The total number of prescription items for private unlicensed cannabis-based medicines, broken down by individual prescriber code, for each calendar year from 2019 to 2024 inclusive, and for the period January to May 2025. We can confirm that the NHSBSA holds the requested information. ##Total number of prescription items Please refer to our response to question 2 which provides this information ##Breakdown by individual prescriber code We can confirm that the NHSBSA holds prescriber information, including name, prescriber code, address and linked Integrated Care Board (ICB). However, we consider this information to be exempt under section 40(2) and section 36 of the FOIA as detailed below. ##Section 40(2)- Personal information The names of the ten prescribers is personal data of the prescribers as it would result in their identification. Personal data is exempt from disclosure under section 40(2) of the FOIA if its disclosure would contravene any of the data protection principles. To comply with the lawfulness, fairness, and transparency principle, we either need the consent of the data subjects or there must be a legitimate interest in disclosure. In addition, the disclosure must be necessary to meet the legitimate interest and finally, the disclosure must not cause unwarranted harm. As we do not have the consent of the data subjects, the NHSBSA is therefore required to conduct a balancing exercise between legitimate interest of the applicant in disclosure against the rights and freedoms of the data subjects. The NHSBSA acknowledges that there are public concerns surrounding private unlicensed cannabis prescribing. There is legitimate public interest in understanding that prescribing patterns are appropriate and that the sector is appropriately regulated, and investigations conducted where necessary. Investigating bodies are able to access a wider range of data to support their investigation. However, there is no expectation from prescribers that their personal data will be released into the public domain. The release of prescriber names into the public domain is not necessary to improve regulation or for regulators and/or organisations with monitoring and oversight responsibilities to carry out investigations. The public can already raise concerns without the need for names to be in the public domain. The NHSBSA does, and will continue to work with regulators and those with monitoring and oversight responsibilities to provide data to them where necessary and appropriate as required by the relevant body. The data that NHSBSA holds shows volumes of prescriptions issued by named prescribers. On its own the data we hold cannot provide any wider context about the prescribing and/or its appropriateness. We have concluded that disclosure of the requested information would not comply with the lawfulness, fairness and transparency principle as the requested information is not required to meet the legitimate interests and so would not be fair to prescribers. Therefore, section 40(2) is engaged. Please see the following link to view the section 40 exemption in full - https://www.legislation.gov.uk/ukpga/2000/36/section/40 ##Section 36 – Prejudice to the effective conduct of public affairs The NHSBSA considers that the information you have requested is exempt from disclosure under sections 36(2)(b)(i), 36(2)(b)(ii) and 36(2)(c) of the FOIA. Section 36(2)(b)(i) – This is because disclosure would inhibit the free and frank provision of advice. Section 36(2)(b)(ii) - This is because disclosure would inhibit the free and frank exchange of views for the purposes of deliberation. Section 36(2)(c) -This is because disclosure would otherwise prejudice the effective conduct of public affairs. Section 36(2) of the FOIA requires the public authority to consult the relevant qualified person before the exemption is engaged. It further necessitates that the qualified person has the reasonable opinion that the prejudice referenced would or would be likely to, arise through disclosure. The name of the qualified person in this case is Michael Brodie, NHSBSA CEO. In the qualified person's opinion, sections 36(2)b(i), 36(2)(b)(ii) and (c) are engaged and the prejudices would occur. Section 36 of the FOIA 2000 is a qualified, prejudice-based exemption and is subject to the public interest test. This means that in order for the information to be withheld, the public interest in maintaining the exemption must outweigh the exemption in disclosure. ##Public interest test ##Considerations in favour of disclosure: * 10 prescribers have between them prescribed half of all private cannabis prescriptions between 1 January 2019- 31 December 2025. * There are patient safety concerns regarding the appropriateness of private unlicensed cannabis prescribing. There is therefore public interest in understanding who the prescribers are and prescribing practices. * There is legitimate interest in understanding how the sector is regulated and that regulation is effective. ##Considerations against disclosure: * There is an inherent public interest in allowing free and frank discussion and/or the exchange of views for the purposes of deliberation. * There is an inherent public interest in maintaining the effective conduct of public affairs * The public can already raise concerns without the need for names to be in the public domain. The NHSBSA does and will continue to work with regulators and those with monitoring and oversight responsibilities to provide data to them where necessary and appropriate as requested by the relevant body. * The data that NHSBSA holds shows volumes of prescriptions issued by named prescribers. On its own the data we hold cannot provide any wider context about the prescribing and/or its appropriateness. As part of an investigation, the investigating body will be able to access a wider range of data to support their investigation. * The Advisory Council on the Misuse of Drugs (ACMD) has been commissioned to undertake a review of the use and availability of cannabis-based products for medicinal use. ##Conclusion: We recognise that there is a public interest in the disclosure of information which would contribute to public understanding of private unlicensed cannabis prescribing however, there is also a public interest in the public authorities having the space to have free and frank discussions and/or the exchange of views for the purposes of deliberation without fear of disclosure into the public domain. There is also the inherent public interest in ensuring the effective conduct of public affairs. Having undertaken the balancing exercise, we have concluded that the weight afforded to the public interest in maintaining the exemption outweighs the public interest in disclosure. Please see the below web link to see the exemption in full. https://www.legislation.gov.uk/ukpga/2000/36/section/36 ##Question 2 For each prescriber code provided in response to question 1, please also provide the prescriber organisation name and, where held, the prescriber's specialty or registered title. The NHSBSA does not hold the prescriber organisation name or speciality. NHSBSA holds a record of a prescriber's title, and their type and subtype which can give some information about a prescriber's profession or specialty. ##Section 40(2)- Personal information The prescriber’s title, and their type and subtype are being withheld where there are low numbers of items as it would result in their identification. Personal data is exempt from disclosure under section 40(2) of the FOIA if its disclosure would contravene any of the data protection principles. The considerations for the application of this exemption are the same as for Question 1 above. Please see the attached CSV file and data dictionary. Where possible the data referred to in Question 1 has been matched to NHSBSA records to attach the title, type and sub-type of the prescriber that we have on record for the prescriber identification number (PIN) Data source for identification of unlicensed cannabis medicines is a manual prescription search of private prescriptions that has been taken from data captured as unspecified prescribing and reported as ‘Unspecified Drugs’ within our ePACT2 system. Prescribing information reported as ‘Unspecified Drugs’ within ePACT2 includes any prescribing where the product has been captured as unspecified. Unlicensed cannabis-based medicines that fall into this ‘unspecified’ category are identified by an additional review process which occurs after the prescriptions have been processed. The items identified by this review are reported against the date that the prescription was written and not necessarily when they were submitted for processing; so these figures may be subject to change if more prescriptions are submitted to the NHSBSA in a later month. These records have been matched back to NHSBSA data warehouse Master Data Record(MDR) information to determine the Prescriber type and sub-type and title using the prescriber identification number (PIN). Note that in some cases the type and sub type and title has been give as 'No PIN or PIN not matched to MDR' - this is due to either unidentified prescribers or other issues such as a prescription being dated before the database has been updated with the prescriber details. Prescriber details could be subject to administrative timing delays or updates that may differ from or lag behind actual changes. In the case of the detailed data it may be that the same pseudo-id first appears with 'No PIN or PIN not matched to MDR' for months where it did not match MDR records, and then appears with a known title for months where the data exists in MDR ##Question 3 The total number of prescription items for private unlicensed cannabis-based medicines that were recorded as "unspecified drug" or captured in an "other" category during initial data processing, before the secondary review process identified them as cannabis-based medicines, broken down by calendar year from 2019 to 2024. Information for unlicensed cannabis-based medicines is included in the data available from the link given in question 1. All of these products are recorded as "unspecified drug" as part of the initial processing. The "Other" categories that can apply to private cannabis-based medicines are prescriptions for licensed products. These are able to be classified against specific drugs in the Dictionary of Medicines and Devices (dm+d) during initial processing. These prescriptions for licensed products can be processed and identified using our standard prescription processing and are recorded in our main databases - no additional manual processing is necessary. Please see the attached CSV file and data dictionary for details on licensed private cannabis products. This includes prescriptions submitted as private controlled drug forms linked to private group organisations between 2019 and 2024 where the products were identified as Licensed CBPM products. That is, products included in one of the following BNF Chemical substances: Nabilone (0406000R0), Cannabidiol (0408010AM), Dronabinol/cannabidiol (1002020Y0). ##Question 4 The total number of prescription items for private unlicensed cannabis-based medicines that remain unassigned to a named prescriber code, broken down by calendar year from 2019 to 2024. The requested information is available from the link given in question 1. ##Question 5 A description of the data collection and entry process for private Schedule 2 and 3 controlled drug prescriptions submitted to the NHSBSA, including whether data is entered manually from physical prescriptions, and what quality assurance processes are applied to prescriber code attribution. The NHS Business Services Authority (NHSBSA) receives privately dispensed FP10PCD prescription forms for Schedule 2 and 3 controlled drugs on a monthly basis from dispensers in England. These prescriptions are submitted in paper form. Upon receipt, each prescription is scanned. The scanned image is retained, and the original paper prescription is securely stored for two years in line with retention requirements. Following scanning, the prescription images are processed through NHSBSA data entry systems. Each prescription is reviewed by trained staff, and key data fields, including prescriber details and prescribed drug information, are manually entered. A verification step is incorporated within the data entry process to support accuracy. Staff reference the NHSBSA drug database to identify and code prescribed items. Prescriber details are matched utilising a Prescriber database to attribute prescribing activity. Prescriptions sometimes contain prescribing of medicines that were not populated on the NHSBSA drug database at the time. Any prescribing that falls into this category is captured as an ‘unspecified drug’. Unlicensed cannabis-based medicines that fall into this ‘unspecified’ category are identified by an additional review process which occurs after the prescriptions have been processed. The items identified by this review are reported against the date that the prescription was written, so these figures may be subject to change. Where prescriber details cannot be confidently identified due to illegibility, omission, or obscured information, an ‘unidentified prescriber’ code is applied. Prescriptions recorded in this way cannot be attributed to a specific individual prescriber. This may result in: * An underestimation of prescribing activity for prescribers who are otherwise included within the dataset; and/or * The inclusion of prescribing activity from individuals not otherwise represented in the dataset. Quality assurance processes are applied to support the accuracy of captured data. This includes regular, sample-based reviews of staff input conducted on a monthly basis, ensuring that the information recorded accurately reflects the details on the original prescription, including both prescriber and drug data. ##Data Queries Please contact [email protected] ensuring you quote the above reference if you have any specific questions regarding this response; or, if you feel you may be misunderstanding or misinterpreting the information; or, if you plan on publishing the data. ##Reusing the data and copyright If you plan on producing a press or broadcast story based upon the data please contact [email protected] . This is important to ensure that the figures are not misunderstood or misrepresented. The information supplied to you continues to be protected by the Copyright, Designs and Patents Act 1988 and is subject to NHSBSA copyright. This information is licenced under the terms of the Open Government Licence detailed at: http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/ Should you wish to re-use the information you must include the following statement: “NHSBSA Copyright 2026”. Failure to do so is a breach of the terms of the licence. Information you receive which is not subject to NHSBSA Copyright continues to be protected by the copyright of the person, or organisation, from which the information originated. Please obtain their permission before reproducing any third party (non NHSBSA Copyright) information.