medical cannabis dispensing in England rose from 278 recorded items in 2019 to 663,130 items in 2024, according to an NHSBSA dataset obtained under FOI (FOI-03587) and analysed by Business of Cannabis. The data show rapid expansion, concentrated prescribing, and important limits that prevent firm conclusions about individual clinicians or patient care.
Growth and monthly trends Between 2019 and 2024 private cannabis-based medicinal product (CBPM) items recorded in England increased 2,382-fold: 278 items in 2019 versus 663,130 in 2024. Monthly averages moved from under 400 items early in 2020 to roughly 85,000 items per month in the first five months of 2025 (provisional). The 2024 total alone exceeded the combined total of all previous years in the dataset.
Data source and validation caveats The NHS Business Services Authority (NHSBSA) supplied the dataset but described it as captured for monitoring and explicitly unvalidated. CBPM prescriptions were identified through manual review of forms filed under “unspecified drugs,” not via a standardised medicine coding system. The NHSBSA warns completeness and accuracy cannot be independently verified, and that 2025 figures are provisional because prescriptions are logged by date written rather than submission date. Reporting delays can alter recent-month totals.
Prescribing concentration The dataset lists prescriber identifiers (PINs). Since 2019, nine identifiers account for more than half of all recorded CBPM items. The top ten identifiers together account for 805,255 items — 52.2% of the 1.54 million total items in the dataset. Thirty-seven identifiers represent 80% of all dispensed items. Conversely, 121 of 314 identifiers issued fewer than 100 items across the entire period.
In 2024 the concentration tightened: three identifiers each issued 50,000+ items and together made 31.6% of that year’s volume. An additional eleven identifiers (10,000–50,000 items) supplied 37.5% of 2024 volume. At the low end, 113 identifiers that issued fewer than 500 items across 2024 collectively contributed under 2% of that year’s total.
Measures of inequality The analysis reports a Gini coefficient for prescriber volume (a standard inequality measure). The Gini peaked at 0.861 in 2022, fell to 0.850 in 2024 and reached 0.775 in the provisional Jan–May 2025 data. The top single identifier’s annual share fell from 14.9% in 2023 to 12.2% in 2024 and to 10.8% in the early 2025 sample. The number of active prescriber identifiers rose from 116 in 2022 to 200 in 2024, with 77 new entries that year.
Key limitations on interpreting prescriber concentration Two limitations prevent equating a PIN with an individual doctor or with new-patient activity. 1) Some PINs are group accounts. NHSBSA says most PINs map to individual clinicians but that group PINs exist; it has not tested which disclosed PINs are group accounts. Where a group PIN appears, item totals may combine multiple prescribers’ activity. 2) The dataset counts items, not patient visits or unique patients. An “item” equals one product line on a prescription form. A single consultation may generate multiple items. NHSBSA and the Medical Cannabis Clinicians Society (MCCS) note that item counts cannot be converted reliably into numbers of consultations, patients, or assessment quality. The MCCS estimates, on average, about two items per patient per prescription, but this varies by clinician and clinic model.
Example scale The single highest-volume identifier in the dataset issued 172,755 items since early 2020 (11.2% of the all-time total). In Jan–May 2025 that identifier logged 45,947 items — about 9,189 items per month on average for that period. Using the MCCS’s two-items-per-prescription average, that monthly total would imply roughly 4,595 prescription events per month, but NHSBSA disavows any extrapolated per-minute or per-hour prescribing rate derived from the raw items.
Product strength and comparisons with illicit cannabis Media reporting compared the THC strength of a named medical product (reported at 34% THC) with typical street cannabis (14–16% THC). NHSBSA can capture product descriptions as written on prescriptions but warns its manual capture produces inconsistent naming and strength entries because CBPMs are unlicensed and lack a standardised naming convention in NHS systems. The MCCS emphasises that prescribed products are used in clinical contexts: clinicians titrate doses from low starting points, products undergo quality control, and formulations often contain cannabidiol (CBD), which affects psychoactive outcomes. The MCCS updated Good Practice Guidance in May 2026 urging clinicians to avoid recreational-market terminology in prescriptions because such names lack clinical meaning.
Attempts to identify individual prescribers After publication of the FOI-based story, two further FOI requests (FOI-03715 and FOI-03716) sought to identify specific prescribers or clinics tied to the high-volume PINs. NHSBSA refused both requests under data-protection (Section 40(2)) and public-affairs prejudice (Section 36), stating that its data alone cannot provide clinical context or assess appropriateness of prescribing. NHSBSA concluded it would be unfair to publish individual identities based solely on item-volume figures.
Regulatory follow-up The Advisory Council on the Misuse of Drugs (ACMD) has been commissioned to review medical availability and use of CBPMs. The MCCS says lack of mandatory training and consistent clinical standards has produced variation across the sector; the ACMD review may result in enforceable standards and regulatory change.
What the data can and cannot show The FOI dataset quantifies rapid growth and a concentrated prescriber base in private CBPM dispensing in England. It cannot, on its own, determine whether care met clinical standards, how many patients received treatment, whether PINs represent individuals or groups, or whether high item volumes represent new assessments or routine repeat prescriptions. Policymakers, regulators and clinicians will need patient-level, validated data or mandatory registries to link prescribing volumes with clinical governance, outcomes and safety measures.
