Request

You asked us:

Can you provide me with some market-related data on medical cannabis, such as the number of medical cannabis patients, the number of prescriptions approved and the number of licensed medical professionals that can prescribe from March 2023 to March 2024.

On 29 May 2024 you clarified the following:

I confirm that I am asking for both unlicensed cannabis prescribing for NHS and private prescribing. Item counts for the private prescribing since September 2023 works perfectly fine.

Response

I can confirm that the NHSBSA holds most of the information you have requested, and a copy of the information is attached.

With regards to the number of private medical cannabis patients, as patient information is not extracted and processed by NHSBSA, we cannot confirm nor deny if this information is held as doing so would require a manual search of each scanned prescription to confirm if the NHS number is held to determine the number of private cannabis patients.

We estimate that the cost of complying your request would exceed the non-central Government limit of £450. The limit has been specified in The Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulations 2004 https://www.legislation.gov.uk/uksi/2004/3244/contents/made and represents the estimated cost of one person spending 18 hours in determining whether the NHSBSA holds the information, and locating, retrieving, extracting and checking the information.

Please see the following calculations which sets out the estimated cost for compliance with this request:

124,337 x 30 seconds per review of the scanned prescription = 31,084 hours.

We can confirm that the figure of NHS medical cannabis patients is less than 5. Please see the below section 40(2) and section 41 exemptions in full.

Section 40(2) - Personal information   Please be advised that low figures under 5 have been supressed as this information is exempt under section 40(2) of the FOIA (personal information).  

Section 40(2) is an absolute, prejudice-based exemption and therefore is exempt if disclosure would contravene any of the data protection principles. In order for disclosure to comply with the lawfulness, fairness, and transparency principle, we either need the consent of the data subject(s) 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 subject(s), 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 subject(s).  

The NHSBSA acknowledges that you have a legitimate interest in disclosure of the information in order to provide the full picture of the requested data held by the NHSBSA; however, we have concluded that disclosure of the requested information would cause unwarranted harm and therefore, section 40(2) is engaged. This is because there is a reasonable expectation that patient data processed by the NHSBSA remains confidential.  

Please see the following link to view the section 40 exemption in full - https://www.legislation.gov.uk/ukpga/2000/36/section/40   

Section 41 – Provided in Confidence

In addition, this information is also exempt under section 41 of the FOIA (information provided in confidence). This is because the requested information was provided to the NHSBSA in confidence. In order for Section 41 to be engaged, the following criteria must be fulfilled:

• the authority must have obtained the information from another person, • its disclosure must constitute a breach of confidence, • a legal person must be able to bring an action for the breach of confidence to court, and • that court action must be likely to succeed.

The NHSBSA can confirm that the information has been obtained from a third party and that subsequent disclosure of that information would constitute a breach of confidence. In addition, disclosure could result in a legal person being able to bring action for the breach of confidence to a court and that court action.

Remaining Information:

Part 1- NHS prescribing of unlicensed cannabis-based medicines (March 2023-March 2024)

Part 2- Private prescribing of unlicensed cannabis-based medicines (March 2023-September 2023)

Part 3- Number of Unique Identified Prescribers for unlicensed cannabis-based medicines (NHS & Private)

NHS Prescription Services process prescriptions for Pharmacy Contractors, Appliance Contractors, Dispensing Doctors and Personal Administration, The information is then used to make payments to pharmacists and appliance contractors in England for prescriptions dispensed in primary care settings (other arrangements are in place for making payments to Dispensing Doctors and Personal Administration). This involves processing over 1 billion prescription items and payments totalling over £9 billion each year. The information gathered from this process is then used to provide information on costs and trends in prescribing in England and Wales to over 25,000 registered NHS and Department of Health and Social Care users.

Data Source

When prescriptions are processed by NHSBSA data capture, prescriptions sometimes contain prescribing of medicines that were not populated on the NHSBSA drug database at the time. This type of order will be captured as an ‘unspecified drug.’ Data for prescribing of unlicensed cannabis-based medicines has been taken from data captured as unspecified prescribing. Unlicensed cannabis-based medicines 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. Therefore, these figures may be subject to change if the prescription is submitted to the NHSBSA in a later month.

This Dataset

This dataset shows items and the number of unique prescribers for prescriptions of unlicensed cannabis-based products.

Unlicensed cannabis-based medicines that fall into the ‘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 payment. Therefore, these figures may be subject to change if the prescription is submitted to the NHSBSA in a later month.

Time Period

March 2023 to March 2024 (NHS prescribing), March 2023 to September 2023 (private prescribing). At present, private unlicensed cannabis data is only available until September 2023.

Data is presented monthly for items data, and for the aggregated time-period for the number of identified licensed prescribers who have issued prescriptions.

Organisation Data

Data for NHS and private unlicensed prescriptions is limited to prescriptions prescribed in England and dispensed in a community setting.

Items shows the number of times a product appears on a prescription form not the quantity prescribed.