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Medical cannabis clinics are often driven to scale their operations quickly, out of a desire to reach more patients who could benefit from treatment and the need to remain affordable for them. But doing so shouldn’t come at the cost of regulatory compliance.
As awareness and demand for medical cannabis continues to grow in the UK, how can clinics ensure they scale responsibly?
Australia’s medical cannabis spike
In Australia, which is often cited as a benchmark for the UK market, more than one million new patients have now received cannabis prescriptions for more than 200 health conditions, with numbers increasing significantly since GPs have been permitted to prescribe without the support of a specialist consultant.
According to official data, Australian medical cannabis imports nearly doubled between 2022 and 2023, rising from 24,887kg to 42,104kg, and revenue is expected to grow from around US$600m in 2024 to more than US$1.2bn by 2028.
However, alongside the growth in patient numbers, complaints of malpractice and breaches of guidelines have also increased.
A recent study found that almost half of the clinics it examined were failing to comply with Therapeutic Goods Administration (TGA) guidelines on the advertising and promotion of cannabis-based medicines. The TGA has issued more than 165 infringement notices totalling more than $2.3 million in penalties in the last two years.
Regulatory red flags
Certain practices serve as red flags for authorities and may prompt regulators to conduct audits, formal investigations, or even take legal action.
Some of these may include:
Unusally high prescription volumes
A spike in prescription volume disproportionate to clinic size or patient base is likely to lead to regulatory attention.
Prescriptions without proper justification
When patient notes are vague or rely on generic statements unsupported by medical evidence, it raises concerns about due diligence and patient safety. A lack of clear justification may be interpreted as negligence or misuse of prescribing authority, especially in the context of controlled substances.
Improper marketing or claims
Any claims that overstate the efficacy of cannabis, such as suggesting it ‘cures cancer’ can lead to action from the Advertising Standards Authority (ASA) or enforcement by the Medicines and Healthcare products Regulatory Agency (MHRA).
Non-compliant data handling
Poor cybersecurity, unauthorised data sharing, or breaches of General Data Protection Regulation (GDPR) can lead to penalties from the Information Commssioner’s Office.
Learning from past over-prescribing
To avoid running into regulatory issues, clinics must ensure they have policies in place to ensure there is oversight at every step along the care pathway.
Releaf, one of the fastest-growing clinics in the UK, onboards up to 1,000 new patients a week but its strategy is rooted in balancing growth with governance.
Graham Woodward, Releaf’s Chief Operations Officer, says the team has drawn lessons from the overprescription of drug classes such as opioids, benzodiazepines, and antibiotics, to inform its approach.
“We apply rigorous risk-benefit assessments and closely monitor patients on any controlled or novel therapies, including medical cannabis,” he says.
“We’ve learned that safe prescribing requires systems-level oversight. Our governance framework includes peer reviews, prescribing audits, and multidisciplinary discussions to reduce isolated decision-making and ensure clinical accountability.”
The opioid crisis is just one example which highlights the dangers of prescribing without long-term planning or robust monitoring, Woodward believes.
In conventional medicine, treatment has often relied on repeat prescribing without clear clinical endpoints and sometimes without patients being fully informed about the side effects and alternatives available to them.
“A major issue in previous overprescription trends was a lack of prescriber confidence or training in alternatives,” Woodward continues.
“Our team invests in continuous clinical education and supports a culture of responsible, reflective prescribing. Our model requires clear outcome measures—both subjective and objective—to evaluate ongoing efficacy and justify continuation, and we prioritise shared decision-making, ensuring patients understand both the potential benefits and limitations of treatment.”
Ensuring care and clinical due diligence at scale
Clinical training and education is at the heart of Releaf’s approach to compliance. All of its clinicians are required to undergo an extensive onboarding process, including background, DBS checks and mandatory training.
“We have a dedicated trainer to educate them in the workings of Releaf, as well as the endocannabinoid system, cannabis, terpenes, how to prescribe and more,” explains Medical Director, Dr Sue Clenton.
“We then allow them to shadow current clinicians until they feel ready to go solo.”
While treating patients at Releaf, clinicians undergo continuous training and education through the Thrive platform and have access to resources for information sharing and continued development.
Its clinical team also takes part in multiple MDTs a day to discuss new patients and any issues they are experiencing in their practice.
“We have robust procedures in place, as well as slick safeguarding and governance policies,” Dr Clenton adds.
“We are a designated body so doctors can connect with us for revalidation and we can offer in house annual appraisals.”
Releaf’s Operations Director, Charlene Rowe
A roadmap to responsible growth
Releaf has implemented internal processes which are robust enough to address any potential regulatory red flags, and may offer blueprint for other clinics.
The clinic’s Operations Director, Charlene Rowe, sets out its roadmap to responsible growth:
Robust patient onboarding and verification
All patients undergo ID and eligibility checks and are required to provide an official medical records or letters of diagnosis to support their treatment needs. Patients must sign informed consent documents and are provided with educational materials about the risks and use of CBPMs.
Strict prescribing protocols
This includes ensuring prescribers are appropriately qualified and trained in CBMPs and that every prescription is underpinned by strong clinical rationale and documented in patient records. The clinic utilises electronic health record (EHR) systems that log, timestamp, and track prescribing decisions and repeat prescriptions.
Reporting
Releaf conducts regular follow ups to assess treatment and adjust as needed. This includes monitoring and tracking adverse effects and reporting them to the relevant authorities.
Record-keeping and documentation
Staff maintain detailed logs of appointments, prescriptions, treatment plans, and communications.
Regulatory licensing and inspections
Everyone is responsible for ensuring compliance with Home Office and CQC licening requirements and keeping all documentation audit-ready for spot inspections.
By embedding governance into every stage of the journey, Releaf is scaling rapidly but with a clear commitment to patient care.
“}]] Medical cannabis clinics are often driven to scale their operations quickly, out of a desire to reach more patients who could benefit from treatment and the need to remain affordable for them. But doing so shouldn’t come at the cost of regulatory compliance. Read More
