Audit of the prescribing of Medical Cannabis (FOI)

​Request

The Chief Pharmacist audited (or had oversight of) the prescribing of Medical Cannabis in Jersey. 

This data was then presented at Advisory Council on the Misuse of Drugs either August/September of 2023. Each prescribing doctor had their prescribing rates analysed and compared to a UK national 'Norm'. This data was alluded to in an email to me on 3 October 2023.

"A recent audit of all Jersey medicinal cannabis prescribing undertaken by the Chief Pharmacist which reveals concerns (which the GMC are aware of) of prescribing rates up to and exceeding 100 times that of comparable UK benchmarks, with some local outliers being the most responsible for these excessive rates – and lack of clarity around the adherence to NICE guidance. This was presented at ACMD in the last week."

The audit and the concerns have been something for all medical cannabis doctors to be made aware of. We have asked the Chief Pharmacist several times for the data but she is quite busy and yet we have been asked to reflect on the data for our General Medical Council appraisal.

A

Please provide a copy of the audit? (I appreciate that each individual doctor will have to be anonymised. Naturally I do not expect any patient identifiable data but I do hope there are patient demographics.)

B

What are the UK benchmarks used as a comparison for said audit?

C

Please provide a copy of the presentation given at ACMD (Advisory Council on the Misuse of Drugs) which presumably will also be comments of the audit and current risks posed in Jersey.

D

Please provide a copy of the Minutes of the ACMD meeting where this was discussed and was a member of the Jersey medical cannabis doctors present for the meeting to give perspective and insight into this area of medicine?

E

Was [redacted], the industry expert who helped write the law regarding medical cannabis, involved in this audit either to help interpret the data or give opinion or perspective?

F

Was any medical cannabis clinic in Jersey consulted on or involved with this audit?

Response

A

As stated in a recent Freedom of Information response published on www.gov.je in November 2023, the audit data is currently being reviewed for data quality assurance. It is envisaged that this process will be completed and the findings will be published before end of Quarter 1, 2024. Therefore, Article 36 of the Freedom of Information (Jersey) Law 2011 has been applied.

B

The data used can be found on the Care Quality Commission’s website at the following link:

The safer management of controlled drugs: Annual update 2022 - Care Quality Commission (cqc.org.uk)

As this information is available elsewhere, Article 23 of the Freedom of Information (Jersey) Law 2011 has been applied.

C

The audit information presented to the Misuse of Drugs Advisory Council (MDAC) was in draft only. Please see response to Question 1.

D

The minutes of the 28 September 2023 meeting where the audit data was presented are attached.

20230928 MDAC minutes_Redacted.pdf​

Redactions have been made to the minutes in consideration of Freedom of Information legislation to protect the privacy of individuals, and to reduce the impact on the security of the island. Redactions have been colour coded for ease of reference, as follows:

Blue    Personal Information of the Chair - Article 25 of the Freedom of Information (Jersey) Law 2011

Yellow    Personal Information of the Members of the Council and others mentioned within the minutes – Article 25 of the Freedom of Information (Jersey) Law 2011

Red    Law Enforcement – Article 42 of the Freedom of Information (Jersey) Law 2011 

A doctor who works in a clinic which prescribes medicinal cannabis was amongst the meeting invitees but was unable to attend.

E

Audit data was sourced from the monthly controlled drugs returns sent by pharmacies to the Chief Pharmacist in accordance with Article 16 of the Misuse of Drugs (General Provisions) (Jersey) Order 2009. The industry expert referenced was not involved in the process.

F

No medicinal cannabis clinics were consulted. As set out above, the audit is simply the compilation of data from monthly controlled drugs returns. No consultation or opinion was required in the compilation of that data.

Articles applied

Article 25 - Personal information

(1) Information is absolutely exempt information if it constitutes personal data of which the applicant is the data subject as defined in the Data Protection (Jersey) Law 2018.

(2) Information is absolutely exempt information if –

(a) it constitutes personal data of which the applicant is not the data subject as defined in the Data Protection (Jersey) Law 2018; and

(b) its supply to a member of the public would contravene any of the data protection principles, as defined in that Law.

Article 36 - Information intended for future publication

(1) Information is qualified exempt information if, at the time when the request for the

information is made, the information is being held by a public authority with a view to its

being published within 12 weeks of the date of the request.

(2) A scheduled public authority that refuses an application for information on this ground

must make reasonable efforts to inform the applicant –

(a) of the date when the information will be published;

(b) of the manner in which it will be published; and

(c) by whom it will be published.

(3) In this Article, “published” means published –

(a) by a public authority; or

(b) by any other person.

​Article 42 - Law enforcement

Information is qualified exempt information if its disclosure would, or would be likely to, prejudice –

(a) the prevention, detection or investigation of crime, whether in Jersey or elsewhere;

Public Interest Test

Articles 36 and 42 are qualified exemptions and, as such, Health and Community Services (HCS) has conducted a prejudice test as required by law. 

HCS has assessed whether, in all the circumstances of the case, the public interest in supplying the information is outweighed by the prejudice that would likely result by doing so. It is recognised that there is a public interest in transparency. However, having considered the public interest, HCS has concluded that the public interest in disclosing this information is outweighed by the potential prejudice that would likely result. 

In respect of the application of Article 36 specifically, audit data containing the information requested is currently under review, with publication to follow completion of data quality assurance. It is reasonable for a Scheduled Public Authority to publish reports in an orderly manner, following completion of appropriate internal processes.​