NHS watchdogs have sparked outrage among British campaigners by ruling that cannabis should not be used to treat multiple sclerosis and chronic pain.

The National Institute for Health and Care Excellence (NICE) has just issued draft guidance on the use of cannabis-based medicines following “a comprehensive evaluation of their clinical and cost-effectiveness”. It ruled that MS patients and pain sufferers should not be given marijuana, and it could not recommend cannabis for children suffering from epilepsy either.

NICE said that there is insufficient evidence to suggest that cannabis is safe to take, and it said fast-tracked clinical trials must take place. Without NICE approval, only a tiny minority of doctors can prescribe medical cannabis.

Genevieve Edwards, of the Multiple Sclerosis Society, said the group was bitterly disappointed by NICE’s draft guidance, which is open for public consultation until Sept. 5, 2019.

It added that it does not recommend Sativex, a cannabis medicine produced by British company GW Pharmaceuticals, deeming it to be too expensive in relation to the benefits it provides. Edwards said this decision will deprive thousands of MS sufferers of the medicine they need.

Sir Mike Penning, MP for Hemel Hempstead and co-chair of the All-Party Parliamentary Group on Medical Cannabis Under Prescription, said the hold up in prescribing sick children marijuana is causing suffering for the child and unconscionable emotional and financial stress for the parents.

Paul Chrisp, director of the Centre for Guidelines at NICE, said he appreciated that some would be disappointed that it has not recommended wider use of medicinal cannabis. But he said there was a lack of “a robust evidence base for these mostly unlicensed products” and it could not make any positive recommendations about using products like Sativex.

The UK legalized medicinal cannabis in November 2018, but a lack of support from bodies like NICE, the Royal College of Physicians and The British Paediatric Neurology Association have prevented doctors from actually prescribing it to all but a handful of patients.

Politicians, patient groups, and cannabis companies have lobbied hard for the guidelines to be relaxed, but thus far the NHS has not budged.

Yet campaigners took some solace from a new NHS England report on the barriers to accessing cannabis-based products for medicinal use on NHS prescription. It agreed that more trials are needed, but it said the UK should take into account children’s experiences in other countries as evidence of marijuana’s strong medicinal benefits.

Hannah Deacon, whose son Alfie Dingley is one of just two patients with an NHS prescription, said she was also bitterly disappointed by NICE’s ruling. She argued that hundreds of thousands of people across the world are using medicinal cannabis and enjoying enormous health benefits from it, while accusing the UK of trying to reinvent the wheel to the detriment of patients.