The Regulation of Traditional Chinese Medicine (TCM) in the UK: A Narrative Review

The use of Traditional Chinese Medicine (TCM) is expanding worldwide. In the UK, TCM has developed rapidly since the 1990s, but limited scientific evidence supports its safety, quality, or efficacy. This creates challenges for regulatory governance and public health protection.Objective:To review the development of TCM regulations in the UK and examine how existing regulations address safety, quality, and efficacy through different regulatory instruments, objectives, targets, and enforcement mechanisms. A narrative literature review was conducted, which is supplemented by grey literature searches of government reports and legislative documents published between 1970 and 2020. Thematic and chronological analyses were applied to map regulatory transitions and classify instruments and objectives. Ten key regulations and policy documents were identified, forming a hierarchical and fragmented framework dominated by product-focused oversight. While the system ensures basic safety and quality standards, it lacks consistent mechanisms for enforcement, practitioner regulation, and efficacy assessment. UK-TCM regulation has evolved through a mix of EU and domestic legislation, but gaps in enforcement and practitioner oversight persist. Policymakers should develop proportionate efficacy evaluation methods, enhance enforcement, and establish clearer practitioner standards to ensure safe, evidence-informed practice in post-Brexit UK health policy.