How Do You Get a Medical Cannabis Prescription in the UK?

Medical cannabis was legalised in the UK on 1st November 2018, following years of extensive campaigning. However, over half of the British public are still unaware that they can legally access cannabis as a medicine.

If you’re wondering how the medical cannabis process works in the UK, here’s a one-stop guide covering medical cannabis on the NHS, medical cannabis through private clinics, eligible conditions, how the process works, what types of medicines are prescribed, as well as information about patient groups, Cancard and other useful resources.

What does the UK’s medical cannabis model look like?

The UK’s current medical cannabis model allows patients to access medication via the NHS or through a private clinic or practice. Any clinician on the General Medical Council’s (GMC) specialist register can prescribe medical cannabis if it’s in the patient’s best interest (although most clinics show a list of eligible conditions) – or in simpler terms, only specialist clinicians can prescribe (not GPs).

NHS Access

For those looking to access medical cannabis via the NHS, there are currently only three licenced medical products that can be prescribed:

• Nabilone (synthetic THC) – used as an add-on treatment for chemotherapy-induced nausea and vomiting
• Sativex (THC:CBD spray) – to treat moderate-to-severe spasticity in adults with Multiple Sclerosis 
• Epidiolex (CBD isolate) – prescribed alongside clobazam to treat seizures associated with Lennox-Gastaut syndrome and Dravet syndrome in children

Any products aside from these three are not licensed in the UK – it is very unusual for unlicensed medicines to be prescribed and reimbursed on the NHS.

Although licensed products can be legally prescribed by an NHS consultant, in practice very few prescriptions have been written due to little research into cost effectiveness. Therefore, access to medical cannabis via the NHS is very rare and is unsuitable for most patients. There are several reasons for why the NHS does not currently prescribe cannabis-based medicines – the main ones being a sufficient evidence base and a health-economics analysis. 

Guidance from the NHS states that GPs can make a referral to a specialist clinician for a medical cannabis prescription once the patient has reached an ‘appropriate point on their treatment pathway’. This is usually when there is clear published guidance and once other treatment options have been exhausted. 

Private Clinics

Despite any clinician on the specialist register being eligible to prescribe, in our Known Unknowns report we found that only 0.25% of eligible doctors are currently prescribing. While some companies like Script Assist are looking for solutions to make it easier for clinicians to prescribe from their existing practice, the reluctance of the NHS to issue prescriptions means that the private clinic model dominates in the UK. For many patients, this option provides a quicker route to accessing medical cannabis without the barriers of the NHS, albeit costly. A number of these clinics offer online appointments and so can service patients anywhere in the UK, and in the coming months independent prescribing will be available via the Script Assist platform.

There are a number of private clinics in the UK which currently treat an estimated 25,000-32,000 current medical cannabis patients, although the exact number of patients is unknown. Private clinics allow patients to access a medical cannabis prescription for a relevant qualifying condition or symptom. It’s important to note that the products prescribed by these clinics are unlicensed cannabis medicines, and are not the same as the products prescribed by the NHS (listed above). See the table below for a list of UK medical cannabis clinics: 

(Last updated 21/09/23)

*LVL Health’s pricing structure is unique, with the £299 p/m fee including a monthly consultation and prescription – as part of a clinical trial.

**Birmingham Cannabis Clinic is partnered with Sapphire

So, how do I know if I’m eligible for medical cannabis? How do I access a cannabis prescription?

To access a private medical cannabis prescription the guidance from NICE recommends that you must have a qualifying condition or symptom and have previously tried at least two prescription medications/treatments. However, a clinician may issue a prescription without this if they feel the patient is a suitable candidate. The main conditions for which medical cannabis treatment may be considered are: 

Step 1

The first step in the process to accessing a medical cannabis prescription is to get in contact with a private clinic or find a specialist doctor prescribing from their private practice. There is some variation in what each clinic treats, so it is important to do research beforehand to ensure the clinic is suitable. Check out the table above for a list of medical cannabis clinics in the UK.

Step 2

At this stage your chosen clinic will ask you to complete an initial screening session/eligibility assessment (which is usually free of charge). This helps the clinic to get an idea of your health status and medical history, and helps them determine whether a medical cannabis prescription is an appropriate treatment option. Even patients with conditions that are eligible for treatment may not be individually eligible. 

To carry this out the clinic may ask for a copy of your Summary of Care records from your GP so that they have all the relevant information. The clinic may be able to access this themselves, but sometimes it may be on the patient to request these records. 

Step 3

Once the clinic has determined that a medical cannabis prescription is appropriate, the next step is to set up an initial consultation with a specialist doctor. This appointment can range from £49-£299 depending on which clinic you choose. Some clinics allow patients who are already signed up to a different clinic to switch for free or at a discounted rate. 

During this appointment, the clinician will ask you various questions relating to your condition and symptoms, previous treatments you’ve tried, what you hope to achieve with medical cannabis and any history of cannabis use. The appointment is also an opportunity to ask any questions you may have. 

Although this may seem like a daunting experience, it is important to be open and honest so that they can determine the most helpful course of treatment. If the doctor feels that medical cannabis is right for you then they will write your first prescription for cannabis flower or oil. 

Step 4

Once you have your prescription it needs to be processed and fulfilled by a pharmacy. Technically, any pharmacy can dispense, but usually only specialist pharmacies stock medical cannabis and most high-street pharmacies are likely unable to dispense.

Most clinics will have pharmacies associated with them and so they may recommend these. However, it’s the patient’s decision to choose who they go with. If you want to go with a different pharmacy you can ask your doctor for a copy of your prescription and take it to any pharmacy which dispenses medical cannabis products.

Have a look at the table below for a list of specialist pharmacies that dispense medical cannabis in the UK: 

(Last updated 21/09/23)

Again, it’s important to do your research before selecting a pharmacy as delivery fees and times vary. 

Once the pharmacy has processed your prescription they should contact you to make payment, with your prescription sent to you via courier within 48 hours of your payment being received. 

Step 5

As doctors are only able to issue one prescription per patient per month you will have to book a follow up appointment to continue receiving your prescription. Although the consultant must issue your first prescription, it’s helpful to note that GPs and/or pharmacists can issue follow up prescriptions through a clinic. During the consultation the doctor will assess how you’re getting on with your prescription and adjust the dose/product if necessary. It is important that you attend this appointment in order to access repeat prescriptions in the future.

The cost of a follow up consultation varies depending on the clinic, with prices ranging between £45-£299. 

What kind of medical cannabis is available?

Cannabis-based medicinal products (or CBMPs) come in a variety of forms. The product your doctor prescribed will be dependent on a number of factors such as your age, severity of symptoms, your condition and your health. 

It’s important to note that both licensed and unlicensed cannabis products are very different to over the counter CBD products. Medical cannabis is regulated by strict guidelines to ensure a medical grade product is created for patients with a range of conditions and symptoms. While medical cannabis may often contain the cannabinoid compound cannabidiol, known as CBD (as well as THC and other cannabinoids), over the counter ‘CBD products’ are derived from hemp oil, do not contain THC, and are considered wellness products and are classed as a novel food. 

There are a range of unlicensed products on the UK market available to be prescribed, such as (but not limited to):

Cannabis Flower

This person is grinding up flower to put into a handheld vaporiser. Source: Drug Policy Alliance

Cannabis flower refers to the dried bud of the cannabis plant. Your doctor should explain to you the starting dose and maximum daily dose, as well as how to consume it. 

In the UK, cannabis flower can only be vaporised and not smoked, as smoking your prescribed flower is illegal. Due to this patients require a dry herb vaporiser which heats the cannabis to a temperature where the beneficial compounds of the plant are vapourised and then inhaled. 

To prepare the medicine it is recommended that patients acquire scales that are accurate to 0.01g to weigh out the flower into doses. It can also be useful to use a grinder to break the flower down into a fine, more consistent form for the vaporiser. 

To consume cannabis flower it is recommended that patients use scales that are accurate to 0.01g to weigh out their medication into doses. To prepare a dose it is useful to break down the flower further with a grinder to ensure a finer, more consistent form for the vaporiser. 

Cannabis Oil

This person is holding up cannabis oil in a dropper. Source: Drug Policy Alliance

Cannabis oil comes from extracts taken from dried cannabis flower. The oils are often taken sublingually (under the tongue). Similarly to cannabis flower, your doctor should explain the appropriate starting and maximum doses, and how to administer the medication. 

Medical cannabis oils often come with a dropper and dose indicator accurate to 0.05ml to help you measure out your dose. To administer the dose you should place the end of the pipette under your tongue and squeeze the dropper to release the medication. You should hold the oil under your tongue for 30-60 seconds before swallowing to help with the absorption of the oil.

Vape Cartridges

This person is using a ‘vape pen’. Source: Drug Policy Alliance

Vape cartridges (or carts) are containers filled with cannabis oil that is meant for inhalation. To take the medicine the cartridge is attached to an atomiser which is connected to a rechargeable battery known as a pen or ‘vape pen’. Cartridges must be screwed onto the pen. The user then presses a button, heating the oil, and then inhales the vaporised oil. 

Capsules

Medical cannabis capsules are small tablets that are filled with a measured dose of cannabis oil. They may resemble pills or other prescribed medications you have taken before and are taken orally. This oil may contain CBD only, or a combination of CBD and THC or other cannabinoids depending on your prescription. Your doctor will tell you how many capsules to take a day and when to take them. 

How much will my prescription cost? 

The cost of a medical cannabis prescription depends on the patient and what is prescribed, as each clinic has different costs and products. Estimates suggest that the average monthly prescription for flower is around £200-£300, based on a prescription of 30g. Cannabis oil is generally more expensive and some patients have reported paying £1000 a month for one product. 

As well as medication prices, patients must also consider the cost of initial consultations, follow up consultations and any extra fees specific to the clinic or pharmacy. 

Access Schemes

If you are struggling to afford the cost of a medical cannabis prescription, there are a few access schemes that may be able to help. Access schemes allow qualifying patients to access clinic services and medication at a discounted rate in exchange for taking part in data collection for observational studies. 

T21 is an access scheme that was set up by Drug Science in 2021 to allow patients to access medical cannabis at a discounted cost, whilst collecting real data on the effects of CBPMs. Joining this scheme entitles the patient to a minimum 5% discount off prescribed products from the T21 formulary. To join the scheme, the patient must inform their doctor during the initial consultation. When your prescription is approved, the clinic will notify the pharmacy of the discount. 

Similar to T21, the Sapphire Access Scheme also provides financial help with prescription costs. Signing up to the scheme requires consent for data to be shared with the UK Medical Cannabis Registry, and allows patients to access £50 appointments. All patients receiving medical cannabis treatment through the Sapphire Clinic are eligible for the Scheme. 

The Mamedica Access Scheme is relatively new, having only launched in 2023, and is open to veterans and new patients receiving benefits. The scheme allows patients to access initial consultations, follow up consultations for life and repeat prescriptions for the up front cost of £200, although medication costs are not included in this. 

The Grow Access Project (or GAP) works in collaboration with Integro Clinics, with the aim of reducing cost-related barriers to access to prescribed cannabis medicines. The project is open to patients on low-oncome or disability benefits and veterans of the UK armed forces and allows eligible patients to access a free initial consultation, discounted follow ups and reduces the cost of a select formulary of medicines. To be eligible for GAP, patients need to complete the online registration questionnaires, and provide evidence of receipt of income or disability related benefits, or status as a UK armed forces veteran.

Other useful resources

Cancard

Despite access schemes which are designed to help with the cost of medical cannabis, the price of a prescription still remains prohibitive to those on a low income. To overcome this barrier, a scheme called Cancard was launched to help prevent people using cannabis medicinally without a prescription from being arrested. 

Similarly to private clinics, the Cancard scheme requires patients to provide evidence of a qualifying condition/symptom, and that they have already tried two prescription medications or treatments. 

Cancard membership costs £30, and allows the police to exercise discretion by recognising the patient caught in possession of cannabis has done so because of medical reasons. It’s important to note that having a Cancard is not the same as having a prescription from a doctor for cannabis medicines. Although the card aims to protect patients from arrest, it does not guarantee that they will avoid arrest. As well as this, patients with prescription should rely on their prescriptions as evidence of legality, and not Cancard.

Medbud.wiki 

Medbud.wiki is a resource for medical cannabis patients looking for product type, availability and cost at different clinics. The independent educational platform/directory provides a one stop shop for questions about the medical cannabis industry in the UK. Patients can use the site to research clinics, pharmacies and producers, as well as compare products and costs. 

Forums and patient advocacy groups

Forums and patient advocacy groups can provide a well-needed outlet for medical cannabis patients to access support and get out their thoughts and feelings.

Several groups in the UK help to campaign for patient rights and increased access to medical cannabis. Some of the most popular and well known patient advocacy groups are: 

• Patient-led Engagement for Access (PLEA)
• MedCan Support
• United Patients Alliance

As well as this, there are a large number of active patient groups across social media including on Reddit and on Facebook as well as other platforms, depending on your platform preferences. 

The journey to accessing medical cannabis in the UK can be a difficult and confusing one for new patients who aren’t familiar with the area. We hope this helps offer some guidance and advice on what to expect throughout the process, as well as any helpful resources you might need.