NHS Medical Cannabis: Who Can Get It, How Pathways Work, and Why Access is Still Rare

In November 2018, the rescheduling of cannabis under the Misuse of Drugs Regulations 2001 allowed CBPMs to be prescribed under certain circumstances, by doctors on the GMC specialist register.

 

As of June 2026, an estimated 140,000 patients are thought to be accessing treatment with medical cannabis, but fewer than 10 have access on the NHS, according to a report by Prohibition Partners. 

 

The majority of CBPMs are prescribed by private clinics where eligibility is determined on a case-by-case basis. 

 

Licensed vs unlicensed cannabis medicines 

 

There is an important distinction between the different types of medical cannabis products available in the UK. 

 

• ‘Unlicensed CBPMs’ refers to products that have not been assessed by the MHRA for safety, quality or efficacy. 

 

• ‘Licensed cannabis medicines’ are products that have been granted marketing authorisation (known as a ‘licence’) by the regulator.

 

The majority of CBPMs prescribed in the UK are unlicensed, meaning they have not yet received market authorisation. 

 

Only three CBPMs have a marketing authorisation: Sativex, Epidyolex and Nabilone. 

 

What conditions is medical cannabis prescribed for on the NHS?

 

Currently, the National Institute for Health and Care Excellence (NICE), which makes recommendations based on cost and evidence of safety and efficacy, only advises the prescription of these licensed cannabis medicines on the NHS. 

 

These include: 

 

• Multiple Sclerosis: Sativex is prescribed for the treatment of spasticity in patients with MS.
• Treatment-resistant epilepsy: Epidiolex can be prescribed for seizure management in children with Lennox-Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complex.
• Chemotherapy-induced nausea and vomiting: Nabilone is something prescribed to cancer patients to help manage the side effects of chemotherapy.

 

NICE’s guidance on CBPMs was first published in November 2019 and remains current following its most recent review in May 2025, which did not result in a change in practice.

For chronic pain, NICE does not currently recommend THC, THC combined with CBD, nabilone or dronabinol, while CBD should only be offered as part of a clinical trial. However, it has called for further research into the clinical and cost-effectiveness of CBD for adults with fibromyalgia or persistent treatment-resistant neuropathic pain.

 

An NHS case study 

 

In April 2023, Mike Roberts secured the first NHS reimbursement for medical cannabis flower prescribed through a private clinic to manage chemotherapy-induced nausea and vomiting (CINV).

 

Roberts was 42-years-old when he was diagnosed with terminal cancer in 2021 and started on palliative chemotherapy treatment. After experiencing “severe nausea and vomiting” associated with the treatment, in May 2022 he obtained his first private prescription for THC-predominant cannabis flowers.

 

According to a case report, later that year he approached his GP about submitting an individual funding request (IFR) to the NHS South, Central, and West Commissioning and Support Unit. 

 

The application is said to have been denied twice: the first time due to the panel mistakenly believing it was for the funding of Sativex, the second as he had not exhausted all other treatment options, including Nabilone, a licensed cannabis-based medicine which can be prescribed through the NHS.

 

After trying Nabilone with “minimal efficacy”, the report states that his GP resubmitted the IFR in March 2023 and in April the panel agreed to fund the application, as well as the cost of a certified medical vaporiser, for the administration of his medication. 

 

At last year’s Cannabis Health Symposium, Dr Rob Forbes, a pain consultant in the NHS, also described his experience of the process of submitting two chronic-pain IFR applications, which were successfully approved. 

 

“You really have to exhaust all available options on the NHS before an unlicensed medicine will even be considered,” he explained 

 

“Even submitting an application needs support from your fellow peers … and I also needed senior clinicians. [The patient] has now been stable for approximately two and a half years… but it’s been fraught with difficulty for me having to constantly keep justifying it.”

 

Why is medical cannabis not widely prescribed on the NHS?

 

While NICE guidelines state that CBPMs can be prescribed in any individual case, where a specialist deems it to be ‘clinically appropriate’, the limited number of NHS prescriptions can be linked to multiple factors.

 

When a doctor chooses to prescribe an unlicensed medicine, they accept full responsibility and would not be protected by their NHS trust or health provider should anything go wrong. 

 

A lack of clarity around funding pathways — clinicians must make an Individual Funding Request to their own NHS trust — a gap in education and training around these products, and the limited guidance provided by relevant medical bodies prevent many doctors from feeling comfortable prescribing CBPMs. 

 

“We need clinicians in the NHS who feel confident and knowledgeable about how to prescribe medical cannabis,” Forbes explained.  

“And the second thing we need is a pathway that facilitates them actually issuing the prescription.”

 

Can I take prescribed medical cannabis in hospital?

 

While unlicensed CBPMs are not prescribed on the NHS, several trusts now have formal guidance in place for patients who wish to continue taking privately prescribed CBPM medications while in hospital.

 

Where an unlicensed cannabis-based medicine is confirmed to be legally prescribed, this can continue to be administered while the patient is admitted to hospital, if the prescriber, in discussion with the multidisciplinary team, considers it appropriate to do so. 

 

NHS staff do not need to issue a new prescription and will not dispense these medicines. The patient’s existing prescription can be transcribed onto the inpatient prescribing record as part of a ‘medicines history/reconciliation process’ and is ‘not considered prescribing’ but a ‘patient-specific direction to administer a CBMP while the patient is an inpatient’. 

 

Will medical cannabis be prescribed on the NHS in the future?

 

Over the last eight years, patient advocates have continued to campaign for medical cannabis to be more widely available on the NHS.

 

A new white paper published this month by the advocacy group United Patients Alliance calls for a national NHS pilot programme, an updated NICE review of cannabis-based medicinal products (CBPMs), and a formal parliamentary inquiry into the barriers to NHS access. 

 

The authors say the pilot programme would generate UK-specific real-world evidence under standardised clinical conditions and establish the cost-effectiveness data that commissioners and NICE require before population-level adoption. 

 

This was an approach also highlighted by Dr David Tang, a consultant in emergency medicine, speaking at the Cannabis Health Symposium in 2025.

 

“By focusing on the patient-reported outcome measures, you then gather evidence that is combined across all of the private medical landscape, and you demonstrate what the true benefit is to the patients,” Tang said. 

 

“You demonstrate the health economic benefits. That’s a language that NICE understands, and then together what you’ve got is a bridge, a language that both understand.”

 

It comes as the Advisory Council on the Misuse of Drugs is due to publish new recommendations on the legislative framework for the prescription of CBPMs in the UK, following a major review carried out last year. 

 

Taking place on Thursday 26 November in London, the Cannabis Health Symposium will host a session dedicated to exploring the current NHS landscape for licensed and unlicensed cannabis-based medicines, including barriers to wider adoption and how private providers can work effectively alongside NHS services, opportunities for collaborative care models, and what changes may be required to improve patient access within mainstream healthcare settings.

Frequently Asked Questions

 

Can my GP prescribe medical cannabis on the NHS?

Generally, no. Under current UK regulations, unlicensed CBPMs can only be initiated by a doctor on the GMC Specialist Register. A GP may be involved in a patient’s ongoing care, but they cannot independently initiate a prescription for an unlicensed CBPM.

Do I need a referral for medical cannabis in the UK?

No, you do not need a GP or NHS referral to access medical cannabis in the UK. Patients seeking treatment privately can approach a medical cannabis clinic directly, where their eligibility will be assessed by a specialist doctor. A private clinic may require access to a patient’s medical records or Summary Care Record to assess their medical history, previous treatments and suitability for treatment.

How much does medical cannabis cost privately?

Patients who cannot access medical cannabis through the NHS generally have to pay privately for their treatment. Costs vary depending on the clinic, prescribed product and dosage, and may include consultation, follow-up and prescription or dispensing fees.

Can I get medical cannabis on the NHS for chronic pain? 

Medical cannabis is not routinely prescribed on the NHS for chronic pain. Current NICE guidelines recommend that THC, THC combined with CBD, nabilone and dronabinol should not be offered to adults for the management of chronic pain, while CBD should only be offered as part of a clinical trial.

A specialist may consider an unlicensed cannabis-based medicine where they believe there are exceptional clinical circumstances, although this remains rare.