Only specialist UK doctors can prescribe medicinal cannabis.
Patients and their carers should have sufficient information about the medicine to make an informed decision.
After the initial prescription, subsequent prescriptions can be made under a shared care agreement.

Cannabis-based products were made available for specialist doctors to prescribe legally from 1 November 2018. NICE provides clinical guidance on prescribing unlicensed cannabis-based medicinal products for patients with intractable nausea and vomiting, chronic pain, spasticity and severe treatment resistant epilepsy.

The GMC has also issued information for doctors prescribing cannabis-based products for medicinal use (CBPMs).

Who can prescribe cannabis?

GPs cannot make the initial prescription of cannabis products but can refer patients to a clinician on the GMC's specialist register if they believe cannabis products may benefit the patient.
A specialist can only prescribe if they're on the relevant specialist register and have a special interest in the condition being treated, working within the limits of their competence. Prescribing decisions should generally be agreed by the multidisciplinary team.
For children and young people under the care of paediatric services, the initiating prescriber should also be a tertiary paediatric specialist.

NHS England states that any decision to prescribe should be made by the multidisciplinary team.

After the initial prescription, subsequent prescriptions can be made under a shared care agreement under the direction of the initiating specialist prescriber, provided that:

shared care is appropriate and in the person's best interests
the person's condition is stable
the other prescriber is confident to make a fully informed prescribing decision about the product.

Shared care agreements should include arrangements for monitoring, evaluation and dose adjustment by the initiating specialist prescriber.

It's also essential that patients or their carers have enough information about the medicine to allow them to make an informed choice about taking cannabis-based products. Any decision made by the specialist and patient, and the reason for it, must be clearly documented in the clinical records.

Information and advice

The GMC advises that all adverse reactions should be reported to the Medicines and healthcare products Regulatory Agency's Yellow Card Scheme.

If, in their professional judgement, a doctor decides that prescribing a CBPMs is not appropriate for the needs of the patient, they should not be pressured into prescribing the treatment.

Read more about your prescribing duties and contact us for tailored advice.

Useful links

NICE recommendations

NHS England: FAQs - cannabis-based products for medicinal use

Information for doctors on cannabis-based products for medicinal use (CBPMs) - GMC

Prescribing cannabis-based products

More on prescribing

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