Currently in the UK, medical cannabis is only available to patients with an unmet clinical need on a private prescription basis. GPs are not able to initiate scripts for unlicensed cannabis based medical products under current UK legislation. However, GPs can play an important role in the management and monitoring of their patient’s use of medical cannabis, and a GP can prescribe for follow-up under the direction of a specialist.

When it comes to shared care arrangements, the NHS guidance states:

Whilst it is possible for a GP to continue prescribing legally, it is advised that all prescriptions will need to be initiated and signed by a specialist doctor. Consideration will be given to how shared care arrangements should or could work, including determining whether it is indeed appropriate to have such arrangements in place. If a doctor prescribes a medicine under shared care arrangements, he or she accepts clinical and professional responsibility for that prescribing decision.

Private GPs need to have an FP-10 special prescribing pad to undertake shared care prescribing of medical cannabis and have the permission of their CQC licensed clinic to do so.

A review by Christopher Hodges, emeritus professor of justice systems at the Centre for Socio-legal Studies at the University of Oxford, found in a survey of 1500 people, two thirds believe GPs should be allowed to prescribe medical cannabis.

GPs should be open minded about talking to patients who are self medicating with cannabis because it is becoming increasingly accepted in the UK as an effective means of treating various health conditions. It is becoming more and more available through prescription, meaning that it is legally used to treat a range of illnesses, including severe epilepsy, multiple sclerosis and chronic pain.

A YouGov poll carried out in October 2022 found that approximately 1.8million people with diagnosed medical conditions are turning to illegally obtained cannabis to manage their illness – 400,000 more than a similar report carried out in 2019. A study by Sapphire Medical Clinics found that nearly half of the UK population (48.6%) are unaware that medical cannabis is legally available on prescription since the law change in November 2018.

Given the increasing acceptability of cannabis as a medicine, GPs should be open minded about talking to patients who are self medicating with cannabis. Such conversations can help doctors to identify and treat any potential medical issues that arise from the use of cannabis and provide information about legal routes to treatment.

The Royal College of GPs (RCGP) has published guidance and resources for GPs interested in learning more about medical cannabis.  The RCGP eLearning course provides an in-depth introduction to medical cannabis, including information on the legal framework, clinical considerations and potential risks and benefits.

The Australian Royal College Of General Practitioners also provides some excellent information and resources for GPs who are interested in learning more and becoming active prescribers of medical cannabis.

The Society and PCCN have produced a range of educational resources to support GPs and clinicians to learn more. Members of the Society also have access to our peer support group to learn from and advise each other.

GPs in the UK are likely to find themselves encountering more patients who are being prescribed medical cannabis or who are using over the counter CBD for a range of health conditions. 

GPs need to be aware of the benefits and potential risks posed by over-the-counter CBD products. Many such products are not regulated and may contain varying concentrations of CBD, making them difficult to accurately dose. Furthermore, as these products are not subject to the same rigorous quality control measures and evidence-based standards as licenced products, it is difficult to know whether they are safe and effective.

Two guides below offer advice so doctors feel comfortable talking to their patients.