1. Join a supportive community

Join The Medical Cannabis Clinicians Society here. Membership gives you access to a peer support network of prescribers, expert mentorship, regular sector updates and reduced entry for events and training.

Speak to our committee members, who are already prescribing. Share your experience of learning and training, share evidence and research and ask for support, 24/7.

2. Familiarise yourself with the guidelines

Since Medical Cannabis became legal in 2018, the Government, NICE and other bodies, have produced guidelines for clinicians. Here is an overview of some of the more important publications:

3. Get some training and explore the evidence 

It is crucial to access robust, evidence-based training and product information when learning to prescribe medical cannabis..

Face to face training

Explore and add to the evidence base

The Medical Cannabis Clinicians Society has developed an independent database of evidence for members which brings together research studies and papers featuring human and animal studies. This gives clinicians the ability to review global published research in one place.

Drug Science’s Project Twenty21 is creating a body of evidence using a real-world data (RWD) registry to document efficacy, safety, quality-adjusted life year and patient reported outcomes with regards to medical cannabis use. By later 2024 it has recruited nearly 5000 patients, creating the largest body of evidence for the effectiveness and tolerability of medical cannabis.

4. Learn about cannabis-based medicinal products, their availability and interactions

Your training should include detailed information about products, possible interactions and the current landscape for prescribing as set out below.

Cannabis-based products for medicinal use (CBPM) are new to the vast majority of prescribing doctors. According to NHS England, products are classed as CBPMs of they satisfy the following  three requirements:

• The product is or contains cannabis, cannabis resin, cannabinol or a cannabinol derivative
• It is produced for medicinal use in humans; and
• It is a product that is regulated as a medicinal product, or an ingredient of a medicinal product.

It is important to note that CBD oil products are available to purchase over-the-counter without prescription and are not classed as medical cannabis as they do not contain any, or very little, THC. They are classed as food supplements and subject to control by the Food Standards Agency. We recommend you read our publications on CBD products.

Importing CBPMs into the UK

At the time of writing, the Medicines and Healthcare products Regulatory Agency (MHRA) allows CBPMs to be brought into the country via wholesalers, through a specialist import licence. The products must be made to eu GMP standards which basically means to the highest pharmaceutical standard. Thus prescribers can be reassured that the products available in the UK are fit to prescribe and all have been approved for import.

Most products are imported but in 2024 UK growers began to supply UK products to the medical market. There is still variability in the supply chain and prescribers should check availability through the pharmacies (often linked to the clinics) before prescription.

• Read the MHRA guidance 

Availability of cannabis based medicinal products

MedBud Wiki maintains an excellent, in-depth overview of available products in the UK. The Society can provide guidance on specific information about dosing and prescribing strains.

Drug interactions and adverse effects

The NHS Specialist Pharmacy Service has published information on potential drug interactions for both CBMP and CBD.

• Cannabidiol oil – potential adverse effect / Published 29th November 2018, updated 3rd January 2020
• Cannabis – based medicinal products – potential drug interactions / Published 30th November 2018, updated 10th January 2019
• Drugs.com also produces a useful interaction web resource

5. Find suitable premises

Clinicians wishing to prescribe medical cannabis in the UK must be associated with a CQC-registered clinic or hospital. It is possible to obtain a personal CQC license but that process is rather cumbersome.

In their November 2019 update, the CQC stated:

Specialist doctors who intend to prescribe and treat patients with cannabis-based medicinal products must be able to provide assurance and demonstrate that they deliver safe and effective care in line with relevant legislation and guidance. 

Doctors wishing to prescribe medical cannabis can do so:

• From rooms in a private practice or rooms in a clinic with CQC registration
• As an employee of a medical cannabis clinic
• If they have practising privileges or if you have a contract in an existing service with CQC registration

If you would like to see patients in their own home, the CQC Statement of Purpose must include home visits. The CQC produced updated guidance in 2022 and in 2024.

ScriptAssist also has options for independent clinicians to prescribe with their support.

6. Apply for your ‘Pink Pad’

When you have suitable premises from which to prescribe, you’ll need to apply for your private controlled drug prescription pad (CDFP10), often referred to as the ‘pink prescription pad’.

1. Find your controlled drug accountable officer (CDAOs are responsible for all aspects of controlled drugs management within their organisation). The CDAO for the application needs to be the one covering the geographical area of the clinic from which you will practice. The address can be found via NHS England.
2. When your application is approved, you will usually wait a few weeks for it to be printed. Your CDFP10 is sent to the premises from which you are going to practice. It can take up to two months.

7. Familiarise yourself with the specials prescribing system

When it comes to accessing the product, after prescribing, it’s important that products are prescribed in the best interest of the patient, not because there is any commercial link to the product from the doctor.

Familiarise yourself with the specials prescribing system, in these guidelines from the Royal Pharmaceutical Society. This is needed for all unlicensed products which includes all cannabis-based products except Epidiolex and Sativex from Jazz Pharma which are licensed medicines (and Nabilone, Cesamet, a synthetic cannabis medicine from Valeant).

Medical cannabis products are classed as controlled drugs so the pharmacist has responsibility to work through the associated processes. The Royal Pharmaceutical Society has helpful guidance – Medicinal Cannabis Pharmacy Alert – which summarises what pharmacists need to do.

The best thing to do is speak to your local pharmacy, prior to issuing your first prescription, so they have some warning. Though it will depend on the pharmacy, speaking to them beforehand is likely to benefit the patient.

8. Review your indemnity insurance arrangements

In England, doctors working for NHS trusts and health and social care bodies are provided with indemnity insurance through the Clinical Negligence Scheme for Trusts (CNST). Similar arrangements are in place for Scotland, Northern Ireland and Wales.

As medical cannabis in the UK is currently effectively only available privately, doctors must have suitable insurance.  The GMC state that doctors working in private practice in the UK must have “adequate and appropriate insurance or indemnity arrangements in place covering the full scope of your medical practice”. This means that even if doctors are working privately within an NHS or health and social care body premises, they must still be covered.

If you already have insurance in place, then review the terms of your coverage. If you’re looking for insurance which covers medical cannabis prescriptions, read the Society’s insurance guide which includes links to insurance brokers with medical cannabis in their coverage. The MCCS has good links with a broker who can provide indemnity cover.

9. Start seeing patients

Assuming you have met all the above requirements, you will now be in the position to prescribe for your first patient.  Clinicians must ensure:

1. They have discussed medical cannabis treatment options in full with the patient
2. Patients should have tried at least some of the licensed treatments available to them. The regulation on this point is not entirely clear. Many clinics insist on the patient having taken at least two licensed medicines for their condition. Others “allow” the use of other appropriate treatments such as over-the-counter analgesia for pain or non-pharmaceutical intervention such as therapy, counselling, etc., for anxiety. As long as the use of cannabis is not first line and in the Best Interest of the patient, then a prescription of cannabis is acceptable.

When you have satisfied these requirements:

• Write the prescription

The prescription will need to approved by a peer panel of prescribing doctors or clinicians before being available the patient. Most private clinics have this system available and now there is similar support for individual doctors. The Regulations about peer panel approval of follow-up prescriptions is not clear. Most clinics adopt a pragmatic approach that requires approval for any “significant” dose change or change of product or, as recommended in our Clinic Good Practice guide, for prescription of high THC flower or for high volume of flower (perhaps over 22% flower and more than 2gs daily). We consider this good practice.

• Let your patient know they can take the prescription to any pharmacy

You may wish to share your knowledge about local pharmacies or previous experiences with chemists in their area. Many clinics have linked pharmacies although there must be no obligation that the linked clinic will be used.

• Arrange a follow-up appointment with the patient

The first appointment should normally be at about one month (the prescription is only valid for one month). Thereafter the frequency of clinic appointments is at the discretion of the prescriber and in accord with clinic practice, depending on the patient response to treatment.

10. Share your experience with your peers

In the UK, prescribing medical cannabis for patients is still at a fairly early stage, with relatively few prescribers (about 150 in total).  It’s so important that clinicians share their experience of the sector, treatments and products and patient outcomes with their peers, so doctors can benefit from each other’s knowledge.

You may wish to talk about your experience with applying for your pink pad, discuss the arrangement with your premises or share what your patient felt about different products.

A good way to do this is via the Medical Cannabis Clinicians Society’s secure peer support group for members or at our monthly virtual Member’s Meet Ups.  Join Today.

11. Commit to your continuous professional development

Commit to your ongoing learning about this rapidly changing field.

Stay up to date with the developments in legislation by signing up to the Medical Cannabis Clinicians Society’s newsletter.

Members of the Society have access to hours of webinar recordings within the Member’s Area.