Cannabis-based medicinal products (CBMPs) have been legal to prescribe in the UK since November 2018. Since then, an estimated 95,000 patients have received prescriptions, supported by around 160 prescribers across approximately 40 private clinics. Despite this growth, NHS prescribing remains extremely limited. At the same time, the absence of mandatory training and consistently applied clinical standards has led to variation in practice across the sector.
The Medical Cannabis Clinicians Society (MCCS) has today published an updated version of its Good Practice Guide for Prescribers of CBMPs. This guidance is intended to support clinicians in making safe decisions and strengthen consistent prescribing in a developing area of medicine. It draws on the collective experience of the Society’s multidisciplinary membership, committee and executive, reflecting real-world prescribing across a wide range of clinical settings.
The Society’s position
Medical cannabis can be a safe and effective treatment option for selected patients, particularly where conventional therapies have been unsuccessful, when prescribed within a structured clinical framework with appropriate assessment, decision-making and follow-up.
Prescribing must meet the same standards expected of any other unlicensed medicine. Consistent application of these standards is essential to minimise risk for patients and maintain confidence in the sector. This guidance aims to define good practice, based on real-world clinical experience and supported by existing regulatory expectations.
Central to this is clinical responsibility. Prescribing decisions sit with the clinician. They must be justified, based on appropriate assessment, and always remain in the patient’s best interest. This includes independent decision-making and full accountability for documentation, monitoring and outcomes.
This guidance does not replace clinical judgement or existing regulatory frameworks. Medical cannabis remains an individualised treatment, and decisions must be made on a case-by-case basis. The aim is to support safe access to treatment while ensuring prescribing remains clinically appropriate, accountable and evidence informed.
A structured approach within existing regulation
The Good Practice Guide provides a practical framework covering:
- Patient assessment and selection
- Clinical decision-making and justification
- Informed consent
- Communication and documentation
- Prescribing and product choice
- Ongoing monitoring and follow-up
- Identification and management of clinical risk
These are standard principles of medical practice. The purpose of the guide is to apply them clearly and consistently to cannabis-based medicines. It reflects established principles already recognised by the Society, including careful patient selection, multidisciplinary input where appropriate, and thorough documentation of prescribing decisions.
This guidance sits alongside existing regulatory frameworks. Clinicians must continue to work within the standards set by the General Medical Council, Care Quality Commission, MHRA and NICE. CBMPs remain unlicensed “specials”, and prescribing carries the same responsibilities as any other unlicensed medicine.
The role of the Good Practice Guide is to translate these high-level requirements into practical, day-to-day clinical application, providing clarity on how regulatory expectations apply in the context of medical cannabis.
The Society is committed to working with regulators to support alignment, share clinical expertise and contribute to the development of clear, proportionate and workable oversight as the sector continues to evolve.
Safety in context
Medical cannabis has a favourable safety profile when prescribed appropriately. However, it is not risk-free and requires active clinical oversight. The updated guidance places clear emphasis on risk identification and management. Clinicians are expected to assess, monitor and manage:
- Side effects
- Drug interactions
- Mental health considerations
- Risks associated with higher THC exposure
- Potential for dependency or misuse
Prescribing should follow a cautious, structured approach. This includes starting at low doses, titrating gradually, and maintaining regular follow-up to assess response and tolerability, consistent with established prescribing principles.
What the Good Practice Guide (V4) covers
- Prescribing responsibilities, including initiation, shared care, and follow-up
- Core principles of CBMP prescribing, including unlicensed use and alternatives
- Indications for treatment and the role of evidence and clinical judgement
- Standards for initial consultation and assessment, including complex cases
- Contraindications, including medical, psychiatric and dependency risks
- Drug interactions, including psychiatric considerations and polypharmacy
- Available products, including quality, composition and terminology
- Practical prescribing guidance, including dosing, product selection and stopping rules
- Multidisciplinary oversight and peer review for higher-risk patients
- Safe prescribing and adherence, including consent, outcomes and access considerations
- Communication, documentation and ongoing monitoring
- Prescribing independence, pharmacy choice and information sharing
- Training and continuing professional development
- Supporting appendices, including published guidance and the MCCS evidence base
Raising standards in a developing field
“Prescribing cannabis-based medicinal products requires careful clinical judgment, a strong understanding of the evidence, and a clear grasp of professional responsibilities. This guide provides the structure and support clinicians need to practise safely, lawfully and in the best interests of their patients.”
— Professor Mike Barnes, Chair, Medical Cannabis Clinicians Society
Medical cannabis remains a developing area of medicine. The evidence base continues to evolve, clinical experience is expanding, and expectations around governance are becoming more defined.
The updated guidance provides clinicians with a clear framework for safe, accountable prescribing, and offers reassurance to patients, regulators and the public that medical cannabis is being prescribed within a structured, professionally governed system.
As the sector matures, consistent standards matter. This guidance sets a clear direction for safe, responsible prescribing across the sector.
The MCCS expects this Good Practice Guide to be adopted by prescribers and across clinics, supporting a consistent approach that prioritises patient safety and quality of care. This will help raise standards across clinical practice and the wider sector.
Access the Guide
The Good Practice Guide for Prescribers of CBMPs is available now for all.
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