Although theoretically doctors can prescribe medical cannabis for a few medical conditions, in practice, cannabis use for managing medical conditions remains relatively low. It means that the healthcare system is not fully utilising the benefits of medical cannabis. This also means that many patients who might have benefited are not being prescribed these medications.
Medical cannabis is legal in the UK, but getting a prescription is far from easy. The law changed in November 2018, and since then only a small number of people have been able to access it. The process is strict, narrow, and often frustrating for patients. So, understanding each step is important, especially for those hoping to qualify.
Step 1: Know who can prescribe
It is also vital to understand that GPs cannot prescribe medical cannabis. Only doctors listed on the specialist register of the General Medical Council (GMC) are allowed to do so. This means a GP can refer you to a specialist, but they cannot write the prescription themselves.
This rule alone makes access difficult. Patients first need to convince their GP to make a referral. Many GPs feel unsure about cannabis-based medicines or worry about the lack of evidence. Some refuse to refer altogether. That leaves patients stuck before the process even begins. Navigating the legal landscape of cannabis in the UK may also help understand the topic.
Step 2: Show standard treatments have failed
Moreover, specialists cannot prescribe medical cannabis as a first option. Patients must prove that other licensed medicines have already been tried.
Thus, for epilepsy, this might mean multiple anti-seizure drugs. For multiple sclerosis, standard spasticity treatments have failed. For chronic pain, a range of opioids and nerve pain medicines have failed to help.
This requirement blocks many patients. If a doctor believes that you have not exhausted all other routes, they will not prescribe cannabis for medical conditions. The system is built to keep cannabis as a last resort, even when standard medicines cause severe side effects or do not work. For example, even non-opioid drugs like benzodiazepines, various anti-depressants are known to cause numerous side effects, yet they remain preferred treatment over cannabis in most instances.
Step 3: NHS or private pathway
The NHS pathway is technically open, but in practice very few prescriptions are issued. NHS trusts require strict approval processes, and committees must sign off on each case. Data shows only a handful of NHS prescriptions have been written since 2018.
Consequently, most patients turn to private clinics. These clinics are legal and employ specialists who can prescribe cannabis-based products. The problem is cost. Initial consultations can be hundreds of pounds, with monthly prescriptions running into several hundred more. For families already struggling, this makes access impossible.
Step 4: The specialist assessment
If you reach a private clinic, the next step is a full assessment. The specialist reviews your medical history, your past treatments, and your current symptoms. Evidence is key. Patients must provide medical records, test results, and letters from previous doctors. Without this, the specialist may refuse.
Even at this stage, there is no guarantee. Specialists are cautious. They must justify their decisions and remain under scrutiny from regulators.
So, if they feel the case is weak, they may decline to prescribe. Patients often report disappointment after long waits and high fees.
Step 5: Prescription and pharmacy
If approved, the prescription is usually for a cannabis-based medicine such as oils, capsules, or sprays. These are dispensed through licensed pharmacies that handle controlled medicines. Supplies can still face delays, and some products may not always be in stock.
The cost is a continuing challenge. These medicines are rarely funded by the NHS, so patients under private care must pay the full amount. For many families, this can mean several hundred pounds each month.
Step 6: Follow-up reviews
Prescriptions are never permanent. Specialists require follow-up reviews every month or every few months. This allows them to check for side effects, dosage issues, and ongoing benefit. Patients pay for each appointment. If progress is not clear, the prescription may be stopped.
This cycle of ongoing costs and reviews adds to the difficulty. Patients who cannot afford regular consultations lose access, even if the medicine helps.
Why access is so limited
The barriers are deliberate. Regulators fear that wider access would lead to misuse or unsafe prescribing. They insist on more evidence before the NHS will expand use. Clinical trials are slow, and until results are stronger, the rules are unlikely to change.
Campaigners argue that the system punishes patients who could benefit. Children with epilepsy, adults with chronic pain, and people with multiple sclerosis often struggle while waiting for approvals. Families feel forced into private care, where costs are crushing.
The reality for patients
For many, the pathway feels like a dead end. Each step is another hurdle: GP referral, failed standard treatments, NHS refusals, high private costs, cautious specialists, and ongoing reviews. Success stories exist, but they remain rare.
Medical cannabis is legal in the UK, yet for most people it might as well not be. The law opened the door, but only a narrow gap. Until access is simplified, patients face an uphill battle just to try a treatment that could help.
