NHS vs Private Medical Cannabis in the UK

Most patients pay privately. Here is why — and the three cases where the NHS will fund treatment.

The short answer

NHS specialists are legally allowed to prescribe medical cannabis, but it rarely happens, so most patients pay a private clinic. The NHS funds it in three cases: Epidyolex for seizures in Dravet and Lennox-Gastaut syndromes, Sativex for spasticity in multiple sclerosis, and nabilone for sickness caused by chemotherapy.

NHS funding decisions and NICE guidance are subject to change. Always verify current information with your GP or specialist. Wording last changed on .

Why Most Patients Go Private

The 2018 rescheduling made it legal for specialist doctors to prescribe CBPMs on the NHS. In practice, it rarely happens. NICE (the National Institute for Health and Care Excellence) sets clinical guidelines that NHS commissioners use to decide what to fund. For most conditions, NICE has concluded that the evidence for CBPMs is insufficient to recommend NHS prescribing — not because cannabis-based medicines do not work, but because the randomised trial evidence does not yet meet the standard NICE requires for NHS recommendation.

The result is a legal situation where prescribing is permitted but commissioning guidance does not support it for most conditions. NHS clinicians who are not comfortable prescribing without NICE backing, combined with the perceived risk of prescribing an unlicensed product, means that private clinics have filled the gap.

In short: It is legal for an NHS consultant to prescribe medical cannabis, but most will not do so for conditions without NICE guidance, meaning private clinics are the practical route for most patients.

When the NHS Will Fund Medical Cannabis

Three specific situations — everything else is private

Epidyolex

NICE-approved (TA614 and TA615)

Seizures associated with Dravet syndrome and Lennox-Gastaut syndrome in patients aged 2 and over

Prescriber: Paediatric or adult neurologist

The most clear-cut example of NHS-funded medical cannabis. Highly purified CBD oral solution. Fully licensed as a medicine in the UK.

Sativex

NHS funding — subject to 4-week trial

Moderate-to-severe spasticity due to multiple sclerosis, where other antispasticity treatment has not been adequate

Prescriber: Neurologist (MS specialist)

Patients must demonstrate a clinically significant response during an initial 4-week trial period before ongoing funding is approved. Availability varies across England, Scotland, Wales, and Northern Ireland.

Nabilone

Licensed and routinely available

Nausea and vomiting caused by cytotoxic chemotherapy that has not responded to conventional antiemetics

Prescriber: Oncologist or haematologist

A synthetic cannabinoid (not derived from the cannabis plant) but included here as a licensed cannabinoid medicine. Widely available through oncology services.

Advantages of Private

  • Access to a far wider range of conditions and products
  • Faster initial assessment — often within 1–2 weeks
  • More choice of specialists and clinics
  • Products tailored more precisely to individual need
  • No requirement for NHS specialist referral first

Disadvantages of Private

  • Ongoing cost: you pay the clinic's fees and for your medication
  • Not covered by most private health insurance
  • GP may be reluctant to engage in shared care
  • Products are unlicensed specials in most cases

Shared Care — What It Means

Working with your GP alongside a private specialist

Shared care is an arrangement where responsibility for managing a patient's medication is shared between the specialist (who issues the prescription) and the GP (who provides day-to-day monitoring and may co-prescribe). For medical cannabis, this is complex — most GPs are not trained in CBPM prescribing and many will decline formal shared care.

1

Inform your GP

Tell your GP that you have been prescribed a CBPM. They are not obliged to enter a shared care agreement but should be kept informed — particularly regarding interactions with other medications.

2

Request a shared care letter

Many private clinics will produce a shared care protocol letter for your GP, explaining the medication, dose, monitoring requirements, and the clinical rationale. Some GPs will accept this; many will not.

3

Manage realistic expectations

The majority of GPs in the UK have not received training in medical cannabis and many will decline to co-prescribe or monitor formally. This does not mean you cannot proceed with private prescribing — it just means the responsibility for monitoring remains with your specialist.

4

Consider a GP referral first

If your condition has a pathway for NHS specialist referral (e.g. pain clinic, psychiatry, neurology), getting an NHS specialist involved first can sometimes lead to a more joined-up approach, even if prescribing ends up being private.

Can I Ask My GP to Refer Me?

Yes — and in some cases this is the right first step. If your condition has an NHS specialist pathway (pain clinic, rheumatology, psychiatry, neurology), getting seen by an NHS specialist first can sometimes result in a more co-ordinated approach. Some NHS consultants, particularly in pain management, are becoming more knowledgeable about CBPMs and may be willing to prescribe directly or support a private prescription more actively.

If you are not in an urgent situation, a GP referral to an NHS specialist is worth trying before committing to private fees. Be prepared for waiting times (NHS pain clinics typically have 6–18 month waits). Many patients pursue NHS and private routes in parallel.

Understanding Costs

Full private cost breakdown

How to Get a Prescription

Step-by-step guide

Find a Clinic

Browse private clinics and their fees

Ready to explore private options?

Browse CQC-registered private clinics with transparent pricing in our directory.

Browse Clinics

Sources

The official sources this page rests on. Each was read and checked on .