Unlocking Access: The Case for More Medical Cannabis Prescribers in the UK

Understanding the challenges, responsibilities, and pathway to becoming a cannabis prescriber

As more patients seek safe, regulated cannabis-based treatments, the bottleneck isn’t just supply, it’s clinical capacity. With only a limited pool of specialist prescribers in the UK, access hinges on how quickly and confidently we can support more clinicians to prescribe responsibly.

“As demand grows, the question isn’t should we prescribe, it’s how we equip clinicians to do it safely and consistently.”

What does ‘good practice’ look like when initiating CBPMs?

At CB1 Medical, good practice begins with ensuring patients are fully informed and feel empowered in their treatment decisions. They should understand all available options, what cannabis-based products may help with, and any potential risks or limitations.

It’s equally important to confirm that medical cannabis is appropriate and safe. Some situations make it unsuitable, so careful assessment is vital. Once treatment begins, we focus on whether it genuinely improves symptoms and quality of life. Regular reviews, adjustments, and clear communication ensure patients feel supported throughout their treatment journey.

How do you decide when a CBPM is appropriate versus a licensed alternative?

CBPMs are only considered after licensed treatments have been tried and either haven’t worked or haven’t been well tolerated. That principle makes sense – if a well-researched, licensed option is available, it should be tried first.

However, many patients have complex conditions or side effects that make standard treatments unsuitable. In such cases, medical cannabis may be the most appropriate option. Every case is judged individually, balancing the available evidence with what is clinically right for that person.

What governance or peer review supports your prescribing decisions?

At CB1 Medical, every prescribing decision undergoes peer review by clinicians experienced in medical cannabis. This ensures that each case is considered from multiple perspectives and that safety and suitability are prioritised.

Many of our patients have complex medical histories, so input from colleagues across specialties – for example, in cardiology or neurology – can be invaluable.

We also maintain strong governance systems. As a controlled drug, cannabis-based products require strict identity checks, accurate documentation, and careful reporting of any adverse reactions. Pharmacy oversight and legal compliance form an essential part of our prescribing framework.

What It Takes to Become a Cannabis Prescriber

Getting started: What training, policies and approvals did you need before initiating CBPMs (e.g., unlicensed-medicine consent, controlled-drug SOPs, PV/adverse event reporting, DVLA guidance)?

If you’d told me a few years ago that I’d end up being CEO of the largest medical cannabis clinics in the Channel Islands,  and one of the fastest growing and the most affordable in the UK, I probably wouldn’t have believed you. Because when this all began, I was looking at options that arose out of the Jersey Government allowing people to grow Medicinal cannabis on island. What I did have was an idea, sparked by reading about the potential of medical cannabis which was transforming the way people live with long-term conditions.

That idea turned into an 18-month deep dive into: research, planning, and surrounding myself with some of the best cannabis consultants and specialists from around the world. Very quickly, I realised that if Medicann was going to exist, it had to be built on proper clinical and regulatory foundations. No half measures. No shortcuts. Just a clinic that operated at the highest possible standard from day one and that put patients first.

Even though Jersey doesn’t fall under the UK’s CQC regulations, we chose to build Medicann as if it did. We aligned ourselves with the CQC, MHRA and good clinical governance guidelines; because if you’re prescribing CBPMs, patient safety isn’t optional. It’s essential.

And because this was completely new territory in the Channel Islands, no one had ever issued a medical cannabis prescription locally before — we had to work closely with the local government and regulatory bodies. There was a lot of engagement, a lot of explaining, and a lot of making sure everything we did was legally, ethically and clinically watertight before that first prescription was ever written.

From the outset, I believed that Medicann needed not just trained doctors, but the right doctors. Specialists in chronic pain, neurology, psychiatry; clinicians who understood the complexities of the conditions patients were living with, and who received dedicated training in CBPMs as part of joining the team. That commitment to expertise has shaped the clinic into what it is today.

On the operational side, we made sure every policy was firm and futureproof:

• Robust GDPR and patient-confidentiality policies
• All licenses and approvals required to operate in Jersey
• Proper controlled-drug governance
• Systems aligned with MHRA expectations and UK best practice

What started as a simple idea,  that medical cannabis could genuinely improve people’s lives; became a fully governed, safe, compliant clinical service. And that foundation is exactly why Medicann has grown into the award winning respected clinic it is today,  which is an award-winning clinic that can be found in Jersey, Guernsey, the Isle of Man, and now the UK.

Clinical decision-making: How do you select patients and choose formulation/chemotype and starting dose—and what are your titration and stopping rules?

At Medicann, patient safety and suitability always come first, so the journey starts with a simple pre-qualification process. Before anyone ever meets a doctor, we gather enough information to understand their condition, what treatments they’ve already tried, and whether CBPMs might genuinely be appropriate. It’s also at this stage where two hard rules apply: anyone under 21 doesn’t qualify, and anyone with a past history of psychosis or schizophrenia cannot be prescribed CBPMs. Those lines aren’t flexible — they exist purely to protect patients.

If someone looks like they may be suitable at the initial stage, they’re invited to share more detailed information through the free Medicann app. That’s where we start to understand the patient’s condition properly — their symptoms, patterns, day-to-day challenges and what they’re hoping to achieve. The more detail we get, the more personalised their care becomes.

After this and evaluation by one of our specialist doctors , every patient goes through a full review by our Multi-Disciplinary Team. This is one of the parts of Medicann I’m proudest of. Rather than a single clinician making a decisions, the patient’s case is looked at by a group of specialists,  people with backgrounds in chronic pain, neurology, psychiatry and other important areas. It means every patient benefits from combined expertise, not just one opinion.

From there, the patient’s doctor guides them on the most suitable type of medication. Different people need different formulations depending on their symptoms and lifestyle, so this could be flower, lozenges, capsules, oils or vape cartridges. It’s never a one-size-fits-all exercise; it’s about finding what genuinely works for the individual patient, and their personal preferences.  

When it comes to dosing, we follow the same responsible approach used by good clinics everywhere: start low and go slow. There’s solid science behind that. Everyone has a slightly different endocannabinoid system, meaning two people with the same condition and the same product can still respond in completely different ways. Building up slowly gives us the safest and most accurate way to find each patient’s ideal therapeutic range, without side effects or unnecessary discomfort.

It’s a careful, personalised and clinically grounded process, and it’s one of the reasons Medicann sees consistently strong outcomes across such a diverse range of conditions and patients.

Follow-up & coordination: How do you monitor outcomes and safety over time, and how do you coordinate with the dispensing pharmacy and the patient’s GP (including any shared-care arrangements)?

At Medicann, the relationship doesn’t end when the first prescription is written, in many ways, that’s where the journey begins. Every patient has regular follow-up consultations, usually every 3 months, so we can keep a close eye on how they’re responding. These reviews are there to make sure the prescription is doing what it’s meant to do, that the patient is comfortable with their treatment, and that any changes in their condition, lifestyle or other medications are properly factored in. Nothing stays static in healthcare, so these check-ins give us the chance to adjust, improve or rethink the treatment if needed.

Monitoring outcomes is a continuous process. We look at symptom patterns, functionality, sleep, side effects; all the things that genuinely matter to the patient in day-to-day life. And if something isn’t working, we don’t just sit back. We review, we adjust, and we guide the patient to where they need to be.

One of the unique strengths of Medicann in the Channel Islands is our partnerships with pharmacies in particular Delta 9 and 420 Pharma groups. These collaborations mean that once a doctor approves a prescription, patients can benefit from same-day dispensing — something you don’t often see with medicinal cannabis. For the patient, it creates a real sense of continuity and reassurance. They’re not left waiting for days or weeks, wondering when their medicine will arrive. It’s a smooth, dependable process where the clinic, pharmacy and patient are all aligned.

We also communicate with each patient’s GP, making sure their wider healthcare team is kept informed. If something changes, i.e.  the dose is adjusted, or if there’s a clinical concern, the GP is kept in the loop so there’s never a disconnect in the patient’s wider medical journey the GP should also interact with Medicann if they have any concerns.

The whole approach is built on consistency and collaboration — the Patient, the Clinic, the Pharmacy and the GP all working in sync. It’s a system that gives people confidence, keeps care safe, and ensures every patient gets the level of support they deserve. THC (Transparency Honesty and Care).

Barriers to Entry

We return to Dr Vijay Delaffon to tackle a crucial topic, the barriers to entry for clinicians. From evolving guidance and legal optics to the realities of unlicensed prescribing, Vijay unpacks what really gives prescribers pause; and how clear governance, documentation and plain-English conversations help bridge the gap.

Which concerns crop up most among clinicians – evidence, legal status, or optics?

All three – evidence, legal status, and optics – present challenges, though legal status is often the biggest concern. Medical cannabis remains relatively new in the UK, and regulatory guidance continues to evolve. Because the evidence base is still growing, interpretation can vary, leaving some prescribers cautious.

There’s also the question of stigma. Some still confuse medical cannabis with recreational use, though this is improving as awareness and clinical experience increase.

Ultimately, medical cannabis challenges the traditional medical model built around single active ingredients. Cannabis-based medicines are more complex, and both regulation and professional understanding are still adapting to that.

What misconceptions do you correct most often?

The most common misconception – among both clinicians and the public – is that medical cannabis is the same as recreational use. In reality, it’s a carefully regulated treatment option with specific clinical indications.

Another misconception comes from patients, who sometimes assume prescribers control product quality or formulation. In fact, CBPMs are produced by licensed manufacturers, so clinicians have no direct control over those aspects. Clear communication about this helps manage expectations and maintain trust.

What does ‘safe documentation’ look like for unlicensed prescribing?

There’s no single template, but good documentation should always record:

• the indication for prescribing,
• confirmation of no contraindications,
• evidence the patient received enough information to make an informed decision, and
• notes confirming they understand the potential benefits and risks.

Thorough records demonstrate sound clinical judgement and protect both the patient and the prescriber.

How do you communicate uncertainty with patients while maintaining confidence and consent?

At CB1 Medical, we’re open about the fact that research into medical cannabis is still developing. We explain that while large-scale clinical trials are limited, growing real-world data show meaningful benefits for many patients.

We also discuss that individual responses vary – different strains and cannabinoid profiles can work better for different people. It often takes some adjustment to find the right balance.

By being transparent about uncertainty while also sharing emerging evidence, we help patients make informed choices and feel confident in their treatment decisions. That openness builds trust and supports genuine consent.

Why it matters

When clinician capacity lags behind patient need, two things happen: delays lengthen and some patients drift to unregulated routes. Growing the pool of trained prescribers fixes the bottleneck where it matters (in the clinic) so decisions are made under governance, with informed consent, CD controls and documented follow-up.

More prescribers also means better geographic equity (not just a few hubs), shorter waiting lists, and time for the fundamentals: eligibility checks, shared decision-making, titration, and review. Critically, responsible prescribing at scale generates cleaner real-world evidence (consistent products, dose, duration, outcomes), which strengthens safety signals and supports future guidance.

That creates a positive flywheel:
more trained prescribers → better oversight and documentation → higher-quality data and outcomes → greater professional and public confidence → broader, safer access.

It also helps the wider system; clearer communication with GPs, more consistent pharmacy coordination, and a more robust basis for health-economic assessment in the long term. In short, building prescriber capacity is not about volume for its own sake; it’s about safer care, stronger evidence, and fairer access—the preconditions for a credible, sustainable pathway.

The Path Forward

A market leading prescriber programme provided by Curaleaf Laboratories, the UK’s largest manufacturer and distributor of medical cannabis helps with the onboarding of new specialists.

Curaleaf Laboratories is a long-established manufacturer of “specials” (unlicensed medicines) and after medical-cannabis legalisation in 2018 refocused on producing CBPMs. Their prior experience in unlicensed medicines, coupled with their group and partnership infrastructure, gives them a unique positions to support safe, high quality CBPM prescribing

The Programme forms part of a broader strategy: not only to manufacture and supply CBPMs, but to ensure that clinicians prescribing them are properly educated, supported, and confident.

Through the Prescriber Programme, Curaleaf offers a range of supports designed to help clinics or prescribers, especially those new to medical cannabis, to get started. 

Services include:

Regulatory & operational support: For clinics not experienced with unlicensed medicines, Curaleaf helps with practicalities  e.g. updating or preparing for regulatory registration (e.g. with Care Quality Commission, “CQC”), insurance considerations, formulary advice, dosing guidance, and prescription-pad support.

Education and training for prescribers: The Programme includes workshops, in-practice support sessions, bespoke educational content, and engagement with professional institutions. This helps clinicians understand CBPMs: mechanisms (e.g. endocannabinoid system), product formulations, clinical indications, safety considerations, and how to integrate cannabis-based medicines responsibly into practice. 

• Access to an EU-GMP manufactured product formulary: Curaleaf supplies a variety of medical cannabis product types, formulations, dosage forms) and price points. This gives prescribers a wide choice of CBPMs to match patient needs. 
• Partnership with clinicians’ professional bodies: Curaleaf Laboratories recently formalised a partnership with Medical Cannabis Clinicians Society (MCCS), enabling the Society to leverage Curaleaf’s resources to deliver CPD-accredited education and shape a “central source of information” for UK prescribers.

Closing thought

If the UK wants a credible, equitable pathway, capacity at the point of care is the unlock. More trained prescribers doesn’t mean lower standards; it means safer decisions, better documentation and stronger evidence, the foundations of patient trust and future guidance. We’ve heard how governance-first clinics and multidisciplinary teams make this practical today. The next step is simply more clinicians stepping forward.

If you’re a consultant or SAS doctor curious about prescribing CBPMs within a compliant framework, start a conversation with teams who do this well:

• CB1 Medical – governance-led onboarding, peer review and clear documentation standards: Wh.pa@nhs.net
• Medicann – MDT model with structured induction and regular follow-up: gary@medicann.co.uk 
• Curaleaf – established education and clinical support pathways across multiple indications. info@curaleaflaboratories.co.uk

Reach out via their websites to the clinical education/onboarding teams, or register interest for upcoming training sessions. If you’d like an introduction, reply here and we’ll connect you to the right contact.

Clinicians who want to practise safely, legally and confidently with CBPMs should consider joining the Medical Cannabis Clinicians Society (MCCS). Membership offers CPD-accredited training, 24/7 peer support from experienced prescribers, practical guides and templates, and access to prescribing information and product updates, all within an independent, not-for-profit, clinician-led network. It’s a fast way to de-risk your learning curve and strengthen governance in day-to-day practice. 

Join or register your interest here: ukmccs.org (Membership & Benefits).

Build confidence. Build capacity. Build access. That’s how we move from pockets of provision to a robust, sustainable UK pathway.

Disclaimer: 

The information provided in this blog is for educational purposes only and is intended for healthcare professionals involved in the prescribing and administration of cannabis-based medicinal products (CBMPs). It does not constitute medical advice, diagnosis, or treatment recommendations. While every effort has been made to ensure accuracy, regulatory guidelines and clinical best practices may evolve. Prescribers should refer to the latest guidance from the Medicines and Healthcare products Regulatory Agency (MHRA), the National Institute for Health and Care Excellence (NICE), and other relevant bodies when making treatment decisions. Dalgety does not endorse any specific product or treatment pathway and encourages healthcare professionals to exercise their clinical judgement in patient care.