For many people considering prescribed cannabis, the private clinic versus NHS question is less about preference than reality. The NHS can prescribe cannabis-based medicines, but access to unlicensed medical cannabis products remains exceptionally limited. Private clinics have therefore become the route most UK patients encounter - with faster assessments and wider prescribing options, but significant ongoing costs.
That does not make private treatment automatically appropriate, nor does an NHS refusal mean a patient has no clinical options. The two routes operate under different funding pressures, evidence thresholds and prescribing arrangements. Understanding those differences matters before paying for an appointment or assuming a prescription will be issued.
Private clinic versus NHS: the central difference
The NHS is designed to provide treatment according to clinical need and the evidence assessed by bodies such as the National Institute for Health and Care Excellence (NICE). For cannabis-based medicines, NICE recommendations are narrow. NHS prescribing is generally limited to particular licensed medicines for specific conditions, such as severe treatment-resistant epilepsy, spasticity associated with multiple sclerosis and chemotherapy-induced nausea and vomiting.
By contrast, most products prescribed through specialist medical cannabis clinics are unlicensed cannabis-based products for medicinal use, often called CBPMs. These can include THC and CBD oils, capsules and dried flower for vaporisation. A specialist doctor may prescribe an unlicensed medicine where they consider it clinically justified, but the decision carries additional professional responsibility and requires careful monitoring.
The practical result is stark. An NHS consultant may be able to discuss medical cannabis, but many patients with chronic pain, anxiety, post-traumatic stress disorder or sleep problems will not receive an NHS prescription for an unlicensed cannabis product. A private specialist may assess such patients for treatment, particularly where conventional options have not worked or have caused unacceptable side effects.
This is not evidence that private cannabis is more medically effective than NHS care. It reflects a different system of funding and clinical risk. The NHS must make population-level decisions about limited resources. Private patients fund consultations, medication and follow-up themselves.
What the NHS can prescribe
It is useful to separate licensed cannabis-derived medicines from the wider private prescription market. The NHS has established routes for a small number of products, each with defined indications and specialist oversight.
Epidyolex, a purified CBD medicine, may be used alongside other treatments for certain rare and severe forms of childhood epilepsy. Sativex, which contains THC and CBD, may be prescribed for moderate to severe spasticity in multiple sclerosis when other treatments have not worked. Nabilone, a synthetic cannabinoid rather than a cannabis plant product, may be used for chemotherapy-related nausea and vomiting.
These medicines are not a general pathway to cannabis treatment. Patients must meet specific clinical criteria, and prescribing is usually led by relevant hospital specialists. GP involvement may follow, but a GP cannot simply initiate a medical cannabis prescription on request.
For unlicensed CBPMs, NHS prescriptions can technically be made by a doctor on the Specialist Register of the General Medical Council. In practice, they are rare and often dependent on an individual funding arrangement, a specialist team’s support or participation in a research setting. Families seeking treatment for severe childhood epilepsy have repeatedly highlighted how difficult this can be.
Why patients choose a private clinic
Private clinics usually offer a more accessible referral pathway. Many accept self-referrals, assess medical records remotely and can arrange an initial consultation within weeks rather than months. A patient will normally need a diagnosed condition and evidence that standard treatments have been tried, although each clinic’s criteria differ.
The consultation should not be treated as a transaction for a particular product. A responsible prescriber will review the diagnosis, previous medicines, mental health history, cardiovascular risk, substance-use history and potential interactions. They may decide cannabis is unsuitable, recommend a CBD-dominant approach, or suggest another treatment should be explored first.
Private prescribing can also be more flexible in format. Oils may suit patients who want measured dosing and a longer-lasting effect. Dried flower can offer quicker onset when used in a medically approved vaporiser, but it is not suitable for everyone and must not be smoked. The lawful route is crucial: prescribed flower remains a controlled drug and should stay in its original pharmacy packaging with the dispensing label.
For some patients, this combination of access, specialist review and product choice is meaningful. For others, the financial commitment makes it impractical.
The cost question is not just the first appointment
A private assessment may be only the first expense. Patients commonly pay for an initial consultation, follow-up reviews, the prescription process and medication. Monthly costs vary substantially according to product type, dose and clinic fees, but can run from tens of pounds to several hundred pounds.
A low advertised consultation fee does not show the full cost of treatment. Before booking, ask what follow-ups are required, whether repeat prescription charges apply, how often the clinic expects to review patients and what a typical monthly medicine cost could look like at the proposed dose.
Price also should not be the only deciding factor. A clinic offering minimal clinical contact or making broad promises about eligibility should prompt caution. Medical cannabis can cause side effects, including tiredness, dizziness, dry mouth, changes in appetite and, for some people, anxiety or cognitive effects. THC-containing products can impair driving and operating machinery.
Safety, regulation and the GP relationship
A legitimate private prescription is not a loophole around cannabis law. The product must be prescribed by an appropriately qualified specialist, dispensed by a registered pharmacy and used only as directed. Patients should be wary of anyone selling cannabis as “medical” without a prescription or suggesting a private prescription makes public consumption risk-free.
Clinic standards matter. Patients can ask who will prescribe, whether the clinician is on the GMC Specialist Register, how adverse effects are managed and what happens if treatment is not helping. They should also check whether the service is regulated by the Care Quality Commission where required, and whether its costs and complaints process are clear.
Your GP does not have to take over a private cannabis prescription, and many will not enter into shared-care arrangements for unlicensed CBPMs. That can leave prescribing, monitoring and medication costs with the private clinic. Still, it is sensible to tell your GP about a prescription so that other medicines and relevant health information can be considered safely.
Mental health screening deserves particular attention. Cannabis is not suitable for everyone, especially people with a personal or family history of psychosis, and clinicians should assess risk rather than relying on a condition label alone. CBD products sold on the high street are not equivalent to prescribed medicines: their legal status, quality controls, cannabinoid content and clinical oversight differ.
Driving, work and everyday practicalities
A prescription does not create a blanket right to drive after using THC. UK drug-driving law sets a very low blood limit for delta-9-THC. A statutory medical defence may be available where a medicine was prescribed and taken as directed, but it does not apply if a driver is impaired. Police can still stop a driver, carry out roadside testing and investigate whether they were fit to drive.
Patients should follow their prescriber’s advice, avoid driving when affected and consider how a new medicine changes alertness before getting behind the wheel. Work can raise separate issues, particularly in safety-critical roles or where an employer uses drug testing. A lawful prescription may be relevant, but it does not remove an employer’s health and safety duties.
Travelling also requires preparation. Carry medication in original packaging and check the destination country’s rules before leaving the UK. A UK prescription does not automatically permit possession overseas.
Which route makes sense?
The NHS route is the right place to start where a patient’s condition falls within the established indications for a licensed cannabis-based medicine. It offers treatment without private medication bills and places care within a specialist NHS team. But it is not currently a realistic route for most adults seeking unlicensed cannabis products for common chronic conditions.
A private clinic may be worth considering for patients who have a documented diagnosis, have tried conventional treatments and can afford ongoing care. The best decision is an informed one: review the clinic’s credentials, understand the total cost, be open about your health history and do not assume that a consultation guarantees a prescription.
Medical cannabis policy in Britain remains out of step with the expectations created when the law changed in 2018. Until NHS evidence and commissioning pathways broaden, patients will continue to face a difficult choice between limited public access and costly private care. That makes clear information, cautious prescribing and honest discussion of the trade-offs more valuable than ever.
