NHS England Expands Medical Cannabis Guidance for Neurologists
NHS England has issued updated guidance to neurology departments across England, expanding the clinical scenarios in which specialist neurologists may consider prescribing cannabis-based medicinal products (CBMPs). The guidance focuses on treatment-resistant epilepsy, multiple sclerosis-related spasticity, and neuropathic pain unresponsive to conventional therapy. The update is expected to increase the number of NHS-funded cannabis prescriptions significantly, although private prescriptions will remain the most common route for most patients in the near term.
NHS England has released expanded guidance for consultant neurologists regarding the prescribing of cannabis-based medicinal products (CBMPs), marking one of the most significant regulatory developments for medical cannabis in the UK since legalisation in 2018.
The updated guidance, distributed to all NHS England neurology departments in May 2026, clarifies the clinical circumstances under which neurologists may consider CBMPs for patients who have exhausted conventional treatment options. The three primary areas addressed are treatment-resistant epilepsy (particularly Dravet syndrome and Lennox-Gastaut syndrome in adults), multiple sclerosis-related spasticity where Sativex has been ineffective or is contraindicated, and severe neuropathic pain unresponsive to standard analgesic regimens.
Previously, many neurologists cited uncertainty about NHS funding, prescribing authority, and clinical governance as barriers to CBMP prescribing. The new guidance provides clearer frameworks for each indication, including recommended assessment tools, dosing starting points, and monitoring protocols.
Dr Sarah Mathews, a consultant neurologist at University College London Hospital and member of the Medical Cannabis Clinicians Society, welcomed the development: "This guidance removes a lot of the ambiguity that has prevented neurologists from prescribing for appropriate patients. For people with severe, treatment-resistant neurological conditions, this could be transformative."
The guidance does not extend NHS funding to all CBMP prescriptions — most patients with conditions outside the specified indications will still need to access cannabis medicine through private specialist clinics. However, advocates say the shift signals growing NHS acceptance of cannabis-based medicine and may pave the way for further indication expansions.
Patients seeking medical cannabis for neurological conditions can compare UK specialist clinics on LeafMe's clinic comparison page.
