Frequently Asked Questions

Any cannabis-based medical flower prescribed for inhalation must comply with the British (Br. Ph. Appendix XVI.D) and European Pharmacopeia (Eu. Ph. 5.1.4) regulatory guidance on microbiological content. The guidance is designed to ensure that patients are not exposed to potentially harmful yeasts, moulds, or bacteria which can be naturally occurring on plants, particularly when grown in soil.

The British and European Pharmacopoeias outline quality standards for the pharmaceutical industry to control the quality of medicines, and the substances used to manufacture them. It is an official reference designed to serve public health and adhering to the guidance is a legal requirement in the UK.

If cannabis flower does not meet these standards for inhalation prior to manufacturing, it needs to undergo a process of decontamination. The most common method is irradiation. This has been shown in scientific studies to effectively reduce the presence of microbes on the surface of cannabis flower. This process does not affect the major cannabinoids, cannabidiol (CBD) or delta-9-tetrahydrocannabinol (THC) which are found within cannabis flower.

If cannabis flower meets these standards prior to manufacturing into a medicine prescribed for inhalation then it would not necessarily have to undergo any decontamination, such as irradiation.

medicine it is important to carry copies of any evidence supporting your medical condition and prescription.

Evidence you should carry:

  • Copy of your clinic letter from your specialist doctor and/or copy of prescription.
  • Proof of ID e.g., driving licence/passport- which matches the name on the prescription/letter.
  • Medication container- always ensure you keep medicine in the original container with the pharmacy label.
  • You can carry your medication with you and in your car, but it is best to avoid leaving your medical cannabis unattended.

We advise that even if you are not carrying your medication, you should still carry evidence supporting your medication.

Licensed medical cannabis prescriptions are currently only prescribed through the NHS for certain individuals with severe epilepsies (Dravet syndrome with intractable epilepsy, Lennox-Gastaut syndrome and tuberous sclerosis complex), and for nausea caused by chemotherapy.

Fewer than 5 individuals have been successful in having their prescription for unlicensed medical cannabis products funded by the NHS.

Whilst many people may refer to cannabis as marijuana, it has a long history of inappropriately stigmatising individuals from Central and South America. Therefore, the correct terminology to use is medical cannabis, rather than medical marijuana.

Medical cannabis must be prescribed by specialists on the GMC register on a ‘named patient’ basis within the area of their expertise, agreed upon by a multidisciplinary team and adhering to all existing protocols for controlled drugs. Sapphire Medical Clinics adhere to all these criteria.

medicine it is important to carry copies of any evidence supporting your medical condition and prescription.

Evidence you should carry:

  • Copy of your clinic letter from your specialist doctor and/or copy of prescription.
  • Proof of ID e.g., driving licence/passport- which matches the name on the prescription/letter.
  • Medication container- always ensure you keep medicine in the original container with the pharmacy label.
  • You can carry your medication with you and in your car, but it is best to avoid leaving your medical cannabis unattended.

We advise that even if you are not carrying your medication, you should still carry evidence supporting your medication.

The speed at which medical cannabis starts to have effects on the body varies between individuals and according to the type of medication they are prescribed. For some patients it can take a few months to find the right care plan. In some patients the improvement may be gradual, and improvement might be seen in an unexpected way.

Exactly how people respond varies from person to person and cannabis doesn’t work for everyone. At Sapphire, we support you with finding a regimen that works for you.

Our clinicians are experts in providing medical cannabis-based care. All individuals are reviewed by our multidisciplinary team to ensure they are not only eligible for medical cannabis, but also to ensure they are on the most appropriate treatment plan. This includes assessing for risk of dependence. Our doctors work closely with patients to monitor closely for addiction and identify the most appropriate care plan for them.

We take any complaint seriously. You can find our complaints leaflet here.

You can call us on 020 7459 4075 or send details of your complaint to complaints@sapphireclinics.com

Sapphire Clinics set up the UK Medical Cannabis Registry in 2019, the first national registry on medical cannabis prescribing in this country. By contributing your data – a mix of routine clinical data and health tracking questionnaires – you help grow the evidence base for medical cannabis prescribing, data which we believe is crucial to support calls for government funding of clinical trials in the UK.

Cannabidiol (CBD) is one of the main compounds derived from the cannabis plant and is used for its medicinal properties as part of medicinal cannabis preparations. Oil-based CBD products are also available over the counter as wellness products. CBD oils prescribed for a medical condition from a specialist doctor typically have higher concentrations of CBD than those available on the high street. CBD oil available on the high street is classified as a novel food and therefore does not have to meet the same stringent regulations regarding its manufacture as medicinal preparations.

Yes, medical cannabis is legal when prescribed to eligible patients by a specialist doctor on the GMC register. Prior to 1st November 2018 medical cannabis was categorised by the Home Office as a schedule 1 drug. Based on the evidence to support its use as a medicine by the Chief Medical Officer it was reclassified to permit its prescribing as a controlled drug. This means that medical cannabis is legal when prescribed by specialist doctors on the GMC register within the area of their expertise, and when agreed upon by a multidisciplinary team adhering to all existing protocols for controlled drugs. Sapphire Medical Clinics adhere to all these criteria.

Patients can self-refer by completing our online eligibility checker via the Sapphire Clinics Webapp.

Alternatively, your healthcare professional can refer you to us by completing this form.

To help our specialists make a full assessment of your condition, you will need to provide your medical records. You can provide these, or you can ask that Sapphire retrieve the information on your behalf. For more detail about how to access your summary of care record click here.

We will also require a copy of your photographic ID (e.g. driver’s license or passport) as well a signed treatment agreement, which can all be done electronically.

If you’re joining us from another medical cannabis clinic, we ask you to provide us with the clinic letters they have given you.

Our clinicians will review your records and if eligible, you will be invited for a consultation with a specialist in your condition. Please note, medical cannabis is not a first line treatment, so eligible patients must have failed to find sufficient benefit from relevant, first-line therapies.

Eligible patients can book an appointment directly. To start the process, please complete our eligibility form via the Sapphire Clinics web app. You will need to provide your medical records. You can provide these, or you can ask that Sapphire retrieve the information on your behalf. For more detail about how to access your summary of care record click here. Once your details have been reviewed by our specialists you will be invited to book an appointment, if appropriate.

We see patients for conditions where there is clinical evidence to support the use of medical cannabis and only when conventional therapy has not provided effective symptom relief. You can find the full list of conditions here.

There are a number of instances where we would not prescribe, for example: pregnancy, breast feeding, on-going psychosis or unstable cardiovascular disease. Your consultant will review your full medical history to understand whether medical cannabis is appropriate for you.

Patients can self refer via the Sapphire Clinics Webapp or get a referral from their GP or consultant.

We see patients for conditions where there is clinical evidence to support the use of medical cannabis and only once a patient has exhausted conventional therapy specific to their condition. Some of the conditions we see at Sapphire:

Pain Conditions

  • Cancer-Related Pain
  • Chronic Pain
  • Chronic Regional Pain Syndrome (CRPS)
  • Ehlers Danlos Syndromes (EDS)
  • Fibromyalgia
  • Musculoskeletal Pain
  • Migraines
  • Headache
  • Neuropathic Pain
  • Palliative Care
  • Cancer
  • Endometriosis

Psychiatric conditions

  • Anxiety
  • Depression
  • Insomnia
  • Post Traumatic Stress Disorder (PTSD)
  • Attention Deficit Hyperactivity Disorder
  • Agoraphobia
  • Autistic Spectrum Disorder
  • Obsessive Compulsive Disorder (OCD)
  • Tourette’s Syndrome

Palliative Care

  • Chemotherapy induced nausea and vomiting (CINV)
  • Cancer-Related Appetite Loss

Gastrointestinal Conditions

  • Crohn’s Disease
  • Ulcerative Colitis
  • Irritable Bowel Syndrome (IBS)

Neurological Conditions

  • Autistic Spectrum Disorder
  • Epilepsy – Adult/Child
  • Migraine
  • Headache
  • Multiple Sclerosis (MS)
  • Neuropathic Pain
  • Parkinson’s Disease

Like many everyday medicines, your driving ability may be reduced (driving impairment) while you are taking your medical cannabis. Your medication may cause drowsiness and can initially reduce your reaction times. This can increase your risk of having an accident, putting yourself and others at risk.

You only need to inform the DVLA if you have a notifiable medical condition or disability that could affect your ability to drive safely. You do not need to inform them about your prescription. The only condition that medical cannabis is commonly prescribed which requires an individual to inform the DVLA is epilepsy.

A statutory defence may apply if a car accident occurs where a specialist doctor has legally prescribed medical cannabis and driving performance was not impaired.

The current legal limit for blood tetrahydrocannabinol (THC) levels is 2 micrograms/L. It is highly likely that if you have been prescribed medical cannabis preparations containing THC, you will exceed this limit.

THC can show up in your blood within minutes after taking your medication. THC is also stored in fat cells and is slowly released. This means that THC can still be detectable in your blood stream well beyond 28 days.

No matter your medication, you should never drive whilst impaired. Your dose and prescription can affect you differently from someone else, so you should always speak to your specialist doctor about possible impairment while taking your medication. Cannabidiol (CBD) only products have been shown to have no potential effect on driving reaction speed and risk of collision.

No, in fact, smoking your medical cannabis invalidates the prescription. Medical cannabis flower prescribed in the UK must be administrated using a medical-grade vaporiser. This is due to the negative implications that smoking has on a person’s health.

Inhalation of smoke from cannabis flower when smoked carries significant health risks. Much like with tobacco, the burning of cannabis (and any other plant material) can produce carcinogens and other harmful materials. Exposure to these compounds can lead to health complications. Smoking also produces changes to the active compounds in the cannabis plant, resulting in different levels to what was intended when initially prescribed.

Evidence suggests that the vapour produced when using a medically approved vapouriser makes for a less harsh and less harmful means of administration when compared with cannabis smoke. Sapphire Medical Clinics exclusively recommends the three vaporising devices that have been approved for medical use in the UK: the Storz-Bickel Mighty Medic, Mighty+ Medic and the Volcano.

Medical Cannabis prescription costs will vary based on individual need and dosage required. Please speak with your consultant for further details.

To request a repeat of your prescription please login to your Sapphire Clinics Webapp and click on the ‘Prescriptions’ tab to view your active prescriptions and request a repeat. Please do this at least one week before running out to enable us to send your paper prescription to your nominated pharmacy. If you also include how much of your medicine you are taking while in the titration period, we can ensure we request adequate quantities to be resupplied.

Please note, most oils come in thick amber bottles. It can be difficult to know when the oil is running low, if you peal back the label either side of the bottle, it will allow you to check the level of oil remaining. Most oils come in 10ml and 30ml bottles.

Please be aware that you must have a regular review with your clinician to continue treatment and to request changes to the treatment plan you must book in to see your clinician.

Most oils come with an oral syringe. Oral syringes are marked to enable accurate measurement of the dose prescribed. 1ml syringes are marked in steps of 0.1ml. These oral syringes may be washed in warm soapy water then rinsed to reuse them. The bottles come with instructions, contained in the letter sent to you by your doctor.

On receiving a referral, the clinical team review the information provided. At times, we may require further information to be gathered from you, your GP, or other specialists. Once the referral has been accepted by one of our specialists, we you can arrange a time that is convenient for your appointment. Patients are typically booked in 3 working days after a complete referral is received. Missing information may cause a delay.

Once seen by a consultant who specialises in your condition, your case is presented to our multi-disciplinary team (MDT). MDT meetings are held on a weekly basis. If appropriate, and a prescription for medical cannabis is authorised, the prescription is sent by post to your nominated pharmacy to be dispensed.

We strive to book patients in as swiftly as possible, however, in certain circumstances there are unavoidable delays as mentioned above.

We encourage patients to discuss consultation and prescription fees with their individual provider.

Some patients experience side effects with these medicines. Some are listed below. Most people who experience side-effects find they are short lived. We support our patients though these issues and adjust medication where needed.

Very Common*

  • Drowsiness/Fatigue
  • Dizziness
  • Dry Mouth
  • Cough
  • Anxiety
  • Nausea
  • Effects on thinking
  • Appetite Stimulation
  • Constipation/Diarrhea

Common*

  • Euphoria
  • Blurred Vision
  • Headache

Uncommon*

  • Low blood pressure
  • Paranoia
  • Depression
  • Problems with balance
  • Fast heart rate

*These lists are not exhaustive. Check the leaflet that comes with your medicines or speak to your clinician if you are worried about a side-effect.

Our Clinicians can prescribe a wide range of cannabis-based medicines and in a variety of forms such as oils, capsules and dry plant. The medicines available are all produced to ‘Good Manufacturing and Distribution Practices’. The different medicines contain a range of single cannabinoids or full plant extracts and vary in their levels of cannabidiol and tetrahydrocannabinol. If suitable to receive medical cannabis therapy, the choice and dose of medicine is tailored to you and your condition.

Yes, our consultants have the autonomy to prescribe a full spectrum of medicinal cannabis products. All prescribed products must meet regulations put in place by the Medicine and Healthcare products Regulatory Agency including compliance with ‘Good Manufacturing and Distribution Practices’ (GMP). All patients and proposed prescriptions are reviewed by our Multi-Disciplinary Team to ensure the right care plan is in place, whether or not that includes medical cannabis.

Yes, consultations are available online. Some patients may not be suitable for telemedicine if this will impact the standard of care the doctor is able to provide on an individual basis. This decision is at the clinician’s discretion.

Video consultation fees for patients enrolled in the Sapphire Access Scheme.

  • Initial appointment: £50
  • Follow up appointments: £50
  • Pharmacist led follow up appointment: £50

Video consultation fees for patients outside of the Sapphire Access Scheme.

  • Initial appointment: £210
  • Follow up appointments: £125
  • Pharmacist led follow up appointment: £125

*Initial appointment for psychiatric patients: £420

Sapphire Clinics do not charge any repeat prescription fees.

Please note, prescription cost will vary based on individual needs and dosage.

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