Policy Update
NHS Trust SOP
May 2026
Devon Partnership NHS Trust Publishes UK-First Inpatient Medical Cannabis Policy
Devon Partnership NHS Trust has formally approved CD21, a Standard Operating Procedure that gives medical cannabis patients a clear, safe pathway to continue their lawful prescriptions while admitted to hospital. Here is what it means for you.
Why This Matters
A lawful cannabis prescription can now be continued during a DPT hospital admission rather than being automatically stopped.
The SOP protects patients from being misclassified as illicit drug users simply because their medicine looks or smells like cannabis.
CD21 explicitly creates a governance pathway for cannabis flower administered via a dry-herb vaporiser or heated nebuliser, a UK first for an NHS Trust.
The NHS cannot supply or fund unlicensed cannabis products. You must continue to arrange and pay for supplies through your private prescriber.
Overview
What CD21 Actually Does
A formal medicines pathway, not an informal workaround
Before CD21, medical cannabis patients admitted to a Devon Partnership NHS Trust (DPT) inpatient unit faced a confusing and often distressing situation. There was no formal procedure. Staff were uncertain how to handle legally prescribed cannabis products. Patients risked having their medicines treated as illicit substances, confiscated, or simply not given to them, causing abrupt interruption of a treatment they rely on.
CD21 changes this. It is a Standard Operating Procedure (SOP) ratified by DPT’s Medicines Safety Committee in May 2026. It gives ward staff, pharmacists, nurses and doctors a clear, step-by-step process for identifying, verifying, storing and administering cannabis-based medicinal products (CBMPs) during a hospital stay, treating them as the controlled medicines they legally are.
The key legal clarification: continuing is not the same as initiating
One of the most important things CD21 establishes is this: transcribing an existing, authentic cannabis prescription onto an inpatient prescribing record is not considered initiating a new prescription.
Instead, it is treated as a patient-specific direction to administer the medicine during the admission, the same approach used for any other controlled drug a patient brings in. This removes one of the biggest anxieties staff had about “starting” cannabis prescribing, which they were not in a position to do.
What this means for you: If you arrive at a DPT inpatient unit with a valid, clearly labelled medical cannabis prescription, staff now have a defined pathway to continue your treatment, not a reason to stop it.
Why mental health inpatient settings make this especially significant
DPT is a mental health and learning disability trust. Medical cannabis patients in these settings can face greater scrutiny than in acute hospitals, concerns about intoxication, psychosis risk, and substance misuse histories can lead to heightened gatekeeping.
CD21 takes a balanced position. It acknowledges CBMP use for conditions including PTSD, anxiety, OCD and depression. It requires multidisciplinary review of appropriateness, method of administration, and capacity to self-administer, but it does not use these as automatic reasons for refusal.
On psychological therapies, CD21 notes the ongoing clinical debate but is clear: cannabis use should be considered in therapy planning, but is not a barrier to accessing psychological therapy.
How the SOP Categorises Products
The Four Product Categories
Licensed cannabis-based medicinal products are the most straightforward category. They can be prescribed, stored and administered using standard NHS controlled drug procedures.
- Nabilone — a synthetic cannabinoid for chemotherapy-related nausea and vomiting. Schedule 2.
- Sativex — cannabis extract oromucosal spray licensed for MS spasticity. Schedule 4, but DPT applies full Schedule 2 record-keeping requirements.
- Epidyolex — oral CBD solution licensed for rare epilepsy (Dravet syndrome, Lennox-Gastaut). Schedule 5, treated as Schedule 2 within DPT.
Further inpatient supplies of licensed CBMPs can be obtained on a named-patient basis from acute Trusts, and supply can be made on discharge if needed.
This is the most common category for private medical cannabis patients and the most important part of CD21. Unlicensed CBMPs may look, smell or be packaged similarly to illicit cannabis, so verification is essential before any clinical handling takes place.
To be usable on the ward, your medicine must:
- Be in its original pharmacy-dispensed container, not decanted into a weekly pill box or any other container
- Have a legible dispensing label showing your name, the product name, route of administration, dosage instructions, and THC/CBD quantities
- Have its legality confirmed by pharmacy staff, prescriptions are often online-only, but your clinic can usually provide a copy or a doctor’s letter
Cannabis cards (Cancard, Releaf Card) cannot verify legality under this SOP. What matters is the prescription, dispensing label, and confirmation of specialist prescribing. If legality cannot be confirmed, the product must be handled as an illicit substance under the Trust’s CD6 policy.
Once verified, an unlicensed CBMP is classified as a Schedule 2 controlled drug, stored in the CD cupboard, and administered under full controlled drug procedures. You will need to continue funding and sourcing further supplies through your private prescriber during your admission.
Commercial CBD products, oils, capsules and vapes bought online or from health shops, are legally food supplements, not controlled drugs. They are not classified as CBMPs.
- Can be continued during admission if agreed by the multidisciplinary team
- Must be assessed as a Patient’s Own Drug under the Trust’s MM08 procedure
- Should be included in the patient’s electronic prescribing record
- CBD vapes require additional care planning, where it can be used, whether the patient needs to be accompanied, and PAT testing of the device
Be aware: commercial CBD products are not subject to the same quality controls as pharmacy-dispensed medicines. They may occasionally contain more THC than the legal 0.3% limit, which could be relevant to your care plan discussion.
Illicit cannabis, home-grown or street-sourced cannabis, is not covered by CD21. It is managed under DPT’s separate CD6 Illicit Substances policy.
A CBMP that cannot have its legality confirmed, has been decanted into another container, or is intended to be smoked, will also be handled as an illicit substance under CD6, regardless of whether it was originally prescribed.
Smoking cannabis remains prohibited in all NHS settings, even when the product is legally prescribed. A dry-herb vaporiser or heated nebuliser is the required method for inhaled flower.
CD21 treats cannabis-based medicinal products as medicines requiring verification, storage, prescribing records, administration records, risk assessment and discharge documentation, exactly the kind of institutional normalisation the sector needs.
PatientsCann UK Analysis of CD21, May 2026
Practical Patient Guide
What You Need to Do If You’re Admitted to a DPT Unit
Bring your medicine in its original pharmacy packaging
The dispensing label must be legible and show your name, the product name, the route of administration, dosage instructions, and the THC or CBD quantity. Do not decant your medicine into a pill organiser or any other container, it will not pass the Patient’s Own Drug assessment and will be treated as an illicit substance.
Have proof of your prescription ready
Many cannabis prescriptions are issued digitally. Contact your cannabis clinic before admission and ask for a copy of your current prescription or a letter from your prescribing doctor. The letter should include your name, address, and the prescriber’s name and contact details. Your clinic should be familiar with hospital verification requests.
Cannabis cards (Cancard, Releaf Card) cannot verify a prescription under this SOP.
Tell ward staff about your prescription at admission
Declare your cannabis prescription as part of your medicines history when you are admitted. This triggers the CD21 process. Ask to speak with a ward pharmacist or pharmacy technician who can begin the Patient’s Own Drug assessment. The CD Accountable Officer will be informed of all cannabis prescribing activity.
Work with your team on a personalised administration care plan
CD21 requires an individual care plan to be put in place, especially if your medicine involves vaporised flower. The care plan should cover the method and frequency of administration, where vaping can take place on the ward (own bedroom, side room, or designated area), whether you need accompaniment, and PAT testing of any device. This is not a barrier to treatment; it is the framework that makes treatment possible.
Arrange your own resupply during a longer admission
The NHS cannot supply or fund unlicensed CBMPs. If you need additional supplies during your stay, you must contact your private cannabis clinic and pharmacy directly. Ward staff should support you with this process. Your discharge prescription will include your CBMP for completeness, with a note that no NHS supply was made.
Your Rights Under CD21
- Your lawful prescription should be recognised, not assumed to be illicit
- You should not face confiscation or disciplinary action for bringing prescribed cannabis to hospital
- You should be able to access a multidisciplinary review of whether your treatment can continue
- Cannabis use should not automatically exclude you from psychological therapies
- Staff should support you in contacting your private prescriber if needed
What CD21 Does Not Cover
- NHS funding or supply of private unlicensed cannabis products
- Products decanted from original pharmacy packaging
- Smoking cannabis, this remains prohibited in all NHS settings
- Products where legality cannot be confirmed
- Cannabis cards as proof of legal supply
PatientsCann UK Analysis
Recommendations for DPT to Maximise CD21’s Impact
CD21 is a strong policy, but policies do not implement themselves. PatientsCann UK’s analysis identifies the following practical steps that would help ensure the SOP achieves its purpose in real ward environments:
Ward Quick Reference Guide
A one-page visual guide showing what legal dispensing labels and original pharmacy packaging look like, alongside clear escalation routes to pharmacy. Without this, staff may still default to illicit-substance thinking.
Mandatory Staff Training
CD21 must be supported by training for inpatient nurses, doctors, pharmacists, pharmacy technicians, ward managers and site managers, covering verification, controlled drug handling, and how to avoid conflating medical use with illicit use.
CBMP Care Plan Template in SystmOne
A standardised cannabis-based medicinal product care plan template within the Trust’s electronic patient record system would help teams consistently manage oils, flower, cartridges, pastilles and CBD vapes, reducing variation between wards and teams.
Patient-Facing Admission Leaflet
A clear leaflet explaining what patients must bring (original packaging, dispensing label), what not to bring (decanted products), and what to expect from the verification process, available before and during admission.
Clinic Verification Pathway
A clear protocol for pharmacy staff to contact private cannabis clinics and pharmacies for prescription verification, particularly for patients without paper prescriptions or digital access.
Audit at 6–12 Months
DPT should audit CD21 implementation within 6 to 12 months, capturing the number of patients affected, products continued or refused, missed doses, incidents, equality impacts, staff confidence and patient experience.
Engagement with Patient Organisations
Patient organisations including PatientsCann UK can help test whether the SOP works in practice, not just on paper, and support DPT in reaching patients ahead of admission with clear, accessible information.
Wider Context
Why This Matters Beyond Devon
A Template for Other NHS Trusts
Medical cannabis has been legally prescribable in the UK since November 2018, but national law has not automatically translated into safe, consistent inpatient practice. Many NHS trusts — mental health, community and acute, still lack formal SOPs for handling prescribed cannabis products on wards. CD21 offers a practical, governance-compliant template they could adapt.
Normalisation, Not Exceptionalism
CD21 does not treat cannabis as a special case requiring exceptional processes. It routes it through the same controlled drug, medicines reconciliation and patient-own-drug frameworks used for any other Schedule 2 medicine. That is precisely the kind of institutional normalisation the medical cannabis sector needs to progress from legal in principle to safely delivered in practice.
Access inequality remains unresolved. CD21 improves continuity during hospital admission, but it does not change the fact that unlicensed CBMPs remain privately funded. Patients who can afford private prescriptions are in a very different position to those who cannot. This is a national problem that no individual Trust SOP can solve.
This article is for information purposes only. It is not medical or legal advice. CD21 applies to Devon Partnership NHS Trust inpatient units specifically; practices at other NHS Trusts may differ. If you are a medical cannabis patient and you are being admitted to hospital, speak with your prescribing clinic and the ward pharmacist as early as possible. Always bring your medicine in its original, labelled packaging.
Our Campaign
PatientsCann UK Is Taking CD21 National
Alongside publishing this article, PatientsCann UK has written directly to NHS bodies, Integrated Care Boards, and Controlled Drug Accountable Officers across England, Wales, Scotland, and Northern Ireland, sharing the CD21 SOP and our recommendations, and calling on them to develop equivalent policies without delay.
We are willing to engage and to support NHS organisations in developing their own SOPs. But patients cannot keep waiting, and we expect those we have written to, to act.
Outreach Status
Last updated: May 2026
Contacted
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NHS England
National commissioning body — EnglandContacted
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NHS Wales (Executive)
Devolved health body — WalesContacted
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NHS Scotland / Scottish Government
Devolved health body — ScotlandContacted
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DHSC Northern Ireland
Devolved health body — Northern IrelandContacted
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Controlled Drug Accountable Officers (CDAOs)
NHS Trust and ICB CDAOs — all four nationsContacted
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Integrated Care Boards (ICBs) — England
All 42 ICBs — regional NHS commissioning — EnglandPending
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Regional Partnership Boards — Wales
Devolved equivalents to ICBs — WalesPending
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Integration Joint Boards — Scotland
Devolved equivalents to ICBs — ScotlandPending
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HSC Trusts — Northern Ireland
Devolved equivalents to ICBs — Northern IrelandPending
Planned Outreach
We will update this page as responses are received. If your organisation has received our letter and would like to respond or engage, please contact us at info@patientscann.org.uk.
Standard Operating Procedure
Devon Partnership NHS Trust — CD21 SOP
Read the Full CD21 Standard Operating Procedure
The complete SOP — including the product flowchart, Sativex management appendix, and vaporiser administration guidance, is publicly available.
<p>The post UK-First Inpatient Medical Cannabis Policy first appeared on PatientsCann UK®.</p>
