From Monday 23 June 2025 NHS England guidance on Tirzepatide (Mounjaro) stipulates that it must be implemented in primary care. That implementation can be via general practice, federations, or community specialist clinics.
This is a nationally agreed service, with local ICB commissioners. Tirzepatide represents a new therapy for weight management, but requires structured implementation, appropriate monitoring, and clarity around responsibilities.
Responsibility for commissioning local service/ access has been delegated to ICBs. The funding for this is based on population obesity levels and is separated into drug costs and primary care management costs. GPs should engage in prescribing where clinically appropriate and safely resourced to do so.
Tirzepatide prescribing must be accompanied by wrap around support consisting of psychological, nutritional and exercise advice, and this will be delivered separately through a centrally funded digital package in the first year.
The target population for Tirzepatide will be risk stratified into cohorts and the first year will focus on the highest end; those with a BMI ≥ 40 and at least four comorbidities, including:
- A BMI of 40+ (dyslipidaemia/ abnormal fat levels in the blood)
- Hypertension (high blood pressure)
- Obstructive sleep apnoea (when your breathing stops and starts while you sleep)
- Cardiovascular disease (heart and blood vessel disease)
- Type 2 diabetes mellitus
GPC England has produced a Focus on Tirzepatide (Mounjaro) for weight management in General Practice document, which explains how Tirzepatide is used, commissioning arrangements (responsibility for funding lies with ICBs), and responding to information requests from private providers. The guidance also includes a template letter for practices to respond to requests for medical information following a private consultation. The BMA have also produced guidance on Mounjaro.
Update on commissioning intentions in the five London ICB areas:
- NWL: Details on the commissioned service in the NWL ICB area are here: Tirzepatide and the NHS in North West London: North West London ICS.
- NEL: On Tuesday 24/6/25 NEL ICB released an Interim Policy Statement: Access to Wegovy and Mounjaro for Weight Management on the NHS in North East London.
- In summary, NEL ICB is “currently in the process of establishing new weight management services in NEL, in a phased approach. Tirzepatide will be made available on behalf of primary care as part of these services.” The ICB is “working as quickly as possible to make these services available across North East London, over the next few months”. NEL ICB have advised that they “will continue to update this policy statement and share information with local partners” as they finalise their approach.
- NCL: NCL LMC have had initial conversations with NCL ICB on the proposed single point of access model, which would also include monitoring, management of side effects, continued prescribing, and the necessity to implement the service in a phased approach. NCL ICB also published guidance available on the NCL ICB Website.
- SWL: SWL ICB has provided a letter for practices to use for patients who are not currently eligible for Tirzepatide on the NHS for weight loss at the request of the SWL LMCs.
- SEL: SEL ICB have issued comms via SELnet: IMPORTANT: Tirzepatide (Mounjaro) Service Model Update.