The Leicester, Leicestershire and Rutland Integrated Care Board (LLR ICB) published the GP Tirzepatide Implementation and Management Weight Management Service Guidance (2025/26–2027/28) and accompanying supporting documents in December 2025. The guidance, spec and supporting documents sets out the phased approach to implementing tirzepatide (Mounjaro) as part of weight management pathways across General Practice and specialist weight management services.
This guidance reflects the recent NICE Technology Appraisal (TA1026) for tirzepatide for managing overweight and obesity, which recommends its use alongside lifestyle interventions for adults with a body mass index (BMI) of ≥35 kg/m² and at least one weight-related comorbidity.
Key documents
- Contract Variation – Tirzepatide pilot
- Appendix 1 – Tirzepatide LES spec 2025
- Appendix 2 – Frequently asked Questions
- Appendix 3 – Pharmacology for weight management for Tirzepatide Guide
Any questions, please contact the LMC office directly.
Requests from Private Providers
The LMC has been contacted by several practices concerned about private weight loss clinics writing to practices asking them for information about whether a patient has any contraindication to be prescribed medication (Wegovy/Mounjaro).
The responsibility to decide whether a patient is suitable lies with the prescriber. The LMC has issued the following statement that you can use in discussion with private clinics or patients.
LMC position statement on Wegovy / Mounjaro Prescribing by Private Providers
The Leicester, Leicestershire and Rutland Local Medical Committee has released its position statement regarding Wegovy / Mounjaro Prescribing by Private Providers.
Local Medical Committees were first established under the National Insurance Act 1911 and have been continued to be recognised by subsequent legislation (currently NHS Act 2006) and are the only independent representative body of general practice and have various statutory functions.
We have been contacted by local practices, as their statutory representatives, about requests from private providers asking practices to undertake a review of patient’s notes to check that private providers are safe to prescribe Wegovy or Mounjaro. This, by default, means that the practice takes responsibility for prescribing initiated by other organisations.
Under GMC regulations it is the responsibility of the prescribing clinician to assure themselves that their prescribing is safe – this would include taking an adequate history, examining the patient and are responsible for providing and acting on any appropriate pre-prescribing investigations. Professional medication safety guidelines (NICE) require examination of the patient. This would seem to include objective and accurate weight measurement, at initial assessment and at regular review. At no point is it expected that the provider asks the patient’s NHS GP to do this private work on behalf of other organisations. Private providers must be aware that they cannot assume that a non-response is an agreement that there are no contraindications to prescribing this type of medication.
General Practice is under extreme pressure and practices are not contracted or funded to provide this service for outside providers.
The LMC gets asked whether a practice should respond to requests from private providers and there have been the following relevant announcements.
- Guidance from the Medical Defence Union
- Updated guidance for pharmacists by the General Pharmaceutical Council
In view of these, private pharmacists are more likely to be contacting GP surgeries for information before providing these medications to patients.
There is a local enhanced service in LLR, but this has a strict criteria for practices to follow – the LMC has designed a template letter that practices can decide to use to private prescribers.
However, if a practice is aware that there is a contraindication for a prescription (e.g. underweight, eating disorder, history of pancreatitis) the practice should consider advising the patient and/or the private provider about this.
If a patient commences on treatment, consider adding the medication as a ‘hospital issued’ medication to ensure any interaction with medication prescribed in the future can be checked for interactions etc.