THIS SERVICE WAS WITHDRAWN FROM LLR PRACTICES ON 1ST APRIL 2026 – THE LMC HAS SINCE COMMUNICATED THE FOLLOWING MESSAGE TO PRACTICES.
The LMC wishes to reiterate its recent communication regarding Tirzepatide/ Mounjaro services, following a significant increase in enquiries received by the LMC office, and our ongoing concern that since the ICB stopped the LES there is no locally contracted service to initiate, titrate and monitor Mounjaro.
The ICB have decided not to commission a Tirzepatide/Mounjaro LES from 2025/26 due to the ‘introduction of new QOF Obesity Indicator.” The LMC was given no prior notice of this, and we found out purely via the LLR GP Newsletter for week commencing 16th March 2026. The LMC believes that this breaches the agreement for the ICB to consult with the LMC as the only statutorily recognised independent representative body for all general practice providers in LLR.
The QOF was not and never has been designed to pay for activity, but purely for ensuring targets are met wherever the activity has happened (which would include, for example, if a service is not commissioned from general practice in secondary care).
We have contacted the GP Committee of the BMA and can confirm that Dr Katie Bramall, GPCE Chair, supports the LMC’s position. The GPC has formally raised this with NHSE and DHSE, and the LMC has also formally written to the ICB to express our concerns.
The LMC advises that you should continue with the service provision for patients already funded under the 2025/26 LES as per the specification, but practices should consider advising these patients that it will not continue beyond the one year due to a decision by the ICB to decommission the service.
Practices should also consider advising all patients that with effect from 1st April 2026 due to the ICB decommission the service, the practice will no longer be starting patients on Mounjaro/tirzepatide or other similar drugs purely for weight loss (but consider to continue to prescribe if also needed for diabetes). You can also advise that the ICB has not commissioned any local service to provide patients with Mounjaro irrespective of whether they meet the criteria or not.
The LMC advises that practices consider a Personal Care Adjustment (exception report) patients for the QoF Obesity points. One of the accepted grounds for exception reporting is if there is no local service available.
You may wish to suggest that patients affected by the ICB’s decision should complain directly to them via email: llricb-llr.Complaints@nhs.net, and/or raise with their Member of Parliament.
The LMC has drafted a template letter which LLR practices are welcome to adopt and amend to give to their patients.
If you have any further questions or issues relating to this, please contact the LMC.
GP Tirzepatide Implementation and Management Weight Management Service Guidance (WITHDRAWN)
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.