The LMC recognises that this is a topical matter within General Practice at the moment, so we have produced a briefing note for practices in LLR to use to act as a guide and to support practices:
- Briefing note on Tirzepatide in general practice (updated August 2025)
In the June LMC newsletter, we reported to practices that following the announcement of the national directive of this being prescribed in General Practice, there is currently no commissioned service in LLR.
Although the details are not yet agreed it is likely that the service will be a hybrid in LLR:
- Referral by general practice to a secondary care service.
- Secondary care to do the initial triage: checking criteria, counselling, teaching how to self-administer, and arranging wrap-around services. They will also be responsible for rationing if the number of eligible patients exceeds the number funded by NHS England (see May Newsletter). The referral proforma will also ask some additional questions to help prioritise treatment (e.g. if patient having fertility treatment, waiting for operation or has pre-diabetes etc).
- Once commenced on tirzepatide, patients will be referred back to general practice for further reviews and titration in line with NICE guidelines. This will be contracted/funded by a separate contract. Although the service was supposed to be available from 23 June 2025, it will not go live until at least August
The LMC are aware that patients are also asking to be referred to services like ‘Oviva’ under he Right to Choose framework. The ICB is currently not commissioning any Tier 3 services, and in their LLR GP Newsletter for the Leicester, Leicestershire & Rutland Local Medical Committee / Newsletter week commencing 26 May 2025, the ICB advised that they would not fund any patient referred to Oviva at present.
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 around whether they need to 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 tension as GPs have a duty of care to their patients, but this is currently unfunded in LLR. We therefore provide the template letter below that practices can decide to use.
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.