It was announced on 23 June 2025 that people living with obesity will be able to begin accessing tirzepatide (Mounjaro®) for weight loss purposes in primary care settings.
However, this announcement does not mean prescriptions will be provided immediately to all eligible patients in GP practices across the country.
Weight management services are locally commissioned and funded at an Integrated Care Board (ICB) level, which means services will differ across each ICB. In mid and south Essex, access to tirzepatide (Mounjaro) will initially be through specialist weight management services only.
Patients who wish to access Mounjaro through the specialist weight management service must meet the eligibility criteria for Mounjaro. Patients who currently pay for Mounjaro outside of the NHS and would like to request a prescription through the NHS will need to meet the eligibility criteria for the medication at the time of their NHS referral to the Tier 3 specialist weight management service. Please refer to the FAQ below for further details.
Please note that acceptance onto the Tier 3 specialist weight management service does not guarantee access to Mounjaro. Access to this medication is prioritised for those with the greatest clinical need; it’s for people living with obesity, in poor health with multiple obesity-related conditions as they would benefit most from the treatment. Details of the eligibility criteria for Mounjaro are included in the FAQ below.
Access to tirzepatide (Mounjaro®) through primary care is not expected to start in mid and south Essex until later in 2025.
Find out more through the Frequently Asked Questions (FAQ) below:
Eligibility criteria and access to tirzepatide (Mounjaro®)
The National Institute of Health and Care Excellence (NICE) has recommended a treatment called tirzepatide (Mounjaro®) to help manage obesity. This treatment is to be used alongside healthy eating and physical activity advice.
The use of this treatment is now being rolled out in accordance with NHSE Interim Commissioning guidance.
In mid and south Essex, this means that tirzepatide will be offered to those patients at highest risk first, and gradually expanding the groups of people who can access this based on clinical risk.
In mid and south Essex, tirzepatide (Mounjaro®) will be available through Tier 3 specialist weight management services to individuals facing the most significant health risks related to their weight.
Click here to read the eligibility criteria for the Tier 3 weight management service. Please note that acceptance onto the Tier 3 programme does not guarantee access to weight loss medications. Medication is offered via this service where available and appropriate for patient’s clinical needs.
Tirzepatide (Mounjaro®) will not be accessible to everyone who wishes to use it. People with the highest health risks and who meet the clinical criteria will be prioritised. Full qualifying clinical criteria is a BMI (Body Mass Index) of 40 or more plus four or more of the following diagnosed health conditions:
- type 2 diabetes
- high blood pressure
- heart disease
- obstructive sleep apnoea
- abnormal blood fats (dyslipidaemia)
Access to the drug must be accompanied by wraparound care which will include support for people to make dietary changes and to increase physical activity. Tirzepatide will not be prescribed as a standalone treatment, and patients must fully participate with the wraparound support programme.
Tirzepatide (Mounjaro ®) might not be considered clinically suitable for everyone, and not everyone who meets the eligibility criteria will want to use it to support their weight loss. Therefore, there are a number of alternative weight management services available in mid and south Essex.
The national roll out of tirzepatide for the management of obesity in primary care settings to eligible patients begins on 23rd June 2025. However, the national roll out on 23rd June does not mean people will be able to get a prescription for tirzepatide (Mounjaro®) on this day.
Weight management services are locally commissioned at an Integrated Care Board (ICB) level, which means services will differ in ICBs across England.
In mid and south Essex, access to tirzepatide will initially be through Tier 3 weight management services only. Access to tirzepatide through primary care is not expected to start in mid and south Essex until later in 2025.
According to NICE’s calculations, as part of its Technical Appraisal for tirzepatide (Mounjaro®), 3.4 million patients would potentially be eligible for the drug, however the NHS does not have the services or existing resources to manage this number of people all at once.
Therefore, access will be phased in gradually through a special agreement between NICE and the NHS in England, to make sure healthcare services aren’t overwhelmed and can manage the extra demand safely. NHS England has acknowledged that it is likely to take up to 12 years for every eligible patient to access this medication.
There will be a phased approach to rollout in primary care settings, and initially access to the medication on the NHS will be prioritised to ensure patients with the greatest clinical need can access the medication. This approach was developed based on discussions with clinical experts and engagement with key organisations.
The following weight related health conditions are considered as a way of prioritising groups of people with the greatest clinical need:
- type 2 diabetes mellitus
- high blood pressure
- heart disease
- obstructive sleep apnoea (when your breathing stops and starts while you sleep)
- abnormal blood fats (dyslipidaemia)
The following groups of patients will be eligible for access to tirzepatide (Mounjaro®) in primary care settings in the first three years.
Cohort 1 – will start in 2025
- At least four of the five health conditions listed above plus a BMI of 40 or more.
Cohort 2 – in addition to the patients in Cohort 1 access to the medicine will also be offered to patients meeting the following criteria for year two.
- At least four of the five health conditions listed above plus a BMI of 35 – 39.9
Cohort 3 – in addition to patients in Cohorts 1 and 2, access to the medicine will also be offered to patients meeting the following criteria for year three.
Tirzepatide might not be suitable for everyone and not everyone who meets the eligibility criteria will want to use it to support their weight loss.
A healthcare professional will discuss the most appropriate care and support based on individual patient’s need. This could include behavioural support programmes, and medical options including prescribing or bariatric surgery.
Patients can continue taking tirzepatide (Mounjaro®) if they are prescribed it by the NHS to manage their diabetes. If you have any questions, contact a suitable healthcare professional.
If patients are using tirzepatide (Mounjaro®) bought privately, they may be able to access the medication through an NHS prescription if they meet the NHS qualifying criteria outlined above. However, patients should not gain advantage over other patients waiting for NHS care and would join the end of any existing waiting list for that service.
It is important your GP is aware you are taking tirzepatide (Mounjaro®) if it hasn’t been prescribed by the NHS, as it may impact on your health and any other treatments you are having or may need.
NHS Mid and South Essex ICB is working with local healthcare providers to make access to tirzepatide available in primary care settings in late 2025. Until then, access will be through specialist weight management services.
Tirzepatide will only be available on the NHS initially to those with the highest clinical need in line with the clinical criteria for the medication.
Access via primary care won’t necessarily be through a patient’s GP practice; community based programmes and other non-GP primary care providers will also provide access. These models are designed to relieve current pressures on GP practices and ensure weight management services are delivered holistically.
There are currently no plans to make tirzepatide available on the NHS through pharmacies in mid and south Essex.
Mid and south Essex only commissions one NHS specialist weight management service, therefore it is not possible to transfer to another MSE ICB commissioned service.
Information about weight management services is available at Weight management services – Mid and South Essex Integrated Care System.
Tirzepatide (Mounjaro®) will not be suitable for everyone and not everyone who meets the eligibility criteria will want to use it to support their weight loss.
There are a number of alternative weight management services available in mid and south Essex. These services are listed on the MSE ICB website at Weight management services – Mid and South Essex Integrated Care System.
About tirzepatide and how it works
The weight loss medicine tirzepatide, also known as Mounjaro®, is a GLP-1/GIP agonist. Other medications such as semaglutide (Wegovy ®), liraglutide (Saxenda ®), are known as GLP-1 agonists.
These medications help reduce your appetite by affecting the part of the brain that controls hunger and digestion. It decreases your appetite and slows the movement of food passing through your body, making you feel fuller for longer. They also slow down the time it takes the stomach to empty and help control blood sugar levels.
Until now most of these medicines have been used in the NHS to treat diabetes, to help control blood sugar levels, and to help improve diabetes and other health conditions.
Tirzepatide (Mounjaro®) can only be prescribed by a healthcare professional alongside programmes that support people to lose weight and live healthier lives, by making changes to their diet and physical activity.
Tirzepatide (Mounjaro®) comes as an injection, which you inject yourself once a week.
More information can be found here: GLP-1 medicines for weight loss and diabetes: what you need to know – GOV.UK
Any patient prescribed tirzepatide must participate in the specifically designed ‘wraparound’ care required by NICE guidance.
This focuses on diet, nutrition and increasing physical activity levels. As NHS England develops the service, it will provide more details of the wraparound support offer for patients who qualify.
Patients cannot be prescribed tirzepatide if they do not wish to undertake the wraparound care support.
Information for patients who are prescribed tirzepatide
Eligible patients will be contacted and invited to attend the service for an assessment.The assessment will include discussions around the different options for weight management. The clinician will carry out checks to make sure you are eligible, this includes BMI, medical assessment, medication history and psychological assessment. The risks and benefits of starting the medication will be discussed, so you have the information to make the right choice for you.
If you are eligible, you do not need to decide immediately if you want to start tirzepatide (Mounjaro®). More information can be found in this tirzepatide (Mounjaro®) decision aid produced by NICE. If you do decide to start Tirzepatide, you must also agree to fully participate in the wraparound diet and exercise programme for at least 9 months.
Normal prescription charges will apply unless you are entitled to free NHS prescriptions (for example, because you have a medical exemption certificate).
Follow the link to find out more about whether you are entitled to help with health costs Help with health costs – NHS.
Like all medications, tirzepatide (Mounjaro®) can cause side effects and healthcare professionals should discuss the side-effects with you. The medication will come with a Patient Information Leaflet which lists common side effects including:
- feeling sick
- indigestion (heartburn)
- constipation
- diarrhoea.
There can be some more serious side effects, such as low blood sugar, gallstones and inflammation of the pancreas (pancreatitis).
Tirzepatide (Mounjaro®) is a new medication, so any side effects should be reported through the Yellow Card Scheme, which is the government system used for recording side effects with medicines in the UK.
Patients taking tirzepatide (Mounjaro®) on the NHS for obesity management will be supported by the healthcare professional who is prescribing the medication – this may be in a primary care setting or specialist weight management service.
Healthcare professionals will focus on prescribing the medication, managing side-effects, monitoring the other long-term health problems, and managing any potential medicine interactions.
Patients must also participate in a lifestyle support programme that focuses on diet and nutrition advice when taking the medication and physical activity advice. Through the programme, people will be encouraged to make lasting habits that encourage long-term improvements in metabolic health, physical wellbeing and lifestyle. Patients must participate in this lifestyle support programme for the first 9 months of being prescribed the medication.
Patients cannot be prescribed tirzepatide (Mounjaro®) if they do not wish to undertake the wraparound care support. This is because the NICE recommendations state tirzepatide (Mounjaro®) must be prescribed alongside diet and physical activity advice.
NICE guidance recommends if you do not lose enough weight (5%) after 6 months of being on the highest dose you can manage, tirzepatide (Mounjaro®) should be stopped. This is because the medication is not working as well as it should be for you.
Currently there is no specified time limit for being prescribed tirzepatide (Mounjaro®). The decision to continue or stop tirzepatide (Mounjaro®) should be discussed with an appropriate healthcare professional at least annually.
Tirzepatide (Mounjaro®) should not be taken during pregnancy or just before trying to get pregnant. This is because there is not enough safety data to know whether taking the medicine can cause harm to the baby.
There is specific information about how these medications affect contraceptive methods, like the pill. The Faculty for Sexual and Reproductive Health has produced this information leaflet for patients to read: Patient-information-GLP-1-agonists-and-contraception.pdf
Tirzepatide (Mounjaro®) can affect the absorption of other medications being taken. In some cases, this may affect how well and/or how fast those medications work; or it may make no difference. For this reason it is particularly important that patients receive follow up care and advice from a healthcare professional. This medication is still relatively new, and the healthcare community are learning about how tirzepatide (Mounjaro®) interacts with other medications, for example HRT.
Before starting the medicine, a healthcare professional will check which other medications you are taking to see if there may be any medicine interactions and to see if they are compatible when taken together. While taking the medicine, some people may find that their long-term health conditions (like high blood pressure) improve, and they might need less medication. Your healthcare professional will talk to you about this, any monitoring that might need to happen and make any necessary changes to your treatment.
It is important to be honest with the healthcare professional if you are eligible for the medication. Let them know about any medical conditions, other medicines you are taking, the dose and if you buy any medication over the counter. This information will need to be considered before you are prescribed tirzepatide (Mounjaro®).