Tirzepatide (Mounjaro®) for obesity: Information for patients from 1 April 2026

From 1 April 2026, NHS England has confirmed that prescribing of Tirzepatide for obesity will be incorporated into the 2026/27 GP contract through new Quality and Outcomes Framework (QOF) indicators. GP practices are not mandated to prescribe tirzepatide, and participation may vary between practices.

How the service previously worked

From June 2025 to 31 March 2026, NHS England provided funding to NHS Cheshire and Merseyside Integrated Care Board (ICB) to support locally commissioning services to support access to Tirzepatide (brand name Mounjaro®) for eligible patients with obesity, in line with NHS England interim commissioning guidance.

Using this funding, NHS Cheshire and Merseyside ICB established community weight management services. This allowed:

• Patients to be triaged to assess whether they met the eligibility criteria. Where patients were assessed as suitable:

• Prescribing was undertaken by a trained prescriber, and
• Patients were referred to a ‘wrap-around’ lifestyle support provider alongside treatment.

Why the change?

In February 2026, NHS England confirmed that it would not be providing further funding to ICBs to continue this service beyond 31 March 2026.

Instead, NHS England confirmed that prescribing of Tirzepatide for overweight and obesity would be included within the new GP contract, which comes into effect from 1 April 2026.

Under the new national GP Quality Outcomes Framework approach:

• Participation by GP Practices is optional, and uptake may therefore vary between practices.
• Meeting the eligibility criteria does not guarantee access to treatment, as prescribing depends on local service availability and clinical assessment.
• Practices that choose to prescribe tirzepatide for obesity may do so only for specific patient cohorts, in line with NHS England interim commissioning guidance:

The National Institute of Health and Care Excellence (NICE) published recommendations for tirzepatide but recognised the need for a gradual approach to prioritise treatment for patients. So, NHS England developed qualifying criteria and patient groups who should be able to access tirzepatide first.

To be able to access the drug in the first 3 years, patients must meet the criteria we have outlined below.

NICE has committed to reviewing access criteria after year 3 to evaluate the implementation and delivery of Tirzepatide.

Further details on the prioritisation of availability of Tirzepatide can be found in the NHS England Interim Commissioning Guidance for Tirzepatide.

NICE has not approved these drugs for prescribing in GP/community settings so they are not available in our community weight loss prescribing service.

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. They mimic gut hormones released by the body after eating, telling the brain you are full, 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 helping 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®) is an injection, that 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

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. There are other options available including weight loss programmes that use tried and tested methods such as lifestyle and behavioural changes, nutrition and physical activity advice. Please speak to a healthcare professional about the best option for you in your local area.

There are a range of local weight management services which offer support in losing weight. These will vary depending on where you live. These include services commissioned by our local authorities.

The NHS Digital Weight Management Programme supports adults living with obesity who also have a diagnosis of diabetes, hypertension or both, to manage their weight and improve their health. It is a 12-week online behavioural and lifestyle programme that people can access via a smartphone or computer with internet access.

More information about obesity treatment is available via the NHS website.

The NHS Type 2 Diabetes Path to Remission Programme is available if you are aged 18 to 65, have a diagnosis of type 2 diabetes within the last 6 years and have a BMI over 27 kg/m2 (for people from White ethnic groups) or over 25 kg/m2 (for people from Black, Asian and other ethnic groups).

Adults can access the NHS Diabetes Prevention Programme if they have had a blood test in the last year that shows they are at risk of diabetes.

There are also a range of NHS online tools you can access:

Lose weight – Better Health – NHS

How to be more active – Better Health – NHS

NHS Food Scanner app – Healthier Families – NHS

You can browse more weight loss support apps via the Cheshire and Merseyside health apps library.

We also know there will be many people who do not qualify for weight loss medications which may cause disappointment and/or exacerbate new and existing mental health and wellbeing issues. People may find NHS talking therapies a helpful source of support.

For people meeting the eligibility criteria described in section 3, your GP may be able to support you in prescribing Tirzepatide. You will also receive support in relation to your lifestyle alongside the medication.

Every patient prescribed Tirzepatide on the NHS is required to participate in a specifically designed ‘wrap-around’ care service, as stipulated under NICE guidance. This focuses on diet, nutrition and increasing physical activity. Patients cannot be prescribed

Tirzepatide if they do not wish to get the wrap-around care support.

When you are prescribed Tirzepatide the person making the prescription will refer you to this service (provided by Reed Health who also locally provide the Diabetes Prevention Programme) who provide this support in Cheshire and Merseyside.

Any ‘digital/telephone provider’ under ‘Right to Choose’ must meet our remote weight management commissioning policy. This policy includes a number of eligibility requirements including:

1. The patient is aged 18 or over and registered with a C&M GP. AND
2. The patient has attempted to engage with community weight services but has been unable to gain any benefit. AND

a) Patients must have a BMI≥40 AND

b) 4 or more related comorbidities that could be improved if they lost weight.

Obesity related co-morbidities accepted:

• established cardiovascular disease
• hypertension
• obstructive sleep apnoea
• dyslipidemia
• type 2 diabetes mellitus

There is a tolerance unit of BMI 2.5 on each element of the criteria above in relation to at-risk groups that have higher obesity prevalence rates, particularly those with black African or Caribbean and South Asian origin.

Like all medications, Tirzepatide can have side effects, and healthcare professionals should discuss these with you. The medication comes with a patient information leaflet listing common side effects, including:

• feeling sick
• indigestion
• constipation
• diarrhoea

There can be some more serious side effects, such as low blood sugar, gallstones and inflammation of the pancreas (pancreatitis).

Tirzepatide is a new medication, and any side effects should be reported through the Yellow Card Scheme, the government’s system for tracking medicine-related side effects.

NICE guidance for obesity recommends that, if you do not lose enough weight (5%) after 6 months of being on the highest dose you can manage, Tirzepatide should be stopped. This is because the medication is not working as well as it should for you.

Currently, there is no specified time limit for Tirzepatide prescriptions. The decision to continue or stop Tirzepatide should be discussed with an appropriate healthcare professional.

If you are trying to get pregnant, you should have a discussion with an appropriate healthcare professional. There are specific recommendations about when to stop the medication before trying to get pregnant. Tirzepatide is not recommended in pregnancy or during breastfeeding because we have limited safety data. It should be stopped if you become pregnant.

The Faculty for Sexual and Reproductive Health has produced a patient information leaflet about how these medications affect contraception, like the pill.

Patients can continue taking Tirzepatide 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 bought privately, they may be able to access the medication through an NHS prescription if they meet the NHS qualifying criteria outlined in section 3 at the point of transition. However, patients should not gain advantage over other patients waiting for NHS care. You will also be expected to engage with the wrap around support that is mandated alongside Tirzepatide for weight loss.

It is important that your GP is aware you are taking Tirzepatide even if it hasn’t been prescribed by the NHS. It may affect your health and interact with other treatments.

A healthcare professional will advise you if you are eligible and if it is clinically appropriate for you to receive Tirzepatide as part of your care. This will reflect the criteria in section 3.

Every patient prescribed Tirzepatide on the NHS is required to participate in a specifically designed ‘wrap-around’ care service, as stipulated under NICE guidance. This focuses on diet, nutrition and increasing physical activity. Patients cannot be prescribed Tirzepatide if they do not wish to get the wrap-around care support.

When you are prescribed Tirzepatide the person making the prescription will refer you to this service (provided by Reed Health who also locally provide the Diabetes Prevention Programme) who provide this support in Cheshire and Merseyside.

If you do not engage with this ‘wrap-around’ support you may have your prescription of Tirzepatide stopped.

Behavioural support for obesity prescribing | Healthier You | Diabetes Prevention

Wraparound care is the name given to the support programme that must be provided alongside Tirzepatide (Mounjaro®).

This includes:

• Advice on healthy eating and nutrition
• Support to increase physical activity
• Help with making long-term lifestyle changes

You must agree to take part in this support programme in order to be prescribed tirzepatide for weight loss.

Normal prescription charges will apply unless you are entitled to free NHS prescriptions (for example, because you have a medical exemption certificate).

If you are taking a GLP-1 medication, please review our nutrition advice to help maintain muscle strength, prevent nutrient deficiencies and support healthy weight loss and condition control.