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Weight Management - Tirzepatide (Mounjaro)

Checked: 13-06-2025 by Rob Adams Next Review: 13-06-2027

Overview

Update 11.7.25

NICE technology appraisal (1) in December 2024 advised that Tirzepatide (Mounjaro) should be available in primary care for weight management and NHS England have been working towards implementation provisionally from 23rd June 2025.

The BNSSG Weight Management Group (including representatives from BNSSG ICB, GPCB and Avon LMC) have been developing the delivery model and infrastructure so that tirzepatide can be delivered locally in primary care. The following information is to support Practices to prescribe tirzepatide in weight management.

Primary Care Delivery Model and offer to Practices (LES)

A delivery model and offer of a LES to practices has been shared with BNSSG Practices. The delivery model is shown below.

Face-to-face appointments in green on initiation, at 6 months and at 12 months.
Patient contact at weeks 4, 8, 12 and 16 shown in blue (do not need to be face-to-face).
Wraparound care (WAC) touchpoints are shown in brown – see WAC details below.

Wrap Around Care (WAC)

WAC is mandated by NICE alongside tirzepetide prescribing (1) and should encompass nutrition and dietetic advice, physical activity and functional movement, behavioural support and lifestyle change tools.

NHSE have commissioned an interim WAC provider to allow systems to mobilise a weight management service in primary care through the NHSE Diabetes Prevention Programme (NDPP); in BNSSG this is Living Well Taking Control.

Patients will be provided with Behavioural Support for Obesity Prescribing (BSOP) accessed from primary care as a 9-month programme. Patients will be offered a choice of three delivery models:

Face to face group sessions – traditional format with peer interaction within community settings.
Remote digital groups sessions – live, interactive support via video conferencing.
Fully digital delivery – Flexible 1-1 support via the Liva Healthcare App using a smart phone or tablet.

Please complete the attached referral form (also available on EMIS).

**Please note: Tirzepatide should not be prescribed for weight management if the patient does not agree to engage with WAC.**

Prescribing criteria

The primary care eligibility criteria for the NHSE cohort 1 in Year 1 are as follows*:

BMI ≥ 40 and;
4 or more ‘qualifying’ comorbidities from the following list – hypertension, dyslipidaemia, obstructive sleep apnoea, cardiovascular disease, type 2 diabetes mellitus.

Use a lower BMI threshold (usually reduced by 2.5 kg/m2) for people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean ethnic backgrounds.

* NICE technology appraisal TA1026 recommends tirzepetide BMI ≥ 35 and 1 or more weight related comorbidities but the recommended implementation from NHSE for primary care at this stage is as above. Patients meeting the NICE TA criteria can be considered for referral to Tier 3 & 4 Weight Management Service - BNSSG , if appropriate.

GP IT template

We recommend that the Ardens ‘NHS Obesity Medication Pathway’ template is used as a clinical tool to support assessment of eligibility, medication initiation, medication review and record of wraparound pathway. This template also supports the key metrics that NHSE require to be completed to support funding for the ICB. See Tirzepatide BNSSG Prescribing Guidance for further information and guide to completion.

Training

A live Teams webinar for Practices was run on Wednesday 11 June. This has been recorded and is available below in addition to FAQs from the webinar.

Resources

Training and Prescribing

Patient Information

BNSSG ICB information

New medication for weight loss: Tirzepatide (Mounjaro) BNSSG ICB website

NHSE have provided FAQs for patients and this can be found on the Joint Formulary Remedy website:

Obesity (Remedy BNSSG ICB) - see link to Tirzepatide FAQs for patients.

There is also information on the NHSE website:

NHS England » Weight management injections
NHSE Interim commissioning guidance
NICE TA 1026 Overview | Tirzepatide for managing overweight and obesity | Guidance | NICE (also see tools and resources tab)
NHSE Obesity Medication - Pathway Obesity Medication Pathway

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.