GPs report surge in workload from patient requests for Mounjaro

Exclusive GPs are facing a major increase in workload as patients seek access to tirzepatide (Mounjaro), since the NHS began offering the obesity drug in primary care in June.

A survey carried out by Pulse and our sister title Nursing in Practice asked more than 1,200 GPs and practice nurses about patient requests for tirzepatide, finding that on average one in 25 consultations (4%) now involve some discussion about the GLP-1 receptor agonist, either as the main issue or as a ‘while I’m here’ question.

And one in 10 respondents (9% of GPs and 10% of practice nurses) reported that patients ask about Mounjaro in as many as one in 10 consultations.

GPs told Pulse that there has been a ‘huge influx’ of patients wanting to be put on the drug, with one reporting that ‘between one in five to one in 10’ appointments now include discussion about it.

Around 240,000 people are expected to be offered Mounjaro on the NHS for obesity over the next three years, with frameworks supposed to have been set up by ICBs by 23 June.

But GPs say that, in many cases, they are not yet able to prescribe the drug because ICBs have been slow to set up prescribing pathways. Under national guidance, patients must receive wrap-around care alongside the injections, and ICBs are responsible for commissioning these services.

As a result, GPs have found themselves explaining to eligible patients that the treatment is not yet available locally, despite national announcements.

One GP, who wished to remain anonymous, said: ‘From 23 June, patients started asking about [Mounjaro], but our local ICB did not develop a plan before this date. It would have helped if that had been done before media announcements.

‘Patients were calling up to request appointments to be given GLP-1, which then took up a lot of our admin time and time away from other unwell patients.’

He added that ICBs had not yet arranged weight management hubs to provide wrap-around care, and that GPs don’t have the expertise required to manage these patients.

‘There would need to be designated clinicians who were trained in prescribing GLP-1s for weight loss, and many GP colleagues are not trained in this yet, nor has there been any training forthcoming in my locality as far as I am aware.’

Media coverage about Mounjaro has been extensive, but it has not made clear to patients the service is being rolled out in phases to manage demand. The first cohort of patients are those with a BMI of 40 or above, together with at least four weight-related comorbidities.

Even where services have been set up, areas have only budgeted for very small numbers of patients. That means many will not be able to access the drug even if they meet eligibility criteria, one GPwSI in weight management told Pulse.

‘I have heard from our LMC that some PCNs were allocated four places for patients, but they’ve actually got 16 that meet the “40-plus-four” criteria. So, they’ve now got to choose which four out of 16 can have it – and that is just not equitable,’ she said.

GPs responding to Pulse’s survey said they are bracing themselves for even more requests for Mounjaro, from patients who have accessed it privately wanting to switch to NHS treatment.

This comes as the UK price of tirzepatide for those accessing it privately is set to increase by 170% next month, with a month’s supply rising from £122 to £330. GPs have been told they can only switch patients to NHS-funded treatment if they meet the eligibility criteria.

One GP told Pulse: ‘Very soon, I anticipate floods of people coming to us saying, “I need you to continue this medication for me because I can no longer afford it”.

‘You’ve got unlimited demand, and limited resource. That’s really difficult for the individual, and it’s really difficult for the doctor – there’s a lot of moral injury, and it places a lot of strain on the doctor patient relationship.’

Meanwhile, Pulse has exclusively revealed GP concerns as some patients who do not meet all the criteria but are in greater need are unable to access the drug, in some cases delaying access to life-saving treatment.

A GPwSI in weight management told Pulse: ‘We have people who have got cancer and can’t have surgery because they’re too overweight, and they’re waiting but can’t get weight-loss medication. Or someone with a BMI of 90 but only has one of the comorbidities.

‘We just want to be given discretion for sensible prescribing. We’re not trying to put everyone on it, but these people are desperate.’

GPs are also fielding requests from secondary care doctors asking them to prescribe it, piling more pressure and work onto practices.

Dr Lee Sanders-Crook, a GP based in Stafford, said: ‘On occasion we receive clinical letters from specialists, like orthopaedics looking for weight loss pre-knee replacement, advising we start tirzepatide.

‘Putting aside the issues with prescribing on behalf of others, these letters cause problems, as we are left to deal with patients’ unrealistic expectations, unfairly raised by other health care professionals’ recommendations.

‘At best it simply wastes an appointment, and the patients’ and our time. At worst it leads to resentment and discontent in the patient-healthcare interface.’

Liverpool GP Dr Laura Shaw agreed, saying requests from hospital doctors to start weight-loss medication is ‘frustrating’.

‘This has happened on multiple occasions. It is leading to patient frustration and complaints in some cases.’

Commenting on Pulse’s survey results, a Department of Health and Social Care spokesperson said: ‘We expect NHS Integrated Care Boards to be making these drugs, which can help tackle the obesity crisis, available as part of the phased rollout, so those with the highest need are able to access them.

‘As we shift the focus from treatment to prevention through our 10-Year Health Plan we are determined to bring revolutionary modern treatments to everyone who needs them, not just those who can afford to pay.’

An NHS England spokesperson said: ‘Weight loss drugs have a vital role to play in helping many more people manage their weight and lead healthier lives, and the NHS is developing and rolling out a range of lifestyle support that will be available locally and online to ensure they can be prescribed by GPs as part of holistic care.

‘The NHS is fully supporting the phased rollout of tirzepatide for eligible patients, having issued guidance in line with the NICE guidance, and provided funding to local ICBs to support patient care in March 2025.

‘These represent brand new services in primary care that are being established and scaled up over time, starting with those who are in the most need – and in the meantime, eligible patients can get weight loss support from a range of other services including the NHS Digital Weight Management programme.’