ICB resumes referrals for weight-loss drug pathway amid GP ‘frustration’
Exclusive One ICB has acknowledged ‘frustration’ experienced by GPs due to pausing of referrals to weight-loss medication pathways, amid issues with wraparound obesity care capacity.
GP practices in North East and North Cumbria who signed up to the tirzepatide (Mounjaro) LES were told to pause referrals as ‘treatment capacity’ had been reached, and the ICB said it was ‘awaiting confirmation’ from NHS England regarding the possibility of additional places on behavioural support programmes.
The ICB had also told practices to set up waiting lists and advise patients that they would be contacted if more places became available.
In a message to GPs, seen by Pulse, the ICB said: ‘Referrals to the weight-loss medication pathway are currently paused as treatment capacity has been reached and we are awaiting confirmation from NHS England regarding the possibility of additional places, please do not submit new referrals at this time.
‘Practices may wish to maintain a waiting list or advise patients they will be contacted if further places become available.’
The pause was due to an ‘internal auditing’ to ensure there were ‘sufficient’ levels of behavioural support available on the NHS Behavioural Support for Obesity Prescribing (BSOP) programme, which is commissioned separately by NHSE.
NHS England is responsible for providing ‘centrally funded wraparound care services’, which NICE said is essential alongside the weight-loss injections, when it greed to a phased approach to implementation starting in June last year.
NHS England confirmed to Pulse that there were enough spaces on the programme and now the ICB has reopened referrals following the auditing, but Pulse understands that the week-long pause caused GPs to turn patients away and increased levels of admin workload.
It comes after the Government announced last week that the GP contract will be amended to include two new QOF indicators, which will ‘track’ the provision of obesity care, including offering ‘evidence-based advice’, referrals to weight management programmes and NHS-approved weight-loss drugs.
ICBs are also meant to expand access to the drugs on a rolling basis, with patients with at least four of the five health conditions listed plus a BMI of 35 – 39.9 expected to access the service from June this year.
One GP in county Durham told Pulse: ‘I thought it was pretty striking since it came in the same week we were told it was going to be added to QOF.
‘I do our Mounjaro clinic and there’s more people coming through all the time asking about this, and from later this year we are supposed to be doing cohort 2.
‘It feels like there’s a real mismatch between what we have been told to do, and then what we are told we can do.’
An ICB spokesperson told Pulse: ‘With clinical need for tirzepatide in the North East and Cumbria so high, we understand that temporarily pausing referrals can be frustrating for GPs who just want to get on with treating their patients.
‘While referrals have now re-opened, this short pause was due to internal auditing to ensure there were sufficient levels of externally commissioned behavioural support available for patients – this audit was not due to issues with capacity, nor are there any at present.’
An investigation by Pulse’s sister title The Pharmacist revealed this week that some ICBs are imposing their own thresholds for prescribing Mounjaro through primary care that go further than the national thresholds.
Last week MPs heard evidence collected by Pulse that weight-loss jabs are significantly adding to GP workload in a hearing of the Health and Social Care Committee on food and weight management.
A Pulse survey in September which found around one in 25 GP consultations now relate to Mounjaro was highlighted by witnesses advising MPs on how weight-loss jabs should be provided through the NHS.
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