GPs caught in the middle of a muddled tirzepatide rollout

Editor Sofia Lind questions the lack of planning, support and infrastructure for GPs among the rollout of tirzepatide in primary care

This week marks the start of the tirzepatide rollout in primary care. It’s a significant milestone for a drug that could transform the treatment of obesity. But while the clinical potential is clear, the implementation has left much to be desired.

Instead of a national programme, NHS England passed responsibility to ICBs with limited notice and a vague centralised framework, leaving local leaders scrambling to decide how (or whether) general practice would be involved. The result has been a patchwork of plans, some involving GPs with funding, others designing services that bypass practices to an extent – and many not ready at all.

Several GPs have told us they only heard from their ICBs this week – on the day the rollout was due to begin – that services weren’t yet in place. In some areas, practices have been left to manage patient expectations without clear messaging, funding or protocols. One GP reported three separate ‘by the way’ queries about tirzepatide in a single session on day one.

This isn’t surprising. The media coverage has been extensive, and few patients will have understood that this is a long, slow, targeted rollout. But it’s not fair to leave practices in the dark and expect them to manage the fallout.

Perhaps GPs could have been given a national (and lucrative) enhanced service, centrally funded and designed? This could have ensured consistency, supported practices, and avoided creating postcode lotteries. As we have revealed today, some ICBs aren’t planning to offer access until later in the year, in contradiction to NHS England’s own timeline and not in the spirit of NICE’s recommendation.

This disjointed approach risks deepening health inequalities. Patients in some areas will get access and structured support, while others will wait months for a service to be set up.

And although the focus here is on implementation, it’s worth remembering what’s at stake. Obesity-related conditions like type 2 diabetes and cardiovascular disease already place a huge burden on the NHS, particularly in primary care. Tirzepatide has the potential to reduce long-term costs – and workload – significantly, if it’s used well.

Dr Heather Ryan’s recent piece for Pulse is a reminder that these treatments are not just clinically powerful, but capable of shifting the entire dynamic of patient consultations. But that potential won’t be realised without proper planning and support.

GPs aren’t resistant to helping deliver this. But once again, they’re being expected to do so without the tools, time or clarity to do it properly.

Sofia Lind is editor of Pulse. Find her at [email protected] or on LinkedIn