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NHS England is looking to tender for a contract to provide behavioural change support for patients prescribed tirzepatide (Mounjaro; Eli Lilly) for weight management in primary care.
On 15 May 2025, NHS England published a pre-tender market engagement request for information (RFI), which it said will be used to inform NHS England’s strategy to reprocure the NHS Diabetes Prevention Programme alongside the tirzepatide support programme.
The ‘wrap around care’ for patients using tirzepatide would comprise of two distinct elements: clinical support — including safe prescribing, monitoring of comorbidities and management of potential drug interactions — and behavioural support to drive sustainable lifestyle change through structured interventions, the document said.
“This service will ensure that all patients prescribed relevant weight-loss medications in a primary care setting have access to high-quality behavioural wrap around care that supports long-term lifestyle change; addresses the complex drivers of obesity; and maximises the clinical effectiveness of pharmacological treatment through accessible, person-centred support,” it added.
Both services would be delivered under one national provider framework, with a single operating model aiming to achieve “a coordinated referral approach” and “a designated lead provider responsible for enabling and supporting participant choice between face-to-face and digital delivery channels on an equal and informed basis from the outset”, according to the document.
The RFI also stated that if no responses were received, NHS England “may conclude that the planned approach is unviable”.
A spokesperson for NHS England confirmed to The Pharmaceutical Journal that the RFI was to inform behavioural wrap-around care only, not any potential availability of glucagon-like peptide-1 medicines in pharmacies.
National Institute for Health and Care Excellence (NICE) guidance on tirzepatide provision, published in December 2024, recommended the medicine as an option for managing overweight and obese patients, alongside a reduced-calorie diet and increased physical activity — either through primary care or specialist weight management services.
As part of a consultation process, published prior to the guidance, NHS England proposed to NICE a phased implementation plan for tirzepatide for weight management, which would lead to 1.6 million people being treated with tirzepatide by 2036.
NHS England interim commissioning guidance for tirzepatide, published in March 2025, said that centrally funded wrap-around care services for people prescribed tirzepatide would be available to all independent care board areas from 23 June 2025, which will be accessible from primary care settings.
A paper published by the Tony Blair Institute for Global Change (TBI) on 20 May 2025 called for a faster, broader approach to the rollout of anti-obesity medications (AOMs), as a slow rollout would “perpetuate access based on ability to pay rather than need” and widen health inequalities.
Under the TBI’s proposals, eligibility would be broadened to those with a BMI of 27 or above, while delivery would be predominantly through digital channels and access to free treatment would be means-tested.
The recommendations set out in the paper also suggested that weight management services should be commissioned based on outcomes and price, rather than specifying the model of care, and for the establishment of an accredited framework of providers to deliver direct-to-consumer services for weight loss.
“The NHS’s ten-year health plan rightly plans to pivot health services from treatment to prevention and tackle deep-rooted unfairness in health equity — but without a credible obesity strategy that can deliver at scale and pace, it will simply not achieve it. There must be recognition of the vital role that AOMs will play,” the paper said.
