AIBU to question GP incentives for prescribing weight-loss drugs?

[NinaNinComPoop]

And to ask what other prescribed medication awards GPs with financial incentives?

Beginning in April 2026, GPs in England will receive financial incentives, averaging £3,000 a year, to increase the prescription of weight-loss drugs, specifically Mounjaro (tirzepatide), to eligible patients. This move is part of a government initiative to accelerate the NHS rollout of these treatments to manage obesity, with up to £25 million in ring-fenced funding.
BBC +2
Key Aspects of the New Initiative:

• Targeted Incentives: The bonus is intended to encourage GP practices to prescribe Mounjaro to those with the greatest clinical need, rather than just those who can afford private prescriptions.
• Eligibility Restrictions: Despite the push, access remains restricted to specific groups. Initially, this includes patients with a BMI of 40 or higher (or 37.5 for certain ethnic groups) who also have at least four weight-related conditions. The eligibility threshold is expected to drop in 2026/27.
• Concerns over Implementation: While aimed at improving access, some GP leaders and experts have voiced concerns that the incentives may not overcome the "stark divide" in access and could strain GP workloads.
• Alternative Care Models: Amidst the focus on medication, some GPs are also expanding "social prescribing" to improve mental and physical health through non-clinical activities like community projects, which can in some cases reduce the need for medication.
• BBC +5

The move follows a broader push to make weight-loss treatments "to the many, not the few," aiming to reduce the long-term health burdens on the NHS.

This is literally how Primary Care funding works, OP. All of it.

Prescribing WLIs require GPs to do more work, eg additional appointments, monitoring etc. So under the current funding model they need to be paid for the additional resources required. Otherwise they would need to cut other services to free up resource.

There have always been additional payments for gp practices when the NHS has determined there is a clinical need to incentivise. These initiatives mean already cash strapped practices, need more manpower/resouces and more staff time to deliver. How would you suggest they do this? Ask people to work extra hours for free?

You’ve literally copied and pasted an AI search there.

What exactly are you objecting to, in your own words?

Are you suggesting that GPs are PERSONALLY incentivised to prescribe?
So bribery?

If so, what a load of rubbish. They are not.

If you are not suggesting this then you need to be much clearer in your OP because that is what it sounds like.

Exactly this. If you wish gp’s to take on additional work, they will have to be allocated the funding to do it- or allow them to reduce/stop other responsibilities. As this would fall outside the remit of the current GMS contract, it is not unreasonable to expect gp’s to be funded for it.

The rules which are to be applied to these new plans means it is not simply a case of gp seeing a patient once and prescribing the drug on repeat thereafter- there is going to have to be additional monitoring of progress and support with weight loss. In the case of patients with some other health conditions, these other conditions are going to require more intensive monitoring too. I doubt the funding is going to allow any significant profit for the practices, especially with rising costs they are currently facing. They won’t be raking it in by prescribing weight loss drugs.

Just echoing that this is literally how GP funding works. The government wants them to do extra work, it needs to be resourced.

Don't forget most GP practices like dentists, pharmacies and opticians are private businesses with NHS contracts. They are keen to do the extras as will get paid on treating a certain number.

You’re objecting to GPs being paid for work done?

Do you know what a BMI of 40 plus looks like?

Do you know how much it costs to treat ONE person who has had a stroke effectively, even quite a minor one? And how much it might save us as a country to reduce the number of strokes people have?

For some reason the idea that changing the NHS funding model would solve problems inherent in having health services is gaining traction. This is one example of this country’s ability to identify a health issue coming down the tracks and actually do something about it. Nationally. For everyone, whether they could pay for this out of disposable income or not. Because we have a national network of experienced general physicians out in the community who, given a chance, can build relationships with people and do things to improve their health.

GPs get extra money for all sorts of things. They are now business’s and obviously want extra money where possible.

But, it’s up to individuals whether they choose to take certain meds etc. 🤷‍♀️

Given you have to have four related conditions it's still a very high threshold. I can only muster up being fat so nowhere near qualifying.

Yes, YABU. Why no vote?

First post nails it.

Now ask Chat GPT about how GPs are incentivised to fit mirena coils, do age related health checks, offer flu vaccines and do smear tests and see what it churns out.

This is how GP practices are paid by the NHS!!!

Well, hopefully OP has learned something about how primary care is funded today!

Yabu
This sounds like a worthy initiative to try to get the medicine to those who need it. Rather than it being used by those who can afford it as a lifestyle drug.

Frustrating, isn’t it? I know my health would improve significantly, but those signifiers aren’t the ones they look at. My blood pressure, heart, blood sugar etc all seem to be ok. I’m hanging on for the wider roll out and hoping nothing breaks too badly while I wait!

You would think someone would learn about a subject before posting about it

I think that sounds like quite good news, rather than people having to go through Tier 3 weight-loss services, which are often miles away.

Not eligible myself due to BMI but I have watched many of the documentaries about weight loss injections.

Excellent move. It will help tackle the huge problem of obesity and save more money in the long term.

Hopefully it will also make GPs who have been reluctant to prescribe the WLI a bit more willing to reconsider.

Fingers crossed!

What's your incentive to post this OP? Are you against overweight people taking the opportunity to get control back over their weight and health? Why are you only questioning WLI's? We could provide a list of all the other treatments GP's provide through the same processes.

The majority of people who can afford it are not using it as a lifestyle drug. Would you like an example? I'm using it in order to start IVF (my weight is not the cause of infertility). It is being used as a tool to lose weight for a multitude of health concern reasons. Please educate yourself. My mental health took a massive hit after my 3rd pregnancy loss and I need a bit of help. Is that reason enough? Or would you class that as a lifestyle use?

You misunderstand the situation- it has never been the case of GP’s being reluctant to prescribe weight loss medication. The fact is that they have not been allowed to prescribe these medications in non-diabetic patients as there was no NHS funding for it. They were specifically prohibited from prescribing it on an NHS prescription other than as treatment for diabetes (and in some other conditions- not related as a route to weight loss- when advised by a specialist).

it is still going to have inclusion criteria for prescription, as currently the NHS budget would struggle to meet the costs if everyone with a raised BMI became eligible for NHs funded weight treatment with these medications.

You misunderstand the situation.

I totally understand about rules for what GPs can prescribe and how that changes. I'm not stupid.

I also know that many GPs have had different views about WLI and have not prescribed them even when they could. Many GPs don't understand obesity.