Letter from my GP re GLP1s

[TheActualQueen]

I have been on WLIs since October.
I received a letter from my GP today thanking me for letting them know I’m taking WLIs… (the provider asks permission to tell them) so, 5 months later, telling me that:

“Currently, we are unable to offer NHS support or resources for GLP-1 medications prescribed privately to patients who do not meet the NHS prescribing criteria”

What the hell is the point in my telling them I’m on these meds and what is the point in this letter?!

I’m saving the NHS 100’s of pounds paying for my own meds and now I’m no longer “obese” I’m probably saving them money down the line as I age.

Anyone else had similar?

The providers give it before checking with the GP. I don't think they should personally. My surgery is in Wales and they don't charge for sending such a letter.

That would add enormously to workload of GPs and is not feasible.

@TheActualQueen - Of course your GP isn't saying they wouldn't treat you if you had any issues. There's been a lot of misunderstanding by posters here.
The NHS do not prescribe WLIs on their own, they will only prescribe them if they put in place what is called "wraparound care". This consists of lots of things including clinical support (dose management, medication reviews, referrals to other clinicians) and behavioural support (diet, nutrition and exercise support etc).
Your GP is simply saying that they will not provide these wraparound services to you as you have not been prescribed by the NHS.
You can read all about the wraparound services the NHS provide for those prescribed the drug HERE - and it is the cost of providing these services which is delaying a wider rollout of WLIs generally, not the cost of the drug itself.

It's a ton of work for them as it is. There should be tighter safety measures in place. People will say anything to get the jabs.

@MissBattleaxe I hope that GP surgeries and the people that work there appreciate that people like the OP and me have no choice about letters being sent to GP surgeries? I fully understand that they are overworked and that they don't have capacity for even the basics for the patients that they do need to see. I don't make appointments for myself with the GP, I haven't been to see them in person for anything to do with my own health for several years now. I have an annual review for BP medication which is done via text with a pharmacist, using my own at home BP readings and a blood test done at the local phlebotomy clinic, and my ongoing BP medication prescription. That's the only contact I have with them. I'd ideally like to get off the BP medication at my next review, as my BP is now significantly lower than it was, due to the Mounjaro-induced weight loss. Then I'd be even less trouble to my GP.

Anything else, if there was anything, I'd use the private GP service I have access to via my partner's work health insurance.

Considering they force people to go online for appointments (which has really worried and upset some people in our area), it seems ridiculous they're sending a paper letter!
I've read that providers now need to tell GPs, but lots of people are buying/doing things that could affect their health, and don't tell the GP (food supplements, types of exercise, maybe even surgery abroad that they then want the NHS to fix).

Some people. And there are tighter measures, but if GPs can’t cope now, then asking them to approve each one prior to sending out would take them down. It’s a ridiculous idea.

Thanks for your reply.
That was really not apparent from their letter.
I haven’t asked them for anything.
I had no choice but to provide their details when getting my online prescription.
I don’t often visit the GP to be honest!

I agree there isn't the capacity to approve prior to prescribing, but the danger is to the people who are not honest with the provider. The questions are along the lines of eating disorders, Diabetes etc and it can put the patient at risk. It's a dilemma.

At the surgery where I work, if people are unable to complete the forms, they can still phone in and a receptionist will do it for them.

Just ignore it, they OBVIOUSLY have to treat you if there’s side effects

When I went to my GP (BMI of 21 now) he almost hugged me he was that delighted and I’d NEVER met him before. He was so happy that literally all my conditions had gone.

I was there to check they’d all gone as they’d been hassling me for about a year about being pre-diabetic.

Different doctors seem to have different views on weight loss jabs. My weight loss led to gallstones and the first couple of times I ended up in agony on a&e the drs dismissed my symptoms as side effects of the jabs. The third dr ensured I had for them from a proper pharmacy and then investigated what was actually going on. I quickly had my gallbladder removed and a month or two later went back on the jabs and have continued to lose weight.

So if a GP surgery refuses to help on what appears to be a side effect related issue (although it might not be), the patient has to rock up to A+E clogging that up now?

@islingtontrial I really think you should be escalating that with the practice manager. That should NOT be happening. The pharmacist is significantly overstepping (and is incorrect).

I guess that’s why they insist on telling your Dr. Makes sense they tell them. But not that your Dr should be annoyed with you!

My friend took the jabs because both her parents are GPs and they suggested she try them. They said they’re perfectly safe. She’s lost 4 stone and looks and feels so much healthier.

So not all GPs are against it.

Small point…no drug is “perfectly safe” . I’m shocked a doctor would even say this

All drugs have a risk benefit profile ( indications vs counter indications).
everyone needs to know these for the drugs they take, and make informed decisions as to where they draw line on benefits vs risks.

so these drugs, developed from years old diabetes 2 drugs, are “safe” for a lot of people who obese and with comorbidities. Hence NICE clinical decions re nhs funding. How much benefits outweigh risks in people marginally overweight, or even normal weight because this is happening, in private prescription, is in long term less clear. Clinical trials did not cover long term use. Nor use in mildly overweight.

I worked in pharma industry as a development chemist, including one of companies now producing weight loss drugs. I personally worry about “over prescribing” through private prescriptions without wrap around protocol used by nhs. I worry people aren’t being picked up with side effects early enough. I worry that stage 3 CT showed a lot of people put weight back on when they stopped drugs, so without wrap around people are going to put weight back on, then retake drugs, put weight back on and yo-yo like any diet. Or they’ll spend a shit ton of money staying on drugs for decades, when there isn’t data from any longitudinal study yet to determine risk vs benefits in people near normal weight by then, and without comorbidities. I’m also friggin worried at increasing amounts of counterfeit drugs getting into supply chain. That’s a massive challenge to pharma companies, like an arms race to outwit counterfeiting

I do think these drugs can be useful “tool” but they are not a miracle cure for long term weight management. I think in years to come they’ll be part of wider treatment protocol along with other different pathway drugs. A bit like how we’ve evolved from the initial antivirals used to prevent hiv becoming aids, to a protocol we have now, 30 plus years later, where a combo of drugs reduces the viral load to effectively nothing, producing as close to cure as we have. We’re early stages in fighting obesity- a lot of great research happening….and that’s because pharma companies just like diet industries and gyms know there is a lot of money to be made from people struggling to control weight. They all want a slice of that pie 😉

They’ll tell you to contact your private provider if there’s a hint of a gastric problem. I thinks it’s really poor practice as you’re improving your health at your own expense.

Agree with this.
nhs is legally obligated to treat people no matter what their lifestyle choices or private health care options are

gps aren’t going to provide the wrap around servives for these drugs given privately, as they do with nhs prescriptions. They ain’t going to provide advice on dosage, type or write a script

but they’re, like the pharmacist legally obligated to investigate and report adverse reactions under yellow card system.

pharmacist implying he’d refuse to use yellow card system shouldn’t be a registered pharmacist frankly

It means that they will not be responsible for any issues arising from their patients lying about pre-existing conditions/medications/eating disorder/current weight to their private provider. Sometimes the letters from the private providers ask GPs to check the patient records to make sure they meet the criteria, or even ask them to basically give the patient a health check outside the standard NHS health checks - and then inform the private provider. Effectively doing the private provider’s work for them in NHS time and without a shared care agreement.

They saying they didn’t prescribe the drug so aren’t monitoring how it affects you or how much progress you’re making with it or whether it interacts with anything else you might be taking etc. The responsibility, as always, lies with the prescriber.

Of course if you turn up with stomach pains or other side effects they will help you. They don’t prescribe alcohol but GPs help with the issues it causes.

I think it's just acknowledging that the NHS would not prescribe it to you but they have noted that you are taking it privately. I'm pretty sure I had a similar letter from my GP. I think it's only weird that you received it months later, which sounds more like slow admin than unnecessary admin. I'm glad my GP has acknowledged it and so is up to date if I do present with any related issues / other issues.

@WickedWitchoftheDesk if GPs get asked to do that work, they should and I hope do, say no. Because the onus is on the private provider to do those checks or simply refuse to prescribe. Do you know of GPs who are actually responding and spending time and money on additional health checks?

They’re not saying they won’t treat you, they’re saying they cannot assist you in eg taking over the prescribing of it, weighing you, offering psychological weight loss support, providing needles and sharps bins etc.

I work in a GP surgery. We have HUNDREDS of people now using Mounjaro (and other GLP-1s) privately. Some seem to think that now the prescriber has “involved” is the care has devolved to us. This is not the case. The responsibility lies with the prescriber, and with you.

You wouldn’t believe the stuff people source or take privately then expect us to take over, such as monitoring bloods, observations such as weight, blood pressure etc, switching their prescriptions from private to NHS.

Your GP practice is just making it clear that they won’t be doing that. No need to be snarky about them. Proactive admin like that can save a lot of time, phone calls, emails and appointments.

He may, potentially, have been saying that he isn’t an expert on WLI so has limited knowledge on how they interact with other meds. That’s being kind to him.

As for your thyroid, no. If you need that checking and/or treating then of course your GP surgery should & will do that. It’s negligent to say otherwise surely?

@SilenceInside No, none of the ones I work for would take on this additional work or responsibility. I do know of an occasion where they have contacted a patient to discuss GLP1 if they have been prescribed inappropriately (i.e the patient has not told truth to the prescriber) but that is quite rare. Normally if it is the first time it has been prescribed, the letter gets sent to the GP or pracice pharmacist to note on the medication list so that any interactions with other meds/pre-existing conditions will be flagged by the system.