FOI 2026/1619

I am writing to request information under the Freedom of Information Act (2000).

I am conducting research on the national rollout of Tirzepatide for weight management, and variation in implementation across Integrated Care Boards.

For the purposes of this request, I would be grateful if you could provide information as it applied to your ICB as structured in early 2025 (NHS Greater Manchester ICB). I am aware that some ICBs have since merged or reorganised. I would be grateful if you could answer the following questions:

1. Is Tirzepatide available in primary care for weight management according to your ICB’s formal position?
2. If yes, please provide the month/year for each of the following, where applicable:

• Local pathway or ICB decision publication
• Formal notification to primary care of rollout (e.g., via bulletin/guidance/communication)
• Formulary inclusion/update to recommend primary care use
• Local Enhanced Service (LES) or Local Commissioned Service (LCS) to support primary care prescribing

3. Is Tirzepatide subject to an ICB-led prior approval process? If yes, please specify: (a) which clinicians or professionals are authorised to submit prior approval requests (e.g., GPs, specialists, pharmacists), and (b) the month and year the process was introduced.
4. Is Tirzepatide available for prescribing through specialist weight management services (e.g., Tier 3 or 4)? If yes, please provide the start date (month/year).
5. Has the ICB provided any additional funding to specialist services to support the prescribing of Tirzepatide for weight management? If yes, please provide the start date (month/year).

If available, please supply supporting documents such as:

• your local primary care and/or secondary care weight management pathway,
• any LCS/service specifications,
• any communications, formulary updates or guidance issued to practices or specialist services about Tirzepatide prescribing.

1. Yes. Tirzepatide for weight management is available in primary care in NHS Greater Manchester in line with the GM commissioning statement (see for link below).

• Local pathway or ICB decision publication:
  The GM commissioning statement (v1.2) was published in September 2025.

• Formal notification to primary care of rollout (e.g., via bulletin/guidance/communication):
  The GM weight management pathway was published in August 2025.Prescriber communications to primary care were issued in September 2025.
• Formulary inclusion/update to recommend primary care use:
  The Greater Manchester formulary was updated to reflect local commissioning arrangements in October 2025.
• Local Enhanced Service (LES) or Local Commissioned Service (LCS) to support primary care prescribing:
  The service commenced from October 2025. Please see attached GM standard service specification which is adapted with local information.

3. Yes. Tirzepatide is subject to an ICB-led prior approval process.

• (a) Only clinicians can submit prior approval forms for tirzepatide for weight management. These are typically GPs and pharmacists within practices.
• (b) Prior approval forms were enabled for use on 13 October 2025.

4. Tirzepatide is available through Tier 3 specialist weight management services (SWMS). Work is underway to enable prescribing.

Tier 4 services are prescribing in accordance with the commissioning statement, but this is currently part of the Tier 4 medial pathway only.

5. Where a patient is referred into the Tier 3 SWMS and are eligible for tirzepatide, this is funded through the existing contract. In those instances where a Tier 3 SWMS provider is delivering the tirzepatide service instead of GP practices, the provider is being funded in addition to their existing contract for this additional activity.

Supporting Documentation

The ICB can confirm that the following information is held:

• GM weight management pathway (https://gmmmg.nhs.uk/wp-content/uploads/2025/08/GM-Weight-Management-Clinical-Pathway-for-Adults-final-v1.0-.pdf )
• GM commissioning statement for tirzepatide for weight management (https://gmmmg.nhs.uk/wp-content/uploads/2025/09/Tirzepatide-for-weight-management-in-adults-commissioning-statement-for-GM-V1.2-for-GMMMG-website.pdf )
• Primary Care Tirzepatide service specification (see attached)
  **A word document was sent to the requester with this response.  If you require a copy of the full response, together with the attachment, please contact NHS GM’s FOI team – nhsgm.foi@nhs.net **

• NHS Greater Manchester formulary (https://www.greatermanchesterformulary.nhs.uk/chaptersSubDetails.asp?FormularySectionID=4&SubSectionRef=04.05.01&SubSectionID=A100&drugmatch=6078#6078 )
• Public communications (https://gmintegratedcare.org.uk/weight-management-in-greater-manchester/ )

Please note that these documents relate to a live and evolving service and are subject to ongoing development as well as changes to national recommendations. Further updates are expected in line with forthcoming national guidance updates. As such, these documents may be revised, and the most up-to-date versions may supersede those currently available.