FOI 2026/1680

Under the Freedom of Information Act 2000, I would like to request the following information regarding the use of injectable pharmacological treatments for overweight and obesity (e.g. GLP-1 receptor agonists or dual GIP/GLP-1 receptor agonists).

Since the publication of NICE TA 1026 on 23 December 2024, up to 01 April 2026:

1. Are injectable pharmacological treatments for overweight and obesity currently being initiated for patients as part of routine services commissioned or delivered by your organisation?
   If so, please identify which medication(s) are currently used as first-line injectable pharmacological therapy for overweight and obesity within commissioned services.
2. What are the eligibility criteria for patients to access injectable pharmacological treatments for overweight and obesity within your organisation?
   Where these criteria are already published online, please provide the relevant link and confirm whether the published criteria are currently being applied in practice.
3. Please confirm whether the model of care through which these treatments are (or will be) delivered:
   • Directly from general practice
   • Primary care-led weight management service (e.g. GP or pharmacist-led weight management service, community weight management hub, etc.)
   • Tier 3 specialist weight management services
   • Other (please specify).
4. Please confirm whether the relevant pathway within your organisation is currently:
   • operational and accepting referrals
   • operational but limited (e.g. pilot sites)
   • approved but not yet implemented
   • currently under development.
5. Please provide copies of any key or current clinical pathways, service specifications, prescribing guidance, or referral criteria relating to the use of injectable pharmacological treatments for overweight and obesity, if held.

If any of the requested information is already publicly available, please provide links where possible.

1. Injectable pharmacological treatments for weight management are being initiated within commissioned services in Greater Manchester.

• In primary care, there is a commissioned weight management service through which tirzepatide is provided. This is the only injectable pharmacological treatment for weight management currently initiated in primary care, in line with NICE guidance and national commissioning arrangements.
• NHS Greater Manchester also commissions Tier 3 specialist weight management services, where patients can access:
  • semaglutide
  • liraglutide
  • tirzepatide (for more complex patients who require specialist input and cannot be managed in primary care settings)

2. Eligibility criteria are defined within the NHS Greater Manchester interim commissioning statement for tirzepatide for weight management in adults.

This document is publicly available and can be accessed here:
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

The published criteria are currently applied in practice.

3. Injectable pharmacological treatments for weight management in Greater Manchester are delivered through a mixed model of care, including:

• Primary care-led weight management services, where prescribing of tirzepatide is undertaken by commissioned providers, which may include:
  • Individual GP practices
  • Primary Care Networks (PCNs)
  • GP federations
  • other commissioned providers (including independent providers where locally commissioned)
• NHS GM commissioned Tier 3 specialist weight management services, where:
  • semaglutide and liraglutide are prescribed
  • more complex patients may receive tirzepatide
• Tier 3 Specialist Weight Management Services operating under Right to Choose and delivering under non contracted activity arrangements

4. The pathway is currently operational and accepting patients, subject to commissioning arrangements and phased implementation.

In primary care:

• GP practices identify eligible patients and invite them for assessment within the commissioned service.
• Treatment may be initiated either by the identifying practice (where commissioned to do so) or by another commissioned primary care provider.

Where appropriate:

• Patients requiring specialist management are referred to Tier 3 specialist weight management services.

5. The following documents are publicly available:

• NHS Greater Manchester interim commissioning statement for tirzepatide for weight management in adults
  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
• Greater Manchester weight management clinical pathway
  https://gmmmg.nhs.uk/wp-content/uploads/2025/08/GM-Weight-Management-Clinical-Pathway-for-Adults-final-v1.0-.pdf