Source: Practice Index in GP Practice Management, Patients, PPA 10.4.25
The recent news that GPs will be able to prescribe Mounjaro weight-loss injections from late June to ‘prioritised patient cohorts’ has brought to the fore the impact that weight-loss drugs are having on practices. While the headlines paint a glossy picture of a new era in obesity care, behind the scenes, Practice Managers are dealing with what they describe as ‘an unfunded wave of additional work’.
Over the past few months, practices have reported a sharp increase in workload from patients accessing weight-loss jabs through private providers. This includes everything from processing paperwork and updating records to fielding difficult conversations about why GPs can’t simply take over prescribing, all of which are problems practices could do without’?
Unfunded, unmanageable
“When patients seek treatment privately, they don’t realise the impact it has on their GP practice,” one Practice Manager told us. “The private treatment triggers a letter to their GP and the burden falls on the practice to add information to the records, check for contraindications and, in many cases, liaise with the private provider. None of this work is funded.”
This growing workload is not only pulling admin teams into time-consuming tasks but it’s also placing clinical responsibility back on the GP, despite the fact that the prescribing is done privately.
“Some GPs feel they have no choice but to respond to requests from these companies,” one Practice Manager told us. “It puts us in a really awkward position. You don’t want to compromise patient care, but this isn’t part of our contract, and it’s pulling time from NHS patients.”
Another added: “There’s an assumption that we’re just being difficult or unhelpful when we push back, but we simply don’t have the time to pick up private work that someone else is being paid for.”
The expectation trap
Compounding the issue is the assumption from patients that their NHS GP will continue the prescribing once the private treatment has started, even though the NHS rollout of Mounjaro is still being phased in, with only the highest-risk patients being eligible for now.
When practices explain they can’t take over prescribing or provide monitoring, many patients react with frustration or formal complaints. “It’s really fraught,” said a manager. “People think we’re being obstructive, when really we’re just sticking to what we’re allowed and resourced to do.”
“We’re getting patients in tears at reception when we say we can’t help,” said another Practice Manager. “We’re not unsympathetic, but it’s not fair for private clinics to hand the patient back to us and expect us to sort it all out.
“The phased rollout announced by NHS England won’t help. I may be wrong, but I doubt there will be extra payments and the money will just go into the global sum. I also worry about what will happen when there’s an inevitable Mounjaro shortage.”
Another Practice Manager we spoke to pointed to the fact that it’s the responsibility of the private provider to ensure the safety and suitability of the treatment they’re prescribing. “Practices are not obliged to run blood tests, chase results or complete paperwork for treatments initiated outside the NHS,” they said. “Some surgeries have started charging for this work, classifying it as private and therefore outside their NHS obligations. Us included, with little pushback from customers (sorry, patients).”
Rollout pressure on the horizon
From late June, practices will start prescribing Mounjaro through NHS channels but only to patients in prioritised cohorts set by NHS England. Most of the managers we spoke to expect the workload related to weight-loss drugs to climb further as a result.
Each prescription will require ‘wraparound care’, including dietary advice and behavioural support, none of which general practice currently has capacity for. NHS England says this care will be centrally funded and available to all ICBs, but practices have yet to see any clear plans.
RCGP Chair, Professor Kamila Hawthorne, recently warned that serious consideration needs to be given to the impact on general practice. “It’s vital that general practice is resourced appropriately, and that GPs have the necessary training to safely take on any additional responsibility that comes their way.”
For many Practice Managers, though, the warning signs are already flashing. “We’re not set up for this,” said a manager in London. “The drug might be new, but the story is old; more work, no funding and no time to deliver it.”
What practices can do now
In the absence of formal support, some practices are taking practical steps to reduce the burden. These measures include setting clear internal policies on how to handle private prescription requests, signposting patients back to private providers for monitoring, screening and safety checks, communicating boundaries early and clearly to patients, both in person and on practice websites and, as mentioned above, charging for non-NHS work, where appropriate.
Until clearer guidance, adequate resource and robust systems are in place, Practice Managers will remain stuck in the middle: trying to shield teams from the strain, keep patients safe and hold the line as another wave of work lands on desks.
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