NHS Mounjaro Rollout Expands as GPs Offered £3,000 Incentive Under New Obesity Strategy

The NHS is set to accelerate the delivery of the weight-loss drug Mounjaro as part of a significant strategic shift in the 2026/27 GP contract. Announced on 23 February 2026, the new government obesity strategy introduces financial incentives for General Practitioners to move weight management from specialist clinics into local surgeries. This transition aims to address a public health crisis that currently costs the health service an estimated £11 billion (approximately $14.8 billion) annually.

Under the new framework, the Department of Health and Social Care (DHSC) seeks to decentralise treatment by offering bonuses to practices that meet specific prescribing targets. By moving these services into primary care, the government intends to reduce the pressure on hospital-based specialist weight management tiers. The initiative is being positioned as a fundamental change in how the British state manages long-term metabolic health.

The strategy also aims to tackle the 'postcode lottery' of care, where access to GLP-1 receptor agonists has previously been dictated by local funding variations. Health Secretary Wes Streeting told the BBC that these incentives are designed to end a two-tier system where access often depends on an individual's private wealth. The goal is to ensure the medication reaches those with the greatest clinical need regardless of their geographic location.

Addressing the 'Postcode Lottery' and the Black Market

Despite the national mandate for wider access, a British Medical Journal (BMJ) investigation in January 2026 found that one in five local areas still lacked a functional NHS pathway for Mounjaro. These Integrated Care Boards (ICBs) have been criticised for unacceptable delays in implementing the rollout. These regional gaps are reportedly pushing some patients toward an unregulated black market for GLP-1 drugs, which poses significant safety risks.

The 2026 strategy aims to resolve these regional discrepancies by streamlining the pathway through primary care settings. By July 2026, a new £85 million programme co-funded by the government and the manufacturer, Eli Lilly, is expected to launch. This initiative will test additional routes for access through community pharmacies and digital health platforms to ensure that patients are not reliant solely on their local GP surgery for initial consultations.

Financial Incentives and Regulatory Changes

As part of the updated GP contract, practices in England will be offered a bonus of up to £3,000 (around $4,000) for actively managing patients on weight-loss injections such as tirzepatide. This is supported by £25 million (approximately $33.7 million) in ring-fenced funding. Key updates to the Quality and Outcomes Framework (QOF) for 2026 include new indicators where GPs will be monitored on their provision of obesity care and the recording of patient BMI.

Furthermore, GPs are now being explicitly encouraged to manage 'wraparound care.' This involves mandatory nutritional and behavioural support that must accompany the medication to ensure long-term efficacy. This support is intended to prevent the medication from being used as a standalone intervention without the necessary lifestyle adjustments.

Revised Eligibility Thresholds for 2026

The eligibility criteria for receiving the treatment through primary care have undergone a phased expansion. In 2025, access was reserved for patients with a BMI of 40 or higher who also presented with four weight-related conditions. Under the new 2026/27 framework, these requirements have been lowered to include those with a BMI of 35 and four conditions, or a BMI of 40 with three conditions.

It should be noted that BMI thresholds are reduced by 2.5 kg/m² for individuals from South Asian, Chinese, Middle Eastern, and Black African backgrounds. This adjustment ensures that clinical intervention is available at an earlier stage for groups at higher risk of weight-related complications.

Implementation Challenges and Workload

While the funding has been welcomed by some, the British Medical Association has expressed concerns regarding the practical implications for overstretched surgeries and existing backlogs. NHS England estimates suggest that if all 3.4 million eligible people sought treatment simultaneously, the process could consume approximately 18 per cent of all GP appointments.

The 2026 obesity strategy marks a shift from reactive treatment to proactive prevention. Success will ultimately depend on whether the support systems can scale at a rate that meets unprecedented demand. For millions of eligible citizens, these changes represent a formal path to accessing life-changing medication free at the point of use.