GP leaders across the country are advising practices to push back on private providers requesting input for weight-loss jab prescriptions.
Advice from LMCs in Cornwall, Essex and Derbyshire revealed that GP practices are dealing with a rising number of requests from private providers seeking patient information to inform their prescribing of weight-loss medication such as tirzepatide and semaglutide.
Kernow LMC told practices that this is ‘private work’ and a fee can be charged to private providers, while North and South Essex LMC said GPs – who are already ‘under extreme pressure’ – cannot take on ‘unfunded, non-contractual work’.
LMCs also said practices can tell private providers selling weight-loss medication to ask patients to find the relevant information themselves via the NHS App.
GP leaders in Derby and Derbyshire noted that ‘a number of patients’ are now seeking GLP-1 injectable medications via private companies.
The LMC’s advice continued: ‘Some GPs are receiving letters asking us for any reasons why the patient should not be prescribed the drug for weight loss etc.
‘To limit our responsibility we can ask the provider to ask the patient to seek a summary of their patient record.’
In North and South Essex, the LMC said that given the ‘volume of work practices are already dealing with’, there is ‘no guarantee’ that any review of patient notes could be done within the requested timescale.
Their advice said: ‘Under GMC regulations, it is the responsibility of the prescribing clinician to assure themselves that their prescribing is safe.
‘This would include taking an adequate history and checking with the patient’s NHS app for confirmation, doing and acting on any appropriate pre-prescribing investigations, and not asking the patient’s NHS GP to do this private work on their behalf.’
The guidance document for GPs in Essex, shared earlier this month, also stressed that private providers ‘cannot assume that a non-response is an agreement’ from the GP that there are no contraindications for prescribing weight-loss jabs.
Essex LMC chief executive Dr Brian Balmer said GPs are ‘getting it from all corners’, and that private providers trying to shift responsibility to GPs is ‘unethical’ and ‘negligent practice’.
He told Pulse: ‘The worst providers go “well, if we don’t hear from you we’ll assume everything’s OK”, in a rather thin attempt to pass responsibility for prescribing and any risk onto a GP. It really does irritate people a lot.’
Dr Balmer also said that such requests to GPs have risen in the last three months due to the availability and ‘publicity’ of weight-loss jabs, meaning demand has gone up.
Kernow LMC said private providers have asked GPs to collate ‘time-consuming information’ about a patient’s weight and knowledge of any eating disorders or other chronic diseases.
Their recent newsletter continued: ‘The LMC can confirm that this is private work and therefore isn’t covered by state-backed indemnity of the Clinical Negligence Scheme for General Practice.
‘If you decide to undertake the work then a fee can be charged.’
Semaglutide, marketed as Wegovy, became available on the NHS in 2023 via specialist weight management services.
Last month, NICE accepted NHS England’s request for a slower rollout of tirzepatide, reserving eligibility for those with the highest clinical need at first.
In October last year, over 200 GPs and other health professionals called for an urgent review of ‘insufficient’ obesity management services in light of increased public demand for new weight-loss drugs.
At our practice we have had a situation where a type 1 diabetic was precuring weight loss medication. The Patient had refrained from providing a full medical history to the provider. We became aware via a standard letter informing us that patient was using the product. We had to contact the patient, the drug provider and reports this as a significant event to the general pharmacuetical council (CQC reported it was not their remit to investigate!) ..etc. Its taken up a lot of work, and patient was not entirely happy
We do not feel its as simple as “reject request”. Once we have been made aware are we not responsible. Would appreciate others views.
just send back standard letter. all responsibility lies with them as the prescriber. It is not GPs responsibility to police or be responsible for others provision of services or scripts. If the patient lies on the form, it is on them and the prescriber. Why would anyone police this or want to get involved? Don’t we have enough work.
Good luck with the reject request stance. Until the first coroner’s inquest into a death related to GLP1 use.
Private pharmacy requested info from GP. GP said no. Patient had unrevealed eating disorder. GP to defend not sharing information. “But Pulse said an LMC said we didn’t have to, ‘cos it’s not our contract”.
I’m not taking responsibility for prescribing – that’s always lies with the prescribing. Safeguarding is always a shared responsibility.
Enjoy all the extra work then. This is nothing to do with safeguarding – which is everyone responsibility. There is no onus on any GP to check everyones elses homework. As I said , we have enough work to do and no responsibility to the private providers.
Of course the CQC weren’t interested. They have smaller fish to fry.
Don’t see a problem if a fee is chargeable.
Just send the request back and say the prescriber has the responsibility of taking a history, assessing and discussing the risks as well as follow up. I had a patient and I told her that the NHS do not do private stuff and she should not be on the weight loss injection just “to look good” and sent her back to the private prescriber for consultation.
So, GPs will be responsible for ensuring the safety of the process – but only to the point that we would for any other private referral, in that we need to provide basic information : however, it is over-stepping to expect a GP to have sufficient specialist knowledge to competently screen the patient’s medical history, so the sensible and logical response appears to be to reject any request that we ‘screen history for ‘ or “provide reasons why it should not be prescribed”, which requires specialist knowledge outwith GP competence, as normally contained in GMC advice about sticking within your competence.
It is also notable that this is not part of GMS, so is excluded from NHS indemnity scheme. Consequently, it would probably be excluded from mainstream NHS GP practice by MDO insurers too, who would class it as an additional specialist class of Private Practice, and charge premiums accordingly.
The best advice I have seen is to respond and tell patients that they should give the private prescriber access to their full GP health records via the UHR or the NHS-App. This appears to be the only course that neither accepts responsibility for the prescribing of a non-medically qualified tele-marketting specialist; nor breaches GMC guidance on areas of competence; nor requires special MDO additional cover; nor is a breach of GMS Contracts; nor generates a risk to the patinet or of patient complaint : just point out to them it is a private service.
Problems may arise in areas which do not yet have fully-developed Records Access, but that is not fault of GPs!
It is also worth noting that many of these companies are criminal anyway, because they have breached the law on direct marketting of drugs to patients, through TV ads, which additionally are obnoxious and damaging to society and doctor-patient relations by insinuating that doctors are denying them treatment, and that only drugs are needed or useful.