GP practices in England are to be paid an average of £3,000 a year in bonuses to prescribe weight loss drugs to patients

(Announced 4th February 2026)
The government is adding incentive payments of up to £3,000 to the GP contract starting in April but the payments will only apply to Mounjaro. This will be the first time weight loss drugs have been made part of the GP contract with £3,000 available for prescribing Mounjaro to the maximum number of eligible patients. This sum is the average available and the size of the bonus dependent on the size of the practice.

The other new weight loss drug available on the NHS is Wegovy which is not prescribed by GPs but is given by specialist NHS weight loss services. GPs will also get extra money, worth about £1,000 a year, for referring patients to these weight loss programmes.

Mounjaro became available on the NHS in 2025 but not all GPs are prescribing it as often as expected. More than 1 million people are estimated to be using weight loss drugs, with 9 in 10 paying for them privately.

Ministers said it was important that patients who could benefit from weight loss support were able to access it. However, obesity experts have warned that the scheme would have limited impact because the drugs are still being tightly-restricted on the NHS, so this decision will not widen eligibility. (Access has been restricted to those severely obese with both a BMI of over 40 and certain health conditions.)

Health Secretary Wes Streeting is quoted as saying: “I’m determined that access should be based on need, not ability to pay. Outside the NHS, we’ve seen those who can spare the cash buying privately, and the proliferation of rogue prescribers peddling dangerous unlicensed drugs that are putting patients at risk. Investing in general practice will help bring this modern medicine to the many, not just the few, and help shift the focus of the NHS from treatment to prevention.”

Incentive payments are a normal part of the GP contract and in the past have been paid for a variety of other things to improve everything from dementia care to boosting vaccination rates and to prescribe statins to lower the risk of heart disease.

Next year prescribing will be widened to those with a BMI of over 35 with the expectation that by 2028, 220,000 patients will be on Mounjaro provided by the NHS. The eligibility thresholds are lower for certain ethnic groups. However, rollout so far has been reported to be patchy.

This leaves unanswered questions!

• If doctors believe that someone who fits into the criteria would benefit from being on Mounjaro, surely they would prescribe it as part of their care for their patient? If not why not, or is it a local ICB decision not to prescribe it?
• Calling it an incentive payment suggests that money will encourage GPs to prescribe it but wouldn’t we rather that GPs use their clinical judgement to decide whether or not to prescribe it?
• Are the people who are now paying privately for Mounjaro, and who fit into the NHS criteria, going to now have it prescribed on the NHS?
• Evidence of different adverse or even positive reactions continue to come to light, should the decision to encourage prescribing be better left until the drug has had wider use and the MHRA have had time to assess Yellow card reports of adverse effects? Have we not learned lessons from the initial prescribing of statins many years ago?
• What happens after the 2 years that people are advised to use weight loss drugs and then, as evidence suggests, they put the weight back on? How does the system cope?
• If the government is serious about improving health, why have they not taken stronger action with the food industry? They could put warning labels on unhealthy food, take more action in schools and provide facilities for ALL pupils to have regular exercise.

Widening the availability of these medications in general practice could increase the GP workload, not to mention the risk of raising expectations among patients who may not be eligible or for whom these medicines are not suitable. We will have to wait and see the outcome….