Encyclopedia entry

NHS GLP-1 access

NHS England is rolling out tirzepatide (Mounjaro) for weight management in phased cohorts defined by BMI threshold and the number of weight-related comorbidities. The phasing is set out in the NICE technology appraisal TA1026 (2024) and operationalised by Integrated Care Boards (ICBs) at different paces across England, over a period of up to 12 years.

Published cohorts

• Cohort 1 (live since June 2025): BMI 40+ (37.5+ with ethnicity adjustment), four or more weight-related comorbidities.
• Cohort 2 (launches 23 June 2026): BMI 35 to 39.9 (32.5 to 37.4 with ethnicity adjustment), four or more weight-related comorbidities.
• Later cohorts (beyond June 2026): NHS England extends eligibility progressively in later phases, prioritised by clinical need, with the full eligible population reached over a period of up to 12 years. The criteria and timing for cohorts beyond June 2026 have not yet been finalised by NHS England.

What counts as a comorbidity

Weight-related health conditions defined in NICE TA1026: type 2 diabetes, hypertension, dyslipidaemia (raised cholesterol or triglycerides), obstructive sleep apnoea, cardiovascular disease (including heart failure and ischaemic heart disease).

Ethnicity-adjusted BMI

NICE recommends a 2.5 kg/m² downward adjustment of the BMI threshold for South Asian, Chinese, Black African, and African-Caribbean populations, reflecting higher metabolic risk at lower BMI in those populations.

ICB pace variation

The 42 English ICBs operate at different paces. Some launched Cohort 1 immediately in June 2025; others took six to twelve months to commission specialist weight management services to manage referrals. PeptideClear tracks the rollout status on the ICB rollout tracker page.

Related: NHS access editorial · ICB rollout tracker · NICE TA1026 explained · ethnicity-adjusted BMI.