As the phased rollout of tirzepatide (Mounjaro) for weight management continues in primary care, it’s worth being clear on what the prescription is meant to sit alongside — because it isn’t meant to stand alone.
Wraparound care is a required part of the pathway, not an optional extra. The prescriber delivering clinical support should ensure patients are referred to a behavioural support service — the NHS England commissioned Healthier You: Behavioural Support for Obesity Prescribing (BSOP) service is the named route. BSOP provides advice on nutrition, physical activity and behavioural change, designed to help patients on pharmacotherapy achieve and maintain meaningful health benefits, rather than relying on the medication alone.
The service is available to all patients eligible under the NICE funding variation for tirzepatide, and it’s centrally funded — so there’s no cost barrier to making the referral.
For practices, the practical point is documentation as much as clinical process. With patient demand for Mounjaro likely to keep rising, it’s worth being able to show, for each patient prescribed, that the referral to BSOP (or an equivalent behavioural support service) was actually made — not just that it’s mentioned in a protocol somewhere. That’s the difference between a pathway that exists on paper and one you can evidence if asked.
Worth doing now: check your practice’s tirzepatide prescribing protocol explicitly includes the BSOP referral step, confirm who’s responsible for making that referral and recording it, and spot-check a few recent patient records to make sure the referral is actually happening in practice, not just in policy.
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