Can I get Mounjaro on the NHS in 2026? The rules in England, Scotland, Wales and Northern Ireland
NHS access to Mounjaro for weight is rationed, and the rules change at the border. Here is what each nation’s official sources say, as of October 2026.
Written for the UK.
Possibly, but access is rationed and depends on where you live. In England, since June 2026, NHS Mounjaro for weight goes to adults with a BMI of 35 or more and at least 4 of 5 named conditions, in practices that take part. Scotland’s criteria are broader on paper. Wales and Northern Ireland are narrower.
Key takeaways
- In England, NHS Mounjaro for weight is phased in: since around June 2026 it covers adults with a BMI of 35 or more and at least 4 of 5 named conditions.1,2
- Each BMI threshold is 2.5 points lower for people of South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean background, so 32.5 instead of 35.1
- Since 1 April 2026, GP prescribing of Mounjaro in England sits in the GP contract, but practices are not required to take part.2
- Scotland’s medicines body accepts Mounjaro for adults with a BMI of 30 or more and one weight-related condition, broader on paper than England’s phases.3
- Wales opened Mounjaro to urgent groups, such as people waiting for time-sensitive surgery, in October 2025; Northern Ireland planned its first service for early 2026.4,5
- GLP‑1 medicines are prescription-only medicines in the UK, never sold over the counter.6
- Ozempic and Rybelsus are licensed for type 2 diabetes only, not for weight loss.7
- A prescriber decides whether a medicine fits, which one and at what dose. Nothing here is a recommendation.
- The risks are the same however you get it: see our side effects guide.
On this page
- Who can get Mounjaro on the NHS in England right now?
- Will my GP practice offer it?
- What are the rules in Scotland?
- What are the rules in Wales?
- What are the rules in Northern Ireland?
- What does NHS Mounjaro cost you?
- What do the trials show, and what are the risks?
- Questions people ask
- How we researched this
- Sources
Who can get Mounjaro on the NHS in England right now?
Adults with a BMI of 35 or more and at least 4 of 5 named conditions, where a GP practice or service offers it.1,2
NICE decides what the NHS in England funds. It recommends Mounjaro (tirzepatide) for adults with a BMI of at least 35 and one weight-related condition.1 NICE estimates 3.4 million people fit that description.8 The NHS could not treat them all at once, so NICE agreed a phased rollout over up to 12 years.8
The first 3 years aim to reach around 220,000 people, chosen by health need.8 Priority depends on your BMI and how many of 5 conditions you have:1
- high blood pressure
- abnormal blood fats (dyslipidaemia)
- obstructive sleep apnoea (breathing that stops and starts in sleep)
- heart or blood-vessel disease (cardiovascular disease)
- type 2 diabetes
| Phase | From | Conditions | BMI | BMI for named ethnic groups |
|---|---|---|---|---|
| Phase 1 | June 2025 | 4 or more | 40 or more | 37.5 or more |
| Phase 2 | Around June 2026 | 4 or more | 35 to 39.9 | 32.5 to 37.4 |
| Phase 3 | Around March 2027 | 3 | 40 or more | 37.5 or more |
Each phase adds to the ones before. Dates from NICE TA1026; one integrated care board (ICB) gives 23 June 2026 and 1 April 2027. The lower column applies to South Asian, Chinese, other Asian, Middle Eastern, Black African and African-Caribbean backgrounds.1,2
At 1.70 m (5 ft 7 in) tall, a BMI of 35 is about 101 kg (15 st 13 lb). A BMI of 32.5 is about 94 kg (14 st 11 lb). Our ethnicity and BMI post explains the lower column.
The support programme is compulsory. NHS patients prescribed Mounjaro for weight must join a “wrap-around” diet and activity programme. If you don’t want that support, you cannot be prescribed it on the NHS.2
Will my GP practice offer it?
Not necessarily: from April 2026, Mounjaro prescribing moved into the GP contract in England, and taking part is optional for each practice.2
From June 2025 to March 2026, NHS England paid ICBs to set up local Mounjaro services.2 From 1 April 2026, prescribing became part of the GP contract, through new Quality and Outcomes Framework indicators.2 GP practices are not mandated to prescribe it.2
So meeting the criteria does not guarantee treatment. Cheshire and Merseyside ICB says access “depends on local service availability and clinical assessment”. It could not yet confirm which practices would prescribe.2
The government has said it is investing £25 million in weight-loss support and GP referrals for weight-loss medicines.9 Wegovy is a different story: NICE keeps it in specialist services, as our Wegovy on the NHS post explains.2
What are the rules in Scotland?
Scotland’s medicines body accepted Mounjaro for adults with a BMI of 30 or more and at least one weight-related condition.3
The Scottish Medicines Consortium (SMC) accepted tirzepatide “for restricted use within NHSScotland”.3 The restriction is a BMI of 30 or more plus one weight-related condition. It adds that “a lower BMI cut-off may be more appropriate” for minority ethnic groups.3
That is broader on paper than England’s phases. But each health board decides how to deliver it. We found no national list of which boards prescribe it now. Prescriptions in Scotland are free.10
What are the rules in Wales?
Wales keeps weight medicines in specialist services, but since October 2025 it also offers Mounjaro to some people with urgent medical needs.8,4
NHS England’s phased plan does not run in Wales. The All-Wales Weight Management Pathway says weight medicines are prescribed only within a specialist service.8
On 23 October 2025, the Welsh Government widened access. Eligible groups include people waiting for time-sensitive surgery or transplants, and women seeking fertility treatment. So do people with conditions such as severe asthma, severe sleep apnoea or cancer.4 Wales estimates 186,000 people could meet NICE’s criteria, and says it is building a wider service.4
Prescriptions are free if you are registered with a GP in Wales.11
What are the rules in Northern Ireland?
In May 2025, Northern Ireland had no NHS weight-medicine service; a new regional service was planned to begin in phases from early 2026.5
On 21 May 2025, the Health Minister told the Assembly that patients had no specialist weight management service. That meant no access to “the new generation of innovative weight loss injections”.5 Phase 1 of a Regional Obesity Management Service was due in early 2026, offering lifestyle support and medicine where appropriate.5
We could not confirm what the service offers in October 2026. All prescriptions dispensed in Northern Ireland are free.12
See what NICE and your nation’s NHS describe, in 2 minutes. It ends with questions for your GP.
What does NHS Mounjaro cost you?
Nothing in Scotland, Wales or Northern Ireland, and £9.90 per prescribed item in England unless you are exempt.13,10,11,12
In England, a prepayment certificate covers all your NHS prescriptions for £32.05 for 3 months, or £114.50 for 12 months.13 It saves money for more than 11 items in 12 months.13
People with diabetes treated by medicines, not diet alone, can get a medical exemption certificate. People aged 60 or over already get free NHS prescriptions.14 Our cost post compares NHS charges with private list prices.
What do the trials show, and what are the risks?
In the main weight trial, people on Mounjaro lost an average of 16–22% of their body weight over 72 weeks, depending on dose, against 2.4% on a dummy injection.15
SURMOUNT-1 gave 2,539 adults weekly Mounjaro at 5, 10 or 15 mg, or a dummy injection (placebo). Average weight change was −16.0%, −21.4% and −22.5%, against −2.4% on placebo.15 For a 100 kg (15 st 10 lb) person, 16–22% is about 16–22 kg. About 89 to 96 in 100 people on Mounjaro lost at least 5% of their weight, against about 28 in 100 on the dummy injection.15 Put the other way, about 4 to 11 in 100 on Mounjaro lost less than 5%. These are trial averages, and results vary widely.
Our guide to what GLP‑1 medicines do explains how it works. The risks travel with the benefits.
- Stomach effects. In the Mounjaro weight trials (SURMOUNT-1 and -2), about 25 to 29 in 100 people on Mounjaro felt sick (nausea), against about 9 in 100 on a dummy injection. Most cases were mild or moderate.16
- Gallbladder problems. In the pooled weight trials, acute gallbladder disease affected about 20 in 1,000 people on tirzepatide, against about 16 in 1,000 on a dummy injection.16
- Pancreatitis (an inflamed pancreas): severe stomach pain that won’t go away and may spread to the back. The MHRA updated its guidance on it in January 2026.17
- Dehydration from vomiting or diarrhoea can harm the kidneys.16,18
- Surgery and pregnancy. Tell the team before any anaesthetic. The MHRA advises stopping semaglutide at least 2 months before a planned pregnancy, tirzepatide 1 month.7
Questions people ask
Can my GP refuse to prescribe Mounjaro?
In England, GP practices are not required to prescribe it under the 2026/27 contract, so some won’t. Meeting the criteria does not guarantee treatment.2
Is there a time limit on NHS Mounjaro?
There is currently no specified time limit, unlike Wegovy’s 2 years in specialist services. If under 5% of starting weight is lost after 6 months on the top tolerated dose, the prescriber reviews it.2,20,1
What BMI counts for NHS Mounjaro in England?
In the current phase, 35 or more with at least 4 of the 5 conditions. For the ethnic groups NICE names, it is 32.5. NICE’s full recommendation is 35 with one condition, reached over up to 12 years.1,8
Is Mounjaro free on the NHS?
In Scotland, Wales and Northern Ireland, prescriptions are free. In England it is £9.90 per item unless you are exempt, for example with diabetes treated by medicines.13,10,11,12,14
Will the NHS rules in England change in 2027?
Yes. NICE adds a third group from around March 2027: 3 of the 5 conditions and BMI 40 or more.1
How we researched this
On 12 October 2026 we read NICE TA1026, the SMC decision, and Welsh and Northern Ireland government statements. We also read NHS charge pages and one ICB’s patient page.
NHS England’s own commissioning page blocked our checks. So phase dates come from NICE’s summary of it and from Cheshire and Merseyside ICB. Local delivery varies. We name no clinics or providers.
Before you move on
- Check which nation’s rules apply to you: it depends where your GP is.
- Know your BMI and which of the 5 conditions are on your record.
- Ask your GP practice whether it prescribes Mounjaro for weight.
- Expect a compulsory support programme alongside the medicine.
- In England, check whether a prepayment certificate or exemption saves you money.
More from the UK blog
The monthly UK update
An independent guide to GLP‑1 medicines. We don’t sell medicines, take drug-company money, earn commissions or link to any provider. Once a month: NHS changes, approvals, list prices and safety alerts. How we write
Sources
- NICE. Tirzepatide for managing overweight and obesity, technology appraisal TA1026, section 1 (recommendations and “What this means in practice”). Published 23 December 2024, last updated 1 September 2025. Link
- NHS Cheshire and Merseyside (integrated care board). Tirzepatide (Mounjaro) for obesity: information for patients from 1 April 2026. Link
- Scottish Medicines Consortium. Tirzepatide (Mounjaro) for obesity, SMC2653: accepted for restricted use within NHSScotland. Link
- Welsh Government. People waiting for time-sensitive surgery get weight loss drugs on NHS. News release, 23 October 2025. Link
- Northern Ireland Assembly. Written ministerial statement, Department of Health: Establishment of a Regional Obesity Management Service for Northern Ireland. 21 May 2025. Link
- MHRA. UK first in Europe to authorise orforglipron for weight management and type 2 diabetes. Press release, 10 August 2026. Link
- MHRA. GLP-1 medicines for weight loss and diabetes: what you need to know. Guidance, published 5 June 2025, updated 5 February 2026. Link
- NICE. TA1026, section 4: Implementation (funding variation, 12-year period, 220,000 people, Wales). Link
- MHRA. MHRA disrupts second manufacturing facility suspected to be involved in the manufacture of illegal weight loss medicines. Press release, 25 February 2026. Link
- Scottish Government. Help with health costs (HCS2): quick guide; and Citizens Advice Scotland, Help with health costs. Link
- Welsh Government. Free prescriptions. Link
- nidirect (Northern Ireland government). Help with health costs. Link
- NHS Business Services Authority. NHS Prescription Prepayment Certificate (PPC). Link
- NHS Business Services Authority. Medical exemption certificates. Link
- MHRA. MHRA authorises diabetes drug Mounjaro (tirzepatide) for weight management and weight loss. Press release, 8 November 2023. Link
- Eli Lilly. Mounjaro KwikPen: UK summary of product characteristics (SmPC), electronic Medicines Compendium. Date of revision 29 August 2026. Link
- MHRA. MHRA updates guidance for GLP-1 prescribers and patients. Press release, 29 January 2026. Link
- Novo Nordisk. Wegovy FlexTouch: UK summary of product characteristics (SmPC), electronic Medicines Compendium. Date of revision 09/2026. Link
- NHS. When to call 999. Link
- NICE. Semaglutide for managing overweight and obesity, technology appraisal TA875, section 1. Published 8 March 2023, last updated 4 September 2023. Link
Last checked 12 Oct 2026 · Next review due 12 Apr 2027 · Report an error
How this post was made. Written by the GLP Guidebook team from the sources above. It’s general information, not medical advice. Talk to your GP, pharmacist or prescriber before starting, stopping or changing any medicine. We don’t sell, prescribe or recommend any brand or provider. How we write