NHS faces funding shortfall for weight-loss jab rollout, raising fears of rationed care

A significant funding gap in the NHS rollout of the new Mounjaro weight-loss injection means that only a fraction of eligible people are likely to receive treatment, according to new research.

While NHS England has estimated that around 220,000 people living with obesity will be eligible for the drug over the next three years, analysis by the British Medical Journal (BMJ) suggests that local health bodies lack the resources to meet demand.

Freedom of Information requests revealed that just nine of the 40 Integrated Care Boards (ICBs) in England have sufficient funding to treat the 70 per cent of eligible individuals expected to come forward. Four ICBs said their allocations would cover only 25 per cent or fewer of those eligible, with Coventry and Warwickshire reporting capacity to treat just 21 per cent.

The findings echo an earlier investigation by Sky News, which highlighted concerns over a “postcode lottery” for access to the treatment.

Ellen Welch, co-chair of the Doctors’ Association UK, told the BMJ: “These figures confirm the fear that the rollout is not fit for purpose. There is a huge discrepancy between national messaging and what patients are actually being delivered on a local level.”

Some ICBs admitted they are already considering tightening prescribing criteria or rationing treatment beyond what NHS England had initially outlined, a move likely to exclude people who previously believed they qualified. Birmingham and Solihull ICB, which received funding for 52 per cent of its eligible cohort, said: “Difficult decisions are having to be made to ensure money is spent in the most effective and efficient way possible and for the greatest patient benefit.”

Dr Jonathan Hazlehurst, an obesity specialist at the University of Birmingham, argued that the scale of underfunding points to a lack of political commitment. He noted that NHS England has funded treatment for just over 22,000 people in the first year, despite obesity costing the NHS an estimated £11.4 billion annually. “We cannot even afford to properly fund the rollout of a life-changing drug in year one,” he said. “That just does not make any sense.”

In response, an NHS spokesperson said: “The NHS is fully supporting the phased rollout of tirzepatide for eligible patients, having issued guidance in line with NICE recommendations and provided funding to local ICBs in March 2025. These represent brand-new services in primary care that are being established and scaled up over time, starting with those in the greatest need. In the meantime, eligible patients can access weight-loss support through a range of other services, including the NHS Digital Weight Management programme.”