Question to the Department of Health and Social Care:

To ask His Majesty's Government what guidance they have provided to Integrated Care Boards regarding the definition of exceptional clinical grounds for neurodiversity assessments and weight management treatments; and how they intend to ensure that the prioritisation of maximum health gain does not lead to the exclusion of patients with moderate symptoms who may deteriorate without early intervention.

Integrated care boards (ICBs) are legally required to fund and make available medicines recommended by the National Institute for Health and Care Excellence (NICE), including obesity medicines. These are available in specialist weight management services and recently one of these medicines, tirzepatide, under the name Mounjaro, has started to become available in primary care. NHS England has been supporting ICBs with a phased rollout for tirzepatide, prioritising those with the highest clinical need first to manage National Health Service resources and allow time to establish new obesity care pathways. NHS England worked with experts, patient and public representatives, and relevant organisations to develop the prioritisation approach.

Neurodiversity does not exclude patients from clinical assessment, and decisions about treatment are clinically led. NHS England’s interim commissioning guidance to ICBs on tirzepatide states that people with severe mental health conditions, a learning disability, or who are autistic, are at higher risk of cardiometabolic disease and will potentially benefit from weight management support and/or treatment through weight loss therapies. It states that these patients should be actively supported to access treatment, unless there is a clinical reason not to do so.

Where a patient is assessed as likely to benefit from treatment but does not fall within the scope of primary care management, they may be referred by their clinician to specialist services and secondary care to receive more individualised, multidisciplinary support. As part of a holistic assessment, clinicians consider the risk of deterioration and the benefits of earlier intervention when determining the most appropriate care pathway.