UK doctors' union tells GPs not to start Wegovy for heart risk without written proof of funding

People in England who have had a heart attack or a stroke and who carry extra weight were told in May that the NHS would offer them semaglutide, sold as Wegovy, to lower the chance of another cardiac event. In the first week of September the doctors' union told family doctors not to start prescribing it unless they hold written proof that someone is paying for the work.

The British Medical Association's England GP committee set out the position in its 4 September 2026 update to local medical committees. The BMJ reported it on 10 September.

NICE set a 90 day funding deadline that passed on 5 August

The National Institute for Health and Care Excellence, the body that decides which treatments the NHS in England pays for, published its decision on 7 May 2026 as technology appraisal TA1152. It says semaglutide, up to a maintenance dose of 2.4 mg once a week, can be used to reduce the risk of a major adverse cardiovascular event, meaning a heart attack, a stroke, or death from heart disease.

To qualify, an adult needs a body mass index of at least 27 plus established cardiovascular disease. NICE defines that as at least one of the following: a previous heart attack, a previous stroke caused by either a clot or a bleed, or symptomatic peripheral arterial disease. Peripheral arterial disease means narrowed arteries in the legs, and NICE counts it when a person has leg pain on walking with an ankle-brachial index below 0.85 at rest, or has had surgery to reopen an artery, or has lost a limb because of hardened arteries. The medicine is meant to be used alongside a reduced-calorie diet and more physical activity.

NICE guidance carries a funding rule attached to it. TA1152 states that semaglutide "must be funded in England within 90 days of final publication of this guidance." Ninety days from 7 May 2026 is 5 August 2026. Roughly 1.2 million people in England meet the eligibility criteria.

The BMA is telling practices to get commissioning in writing first

The GP committee's update called the rollout "a welcome and important development, with clear evidence demonstrating a reduction in major cardiovascular events," then added that "its implementation must be supported by appropriate funding, commissioning, and infrastructure. General practice should not be expected to deliver this work within existing resources."

In practical terms the union is telling practices to ask their integrated care board, the regional NHS body that buys local services, for written confirmation that the work is commissioned and funded before they begin. That confirmation is meant to cover appointment time, monitoring, administrative support and clinical governance. The BMA's position is that prescribing semaglutide for heart risk is not automatically part of a GP's core contract, and that it is not among the cardiovascular measures practices are scored and paid on.

Whether a patient can get it now depends on the local NHS area

For someone who has had a heart attack and expected a prescription, the effect is that access through a GP depends on whether their local NHS area has set up and funded a service. We could not establish from published sources how many areas have done so, and neither the BMA update nor the news coverage puts a number on it.

This is a decision about NHS funding in England. It does not change access in the United States, where coverage is set by each insurer.

The evidence behind the NICE decision comes mainly from the SELECT trial, which enrolled more than 17,000 people with cardiovascular disease who were overweight and found that semaglutide reduced the risk of heart attack and other cardiovascular events. A caution raised around the NICE decision is that most SELECT participants were white, which leaves open how well the findings carry across other groups, and that people from some ethnic backgrounds face high cardiovascular risk at a BMI below the 27 cut-off and so would not qualify.