You may have seen recent headlines such as this BBC article reporting that GPs can now prescribe weight loss injections, including tirzepatide (Mounjaro), following updated NICE guidance. Naturally, this has prompted questions from patients and clinicians alike.
However, it’s important to clarify that in South Yorkshire, we are not yet in a position to prescribe tirzepatide for weight management in primary care.
The South Yorkshire Integrated Care Board (SYICB) has issued a clear position: tirzepatide should not be prescribed in general practice for obesity or weight loss until appropriate wraparound care pathways are developed and commissioned. This includes access to diet, psychological, and lifestyle support services that are essential for safe and effective weight management.
While tirzepatide has been approved for weight management under NICE TA1026, and while NHSE is working on phased implementation plans, the infrastructure needed to support this safely in general practice is not yet in place locally. Tier 3 specialist weight management services across South Yorkshire are already under pressure, with some areas closed to new referrals or operating with limited capacity.
For now:
Prescribing for weight loss should only occur in specialist services where wraparound support exists.
GPs should not be expected to initiate or continue prescribing tirzepatide for obesity.
Patients can be referred to Tier 3 services or Right to Choose providers if they meet local criteria, but these providers are responsible for both initiation and ongoing prescribing.
Tirzepatide for type 2 diabetes remains an option under separate NICE guidance (TA924), where appropriate.
We understand this is a developing area with high public interest. Please signpost patients to the NHSE patient FAQs to help manage expectations while local services continue to evolve.
We would like to inform colleagues across primary care that the pathology team is currently experiencing a supply issue with the reagent used for Rheumatoid Factor (RF) testing. This disruption is due to a manufacturing delay and is expected to continue until October 2025, when the assay manufacturer is anticipated to resume normal supply.
All RF samples received from 6th June 2025 onwards have been stored frozen within the laboratory to preserve integrity.
These samples will be analysed using a validated interim assay, once internal verification is complete.
We anticipate being able to resume issuing results from no later than 23rd June 2025.
With the introduction of the interim assay, there will be a change to the reference range and the interpretation thresholds. From 6th June 2025, all RF results reported using the interim assay will include the following comment:
“Please note change in Rheumatoid Factor assay and cut-off from 06/06/2025: <20 IU/mL = Negative, ≥20 IU/mL = Positive.”
| Analyte | Units | New Reference Range | Previous Reference Range |
|---|---|---|---|
| Rheumatoid Factor | IU/mL | <20 IU/mL = Negative | <30 IU/mL = Negative |
| ≥20 IU/mL = Positive | 30–50 IU/mL = Weakly Positive, >50 = Positive |
While there is a numerical shift in reported values due to changes in calibration, qualitative result concordance (positive/negative) remains robust and clinicians can interpret results with confidence.
There is no change to the way Rheumatoid Factor tests should be requested. Please continue to request RF as you normally would.
If you have any clinical queries or concerns about RF results during this period, please contact the duty biochemist at:
📞 01302 642870
📧 dbth.biochemistryconsult@nhs.net
We appreciate your understanding and patience as we navigate this temporary issue and will keep practices updated with any further changes.
The latest South Yorkshire (SY) Vitamin D documents are now live and accessible via the LMC website. These resources have been developed to support clinicians in the effective assessment and management of Vitamin D deficiency across the adult population, including pregnant and breastfeeding individuals.
Key Documents Available:
Vitamin D Management in Adults (Including Pregnancy & Breastfeeding) – A comprehensive guide outlining current recommendations and best practices.
SY Adult Vitamin D Management Flow Chart – A visual, step-by-step guide to aid clinical decision-making.
Pregnancy and Breastfeeding Flow Chart – Specific guidance for managing Vitamin D in pregnant and breastfeeding women.
SY Vitamin D Patient Information Leaflet
SY Pregnancy & Breastfeeding Vitamin D Patient Information Leaflet
In addition, a range of patient information leaflets are available in multiple languages and in both full and shortened formats to support accessible communication with diverse patient groups. These can be found on the South Yorkshire Integrated Medicines Optimisation Committee (IMOC) website.
Please note: The main guidance document for adult Vitamin D management includes a direct link to the IMOC site for ease of access to all relevant patient leaflets.
We encourage all practices to familiarise themselves with these resources to ensure consistent, evidence-based care across South Yorkshire.
We would like to inform colleagues across primary care that the pathology team is currently experiencing a supply issue with the reagent used for Rheumatoid Factor (RF) testing. This disruption is due to a manufacturing delay and is expected to continue until October 2025, when the assay manufacturer is anticipated to resume normal supply.
All RF samples received from 6th June 2025 onwards have been stored frozen within the laboratory to preserve integrity.
These samples will be analysed using a validated interim assay, once internal verification is complete.
We anticipate being able to resume issuing results from no later than 23rd June 2025.
With the introduction of the interim assay, there will be a change to the reference range and the interpretation thresholds. From 6th June 2025, all RF results reported using the interim assay will include the following comment:
“Please note change in Rheumatoid Factor assay and cut-off from 06/06/2025: <20 IU/mL = Negative, ≥20 IU/mL = Positive.”
| Analyte | Units | New Reference Range | Previous Reference Range |
|---|---|---|---|
| Rheumatoid Factor | IU/mL | <20 IU/mL = Negative | <30 IU/mL = Negative |
| ≥20 IU/mL = Positive | 30–50 IU/mL = Weakly Positive, >50 = Positive |
While there is a numerical shift in reported values due to changes in calibration, qualitative result concordance (positive/negative) remains robust and clinicians can interpret results with confidence.
There is no change to the way Rheumatoid Factor tests should be requested. Please continue to request RF as you normally would.
If you have any clinical queries or concerns about RF results during this period, please contact the duty biochemist at:
📞 01302 642870
📧 dbth.biochemistryconsult@nhs.net
We appreciate your understanding and patience as we navigate this temporary issue and will keep practices updated with any further changes.
The latest South Yorkshire (SY) Vitamin D documents are now live and accessible via the LMC website. These resources have been developed to support clinicians in the effective assessment and management of Vitamin D deficiency across the adult population, including pregnant and breastfeeding individuals.
Key Documents Available:
Vitamin D Management in Adults (Including Pregnancy & Breastfeeding) – A comprehensive guide outlining current recommendations and best practices.
SY Adult Vitamin D Management Flow Chart – A visual, step-by-step guide to aid clinical decision-making.
Pregnancy and Breastfeeding Flow Chart – Specific guidance for managing Vitamin D in pregnant and breastfeeding women.
SY Vitamin D Patient Information Leaflet
SY Pregnancy & Breastfeeding Vitamin D Patient Information Leaflet
In addition, a range of patient information leaflets are available in multiple languages and in both full and shortened formats to support accessible communication with diverse patient groups. These can be found on the South Yorkshire Integrated Medicines Optimisation Committee (IMOC) website.
Please note: The main guidance document for adult Vitamin D management includes a direct link to the IMOC site for ease of access to all relevant patient leaflets.
We encourage all practices to familiarise themselves with these resources to ensure consistent, evidence-based care across South Yorkshire.
General practices continue to play a key role in supporting patients who wish to change their personal details on their medical record, including their name, title, and gender marker. Below is a summary of current guidance and best practice to avoid administrative issues:
Patients can change their name and choose the title by which they wish to be known.
This includes names and titles that align with their gender identity, regardless of legal documentation. Practices should support patients in this choice, reflecting the individual’s preferred identity in all patient-facing communications and records.
Important: Use the Free Text Box to Explain the Change
When submitting updates via GP clinical systems or notifying PCSE (Primary Care Support England), practices must use the free text field to clearly state why the change is being made. This prevents the PCSE Patient Registrations team from mistaking the update for an administrative error and inadvertently reversing the change.
Gender Marker Changes for Patients Under 18
In line with national NHS guidance, patients under the age of 18 can no longer change their gender marker (e.g., from male to female or vice versa) on their medical record. This policy change reflects recent regulatory updates and applies across all practices in England.
Patients Aged 18 and Over
Patients over 18 who wish to change their gender marker on the NHS record can still do so. This is not linked to whether they have undergone any medical treatment or hold a Gender Recognition Certificate. Practices should refer to the updated guidance on the PCSE website for the correct procedure.
Further Guidance
For full details on how to update patient demographics and how to notify PCSE of a gender reassignment, please consult the official guidance here: PCSE – Patient Demographics Changes
We’re pleased to share a helpful resource that practices can offer to patients who are trying to quit smoking: the Smokefree Homes booklet.
This easy-to-read, patient-facing guide is designed to support individuals and families in creating healthier, smoke-free living environments. It explains the dangers of second-hand smoke to adults, children, babies, and even pets – highlighting that 80% of smoke is invisible and can linger for hours, even with windows open.
The booklet offers:
Clear guidance on why creating a smokefree home is vital.
Practical steps to reduce exposure to harmful smoke indoors.
Advice on quitting, including how to access free local support.
Tips on encouraging others in the household to smoke outside or quit.
Information about alternatives like nicotine replacement and vaping.
It also provides links to Yorkshire Smokefree services, local contact numbers, and a QR code for patients to get started on their quit journey.
You can view and download the Smokefree Homes booklet here and share it directly with patients during consultations, health checks, or opportunistically during routine appointments.
We encourage practices to make use of this resource, display it in waiting areas, and consider including it in social prescribing or care navigation toolkits.
Local public health teams are seeing a notable rise in syphilis cases, particularly among commercial sex workers, their clients, and close contacts. This emerging trend is being observed alongside an increasing number of ceftriaxone-resistant gonorrhoea cases, which present serious challenges for treatment and containment.
These developments carry significant implications for primary care, sexual health services, and wider system partners, particularly if transmission extends into vulnerable or high-risk populations, such as:
Prisons
Youth services
Homeless or insecurely housed populations
Pregnant individuals and neonatal care settings
Of particular concern are the potential consequences of delayed diagnosis or treatment:
Congenital syphilis, which remains rare but has life-altering implications for newborns
Disseminated gonococcal infection, which can cause systemic illness, joint damage, and sepsis
General practices may see an increase in STI-related consultations, particularly among:
Patients requesting STI screening or expressing concerns following high-risk sexual activity
Individuals from high-prevalence groups or with known exposure to commercial sex work settings
Pregnant patients requiring early and comprehensive antenatal STI screening
Practices are reminded to:
Maintain a low threshold for screening, particularly when patients present with non-specific symptoms or are in at-risk groups
Ensure robust pathways for prompt referral to sexual health services
Record and code sexual health concerns accurately to support surveillance and continuity of care
Public Health colleagues are working closely with the UK Health Security Agency (UKHSA) to monitor these developments. Further updates will be shared with primary care as new information becomes available.
It is also worth noting that in early June 2025, the latest annual sexual health data is due for publication. However, this dataset will only cover trends up to December 2024. While useful for historical context, it will not reflect the current situation, which appears to be evolving rapidly both locally and nationally.
Primary care teams and sexual health partners are urged to remain vigilant and work collaboratively to support early detection, reduce transmission, and minimise harm.
We are pleased to announce the addition of a dedicated ECHO session focused on “Writing a ReSPECT Plan”, designed to support healthcare professionals who are involved in creating or completing ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) plans.
This interactive session, scheduled for November 2025, will provide practical guidance, explore best practices, and help clinicians develop confidence and clarity when initiating and documenting ReSPECT discussions with patients and their families.
This opportunity is open to all healthcare professionals who are responsible for completing ReSPECT plans, including GPs, nurses, paramedics, and allied health professionals.
Please share this invitation with colleagues and any members of your team who may find this session valuable.
Providers wishing to deliver the Covid-19 Vaccination Service from their healthcare premises from 1 October 2025 are invited to sign-up through the NHSBSA webpage by 16 June 2025. Providers that already hold contracts that end on 31 March 2026 do not need to participate in this process. Documents include:
Rotherham Doncaster and South Humber NHS Foundation Trust (RDASH), in collaboration with primary care partners, has made a significant commitment to improving the experience of patients and their families — not only during life but also at the end of life and beyond.
From 1st July 2025, RDASH will be extending the verification of expected death to a 24/7 service, ensuring continuity of care and timely support for bereaved families. This marks a key step forward in delivering compassionate, person-centred care across Doncaster and the wider South Yorkshire area.
Verification of expected death will now be available out of hours, 7 days a week, using the same processes and referral route already familiar to practices.
There will be no change to the current in-hours provision — the service will now simply be extended to cover all hours of the day and night.
To qualify for verification by community services, two criteria must be met:
The death must have been expected, due to a recognised life-limiting illness.
The patient must have been known to community nursing teams (District Nursing) and receiving end-of-life care.
The Single Point of Access (SPA) will continue to use the existing screening template to assess eligibility when a referral is made.
Once the verification has taken place, the patient’s registered GP will be notified promptly to ensure accurate and timely updating of records and to support certification and registration processes.
This development is the result of close working between RDASH and local primary care, and reflects a shared commitment to delivering seamless and dignified care at all stages of life.
Doncaster LMC is been a member of the LMC Buying Groups Federation.
Buying Group membership entitles practices to discounts on products and services provided by the Buying Group’s suppliers.
Membership is free and there is no obligation on practices to use all the suppliers. However, practices can save thousands of pounds a year just by switching to Buying Group suppliers. To view the pricing and discounts on offer you need to register for access to the Buying Group’s online portal: https://buying.plexusportal.co.uk/Register.
What is the purpose of the Buying Group and how does it work?
The sole purpose of the Buying Group is to save its member practices money by negotiating discounts on goods and services which practices regularly purchase. The Buying Group team negotiate with suppliers, after which they identify ‘approved’ suppliers, who guarantee to give you significant discounts over what you would otherwise pay for their services, in return for the Buying Group’s endorsement and help in making you aware of what they offer.
Does it cost us anything to be part of the group?
No, membership is free and members are free to use as many discounts as they wish.
Is there any obligation to take up the deals offered?
No. Each practice is free to take up or decline any of the deals the Buying Group have negotiated. If you wish to take advantage of any of the offers in question, you will be given contact details, and all communications take place between you and the individual supplier*.
*The Buying Group accepts no liability for any contract willingly entered into by a practice with an approved supplier. Practices are advised to check that the terms of any contract with suppliers are consistent with those the Buying Group have negotiated and are advised to inform the Buying Group team of any discrepancy. The Buying Group do not, however, accept any responsibility for any member practices’ failure to check the terms of the relevant contract and the principle of caveat emptor (buyer beware) applies in all cases. Your rights as a consumer under the Consumer Protection Act are unaffected. With respect to any services to which the provisions of the Financial Services Act 2000 might apply practices are advised to seek independent financial advice as may be appropriate.
What happens to my details?
When a practice signs up for Buying Group membership, they will keep your basic contact details (practice address) on a secure system. On the membership application form, they also ask you how they can use your personal data (i.e. your email address) but even if you do sign up to receive their emails you can stop them at any time by clicking the unsubscribe button.
What if I am not happy with the quality of goods and services supplied?
Always let the Buying Group know if you encounter any problems getting what you want, and they will endeavour to sort it out.
Contact the Buying Group
The Buying Group is managed by Plexus Support Services Ltd:
Tel: 0115 979 6910
Email: info@plexussupport.co.uk
Website: https://www.plexussupport.co.uk
