Standard operating procedure

GLP-1 Initiation & Titration Procedure

The step-by-step procedure for safely starting and titrating a glucagon-like peptide-1 (GLP-1) receptor agonist for weight management, including confirming eligibility and informed consent, prescribing in line with General Medical Council standards, escalating strictly per the product Summary of Product Characteristics and tolerability, applying stopping rules, and recording every dose decision.

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  • Editable Microsoft Word (.docx)
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What's inside

This standard operating procedure is fully drafted and structured, ready to brand and complete for your service. It covers:

  • 1. Purpose
  • 2. Scope
  • 3. Definitions and abbreviations
  • 4. Responsibilities
  • 5. Procedure
  • 6. Documentation of dose decisions
  • 7. Monitoring and escalation
  • 8. Records
  • 9. Related documents
  • 10. Review and version control
  • 11. Disclaimer

Legislation & standards it maps to

  • Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 12 (Safe care and treatment)
  • The relevant Summary of Product Characteristics (SmPC) for the specific glucagon-like peptide-1 (GLP-1) receptor agonist prescribed, and Medicines and Healthcare products Regulatory Agency (MHRA) guidance
  • National Institute for Health and Care Excellence, Obesity: identification, assessment and management, clinical guideline CG189
  • National Institute for Health and Care Excellence technology appraisals for weight-management medicines (including TA875 semaglutide and TA1026 tirzepatide)
  • General Medical Council, Good practice in prescribing and managing medicines and devices (2021), including the guidance on remote prescribing
  • General Medical Council, Good medical practice (2024)
  • British National Formulary (BNF), current edition
  • Mental Capacity Act 2005

Who it applies to

All prescribers (doctors, and pharmacist or nurse independent prescribers, including any locum, bank or sessional prescriber), clinical staff who support reviews and counselling, and the registered manager or [Insert Job Title] at [Organisation Name] who assess, prescribe for, titrate, supply to or monitor patients started on a glucagon-like peptide-1 (GLP-1) receptor agonist for weight management.

Glossary

Plain-English explanations of the technical terms and legislation used in this document.

Adverse drug reaction
An unwanted or harmful effect caused by a medicine when it is taken correctly.
Adverse event
Any unexpected or unwanted occurrence linked to a treatment that harms, or could harm, a patient.
Body mass index (BMI)
A measure of body weight in relation to height, used to judge whether a person is underweight, a healthy weight or overweight.
British National Formulary (BNF)
The standard United Kingdom reference giving prescribers up-to-date guidance on the use, doses and safety of medicines.
Care Quality Commission (CQC)
The independent regulator of health and social care services in England.
Clinically meaningful response
A predefined degree of weight loss within a set period, used to judge whether the medicine is working well enough to continue.
Cold chain
Keeping vaccines and certain medicines within a safe temperature range from delivery to use.
Contemporaneous record
A note made at the time of, or immediately after, an event so that it is accurate and reliable.
Contraindication
A specific situation or condition in which a medicine should not be used because it could cause harm.
General Medical Council (GMC)
The body that registers doctors in the United Kingdom and sets the standards they must follow.
General practitioner
A doctor who provides general medical care in the community, often a patient's usual family doctor.
GLP-1 receptor agonist
A class of injectable medicine, originally used in diabetes, that reduces appetite and is licensed for certain products as an aid to weight management.
Informed consent
Agreement to treatment given freely after the risks, benefits and alternatives have been clearly explained.
Initiation
Prescribing and issuing the first and lowest dose of a medicine to a patient who is starting treatment.
Licensed indication
The specific condition or use for which a medicine has been officially approved by the regulator.
Maintenance dose
The ongoing dose reached at the end of titration and continued where treatment is working and tolerated.
Medicines and Healthcare products Regulatory Agency (MHRA)
The United Kingdom body that regulates medicines and medical devices and issues safety alerts.
Mental Capacity Act 2005
The law that protects and supports people who may be unable to make particular decisions for themselves.
National Institute for Health and Care Excellence (NICE)
The body that produces evidence-based guidance on treatments and care for use across health and care services.
Near miss
An event that could have caused harm but did not, by chance or because it was caught in time.
Off-label prescribing
Prescribing a licensed medicine for a use, dose or group of patients outside the terms of its licence.
Pancreatitis
Inflammation of the pancreas, which can cause severe abdominal pain and needs prompt medical attention.
Pharmacotherapy
The treatment of a condition using medicines.
Red flag
A warning sign or symptom that may indicate a serious problem needing urgent assessment.
Registered Manager
The person registered with the regulator as responsible for the day-to-day running of a service.
Remote prescribing
Prescribing without a face-to-face consultation, for example through an online or telephone service.
Scope of practice
The range of activities a clinician is trained, competent and authorised to carry out.
Sharps
Needles, blades and other items that can cut or puncture the skin.
Standard Operating Procedure (SOP)
A written, step-by-step instruction describing how a task is to be carried out consistently and safely.
Summary of Product Characteristics (SmPC)
The official document for a medicine that sets out its approved use, dosing and titration schedule, cautions, contraindications and side effects.
Titration
Increasing the dose of a medicine gradually, in planned steps, until the right dose is reached.
Yellow Card Scheme
The United Kingdom system, run by the Medicines and Healthcare products Regulatory Agency, for reporting suspected side effects and problems with medicines.

How it works

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  2. Download your editable Word file from the link we email you straight away.
  3. Complete the placeholders for your service, then have it approved before use.
  4. Add the optional updates subscription and we keep it current as guidance changes.

Related documents

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PolicyInformed Consent Policy£54.99

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