WORCESTERSHIRE health bosses have been forced to defend controversial proposals to ration who can receive hip and knee replacements according to pain levels.

Redditch and Bromsgrove, South Worcestershire, and Wyre Forest NHS Clinical Commissioning Groups (CCGs) have put forward the plans to save £2.12 million a year.

Proposals will slash the number of people who qualify for hip replacements by 12 per cent and knee replacements by 19 per cent under a new Oxford scoring system.

Only patients with "sufficiently severe" pain and disability that interferes with daily tasks or sleep will qualify for treatment, and those who are obese with a BMI of 35 or over.

It is hoped the move will reduce the number of operations each year by around 350, but the Royal College of Surgeons believe the proposals have "no clinical justification".

Vice president Stephen Cannon said: "The CCGs’ policy decision to restrict access to NHS care, based on arbitrary pain and disability thresholds, is alarming.

"It is another example of how the huge financial strains the NHS is currently under are directly affecting patients.

"It is right to look at alternatives to surgery but this decision should be based on surgical assessment, not financial pressures.

"Although the CCGs claim this will save them £2million a year, this overlooks the longer term impact on patients of delayed treatment, prolonged pain, and potentially higher costs of treatment.

"Over the last few years we have heard of more and more examples of policies designed to restrict access to hip and knee operations to only those who are in higher amounts of pain or immobility.

"We are concerned that this is now happening up and down the country affecting thousands of patients. We fear that this latest policy is just the tip of the iceberg."

Health bosses say the plans will help save them money by only treating patients who pick up an Oxford score of 25 or less.

A spokesperson on behalf of the three Worcestershire CCGs said: "Local spend on hip and knee replacement surgery is around £2m higher than comparable CCGs.

"Reducing the Oxford Hip and Knee score from 30 to 25 brings the Worcestershire CCGs into line with what other CCGs already do and would help to reduce this spend difference.

"There are a number of CCGs across the country who have an Oxford hip and knee score threshold of 20 or lower.

"We are therefore continuing to provide hip and knee replacement surgery to more patients compared to some areas in the country.

"If a patient feels that they require this surgery but do not meet these criteria, there is a clear appeals system via individual funding requests whereby the effects can be considered upon the patient and the decision made regarding eligibility for funding."

The paper was approved by Redditch and Bromsgrove, and South Worcestershire CCGs and will go to the public Wyre Forest Governing Body meeting on Tuesday, February 7.

For details of the meeting, call 01562 514619 or email helen.arnold@worcestershire.nhs.uk.