OPERATIONS and procedures, including the removal of gallstones and tonsils, will no longer be performed as a matter of routine across south Essex.

Debt-ridden NHS South West Essex, which covers Basildon and Thurrock, has published new guidelines, scaling back patients’ entitlement to some surgery.

NHS South East Essex, covering Southend, Rochford and Castle Point, already has a similar policy in place.

The move by NHS South West Essex means patients will have to meet a strict list of criteria before they can get the go-ahead for certain surgery.

Included are tonsillectomies, adenoidectomies, surgery for carpal tunnel syndrome, knee and hip replacements, gastric band operations and treatment for hernia repairs.

GPs will have the power to refer patients in extreme cases. However, even then, family doctors may have to apply to NHS South West Essex, which is facing a £35million deficit, for permission for their patients.

Operations to take out gallstones which are not causing the patients any discomfort, are to be scrapped altogether as is funding for ear wax removal.

Tom Abell, acting director of commissioning and service integration at NHS South West Essex, said the move was vital as the trust had been paying for too many operations.

He added: “We have seen a dramatic increase in referrals by GPs, of patients to hospital over the past two years.

“Referrals have been well above the national average.

“The service restriction policy is part of a plan agreed with our local doctors to bring referrals down to a more manageable level.”

NHS South West Essex is facing significant financial challenges and announced its turnaround programme – to get its finances back on track and save more than £50million – in September 2010.

Earlier in the year the trust announced it was putting IVF treatments on ice for couples with fertility problems, as well as slashing its budgets for Aids and HIV treatments by as much as £1.2million.

Making additions to the service restriction policy will help save the trust almost £2million by April.

Mr Abell added: “We anticipate, by using the service restriction policy to bring the number of procedures we carry out in line with other primary care trusts across the country, we will reduce spending on these procedures by £1.9million this year.”

The new measures will also make it harder for overweight patients to get gastric band operations and body contouring procedures.

There will also be less cosmetic surgery being carried out across south Essex, with procedures such as breast reduction surgery being more closely scrutinised.

Specific procedures now subject to tougher criteria before surgery is agreed:

Hysterectomies

Carpal Tunnel Syndrome – a condition characterised by attacks of pain and tingling in the first three or four fingers of one or both hands

Tonsilectomies

Any kind of acupuncture, homeopathy, hypnosis, ionisation and herbal medicine treatment for allergies will not be funded by the trust

Hernia repair procedures under certain circumstances Treatment for scars.

Any operation purely for cosmetic purposes will not be funded.

Bariatric surgery – gastric band. Patients will only be considered if they are aged between 18 and 60, classed as morbidly obese with a body mass index of 50 or more and have type 2 diabetes and or severe sleep apnoea. They must have been receiving intensive obesity management for at least six months and have tried all appropriate and available non-surgical measures adequately, but have not been able to maintain weight loss. Patients will be expected to show they have lost or maintained their weight over a six-month period.