More than half of NHS trusts rationing treatments The newly established NHS Commissioning Board should step in to prevent the worst cases of so-called postcode lotteries determining whether patients are eligible for treatment, the report suggested. Sight loss charities say cataracts operations have been particularly hard hit by cost-cutting measures, with patients in some areas having to wait until they are unable to drive or even read before being deemed suitable for surgery. The new report confirmed the number of cateract surgeries in England fell last year. Orthopaedic surgeons also cite hip and knee replacements, saying that in some parts of the country patients are being left immobile while operations are delayed but in others patients with similar levels of pain or disability are receiving treatment. In the summer, the heads of Britain's top surgical organisations warned that patients" welfare was being compromised by "unproven and arbitrary" rationing that was only a financial "quick fix" for cash-strapped NHS trusts. Andy Burnham, the shadow health secretary, has also called for an "immediate review into rationing in the NHS." Labour has found 125 treatments have been restricted or stopped altogether in the last two years. Growth in hospital activity came down from 3.7 per cent in 2010-11 to 1.2 per cent in 2011-12. Lowering eligibility criteria for "low priority" procedures could prevent patients getting timely treatment and raise the risk of their needing emergency procedures in later years or reduce the effectiveness of future operations, the report claimed. In most cases primary care trusts said eligibility had been restricted for clinical reasons, but 11 per cent of clusters said rationing measures had been brought in primarily to save money. More than one in five clusters also reported that financial caps had been set on GP referrals, or that minimum waiting times had been put in place for certain procedures. The Department of Health told the NAO it does not routinely monitor primary care trust clusters to ensure patients' treatment is not being unfairly rationed, but added that it had investigated individual cases and found no breach of policies which prohibit blanket bans on treatment. The NAO report said: "The aim is to control demand without inappropriately restricting patients" access to care, but the Department [of Health] has no way of routinely gaining assurance that this is being achieved." It recommended that the department "should take a more active interest in demand management and develop ways of gaining routine assurance that patients" access to healthcare is not being inappropriately restricted." Local policies on restricting treatment should be "transparent so that commissioners can be held to account." It continued: "For areas of concern, the NHS Commissioning Board should consider whether it would be useful to establish national access policies." Mr Burnham, Labour's Shadow Health Secretary, said ministers should now accept the advice of the NAO and intervene to end the "burgeoning postcode lottery in the NHS." They promised to overturn cost-based restrictions if presented with evidence. The NAO has provided that. There is now no excuse for their continued failure to act," he said. Older people are being hit hardest as cataract, hip and knee replacements are amongst the most commonly restricted treatments. On David Cameron's watch patients are suffering, losing their independence or facing the agonising choice of going without or paying to go private. Mr Burnham said he had written to Jeremy Hunt, the health secretary, about the issue. The report found that the NHS had made £5.8 billion of savings in 2011-12, principally through the public sector pay freeze and a reduction in the prices primary care trusts pay for treatment. But it added the figure was uncertain because the savings were reported by the chief executives of primary care trusts and the Department of Health had not independently verified the figures. Amyas Morse, head of the National Audit Office, said the NHS had made a "good start" in making savings but "to build on these savings and keep pace with the growing demand for healthcare it will need to change the way health services are provided and to do so more quickly."