Breast reductions, tonsils removal and snoring surgery are among a list of treatments which will be offered to far fewer patients from next year, in cost-cutting plans drawn up by NHS chiefs.
Proposals to reduce 17 treatments are part of plans to prevent more than 100,000 “unnecessary procedures” taking place annually.
NHS England said an estimated £200 million could be saved every year by tightening criteria for treatments where “the risks… outweigh the benefits”.
While there will be some circumstances where these procedures go ahead, NHS chiefs said they will only take place when there is good reason to do so.
Procedures for carpal tunnel, haemorrhoids and varicose veins are among those that will be restricted.
Alternative treatments such as injections, changes of diet or physiotherapy will be effective in the majority of cases, NHS England said.
National medical director Professor Stephen Powis said: “If we want the very best clinical care for our patients, we need to stop putting them through treatments where risks and harms outweigh the benefits.
“By reducing unnecessary or risky procedures for some patients we can get better outcomes while reducing waste and targeting resource to where it is most needed. ”
Speaking to the Times, he added this would be the “first stage” in looking at situations where surgery is better avoided.
He told the paper: “We shouldn’t, at best, inconvenience or disappoint patients by offering treatments that are not effective and, at worst, harming patients.”
NHS England’s board of directors will meet next week to discuss the plans which will then be put out to consultation.
Other procedures on the 17-strong list include grommets for glue ear and tonsil removal, with the plans drawn up in consultation with the National Institute for Health and Care Excellence (Nice).
NHS England proposed that four treatments will only be offered when a patient makes an individual request.
These include surgery for snoring, dilatation and curettage for heavy menstrual bleeding, knee arthroscopies for osteoarthritis and injections for non-specific back pain.
Four of them will be offered only when a patient makes a specific request, with the other 13 being offered only when specific criteria are met.
The 13 treatments that will only be offered when specific criteria are met:
1. Removal of eyelid lesions
2. Grommets for glue ear
3. Tonsil removal
4. Removal of benign skin lesions
5. Breast reduction
6. Carpal tunnel syndrome release
7. Varicose vein surgery
8. Dupuytren’s contracture release for tightening of fingers
9. Trigger finger release
10. Ganglian cyst on wrist or hand
11. Haemorrhoid surgery
12. Hysterectomy for heavy menstrual bleeding
13. Removing bone spurs for shoulder pain
Professor Gillian Leng, deputy chief executive at Nice, said: “It has become commonplace for us to associate action with treatment.
“However, sometimes doing nothing, or doing less, really is the best approach.
“Treatments and procedures that carry a high risk or are associated with serious side effects should only be offered when there is compelling evidence that the benefits are worthwhile.”
Dr Graham Jackson, co-chair of NHS Clinical Commissioners, said: “It is important that we have an honest conversation with the public, patients and clinicians about what can be expected from the NHS within the constrained funds it has available.”