An on-going cash squeeze on NHS budgets could see further restrictions on non-urgent operations and other treatments for patients in west Kent, it has emerged.

The West Kent Clinical Commissioning Group (WKCCG) says “significant cost savings” are needed to balance the books and rationing additional services will have to be considered.

Earlier this year, the CCG - which serves 463,000 people - delayed non-urgent operations for four months to save £3.2m, affecting 1,700 patients.

Now a new report outlining the CCG’s financial recovery plan says it expects further restrictions to be made across a range of treatments.

Among the possible options for rationing treatment are carrying out fewer non-urgent knee operations, stopping unnecessary hospital follow-ups and ending polypharmacy - where patients who take more than four different medicines.

It states: “The CCG can expect to be confronted by an increasing number of such decisions...some of these decisions may well be difficult and include changes in thresholds for accessing services.”

At the same time, health chiefs say they could save money by earlier heart checks and promoting activity among people with long-term conditions.

Dr Bob Bowes, chairman of the West Kent Clinical Commissioning Group said: “The need to ensure high quality, personalised care for a growing number of patients with complex care needs means we are facing significant challenges, like many other NHS organisations across the country.”

“This is why the work we are doing as part of the Kent and Medway Sustainability and Transformation Partnership is so important.”

“We are working together to improve prevention and care for local people, and to make best use of the money and staff available. If people are healthier, and can get better care in their own community, it will improve their quality of life as well as reducing the demand for inpatient hospital care.”

“Alongside this, we are planning carefully to ensure we can secure the best range of services and local healthcare for our population within the resources available.”

The West Kent CCG is not the only health group to be under growing financial pressure.

The Ashford CCG and Canterbury CCG have between them a savings target of £35m but insist patient care will be unaffected.

However, a report outlining the state of their budget, says that some savings are behind schedule - including plans to cut management costs to the tune of £3m.

They are also behind schedule in implementing plans for some care to be brought closer to where patients with long-term conditions live.

The report says that while demand for services is increasing by 5-6%, CCG budgets are only set to increase by 2%.

Simon Perks, Accountable Officer for the two CCGs, said: “The NHS faces substantial challenges as demand for services is rising at around 5-6% each year.

"Many of our services have not changed for decades and are not necessarily providing the right care in the right place for patients or making the best of NHS staff or funding.”

“Together with our partners in the NHS and social care, we are working to make the NHS more cost-effective and provide more local care closer to where people live through the Kent and Medway Sustainability and Transformation Partnership.”

“By working together in this way we will make the most of opportunities to improve health and well-being, prevent illness and support people to manage existing conditions and stay independent.”

The financial state of the three groups will be discussed next week by a cross-party group of county councillors on the Kent Health Scrutiny Committee.

The Department for Health has been asked to comment.