COUPLES desperate for a baby could have restricted access to IVF and obese people could be denied treatments as NHS bosses in Worcestershire look to save millions.

The three Clinical Commissioning Groups (CCGs) in Worcestershire say they face ending the financial year £25 million over budget unless savings are made from their combined budget of £717 million.

NHS leaders say the savings are necessary because of an increasing and unsustainable demand for a wide range of services.

As they probe where the savings could be made, they have launched a questionnaire asking members of the public exactly where they think the axe should fall.

Bosses say full consultations will follow on any proposed cuts, but a health watchdog has warned that the questionnaire will prove 'controversial'.

Suggestions include restricting access to IVF which costs £500,000 a year and restricting treatments for patients with unhealthy lifestyles such as heavy drinkers, smokers and obese people, 'particularly where the need for that operation has been partially caused by their own unhealthy lifestyle'.

Other potential options include restricting access to chiropody (£2 million a year), restricting access to cataract surgery for people with minor vision difficulties (£3 million a year), restricting access to physiotherapy, such as acupuncture, for minor injuries, restricting access to knee and hip replacements and restricting access to hearing aids for people with mild hearing loss.

Also in the mix is the possibility of reducing some of the 300 beds in the county's five community hospitals in Malvern, Pershore, Evesham, Tenbury and Bromsgrove, and three social care centres, and caring for more people in their own homes instead.

GP practices could also be encouraged to offer urgent appointments to patients who are registered with a different GP, to reduce the chances of them attending A&E - which costs £70 to £100 each time a patient attends.

Members of the public are being asked to complete a tick box questionnaire, asking them whether they strongly support, support, are neither for nor against, against or strongly against, each of the ideas.

A spokesman for the three CCGs said: "No decisions or even formal proposals are being made; this is just a very broad engagement exercise to see what people think.

"The results of this survey will inform future plans we make as healthcare commissioners and further engagement work will follow.

"If any of these ideas are considered in more detail in the future then we would undertake a more formal consultation with the public, providing clear proposals, the reason for these proposals, and invite further public discussion about such plans.

"We believe this is absolutely the right thing to do to make sure we are reacting to the views of our local population and having an open and honest discussion with them is the best way to achieve this."

Robin Walker, MP for Worcester, said the NHS budget has been increased significantly and is set to receive an additional £10 billion a year above inflation by 2020, with £6 billion made available this year alone.

He said: "The increase in the budget of the South Worcestershire CCG this year was 3.3 per cent and it will be 1 per cent above the rate of inflation for each of the next four years.

"Therefore it is certainly the case that the overall resources available to commissioners locally are increasing.

"I recognise however that there are a great many sources of demand for their services and that it will be a challenge to meet all of this.

"I don't think that patients will want to see any cuts to frontline services in a period that we know that CCGs are seeing an increase above inflation in their resources."

But Peter Pinfield, chairman of patient watchdog HealthWatch Worcestershire, says the savings being sought will have a 'significant impact' on services.

He is calling on as many people as possible to complete the questionnaire, saying it will prove 'quite controversial'.

"This is about finding out what the people of Worcestershire think.

"Let's have a wide debate and encourage as many people as we can to contribute.

"Yes NHS funding is increasing but it's not keeping up with demand. We're living longer and the NHS is being squeezed."

The survey will remain open until May 30. It can be obtained from GP surgeries or online from the CCG websites.