Draconian rules which could deny you an operation

Wiltshire

Patients must have ‘intense’ or ‘severe’ pain, be ‘largely or wholly incapacitated’, and need a walking stick, frame or wheelchair. Otherwise, they must try six months of conservative measures before they can be considered, including wearing shockabsorbing shoes and taking painkillers.

Barnsley

Must suffer pain after walking less than 20ft, standing for half an hour or in constant pain for at least 75 per cent of the day.

Ashford & Thanet

Pain ‘significantly interfering’ with patient’s ‘activities of daily living and their ability to sleep’. Should have tried painkillers, walking sticks and adapting their home, by installing handrails for example, for an unspecified length of time beforehand.

Scarborough & Ryedale

Patients’ pain must interfere with their ‘activities of daily living’ including washing, dressing, lifestyle and sleep. They must also be suffering from a ‘diminished quality of life.’

Cambridgeshire

Pain must be ‘uncontrolled, intense and persistent’ and when walking short distances. All patients must try six months of ‘conservative management’, including avoiding heavy use of the affected joint, for at least six months.

Norfolk

Must have tried conservative measures for at least six months and provide evidence of this in doctors’ letters.

Birmingham & West Midlands

Pain and disability should be ‘sufficiently significant’ to interfere with daily life or ability to sleep.

Vale of York

Must try ‘conservative’ measures for at least three months including muscle strengthening exercises, taking three types of painkiller and wearing insoles in their shoes. They will be referred for hip and knee replacements afterwards if pain is interfering with their daily living, including washing, dressing and sleep.