Patients waiting for knee replacements and cataract surgery could be declined treatment for four months after health chiefs said they could not continue to pay for all NHS services.

The governing body of West Kent Clinical Commissioning group (WKCCG), which procures health care for just under 500,000 people agreed to reduce the number of non-urgent surgical procedures as part of a package of measures aimed at plugging just under £4 million pound black hole in its finances.

Until April 17, the number of non-urgent procedures, which include hernia repair and some forms of heart surgery will be reduced at Maidstone and Tunbridge Wells NHS Trust (MTW) and private hospitals.

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Currently WKCCG is paying for a higher number of elective activity than budgeted. The reduction will bring planned care back to budgeted levels, but this is cold comfort to thousands of patients facing an uncertain Christmas.

Patients who have dates for operations within the next six weeks will not lose their appointments.

Dr Bob Bowes, chairman said failure to act would only delay the inevitable: “We have looked very carefully at what we can do that will have the least impact on patients. As with all such restrictions there will of course be exceptions that will be dealt with on a case by case basis by a specialist panel.”

“We will not be able to invest in the way we want to next year and the consequences would be deeper and bigger cuts then”, he added.

Video: CCG chairman describes changes agreed by the governing body

The board also agreed to stop funding all sterilisation and ban MTW from outsourcing planned treatment to the private sector - a move that alone would save £2.1m.

Bosses will also conduct a wider review the amount of work being given to the independent sector.

More controversial measures were also put forward, which will require further consultation before they are implemented.

They include restricting access to some forms of elective surgery - such as cataract operations and to limit women to one cycle of IVF, where previously they could have two at a cost to the NHS of £3,250 each.

Access to food supplements and some forms of treatment held to be of limited clinical value could be restricted.

In September West Kent CCG introduced a raft of savings to in a bid to balance its books, but these reductions were wiped out by a significant increase in spending of £412,000 on the acute sector, £226,000 in mental health and £177,000 on continuing care for people in their own homes.

“We will not be able to invest in the way we want to next year and the consequences would be deeper and bigger cuts then”- Dr Bob Bowes, chairman of West Kent CCG

All health and social care organisations in Kent are currently in the process of forming a Sustainability and Transformation Plans setting out the future of how NHS services are provided over the next five years.

They would also see £22 billion cut from the NHS by 2020.