Representatives of the DH and the NHS Confederation have disagreed over the importance of NICE guidance.

A trust survey by GP magazine that showed ‘non-urgent’ operations are being rationed by most trusts triggered a variety of official responses.

The survey found that 90% of trusts were rationing tonsillectomies, two-thirds were rationing cataract surgery, and more than half were rationing weight loss surgery and hip and knee operations.

These findings are similar to ones published a year before – but in the meantime, public concern over the impact of NHS spending cuts has deepened.

The BMA’s Dr Richard Vautrey said: “We’re supposed to have a national health service, so there should be national consistency in service availability.”

Health Minister Simon Burns called rationing “unacceptable” and promised: “If local health bodies stop patients from having treatments on the basis of cost alone, we will take action against them.”

His comments echo recent Government pledges to ensure that NICE guidelines are more closely followed.

However, David Stout (pictured), Deputy Chief Executive of the NHS Confederation, justified rationing by trusts: “The NHS faces considerable financial pressures and scarce resources have to be used as effectively as possible.”

NICE guidelines were “just advice”, he argued, and trusts should not try to follow them closely – though national consistency would have “some advantages”.

Patient feedback on GP practices, including an overall score out of 10, is now available on the NHS Choices website.

The DH claims the new online feature will empower patients both to express their views and to choose the best GP practice for their needs.

The BMA has criticised the new system for reducing multi-factorial patient experience to a single metric.

Patient feedback has been used to evaluate more than 8000 GP practices, based on several factors including ease of securing appointments, time spent waiting in reception, opening hours and communication skills of doctors and practice nurses.

The patient experience data have been gathered from responses to the annual GP Patient Survey.

Health Minister Earl Howe said: “This data will not only help patients choose the right GP surgery for them but will also give GP surgeries and the NHS new information they can use to make fresh, innovative improvements.”

A BMA spokesman commented that while enabling patients to give feedback on primary care was a good idea, the new approach failed to elicit “detailed responses” or to “take into account the differing challenges that each GP practice may face”.

Richard Vautrey, Deputy Chair of the BMA’s GP Committee, noted that the metric did not take proper account of patient priorities: “It is the quality of the consultation that is of most concern to patients.”