Patients needing a new hip will only be operated on if they are in so much pain they cannot sleep or carry out daily tasks under new NHS rationing plans.

The Royal College of Surgeons said the restrictions were “alarming” and “arbitrary” - ignoring the extra costs from delaying treatment and prolonging pain.

Vice-President Stephen Cannon said there was “no clinical justification” for drawing up rules which would force pensioners to endure increasing pain and misery amid a growing financial crisis.

Three Clinical Commissioning Groups (CCGs) in the West Midlands have drawn up plans to dramatically cut the number of people who qualify for hip and knee replacements, in a bid to save £2m a year.

Patients in pain would only receive surgery if they were in such agony that they could not sleep or carry out daily tasks, while the most obese will be told they could only have surgery if they lost weight/

The CCGs are aiming to cut the number of people who qualify for hip replacements by 12 per cent, with a 19 per cent drop in knee replacements.

Mr Cannon said: “The CCGs’ policy decision to restrict access to NHS care, based on arbitrary pain and disability thresholds, is alarming.