Some CCGs have tightened the thresholds for access to "low priority" surgery such as hernia and joint problems, while others have introduced new systems to restrict the flow of patients being sent to hospital.
The BMJ's investigation also found that only four of England's 211 new GP led organisations, which assumed statutory responsibility for commissioning around £60bn of NHS care on 1 April 2013, have adopted new guidelines to help widen access to IVF treatment. This has led to disparities in availability across England.