SURGERY for hernias, tongue tie and some types of laser surgery are expected to take place less frequently across the region as health commissioners look to change their policy.

Referrals for surgical repairs of hernias should fall as a reduction in "ineffective" procedures is expected to result from the policy change.

This means that getting a referral for a lump in the groin will be harder.

Surgical management of Ankyloglossia, more commonly known as tongue tie, is expected to continue as usual although patients will now be sent to a specialist clinic rather than a GP.

The "aesthetic" policy which relates to laser surgery for the correction of refractive errors and surgical correction of Adult Strabismus, also known as squint, has also been tightened up.

GPs will be instructed to refer a patient and let a surgeon make a decision if there is any confusion.

The changes, which are part of the Greater Manchester Effective Use of Resources Policy, were approved by Bolton's clinical commissioning group (CCG) on Friday.

This comes as the health authorities in Bolton prepare to make millions of pounds of savings as it reaches the end of a three-year transformation fund period in which it has received £28.8m to shake up the health service.

Chief officer Su Long told the CCG board that without a fourth year of funding, health authorities would need to find an additional £8m.

She said: "We are already in a year where we are fighting to keep our heads above water. This year and next year we are really in the position to decide which are the things to take forward."

In July, there was an overspend in funded care which was highlighted as an area with significant pressures.

But all other areas were reported to be performing as expected.

CCG chair Wirin Bhatiani recognised the pressures that the health authorities must brace themselves for.

He said: "The system pressures are quite significant for both the CCG and the foundation trust. This is going to be quite an important time. We have to get the system into balance."