THE PCT has said it is implementing its prior approval system for an initial three months.

Bosses have admitted the system will put a constraint on clinical practice - but said the PCT's severe financial situation made it "unavoidable".

The trust is heading for a £45million debt this year. But it hopes its package of money-saving measures, including the prior approval system, will save £10million.

Under the system, doctors who want to refer patients for a treatment that is currently being restricted must fill out a form and send it to the PCT's exceptions panel.

Under previous systems, a GP would have sent a referral straight to hospital.

The PCT Exceptions Panel for Prior Approval decides whether a patient's case is serious enough to warrant referral to hospital.

Sitting on the panel at any one time are two out of four GPs who work for the PCT.