Patients in Bradford waiting for hip and knee replacements are being treated in private hospitals to ease pressure on waiting lists.

A total of 187 patients from across the district have received orthopaedic surgery in private hospitals in the last year to ensure that waiting list targets are met.

Now the move, which costs more than treating patients in a local hospital trust, is being blamed by local health chiefs for a poor performance in surgery rates for joint replacements in Government ratings.

They say these patients were not counted in NHS figures compiled by the Department of Health when they assessed all primary care trusts in the country for the first time.

It meant Bradford City Primary Care Trust, Bradford South and West Primary Trust and North Bradford Primary Care Trust were all rated as performing "significantly below average" for the number of hip and knee operations they commission for patients in Bradford.

Bradford City PCT's surgery rate for joint replacements was 43 per 100,000 of the population, North Bradford's figure was 67 and Bradford South and West, 82.

This was measured against a national average figure of 133 hip and knee replacements per 100,000 of population.

However, a spokesman for the three trusts said if the figures had included NHS patients being treated in private hospitals, which is an accepted part of Government policy, they would have performed significantly better.

"We are well aware of the importance of joint replacements for people with certain orthopaedic conditions and the improved quality of life they offer," she said. "In an effort to make sure patients are treated quickly and conveniently, we have worked with our local hospital trusts to make optimum use of their capacity and with the private sector to use capacity there to provide further additional operations.

"These operations are not recorded within NHS activity. If they had been, our performance indicators in this area would have looked significantly better.

"However, we believe that this has offered the best treatment option for some of our patients, while reducing pressure on the NHS and are confident this will be reflected in an improved performance in this area in future indicators."

A spokesman for the Department of Health, said: "Every NHS organisation had the opportunity to correct and sign off their own information prior to the publication of the performance ratings."