A study by the Royal College of Surgeons shows that in 2010-11 some CCGs provided no surgery to over-75 year old patients for a number of prevalent conditions. This finding raises the concern that an informal, and since last year, illegal curb has been placed on such surgery. For example, in 2010-11 Bradford City CCG commissioned no surgery for breast cancer excision, for gall bladder removal or for knee replacement. While there is always a balance of risk and benefit with surgery the study shows wide variation between CCG areas.