could become infertile because of the local NHS primary care trust's decision to spend less on screening for chlamydia. Failure to detect and treat the common sexually transmitted infection increases the risk of a sufferer not being able to have children later in life. "Chlamydia screening has been cut by Lambeth PCT to save money. That's sad and short-sighted because it will mean that young girls end up being infertile because they won't find out that they had chlamydia," said Gerada. GPs in Lambeth have also seen cuts to budgets for interpreting services to help them communicate with patients whose first language is not English, and patients forced to wait longer for physiotherapy. Nicholson, other NHS leaders and ministers have stressed repeatedly this year that the task of saving 20bn by 2015 should not mean cuts to patient services. "Despite the huge scale of the 20bn efficiency savings demanded by the 'Nicholson challenge', the secretary of state for health has consistently pledged to protect the NHS frontline," said Dr Tim Ringrose, a spokesman for Doctors.net.uk. "Yet our research, among the doctors who are working there, finds that the reality is somewhat different." He added: "We have received reports about across the board budget cuts to essential services, staffing shortages, and pressures to reduce prescribing of newer, potentially more effective therapies. "Doctors are very supportive of the drive to improve efficiency in the NHS but don't want to see reductions in access to services or reduced quality to services for patients."