Surgeons could earn bonuses for operations under plans being considered by the UK's largest hospital trust.

The Imperial College Healthcare Trust in London will launch a pilot programme later in 2008 aimed at "rewarding excellence", a spokesman said.

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But Department of Health spokesman said it wanted to strengthen the Clinical Excellence Awards Scheme, which rewards consultants for high performance.

'Widespread and robust'

The trust spokesman said it was looking at awarding bonuses for a specific procedure for which patient outcomes could be clearly measured, with a view to introducing it within a few months.

"We are looking at a pilot scheme for a particular operation which will measure the improved functionality of the patient and we are looking at linking certain performance-related bonuses to that," he said.

"At the moment we are in discussions with the surgical team."

But Katherine Murphy from the Patients Association warned there was a risk that the most complicated cases would be forgotten because they would not guarantee the best outcomes.

"Doctors already have a duty to provide high-quality care," she said.

"I think a good doctor would be insulted by the idea that they will only do their best on the operating table if there is extra money in it."

A review into the future of the NHS led by health minister Lord Darzi promised a system of care which focused on quality.

The Department of Health spokesman said the trust's pilot was not a government scheme, but bonuses could be awarded for procedures such as hip operations, after which patient mobility could be measured.

"Quality indicators such as complication rates and patient feedback are already used in specialties where they are available," he added.

"As such measures become more widespread and robust, they will become increasingly influential in determining who gets awards."

(BBC)

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