Doctors in Hounslow are being paid to reduce the number of patients they send to hospital in a move one GP has claimed creates an 'uncomfortable conflict of interest'.

Hounslow Clinical Commissioning Group (HCCG), which funds healthcare in the borough, has asked surgeries to cut the number of hospital referrals they make by about four per cent this financial year.

Those meeting the target have been promised 35p per patient registered at their practice, with an additional 15p per patient should the target for all surgeries in the 'locality' be met.

That means a large practice with 10,000 patients could boost its income by £5,000 should it achieve the required reduction.

Dr Alick Munro, of Cranford Medical Centre, dismissed the measure as a 'silly idea', which could shatter the trust doctors work so hard to engender in their patients.

"This seems a rather crude mechanism to prevent referrals that may or may not be necessary," he said.

"This new scheme may result in further hardship to patients and conceal the true problem, which is lack of resources for hospital care.

"It places an uncomfortable conflict of interest between doctors and patients. If doctors are making unnecessary referrals there are much better ways of dealing with that on a practice by practice basis."

Practices are also being rewarded for reducing the proportion of their patients attending A&E departments, a move which coincides with the closure of emergency wards at some west London hospitals, including Central Middlesex and Hammersmith .

HCCG chairwoman Dr Nicola Burbidge said the reward scheme was part of a move to ensure more patients are treated closer to home.

"Our local improvement scheme gives our GPs the resource to work together to review referrals to ensure their patients are receiving care as close to home as is clinically appropriate. This could be with another local GP with specialist skills or in a community service," she told getwestlondon.

"With people living longer, and often with long term illnesses, we need to manage the demand for hospital care within the resources available.

"Improving prevention and early intervention in community settings means people will be less likely to get so ill that they need to go to hospital."

Dr Munro was also critical of the referral facilitation service, which he said costs about £1m a year in Hounslow yet still resulted in many costly missed appointments.

But Dr Burbidge said the service was regularly monitored and a recent survey indicated 87 per cent of patients and 94 per cent of GPs were satisfied with the service.