An influential health think tank has warned that the proposed radical changes to the NHS could turn patients against GPs because doctors are likely to start receiving “unpalatable” cash bonuses.

According to the Nuffield Trust, the government runs the risk of a patient backlash if they decide to give income incentives to GPs - who earn an average annual salary of £105,300 - because people might believe that money meant for healthcare is enriching doctors at the expense of patient treatment.

Under the new proposals, GP consortia will be charged with the task of commissioning healthcare, but they could end up alienating their patients if they offer doctors financial incentives to send fewer patients to hospital, the Nuffield Trust added.

The trust has submitted a report that raises fears about emerging tensions in the relationships between doctors and patients once GPs become responsible for spending £80bn of the NHS budget in the new era of GP-led commissioning in 2013.

It also believes that the NHS needs to learn from the US where, for 20 years, groups of doctors have been working in ways similar to how the future GP consortia in Britain will operate.

The Nuffield Trust discovered that income incentives were used routinely by the four groups of doctors they studied in California to reward them for delivering the best possible care, and warned similar incentives for family doctors will be needed in the NHS after 2013.