Family doctors will lose millions of pounds in funding because of complaints from patients over the waiting times for appointments.

Most general practices around the country are expected to suffer losses — some as much as £25,000 — when the results of a survey are released today.

The GP Patient Survey, the first to financially penalise doctors who receive negative responses, is expected to cost practitioners more than £10 million and in the worst cases could force cutbacks such as staff redundancies.

The estimated cost to surgeries in Birmingham has been calculated at more than £1 million, while those in Northern Ireland and Wales are likely to lose similar sums. In Greater Manchester, about half of GP practices have been told they will lose up to £10,000.

The system, designed to encourage a better service from GPs, has been widely criticised for punishing some practices that need more help. Doctors have also raised concerns about being judged on a small number of responses and queried why just two of the survey’s 49 questions — concerning access to a GP in 48 hours and more advanced appointments — carried all the financial penalties.

In Scotland, where patient responses were processed last month, some practices serving more than 10,000 patients were hit with five-figure penalties as a result of the responses of only 50 patients.

Laurence Buckman, chairman of the British Medical Association’s GPs’ committee, said that the lengthy survey did not encourage responses, and a few negative patients could skew the perception of a good practice. This was particularly likely in inner-city areas, where high numbers of patients could not be bothered to respond. “Some practices are going to be very badly hit with huge amounts of money on the say-so of very small numbers of patients,” Dr Buckman said. “We know in England that there are going to be similar results as there were in Scotland.

“If you reduce money, you are reducing the services, not improving them. Because of the way payment is geared you can only have the money taken away. We will be looking at thousands of practices that will be adversely, and in some cases, unfairly hit.”

Describing the survey’s flawed methodology, Dr Buckman said that most questions were angled negatively to seek out underperformers while none covered simple issues such as “how good is your doctor?” He said that the process “was so long that most people would just get worn out and give up”.

Practices that receive less than 60 per cent of positive responses to the two key questions would sacrifice all the money available as part of the Quality and Outcomes Framework, which pays doctors for achieving service targets. The BMA predicted an average-sized practice could face losses of £7,500, while larger lists could lose more than £10,000. Hundreds of practices are expected to appeal.

In Glasgow, 170 of 270 practices will appeal. GPs’ leaders in Scotland said that few practices had escaped losses entirely.

David Stout, the Primary Care Trust network director at the NHS Confederation, said that money taken from GP budgets would be reinvested by trusts in other services. He said that PCTs had discretionary powers to reduce the penalties if they felt that a practice had been treated unfairly.

“If it’s over-zealous then [the Government] will want to look at that in the cold light of day and if it needs to be re-examined it will.”

A Department of Health spokesman denied that the survey was flawed, adding that it had been agreed by stakeholders and would be an accurate reflection of patient perceptions.

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