The NHS Future Forum proposed the move, as well as raising upper QOF thresholds, as part of its second report this month. The government has accepted all of the recommendations in the report.

But the GPC said making GPs responsible for patients outside their practice list was ‘fraught with challenges’.

GPC deputy chairman Dr Richard Vautrey said raising QOF thresholds would increase exception reporting and undermine patient autonomy.

The Future Forum said it had considered recommendations that general practice should be given ‘better incentives to reach out to unregistered patients’ and higher thresholds in the QOF ‘to ensure that all patients receive the best care’.

It recommended that payment incentives such as the QOF ‘should reward GP practices for improving the local population’s mental and physical health and wellbeing and reducing health inequalities’.

In its response to the report, the DH said the future development of the QOF ‘will provide an opportunity to explore how to create stronger incentives for GP practices’ to achieve these goals.

GPC deputy chairman Dr Richard Vautrey said: ‘I can't see how general practice could be judged on unregistered patients. It is for clinical commissioning groups, and PCTs currently, to ensure services are provided to whole of community.’

Proposals to raise indicator thresholds are ‘self defeating’, he said. ‘We have reached the point where it is increasingly risky to increase thresholds. We could find some [GPs] simply exception reporting large numbers of patients.’

He said continued pressure would also begin to ‘undermine patient autonomy’, as GPs would have to lean on patients to stick to treatment regimes in order to maintain income.