Doctors' leaders have warned that plans to pay bonuses to surgeons based on the outcomes of operations could discourage doctors from treating high-risk patients.
The country's largest hospital trust, Imperial College Healthcare Trust in London, is discussing a pilot scheme in which doctors would be rewarded financially for operations that are particularly successful.
But the British Medical Association, the professional association which represents doctors, warned that this could deter doctors from carrying out complex surgery or operations on frail and elderly patients.
It added its voice to other critics of proposals to extend NHS cash reward schemes to reflect performance against a number of quality indicators such as mobility after surgery.
Dr Jonathan Fielden, chairman of the BMA's consultants committee, said: "The outcome of an operation is based on multiple factors ... Other members of the medical team would also have fundamental roles in the care a patient receives and the outcome achieved."
A spokesman for the Imperial College trust would not say which operation the scheme would apply to, but he added: "It's about rewarding excellence."
Katherine Murphy, from the charity the Patients Association, said: "Patients will be horrified."