GPs are being offered extra payments to boost their salaries, which are due to fall next year when patient numbers are reduced by the arrival of more family doctors.

Doctors, who are paid per patient on their books, are expected to see their average salary fall by about £11,000 from around £110,000.

Now NHS Stoke-on-Trent, the primary care trust, is offering doctors incentives totalling £1.25 million per year to carry out extra work with patients suffering long-term conditions.

The PCT says doctors can otherwise opt to cut their salary and benefit from more free time after between 12 and 16 new GPs are appointed over the next year.

About 200 patients will be clipped from each doctor's list as people move to the practices planned for Meir, Middleport and Hanley.

And as GPs are paid around £57 a year for each patient, their basic earnings will fall.

But by taking part in the new incentive scheme they can make most of that sum up.

They will be given cash rewards for doing extra work with patients suffering heart disease, chest illness and diabetes.

Graham Urwin, chief executive of NHS Stoke-on-Trent, which has devised the programme, said: "If they wish, GPs can use that as a chance to cut their hours for less pay. But we would prefer them all to safeguard their incomes by deploying their new free time to tackle the needs of those patients most requiring it."

Before the so-called Quality Improvement Framework (QIF) is launched, all 55 practices will be assessed to ensure they are good enough to take part.

Those falling below an entrance threshold will be offered support to "lift their game and improve their care", according to Mr Urwin.

That backing will come from a new Primary Care Development Unit being created by the primary care trust and Keele University to step up training for surgery staff and help organise the practice better.

The PCT is pumping in the first year's costs but then funding will come from falling basic income of the doctors and savings made by reducing expensive hospital admissions as people's chronic illnesses are kept in check better.

The scheme was welcomed as "unique and innovative" by city GPs' leader Dr Paul Golik.

The secretary of the North Staffordshire local medical committee said: "This is not about lining our pockets – it is about doing something radical to help tackle long-standing morbidity in Stoke-on-Trent.

"It will be hard work for us but I've seen no resistance from my colleagues."