A GP surgery in Manchester is one of first in the country to test a system where patients first discuss symptoms with their doctor over the phone.

Bosses at the Simpson Medical Practice, in Moston, say the trial means they can help three times as many people every day.

Patients are first offered advice over the telephone, but a doctor may then decide a face-to-face consultation is needed.

Dr Washik Parkar, from the practice, said the scheme was speeding up the treatment process and freeing up appointments for people with more serious conditions.

Previously, doctors at the Moston Lane centre would only have time to see around 20 patients per day – but now they are able to help up to 60.

Dr Parkar, the practice’s clinical lead, said: “I can deal with about three patients in the same time it would take to see one. We want to ease the pressure on the frontline and this system seems to be helping. It could potentially have massive implications nationally.”

He described the project as a ‘triage’ system, ensuring patients get their treatment from the most appropriate place.

He added: “Ninety per cent of the old fashioned diagnosis is on a patient’s history – we don’t need to physically see them to do that.

“I’m not saying it will work for everyone, but I think the old way doesn’t work. many people had a lot of complaints and sometimes have to wait days to see their GP. This is a massive improvement.”

The system, known as Patient Response, is being trialled at 40 practices in the UK, with national health bosses monitoring its success. It is hoped the project could be introduced elsewhere.

Simpson Medical Practice is the only surgery in Greater Manchester to take part.

The practice was named in the top one per cent in a survey by the NHS Information Centre in the category of ‘very easy to speak to the doctor’.

It also had one of the lowest A&E attendances by patients in the region.

A spokesman for NHS Manchester said: “This system allows clinical staff to help patients get the treatment they need in the best possible way, including seeing a GP or nurse, or taking an ‘over the counter’ remedy from a pharmacist.

“The triage system helps patients get the care they need quickly, and helps avoid unnecessary visits to the practice or to hospital A&E departments.”

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At the Update Pharmacy Stephanie Lennard, a patient who presents frequent prescriptions for trivial conditions, has asked to speak to pharmacist David Spencer. in the consultation area David asks how he can help.Miss Lennard replies: “Three weeks ago I had influenza – although Dr Merali said it was just a cold – and it’s left me with this hoarseness in the throat. What should I do about it?”“Have you seen Dr Merali?” asks David.“Not this time, I’m a bit afraid to. last time I went he more or less told me not to keep coming about minor things. I think he thinks I’m a hypochondriac. But I really worry every time I get a symptom that this time it’s something serious.”  “Alright,” David says, “tell me a bit more about it.”“well, I think you can hear that my voice is a bit croaky, although the hoarseness does come and go. On top of that, it feels like I’ve got phlegm in my throat all the time that I want to keep clearing. and being a schoolteacher doesn’t help, I’m always having to raise my voice to be heard in the class. Be honest with me, I’ve got throat cancer, haven’t I?”“I think that’s most unlikely,” David answers. “But I’m going to ask you some more questions and if I think there’s anything that needs further investigation, I’ll get in touch with Dr Merali for you.”QUESTIONS1 how common is hoarseness, and how likely is the symptom to indicate laryngeal cancer?2 Is Miss Lennard’s feeling of phlegm in the throat an indicator of serious disease? 3 What symptoms should make David refer Miss Lennard to Dr Merali?  4 Assuming that David rules out the likelihood of anything serious, what advice could he give to help Miss Lennard to clear her hoarseness and minimise the chance of it recurring? ANSWERS1 Hoarseness has a prevalence of 6 per cent in the general population, rising to 11 per cent for professional voice users. most episodes are benign. It often follows a viral upper respiratory tract infection. Hoarseness after prolonged use of the voice, or strain, suggests a benign cause. Incidence of laryngeal cancer is five per 100,000 in males and one per 100,000 in females. most patients with laryngeal cancer have risk factors, mainly smoking, high alcohol intake and increasing age. Heavy smoking and drinking are synergistic risk factors, and together increase risk 80-fold.2 Associated symptoms, such as throat clearing, a sensation of a lump in the throat and cough are common, but are usually benign.3 Persistent, rather than intermittent, hoarseness lasting more than three weeks; difficulty or pain on swallowing; haemoptysis; ear ache; weight loss.4 Avoid: cigarette smoke, dry atmospheres, dust, fumes; excessive alcohol or caffeine; decongestant drugs, as they can dry out the throat; prolonged use and straining of the voice; repetitive throat clearing and coughing. try: yawning and humming to relax the voice box; drink plenty of water.REFERENCEJudd O. 10 Minute Consultation: Hoarse Voice. BMJ 2010; 340:c522 Have you got a suggestion for a Practical Approach scenario? Email haveyoursay@chemistand druggist.co.ukMore Practical Approach scenarios