contents

4PROFILE

5MISSION/VISION/VALUES

6CHAIRMAN’SMESSAGE

10CEO’SMESSAGE

14BOARDOFDIRECTORS

16SENIORMANAGEMENT

18FASTER

26BETTER

36CHEAPER

40SAFER

46OURPEOPLE

52MILESTONES

70FINANCIALS

64ABOUTNHGINSTITUTIONS

Energy is the power behind every action.

It expresses the driving force behind NHG

and our people. It describes the capabilities,

dynamism and passion of NHG and

our staff. Energy is also infinite and will not

be depleted. Likewise, it describes the potential

and aspiration of NHG to provide faster,

better, cheaper and safer healthcare, to

fulfil its vision of “Adding years of healthy life”.

NHG profile

NHG’s vision is “Adding years of healthy life”. This vision departs

from merely healing the sick to the more difficult but infinitely

more rewarding task of preventing illness and preserving health and

quality of life.

NHG is a leader in public healthcare in Singapore, recognised at home

and abroad for the quality of its medical expertise and facilities. Care

is provided through an integrated network of primary healthcare

polyclinics, acute care and tertiary hospitals, national specialty centres,

innovative virtual specialty centres and business divisions. Together, they

bring a rich legacy of 325 years of medical expertise to our philosophy

of patient-centric care.

With more than 11,000 staff and S$1 billion in annual revenues,

NHG aims to provide care that is accessible, seamless, comprehensive,

appropriate and cost-effective.

our vision Adding years of healthy

life. our mission We will improve

health and reduce illness through patient-centred

quality healthcare that is accessible and seamless,

comprehensive, appropriate and cost-effective; in an environment

of continuous learning and relevant research. our values Integrity – We are committed to the highest standards of ethical

conduct. Compassion – Our paramount concern is the welfare

and well-being of our fellow human beings. We sympathise with

those struck by illness and suffering and will do our best to help

alleviate their condition. Professionalism – We are committed

to being the best in what we do, and to achieving the best possible

outcome for our patients. Respect – We treat everyone with

honesty, decency and fairness. Collegiality – We nurture

success by promoting collaboration, participation and trust between

individuals and other healthcare organisations, within an environment

of sharing and mutual respect. Social Responsibility – We

contribute positively to the well-being and welfare of the community.

�

We are on the threshold of a new era in healthcare – exciting and profoundly challenging.

In the long term, there are four key challenges that we must address.

The foremost challenge, which literally grew on us, is our ageing population and its attendant issues. Globally, these trends are stark in developed economies, like Japan, the US and western European countries. But Singapore is in this league. It is projected that the number of Singaporeans aged �5 years and above, now at 9% of total population, will escalate to 18% in 2030.

Another challenge, and opportunity, is the rapid change in how care is provided. One of the fastest catalysts for change is technology. Globally, it has transformed healthcare in the last two decades or so. We stand now on the cusp of exponential change in diagnosis, treatment and delivery of healthcare. Only a few years ago, telemedicine seemed tenable only in the distant future. Today, we have taken the first significant steps.

On a related note, healthcare is already transcending geographical barriers. International patients in search of quality healthcare are on the rise. Globally, the healthcare tourism market is estimated to be worth more than $100 billion and growing at 20% per annum. Countries like Thailand have already set their sights on this huge market. Singapore needs to compete aggressively or risk losing out in the race to be a regional medical hub.

Fourth but not least, new diseases, more virulent and deadly, are emerging. The “old” diseases we knew are making a comeback, some mutating into more threatening forms. SARS in 2003 was the worst crisis to hit Singapore since independence. An Avian flu pandemic, if it does happen, will almost surely take many lives globally. And no vaccine yet exists against these mutated viruses.

NHG’sResponse

What then should NHG’s response to these key issues be? Do we draw on experience and tested methods? Or do we need to think out of the box, start with a blank slate, to identify and address areas that need fundamental changes? To do things both differently and well? Or as we like to put it Faster, Better, Cheaper and Safer? My belief is the answer lies in both.

Managingtheageissue

Among the host of challenges an ageing population presents is a rise in chronic diseases.

Today, four common chronic diseases - diabetes mellitus, hypertension, hyperlipidemia and stroke - affect about one million Singaporeans. Chronic diseases are a major source of morbidity, mortality, suffering and misery to patients and their families. To tackle this serious problem, the Ministry of Health (MOH) took the unprecedented step of approving Medisave withdrawals for outpatient treatment of

Mr Michael Lim Choo San

Chairman

National Healthcare Group

�

selected chronic diseases, radically changing the way chronic diseases are treated.

NHG was among the first to advocate and champion the use of chronic disease management programmes to raise the level of care for chronic patients. Examples include the NHG Control of Coronary Risk Factor Initiative (LIVE) programme and the National Healthcare Asthma Tripartite (NEAT) programme.

Patients in these programmes are encouraged to work with their doctors, particularly their Family Physicians, to proactively manage their diseases, through regular monitoring, appropriate medical treatment and lifestyle changes.

So far, the NEAT programme has recruited more than 120 GPs and discharged 30 patients, of which 95% did not suffer any relapses that required them to be referred back to the hospitals. We also worked out a special arrangement with these GPs to price their drugs at rates similar to the hospitals, to address the issue of affordability. Patients enrolled in this programme stand to gain in every way.

The start we have made in the area of chronic disease management has yielded good results and shows we are on the right track. It enables us to live our pledge to help ensure our patients have longer years of healthy life.

Changingmodesofdiagnosisandtreatment

Globally, the medical profession stands on the cusp

International patients in search of quality healthcare

are on the rise. Globally, the healthcare tourism market

is estimated to be worth more than $100 billion and growing

at 20% per annum.

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of exponential change in diagnosis, treatment and delivery of care. At NHG, we want to leverage the best of these technological changes to bring potentially vast benefits to our patients.

In recent years, local healthcare providers are quickly catching up. MOH started the ball rolling with the launch of the Electronic Medical Record Exchange (EMRX) in April 2004. For the first time, hospitals and polyclinics across Singapore’s two public healthcare clusters are able to electronically share vital patient information.

Concurrently, NHG rolled out several landmark IT initiatives including Naut1cus, the Computerised Clinician Order Entry (CCOE) system, the Lab Automation System (LAS) and the Laboratory Information System (LIS). All these systems have a common goal - to bring faster, better, cheaper and safer care for our patients.

In 2005, NHG introduced teleradiology to Singapore. Teleradiology drastically shortened the waiting time for radiological reports, for both doctors and patients, ensuring faster treatment response time, without compromising quality and at lower costs.

Beyond NHG, teleradiology will add impetus to Singapore’s aspiration to be a medical imaging hub. Teleradiology is also Singapore’s first step into the world of telemedicine. Possible future applications include telecardiology and teleconsultations where patients are monitored on ECGs while at homes or GP clinics, without having to be referred to specialist care.

Technology is a win-win for our patients and Singapore.

StrongsupportforSingaporeMedicine

The government kick started the drive to harness the growth potential of Singapore’s fine healthcare system by launching the Singapore Medicine initiative in October 2003.

Singapore, with one of the world’s best healthcare systems and an excellent reputation for quality medicine, has the pre-requisites to be Asia’s premier healthcare services hub. Our geographical location

and connectivity are strong pull factors for regional patients in search of high-end medical care.

We should leverage our advantage. The volume generated from these patients will give our doctors the opportunity to treat uncommon diseases and build up their sub-specialties. The revenue can be reinvested in providing or upgrading medical equipment that may otherwise not be available to local patients.

To complement the Singapore Medicine initiative and market NHG to foreign patients, the NHG International Business Development Unit works closely with the National University Hospital (NUH) and Tan Tock Seng Hospital (TTSH) to provide a one-stop centre for foreign patients. To date, our various efforts are bearing fruit. Our foreign patients volume increased from 4�,2�1 to 52,��9 and revenue grew by 10% from the last financial year.

For Singapore to become a medical hub, NHG and other public hospitals must be proactive. Countries like Thailand and India are already on the march. Singapore Medicine’s target is to serve one million foreign patients a year by 2012, generate $3 billion in revenues and create at least 13,000 jobs. These are big targets but achievable and will require mindset change and close collaboration between the public and private healthcare sectors.

Thebattlefrontagainstoldandnewdiseases

New battles are shaping up daily in the fight against new, emerging diseases like SARS and Avian flu, the search for cures for cancer, Aids and similar tough enemies and the resurgence of old foes like TB.

A key strategy is to identify and promote biomedical research that will translate into useful treatments for patients. This strategy is in tandem with the government’s efforts. Singapore’s high-powered Research Council, chaired by Prime Minister Lee Hsien Loong, is set to approve $1.4 billion over the next five years to boost the economy through biomedical sciences, environmental and water technologies, and interactive and digital media.

To support the growth of the biomedical industry, NHG is committed to building a pool of talented clinician scientists. So far, NHG is doing well. A poll in March 200� showed that approximately 50% of our doctors conduct some form of clinical research, up from 43% in April 2003. We also had the highest number of awardees - four out of eight awardees - at the inaugural Biomedical Research Council – National Medical Research Council (BMRC-NMRC) Clinician Scientist Investigator (CSI) award in 2005.

But we still need to do much more. To put Singapore on the world map for biomedical research, our clinician scientists need to benchmark themselves against the world’s top scientific brains. On NHG’s part, we will do whatever is necessary to nurture and support outstanding researchers.

For a start, to ensure proper recognition and funded time for clinician scientists, we introduced two programmes - Mentorship & Assessment Programme (MAP) and Researcher-Investigator-Scientist-Enabler (RISE) Grant Scheme. We are cognizant that talent management will be the key determining factor to NHG’s success in developing outstanding clinical research.

Over the next few years, NHG will take on a more aggressive approach to seed a culture of research that will bring life and hope to patients.

Benchmarkingagainstglobalstandards

These four challenges are exciting and pertinent for us to address. And we do so while constantly striving for world class quality standards. What is the yardstick for patients when we claim we have one of the best healthcare systems in the world?

We benchmark ourselves against world class facilities, standards and service delivery by our people.

In 2005, we boldly applied for the prestigious Joint Commission International (JCI) accreditation, synonymous with hospital quality. We passed the auditing with flying colours and became the first public healthcare group in Singapore to attain the international accreditation.

This is an affirmation of the NHG quality journey that we have committed ourselves since day one. To patients, JCI accreditation is the assurance that they will receive world class care from any of our institutions. To Singapore, the JCI stamp positions us as the preferred healthcare destination for foreign patients.

Thefutureisinourhands

On behalf of the Board, I thank all our staff for their hard work and “heart” work in making 2005 an excellent year for NHG. Even as we review our achievements in 2005, a new future beckons.

All our institutions are raring to go. NUH’s vision is to be a leading University Hospital internationally by 2010; TTSH as the second largest acute care hospital in Singapore is moving forward to serve, care and heal the Faster, Better, Cheaper, Safer way; AH aims to be a hassle-free hospital; IMH seeks to be the choice mental health centre in Singapore by 200�; and NHG Polyclinics targets to transform the Singapore primary healthcare model.

Are these impossible dreams? No. Every distinguished and world class institution must hold lofty aspirations. The NHG’s vision is to add years of healthy life. Together, we can make this a reality.

Mr Michael Lim Choo San Chairman

National Healthcare Group

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eNerHGy:PoweringGrowth

At the October 2004 strategic retreat, senior NHG staff set out a three-year strategic plan comprising 1� objectives and 2� initiatives that will bring NHG closer to its vision of “adding years of healthy life”.

Since then, there has been no let up. One by one, our institutions and departments rolled out their key initiatives. At the end of financial year 2005, we were able to achieve most and even surpassed some of the targets that we had set for ourselves.

Our success can best be summarised under the FBCS framework – faster, better, cheaper and safer care for our patients. This is a unique proposition of NHG, and one that has served us well since our inception in 2000.

FASTER

Faster does not always mean better. In healthcare however, timeliness is of utmost importance. A timely diagnosis, a timely laboratory or x-ray result can mean the difference between life and death. It will also go a long way to alleviate the anxiety of patients’ and their loved ones.

To provide faster care for our patients, we have not been afraid to do things differently.

Teleradiology

Take teleradiology as an example. Realising its potential to provide faster and cheaper radiological reports for our patients, NHG took the bold step to pilot it at Ang Mo Kio polyclinic in December last year. Our key concern during the pilot was to ascertain the quality standards of outsourcing. After a thorough and stringent review by both NHG and MOH, our vendor Teleradiology Solutions (TS) in India passed the test with flying colours. TS was able to revert on most reports within an hour, when it previously took us two to three days. The quality of its reports was also comparable, if not better, and at a lower reporting fee.

The decision was clear –teleradiology was beneficial to our patients and we had to adopt it.

LabAutomation

Automation is well established in big laboratories in Canada, USA, Japan and Western Europe. It has been proven that with automation, turnaround for lab tests can sometimes be twice as fast. It is also a cheaper and safer alternative to the conventional method that relies heavily on human manpower.

NHG is the first in Singapore to embrace lab automation on a large scale. In June, National University

Dr Lim Suet Wun

CEO

National Healthcare Group

11

Hospital (NUH) and Tan Tock Seng Hospital (TTSH) signed the contract with Bayer and Beckman-Coulter respectively to automate their laboratories which have since become the most sophisticated line in the region. Both vendors are committed to making the two hospitals their regional reference sites and are investing a total of more than S$14 million in state-of-the-art technology and R&D.

The two laboratories were fully automated by December and have reaped time and cost savings. Lab results delivered to our doctors at the quickest time possible enable them to arrive at diagnosis earlier and provide more timely intervention and treatment for our patients.

BETTER

The quality of medicine has improved tremendously along with rapid progress in science and technology. Many diseases which used to be incurable are now treatable and with very good outcomes. On the other hand, many diseases remain incurable and new diseases are emerging.

But we are not daunted. People come to us each day with hopes in their hearts – hope of a cure and hope of a better life. It is our calling and privilege to make these hopes a reality.

JCI

I am proud to say that NHG is the first public healthcare group in Singapore to attain the prestigious Joint Commission International (JCI) accreditation. Our success is a result of the single-minded purpose of NHG to deliver quality patient care, despite the unique identity and strengths of each institution. During the audit, AH was praised for its beautiful and healing environment and a well-organised and consistent care approach; TTSH impressed with its ability to work together as a team in caring for patients in a cohesive and mutually respectful manner; NUH was noted for its inspiring leadership to quality and safety; and IMH was commended for its excellent competency assessment of nursing staff training, which is now recognised as a JCI best practice in the international arena.

RightSiting

In line with right siting, which is one of NHG’s key strategic objectives under our three-year plan, we launched the NHG Control of Coronary Risk Factor Initiative (LIVE) programme and the National Healthcare Asthma Tripartite (NEAT) programme. These programmes are based on a new model of care where we partner GPs in the co-management of chronic patients. Chronic patients, whose conditions

Our success can best be summarised under the FBCS framework –

faster, better, cheaper and safer care for our patients. This is a unique proposition of NHG, and one that has served us well since our inception in 2000.

12

are stable, are best cared for by GPs at the primary level instead of specialists at the hospitals.

So far, the results of these programmes have been very positive. Plans are already underway to introduce similar programmes for heart failure and diabetes patients. Also in the pipeline, as part of NHG’s arsenal against the war on chronic diseases, are a new diabetes registry and the development of a GP portal to give GPs access to vital patient information.

CHEAPER

Can anything good be cheap? Rising healthcare cost is a perennial issue and the answer to it is providing care and services cost effectively.

Leveraging technology is one way we have been able to make ourselves more cost effective. While cost is not the only motivating factor behind our initiatives such as teleradiology and lab automation, we are reaping cost savings alongside other intended benefits. Likewise, our Clinical Practice Improvement

Programme (CPIP) which has been pivotal in NHG’s quality success, rolled out many projects with significant cost impact. An NUH project, for example, successfully reduced unnecessary admission for children with febrile seizures by 50%, twice its original target! Aside from the significant cost savings, this initiative went a long way to make more than 130 young patients and their parents happier. Well done!

SAFER

Despite the progress of science and technology, we are not infallible. We have a responsibility to take a serious view of mistakes, learn from them and hopefully not repeat them.

As part of the NHG quality and safety framework, we encourage greater transparency and self-reporting of adverse events. To underscore our emphasis on patient safety, we will also be measuring ourselves by the spread and results of the IHI (Institute for

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Healthcare Improvement) initiatives including those to prevent ventilator-associated pneumonia and surgical site infection.

The Computerised Clinician Order Entry (CCOE) system was a key 2005 project to improve the quality and safety of our patient care. One of its main features is e-prescription which checks for drug allergies and dosage among other things. It also improves safety by replacing handwritten prescriptions which may be hard to decipher. To date, most of our Specialist Outpatient Clinics and polyclinics are using e-prescription. Eventually, we hope to implement e-prescription at hospital wards too.

OurPeople,TheeNerHGy

It is a challenge to daily live and breathe the Faster, Better, Cheaper and Safer way. Lots of energy is required. I am proud to say that our staff, rose to the occasion and stayed focused and energised. Our people are the driving force and energy behind NHG.

TalentManagement

People are our most important assets. In healthcare, no systems can take the place of a highly trained and skilled workforce. To serve our patients well, we must continue to invest in our people. The Talent Management Unit was set up with this purpose in mind. The unit identifies, develops and tracks talented staff to fulfill their aspirations and potential. The unit is also tasked to facilitate succession planning for key leadership positions across all institutions within

the cluster. In tandem, we developed various talent management schemes, starting with nurses who form the majority of our manpower.

E-learning

E-learning will be our main training platform. It is cost-effective and maintains the standards of training which translates into better patient care. With e-learning, staff have the flexibility to learn at their own pace and time. So far, 14.�% of our staff had attended e-courses. �5% of staff who e-learned felt that their learning objectives had been met. Our target for the year ahead is to convert 50% of relevant classroom courses to e-based curriculum.

Energy–Thepotentialiswithoutlimits

Our patients see and appreciate the good work that we are doing. Our total patient experience index improved from 91% in 2004 to 92.5% in 2005. At the annual Excellent Service Awards 2005, NHG was again the top winner in healthcare sector with 128� awards. 1� NHG staff, who went beyond their call of duty to touch the hearts and lives of their patients, were awarded the Healthcare Humanity Awards. The list of accolades for our staff goes on and on.

Over the past one year, we have achieved much. I would like to thank our Board and my colleagues for their dedication and hard work in fulfilling the NHG vision of adding years of healthy life. The future holds many promises, opportunities and challenges. I am confident that NHG has the will, power and potential to succeed and do much more.

Dr Lim Suet Wun CEO

National Healthcare Group

directorsboard of

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MrMichaelLimChooSan has been Chairman of the National Healthcare Group (NHG) Board of Directors since March 2000. He is also the Senior Advisor of Nomura Singapore and the Chairman of Land Transport Authority. He currently serves on several other Boards including the Public Service Commission, Nanyang Technological University and Olam International Liimited.

MrAlexanderChanMengWah, the Executive Director of MMI Holdings Ltd, has been on the NHG Board since April 2000. Mr Chan is also Chairman of the Singapore Sports Council and Vice-President of Singapore National Employers Federation and serves on the Boards of MFS Technology Ltd, SNP Corporation Ltd, and the Defence Science & Technology Agency.

AssociateProfessorCheongPakYean has been on the Board of NHG since April 2000. A physician in private practice, A/Prof Cheong is the President of the College of Family Physicians and Adjunct Associate Professor of National University of Singapore, Medical Faculty. He also serves on the Board of Governors at the Institute of Technical Education.

Mr Benedict Cheong Thiam Beng, Chief Executive Officer of National Council of Social Service, was appointed to the NHG Board in April 2003. He is a member of Medifund Advisory Council and Chairman of National Heart Centre Medifund Advisory Committee. Mr Cheong is also a member of the National Volunteer and Philanthropy Centre Board.

MrKohPohTiong is the Chief Executive Officer and Director of Asia Pacific Breweries Limited (APB) and holds directorships in most of the group’s subsidiaries. He is Chairman of Agri-food and Veterinary Authority (AVA) and a director of PSA International Pte Ltd and PSA Corporation Ltd.

Dr Grace Lee Siew Luan has been on the NHG Board since April 2003 and is a consultant nephrologist in private practice. She is the Medical

Director for Peritoneal Dialysis of the Kidney Dialysis Foundation, and is a member of the National Research Council Peer Review Subcommittee. She sits on the Complaints Panel of the Singapore Medical Council and is also the Vice-President of the Singapore Society of Nephrology.

DrJohnLimChienWei, Director of the Centre for Drug Administration, Health Sciences Authority, has been on the NHG Board since April 2003.

Associate Professor Loong Si Chin, a neurologist in private practice, has served on the NHG Board since April 2000. He is an Adjunct Associate Professor with the Department of Medicine at the National University of Singapore, a member of Neurology Specialist Training Committee, Academy of Medicine and a visiting consultant at the National Neuroscience Institute, Singapore General Hospital and the Singapore National Eye Centre.

Mr Ng Ooi Hooi, Director (Sea/Corporate Development) in the Ministry of Transport, was appointed to the NHG Board in April 2003.

MrSohKimSoon, Chairman of Orix Investment and Management Pte Ltd and Orix Leasing Singapore Ltd, was appointed to the Board in April 2000. Mr Soh is also a director in Engro Corporation Ltd, Juniper Capital Ventures (Pte) Ltd and Singamas Container Holdings Ltd.

Dr Teoh Hoon Cheow has been on the NHG Board since April 2000. He is a paediatrician in private practice. Dr Teoh is a member of the Ministry of Health’s Electoral College and the Inquiry Panel with the Legal Profession Act and a member of the Panel on the Disciplinary Committee of the Singapore Institute of Architects. He is also a member of the Board of Governors, Duke – NUS, Graduate Medical School.

DrMichaelYapHockLeong, who was appointed to the NHG Board in April 2002, is a consultant neurologist and physician in private practice.

managementsenior

1�

DrLimSuetWunChief Executive Officer, National Healthcare Group Chief Executive Officer, Tan Tock Seng Hospital

ProfessorCheeYamCheng Assistant Chief Executive Officer (Clinical), National Healthcare Group

MrChuaSongKhim Chief Executive Officer, National University Hospital

MrLeongYewMeng Chief Executive Officer, Institute of Mental Health/Woodbridge Hospital

MrLiakTengLit Chief Executive Officer, Alexandra Hospital

AssociateProfessorRoyChan Medical Director, National Skin Centre

AssociateProfessorPhilipChoo Chairman, Medical Board, Tan Tock Seng Hospital

AssociateProfessorBenjaminOngChairman, Medical Board, National University Hospital (w.e.f. January 200�)

AssociateProfessorLimYeanTeng Chairman, Medical Board, National University Hospital (until December 2005)

AssociateProfessorPangWengSun Chairman, Medical Board, Alexandra Hospital

AssociateProfessorWongKimEng Chairman, Medical Board, Institute of Mental Health/Woodbridge Hospital

AssociateProfessorShantaEmmanuel Chief Executive Officer, NHG Polyclinics (until June 2005)

ProfessorJohnWong Dean, Yong Loo Lin School of Medicine, National University of Singapore

DrJasonCheah Chief Executive Officer, NHG Polyclinics (w.e.f. November 2005) Chief Projects Officer, National Healthcare Group

MsLimYeeJuan Chief Financial Officer, National Healthcare Group

MrNgLang Chief Human Resource Officer, National Healthcare Group (until December 2005)

MsOliviaTay Acting Chief Human Resource Officer, National Healthcare Group (w.e.f. January 200�)

MrLinusTham Chief Information Officer, National Healthcare Group

MrJeffreyChun Director, Corporate Development, National Healthcare Group (w.e.f. January 200�)

MrJoeSim Chief Corporate Development Officer, National Healthcare Group

MrsNellieYeoSokLeng Chief Quality Officer, National Healthcare Group (until December 2005)

MsOliviaBranson Director, Corporate Communications, National Healthcare Group

Director, Corporate Communications, Tan Tock Seng Hospital

patientshealthcare to

Time is of the essence in pat ient

care. Faster diagnosis. Quicker

laboratory and x-ray results. Shorter

waiting time for beds. All these and

more make a difference to our patients.

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EmergencyDepartments–Whereitmattersmost

Timely intervention at Emergency Departments

(EDs) for patients in critical condition is a must,

not a choice. An unnecessary delay can mean the

difference between life and death. For this reason,

we spend a lot of our time and energy into improving

waiting times at our various EDs.

To address the start point of the value chain, our

hospitals have been deploying specially trained triage

nurses to assess patients’ condition. This is to ensure

that patients with critical conditions ie P1 cases are

attended to first. Some of our hospitals like Alexandra

Hospital (AH) and National University Hospital (NUH)

have taken this initiative a step further by deploying

a senior doctor at the triage point especially during

peak periods. This senior doctor, often an emergency

medicine specialist, is able to rapidly assess the

patients, order relevant tests and provide definitive

care if need be, all at the first point of contact.

Not all patients with serious but stable conditions

need to be admitted. To manage this group of patients,

Tan Tock Seng Hospital (TTSH) set up an Emergency

Diagnosis & Therapy Centre (EDTC) in September

2005 to provide protocol-based treatment for those

with acute conditions that require short and focused

care. Patients who respond to the treatment need not

be admitted and can be discharged from the EDTC

within 24 hours. This is similar to NUH’s Extended

Diagnosis Treatment Unit (EDTU), which was set up in

early 2005 to monitor and observe ED patients whose

conditions may not be serious enough to warrant

admission. Patients are happy with this arrangement,

as they receive appropriate care without the hassle

and cost of hospitalisation.

Since December last year, a full-time consultant

has also been appointed at the Institute of Mental

Health’s (IMH) ED to upgrade the overall level of

emergency psychiatric care. The consultant provides

direct on-site supervision to the medical officers and

registrars and attends to the more difficult cases. This

has resulted in better clinical assessment and timely

intervention, and preventing unnecessary hospital

admissions.

Other initiatives to improve waiting times at EDs

include AH’s Digital Clinical Dashboard, an all-in-one

Timely intervention at Emergency

Departments (EDs) for patients with

critical condition is a must, not a choice.

22

patient management system which allows doctors

to see patients and prescribe medication at one

go, translating to a shorter overall waiting time for

patients.

BetterBedManagement

To improve waiting times, we looked at the entire

value chain, from admission at EDs to discharge

at wards. In December 2005, NUH piloted an e-

Housekeeper’s Intelligent Management System

(eHIMS), a bed management tool, to provide its

wards, Bed Management Unit and Housekeeping

with a real time overview of bed status from dedicated

terminals. A quick comparison of the results over one

week showed a �0% improvement in turnaround

time, from time of patient’s discharge to having the

bed ready for the next patient.

In January 200�, TTSH started a trial that uses RFID

technology to identify and track C class patients,

and their actual admission and discharge status. By

doing so, ground staff are equipped with real-time

information on bed availability and can more promptly

assign an empty bed to the next ill patient waiting

at ED. Similarly, AH leveraged the latest technology

- the Cisco Clinical Connection Suite (CCS) – and

became the first in Asia to implement this system to

improve its bed management. A pilot trial conducted

by the hospital last November showed that CCS

was able to reduce patients’ waiting time for beds

by up to 30 per cent.

In addition to improving waiting times at EDs and

wards discharge, other innovative ideas to improve

waiting times were extended to the Specialist

Outpatient Clinics (SOCs) as well. This includes

the National Skin Centre’s (NSC) new system at its

subsidised clinics where the consultant reviews new

cases together with medical officers or registrars in

the same consultation room.

MobileCommunications

TTSH started a pilot leveraging a smart messaging

system in October 2005. The system which replaced

doctors’ pagers with mobile phones was designed

to cut down on unnecessary waiting times between

the communication of doctors and nurses. Time

savings will eventually translate into more responsive

23

patient care. The pilot study also concluded that the

use of mobile phones did not compromise patient

safety. With the success of the pilot, TTSH issued

mobile phones to all its doctors in January 200�. Its

success also prompted the InfoComm Development

Authority of Singapore (IDA) to approve a grant

of $494,000 to NHG to deploy the mobile phone

system across its institutions and to further develop

the system for other applications.

Patients who have had surgery at AH can update their

wound condition by sending pictures via multimedia

message service (MMS) or email. All they have to do

is take a picture of the wound, and send it to nurses at

the hospital for assessment. This innovative process

saves both time and money. Patients are spared the

hassle of making trips to the hospital and are also

more involved in their own recovery process.

FilmlessRadiology

Teleradiology is set to change the practice of

diagnostic medicine. The key advantage of filmless

technology, where images such as x-rays are taken,

stored and read digitally, is shorter waiting times

for patients for their results. It also facilitates the

seamless transfer of patient information between

care providers, leading to improved care as clinicians

now have quick and accurate access to essential

medical information to better customise treatment to

meet patients’ unique needs.

Since February 200�, all NHG Diagnostics (NHGD)

centres have gone filmless through the implementation

of the Computed Radiography (CR), Radiology

Information System (RIS) and Picture Archival

Communication System (PACS). This was followed

by NUH’s Department of Diagnostic Imaging and

TTSH’s Orthopaedic Surgery, Otorhinolarygology,

Ophthalmology, Psychological Medicine and General

Surgery Departments. For the period of January

to March 200�, these TTSH departments saw an

immediate cost savings from films and chemicals,

to the tune of $1�,000.

TeleradiologyHub

Within NHG, the digitisation of x-ray images

and teleradiology have allowed efficient sharing

of resources among polyclinics and hospitals.

Teleradiology is set to change the practice of diagnostic medicine.

The key advantage of filmless technology, where images such

as x-rays are taken, stored and read digitally, is shorter waiting times for patients for their results.

24

Singapore’s long-term goal is to make public sector

healthcare institutions a seamless environment

in medical imaging and position the country as a

medical imaging hub.

A pilot programme was initiated at Ang Mo Kio

(AMK) Polyclinic last December to test the feasibility

and quality of outsourcing the reading of routine

x-rays to Teleradiology Solutions (TS) in India. TS

is one of the leading teleradiology centres in India

and is accredited by the US-based international

accreditation agency Joint Commission on

Accreditation of Healthcare Organisations (JCAHO).

Both pre-pilot and pilot tests conducted by NHGD

and the Ministry of Health (MOH) showed that TS

was able to deliver high quality reports within an hour,

compared to the usual two to three days in Singapore

- a dramatic improvement in the waiting time for

x-ray results. With the results made known on the

same day, polyclinic patients no longer have to return

and incur the additional cost of a second trip to

collect their results.

In outsourcing reading of routine x-rays, we are also

enabling our doctors to focus on the more complex

radiology procedures and techniques such as CT

scans and MRIs. They will also be able to devote

more time to research, teaching and training.

Since the completion of the successful pilot at

AMK polyclinic, all NHG polyclinics have outsourced

the reading of routine x-rays to TS. NHG Polyclinics

patients now enjoy a faster and more convenient

x-ray service.

LaboratoryAutomation

With automation, NUH and TTSH’s laboratories are

now among the most sophisticated in the region,

being the first automation line to integrate chemistry,

haematology, immunochemistry and coagulation tests.

Automation has improved the overall turnaround time

for laboratory tests and in some instances results

can be out twice as fast. Laboratory results delivered

to our doctors at the quickest time possible enable

them to arrive at diagnosis earlier and provide more

timely intervention and treatment for patients. Cost

savings is expected to be about S$10 million over

seven years.

Other benefits of automation include increased staff

safety and productivity. Staffs also derive a higher

job satisfaction by focusing on higher value-added

laboratory work.

Since November 2005, the Lab Information System

(LIS) has also been implemented at all NHG

hospitals. This system enables lab results to be

reported and retrieved electronically, across cluster.

With automation and LIS, the entire lab process,

from sample collection, analysis to result reporting,

is fully integrated and more efficient.

25

servicehealthcare

For a healthcare institution, quality of care

is a basic and fundamental requirement.

Patients place their lives, and hopes, in us

and expect nothing but the best care. Our

success and pursuit of excellence

in quality is what differentiates

and distinguishes NHG from the rest.

28

JointCommissionInternational

Bearing testimony to our quest for world-class quality

care, NHG is proud to be the first public healthcare

group in Singapore to attain the prestigious Joint

Commission International (JCI) accreditation.

NUH led the way when it became the first hospital

in Singapore in 2004 to be accredited. The rest of

the hospitals under NHG – AH, TTSH and IMH –

successfully attained the prestigious accreditation

in September 2005. IMH is also the first mental

health institution in the region to bear the JCI stamp

of approval.

RightSiting

NHG is one of the forerunners in Singapore to

advocate the principle of right siting – to provide

patients with the right care, by the right provider, at

the right place and at the right time. It is increasingly

recognised by both local and international

healthcare authorities that right siting is one of

the most effective solutions to managing limited

healthcare resources, without compromising on

the quality of care.

HealthcareintheCommunity

According to the World Health Organisation (WHO),

two out of three deaths worldwide are caused by

chronic diseases. In Singapore, chronic diseases

are also the main cause of mortality and morbidity.

As part of its strategy to tackle this serious problem,

MOH made the unprecedented move to liberalise the

use of Medisave for selected chronic diseases. The

new policy is expected to take effect in 200�.

Studies worldwide have shown that the answer to

chronic diseases lies in disease management. A key

tenet in successful disease management is right

siting. In NHG’s disease management programmes,

we have been actively engaging and training

community healthcare providers, primarily the Family

Physicians/General Practitioners (GPs), to manage

chronic patients.

The NHG ControL of Coronary RIsk Factor InitiatiVE

(LIVE) programme was launched in August 2005.

It aims to ensure that heart patients reach optimal

control of risk factors through standardised clinical

pathways and patient education. Part of the

programme involves discharging stable patients to

NHG is proud to be the first public healthcare group in Singapore to

attain the prestigious Joint Commission

International (JCI) accreditation.

30

GPs for co-management. A similar programme for

asthma patients - the National HealthcarE Asthma

Tripartite (NEAT) programme - was also introduced

in October 2005 to enable stable patients to receive

follow-up care from GPs. Patients in the NEAT

programme are assigned community care managers

who liaise directly with GPs regarding follow-up

compliance and treatment outcomes. Thus far, the

NEAT programme has recruited more than 120 GPs

and referred 30 patients, of which more than 95%

did not suffer any relapses that required them to be

referred back to the hospitals. These are excellent

results that have established NHG as a leader in

shared-care programmes.

Beside a higher quality of life, patients under such

programmes enjoy the convenience of the proximity

of the GPs’ clinics, shorter waiting times and lower

costs from fewer hospitalisations.

Community healthcare extends to mental health as

well. Since April 2005, IMH has started to collaborate

with GPs to provide affordable and convenient care

for stable adult patients with chronic mental illness.

So far, more than 20 GPs have been trained in the

care and management of such patients within the

community setting. Referrals are underway and

patients have given positive feedback.

NHG Polyclinics have adopted a comprehensive

multi-disciplinary approach to managing patients

with chronic conditions such as diabetes, hypertension

and hyperlipidemia. These patients are managed

by doctors in collaboration with care managers

and dieticians. Over the years, the percentage of

patients who has achieved excellent control of their

conditions have increased significantly.

In May 2005, NHG Polyclinics introduced the Family

Physician clinic (FP clinic) as part of their strategy

to tackle chronic diseases. At the FP clinic, patients

with chronic illness are better managed as they

are treated by a senior doctor with postgraduate

qualifications in Family Medicine. These patients also

enjoy a longer consultation time with the same senior

doctor at every visit and at shorter waiting times. The

first FP clinic was launched in Ang Mo Kio Polyclinic

in May 2005. Since then, five more FP clinics have

been launched in Bukit Batok, Hougang, Toa Payoh,

Woodlands and Yishun Polyclinics. Results have

31

Patient empowerment is an integral factor in the NHG

Integrated Chronic Obstructive Pulmonary DisEase (NICE) programme.

Implemented in May 2005 at all three NHG hospitals – AH, NUH and TTSH,

it provides essential home care services for patients

with Chronic Obstructive Pulmonary disease (COPD).

been very encouraging - 50% of patients seen at the

FP clinics have shown improvements in their sugar,

blood pressure and cholesterol levels.

Diabetes is among the most prevalent and serious

chronic disease. In Singapore, �00 amputations are

carried out each year for patients with diabetes. The

Singapore Footcare Centre (SFC) was opened in

November 2005 to provide a full range of affordable

footcare and podiatry services aimed at reducing

hospitalisation and improving the health of patients

with diabetes. The SFC is part of a concerted effort

by NHG to address diabetes.

Other measures included the setting up of the first

diabetes registry in Singapore and the NHG Footcare

Programme at the various hospitals. This footcare

programme is established by the NHG Diabetic Foot

Problems Workgroup and aims to screen all diabetic

patients at NHG for any foot problems so as to

prevent amputation.

PatientEmpowerment

The Patient is his own best doctor. To lead a healthy

life and to prevent conditions from deteriorating,

patients must actively take ownership of their health,

change their lifestyles whenever necessary and

comply with the treatment prescribed.

Patient empowerment is an integral factor in the NHG

Integrated Chronic Obstructive Pulmonary DisEase

(NICE) programme. Implemented in May 2005 at

all three NHG hospitals – AH, NUH and TTSH, it

provides essential home care services for patients

with Chronic Obstructive Pulmonary Disease (COPD).

Although exacerbations of COPD are a major cause

of hospital admissions, they do not require intensive

investigations or complex therapy. Severe but

uncomplicated cases of COPD exacerbation can be

successfully managed at home. As of December 2005,

3�2 patients have been enrolled in the programme

and early results showed reduced hospitalisations

– the average length of stay for a patient was 1.23

days a year compared to 1.39 days before. Total cost

savings from reduced hospitalisation is estimated

to be about $100,000.

IMH introduced the Milieu Therapy to all its acute

wards in November 2005. Milieu therapy aims to

change the patient’s role from that of a passive

recipient of care to that of an active participant.

32

Milieu therapy uses careful structuring of the social

and physical environment to ensure that every

interaction and activity is therapeutic for the

patient. For example, patients are encouraged to

go beyond the wards to engage in social activities

such as gardening. Many patients have responded

positively to the Millieu therapy programme and

have seen improvements to their medication

compliance, problem solving skills as well as the

ability to manage their stress and anger.

For patient empowerment to be successful, patient

education is vital. The Cancer Institute (TCI) produced

two educational videos – ‘A Guide to Chemotherapy’

and ‘A Guide to Radiation Therapy’ to equip patients

and help them better understand the treatment

procedures and side effects, and hopefully alleviate

their anxiety.

ClinicalPracticeImprovementProgramme

Since its inception in 2000, the NHG Quality

Framework has provided a platform for healthcare

professionals to drive quality using various tools

and methodologies including the Clinical Practice

Improvement Programme (CPIP). The programme

equips clinicians with the knowledge and skills to

participate effectively in healthcare re-design and

improvement. Participants are required to complete

a project that has a positive impact on clinical and

cost outcomes and patient satisfaction.

To date, more than 300 clinical, nursing, allied

health and administrative staff have undertaken

240 projects. These clinical improvement projects

have improved the quality of care and safety for

our patients. Many of them have also achieved

significant cost savings for NHG through streamlining

of processes and clinical pathways and a more

efficient use of facilities, equipment and manpower

resources.

For example, TTSH’s phlebitis project successfully

reduced infection rate from 2�% to less than 1%.

This best practice was among the seven that was

selected to be spread across NHG hospitals.

Another project, championed by AH, successfully

achieved for all patients with Open Reduction

Internal Fixation, Incision & Drainage and Ray

Amputation surgeries a pain score of 3 or less

within 48 hours of surgery.

34

NHGQualityWeek2005

The annual NHG Quality Week remains an important

event in the NHG calendar. Held in September 2005,

NHG was honoured to have as keynote speaker

Professor David Bates, Chief of the Division of

Internal Medicine at the Brigham & Women’s Hospital

in Boston, USA. Professor Bates, who is also the

Advisor to NHG’s Medication Safety Collaborative,

spoke on “The Promises and Perils of CPOE – 10

Pitfalls You’II Want To Avoid”. It was a valuable and

timely sharing for NHG in its own Computerised

Clinician Order Entry (CCOE) journey.

NHGPharmacy

To help elderly patients and those with poor

compliance or taking multiple medications, NHG

Pharmacy introduced the Medication Therapy

Management (MTM) service in 2005. During the MTM

session, a trained pharmacist will review patients’

medications, vitamins and herbal supplements,

provide personalised advice and information on

medication therapy, assess risks of drug interactions

and medicine-related problems, and organise

patients’ medications for easy consumption and to

minimise the chances of errors.

ClinicalResearch

Clinical research is an essential part of clinical

practice. Today, many of the cures for once

incurable diseases are a result of successful and

painstaking research and trials. Notwithstanding,

there remain many diseases which are baffling our

doctors and scientists and robbing lives and health.

There is a pressing need to devote more resources

and manpower to conduct relevant research that

will translate into better patient care.

NHG research areas are in line with the nation’s

focus on key research areas. In 2005, the highest

number of research in NHG was done in the field of

Oncology (12%), Ophthalmology (9%), Cardiology

(�%), Infectious Disease (�%), Allied Health (�%),

Gastroenterology (�%), and Psychiatry (�%), which

showed an increasing trend in these fields. In that

year, a total of 492 applications for new research

projects were received and there are approximately

800 ongoing research projects in NHG.

Four NHG doctors, out of eight awardees, received

the inaugural Biomedical Research Council

– National Medical Research Council (BMRC-

NMRC) Clinician Scientist Investigator (CSI) award

in 2005. This affirmed our clinicians’ research

capability and the importance of nurturing more

research talents.

35

ResearchWhitePaper

The NHG Research White Paper was developed to

outline the key initiatives to seed a culture of relevant

and significant research in NHG over the next three

years. The Paper was a result of a year of consultation

and planning to develop a three-pronged strategic

direction with emphasis on translational research,

investment in research manpower, and improvement

in the quality of research and human research

protection.

Research talent management is identified as a key

capability to attain the cluster’s research goals.

Mentorship & Assessment Programme (MAP) was

launched in November 2005 to nurture potential

clinician-scientists and ensure appropriate recognition

for them. Last year, about 5� NHG doctors spent at

least one day a week or more in research. MAP was

implemented to boost this number. Working in tandem

with MAP, the Researcher-Investigator-Scientist-

Enabler (RISE) Grant Scheme was implemented

to provide protected time for clinicians scientists.

The inaugural batch of RISE awardees comprised

seven outstanding investigators of high potential. In

parallel, nine aspiring clinician-scientists, who were

nominated by their respective institutions, were

accepted into the MAP programme.

On the ethics front, the NHG Research Quality

Assurance Programme will be launched in May 200�

to promote responsible conduct of research and a

research culture that operates on high ethical standards.

patientshealthcare to

Healthcare cost is a major concern. Cost

factors like inf lation and limited healthcare

resources a re major challenges.

While it is inevitable that healthcare

costs will continue to go up, we make

it one of our priorities to provide cost-

effective care by always questioning

the way we work, re-inventing our

processes and re-thinking our paradigms.

38

LeveragingIT

The appropriate use of information technology has

been proven to lead to cost savings, especially in

the long run. Laboratory automation, which reduces

waiting time for tests, has also resulted in significant

cost savings for NHG - S$10 million over seven years.

Plans are underway to pass some of these savings

to patients through cheaper laboratory tests.

Similarly, teleradiology has helped NHG achieve

cost savings from lower reporting costs charged by

Teleradiology Solutions (TS), our partner in India.

Through the implementation of filmless radiology,

TTSH’s Orthopaedic Surgery, Otorhinolarygology,

Ophthalmology, Psychological Medicine and General

Surgery Departments saved about $1�,000 from

films and chemicals for the period of January to

March 200�.

With the Computerised Clinician Order Entry (CCOE)

system, patients also save from repetitive tests when

doctors are alerted to such tests.

Clinical Practice Improvement Programme(CPIP)

One of the criteria of a successful CPIP project is its

impact on cost outcomes. Since 2000, there have

been numerous projects that have helped cut down

costs for patients. Some of these projects have been

identified as best practices to be spread across NHG

for the benefit of more patients.

In 2005, projects that resulted in significant cost

savings included an NUH project that looked into

reducing unnecessary admission of children with

febrile seizures. The primary aim of the project was to

improve clinical care through reducing unnecessary

admission. At the end of the ten-month project, total

admissions for children with simple febrile seizures

were reduced by more than 50%, double the original

target. This was achieved without any compromise

to the safety of the discharged children. Total cost

savings from avoided admissions was estimated to

be about S$3�,000 over 10 months.

Another project, undertaken by IMH, successfully

reduced the percentage of SOC patients with surplus

medication from ��% to 2�% which translated to

cost savings of around $4,300 over a one year period.

RightSiting

Successful right siting has a positive impact on cost

outcomes. Right siting - to provide patients with the

right care, by the right provider, at the right place

and at the right time – is based on the rationale that

it is the most efficient use of limited and precious

healthcare resources. The National HealthcarE Asthma

Tripartite (NEAT) programme, for example, has seen

a cost savings of almost $100,000 from avoided

hospitalisations for patients under the programme.

practices

“First, do no harm”. The safety of

our patients and our staff in their

delivery of care is a cornerstone of

good healthcare. To minimise the chances

of errors, we are rigorous in instituting systems

and measures to ensure consistency

in standards of care and reducing

human intervention whenever possible.

42

PatientSafetyOfficersandSafetyChampions

A Patient Safety Officer (PSO) has been appointed at

each of the NHG institutions. The role of the PSO is

to oversee the entire patient safety programme at his

or her respective institution. The first batch of PSOs,

upon their return from overseas training, started a

series of in-house workshops to train clinical staff on

patient safety concepts, human factors, teamwork

and communication.

Beside NHG PSOs, NUH, TTSH and IMH appointed

their own department safety champions. These safety

champions ensure that patient safety initiatives are

in place at their respective department or unit to

support the cluster or the institution’s Patient Safety

Framework.

Patient Safety Leadership WalkRounds was

implemented in 2005 at all NHG hospitals. The

WalkRounds are conducted monthly by senior

members of the management team. It aims to

inculcate a patient safety culture amongst staff,

by addressing staff’s concerns regarding safety

issues. It is a commitment from the management

to listen and act on those issues that can hinder

the safe delivery of patient care.

ClinicalPathwaysandTreatmentAlgorithms

While each patient is unique and may respond to

treatment differently, there is growing evidence and

acceptance that clinical pathways will ensure a higher

and more consistent standard of care. For the past

few years, the respective NHG institutions have been

developing clinical care paths for major diseases

such as stroke and cancer. With these pathways, our

patients are assured of safe and consistent “person-

focus” quality care in our multidisciplinary approach

to treating them.

New pathways developed in 2005 include IMH’s

Psychiatric Rehabilitation Clinical Pathway and

Attention Deficit Hyperactive Disorder (ADHD)

Pathway and NUH’s Neurosurgery and Minor Head

Injury pathways. In addition, IMH developed a

calendar-like flipchart compiled from eight treatment

algorithms, in addition to Suicide Risk Assessment

and Rapid Tranquillisation Guidelines, for doctors’

quick and easy reference.

A Patient Safety Officer (PSO) has

been appointed at each of the NHG institutions.

The role of the PSO is to oversee the entire

patient safety programme at

his or her respective institution.

44

Communication is a key factor in improving patient

safety. TTSH, through its Patient Safety Programme,

used Resuscitation Drills as the vehicle to enhance

communications between staff as part of teamwork

training.

At AH, all patients are requested to bring along

their existing medication upon or within 24 hours of

admission. Pharmacists will reconcile medication

recording available with the medications that they

are currently taking, to avoid errors and reduce drug-

related adverse events.

In October 2005, AH also devised a “nurse helper”

to reduce fall rates among patients especially the

elderly. Sensors fitted under the patients’ beds are

linked to a system at the nurses’ station to alert

staff in the ward when patients are preparing to get

out of beds.

As part of its continuing quality assurance improvement

programme, TCI Radiation Oncology implemented a

‘Quality Assurance Review’ in addition to its weekly

review, to assess the treatment accuracy on the

intended treatment site.

ComputerisedClinicianOrderEntry

A key IT project undertaken by NHG in 2005 was

the Computerised Clinician Order Entry (CCOE)

system, which aims to raise the safety and quality

of patient care. A key feature of the CCOE system

is e-prescription. E-prescription checks and alerts

doctors to patients’ drug allergies, and cautions

them on drug-to-drug interactions and drug dosage

for certain medical conditions. Prescribing errors are

also reduced, as pharmacists no longer need to rely

on doctor’s handwritten paper prescriptions.

To date, the adoption rate for e-prescription at our

hospital SOCs and polyclinics has reached almost

100%.

The potential of CCOE extends beyond e-prescription.

A possible application is e-ordering. Using this feature,

doctors can order electronically medication, x-ray and

laboratory tests for patients. E-ordering’s decision

support tools checks for appropriateness of tests

orders, and suggests other relevant orders if necessary.

It complements the e-alert feature that prompts doctors

to repetitive tests orders. E-ordering and e-alert features

will be developed and rolled out in time to come.

45

Outside of CCOE, various departments are also

leveraging technology to improve patient safety

and care. For example, NUH Pathology Department

has gone paperless for reports and the electronic

system alerts doctors if results of cancer patients are

abnormal. Likewise, eLab review capabilities, which

remind and alert doctors to abnormal results, was

piloted at NUH and has since been also rolled out

to TTSH and polyclinics.

MedicationSafetyCollaborative

Since the introduction of the Medication Safety

Collaborative in April 2004, new initiatives have been

added and piloted in AH, NUH and TTSH. These

include a dedicated ICU pharmacist, an inpatient

Warfarin project, and medication reconciliation.

Premixed KCL replacement is now available

throughout the wards at AH, NUH and TTSH. The use

of smart pumps was piloted at TTSH Surgical ICU

in July 2005 and the responses from the users have

been good.

The electronic Hospital Occurrence Reporting

(eHOR) system has undergone enhancement to

aid staff to report any incident with minimum

hassle. The Medication Safety Collaborative also

introduced the IHI Trigger Tool within the Clinical

Review Programme to identify Adverse Drug Events

(ADEs). The development of an electronic pharmacy

intervention database, replacing the existing manual

documentation, is also in progress. In the pipeline

are plans to build an automated ADE surveillance

system, which will enable a comprehensive screening

of the entire NHG inpatient population for potential

ADEs.

A key IT project undertaken by NHG in 2005 was the Computerised Clinician Order Entry (CCOE) system, which aims to raise

the safety and quality of patient care. A key feature of

the CCOE system is e-prescription.

our

Our people are the source of the

NHG energy. It is the power to Faster,

Better, Cheaper and Safer care. Like

energy, our potential knows no bounds

and the possibilities are endless.

48

ANurturingCulture

We launched the inaugural Young Leaders Programme

in May 2005, with the belief that talents must

be nurtured. Twenty-one staff with high potential

were identified and went through an eight-day

programme comprising adventure learning,

management workshops and a dialogue session

with senior management. The programme was well

received by participants and will be conducted on

an annual basis.

TalentManagement

At NHG, we believe that every staff is a talent who

must be harnessed to reach his or her fullest potential.

To better track and develop our talent resource and

to facilitate succession planning for key leadership

positions across all institutions within the cluster, a

central Talent Management Unit was set up in 2005.

Beginning with nurses who form the largest

staff population, the Nursing Talent Management

Programme (NTMP), which comprises an individual

development plan and assigned mentors, was

introduced in 2004. The selection of NTMP nurses

is conducted annually and for FY05, a total of 18 top

calibre nurses were inducted into the programme.

The performance of these NTMP nurses is tracked

closely under a structured matrix reporting system.

Performers will be given an accelerated career

progression.

A pilot talent management scheme similar to NTMP

was started at IMH in September 2005. If it is

successful, the scheme will be replicated in other

institutions. Plans are also underway to introduce a

talent management scheme for doctors with strong

administrative skills.

e-learning

At the end of the financial year, the cluster achieved

an e-learning rate of 14.�% against the original target

of 10%. This was a significant achievement.

The benefits of e-learning are manifold. To our

patients, consistency of staff training standards will

translate into consistency in quality of care. Eventually,

e-learning can also be leveraged for patient education.

We launched the inaugural Young Leaders Programme in May 2005,

with the belief that talents must be nurtured.

50

For staff, e-learning affords them the convenience

of learning at their own time and pace. It also

alleviates clinicians’ teaching workload and allows

them to devote more time to patient care. In the long

run, e-learning is also more cost effective for the

organisation.

In collaboration with the Nanyang Technological

University (NTU), a pilot project was started in late 2004

at TTSH and IMH to convert the theoretical training

and testing for Basic Cardiac Life Support (BCLS) to

e-learning. Results showed that clinical training could

be done efficiently and effectively through e-learning.

The acceptance level among our clinicians was also

very high. With the encouraging outcomes, more core

courses have been converted to e-learning, including

the Foundation Course for Healthcare Management

and the Orientation Programme.

Training

For our unwavering belief in lifelong learning, NHG

HQ, AH and NUH were awarded the Strong Believer

Award (Healthcare Sector) by National Trade Union

Congress (NTUC) and the Singapore Workforce

Development Agency (WDA). The award was given out

by Prime Minister Lee Hsien Loong at the inaugural

Job Redesign Programme Award Ceremony on 24

February 200�.

On our own, we also continued to invest substantially

in the Health Manpower Development Programme

(HDMP) awards. A total of 10� awards valued at $3.85

million were given in 2005. This was an increase over

2004 where 9� awards valued at $3.49 million were

given out.

TotalExperienceIndex

Our 2005 Total Experience Index showed an

improvement over previous year from 91% to 92.5%.

Areas of improvement include the Recommendation

and Value for Money indices at 8�.�% and 8�.9%

respectively.

Beyond excellence in clinical skills, we also believe

that we must excel in our service to patients. The

healthcare profession is not for everyone. It requires

dedication, courage and compassion for the

sick, infirmed and disadvantaged. The Healthcare

Humanity Awards, which recognise such outstanding

healthcare workers, was given out to 1� NHG staff

in 2005.

NHG again emerged as the top winner in the annual

Excellent Service Award (healthcare sector), with

a total of 1,28� awardees. In addition, Associate

51

For our unwavering belief

in lifelong learning, NHG

HQ, AH and NUH were awarded

the Strong Believer Award

(Healthcare Sector) by National Trade

Union Congress (NTUC) and the

Singapore Workforce Development

Agency (WDA).

Professor Leo Yee Sin from TTSH clinched the

Superstar Award, given to persons who have delivered

outstanding service that exceeds all expectations.

Within NHG, we recognise staff who have delivered

excellent services through the NHG Service Champion

Recognition Scheme. In 2005, a total of 1,12�

Service Champions were identified by our patients,

visitors and colleagues. From among these staff, 50

received the Quality Pillar award in recognition of

their consistent performance throughout the year.

InternalAudits

For the 2005 audit conducted between February

and March 200� on our core telephone standards,

results showed that all six institutions’ improved

especially in the areas of Responsiveness and

Reliability and Helpfulness. Similarly, our CARE

(Confidence, Attentiveness, Respect, Empathy)

standards audit showed that the majority of our

staff was friendly, helpful and responsive.

Moving forward, we will continue to reinforce the

importance of these standards and send staff for

more structured and targetted service training.

53

New Services/Facilities/Programmes NationalHealthcareGroup

• Launched the Control of Coronary Risk Factor Initiative (LIVE) programme to ensure that heart patients reach optimal control of risk factors through co-management with GPs.

• Launched the National Healthcare Asthma Tripartite (NEAT) programme to co-manage asthma patients with GPs.

• Launched the NHG Integrated Chronic Obstructive Pulmonary Disease (NICE) programme at all three NHG hospitals – AH, NUH and TTSH – to provide essential home care services for patients with Chronic Obstructive Pulmonary Disease (COPD).

• Introduced the �4-Slice CT Scanner at NUH and TTSH to provide high resolution CT cardiac, vascular, 3D and whole body imaging.

AlexandraHospital

• MMS Wound Service for patients who had surgery to update on their wound condition by sending pictures via MMS or email.

• First institution in Singapore to allow guide dogs on its premises to help visually-impaired patients find their way within the hospital.

• Introduced vascular services for patients with vascular disease through one-to-one consultations.

• Continence clinic for elderly people who have difficulties in passing urine or who are incontinent. Services provided include continence assessment, urodynamic studies, advice on continence care and treatment modalities including bladder re-education, pelvic floor exercises and intermittent catheterization.

• Do-It-Yourself Health Screening for patients and members of the public to check their blood pressure and weight by following simple instructions on an easy-to-read form.

NationalUniversityHospital

• Renovated ICUs and HDs to reduce risk of cross infection among patients.

• Set-up the Surgical Weight Management Clinic to offer a holistic and multi-disciplinary weight management programme.

• Introduced the Rehabilitation Care Service that performs patient assessment and works with patients, caregivers and other healthcare professionals to set and facilitate achievement of treatment goals, planned care and evaluate the results.

• Introduced the first Hypertrophic Cardiomyopathy (HCM) Clinic which provides diagnosis, long-term follow-up, risk stratification as well as screening for family members.

• NUH introduced an Outpatient Parenteral Antibiotic Therapy (OPAT) service to provide intravenous administration to discharged patients. With OPAT, patients can be discharged and obtain their antibiotics daily at NUH’s outpatient centre or self-administer intravenous antibiotics at home.

• Set up the Aesthetic Plastic Surgery Centre to provide an extensive range of plastic surgery services, and serve as a regional training hub for medical specialists.

• Opened NUH Renal Centre to provide a comprehensive range of outpatient medical treatments which include high dependency hemodialysis and peritoneal dialysis.

54

• Performed the first Hip Resurfacing procedure in Jan 0� and the first Middle Ear Implant in Mar 0�

• Celebrated its 20th Anniversary with a series of celebratory and charity events, which included a Charity Car Wash, Charity Treadmill Challenge, Charity Golf and a Dinner & Dance for staff. The hospital also produced a Commemorative Book to mark its achievements.

TanTockSengHospital

• Set-up the Institute of Plastic Surgery Singapore to provide plastic surgery services through private-public sector collaboration.

• John Hopkins International Medical Centre was relocated from NUH to TTSH to provide world-class oncology care.

• Introduced NovaVision Vision Restoration, a first in Asia, to treat patients left partially blind by stroke or brain injury.

• Set-up the International Patient Liaison Centre as a one-stop centre for foreign patients.

• Set-up the East West Clinic at Toa Payoh Central, in partnership with NTUC Healthcare.

• TTSH Renal Unit, together with Fresenius Medical Care, opened the Nephrocare Singapore Dialysis Centre.

• Introduced Immunotherapy and Rhinoscopy services by the Department of Rheumatology Allergy & Immunology.

• Set-up the Contact Centre to assist patients to fix appointments and provide telephone operator assistance and general hospital information.

• Set-up the Inflammatory Bowel Disease Clinic by the Department of Gastroenterology.

InstituteofMentalHealth/WoodbridgeHospital

• Set-up a Satellite pharmacy at Geylang Behavioural Medicine Clinic.

• Introduced the Horticulture Therapy where patients engage in regular gardening activities as a form of therapeutic activity.

• Introduced fortnightly patient education sessions for patients and caregivers, covering a wide range of topics to help them better understand and manage mental illness.

• Introduced a podiatry service, managed by the Singapore Footcare Association, for in-patients.

• Launched three new initiatives to help people with addictions under the Community Addictions Management Programme (CAMP) – Families in Recovery through Education, Support and Hope (FRESH); Sex Addiction Treatment & Education Programme (STEP); and Gambling Addiction Management through Education (GAME).

• Set-up the Clozapine Clinic to assist and monitor patients prescribed with clozapine.

55

NationalSkinCentre

• Introduced the Titan® Skin Tightening Procedure – a new non-surgical process that uses infrared light source to tone, lift and tighten skin.

• Set-up a bi-weekly Urticaria and Angioedema Clinic to provide expertise and comprehensive care for patients and improve the accuracy of diagnosis and treatment of urticaria and angioedema.

• Set-up the Children’s Skin Clinic to provide expert care in Paediatric Dermatology for children suffering from one of the chronic diseases.

TheCancerInstitute

• Introduced the Stereotactic Radiation Therapy using Mini Multi-leaf Collimator (MMLC) at the Radiotherapy Centre@NUH. The MMLC is useful for paediatric treatments and is an improvement in quality of treatment.

• Introduced the Intensity Modulated Radiation Treatment (IMRT) at the Radiotherapy Centre@TTSH. IMRT uses the combined processing power of modern computers and the exceptional advances in organ imaging to enable the accurate delivery of a new type of radiotherapy beam.

NHGPharmacy

• Introduced MedicineAid, a calendar pack system to better organise patients’ medication and improve patient compliance and reduce confusion and errors.

NHGDiagnostics

• Set up new x-ray service at St Luke’s Hospital Pte Ltd in June 2005.

• Set up imaging and laboratory service in January 200� at the Ang Mo Kio –Thye Hua Kwan Hospital.

5�

Awards and Achievements

NationalHealthcareGroup

• AH, TTSH and IMH attained the Joint Commission International (JCI) accreditation, IMH being the first mental health institution in the region to do so. NUH and JH both attained JCI re-accreditation.

• A total of 1,28� NHG staff from five institutions (AH, NUH, TTSH, IMH and NHGP) and NHG Pharmacy received the Excellent Service Award (EXSA), making NHG the top winner in the healthcare category. Associate Professor Leo Yee Sin, HOD TTSH Infectious Disease Department, was conferred the EXSA SuperStar award – the highest individual accolade from Spring Singapore.

• 112� staff were recognised as Service Champions under the Service Champion Recognition Scheme, of which 50 received the Quality Pillar award.

• Professor Chia Boon Lock (THI, NUH) and Dr Poh Soo Chuan were awarded the Lee Foundation-NHG Lifetime Achievement Award.

• 108 staff were awarded a total of $3.8 million under the Health Manpower Development Plan.

• The following staff received awards at the Combined Scientific Meeting 2005

– Dr Wu Qing Hui, Department of Urology, NUH, Young Investigator’s Award (Surgical Disciplines), Project: Non-viral cytokine gene therapy for bladder cancer in an orthotopic mouse model.

– Dr Edmund Chiong, Department of Urology, NUH, NHG Doctor Award (Surgical Disciplines), Project: Non-viral gene therapy for bladder cancer: Gene delivery to malignant human cells in vitro and ex vivo.

– Dr Tiffany Tang, Department of Surgery, NUH, NHG Doctor Award (Surgical Disciplines), Project: Transplantation of embryonic cells with endothelial potential immediately after myocardial infarction lowers mortality rate and reduces myocardial damage in the murine model of AMI.

• 1� staff received the Healthcare Humanity Awards.

• The following staff received the National Day Awards:

– A/Prof Wong Kim Eng, Chairman of Medical Board, IMH (Public Administration Medal - Silver)

– Prof John Wong, Director, TCI (Public Administration Medal - Silver)

– A/Prof Ong Tiew Chai, Senior Consultant, Psychological Medicine, TTSH (Public Administration Medal – Bronze)

– Ms Soh Lee Choo, Senior Nurse Manager, IMH (Efficiency Medal)

– Ms Lim Giok Eng, Executive, NHG Pharmacy (Efficiency Medal)

– Mr Wu Tuck Seng, Manager, Department of Pharmacy, NUH (Commendation Medal)

– Clinical A/P Suresh Pillai, Senior Consultant, Emergency Department, NUH (Public Service Medal – The Tsunami Relief Operation)

– Ms Lim Siew Woon, Principal Pharmacist, Department of Pharmacy, NUH (Efficiency Medal)

5�

– Ms Lim Woan Ying, Senior Pharmacy Technician, Department of Pharmacy, NUH (Efficiency Medal)

– Ms S Andal Jaya, Senior Coordinator, Patient Services, NUH (Efficiency Medal)

– Ms Dennie Hsu, Senior Manager, Operations, NUH (Efficiency Medal)

– Gan Yi Ming, Principal Physiotherapist, Physiotherapy, TTSH (Efficiency Medal)

– Tay Meow Hoon, Senior Nursing Officer, Nursing, TTSH (Efficiency Medal)

– Ms Magdalene Lim, Senior Nursing Officer, Nursing, TTSH (Efficiency Medal)

– Prema Balan, Senior Nurse Educator, Nursing Service, TTSH (Efficiency Medal)

• IMH, NUH, NHGP and NSC received the Singapore H.E.A.L.T.H. Gold Award.

• The following nurses were awarded the Ministry of Health’s Nurses Merit Award:

– Ms Susheela Chugani, IMH Nurse Manager

– Ms Doris Koh Sok Hian, IMH Nurse Manager

– Ms Ong Shi Wei, IMH Nurse Clinician

– Ms Tan Soo Thian, NHGP Nurse Manager

– Ms Satran Kaur, NHGP Senior Staff Nurse

– Ms Haryani Binte Mustadi, TCI@NUH Senior Staff Nurse

• The following institutions received the Asian Hospital Management Award (AHMA):

– TCI, Most outstanding project (“Improving the efficiency of radiation oncology services between two hospitals by exploiting a digital information technology network under a virtual institute model of service delivery”) in the Technical Service Improvement category

– NSC, Most outstanding project (“Paperless Electronic Medical Record System”) in the Internal Service Project category

– NUH received the International Accolade for Improved Patient Care.

– IMH, Runner-up prize (“Advanced Practice Nurse Scheme”) in Human Resource Development category.

AlexandraHospital

• Awarded the Singapore H.E.A.L.T.H award by Health Promotion Board.

• Awarded the Community Chest SHARE Platinum Award.

• Adjunct A/P Au Eong Kah Guan - Visionary Award 2005.

• Clinched the inaugaural “Strong Believer” award by the Job Recreation Programme (JRP) Committee.

• Community in Bloom Award

• Dr Kevin Lee was awarded the Young Orthopaedic Investigator Award 2005

• Palliative Nurse Sim Lai Kiow - PS21 Star Service Award

• Renewal of Singapore Quality Class

58

NationalUniversityHospital

• Dr Sudhakar Venkatesh and A/Prof Wang Shih Chang won the Best Scientific Paper Award (Chest section) at the European Congress of Radiology 2005.

• NUH clinched the A*Star Research Grant of $48.2 million.

• Bagged Gold Award at prestigious �th Asian Innovation Awards.

• NUH clinched the inaugural “Strong Believer” award by the Job Re-creation Programme (JRP) Committee.

• Director of Children’s Medical Institute, Dr Tyrone Goh was conferred the honorary Doctor of Science of London South Bank University.

• CEO Mr Chua Song Khim was awarded the H.E.A.L.T.H leader award.

TanTockSengHospital

• Director of Nursing, Ms Kwek Puay Ee, was awarded the President’s Award for Nurses.

• Awarded the Occupational Health Best Practices Award (Excellence) 2005 for Ergonomic Solution.

• The Heritage Museum was invited by the National Heritage Board to join the Museum Roundtable.

• CEO Dr Lim Suet Wun received the Medal of Commendation from the National Trade Union Congress.

• Professor Chee Yam Cheng, Assistant CEO (Clinical), NHG and Senior Consultant, General Medicine, won the “Da Vinci Diamond” from the International Biographical Centre in Cambridge, England.

• Associate Professor Leo Yee Sin, HOD, Infectious Disease, was picked as one of the Great Women of the 21st Century by the Governing Board of Editors of the American Biographical Institute.

• Dr Lim Poh Lian, Consultant, won the First Annual American Women’s Association International Woman of the Year.

• Ms Ho Lai Peng, Principal Social Worker, won the First Annual American Women’s Association Outstanding Social Worker Award.

InstituteofMentalHealth/WoodbridgeHospital

• Nurse Manager Doris Koh Hian won the Rotary Outstanding Nurse Award 2005 in recognition of her contribution towards building a healthy nation.

• IMH’s Early Psychosis Intervention Programme (EPIP) was awarded the prestigious State of Kuwait Health Promotion Award in April 200� by The World Health Organization (WHO) in recognition of its outstanding contribution to research in health promotion.

• A/Prof Rathi Mehndran, VCMB, A/Prof Chong Siow Ann, Consultant and Chief of EPIP, Dr M Winslow, Chief of CAMP, Dr Eu Pui Wai, Senior Consultant and Head, Rehabilitation Psychiatry, Dr Arthur Lee, Senior Consultant, Addiction Medicine, Dr Alex Su, Consultant and Deputy Chief of Community Psychiatry and Ms Margaret Hendricks, Manager, Case Management Unit, were awarded the first prize in the Scientific Poster Competition (Clinical Pathways and Treatment Algorithms Enhance Psychiatric Care and Improve Clinical Outcomes) at the Singapore Clinical Forum.

59

NationalSkinCentre

• Clinched the TEC Enterprising Agency Award for the project on ‘Quantified Dermatology to Objectively Measure Skin Disease and Track Treatment Response for Better Patient Care’.

• Awarded the Community Chest SHARE Platinum Award.

NHGPolyclinics

• First primary care facility to achieve the Singapore Quality Class award.

• Dr Chong Phui Nah, Consultant, was awarded with the Health Promoter Award 2005.

• Dr Gwee Sheah Min, Family Physician, was awarded the Gold Medal for the MMED Family Medicine examination.

TheCancerInstitute

• Successfully performed the first bone marrow and kidney transplant in Asia with NUH.

• Dr Lee Soo Chin of TCI@NUH received the BMRC-NMRC Clinician Scientist Investigator Award.

• Awarded the Singapore Cancer Society Cancer Research Grant worth $100,000.

TheEyeInstitute

• First in Asia to set up Vision Restorative Therapy service for patients who have lost their field of vision from cerebro-vascular accidents or stroke.

• First in Singapore to offer implantable contact lenses as an alternative to patients unsuitable for lasik.

• First in Southeast Asia to offer 23-gauge vitrectomy surgery.

NHGPharmacy

• General Manager, Ms Chan Soo Chung, was presented the coveted Lucy Wan Outstanding Pharmacist Award 2005 by the Pharmaceutical Society of Singapore.

NHGDiagnostics

• General Manager, Dr Tyrone Goh was awarded the prestigious Singapore Society of Radiographers (SSR) Honorary Membership and the SSR’s Gold Medal for his contribution to local and international Radiography in February 200�. This is the first time a Gold Medal has been presented by SSR.

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Systems and Support Services

NationalHealthcareGroup

• Successfully replaced the pagers of all doctors in TTSH with hand phones and implemented a healthcare messaging system as the communication platform among medical staff. This process of using SMS message board in the healthcare setting is patent pending as intellectual property of NHG.

• eLab review capabilities, which alert and remind doctors to abnormal results, was implemented at NUH, TTSH and polyclinics.

• A Patient Safety Officer (PSO) was appointed at each NHG institution to oversee i ts pat ient sa fe ty programme.

• Safety champions were appointed at every unit at NUH, TTSH and IMH to ensure that patient safety initiatives are in place at their respective department or unit.

AlexandraHospital

• Introduced CISCO Clinical Connection Suite, an advanced medical-grade network solution that connects various parties through IT devices to give them real-time information to help reduce patient waiting times for beds.

• Offered MMS Wound Service to patients who have had surgery at Alexandra Hospital to update on their wound condition by sending pictures via multimedia message service (MMS) or email.

• Introduced first-of-its-kind innovation - known as the Nurse Helper – to reduce fall rates among patients.

• Worked at enlarging the role of Healthcare Attendants, to become Patient Liaison Officers whose roles include taking care of the patient’s basic needs, such as taking the patient’s temperatures and advising them on their dietary requirements.

NationalUniversityHospital

• Implemented intelligent e-rostering system for nurses.

• Developed the e-Housekeeper’s Intelligent Management Systems (eHIMS), which allows for real time overview of bed status.

• Installed Evacuations Chairs that provide the fastest and most efficient method of transporting elderly and mobility-challenged patients in times of emergency.

• Enhanced Patient Safety with Histopathology Verification Email Alert, a system-generated notification from CPSS that is sent via email to alert doctors on the availability of their patients’ histopathology (unviewed and unverified) results. This enhancement helps to expedite diagnosis and treatment and improve overall clinical quality.

TanTockSengHospital

• Together with SingTel and Nokia, the hospital integrated the Smart Messaging System with the CCOE system to send test results and patients’ prescriptions to the attending doctor’s hand phone for verification and authentication.

• Online Patient Dashboard Information System piloted to improve the tight bed situation. The system sends real-time bed supply and demand information to allow for better assignment decisions.

• Conducted an internal trial of an Automated Voice Assistant (AVA) that uses voice recognition technology to help connect calls, page for staff and provide general hospital information.

NHGDiagnostics

• Implemented teleradiology through CR/RIS and PACS at all NHGD polyclinic centers and Ang Mo Kio – Thye Hua Kwan Hospital and outsourced teleradiology to Bangalore, India.

• Implemented the Laboratory Information System at all NHG Diagnostics Laboratory.

NHGPharmacy

• Obtained access to NHG’s Cluster Shared Patient Record System (CPRS) and Critical Medical Information Store (CMIS) to allow pharmacists to draw important clinical information, enhancing patient safety and continuity of care.

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NationalHealthcareGroup

• Collaborated with the Nanyang Technological University (NTU) in a pilot project at TTSH and IMH to convert the theoretical training and testing for Basic Cardiac Life Support (BCLS) to e-learning. More courses have since been converted to e-based.

AlexandraHospital

• Teamed up with the Queenstown Neighbourhood Centre to organise the first Security Week. Staff participated in bomb threat exercise and learnt tips on crime prevention.

• Signed MOU with Batam Hospital (BIDA) and Zainoel Abidin Hospital (ZAH) to promote closer co-operation in areas such as hospital management and the development of clinical expertise, through visits and attachments of clinicians and nursing staff from the two Indonesian hospitals to AH, and vice-versa.

NationalUniversityHospital

• Enhanced training with e-learning through opening of e-Hub with 31 e-learning stations.

• Organised the 2nd Scientific Meeting For Operating Room Nurses on Patient Safety; and the 1st Evidence-Based Nursing (EBN) Seminar on ‘Research to Practice – Bridging The Gap’.

• Inked Memorandum of Understanding (MOU) with Dr Sardjito Hospital, Yogyakarta Indonesia; Santosa Bandung International Hospital; and Dr Hasan Sadikin General Hospital. The partnerships will cover the areas of teaching and education, research and development, shared care of patients and mutual exchange of healthcare knowledge.

• Signed an agreement with B-K Medical to set up the NUH – B-K Asian Institute of Transanal Ultrasonography, the first in the Asia Pacific region.

TanTockSengHospital

• The Hospital’s Trauma Centre organised the first Advanced Trauma Life Support Course and Basic Emergency Sonography for Trauma Course in restructured hospitals.

• The Clinical Research Unit started monthly research talks to stimulate interest in research and assist researchers apply for grants and publish papers.

InstituteofMentalHealth/WoodbridgeHospital

• Organised the 2nd Asia Pacific Suicide Prevention Conference 200� together with the International Association for Suicide Prevention.

• IMH hosted five visiting experts Dr Lynette Joubert, Lecturer, School of Social Work, University of Melbourne; Dr Margaret R Oates, Consultant, Perinatal Psychiatry, Queen’s Medical Centre, Nottingham, UK and Chairman, Perinatal Section, Royal College of Psychiatrists; A/P Hector Tsang, Associate Professor, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University; Professor Graham Thornicroft, Professor of Community Psychiatry and Head of the Multi-Disciplinary Health Service Research Department, Institute of Psychiatry, King’s College and Professor James RP Ogloff, Professor of Clinical Forensic Psychology at Monash University and Director of Psychological Services at Forensicare.

NationalSkinCentre

• Organised the bi-annual NSC Dermatology Update Conference.

TheCancerInstitute

• Signed MOU with the Fudan University Cancer Hospital to promote educational and clinical practice in cancer.

• Collaborated with Siemens to set up the first Siemens Oncology Learning Centre in Asia.

NHGDiagnostics

• Collaborated with Singapore Polytechnic to provide phlebotomy training and conduct the industry attachment for students.

Training and Education

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AlexandraHospital

• Official medical provider to participants at the Standard Chartered Rugby Sevens, JP Morgan Corporate Challenge, The New Paper Big Walk, SGX Bull Run and the Standard Chartered Marathon.

• Provided health screening to 51 corporate companies, benefiting about 21,000 corporate clients.

NationalUniversityHospital

• Organised Diabetes Day in conjunction with World Diabetes Day.

• Participated in the first Yellow Ribbon Fair held within Changi Prision.

• Organised the first NUH Kidney Day where staff were given free health screening.

• Set up the Kids’ Heart Fund under the NUH Endowment Fund to provide financial assistance to needy paediatric patients with Congenital Heart Disease.

• NUH Endowment Fund held its 4th Charity Golf event and raised more than $5 million.

TanTockSengHospital

• Launched the Art of Healing programme to harness the latent therapeutic value of the arts to help patients heal. The programme has featured international renowned jazz musician Jeremy Monteiro, Nominated MP and celebrity pianist Eunise Olsen, and the Singapore Chinese Orchestra among others.

• Published an education booklet “8 Important Things to Know About Bird Flu” for 250,000 households in Singapore, in partnership with the Central Singapore Community Development Council.

• Organised a public exhibition in conjunction with World No Tobacco Day.

• Collaborated with Mind Your Body magazine to organise a public forum on dengue.

• Organised a public exhibition and public forum to commemorate the first World Allergy Day.

InstituteofMentalHealth/WoodbridgeHospital

• 38 ex-offenders were attached to IMH under the Yellow Ribbon Project “Work Release Programme”.

Community Outreach• Provided support, office space and volunteers for the

Silver Ribbon (Singapore) Society.

• Invited the public under the ‘Visit IMH’ programme for a tour of the hospital.

NationalSkinCentre

• Senior Consultant Prof Goh Chee Leok led the Singapore Volunteers Overseas Specialist Team to set up the first Occupational Dermatology Unit at a hospital in Malang, East Java.

• ‘Charity Begins At Home’ project saw 44 staff and their family members deliver food and basic necessities to needy families.

NHGPolyclinics

• Collaborated with adopted charity partner, Sunlove-Abode, to set up the Sunlove-Marsiling Neighbourhood Link to address the social well-being of the elderly and needy families.

TheCancerInstitute

• Part icipated in TEMAN, a community outreach programme for breast cancer awareness.

• Oncology nurses brought together for the first time, Muslim and non-Muslim breast cancer support groups to provide a wider support base for survivors.

TheHeartInstitute

• Participated in the annual Heart Week at the Toa Payoh HDB Hub.

NHGPharmacy

• Participated in events such as the National Healthy Lifestyle Campaign 2005, Family Fun-nival@South West 200� and Jurong HealthConnect to raise national awareness of health promotion and safe medication use.

NHGDiagnostics

• Participated in the National Healthy Lifestyle Campaign 2005 and South West CDC’s �th Community Health Fair to promote breast cancer awareness and screening.

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about NHG

�5

AlexandraHospital

Nestled in the central western area of Singapore, Alexandra Hospital (AH) is a 400-bed general and acute care hospital.

It started out as a military hospital back in 1938. The hospital was restructured and became a member of NHG in October 2000.

Today, it offers personalised care in a tranquil and healing environment in the midst of lush greenery. Here, in AH, the focus is not only to heal the sick but also to help people stay on top of their health. Its prescription for health is prevention and this is done through public education and health screening programmes. It runs a Health for Life Centre and weight management clinics as well as specialist clinics in the different disciplines.

Since the restructure, the hospital was transformed from an old, ageing building into a quaint and bustling garden hospital. The years that followed saw new leadership with new initiatives to provide a patient-centred service.

AH’s care philosophy is to make its services more comprehensive and convenient for patients. Its holistic approach to healing stems from the belief that when patients’ needs are addressed, they recover faster and better.

AH works hard to continue to build on its medical capabilities with new services and facilities to better meet the needs of the people it serves. And it strives to emulate best practices in the other industries to provide even better healthcare for all.

NationalUniversityHospital

National University Hospital (NUH) opened its doors to the public in 1985 as the first restructured hospital in Singapore. Since its inception, it has grown to become a 928-bed, tertiary acute-care hospital.

NUH is the first hospital in Singapore to be accredited by the Joint Commission International (JCI) in September

2004. Being accredited by JCI is a recognition of NUH’s commitment to provide a high standard of patient care. Patients can now receive greater assurance that they are receiving quality and safe care that meets internationally accepted standards.

NUH’s inpatient facilities include 2� wards, 19 operating theatres, � intensive care units, 22 clinical departments, 3 dental and � paramedical departments, 4 medical institutes as well as numerous specialist outpatient clinics and specialised service centres. It also has a comprehensive range of services available to meet the growing needs of our patients. In particular, NUH’s strengths lie in cardiac (heart), obstetrics and gynaecology, oncology (cancer), paediatrics (children), ophthalmology (eye), orthopaedic and gastroenterology services. NUH also runs a national liver transplant programme which began in 1990.

Being the only university hospital in Singapore, most of the NUH clinicians also teach at the Yong Loo Lin School of Medicine, National University of Singapore. Their dual roles mean that these clinicians keep abreast of the developments in medical skills and technology as well as participate in such developments through relevant research from which new cures and treatments are then introduced to NUH patients.

TanTockSengHospital

Tan Tock Seng Hospital (TTSH) was established in 1844 and named after its founder, Mr Tan Tock Seng, a philanthropist. Over the years, TTSH has grown from strength to strength to become Singapore’s second largest acute care general hospital with 1,400 beds.

TTSH is accredited by the Joint Commission International, in recognition of the hospital’s world-class patient care and comprehensive range of high quality holistic healthcare services at its main hospital, Communicable Disease Centre, Foot Care & Limb Design Centre and TTSH Rehabilitation Centre.

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TTSH has 23 clinical departments and a full range of sub-specialties to meet the healthcare needs of patients. Of these, TTSH’s strengths are in infectious diseases, geriatric medicine, rehabilitation medicine, respiratory medicine, rheumatology, allergy and immunology. It is also a major referral centre for emergency medicine, diagnostic radiology, ophthalmology (eye), otorhinolaryngology (ear, nose and throat), orthopaedic surgery, gastroenterology, general medicine and general surgery. The hospital also encompasses two major specialty centres in rehabilitation medicine and communicable diseases.

In March 2003 when Severe Acute Respiratory Syndrome (SARS) struck in Singapore, TTSH was designated as the screening and treatment centre for SARS. Today, the hospital continues to research on emerging infectious diseases and find the best treatment for them.

On top of its top class clinical expertise in the different disciplines, the hospital is equipped with state-of- the-art facilities and medical equipment, as well as the latest communication and information technology tools.

InstituteofMentalHealth/WoodbridgeHospital

The Institute of Mental Health/Woodbridge Hospital (IMH/WH) is a 2,3�9- bed acute tertiary psychiatric hospital located in a sprawling 30-hectare campus called Buangkok Green Medical Park in Buangkok View. Set in a serene environment and with well-designed landscape, IMH/WH is equipped with modern facilities with 55 wards for inpatients and 2 Outpatient Specialist Clinics for outpatients.

IMH/WH offers a multi-faceted and comprehensive range of psychiatric services targeted to meet the special needs of 3 groups of people - children and adolescents, adults and the elderly.

There are � clinical departments, namely: general psychiatry, child and adolescent psychiatry, community psychiatry, geriatric psychiatry, forensic psychiatry, early psychosis

intervention and addiction medicine. For the treatment of more specific disorders, there are sub-specialty clinics such as the Anxiety and Mood Clinic, Sleep Disorder Clinic and the Sexual Dysfunction Clinic.

The hospital’s multi-disciplinary approach to patient care is supported by the Nursing, Clinical Psychology, Occupational Therapy and Medical Social Work departments.

IMH/WH also provides integrated and accessible care to our patients through 3 Behavioral Medicine Clinics located in Viking Road (Alexandra), within the Polyclinic in Geylang and at the Health Promotion Board (HPB) Building in Outram. Our Child Guidance Clinic (CGC) is located at the HPB Building and also at IMH/WH.

In addition to these satellite clinics, IMH/WH runs an extensive range of therapeutic activities at 3 Day Centres located at Buangkok Green Medical Park, Bukit Batok and Alexandra.

Apart from inpatient and outpatient services for the mentally ill, IMH/WH runs mental health education programmes for the general public. Within corporate settings, IMH/WH’s Corporate Consulting Services unit offers a comprehensive workplace emotional health programme and service which include crisis management workshops and coaching sessions. IMH/WH also coordinates and oversees training of clinicians in psychiatry and conducts research related to mental health. Over the years, IMH/WH has established a significant reputation for quality psychiatry research.

JohnsHopkins–SingaporeInternationalMedicalCentre

The Johns Hopkins Singapore International Medical Centre (JHS IMC) is involved in patient care and clinical research activities. The IMC provides Hopkins-quality oncology services to local and foreign private patients in Singapore.

The IMC became the first private hospital in Singapore to be

��

awarded the Joint Commission International Accreditation with outstanding overall performance in August 2004. This affirms our commitment to the provision of the highest quality healthcare standards.

In May 2005, Johns Hopkins Singapore International Medical Centre (JHS IMC) moved to its new premises at Tan Tock Seng Hospital. The centre was officially opened by Singapore’s Minister of Health Khaw Boon Wan on 29 September 2005.

With the move, the medical centre has grown in several aspects. From 1,830 SqM at its old premises in the National University Hospital, the IMC now boasts a space of 3,300 SqM. With the increase in space, it has been able to expand the number of chemotherapy treatment beds from 10 to 12, and the number of inpatient beds from 18 to 30.

Its staff size has also grown. In the last year, the IMC has welcomed a new Director of Operations Mr Sinan Sanvar and a new Director of Nursing Dr Linda Luna. Additionally, all clinical and administrative departments had new staff join them.

As the IMC enters into its second year at Tan Tock Seng Hospital, its aims to continually improve itself so that it can serve patients better and be a contributing member of the local healthcare community.

NationalSkinCentre

In 1988, the National Skin Centre (NSC) moved to its present premises in Mandalay Road where it operates as an outpatient specialist dermatological clinic with consultant dermatologists who have the experience and expertise to treat complex skin diseases in both their private and subsidised clinics.

As a tertiary health care institution, the NSC provides specialised dermatological services, trains medical students and postgraduates, and undertakes research in dermatology.

It aims to be the national and regional referral centre for treatment of complex skin diseases. It is already recongised as a dermatological training centre for local and foreign skin specialists and paramedical personnel with its active educational programmes for undergraduates, postgraduates, professionals and the public.

NHGPolyclinics

NHG Polyclinics form the primary healthcare arm of NHG. The nine polyclinics serve a significant proportion of the population spread over northern and western Singapore.

The focus of NHG Polyclinic care is on disease prevention, early and accurate diagnosis, good disease management, health promotion, and continued care for patients after their discharge from hospitals. NHG Polyclinics works actively with NHG hospitals and institutions to develop integrated and seamless healthcare services for patients, as typified by the Direct Access Scheme, which has since served as the model for a similar healthcare network, developed with NHG’s GP Partners.

Each NHG Polyclinic provides a comprehensive range of health services for the family, including treatment for acute medical conditions; chronic diseases incorporating diabetic foot care services and diabetic retinal photography care, specialists services such as obstetrics and gynaecology. NHG Polyclinics are one-stop family health centres, equipped with good support facilities such as laboratory and X-ray services, mammography and ultrasonograms. Many offer dental and psychiatric outpatient care and their pharmacies carry a wide range of drugs and non-medical items.

NHG Polyclinics is the first primary healthcare provider to be awarded three ISO certifications: ISO 9001, 14001 and OHSAS 18001.

NHG Polyclinic is also the first primary healthcare provider to attain the Singapore Quality Class (SQC) status on

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30 June 2005. The SQC Award is based on business excellence in aspects such as Leadership, Planning, Information, People, Processes, Customers and Results, which help meet the challenges of today’s progressive healthcare system.

These standards speak of a safe and consistent level of family healthcare for all patients at all NHG Polyclinics.

TheCancerInstitute

The Cancer Institute (TCI) offers comprehensive cancer-management programmes to tackle the disease from prevention to recovery and long-term health maintenance. By integrating the various cancer services and expertise in the National Healthcare Group (NHG) institutions, TCI is able to provide seamless and coordinated healthcare so that our patients receive dedicated professional care where they need them, in the most effective manner.

TCI’s research focus involves the identification of molecular markers to be used for diagnosis and the development of new treatment strategies. This work is being done in close collaboration with the National University of Singapore. Our medical staff collaborate with clinical research groups in undertaking clinical trials on new and promising cancer therapies.

Currently, The Cancer Institute’s services are available at National University Hospital, Tan Tock Seng Hospital, Alexandra Hospital and NHG Polyclinics. We also collaborate with the general practitioners, hospices and cancer support groups to ensure that our patients receive the full continuum of care.

TheEyeInstitute

The Eye Institute (TEI) was set up to meet the increasing demand for eye care services. By combining the clinical expertise and facilities across NHG institutions, it is able to achieve greater synergy and provide quality eye care to patients.

There are 10 sub-specialities within the ophthalmology services provided by TEI to adequately cover all aspects of the eye, its diseases and treatment. Among the services, TEI treats cataracts with modern methods with high rates of success.

The Institute places great emphasis on training and research to ensure a high standard of clinical care to patients. And it works with various organisations such as the Singapore Eye Research Institute, the National University of Singapore and clinical research organisations to undertake clinical research programmes of relevance to patients.

TheHeartInstitute

The Heart Institute (THI) provides cardiac services in NHG institutions by bringing together the resources, expertise and other capabilities in the areas of cardiology, cardiothoracic and vascular surgery, to better meet the growing needs of patients with heart diseases.

The cardiac units in NHG hospitals work closely with the polyclinics and general practitioners to provide a seamless continuum of care for heart patients – from inpatient cardiac treatment in the hospitals to outpatient cardiac support such as cardiac rehabilitation and primary cardiac care in the polyclinics.

The roles of THI are caring for patients with cardiac conditions through shared care programmes, coordinating the development of cardiology and cardiothoracic services, setting and maintaining common clinical standards, optimising the medical expertise available, conducting cluster-wide educational programmes for patients, nurses, medical students and clinicians, and coordinating cardiovascular research across the cluster.

NHGCollege

NHG College was started in 2002 with the aim of developing NHG staff to their maximum potential so that they are able to provide quality, cost effective and safe evidence-based care to patients.

�9

NHGPharmacy

Established in 2001, The National Healthcare Group Pharmacy (NHGPh), a business unit of the National Healthcare Group (NHG), manages the pharmacy services and retail pharmacies at all NHG Polyclinics.

Working as a member of the healthcare team, our pharmacists constantly strive to make a difference in the care of our customers by supporting them to achieve best results for their prescribed therapy and promote healthy lifestyles. NHGPh also provides pharmacy services such as medication supply and management to nursing homes and weekly review of residents’ medication charts to resolve any medication-related problems.

One key thrust of NHGPh is public education to promote safe and responsible use of medication through collaboration with various external organisations.

NHGGulf

NHG Gulf came into being in January 2004 to facilitate the referrals of patients and their families from the Gulf Cooperation Council (GCC) countries who want to seek medical treatment in Singapore. NHG has representative offices in Dubai and Abu Dhabi which coordinate with NHG institutions in Singapore to provide the necessary medical care and other arrangements.

In addition, NHG Gulf aims to provide healthcare consultancy and hospital management services in the GCC countries. It draws upon the expertise and resources of NHG institutions that are part of Singapore’s healthcare system, rated one of the top � systems in the world.

The College is equipped with a full range of facilities geared towards supporting training activities, including tutorial rooms, a resource library, a simulation training laboratory and a video broadcast system.

To streamline its programmes to provide more effective training for the different groups of staff, the college is organised into 3 institutes – Institute of Medical Education & Training (IMET), Institute of Nursing Education & Training (INET) and Institute of Management & Allied Health Sciences (IMAS).

NHGDiagnostics

In accordance with NHG’s belief that prevention is better than cure, NHG Diagnostics (NHGD) provides timely and accurate imaging and laboratory services, enabling intervention at the earliest stage possible. Services include a wide range of laboratory tests, general x-rays and mammography services. NHGD is accredited with the Health Promotion Board to provide mammography under the national breast cancer screening programme.

Laboratory and imaging services are available in all the 9 NHG Polyclinics for the convenience of residents in the vicinity. Ultrasound services are available in Ang Mo Kio, Choa Chua Kang and Yishun Polyclinics. NHGD services are manned by well-trained laboratory technologists and radiographers.

NHGD has also satellite sites providing laboratory and imaging services at Ang Mo Kio Thye Hwa Koon Hospital, Northern Hope Specialist Clinic, NUS Wellness Centre, St Luke’s Hospital, Institute of Mental Health and Pier Medical.

2005/2006

�1

Statistics

Trend in SOC Attendance

Trend in Day Surgery

No.

of A

tten

dan

ces 12

3,1�

4

119,

811

�,08

4

44,�

09

39,2

04

�9,4

�1

1,��

1

985

128,

�1�

121,

148

9,13

�

44,2

99

40,1

81

�1,�

0�

1,�0

3

1,5�

8

122,

�58

118,

413

�,8�

8

49,8

55

38,8

88

��,5

48

1,81

1

2,0

0�

130,

�45

122,

941

5,94

5

52,�

99

38,9

80

��,3

�9

1,5�

�

234�

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

160,000NUH

TTSH

TTSH-CDC

AH

IMH

NSC

JOHNS HOPKINS

NORTHERN HOPE

APR 05 – JUN 05 JUL 05 – SEP 05 OCT 05 – DEC 05 JAN 06 – MAR 06

No.

of

Day

Sur

gerie

s P

erfo

rmed

NUH

TTSH

AH

8,5�

2

5,51

9

3,55

0

8,25

9

5,�1

0

3,49

4

8,48

�

5,��

5

3,�4

9

8,�0

�

5,52

0

3,48

0

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

10,000

APR 05 – JUN 05 JUL 05 – SEP 05 OCT 05 – DEC 05 JAN 06 – MAR 06

�2

Trend in Polyclinics Attendance

No.

of

Att

end

ance

sACUTE

CHRONIC

OTHERS

221,

�24

201,

0�3

11�,

5�3

215,

5�4

19�,

430

123,

495

229,

50�

235,

3�1

12�,

998

234,

�05

222,

0��

124,

142

0

50,000

350,000

APR 05 – JUN 05 JUL 05 – SEP 05 OCT 05 – DEC 05 JAN 06 – MAR 06

Statistics

100,000

150,000

200,000

250,000

300,000

Trend in Inpatient Episode

No.

of I

npat

ient

Ep

isod

es

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000NUH

TTSH

TTSH-CDC

AH

IMH

JOHNS HOPKINS

12,1

14

12,5

0�

1,24

1

5,35

0

2,08

5

83

APR 05 – JUN 05 JUL 05 – SEP 05

12,�

�0

12,�

4�

1,��

4

5,34

2

2,0

03

9�

OCT 05 – DEC 05

12,5

14

12,9

21

831

5,01

�

1,85

3

130

JAN 06 – MAR 06

12,2

39

12,5

2�

405

4,92

8

1,84

9

104

�3

Trend in Inpatient Day

No.

of I

npat

ient

Day

s

0

50,000

100,000

150,000

200,000

8,18

5

2�,5

0�

1�8,

801

1,12

3

APR 05 – JUN 05 JUL 05 – SEP 05

9,02

4 2�,0

54

1�8,

4�4

1,31

�

OCT 05 – DEC 05

5,�4

4

25,8

42

1�5,

948

1,25

8

JAN 06 – MAR 06

3,91

0

25,2

00

1�2,

��1

1,3�

4

Trend in A&E Attendance

No.

of I

Att

end

ance

s

0

10,000

30,000

40,000

45,000

23,�

35

34,�

4�

14,2

00

APR 05 – JUN 05 JUL 05 – SEP 05

24,1

95

3�,�

03

14,�

34

OCT 05 – DEC 05

23,0

�9

34,2

18

14,3

09

JAN 06 – MAR 06

23,4

�9

33,�

0�

14,1

04

NUH

TTSH

AH

35,000

25,000

20,000

15,000

5,000

59,3

3�

89,1

82

�1,2

44

89,1

�0

�0,3

20

8�,4

11

5�,8

38

8�,2

00

NUH

TTSH

TTSH-CDC

AH

IMH

JOHNS HOPKINS

�4

Statistics

Average Length of Stay by Hospital and Class of Bedas at 31st March 200�

No.

of D

ays

010.0

170.0NUH

TTSH

TTSH-CDC

AH

IMH

JOHNS HOPKINS

3.8

5.4

4.3

�.2 10

.3

12.2

A B13.

4 5.�

4.9

3.9 9.

�

B2

4.2

5.9

�.5

4.2

15.1

C

4.8 �.� 12

.3

5.4

14�.

3

20.0

30.040.0

50.060.0

70.080.0

90.0

100.0

110.0

120.0

130.0

140.0

150.0

160.0

Bed Complement by Hospital and Class of Bedas at 31st March 200�

No.

of B

eds

0

2,500NUH

TTSH

TTSH-CDC

AH

IMH

JOHNS HOPKINS

149

55

� � 48 30

A B2

331 4�

3

44

130 18

�

c

1�9

4�8

84

1�4

2,04

4

Classless

1�4

131 185

�2 82

500

1,000

1,500

2,000

B1

115 1�

�

5 25 8

�5

Bed Occupancy Rate by Hospital

No.

of B

eds

0%

20%

30%

40%

70%

80%

90%

100%NUH

TTSH

TTSH-CDC

AH

IMH

JOHNS HOPKINS

JAN 06 – MAR 06

�9% 85

%

38%

80% 83

%

��%

OCT 05 – DEC 05

80% 8�

%

53%

�9% 83

%

�8%

JUL 05 – SEP 05

81%

89%

��% 82

%

83%

�9%

APR 05 – JUN 05

80%

91%

�3%

84%

84%

�1%

60%

10%

50%

Distribution of Staff as at 31st March 200�

NURSES

DOCTORS

ADMINISTRATION

ANCILLARY

PARAMEDICS

1,403Administration

12%

2,�40Ancillary

23%

1,503Paramedics

13%

4,80�Nurses

40%

1,389Doctors

12%

��

NUH TTSH NSC AH IMH POLY HQ1 JH NRL NH FY05 FY04 Change Change%Doctors 4�9 4�5 3� 1�� �5 14� 4 5 0 1 1,389 1,420 (31) -2.2%Nurses 1,��0 1,�89 30 520 �40 232 0 32 0 4 4,80� 4,518 289 �.4%Paramedics 4�5 50� 45 1�� 104 � 209 0 0 0 1,503 1,520 (1�) -1.1%Ancillary �45 9�1 29 31� 40� 349 1� 3 0 5 2,�40 2,230 510 22.9%Administration 251 2�2 8� 148 143 4� 394 44 11 8 1,403 1,8�0 (4��) -25.0%

Total 3,500 3,914 227 1,326 1,358 781 623 84 11 18 11,842 11,558 284 2.5%

1 Includes headcount from HQ, Pharmacy & Diagnostics.

NUH TTSH NSC AH IMH POLY HQ JH NRL NH FY05 Doctors 4�9 4�5 3� 1�� �5 14� 4 5 0 1 1,389 Nurses 1,��0 1,�89 30 520 �40 232 0 32 0 4 4,80� Paramedics 4�5 50� 45 1�� 104 � 209 0 0 0 1,503 Ancillary �45 9�1 29 31� 40� 349 1� 3 0 5 2,�40 Administration 251 2�2 8� 148 143 4� 394 44 11 8 1,403

FY 05 3,500 3,914 227 1,326 1,358 781 623 84 11 18 11,842

NUH TTSH NSC AH IMH POLY HQ JH NRL NH FY04 Doctors 555 454 3� 1�1 �� 139 0 � 0 0 1,420 Nurses 1,420 1,�00 30 4�4 �34 23� 0 29 0 5 4,518 Paramedics 4�5 519 40 15� 131 0 195 3 0 0 1,520 Ancillary 551 552 33 290 42� 34� 1� 14 0 2 2,230 Administration 340 �59 80 153 159 5� 280 2� 10 � 1,8�0

FY 04 3,341 3,984 220 1,225 1,417 777 491 80 10 13 11,558

NUH TTSH NSC AH IMH POLY HQ JH NRL NH TotalDoctors (�� ) 21 0 15 ( 2 ) 8 4 ( 2 ) 0 1 ( 31 )Nurses 240 (11 ) 0 5� � ( 4 ) 0 3 0 (1 ) 289 Paramedics (10 ) (12 ) 5 9 ( 2� ) � 14 ( 3 ) 0 0 (1� )Ancillary 94 419 ( 4 ) 2� ( 20 ) 3 0 (11 ) 0 3 510 Administration ( 89 ) ( 48� ) � ( 5 ) ( 1� ) ( 10 ) 114 1� 1 2 ( 4�� )

FY 05 vs FY 04 159 ( 70 ) 7 101 (59 ) 4 132 4 1 5 284 • JH = Johns Hopkins – Singapore International Medical Centre • NRL = NUH Referral Laboratories Pte Ltd • NH = Northern Hope Healthcare Pte Ltd

Headcount

��

FY2005 S$’M

Assets by Major Categories Properties, Plant and Equipment 4�0 Trade and Other Receivables 95 Cash and Cash Equivalents ��2 Other Assets 1��

Total 1,394

Liabilities by Major Categories Trade and Other Payables 454 Other Current Liabilities 83 Non Current Liabilities 139

Total 676

Capital/Reserves by Major Categories Share Capital 54� Reserves and Retained Surplus 1�1 Minority Interests 1

Total 718

Revenue Breakdown by Major Categories Net Patient Revenue 5�� Subvention �55 Other Revenue 50

Total 1,282

Expenditure by Major Categories Manpower ��8 Supplies and Consumables 238 Depreciation and Amortisation �� Other Operating Expenses 2�3

Total 1,246

Key Financial Information

�8

National Healthcare Group

6 Commonwealth Lane, Level 6, GMTI Building,

Singapore 149547 www.nhg.com.sg