STAY HEALTHY LIVE WELL - National Healthcare … Year Book...Khairunnisa Binte Abdul Halek, Jeannie...

STAY HEALTHY•LIVE WELL ENGAGE • EDUCATE • EMPOWER

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Editors Wong Fong Tze, Lydia Soh, Maria Ronald, Kenneth Ng

ContributorsOng Chong Pheng, William Ng, Tania Tan, Trudy Zhang, David Dhevarajulu, Lalitha Naidu, Sabrina Lim, Nathalie Ng, Corrinne Tan, Clara Poh, Eling Ho, Eugene Seng, Lim Wei Beng, Sheryl Wang, Palvannan S/O R Kannapiran, Paul Yeo, Yong May Chin, Khairunnisa Binte Abdul Halek, Jeannie Ong, Wee Fong Chi

Co-designed by NHG and Addiction Advertising

A Publication by NHG Group Corporate Communications

About The Cover Health is more than just the absence of illness. It is about having healthy lifestyle habits and personal wellness. Increasingly, healthcare providers like NHG are advocating preventive care and personal ownership of health and wellness.

The cover features our staff as wellness ambassadors, “walking the talk” and partnering our population in their care journey. We proactively engage our patients and caregivers, empower them with information and the know-how to make sound care decisions. We also inspire them to modify their lifestyle behaviours and habits to achieve better health outcomes.

NHG is a Regional Health System for Singapore. We collaborate with Hospitals, Specialty Centres, Polyclinics, Patients, Caregivers, Partners, Volunteers and the Community to Add Years of Healthy Life to the nation.

NationalHealthcareGroupwww.nhg.com.sg

We Are NHG

Chairman's Statement

Group CEO's Message

Board of Directors

Senior Management

Stay Healthy • Live Well

Population Health

Community Care

Clinical Care

Research, Innovation & Technology

Education

Our People

Financials

About NHG Institutions

We are NHG

OUR MISSIONWe 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 VISIONAdding Years of Healthy Life

National Healthcare Group (NHG)’s vision is Adding Years of Healthy Life. This goes beyond merely healing the sick to the more difficult and 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. NHG is a Regional Health System for Singapore. We provide care through an integrated network and collaborate with Hospitals, Specialty Centres, Polyclinics, Patients, Caregivers, Partners, Volunteers and the Community. Together with our partners, we bring a rich legacy of medical expertise to our philosophy of integrated patient-centred care. With our focus on providing accessible, affordable and quality healthcare services, NHG strives to improve integrated care within the Regional Health System involving long-term collaborations with other healthcare and community partners.

2 | We are NHG

COLLEGIALITY We nurture success by promoting collaboration, participation and trust between individuals and other healthcare organisations, within an environment of sharing and mutual respect.

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 alleviate their conditions.

RESPECT We treat everyone with honesty, decency and fairness.

INTEGRITY We are committed to the highest standards of ethical conduct.

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

PROFESSIONALISM We are committed to being the best in what we do, and to achieving the best possible outcome for our patients.

4P7R

These represent a collective mindset and proactive culture we are adopting to further raise our standards in transforming population health towards Our Shared Future of being a Regional Health System for Singapore.

The 7 Rules are:• Healthcare originates from what patients need

and value

• We care and protect patients and ourselves

• We work with guidelines and standard processes

• We solve the problem or take responsibility for handing over to the next step

• We give ideas, learn, develop, improve continuously and share results

• As a system with partners, it is the system’s results that count

• We feedback to the step before

The 4 Principles are:• Patient-Centred Care

• Systems Thinking

• Learning Organisation

• Staff Engagement

OUR VALUES

We are NHG | 3

Stay Healthy • Live Well | Engage • Educate • Empower

Madam Kay KuokChairmanNational Healthcare Group

CHAIRMAN’S STATEMENT

2015 was a momentous year for the National Healthcare Group (NHG). We celebrated 15 years as a public healthcare cluster, and honoured our staff for their dedicated efforts and contributions in making Singapore’s public healthcare system what it is today: one that is world-class, and which offers quality healthcare that is accessible and affordable.

Our journey as NHG has indeed evolved over the years.

Singapore’s rapidly ageing population, rising prevalence of chronic diseases and onset of health complications, though challenging, have presented NHG with opportunities to radically rethink how we deliver care as a Regional Health System (RHS). In close collaboration with our stakeholders and community partners, we have progressively shifted our focus from episodic care to integrated care centred on our patients, and moved our care services beyond our institutions into the community. Most importantly, we have started to look at the outcomes of care for our population. We have also taken steps to better engage and motivate individuals to make healthy lifestyle choices, empowering them with knowledge and resources to take greater ownership of their health. We believe the continued emphasis on education, prevention and early detection will enhance wellness care in the community, leading to a more sustainable healthcare system.

DOING MORE FOR THE COMMUNITYFundamental to population health is the need to have a deep understanding of the physical, mental, and social health status of our population. In 2015, NHG embarked on a three-year Population Health Survey for the Central Region. I am confident that this survey of over 7,200 residents by our Health Services & Outcomes Research (HSOR) department will reveal valuable insights and enable NHG to design effective programmes to improve the health of the community.

In April 2015, the Institute of Mental Health (IMH) embarked on the Singapore Mental Health Study 2016. This three-year project by IMH, the Ministry of Health (MOH), Nanyang Technological University (NTU) and Saw Swee Hock School of Public Health, will track and trend key mental health disorders including schizophrenia. Researchers will also identify gaps in treatment and develop interventions to address them. Efforts like these are critical in developing long-term care support for our nation.

The shift to health and wellness in the community entails more collaboration, necessitated by the complex care needs of our ageing population. The Geriatric Integrated Network for Dementia (GerIND) set up by Tan Tock Seng Hospital (TTSH) involves

As we toast the accomplishments of the past year, we acknowledge that we must not rest on our laurels. As the needs of our population evolve, so too must public healthcare – to not only heal sickness but to nurture holistic wellness. The journey ahead is just as, if not more exciting, as we continue to strive towards NHG’s vision of Adding Years of Healthy Life for the people we serve.


Chairman’s Statement | 5

key partners in the primary care and community care sectors, including General Practitioners (GPs) in Singapore’s Central Region, to provide better care for persons with dementia. Training and capability building through sharing of expertise and experiences of these sectors ensure that more people with dementia can be supported to live well in the community. Additionally, people with mental health conditions now find it easier to get help in the community as more GPs and Family Physicians in the polyclinics are being trained to diagnose and manage such conditions, a partnership between IMH, National Healthcare Group Polyclinics (NHGP) and the Agency for Integrated Care (AIC).

In 2015, we expanded our network of Family Medicine Clinics (FMCs) with the opening of Hougang Family Medicine Clinic @ Ci Yuan Community Club. FMCs provide continuing care for patients, especially in managing their chronic conditions well, enabling them to lead active and independent lives at home and in the community.

Tapping on the experience of Eastern Health Alliance (EHA) and South East Community Development Council (CDC), we introduced the “Neighbours for Active Living” (‘Neighbours’) programme in the Central Region. ‘Neighbours’, a relationship-based programme, brings together a full-time community care team and volunteers trained to care for frail individuals, to help them stay well after they are discharged from our hospitals back to their homes.

Our achievements as a Regional Health System (RHS) were possible only because of our close and collaborative work with our partners. We are grateful for the support we have received from our stakeholders for our work and programmes.

OUR PEOPLEOur achievements for the past 15 years are the result of the countless hours put in by our Management and staff as ONE NHG Family. Their dedication is remarkable and I would like to commend all 13,000 of them for their motivation and hard work.

I would also like to take this opportunity to congratulate the winners of the recent National Medical Excellence Awards (NMEA) 2016 – Professor Roy Chan from the National Skin Centre (NSC), who received the National Outstanding Clinician Award, and the Nephrology Evaluation Management and Optimisation (NEMO) Joint Team from National University Health System (NUHS) and NHGP who shared the National Clinical Excellence Team Award. The NMEA represents the pinnacle of medical excellence in Singapore and recognises clinicians who have distinguished themselves in the areas of clinical excellence, education, quality, science and medicine.

For the National Day Awards 2016, Professor Chong Siow Ann, Vice-Chairman, Medical Board (Research) and Senior Consultant at IMH, did us proud when he was presented with The Public Administration Medal (Bronze). Recognised for his outstanding work and extensive expertise in the field of early

Mdm Kay Kuok at the NHG Awards 2016 with Professor Chong Siow Ann, Vice Chairman

Medical Board (Research), IMH, recipient of the NHG Distinguished Senior Clinician Award

6 | Chairman’s Statement

psychosis, he was pivotal in the development and implementation of the National Mental Health Blueprint and Policy, the Early Psychosis Intervention Programme (EPIP), and the Translational and Clinical Research in Neuroscience Flagship Programme.

Congratulations too to Professor James Best, Dean of the Lee Kong Chian School of Medicine and member of the NHG Board, on his appointment as Officer of the Order of Australia in the 2016 Queen’s Birthday Honours. Professor Best was acknowledged for his distinguished service to medicine especially in the field of endocrinology, medical education and efforts on rural and indigenous health. We look forward to gaining more insights from his current research in healthcare delivery for diabetes prevention and management in our Singapore population.

BEYOND HEALTHCAREAs we toast the accomplishments of the past year, we acknowledge that we must not rest on our laurels. As the needs of our population evolve, so must public healthcare – to not only heal sickness but to nurture holistic wellness. The journey ahead is just as, if not more, exciting as we continue to strive towards NHG’s vision of Adding Years of Healthy Life for the people we serve.

I would like to welcome Mr Chan Heng Kee, Permanent Secretary, Ministry of Health, and Mr Gabriel Lim onto the NHG Board. Mr Chan assumed his new post in May 2016 and was appointed to our Board on the same day, while Mr Lim was appointed to our Board on 1 September 2015.

I would like to thank our former NHG Board member and Permanent Secretary, Ministry of Health, Mrs Tan Ching Yee, for her dedication to and support for NHG, as well as her visionary and tireless contributions to public healthcare in Singapore. Last but not least, I would also like to thank Mr Lionel Yeo and Mr Paul Chan for their invaluable contributions during their tenure on the NHG Board.

Our achievements for the past 15 years are the result of the countless hours put in by our Management and staff as ONE NHG Family.


Chairman’s Statement | 7

Medicine is no longer just about diagnosis and prescription. It is also about forging relationships with our patients to better understand their physical, psychological and social needs. We must motivate them to take ownership of their health, and to live and stay well.

Professor Philip ChooGroup Chief Executive OfficerNational Healthcare Group

GROUP CEO’S MESSAGE

Healthcare in Singapore is changing. With the number of elderly aged 65 and above expected to triple to 900,000 by 2030, the push for a public healthcare system that meets our ageing and health needs cost effectively, and which is sustainable, has never been more urgent.

Our healthcare delivery system is being transformed from one that is built around the hospital, to one that is directed at meeting the needs of Singaporeans by integrating care through our community partners in the Regional Health System (RHS).

The National Healthcare Group (NHG) and its members — Tan Tock Seng Hospital (TTSH), Institute of Mental Health (IMH), National Healthcare Group Polyclinics (NHGP), National Skin Centre (NSC), NHG Diagnostics and NHG Pharmacy — have had a head start in the Regional Health System (RHS) journey.

NEW NORMS “MOVING UPSTREAM”The fact is most patients will live with their chronic diseases for years, and that their illnesses will tend to worsen over time. There are typically no vaccines or cures for chronic diseases. Several worrying trends have also emerged in recent years: decreasing activity rates across all age groups and increasing consumption of excessive calories leading to rising obesity. Obesity is the major risk factor for chronic disease, such as Type 2 Diabetes. Diabetes has been called ‘the mother of all illnesses’ as it can result in other complex debilitating conditions. Singapore has one of the highest rates of diabetes and disease progression in the world. It is for these reasons that the Ministry of Health (MOH) has declared “War on Diabetes” in an effort to arrest the tide.

NHG is doing its part in this fight. As lifestyle factors play a significant role in disease progression, we are going upstream to where the people are, to tackle social, mental and physical health issues early. It means giving talks in schools or workplaces to influence the young and working adults on good lifestyle habits — well-balanced diets, regular exercise and personal hygiene — they should adopt, and attend community-based health screenings with appropriate follow-ups where necessary, and take charge of their own health to achieve better outcomes. To address the rising rate of obesity among children, NHG has initiated a pilot programme called 'Shaping a Healthy Future'. Over 50 students from five primary and secondary schools participated in the inaugural workshop, which aimed to help students better understand health issues while developing creative solutions to tackle them in school and at home. They complement current health promotion and education initiatives by the Health Promotion Board and Ministry of Education.

For our patients and their caregivers, the ability to influence their mindset and behaviours and provide them with holistic care will mean reorganising our healthcare teams to foster relationships and guide them on lifestyle choices. For example, NHGP’s team-based Patient Empanelment programme, where patients are cared for by their regular multidisciplinary team of healthcare professionals. Initial results in 2015 showed that the proportion of patients with well-controlled cholesterol levels improved by 57 per cent, and the take-up for cancer screening tests such as Pap Smears increased by 1,400 per cent. Frequency of visits to doctors for chronic medical problems also dropped by 16 per cent. After a six-month pilot at the Toa Payoh Polyclinic, NHGP extended the Empanelment programme to select patients at all its polyclinics.

Our transformation has culminated in the establishment of five Strategic Workstreams – Care Redesign; Staff Point of View; Patient Point of View; Organisation Development & Design; and Training for the Future.


Group CEO’s Message | 9

We now direct our care efforts at five different population segments – those who are Living Well; Living with Illness; Requiring Complex and Crisis Care; Living with Frailty; and Dying Well.

BEYOND HOSPITAL WALLSOver the years, NHG has studied various ways to “segment” our population in order to better understand and develop appropriate interventions for varying needs across the broad groups and to bring about more person-centred care. We now direct our care efforts at five different population segments – those who are Living Well; Living with Illness; Requiring Complex and Crisis Care; Living with Frailty; and Dying Well.

Of the five population segments, acute hospitals still play a significant role in caring for people with complex and critical medical needs. But the role of a hospital is changing and is increasingly complemented by link-ups with community-based organisations to provide care services for our population segments, out of the hospital. It involves developing appropriate interventions comprising preventive, proactive and palliative care to support Singaporeans to live independently, and this is realised through effective collaborations across various disciplines. To date, our Central Regional Health Office has brought together several health and social care organisations to create a support network with a focus on the elderly and low-income residents. It has helped integration within and across health and social sectors through a multi-agency collaboration approach. NHG is making inroads in our efforts to

engage and build relationships with the community hospitals, nursing homes, home and day-rehabilitation-care providers, GPs, voluntary welfare organisations and grassroots organisations within the RHS. Through our quarterly networking events, co-organised by NHG and partners, and regular meetings, we have grown closer together. We have engaged eight of nine planning areas in the Central Region, and today, many see us as their strategic partners and we appreciate their support. This has allowed the NHG Family to be more attuned to their needs, which has in turn brought about improved literacy of care services, and partnerships on initiatives with positive outcomes for patient care. Over time, the right siting of care will be the norm to ensure sustainability of the public healthcare system.

10 | Group CEO’s Message

TAKING ACTIONKeeping our population healthy goes beyond optimising resources, raising capacity and integrating care. It also requires ‘heart-ware’, where people are encouraged and empowered to take ownership of their health. Education and training can only go a distance, beyond which people must want to practise and sustain good lifestyle habits. And at NHG, we are taking this health pursuit very seriously.

We launched the Stars For Health - S.H.I.N.E initiative, a collaboration between NHG’s Health Promotion unit, Group Human Resource and Group Corporate Communications. Workshops and hands-on activities engage our colleagues to take charge of their physical, mental and social well-being. Our three new NHG Corporate Ads also encourage our staff to exercise regularly, eat wisely and be happy; indeed, “Health is Wealth”.

Our NHG Corporate Yearbook Financial Year 2014/15 appropriately titled A New Model of Care: Keep Healthy. Stay Well won the Award for Excellence in the Annual Reports category at the annual APEX Awards 2016. This award bears testament to the strong collective effort of NHG and its institutions to produce a yearbook for in-depth and useful editorial content and quality design.

REDESIGNING HEALTHCARE Our transformation has culminated in the establishment of five Strategic Workstreams – Care Redesign; Staff Point of View; Patient Point of View; Organisation Development & Design; and Training for the Future – led by Senior Management and staff from across the Group, to re-examine, crystallise and consolidate ongoing efforts across NHG and our Institutions to better meet future challenges, so as to improve our care delivery. The year-long ideation process involves seeking input from stakeholders, and using the feedback to re-envision the future state of public healthcare in Singapore, as well as NHG’s role as a healthcare provider.

Already, the workstreams have provided valuable insights into the needs of our stakeholders across the care spectrum. These will guide us in our design journey and I look forward to innovative outcomes in the near future.

MOVING AHEADTo ensure our future readiness, NHG will continue to engage, educate and empower our staff, our patients and their families, and the community to take more ownership of their health and live well.

Collaboration with our partners in the private and public sectors to establish primary care as a bedrock for care transformation, chronic disease management, elder care and mental health wellness are our ongoing challenges.

I would like to extend my deepest appreciation to Madam Kay Kuok, Chairman of NHG, the NHG Board, partners, patients and colleagues for journeying with us towards our vision of Adding Years of Healthy Life for all we serve.

Prof Philip Choo, Group CEO, NHG, beating to the rhythm of "ONE NHG" with staff and partners at NHG's 15th Anniversary Celebrations


Group CEO’s Message | 11

BOARD OF DIRECTORS

MADAM KAY KUOK | CHAIRMAN Madam Kay Kuok Oon Kwong is a Barrister-at-Law from Gray’s Inn, London, and works full-time in her family business, the Kuok Group of Companies, as Executive Chairman of Shangri-La Hotel Ltd, Singapore. She is serving and has served on several community service and statutory boards including the Singapore Tourism Board, Singapore Hotels Association, National University of Singapore (NUS) Board of Trustees, South West Community Development Council (CDC), National Environment Agency, National Arts Council and the Wildlife Reserves Singapore Conservation Fund.

Madam Kuok was awarded the Public Service Medal in 1998, the Public Service Star in 2005 and the Meritorious Service Medal at the National Day Awards 2015.

12 | Board of Directors

MR CHAN HENG KEEMr Chan Heng Kee has been the Permanent Secretary of MOH since May 2016. He is Chairman of Ministry of Health Holdings (MOHH) and sits on the Board of Directors of various public healthcare clusters. In addition, he also chairs the National Library Board (NLB), Employment and Employability Institute, and holds board memberships in the Singapore Totalistor Board and Civil Service College (CSC).

Since joining the Singapore Public Service in 1996, Mr Chan has held different appointments in various public sector organisations. These include Chief Executive at the Workforce Development Agency (WDA), and Dean and CEO at CSC. He served as the Permanent Secretary of Social and Family Development and the Permanent Secretary of Community Development, Youth and Sports before assuming his current post.

PROFESSOR PHILIP CHOOProfessor Philip Choo was appointed the Group Chief Executive Officer (CEO) of the National Healthcare Group (NHG) in 2015. He is well recognised as a Geriatrician with more than 20 years of experience.

He was CEO of Tan Tock Seng Hospital (TTSH) and concurrently Deputy Group CEO, NHG (Regional Health) from 2011 to 2014.

Professor Choo was awarded the TTSH Doctor of the Year in 1996. His contribution during SARS, as head of the medical team, earned him the National Day Public Service Star Award in 2003. In 2011, he was awarded the National Day Public Administration Medal (Silver), and the National Day Long Service Medal in 2015.

Professor Choo serves on several Boards including the Johns Hopkins Singapore International Medical Centre, Ren Ci Hospital, Integrated Health Information Systems Pte Ltd, The Courage Fund Limited, and Ang Mo Kio-Thye Hua Kwan Hospital. He also sits on various Ministry of Health (MOH) Committees, and is a member of the Lee Kong Chian School of Medicine Governing Board.


Board of Directors | 13

MR R. SINNAKARUPPAN Mr R. Sinnakaruppan is presently Chairman/Chief Executive Officer (CEO) of Singapore Education Academy (AsiaPac) Pte Ltd, a holding company for a group of education companies involved in a wide range of products and services for children and adult education. He has served and continues to serve in statutory boards/community organisations/listed companies including Housing & Development Board (HDB), Civil Aviation Authority of Singapore (CAAS), Media Development Authority (MDA), Institute of Technical Education (ITE), Singapore Polytechnic, TTSH, SINDA Board of Trustees, Accel Frontline Ltd, SLF Leisure Pte Ltd and many more.

He also served as a Member of Parliament from 1991 to 2001. He is a Foreign & Commonwealth Scholar and was educated at Harvard Business School, Loughborough University and Nanyang Technological University (NTU).


PROFESSOR JUDITH LEA SWAIN Professor Judith Lea Swain is a physician scientist and cardiovascular specialist. She is a Senior Fellow at A*STAR and Professor of Medicine at the NUS Yong Loo Lin School of Medicine. Professor Swain previously served as Dean for Translational Medicine at University of California San Diego, Chair of Medicine at Stanford University and Chief of Cardiovascular Medicine at the University of Pennsylvania. She worked in molecular cardiology and medical device development. She joined the NHG Board in 2009.

MS ANITA FAMMs Anita Fam was formerly a Partner at Khattar Wong & Partners and thereafter a Senior Legal Counsel, at Enron Capital & Trade Resources, before she retired 17 years ago to devote herself to her family. Since then, she has immersed herself in community work and is a full-time volunteer – both at charity and national levels – in the areas of family, palliative care, disability and mental health.

Ms Fam is the Co-Chairman of the Community Silver Trust Evaluation Panel and also chairs the Enabling Masterplan 3 Steering Committee. She serves on the boards/committees of Assisi Hospice, Caregiver Alliance Ltd, Families for Life Council, National Council of Social Service, Sembawang Family Service Centre, Singapore International Foundation and St Andrew’s Autism Centre, among others.

Ms Fam is a Justice of the Peace, and was conferred the Public Service Star in 2014 and the Public Service Medal in 2008 for her work in the community. She joined the NHG Board in 2009.



MRS LIM JOKE MUI Mrs Lim Joke Mui is an accountant by training and has served as Group CFO in various corporate groups, including DBS Land Limited, CapitaLand Commercial Limited and Sembcorp Industries Limited. She retired from Sembcorp Industries on 30 June 2010. She oversaw various functions in the groups including corporate finance, accounting, tax, treasury, risk management, company secretarial and mergers & acquisitions. Besides being a director of several non-listed companies within various corporate groups, her past directorships included those of listed companies in Singapore, Australia and Malaysia such as Sembcorp Marine Limited, The Ascott Limited, The Insurance Corporation of Singapore, Australand Holdings Limited and United Malayan Berhad.

Mrs Lim is Chairman of NHG’s Finance and Audit Committee, Board Risk Committee, and the NHG Endowment Fund. She is also a member of the MOHH’s Audit and Risk Management Committee.

MR SOH GIM TEIK Mr Soh Gim Teik advises corporations through his firm, Finix Corporate Advisory LLP. He has extensive experience in finance, corporate governance and strategic management.

He was previously an Executive Director and Chief Financial Officer (CFO) in a listed company and is currently serving as an independent director in several other listed companies and non-profit organisations.

Mr Soh has a degree in Accountancy from NUS and is a Chartered Accountant (Singapore) with the Institute of Singapore Chartered Accountants (ISCA). He is a Fellow at the Singapore Institute of Directors (SID), where he is a Board member and 2nd Vice Chairman in its Governing Council.

He had also served as a committee member in the Professional Accountants in Business Committee of the International Federation of Accountants (IFAC) and was previously awarded the Best CFO of the Year at the Singapore Corporate Awards.


MR SEOW CHOKE MENG Mr Seow Choke Meng has been with Singapore Press Holdings (SPH) newspaper group for the past 37 years after spending five years in the airline industry. He has held various positions, including those of General Manager, Human Resource Operations, General Manager (Circulation) as well as General Manager of Chinese Newspapers’ Editorial Services Department, and Executive Vice President of Cultural Industry Promotion of Chinese Newspapers Division and Times Properties. Mr Seow is currently the Business Consultant of Chinese Media Group and Times Properties. He is also the Executive Director of Times Development Pte Ltd.

Apart from serving in grassroots and community organisations, Mr Seow serves as the Chairman of the Promote Mandarin Council and a Trustee of Chinese Development Assistance Council (CDAC). He is also Vice-Chairman of Ren Ci Hospital and Board Member of Kwong Wai Shiu Hospital & Nursing Home.

Mr Seow graduated from the University of Singapore with a Bachelor of Science (Honours) degree.

He was conferred the Public Service Star in 2013.

MRS YEE JEE HONG Mrs Yee Jee Hong was a member of the SWIFT Board from 1999 to 2012 representing 10 countries in Asia Pacific, including the ASEAN members, China, Taiwan, Korea and India. SWIFT is a cooperative based in Brussels and owned by banks with three data centres in three countries for high value financial transactions.

Mrs Yee served at PSA, the former Port of Singapore Authority, for 13 years and was at DBS for 17 years before retiring. One of her most significant appointments at DBS was Executive Vice President of all operational departments reporting to the Executive Chairman of the Board. Her scope of responsibilities included Human Resources, Finance, Administration, Risk Management, Legal, Communications and Technology.

She joined the NHG Board in 2013.



ADJUNCT PROFESSOR ER LAU JOO MING Adjunct Professor Er Lau Joo Ming is the Senior Advisor of MOHH. He drives the planning, development and strategic research plans for the Hospital Infrastructure Project Division, provides advice to technical issues, participates in technical reviews for MOH projects. He develops robust and resilient systems in managing the projects, building core functional and technical competencies. He also mentors and guides MOHH’s young professionals.

Prior to his position as Senior Advisor, Er Lau was the Senior Advisor to HDB from 2012 to 2015, Managing Director of the HDB Building Research Institute (HDB BRI) from 2009 till 2012. HDB BRI is the research arm of HDB and envisions being the global leader in housing research, innovations and solutions for a sustainable living environment. In 2006, Er Lau was the Deputy CEO of the Building Group of HDB, managing four departments involved in the planning, procurement, project management, quality assurance and maintenance management of HDB estates. He was the Chief Structural Engineer of the HDB. During his service at HDB, some of the famous milestones under his leadership were the development of prefabrication technology which transformed HDB’s quality and construction technology,

the development of one million HDB apartments, the 50-storey high-rise residential buildings Pinnacle @ Duxton and Punggol Eco-town.

Besides HDB, he was the President of Professional Engineer Board from 2009 to 2014, and currently is an Adjunct Professor at NTU, where he lectures a Master of Science class in the School of Civil Engineering.

He is a member of the Development Projects Advisory Panel, set up by the Ministry of Finance (MOF) to enhance the assessment and management of large and complex infrastructure projects. He offers his professional advice and expertise to other government agencies including Ministry of National Development (MND), Professional Engineers Board (PEB), Building and Construction Authority (BCA), Land Transport Authority (LTA), Centre for Liveable Cities (CLC), HDB, Ministry of Manpower (MOM), Alexandra Health System (AHS), etc.


DR TAN KHAI TONG Dr Tan Khai Tong studied Medicine at NUS and graduated second in his medical class in the final MBBS examination in 1982. He won the Singapore Medical Association Bronze medal, Jane Prize in Paediatrics, Bailey Memorial Medal and Albert Lim Bronze Medal.

He obtained the degrees of Master of Medicine in Internal Medicine (Singapore) and MRCP (UK) in 1986. He is also trained in Endocrinology at the Royal Melbourne Hospital and the Singapore General Hospital (SGH).

He was former secretary of the Endocrine and Metabolic Society of Singapore and a former member of the Medical Advisory Board of Mount Alvernia Hospital.

For the past 20 years, he has been in private practice as a consultant endocrinologist at Mount Elizabeth Medical Centre.

MS LOCK YIN MEI Ms Lock Yin Mei is a partner at Allen & Overy. She graduated with an LLB (Hons) from the National University of Singapore (NUS) and an LLM (Hons) from Cambridge University. She is qualified to practise law in Singapore, England & Wales, and the State of New York.

Apart from her work with the NHG Board, she serves on the Partnership Selection Committee (Capital Markets) of Allen & Overy, and the Compliance Committee (Continuing Professional Development) of the Singapore Institute of Legal Education.

She joined the NHG Board in 2014.



PROFESSOR JAMES BEST Professor James Best joined the NHG Board in 2014. He was appointed Dean of the Lee Kong Chian School of Medicine in July 2014.

He was previously Head of the Medical School at the University of Melbourne for seven years. A medical graduate of the University of Melbourne, he trained in Endocrinology in Hong Kong, Melbourne and Seattle, USA. He has extensive experience as a clinician, researcher and teacher, publishing over 200 scientific papers.

At a governance level, Professor Best was a member of Australia’s National Health and Medical Research Council and chaired its Research Committee from 2006 to 2012.

He was on the Board of St Vincent’s Institute (Medical Research) for over 20 years and on the Heart Foundation (Australia) Research Committee for five years. He chaired the Juvenile Diabetes Research Foundation (JDRF) Clinical Trial Network Scientific Advisory Committee for three years and in 2014 joined the Board of Directors of JDRF Australia. He was on the Board

of Directors of three different Health Services in Victoria, Australia and the Australian Medical Defence Organisation. Professor Best received an honorary Doctor of Medicine degree from St Andrews University, Scotland and honorary professorships from Shantou University Medical College and Harbin Medical University, China.

Since taking up the position as Dean of the Lee Kong Chian School of Medicine in Singapore, Professor Best has become a member of National Medical Research Council Singapore and Deputy Chairman of NTU Institutional Review Board. He chairs the NHG Research Advisory Committee which reports to the NHG Board.


MR GABRIEL LIM Mr Gabriel Lim was appointed Second Permanent Secretary of the Ministry of Communications and Information (MCI) in May 2016. He is Chief Executive of the Info-communications Media Development Authority (IMDA).

Prior to his current appointment, Mr Lim was Principal Private Secretary to Prime Minister Lee Hsien Loong, and served in the Ministry of Defence, Ministry of Health and the Public Service Division.

Mr Lim serves on the Board of Directors for NHG and IMDA. He is also a member of the CapitaLand Technology Council.

Our deepest appreciation to former NHG Board Members: Mrs Tan Ching Yee, former Permanent Secretary, Minister of Health, who stepped down in April 2016; Mr Lionel Yeo and Mr Paul Chan who stepped down in April 2015.

MR CHIA BOON KUAH Mr Chia Boon Kuah was the Group President and Chief Executive Officer at GuocoLand Limited between February 2014 and September 2015. He was responsible for steering the Group’s management team by providing entrepreneurial leadership and strategic direction. In addition, Mr Chia oversaw the business operations and affairs of the Group across Singapore, China, Malaysia and Vietnam. Mr Chia retired in September 2015.

Mr Chia is a member of the NHG Board since April 2015.



SENIOR MANAGEMENT

PROFESSOR PHILIP CHOOGroup Chief Executive OfficerNational Healthcare Group

A/PROF CHUA HONG CHOONDeputy Group Chief Executive Officer (Clinical)National Healthcare Group

Chief Executive OfficerInstitute of Mental Health/ Woodbridge Hospital

PROF LIM TOCK HANDeputy Group Chief Executive Officer (Education & Research) National Healthcare Group

DR EUGENE FIDELIS SOHChief Executive OfficerTan Tock Seng Hospital

DR HENG BEE HOONSenior DirectorHealth Services & Outcomes Research (HSOR); NHG Strategic Research & Analytics (N-Strat) National Healthcare Group

DR JAMIE MERVYN LIMChief Operating OfficerTan Tock Seng Hospital

MR LIM HOCK LENGChief Operating OfficerInstitute of Mental Health/ Woodbridge Hospital

DR PETER CHOWChief Operating OfficerNational Healthcare Group Polyclinics

MR LINUS THAMGroup Chief Operating OfficerNational Healthcare Group

Group Chief Corporate Development OfficerNational Healthcare Group

MRS OLIVIA TAYGroup Chief Human Resource OfficerNational Healthcare Group

MS WONG FONG TZEGroup Chief Corporate Communications OfficerNational Healthcare Group

MS LIM YEE JUANGroup Chief Financial OfficerNational Healthcare Group

22 | Senior Mangement

A/PROF CHONG PHUI-NAHChief Executive OfficerNational Healthcare Group Polyclinics

A/PROF TAN SUAT HOONDirectorNational Skin Centre

A/PROF THOMAS LEWChairman Medical BoardTan Tock Seng Hospital

A/PROF DANIEL FUNGChairman Medical BoardInstitute of Mental Health/ Woodbridge Hospital

MS CHAN SOO CHUNGExecutive DirectorNational Healthcare Group Pharmacy

A/PROF TAI HWEI YEEGroup Chief Quality OfficerNational Healthcare Group

DR ERIC WONGGroup Chief Medical Informatics OfficerNational Healthcare Group

A/PROF NICHOLAS CHEWGroup Chief Education OfficerNational Healthcare Group

Designated Institutional OfficialNational Healthcare Group

MS LIM SOH HARExecutive DirectorNational Healthcare Group Diagnostics

MR HO KHAI LENGGroup Chief Information OfficerNational Healthcare Group

DR LEW YII JENSenior Director (Clinical Services)National Healthcare Group Polyclinics


Senior Management | 23

STAY HEALTHY•LIVE WELLTAKE CHARGE OF YOUR HEALTH

Professor Philip ChooGroup Chief Executive OfficerNational Healthcare Group

To ensure our future readiness, NHG will continue to engage, educate and empower our staff, our patients and their families, and the community to take ownership of their health and live well.

Convenience foods, sedentary lifestyles, lack of exercise and ageing have contributed to unprecedented levels of chronic disease in Singapore. NHG has long advocated the importance of an integrated approach to healthcare and the need for appropriate changes in one’s behaviour, lifestyle and habits to sustain good health management and to keep well.

However, the absence of illness is not health. The promotion of wellness requires an engaged population, where individuals are equipped with the knowledge and know-how to take ownership of their health. Healthcare providers are now taking on the role of wellness ambassadors, to educate and empower the population. The goal is to engage our patients, empower them to make wise health decisions, and to modify their behavioural habits to achieve better and longer-lasting health outcomes.

Ownership also means getting patients and families more involved in the decision-making process regarding their healthcare. More support networks are needed to help patients and families make more informed choices on how they would envisage their care journey from cradle to grave.

For healthcare workers, ownership of care encompasses professionalism, patient care and patient safety. Interactions with patients are grounded in respect, communication and commitment. With a healthcare system that is person-centred and relationship-based, we seek to establish deeper trust with our patients and deliver the appropriate care that they need at the right place, at the right time.

Ownership also means getting patients andfamilies more involved in the decision-making process regarding their healthcare.

STAY HEALTHY• LIVE WELL

26 | Stay Healthy • Live Well

BETTER PEOPLE, BETTER CARE To drive positive change in the general population, we must first catalyse change within our organisation. In 2016, NHG launched its Stars For Health – S.H.I.N.E initiative to encourage staff to take charge of their own health.

Interactive activities, talks to promote physical, psychological and social wellness by experts and doctors, and various fitness and lifestyle interest groups provide staff with ample opportunities to stay healthy. Based on the overarching theme of "Keep Healthy, Live Well", NHG Group Corporate Communications also published a cookbook Everyday Cooking: Eat Well, Live Well featuring recipes contributed by staff from NHG and its institutions to champion healthier meals that are simple, and affordable for staff, by staff, and for our healthcare partners, our loved ones and families.

In December 2015, the National Healthcare Group Polyclinics (NHGP) collaborated with the Health Promotion Board (HPB) to organise the NHGP Steps Challenge. Staff at their respective polyclinics wore step trackers and clocked

as many steps as possible to stay active. 74,013,778 steps were recorded by NHGP staff during that period. Division Heads at NHGP also led exercise sessions that were focused on heart health in July 2015 and February 2016, to build a culture of accessible and regular exercise among employees. For its dedicated efforts in its Workplace Health Promotion (WHP) programmes, NHGP received the Singapore HEALTH (Helping Employees Achieve Life-Time Health) Award – Platinum in March 2014 from HPB.


Stay Healthy • Live Well | 27

STARTING EARLYChildhood obesity is on the rise. According to the Ministry of Education, 12 per cent of school children in Singapore were considered obese in 2014, up from 11 per cent the year before. Growing obesity rates will in turn lead to an increasing prevalence of diabetes and other chronic diseases. It is therefore critical for students to learn about chronic health conditions, prevention and detection from an early age.

To address the rising rate of obesity among children, NHG piloted a programme titled 'Shaping a Healthy Future'. The programme was attended by students from primary and secondary schools, and featured design thinking projects aimed at providing participants with a better understanding of obesity-related issues. Students were also encouraged to come up with creative ideas and solutions to tackle this prevalent health problem, some of which NHG may implement in the community or other schools in the Central Region.

BETTER MANAGEMENT OF CHRONIC ILLNESSES Studies have shown that a significant proportion of our population is living with chronic diseases. To help them manage their conditions more effectively, we need to adapt our healthcare system to their needs. This affects where and how we work with our patients who have illnesses, and how we get them participative and invested in their care process.

Singapore has one of the highest rates of Lower Extremity Amputation (LEA) for patients with diabetes in the world. Four amputations are done every day in public hospitals. According to a 10-year study conducted by NHG’s Health Services and Outcomes Research (HSOR) department, one in five patients with diabetes (22 per cent) who underwent LEA died within a year due to multiple complications.

Our population is growing and ageing. We have illnesses from increasingly unhealthy lifestyles that eventually become chronic diseases, so the way in which we deliver healthcare needs to change. Medicine is no longer just about diagnosis, prescription and cure. It is about forging relationships with our population to better understand their physical, psychological, and social needs. We must motivate them to take ownership of their health, and to live and stay well.Professor Philip ChooGroup CEONational Healthcare Group

28 | Stay Healthy • Live Well

The study involved 2,170 patients from Tan Tock Seng Hospital, with an average age of about 64. As 85 per cent of all major amputations are preceded by foot ulcers, seeking treatment early will help to increase the chances of saving limbs. Thus, it is critical to drive home the importance of regular foot screening for patients with diabetes, and to advocate preventive care to those who are still well.

Services at NHG’s first mobile Community Health Centre (CHC) began in November 2014, where some 50 General Practitioners (GPs) in the Central Region have engaged them to complement the care they provide to patients with diabetes. More than 450 patients have benefitted from its services, which include diabetic retinal photography, diabetic foot screening, dietary counselling and blood glucose monitoring. With the CHC making monthly stops at over 20 locations – community clubs and public car parks within the vicinity of HDB flats, and GP clinics – elderly patients can now easily access the medical services they need.

COLLABORATIVE CARE IN THE COMMUNITYTo provide more seamless, and integrated care to our population, we have tapped on our community partners and their healthcare and social care services to address the needs of our patients outside hospitals.

One example is the NHG 'Neighbours' initiative, where our healthcare professionals work with volunteers and community partners in the neighbourhood to assist frail elderly residents in the Central Region to navigate the healthcare ecosystem and access the social support they require. NHG partnered South East Community Development Council on a volunteer recruitment drive in June 2015 and has trained some 20 volunteers living in MacPherson. We are reaching out to more than 90 vulnerable elderly living in that neighbourhood through this volunteer network, and hope to slow down disease progression by addressing more facets of their care needs. The more equipped and empowered our partners are, the better the care for our patients. It is crucial to develop a collaborative culture of sharing and to support the work of our community partners. This way, we seek to effectively enable the frail and ill to age gracefully at home and in the community. This also allows us to provide holistic, coordinated care to our patients at the right place.


Stay Healthy • Live Well | 29

POPULATION HEALTH PREVENTION • EDUCATION • EARLY DETECTION

Mr Gan Kim YongMinister for Health

We need to shift beyond delivering good healthcare towards promoting good health so as to keep our people healthy. We should aim to start young by helping our children and youth develop healthy habits.

POPULATION HEALTH

As a Regional Health System (RHS), NHG undertakes ownership and responsibility to improve the health of 1.4 million people in the Central Region. Ongoing efforts are being made to strengthen primary care, develop more public-private-community partnerships and foster collaboration among the different healthcare clusters. We are working rigorously to expand upstream into pre-emptive care and downstream into community-based rehabilitation and active maintenance care. Together with our community partners, we advocate education to empower our patients and their caregivers so that they are able to achieve good health and better care outcomes for themselves at various stages of their lives.

FOSTERING RELATIONSHIPSNHG is working with community partners in the Central Region to promote collaborative care between the healthcare system, social service and community care providers. This effort to foster relationships with partners has started as we anticipate a growing number of elderly living with multiple chronic diseases, with low or no income and without caregiver support. These are seniors who tend to be re-admitted frequently to acute hospitals.

Well-coordinated bio-psycho-social-functional care in the community helps frail seniors live better, as their needs cut across many community care providers’ service boundaries. To catalyse this move, NHG’s Central Regional Health Office (CRHO), together with its network of partners in different zones, co-organise quarterly networking events for the community organisations in all nine planning areas in the Central Region. These events help build relationships, improve literacy of services among providers, nurture trust and further actions taken by the partners.

32 | Population Health

NHG collaborates with partners to provide support in the community.

BUILDING HEALTHY COMMUNITIES A rapidly ageing population brings with it a growing chronic disease burden and corresponding increase in demand for healthcare services. To slow disease progression and maintain the overall well-being of our population, our key focus must shift from illness care to preventive care and healthy living – this requires the support of community resources and partners to develop a strong ecosystem for health, social and mental well-being.

NHG aims to reignite the ‘kampung spirit’ by initiating more community-based programmes with volunteers and residents to care for one another in the community. These include identifying health advocates to encourage peers to take greater ownership of their health. They also lead and facilitate support or interest groups, and health-related workshops. To support its community education programme, NHG introduced training workshops for potential health leaders in May 2016. This included the ‘Engage in Life’ workshop where participants learnt more about mental and physical health, social networking, home safety and common medical conditions that seniors may have. Twelve health leaders have since been trained.

NHG CONDUCTS GENERAL HEALTH SURVEY IN SINGAPORE In November 2015, NHG launched a three-year Population Health Survey to reach over 7,200 residents in two phases. The study is a vital first step in establishing a baseline of the general health status of an average Singaporean living in the Central Region.

Researchers from the NHG Health Services and Outcomes Research (HSOR) department will use data collected in Phase 1 to establish a Population Health Index as an indicator of the physical, mental and social health status of the population. The information will help healthcare providers design more effective and strategic programmes to improve health in the community. Phase 2 aims to establish normative Population Health Index scores.


Population Health | 33

NEIGHBOURLY CARE FOR VULNERABLE ELDERLY In March 2016, NHG, Eastern Health Alliance (EHA) and South East Community Development Council (South East CDC) announced plans to expand the “Neighbours for Active Living” (‘Neighbours’) programme across Eastern and Central Singapore. The partnership was launched at the ‘Neighbours’ Volunteers’ Appreciation Event, which was graced by the Guest-of-Honour, Emeritus Senior Minister, Mr Goh Chok Tong.

NHG started the programme in MacPherson and Braddell Heights, with plans to eventually reach about 2,000 patients in the Central Region. Recruitment and training for some 20 volunteers living in MacPherson started in June 2015. Since then, the programme has helped about 90 vulnerable elderly living in the community.

The initiative was pioneered by EHA and South East CDC, and comprised volunteers working with a community care team to look after frequent hospital admitters — frail elderly residents with complex medical and social needs.

NHG VOLUNTEERS NIGHT 2015NHG Volunteers Night 2015 was held in October at NHG HQ to thank volunteers for their efforts in community outreach through Community Health Screening and the Central Regional Needs Assessment (CRNA) programme. Their involvement included surveying close to 1,000 CRNA residents and some 2,700 residents who participated in community health screenings, and visiting some 3,000 rental flat units within the Central Region from June 2014 to September 2015. The event, organised by NHG Central Regional Health Office, also sought to strengthen relationships and inspire more collaborations between NHG, community partners and volunteers.

Mr Linus Tham, Group Chief Corporate Development Officer, NHG, with volunteers at

NHG Volunteers Night 2015


HEALTHCITY DAY 2015 In November 2015, partners of HealthCity Novena gathered at Tan Tock Seng Hospital (TTSH) to celebrate the annual HealthCity Day. The theme of the exhibition "Smart, Connected and Green - Healthcare of Tomorrow" showcased the technology elements of the upcoming development. There were updates on the 17-hectare integrated HealthCity Novena, which will care for the sick. When established, residents in the area will also be able to use its communal spaces and facilities to stay healthy. Partners present that day included NHG, TTSH, National Skin Centre (NSC), Ren Ci Hospital, Lee Kong Chian School of Medicine, Dover Park Hospice and National Neuroscience Institute.

NHG 'Neighbours' was pioneered by EHA and South East CDC, and comprised volunteers working with a community care team to look after frequent hospital admitters — frail elderly residents with complex medical and social needs.

NHG Family and partners celebrate HealthCity Day.

A population is only healthy if they have good physical, mental, and social health. A hospital and its clinics alone cannot achieve this. What we intend to do is to move beyond the walls of our hospitals and our clinics, and go out into the community and integrate the whole community into one system where we provide services that address prevention, early detection, care for acute illness and continuing care. Every unit in the healthcare ecosystem – be it restructured hospitals, community care providers, voluntary welfare organisations or social service agencies – needs to work together with its counterparts closely. If we want to achieve a healthy population, we cannot do healthcare in silos.Associate Professor Chua Hong ChoonDeputy Group CEO (Clinical)National Healthcare Group; andCEOInstitute of Mental Health



STRENGTHENING THE FAMILY MEDICINE CLINIC NETWORK ANG MO KIO FAMILY MEDICINE CLINIC NOW UNDER PARKWAY SHENTON In March 2016, NHG handed over daily operations of the Ang Mo Kio Family Medicine Clinic (AMK FMC) to Parkway Shenton, a private operator. The handover caps the successful public-private collaboration between the two healthcare providers. As of March 2016, over 8,800 patients from the National Healthcare Group Polyclinics' (NHGP) Ang Mo Kio Polyclinic opted to receive healthcare at AMK FMC.

AMK FMC was set up in partnership with Parkway Shenton in 2013 to cater to the rising demand for chronic disease care in the area. As part of the Ministry of Health’s (MOH) Primary Care Master Plan, it aimed to combine the strength and experience of the public healthcare sector, such as care protocols and team-based care, with the capacity and capabilities of private healthcare providers, to provide quality care to residents living in Ang Mo Kio. Patients can be seen by the same doctor and medical team who are familiar with their medical history. They will also receive care that goes beyond medical and clinical care, such as dietetic services.

Patients can be seen by the same doctor and medical team who are familiar with their medical history. They will also receive care that goes beyond medical and clinical care, such as dietetic services.

NHG OPENS THIRD FAMILY MEDICINE CLINIC Hougang Family Medicine Clinic @ Ci Yuan Community Club was officially opened by Prime Minister Lee Hsien Loong in September 2015. The FMC is NHG’s third such clinic and represents another step in NHG’s primary care transformation journey. Located near Hougang Polyclinic, the clinic will boost existing primary care capabilities in the community to meet the healthcare needs of residents. In addition to providing diabetes retinal and foot screening, Hougang FMC also offers patients without medical records pre-consult surveys to identify those at risk and those who are well. Health screenings will be offered to at-risk patients, which help in early detection and intervention.

PM Lee at the opening of Hougang Family Medicine Clinic @ Ci Yuan Community Club

The handover ceremony reiterates the successful public-private collaboration between NHG and Parkway Shenton.


Engage • Educate • Empower

TTSH AND NHGP PROVIDE BETTER DEMENTIA CARE IN THE COMMUNITY TTSH announced the Geriatric Integrated Network for Dementia (GerIND) at its annual World Alzheimer’s Week event in September 2015, a network which aims to increase the accessibility of dementia care services across various healthcare settings. GerIND drives collaborative partnerships among like-minded organisations in the Central Region and facilitates training and capability building for community-based healthcare professionals, key partners in the medical and social sectors including NHGP, General Practitioners (GPs) in the Central Region, Care for the Elderly Foundation (CEF), and the Agency for Integrated Care (AIC).

GerIND began as a partnership with NHGP, which piloted a new multidisciplinary model of shared care in the community. The AMK NHGP Dementia Clinic opened at AMK Polyclinic in 2012 to provide accessible follow-up care for patients with dementia and to offer support for caregivers in the community. Patients suitable to be cared for in the community are discharged from the hospital to the AMK NHGP Dementia Clinic, where they receive holistic care from a team of doctors, nurses and Allied Health Professionals, such as social workers and psychologists.

AMK Polyclinic doctors can also refer patients directly to the AMK NHGP Dementia Clinic for assessment, allowing patients to be seen within a familiar, more convenient environment. These initiatives are leading the way toward greater dementia care capacity across both tertiary and primary care settings.

Interim results of a study by NHG’s HSOR showed that patients discharged from TTSH to the AMK NHGP Dementia Clinic required fewer hospital visits, with savings in direct medical costs, day care, and indirect costs like time spent by caregivers. Caregivers also reported significantly less stress with community support.


IMH LAUNCHES ASCAT@CENTRAL To enable greater access to holistic and person-centred mental health interventions in the Central Region, the Institute of Mental Health (IMH) introduced the Assessment and Shared Care Team (ASCAT)@Central in October 2015. ASCAT@Central, which is run by a specialist-led, multidisciplinary team, comprises clinical service provision, partner training and engagement, and aftercare services.

The service manages patients with mild to moderate mental health conditions, such as depression and anxiety disorders, in the community. It also treats stable patients with more serious mental health conditions such as schizophrenia and bipolar disorder. The clinical service has assisted over 200 patients in their journey to recovery since October 2015 by working closely with primary healthcare providers such as polyclinics and GPs.

Other than referrals from the four Central Region polyclinics (Hougang, Toa Payoh, Sengkang, and Ang Mo Kio), ASCAT@Central

has also engaged Unity Family Medical Centre and Ang Mo Kio Family Service Centre (AMKFSC). Training workshops and case conferences were also organised to better equip community partners to care for those with mental illness in the community.

IMH has enhanced its aftercare services to optimise functioning and well-being of patients already engaged in treatment. Under the Aftercare programme, a pilot launched in October 2015, identified patients will receive intensive case management, which includes having a single-point of contact, home-based monitoring and case-tracking.

The Aftercare team will work with community partners such as AMKFSC, Singapore Association for Mental Health and O’Joy Care Services to deliver care closer to the patients’ home. Four areas are under the programme: Kembangan-Chai Chee; Ang Mo Kio-Bishan (including Sin Ming); MacPherson; and Moulmein-Kallang.

IMH's ASCAT@Central service manages patients with mild to moderate mental health conditions, such as depression and anxiety disorders, in the community.



BETTER SKIN HEALTH FOR THE COMMUNITY NSC PARTNERS APEX HARMONY LODGE TO IMPROVE SKINCARE FOR RESIDENTSDermatological conditions are common in the elderly, who have more sensitive skin. Elderly, bed-bound residents in nursing homes are also susceptible to bed sores. Equipping staff with basic skin care techniques can help improve the quality of life for residents significantly. Following the success of the first collaboration with Lions Home for the Elderly in 2014, NSC has partnered Apex Harmony Lodge (AHL), a purpose-built nursing home for residents with dementia, to improve skin care for its residents. Since July 2015, NSC nurses have conducted monthly sessions to educate AHL staff and residents on skin assessment and care planning. AHL staff learn basic dermatological care to enable them to address the residents’ skin care needs appropriately. The initiative has paid off as the skin conditions of residents have improved.

Tele-DERM enables physician-to-physician telecommunication between NSC and polyclinics.

NSC LAUNCHES TELE-DERM SERVICE In January 2016, NSC piloted the Tele-DERM service with NHGP. First launched in Hougang Polyclinic, Tele-DERM enables physician-to-physician telecommunication between NSC and polyclinics to reduce the number of unwarranted referrals. With this e-consultation service, polyclinic doctors are able to discuss skin care cases with the assigned dermatologist during the clinic’s operating hours, as well as treatment options for patients. If an in-depth assessment is required, photos of the patient’s condition are shared with the dermatologist. This triaging allows patients with simple skin problems to continue their treatment at the polyclinics, reducing unnecessary visits to the Specialist Outpatient Clinics, while referring only those with complex skin conditions to NSC.


SUPPORTING PRIMARY CARE TRANSFORMATIONNHG Pharmacy has been collaborating with NHGP, TTSH and GPs to provide Community Health Assistance Scheme (CHAS) patients with convenient and timely access to subsidised medication. Prescribed medications are packed and delivered to these patients who can then benefit from continuing care by their neighbourhood GP, and enjoy lower cost of medication.

Prescribed medications are packed and delivered to CHAS patients who can then benefit from continuing care by their neighbourhood GP, and enjoy lower cost of medication.

IMPROVING ACCESS TO SUBSIDISED MEDICATION FOR NURSING HOMES AND HOME CARE PROVIDERS The new Drug Subsidy Scheme for the community care sector began in January 2015. Caregivers of eligible patients at MOH-approved nursing homes or home care providers are now able to obtain a subsidy when getting their prescriptions at NHG Pharmacy, located within the NHG polyclinics and the NHG PSC at IMH. Some 7,000 patients have benefitted from the easier access to more affordable medication.

NHG PHARMACY SERVICES CENTRE EXPANDS CAPACITY In September 2015, the NHG Pharmacy Services Centre (PSC) relocated to another site within IMH premises. Twice the size of its previous facility, the PSC was expanded to meet increased demand for its services. The facility now houses five Automated Tablet Dispensing and Packing System (ATDPS) and two Automated Medication Inspection System (AMIS). PSC currently provides multi-dose packaging (ConviDose™) and medication management services to 21 nursing homes and IMH long-stay wards. It also extended medication supply services to 20 homes under the Ministry of Social and Family Development (MSF) and MOH.



RAISING EFFICIENCY IN DIAGNOSTIC TESTING FOR BETTER POPULATION HEATHNHGD BOOSTS NATIONAL ELECTRONIC HEALTH RECORD (NEHR)Since May 2015, NHG Diagnostics (NHGD) has made available non-NHG patients’ diagnostic results through the web-based NEHR system. This is in support of Singapore’s Strategic Vision of “One Patient, One Health Record”. Healthcare partners such as GPs, FMCs and community hospitals can access results beyond office settings and more quickly. This has reduced the need for patients to take the same test at multiple clinics, saving them time and cost.

Since May 2015, NHG Diagnostics (NHGD) has made available non-NHG patients’ diagnostic results through the web-based National Electronic Health Record (NEHR) system. This is in support of Singapore’s Strategic Vision of “One Patient, One Health Record”.

RIGHT-SITING OF CARE IN THE COMMUNITYIMH is NHGD's fourth referral centre for mobile Bone Mineral Densitometry (BMD) service. Besides AMK Community Hospital, Jurong and Woodlands Polyclinics for referrals from primary care and community hospitals, the Mobile BMD at IMH provides convenient screenings for IMH patients as well as screenings for patients from clinics and nursing homes in the vicinity.

EQUIPPING COMMUNITY PARTNERS WITH QUALITY TOOLS Capability building and having a good understanding of quality principles and methods are essential to driving change and developing a culture for improvement. To advocate these values in the community, the Performance Improvement (PI) unit at NHG’s Group Quality Resource Management (GQRM) held Quality Improvement (QI) Toolkit and Patient Safety (PS) courses for partners engaged in centre-based learning, in nursing homes, and senior care centres. As part of a Patient Safety capability building programme under AIC, GQRM also facilitated two QI projects with St Luke’s Eldercare.

PHLEBOTOMY AT HOME NHGD has partnered Thye Hua Kwan Moral Charities (THKMC) to provide phlebotomy for patients cared at their homes, saving THKMC clinical staff the need to make additional home visits for diagnostic testing before the day of consultation. Physicians are also able to get the test results at the patients’ home through the NEHR system.


COMMUNITY CARE CARING FOR EACH OTHER • TOUCHING LIVES

Dr Tang Wern EeConsultant and Family Physician; Head, Clinical Research UnitNational Healthcare Group Polyclinics

I like the diversity, or the cradle-to-grave nature of primary care. Managing patients at different stages of their lives, from newborns to the elderly, gives me the opportunity to see life in its entirety.

COMMUNITY CARE

NHG’s new model of care focuses on wellness rather than illness care, entailing a closer relationship between the healthcare system and patients. Our efforts seek to empower our population to take greater ownership of their health, supporting them in living well and receiving care at the right place and at the appropriate time.

The Central Region has more than 1.4 million residents with 15 per cent of its population over the age of 65 – making this region the fastest-ageing in Singapore. A higher prevalence of co-morbid chronic diseases has made the shift from episodic to sustainable and integrated care more pressing.

NHG’s new model of care focuses on wellness rather than illness care, entailing a closer relationship between the healthcare system and patients. Our efforts seek to empower our population to take greater ownership of their health, supporting them in living well and receiving care at the right place and at the appropriate time. We have gone beyond the “walls” of our hospitals and clinics to connect the whole community into our Regional Health System (RHS), an ecosystem where we advocate and provide services that address education, prevention, early detection, care for acute illness and continuing care.

Such work necessitates close collaboration with stakeholders, community advisors, voluntary welfare organisations and community partners in this Care Network. It also places our patients, their families and caregivers at the centre of our integrated care services and programmes that help in Adding Years of Healthy Life to our population.

ENGAGING THE POPULATION FOR SUSTAINABLE HEALTHCARE NHG has been developing programmes and initiatives that promote better health across ages, health status, and socio-economic levels.

CENTRAL REGIONAL NEEDS ASSESSMENT (CRNA) PROGRAMMEStudies have shown that individuals in the lower socio-economic tiers of society have poorer awareness and management of chronic illnesses. The studies also suggest that social and financial factors compound medical conditions among these individuals. To provide person-centred care to these individuals, NHG launched the CRNA programme in 2014.

The CRNA programme aims to develop a range of coordinated health and social interventions, tailored to the needs of the Central Region focusing on the elderly and those in the lower socio-economic strata. To date, CRNA has reached out to about 5,000 rental block units and engaged more than 1,400 residents through:

NHG brings health screening to the community.

46 | Community Care

› Door-to-Door InterviewsThis personal approach has helped NHG and its community partners connect with and influence isolated and/or unmotivated residents to become active owners of their health by assessing their health, social, mental, and economic lifestyle holistically.

› Post-Care and InterventionsFollowing the door-to-door visits, NHG and its community partners provide free health screenings to eligible residents. They are further assessed by NHG’s Community Case Facilitators (CCF) for specific care needs, and a host of targeted health and social services are identified to ensure that the residents receive sustained care.

› Care at DoorstepA key aspect of CRNA is working closely with NHG’s partners to bring care closer to the population we serve.

The Enhance Care Clinic (ECC), for instance, is an interim clinic which taps on General Practitioners (GPs) in the Central Region to confirm test and assessment results of residents found with cardiovascular conditions during our health screenings. The ECC will then manage the care of these residents or refer them to appropriate follow-up care.

Besides the ECC, the NHG Geriatrics Mobile Clinic (GMC) has a team of geriatricians and Allied Health Professionals from Tan Tock Seng Hospital (TTSH) to help manage the functional needs of residents through basic geriatric assessments, nurse-led counselling, occupational therapy services at home, and active ageing programmes such as 'Stepping into Active Life'. GMC also does right-siting assessments so that residents can continue to receive care.

CRNA OUTREACH AND

INTERVENTION PROCESS

Identify rental blocks/ Collaboration

with on-site grassroots/ partners

On-site Health Screenings

(Cardiovascular S+ Functional S)

Interim Clinics — Enhance Care Clinic

& Geriatric Medical Clinic

Continuous Monitoring & Long Term intervention

care plans

Door-to-Door case findings by Volunteers

Endorsement by local MP advisor/

Mailing of letters to inform residents


Community Care | 47

SHAPING A HEALTHY FUTUREIn January 2016, NHG piloted a programme called ‘Shaping a Healthy Future’ to empower the younger generation to take ownership of their health by focusing on wellness care. A total of 55 primary and secondary school students from the Central Region participated in NHG’s three design thinking workshops conducted between January and April 2016. They were challenged to ‘think-out-of-the-box’ and to come up with innovative solutions to stem rising obesity rates among children in Singapore. The students shared that they gained a better understanding of obesity, and were excited in offering ideas to tackle the issues.

NHG has tested a number of the students’ proposals on a small scale, in school or at home, and will consider adopting the more feasible ideas for implementation in the community.

This pilot programme complements the current health promotion and education initiatives of the Health Promotion Board (HPB) and the Ministry of Education (MOE).

Primary school students brainstorm for solutions to curb obesity rates in Singapore.

WIDENING THE CARE NETWORKWith the new polyclinic due to open its doors in 2017, National Healthcare Group Polyclinics (NHGP) has been proactively engaging residents, schools and other organisations in the Pioneer constituency through activities to help them live healthy and stay well. In March 2015, NHGP held an art competition themed "Healthy Mind, Healthy Body" at Jurong West Primary School. Students learnt about primary care services from healthcare professionals, while NHGP gathered feedback on care concerns. With the knowledge gained, NHGP will continually improve on its healthcare services to better suit the care needs of residents. This is part of NHGP’s ongoing efforts to engage stakeholders in the community to promote healthy living for a sustainable, relationship-based healthcare system.

We are faced with a rapidly ageing population with multiple chronic medical conditions, and the hospitals’ Specialist Outpatient Clinics (SOCs) cannot manage their care needs alone. So patients who have had their medical conditions stabilised can be right-sited for continuing care. Such right-siting programmes serve to foster closer relationships with our General Practitioners (GPs) and other service providers in the community.Associate Professor John AbisheganadenClinical DirectorCommunity Right-Siting Programme Tan Tock Seng Hospital

48 | Community Care

EMPOWERING THE COMMUNITY WITH HEALTH RESOURCES AND INFORMATIONThe NHG Family disseminates information through publications, public talks, road shows and interactive campaigns to empower the community to manage their health better.

WORKING WITH YOUTH TO PROMOTE MENTAL HEALTH AWARENESS IN THE COMMUNITY The Community Health Assessment Team (CHAT) at the Institute of Mental Health (IMH) has been actively engaging young people through several initiatives to heighten their awareness of mental health and wellness.

› In(VISIBLE)CHAT created an interactive, multi-sensory theatre show called In(VISIBLE) in collaboration with students from the Applied Drama and Psychology department of Singapore Polytechnic. Held in February 2016 at *SCAPE, it put the spotlight on three common mental health concerns of youths – depression, anxiety and psychosis. More than 200 people attended the event, found out more about these conditions, and participated in a panel discussion with youth workers from CHAT and youth mental health advocates.

BATTLING ADDICTIONIMH’s National Addictions Management Service (NAMS) rolled out several engagement platforms and initiatives to raise awareness of addictions, and strengthen the community network to provide care and support for persons with addiction issues.

› Addiction Recovery College In November 2015, NAMS set up an education arm, the Addiction Recovery College (ARC), to organise workshops and courses for patients, caregivers and professionals dealing with addiction. With an environment that is conducive to learning about prevention, treatment, and proactive wellness, ARC provides patients and their caregivers with tools to recover from addiction.

› OverCome(D)CHAT partnered students from the Nanyang Technological University (NTU)’s Wee Kim Wee School of Communication and Information on an awareness campaign for Obsessive-Compulsive Disorder (OCD) titled ‘OverCome(D)’. Running from January to March 2016, the campaign included interactive road shows at Temasek Polytechnic, NTU, National University of Singapore (NUS) and *SCAPE, to debunk common misconceptions about OCD. Games that simulate the experience of people with OCD gave participants first-hand understanding of the condition. The campaign ended with a free screening of the award-winning movie As Good As It Gets, which features a character with OCD living in the community.

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The NHG Family disseminates information through publications, public talks, road shows and interactive campaigns to empower the community to manage their health better.

› National Addictions Awareness DayThe third annual National Addictions Awareness Day (NAAD) was held in November 2015. The event themed, "Together for the Better", was jointly organised by NAMS, North West Community Development Council (North West CDC), and Khoo Teck Puat Hospital (KTPH). The event educated residents in the north-western part of Singapore on different types of addiction, preventive measures and treatment, as well as the various platforms to seek help.

HEALTH PROMOTION BY NHG PHARMACY

› Launch of a Booklet on HypertensionIn January 2016, NHG Pharmacy (NHGPh) launched a Hypertension booklet titled Can your heart handle the pressure? Jointly produced by NHGPh, NHGP and the NHG Health Promotion department, the booklet, available in Mandarin and English, gives hypertension patients and their caregivers useful tips on self-management of hypertension.

› World Diabetes Day Talk In conjunction with World Diabetes Day on 14 November 2015, NHGPh, NHGP and the Active Ageing Council at Nee Soon South jointly organised an event centred on diabetes education titled "A Sweet Talk". Targeted at those at risk or with diabetes, and their caregivers, the event aimed to help them understand causes of the disease and how it can be managed through health talks and diabetic health screenings.

› Health Talks at PolyclinicsThe health talks organised by NHGPh at NHG Polyclinics since 2013 have continued to draw good crowds. In 2015, a total of 340 people attended the talks and learnt more about common ailments and ways to manage them. 96 per cent of the feedback received showed that the talks had helped deepen participants’ understanding of their medication.

› Eat Healthy + Live Happy CampaignTo encourage the public adopt healthy eating habits, NHGPh and NHGP, jointly launched the 'Eat Healthy + Live Happy' campaign. The use of tags indicating the nutritional value of food products, and information cards placed visibly on the retail pharmacy shelves helped the public to learn more and make healthier food choices.


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EARLY DETECTION TO PREVENT DISEASE NHG and its institutions are continually working to encourage people to go for health screenings to help detect potential medical conditions early. Better health literacy is an important means to sustain care and achieve best health outcomes. To this end, NHG has taken steps to make health screenings more accessible and affordable for its population.

CORONARY RISK SCREENING INITIATIVE NHGP collaborated with the National University Health System (NUHS) to launch the Coronary Risk Screening (CRS) initiative at all our polyclinics. Under the CRS initiative, patients identified with significant health risks such as smoking, obesity, pre-diabetes, hypertension and hyperlipidaemia are offered targeted interventions and follow-up care.

From April 2015 to March 2016, 12,458 patients were screened in our polyclinics. Almost 40 per cent of them were newly diagnosed with hypertension, diabetes, and hyperlipidaemia, and were referred to their preferred doctor – either private GPs or NHGP – for medical follow-ups. Sixty-three per cent had health issues related to obesity or smoking. Together with HPB and People's Association (PA), NHGP offered these individuals weight management and smoking cessation programmes, and encouraged them to join in healthy activities such as brisk-walking and line-dancing.

CANCER SCREENING IN THE COMMUNITY

› Inter-Agency Collaboration to Provide Screening for Low Income Families In celebration of SG50, NHGP collaborated with HPB and Singapore Cancer Society (SCS) on the Health Screening Initiative, which included free colorectal screenings, Pap Smears, and Mammograms, to low income Singaporeans aged between 50 and 69 years old. SingHealth Polyclinics, Parkway Health Radiology, and NHG Diagnostics (NHGD) also participated in this inter-agency initiative.

Primary care is the cornerstone of any robust healthcare system. Family doctors play an important role in managing population health. They are the first contact points for the population and well placed to promote better health choices and prevent disease progression. A well-developed primary care sector that is integrated with our hospitals and our long-term care providers is the way forward to address the needs of the population in the long term.Associate Professor Chong Phui-NahCEONational Healthcare Group Polyclinics

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› NHGD and SCS Extend Partnership NHGD first partnered SCS in 2011 to provide Mammography services to SCS' clients at the 10 NHGD screening centres located in our polyclinics and on the Mammobus.

In 2015, the partnership was enhanced with NHGD supporting the set-up and management of a Mammography service in the SCS Multi-Service Centre in Bishan. Under the extended partnership with SCS, NHGD now provides Faecal Immunochemical Test (FIT) services as part of colorectal cancer screenings, making them more accessible to the public and reminding them that “Early Detection Saves Lives”.

BRINGING CARE BEYOND THE HOSPITALAs we shift from episodic care to integrated and relationship-based care, there is greater impetus to work with partners in the community to meet the complex health and social needs of our population. NHG and its institutions have been engaging Family Service Centres, Voluntary Welfare Organisations, Community Hospitals, Statutory Boards and Government Organisations to bring healthcare to the heart of the community.

TTSH’S BEFRIENDERS PROGRAMMES About 35,000 elderly people live alone in Singapore. To ensure that these seniors continue to receive the care they need upon discharge from the hospital, TTSH launched two volunteer-led programmes:

The Befrienders Programme at TTSH helps patients transit between care settings.

As we shift from episodic care to integrated and relationship-based care, there is greater impetus to work with partners in the community to meet the complex health and social needs of our population.

› Hospital to Home (H2H) The H2H Befrienders Programme has volunteers engage with patients during their stay in the wards, and continue this relationship after patients leave the hospital. Through regular phone calls and home visits, patients’ health conditions are monitored by the volunteers, who also ensure that they keep to their care plan. The relationship established between patients and volunteers promotes social interaction and contributes to patients’ overall well-being.

› Home to Clinic (H2C) The H2C Befrienders Programme supports patients who need help with getting around in the community. Here, volunteers help patients make the trip home upon discharge, partner them in the recovery journey, and ensure that patients go for their follow-up appointments at the clinics.

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TTSH SIGNS MOU WITH SATA COMMHEALTHIn May 2015, TTSH signed a Memorandum of Understanding (MOU) with SATA CommHealth to provide continuing care for patients in the community. Under this MOU, SATA CommHealth will accept direct referrals from TTSH’s home care initiatives, namely Post-Acute Care at Home (PACH) and Virtual Hospital (VH), where patients have had their acute medical conditions stabilised but still require community support or home care.

SATA CommHealth offers nursing services such as wound dressings, medication reconciliation and education, and supply of home care consumables to patients.

COMMUNITY-BASED ADDICTION COUNSELLINGTo extend the reach of its services in the community, NAMS launched two new programmes in partnership with Credit Counselling Singapore (CCS) and Club HEAL, in August and September 2015, respectively. A NAMS counsellor is now based at CCS and Club Heal once a week. The counsellor helps clients with gambling, or other forms of addiction, which contribute to their financial delinquency. Early screening and timely interventions help address the client’s addiction. Clients are then referred back to NAMS to further manage their addiction, where necessary. The NAMS counsellors have seen 66 clients at CCS, and over 20 clients at Club HEAL, since the launch.

IMH’S JOB CLUBRecognising that having a job is an important part of recovery, IMH set up Job Club in 2009 as a one-stop vocational rehabilitation centre to help individuals with psychiatric conditions acquire relevant job skills and connect them to employers in the community. In FY2015, Job Club conducted three workshops for employers and initiated 275 new job placements. It also engaged more than 10 new employers – seven of whom now hire clients from Job Club.

SKIN CARE IN THE COMMUNITY Since May 2015, the National Skin Centre (NSC) has partnered the Central Regional Health Office (CRHO) to provide low income residents greater access to skin care services in the community. NSC set up a skin assessment booth at Lorong Lew Lian and Cheng San Community Club to screen residents for symptoms of skin diseases and arrange for necessary follow-ups at the Polyclinics.

A/Prof Tan Suat Hoon, Director of NSC brings skin care to residents in the community.

TTSH signs MOU with SATA CommHealth to augment care in the community.


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CLINICAL CARE STRONGER RELATIONSHIPS • BETTER CARE

Associate Professor Tan Suat HoonDirectorNational Skin Centre

Patient-centred care is about treating patients with respect, communicating effectively with information that will help them in their healthcare journey, and above all, involving them in their care decisions through patience and compassion. We work actively to replace transactional care with the fundamental bond between the patient and our care team.

CLINICAL CAREAs the Regional Health System (RHS) for the Central Region, NHG is responsible for the health and wellness of 1.4 million residents. Many of them are frail elderly with complex medical and social needs.

In the past year, various NHG initiatives have further integrated care for patients, raised the quality of care given, and resulted in better health outcomes for them.

NEW MODEL OF CARE TTSH’S INTEGRATED HIP FRACTURE PROGRAMMEThe average length of stay for a hip fracture patient at Tan Tock Seng Hospital (TTSH) improved to 10 days in 2015, down from 15 days in 2008, following the roll-out of TTSH’s new Integrated Hip Fracture Programme. Under the programme, geriatricians, surgeons, nurses and care managers work together to develop a holistic care plan for the patient. All aspects of the patient’s needs are looked into – from care options in the acute hospital to rehabilitation at a community hospital, and post-discharge in the community. This seamless transition between care settings enables patients and their caregivers to anticipate and plan ahead for discharge.

FIRST-OF-ITS-KIND TREATMENT FOR CHRONIC PAINAbout 8.7 per cent of Singapore’s population, or 300,000 adults, suffer from chronic pain.

Psychologists from TTSH have developed a first-of-its-kind treatment programme for patients with chronic pain “delivered online”. Senior Psychologist, Yang Su-Yin, developed the iACT-CEL (Internet delivered Acceptance and Commitment Therapy-Connect Engage Live/ I Excel) online programme to include video, audio, and interactive text-based exercises for chronic pain patients. Based on different patients’ learning styles, the format of the programme can be customised. Psychological support is predominantly given over e-mail, and complemented by phone consults. The online treatment programme promotes self-monitoring of pain, ease in learning about treatments and clarifying doubts, and raises patients’ confidence in managing their health.

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TEAM-BASED CARE FOR BETTER MENTAL HEALTH For greater continuity of care and to help patients stay well in the community, the Institute of Mental Health (IMH) developed four multidisciplinary care teams in January 2016 to proactively provide integrated services to patients across the care continuum, from prevention, early detection, and treatment to community care. This empanelment model supports each patient through his or her care journey. New patients are grouped according to their residential address into North, South, East or West zones. For each zone, a team of clinicians, nurses, Allied Health and community mental health professionals, manages the care needs of the patients. This required IMH to streamline its operational workflow and communications processes for the inpatient, outpatient, transitional, community, and Allied Health settings for better care integration. New processes, such as conducting needs analysis for discharged patients and linking them to appropriate care resources and support in the community, are being piloted and fine-tuned before a full roll-out as part of NHG’s right-site care.

CARE REDESIGN PROJECT ON MANAGEMENT OF LONG-STAY PATIENTS About 900 long-stay patients were re-grouped into different wards in IMH between April and July 2015 as part of its efforts to provide greater patient-centred care. The patients were grouped into the following categories based on their acuity and ability levels: those with good prospects for rehabilitation; those with intellectual disabilities; disturbed, aggressive and violent patients; those who are medically frail and dependent; and psychogeriatric patients. The re-grouping has enabled IMH to design more specialised programmes tailored to meet the needs of each group. Patients with high rehabilitative potential will, for example, undergo a slow-stream rehabilitation programme, which is an extended programme aimed at improving function levels for the transition to living at home. Geriatric patients and patients who are medically frail and dependent will receive more nursing care.

Our care teams seek to understand patients’ medical and psychosocial backgrounds to better customise care plans to meet their needs. With the benefit of stronger relationships between patients and their care teams, health promotion, disease prevention, and patient empowerment can be further enhanced.Dr David TanDeputy HeadJurong Polyclinic; and Designated HeadPioneer Polyclinic


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TEAM-BASED CARE FOR CHRONIC ILLNESS In 2014, the National Healthcare Group Polyclinics (NHGP) introduced a patient-centred care model as a pilot project at Toa Payoh Polyclinic. Chronically ill patients who required regular follow-ups were empanelled into a ‘teamlet’ so that they received care from a team of Family Physicians (FPs), Care Managers (CMs) and Care Coordinators (CCs). These teamlets provided proactive and holistic care based on the patients’ individual needs, resulting in not only better clinical outcomes for patients, but improved staff and patient satisfaction. At the end of the first year of the pilot, patients rated their satisfaction level for care higher by a factor of 14.5 per cent. They also felt that they took greater ownership of their health, with patient empowerment increasing by 18.7 per cent.

The care team itself benefitted from this new care model because of the professional support given to each other which allowed for greater accountability and more cross-disciplinary learning. Continuous engagement with the patients resulted in a deeper understanding of their care needs.

With the success of the pilot, NHGP has rolled out this model of empanelment under teamlets to all nine polyclinics as of March 2016. Training of clinic heads and members, and adaptation of polyclinic layouts to facilitate team-based care delivery will further serve to standardise the practice of team-based care at all polyclinics under NHGP.

QUALITY IMPROVEMENT FOR BETTER CARE The NHG Clinical Practice Improvement Programme (CPIP) marks its 15th year in 2016. What started as a programme to educate senior physicians in NHG institutions on Quality Improvement concepts and methodology has evolved to include participants from all professional backgrounds and from different healthcare clusters in Singapore.

In 2015, the 35th and 37th CPIP courses had a total of 81 participants, from NHG, National University Hospital (NUH), Khoo Teck Puat Hospital (KTPH), Ng Teng Fong General Hospital (NTFGH), Ang Mo Kio-Thye Hua Kwan Hospital (AMK-THKH), Ren Ci Hospital, and St Andrew’s Community Hospital (SACH). Participants from these two runs completed 62 improvement projects, bringing about improved access to care, more effective care in hospitals and for patients in the community, and a reduction in medication errors.

In Quality, the goal post is always moving – new information, technological advances, changing population health profiles, growing patient expectations are some of the many variables we have to deal with. Although NHG Quality has come a long way in 15 years, I would like to see it go much farther, beyond our cluster to the community at large. We are One Team in caring for our patients.Associate Professor Tai Hwei YeeGroup Chief Quality OfficerNational Healthcare Group

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CHANGING FACE OF SURGERYSurgery is the treatment of choice in early stage lung cancer and has traditionally been performed through a large incision on the side of the chest, resulting in long hospital stays and increased pain for patients. Robot-assisted thoracic surgery presents a welcome change.

Pioneered by Dr Aneez Ahmed, chief of TTSH’s thoracic surgery division, this minimally invasive procedure allows surgeons to perform operations using robotic arms inserted through several small incisions. The robot provides enhanced vision and control and is made up of several components, which include an ergonomically-designed console, four interactive robotic arms and a three-dimensional (3D) high definition vision system. The four interactive robot arms are introduced into the patient’s chest using small incisions, while the surgeon sits at the console and uses finger, eye and foot controls to manipulate the arms of the robot. Patients experience less post-surgery pain, and faster recovery times.

INNOVATION AND TECHNOLOGY IN CLINICAL CAREFALLS PREVENTION WITH NEW TECHNOLOGYTTSH partnered Singapore-based engineering company, CoNEX Systems and Services, in June 2015 to innovate, test and commercialise a bed-fall surveillance/prevention/prediction system through thermal sensing. This system, once fully developed, will help to detect and predict falls before they occur by using sensor networks, thermal imaging and video analytics. The thermal imaging sensor will pick up temperature differences, and with the right video analytics applied, will allow the hospital to detect and pre-determine the patient’s movements, so that nurses can be alerted with early warning signs, thereby increasing patient safety.

NEW TECHNIQUE TO TREAT LIVER CANCER Liver cancer is one of the most common cancers in Singapore. In January 2016, liver specialists at TTSH discovered a better way to treat liver cancer – by adapting a technique used by their colleagues in the heart department.

Chemotherapy and other drugs are usually delivered to the liver through the femoral artery in the groin. The new technique involves inserting a catheter through the radial artery in the wrist. The simple switch means greater comfort for the patient and a reduction in recovery time.

Dr Aneez Ahmed uses robot-assisted thoracic surgery to treat lung cancer.

Asst Prof Pua Uei uses a new technique to treat liver cancer.


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IMPROVED & INTEGRATED FACILITIES AT IMH Two newly refurbished specialised wards for mood disorders and early psychosis were set up for more customised intervention.

MOOD DISORDERS UNIT INPATIENT SERVICEThe Mood Disorders Unit (MDU) was set up in 2013 to provide holistic tertiary care for those with mood disorders, such as major depression and bipolar disorder. A newly refurbished Inpatient Service opened in February 2016 to provide assessment and treatment for complex or severe mood disorders. The new ward with its spacious living area equipped with a kitchen, a night lounge in the dormitory, designated rooms

for therapy activities, as well as garden views, provides a more conducive environment for these patients. The MDU is staffed by a multidisciplinary team of psychiatrists, nurses, case managers, psychologists, medical social workers, pharmacists, occupational therapists and art therapists, all of whom work together to provide the treatment required by this group of patients.

EPIP@20BThe Early Psychosis Intervention Programme’s (EPIP) new inpatient facility, EPIP@20B, became operational in IMH in February 2016. The 20-bed, mixed gender facility complements EPIP’s efforts to manage individuals, aged 16 to 40, with early psychosis and those at high risk of developing psychosis in inpatient, outpatient and community settings. To ensure that the ward meets their needs and expectations, the team sought feedback from patients and caregivers in the development of the ward and its services. Special features such as a home-like environment with an open pantry, a night lounge, and an outdoor garden were created to facilitate therapeutic work and recovery. In addition to the ward’s programmes, peer support specialists help to run activities, such as art and craft sessions and group discussions, to better engage patients, lend a listening ear, and partner them in their journey to recovery.

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NHGP has been very supportive of MOH’s move to increase Primary Care capacity. Building a new polyclinic at Pioneer and redeveloping our polyclinics at Yishun and Ang Mo Kio are part of efforts to boost the Primary Care infrastructure in Singapore. At the same time, we have leveraged on technology to offer our patients more convenient access to care, for example through our tele-care initiative, online appointment system, and self-pay kiosks. Through such multi-pronged strategies to deliver accessible and affordable care, NHGP will continue to effectively manage the increasing demands on healthcare by an ageing population.Associate Professor Chong Phui-NahCEONational Healthcare Group Polyclinics

NEUROSTIMULATION SERVICEIn November 2015, IMH set up the Neurostimulation Service to bring the Electroconvulsive Therapy (ECT) and the recently introduced Repetitive Transcranial Magnetic Stimulation (rTMS) services together.

ECT is a fast and effective short-term treatment for depression, mania and schizophrenia, with IMH administering over 2,000 ECT treatments a year for about 400 patients. After a pilot study in the first half of 2015, IMH developed a core group of highly trained doctors, nurses and anaesthetists for the ECT services. Based on an ECT plan formulated for each individual, the specialised ECT team is able to provide quality care consistently, and achieve better care outcomes for patients.

rTMS, a new service, uses strong magnetic pulses to stimulate specific parts of the brain to treat depression. IMH introduced the service in November 2015 for patients who did not respond well to standard anti-depressant therapy.

REVAMPING OF FACILITIES AT NHGPNHGP has started working with the Ministry of Health (MOH) and Ministry of Health Holdings (MOHH) to redevelop Ang Mo Kio and Yishun Polyclinics. This redevelopment is part of MOH’s Healthcare 2020 Masterplan to expand healthcare capacity to meet the needs of Singapore’s growing and rapidly ageing population.

The design of the polyclinics has incorporated feedback from residents and grassroots leaders like having more consultation rooms to accommodate more patients as well as integrated spaces for care teams to provide community-based services. Redevelopment of both polyclinics is expected to be completed in 2018.

JOB & PROCESS REDESIGNS FOR BETTER CARE NURSE-LED VACCINATION AT TTSH’S CENTRE FOR GERIATRIC MEDICINETo raise vaccination rates among older adults and empower clinic nurses to take on more specialised duties, TTSH’s Centre for Geriatric Medicine collaborated with the Outpatient Management Unit (OMU) to start a nurse-led vaccination programme in September 2015. Nurses were required to do an E-Learning course, pass a theory test and a practicum to ensure their competency in screening, counselling, and vaccination. The re-designed vaccination workflow contributed to a higher vaccination rate. It increased by 300 per cent from 40 patients to 160 patients per month at the Centre for Geriatric Medicine.

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INTEGRATING PHYSIOTHERAPY INTO "ED" FOR HIGHER PRODUCTIVITY In June 2015, TTSH’s Physiotherapy and Emergency Department (ED) collaborated to jointly assess and manage patients with musculoskeletal and vestibular conditions. A senior physiotherapist is now based in the ED to attend to such patients, reducing waiting times. In the first six months, the senior physiotherapist attended to 303 patients, many of whom were subsequently discharged without being warded because of the early physiotherapy treatment received. This initiative has enabled specialists to focus their time on treating patients with more serious conditions.

INTRODUCTION OF NURSE-LED PHOTODYNAMIC THERAPY The National Skin Centre (NSC) set up a Nurse-Led treatment service at the Photodynamic Therapy (PDT) Clinic to better coordinate care for patients with actinic keratosis, Bowen’s disease and superficial basal cell carcinoma.

Nurses underwent intensive PDT training to take on an expanded role in the preparatory care of phototherapy, a task previously performed by doctors.

With the new PDT Nurse-led Service, patients referred from different doctors are grouped into a same-day session, and are thus able to enjoy cost-savings in treatment.

Physiotherapists in TTSH's Emergency Department reduce waiting times for patients.


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RE-ACCREDITATION OF NHG INSTITUTIONS NHGP, IMH AND TTSH ATTAIN JCI RE-ACCREDITATION NHGP, IMH and TTSH successfully achieved re-accreditation by the Joint Commission International (JCI), a world leader in accreditation of healthcare institutions using standards that are individually developed for Hospitals, Academic Medical Centres, Ambulatory Care and Primary Care, among others.

The re-accreditation of our institutions was aided by the sustained efforts of Group Quality Resource Management’s (GQRM) Standards and Accreditation Resource Unit (SARU). In 2015, SARU conducted seven cross-institutional mock surveys and was involved in 30 ground activities, such as staff interviews and specialised trainings, to prepare institutions for re-certification.

NHGD GETS RE-CERTIFIED FOR QUALITY & COMPETENCEIn April 2015, the National Healthcare Group Diagnostics (NHGD) successfully attained accreditation under the new standards for ISO15189:2012, which specifies requirements for quality and competence in medical laboratories. All 10 NHGD laboratories have been accredited with ISO15189 since 2007, affirming their quality and reliability.

NHGD laboratories and X-ray centres at the nine polyclinics also attained the JCI re-accreditation.

In the same year, five mammography centres at the Ang Mo Kio, Bukit Batok, Jurong, Yishun, Woodlands polyclinics and the Mammobus were reassessed and recertified under the national BreastScreen Singapore (BSS) programme by the Health Promotion Board (HPB).

TTSH INFECTIOUS DISEASES EXPERTS APPOINTED TO NATIONAL OUTBREAK RESPONSE TEAM In March 2016, MOH set up a 13-member national outbreak response team to boost efforts of healthcare institutions in managing disease outbreaks. This follows an update on actions taken in the aftermath of the Hepatitis C outbreak at the Singapore General Hospital (SGH) in 2015. Infectious diseases experts from TTSH, Professor Leo Yee Sin; Associate Professor Brenda Ang; and Associate Professor Lim Poh Lian were appointed to the taskforce. The team will respond to an outbreak as directed by the Ministry’s Director of Medical Services. Its scope includes reviewing the list of notifiable diseases under the Infectious Diseases Act and modes of notification, timelines and escalation processes.

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RESEARCH,INNOVATION AND TECHNOLOGYREVOLUTIONARY HEALTHCARE • TRANSFORMING OUTCOMES

Science is all about the unknown. To find breakthroughs and innovative ways to scale our efforts in research and development, we need to create a culture and an environment which constantly excite and push individuals to ask questions and challenge the status quo.

Professor Lim Tock HanDeputy Group Chief Executive Officer (Education & Research)National Healthcare Group

RESEARCH, INNOVATION AND TECHNOLOGY

Outcomes founded on solid and sound evidence will continue to shape the future of healthcare. Research is therefore pivotal to how we optimise delivery of services to the population and improve patient care. Innovation and technology can help us advance clinical care and boost workforce productivity and operational efficiency. NHG spearheads research through capability development; collaboration and partnership; and developing strengths in focus areas, such as Population Health and Health Services Research; Metabolic Diseases; Geriatric Medicine; Rehabilitation Medicine; Rheumatology, Allergy and Immunology; Infectious Diseases; Dermatology and Mental Health.

Innovation and technology can help us advance clinical care as well as boost workforce productivity and operational efficiency.

THE FORMATION OF N-STRAT The NHG Strategic Research and Analytics (N-STRAT) Department was established in 2015, bringing together domain knowledge resources from six departments: Group Quality Resource Management; Pharmacy and Therapeutics Office; Information Management; Health Outcomes and Medical Education Research; Enterprise Risk Management; and Health Services and Outcomes Research. This collaborative network reinforces and strengthens NHG’s capability in gathering evidence, and enhancing situational awareness to achieve an effective and sustainable healthcare system in the long run.

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SINGAPORE HEALTH & BIOMEDICAL CONGRESS 2015NHG’s annual Singapore Health & Biomedical Congress (SHBC) 2015 was held in October at the Max Atria in Singapore Expo. Themed "Advancing Health Care into the Future: Innovate, Improve, Integrate", the congress attracted some 3,000 international and local delegates, with Minister for Health Mr Gan Kim Yong as the Guest-of-Honour.

In addition to mainstays such as the Primary Care Forum 2015 and Mental Health Track, three new tracks were introduced. They were: the Women’s Wellness Track which covered female-specific health issues, including preventive measures and treatments for gynaecological cancers and chronic illnesses; the Dental Track which emphasised the importance of oral health in sustaining overall good health; and the Health

Services Research Track which focused on the use of Data Science and Healthcare Modelling to aid decision-making in predictive and preventive care, and better policy making on population health. The NHG Health Services and Outcomes Research (HSOR) department presented findings from data modelling to address healthcare patient trends such as patient behaviour and Emergency Department (ED) re-attendance.

The annual Scientific Competition, which highlights the research of medical professionals and scientists across Singapore, received 615 abstracts, a 30% increase from 2014. Winners received their awards during the SHBC Opening Ceremony.


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PREDICTIVE AND PREVENTIVE POPULATION HEALTH RESEARCH NHG and Nanyang Technological University (NTU) signed a Memorandum of Understanding (MOU) at SHBC 2015 to establish a joint research programme — Predictive and Preventive: Better Health at Affordable Cost. The partnership breaks new ground for healthcare through the conduct of research to better understand disease factors unique to Asian populations, and to develop proactive care interventions for early treatment.

The MOU will play a key role in consolidating data and aligning efforts for population health studies by NHG, NTU’s Lee Kong Chian School of Medicine, and supporting partners. Such studies will examine psychosocial, lifestyle, metabolic, genetic and environmental factors associated with chronic disease progression in the community. Knowledge of these predictive factors will enable researchers to proactively design care and interventions to prevent and/or slow the onset of diseases.

NHGP PRIMARY CARE FORUM 2015National Healthcare Group Polyclinics (NHGP) held its eighth Primary Care Forum in conjunction with SHBC. The annual forum, themed "Primary Care: Beyond 50 Years of Healing and Caring in the Community", highlighted how primary care is the bedrock of creating a sustainable healthcare system that is relationship-based and person-centred. It also examined the crucial role of primary care providers in managing and meeting the evolving needs of the population. Topics discussed included the latest advances and pertinent issues in General Practice, and developmental pathways of physicians in primary care.

The Singapore Primary Care Research Scientific Competition received 41 submissions, and NHGP garnered six awards for the oral and poster categories. These two events are vital platforms for primary healthcare professionals and experts to share ideas on how primary care can support and evolve with the changing healthcare landscape.

Building relationships is the foundation of primary care.

NHG and NTU sign a MOU to establish a research programme to better understand

diseases affecting the Asian population.


HEALTH SERVICES AND OUTCOMES RESEARCH (HSOR) The department of HSOR at NHG aims to improve quality of healthcare by providing the best available evidence for decision-making and knowledge translation; and building capacity and advancing knowledge in Health Services Research. The following are some research findings of the team.

MORTALITY TRENDS OF LOWER EXTREMITY AMPUTATIONS IN DIABETES PATIENTS Lower Extremity Amputation (LEA) is defined as the complete loss in the transverse anatomical plane of any part of the lower limb. Prognosis for patients with Diabetes Mellitus tends to be poor. HSOR studied all LEA performed at Tan Tock Seng Hospital (TTSH) from 1 January 2008 to 31 December 2013 in patients with Diabetes Mellitus (n=1,363) and found that the number had decreased from 274 in 2008 to 206 in 2013. The mean age of patients was 63.9 years old, which was younger than those found in many overseas studies. Indians were over represented in the study.

HSOR at NHG aims to improve quality of healthcare by providing best available evidence for decision-making and knowledge translation, and building capacity and advancing knowledge in Health Services Research.

Glycaemic control, which measures blood sugar levels, worsened in 2013 compared with 2008. 602 (44.2%) patients died, of which 28.7% died from cardiovascular causes. The 30-day mortality ranged from 1.5 per cent to 3.7% and the 1-year mortality rate ranged from 9.7% to 18.3% (Fig 1). This study showed that our patients were younger and many of them had poorly controlled Diabetes Mellitus. One-year mortality remained high despite improvements to the 30-day mortality.

Figure 1 — 30-day and 1-year mortality for patients with LEA from 2008 to 2013

Trend of mortality rates



Healthcare providers need to strengthen the support networks for patients to help build their resilience against adverse socio-biophysical issues in their environment.

NEEDS OF PATIENTS WITH FREQUENT READMISSIONS Patients with frequent readmissions to the ED are often affected by a combination of complex health and social problems, hence hospital-centric episodic care may not be the best solution for them in the long term. The study comprised interviews with patients and staff to find out the perceived needs of patients. They were found to require help in health literacy, in overcoming barriers to access services, as well as social and financial support. While there were existing resources in the community to address these needs, continuous engagement with patients was required to ensure they were able to find and use appropriate services in a timely manner. Healthcare providers need to strengthen the

support networks for patients to help build their resilience against adverse socio-biophysical issues in their environment. The study also highlighted creative methods for patients to cope in the community. For example, an owner of a coffee shop located within the vicinity of a patient with diabetes allowed the patient to store insulin for his jabs in the coffee shop’s refrigerator. Novel yet simple solutions such as these are learning points for healthcare and social care providers in planning and addressing care needs of patients.


* PAC 1 are serious cases such as acute myocardial infarction, cardiac arrest or major trauma that require immediate medical attention.

Our focus at Tan Tock Seng Hospital has always been to drive relevant research that will result in improved outcomes in patient care over the short and medium term, while developing translational programmes in partnership with academic institutions upstream, and industry partners downstream. While our primary mission remains patient care, it is imperative that we develop a strong learning culture supported by our work in education and research.Dr Eugene Fidelis SohCEOTan Tock Seng Hospital

PREDICTING 72-HOUR RE-ATTENDANCE AMONG CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS AT THE EMERGENCY DEPARTMENTThe Ministry of Health (MOH) considers ED re-attendance an important indicator of quality of care. Chronic Obstructive Pulmonary Disease (COPD) is a major cause of morbidity and mortality that often leads to high ED utilisation. HSOR developed a model which identified high-risk characteristics of ED re-attendance within 72 hours. Of the 3,869 ED encounters among COPD patients, 28% resulted in re-attendance.

Age, race, COPD-related diagnoses, neurotic disorder, social issues and PAC 1* status were the most predictive factors for ED re-attendance. The model correctly classified ED re-attendance status 85% of the time (ROC = 0.85) (Figure 2). Applying the model to the validation set demonstrated similar predictive accuracy (ROC=0.81). This can potentially assist emergency physicians with appropriate disposition, reducing the risk of emergency re-attendance among COPD patients.

Figure 2 - C-statistics of ROC curve

DERIVATION SET: ROC = 0.85

Area under ROC curve - 0.8549 Area under ROC curve - 0.8069

VALIDATION SET: ROC = 0.81


ESTIMATING THE RISK OF FUTURE ED VISITS DUE TO ASTHMA EXACERBATIONED visits due to asthma exacerbation can be avoided if the condition is well-controlled. Hence, it is important to identify patients with poor asthma control who are at risk of ED visits in the near future so that appropriate interventions can be implemented. A predictive model was developed using 109,086 primary care doctor consults for asthma patients from 2008 to 2011 and validated using 22,859 doctor consults for asthma from 2012 to 2014.

Figure 3 - Estimating the risk of future ED visits due to asthma exacerbation

The model identified age, ethnicity, hypertension, COPD, previous history of Specialist Outpatient Clinic visits, ED visits, inpatient admissions, history of intubation and number of relievers used in the past three months to be useful for identifying patients with poor asthma control who are at risk of an ED visit in the near future. The model was able to risk-stratify patients into three groups: high risk patients who were likely to have an ED visit within one month of the doctor consult; moderate risk patients who were likely to have an ED visit within 14 months; and low risk patients who were not likely to have an ED visit.



EFFECTIVENESS OF A COMMUNITY-BASED FALL PREVENTION PROGRAMME FOR THE ELDERLYWith an ageing population, the incidence of falls and its consequences will increase but they can be minimised through preventive interventions. HSOR evaluated and assessed the effectiveness of TTSH’s Community Health Engagement Programme (CHEP) in preventing falls and improving physical performance among elderly community-dwellers in Singapore.

Occupational and physio-therapists, as well as nurses provided exercise training and health education during the first three months. For the following nine months, supervision of patients continued under the care of community volunteers. The treatment group consisted of participants who received intervention during a given year, while controls comprised those who consented to participate but were scheduled to receive intervention one year later.

There were 1,641 intervention and 286 control participants. Adjusted results revealed significantly fewer falls (OR=0.832, 95%CI=0.724, 0.957) for the intervention group. There was no significant difference in hospital admissions for falls, however the proportion of ED visits was lower for the intervention group (OR=0.511, 95%CI=0.279, 0.936). Results for four of five performance tests showed significantly greater improvement in falls efficacy and life space assessment in the intervention group.

Findings suggest that the CHEP programme improved physical performance and reduced the incidence of falls in the elderly. Furthermore, it demonstrated the potential role of community volunteers in preventing falls among the elderly.

Mean no. (sd) of falls for the full year of follow-up

Average number of falls per person per quarter


The inaugural NHG-SGA Game Jam was held in conjunction with the Serious Games Conference 2015, which explored how gaming technology can be implemented for the betterment of society.

SERIOUS GAMES TO IMPROVE PATIENT CAREWorking with the Serious Games Association (SGA), 23 NHG teams competed in the first NHG-SGA Game Jam in August 2015. It was a first for SGA to partner a public healthcare group to make use of interactive technology to improve the quality of care. The inaugural competition was held in conjunction with the Serious Games Conference 2015, which explored how gaming technology can be implemented for the betterment of society. Teams were required to develop a game concept in the categories of patient education, health promotion and staff communication. Winning entries were announced at the Conference in August. Game concepts with the most potential were selected for feasibility testing and prototyping, in consultation with professional game developers.

Prof Philip Choo, Group CEO, NHG, champions the use of interactive technology in healthcare.


POPULATION RESEARCH BY HEALTH INFORMATION MANAGEMENTThe Health Information Management arm of NHG’s Central Regional Health Office conducts research and data analytics to support NHG’s efforts to keep the population healthy. Here are some findings of the team.

DIRECT MEDICAL COST OF TYPE 2 DIABETES IN SINGAPORE Diabetes Mellitus (DM) is a chronic medical condition associated with numerous complications that makes it a substantial economic burden incurred by individuals, healthcare systems and society. In Singapore, as in many developed countries, DM is a growing public health problem. The prevalence of DM has risen to 12.3% in 2013, from 8.2% in 2004 and 9% in 1998. Type 2 Diabetes Mellitus (T2DM) accounts for approximately 90% of DM cases and its prevalence increases with ageing. Understanding the patterns of resource use and cost associated with T2DM is becoming increasingly important.

NHG conducted a study to estimate the direct medical cost associated with T2DM in Singapore in 2010. We identified 500 patients with T2DM from the NHG Diabetes Registry (Chronic Disease Management System). The study showed that the mean annual direct cost of T2DM was S$2,034.60,

Screening is critical to early detection of diabetes.

of which S$1,237.20 (61%) was accounted for by inpatient services, S$84.20 (4%) by A&E services and S$713.20 (35%) by outpatient services. The total cost of DM was significantly associated with the use of insulin and having DM-related complications such as cerebrovascular disease, cardiovascular disease, peripheral vascular disease and nephropathy. However, age, gender, race, smoking status, level of glycaemic control and taking only oral medication were not independently associated with cost.

With projected increase in DM prevalence coupled with obesity and the growing need for medical treatment in Singapore, DM will continue to be a heavy burden on health budgets. We need to keep close watch of increasing DM burden and cost, find solutions to keep our population healthy and make care affordable for our patients with DM.



and diabetes will rise steadily from 15.5% to 24.9% and from 13.3% to 22.7%, respectively. By 2035, a further estimate of 733,174 and 100,250 patients with prediabetes and uncomplicated diabetes, respectively, will remain undiagnosed. The prevalence of detected and undetected complications is projected to rise from 60% in 2010 to 70.2% by 2035. The model also showed that the prevalence of prediabetes and diabetes among Singapore residents aged 21 years and above is expected to be one in four and one in five, respectively by 2035.

It is imperative to adopt more aggressive interventions to contain disease progression. Without which, the total costs of care for all residents with DM would more than double from S$0.7 billion in 2010 to S$1.7 billion in 2035.

PROJECTION OF PREDIABETES AND DIABETES POPULATION SIZE IN SINGAPORE USING A DYNAMIC MARKOV MODEL In Singapore, DM is the 10th leading cause of death, contributing to 1.7% of total deaths in 2011. As DM is a chronic disease associated with the development of macrovascular and microvascular complications, the DM epidemic is envisaged to adversely impact the quality of life and increase deaths attributable to complications.

To forecast future prevalence and number of residents with DM between 2010 and 2035, we developed a Markov model using TreeAge Pro 2011 based on the clinical course of DM (refer to Figure below).

From 2010 to 2035, the number of Singapore residents with prediabetes and diabetes is projected to more than double, from 434,685 to 903,596 and from 373,104 to 823,802, respectively. The prevalence of prediabetes

DM: Diabetes Mellitus; T1DM: Type 1 Diabetes Mellitus; T2DM: Type 2 Diabetes Mellitus

T1DM with complications

Detected T2DM without complications

Undetected T2DM without complications

T1DM without complications

T2DM with complicationsDeath

Pre-DM detected

Pre-DM undetected

Normal glucose state

MARKOV STATE TRANSITION MODEL


TOWARDS SUSTAINABLE HEALTHCARE THROUGH HEALTH TECHNOLOGY ASSESSMENT Increasing emphasis has been placed on Health Technology Assessment (HTA) around the world in an effort to address escalating healthcare costs. HTA is a multidisciplinary field of applied research which systematically evaluates the clinical efficacy and cost-effectiveness of health technologies. NHG’s HTA Unit was established in 2014 within the Pharmacy and Therapeutics Office in NHG’s Group Corporate Development department.

The HTA Unit has been bridging research and decision-making to meet future challenges. It partnered the Institute of Mental Health (IMH) to assess the benefits and costs associated with available treatments for major depression and schizophrenia. Advanced network meta-analyses and cost-effectiveness analyses of 10 antidepressants and 18 antipsychotics were conducted. The findings were then incorporated into the treatment guidelines for depression in IMH.

The HTA unit also collaborated with cardiologists, geriatricians and a neurologist from TTSH, National Neuroscience Institute (NNI) and National University Hospital (NUH). Drugs of high-usage-statin and high-treatment-cost-novel oral anticoagulants were analysed to provide insights into the use of chronic medications in the elderly population.

Increasing emphasis has been placed on Health Technology Assessment (HTA) around the world in an effort to address escalating healthcare costs.

NURSING RESEARCH MENTORSHIP PROGRAMME TTSH’s Nursing Research Mentorship Programme reinforces the hospital’s support for clinical nurses keen on research and Evidence Based Practice (EBP). The two-year initiative seeks to test boundaries and it also explores a ‘hybrid track’, providing nurses avenues to be both clinician and researcher. The programme encourages experienced nurses to mentor junior nurses and includes monthly workshop sessions covering various research topics; participation in at least one research study; and guidance in writing proposals and publication. Through the programme, participants will become advocates for research and EBP in their own area of clinical practice. Eight nurses have enrolled in the programme so far. They received grants and submitted abstracts to SHBC 2015.



OUTPATIENT PHARMACY AUTOMATION SYSTEM (OPAS)OPAS is a joint collaboration between TTSH, NUH, NHG Pharmacy and Integrated Health Information Systems (IHiS) to transform medication dispensing in the pharmacy. OPAS is an innovative medication dispensing system which features robotic armatures and radio-frequency identification technology. This automation has reduced man hours needed to pick and pack medications, and lowered medication errors and unnecessary waiting times for patients. Launched in 2014, the system has since been installed in six polyclinics and several awards including the HIMSS Asia Pacific Elsevier Award in September 2015.

MENTAL HEALTH RESEARCH IN IMH IMH has been at the forefront of transforming mental healthcare and advocating mental health literacy. In FY2015, the IMH research team received grants worth more than S$1.7 million, embarked on 54 new studies and published a total of 87 research papers. The findings from a population-based mental health literacy study were also released in FY2015.

MIND MATTERS: A STUDY OF MENTAL HEALTH LITERACYA mental health study found that mental illness is quite common among the Singapore population, and the treatment gap associated with common mental disorders was significant. However, less was known about whether people could recognise mental illnesses, their beliefs about the treatments available and the role of stigma associated with people with mental disorders.

To address these issues, IMH conducted "Mind Matters: A Study of Mental Health Literacy". The nationwide study involving adult residents aged 18-65 years in Singapore was conducted between March 2014 and April 2015, and obtained information on people’s recognition and beliefs about five common mental disorders – alcohol abuse, dementia, depression, Obsessive Compulsive Disorder (OCD) and schizophrenia.

Results revealed that recognition was highest for dementia (66.3%), followed by alcohol abuse (57.1%) and depression (55.2%), but poorer for OCD (28.7%) and schizophrenia (11.5%).

Advances in technology have brought healthcare modelling to a new level. It has enabled us to condense massive amounts of real data into a single chart or infographic and from there, understand trends in the population.Mr Teow Kiok LiangDeputy DirectorHealth Services and Outcomes Research (HSOR)National Healthcare Group


More than 88% of those who were surveyed said seeking help from a psychiatrist would be helpful for someone with a mental illness.

The study also examined and compared the extent of stigma associated with these mental disorders. Some 89.4% of respondents felt that a person with a mental illness could get better if they wanted to, while 62.5% said that people with a mental illness were unpredictable and 50.8% said that a mental illness was a sign of personal weakness. The conclusions of the study can help guide public health policies and formulate better public education initiatives to encourage early treatment and intervention.

FRONTIERS IN MENTAL HEALTH SYMPOSIUMIn February 2016, the inaugural Frontiers in Mental Health Symposium was held. Jointly organised by IMH and the Lee Kong Chian School of Medicine (LKCMedicine), the event brought together local and international experts, including speakers from Imperial College London, University of Oxford and Harvard Medical School. They shared insights and research findings on topics ranging from the genetics of psychiatric disorders and trends in psychiatric neuroimaging, to post-traumatic stress and developmental disorders. IMH and LKCMedicine discussed future collaborations, and ways to build a more robust working relationship in areas of research, learning and joint appointments.

NSC BRIDGES TECHNOLOGY AND RESEARCH SUU BALM – ITCH CREAMThe development of Suu Balm, an itch-relieving moisturising cream, was a collaborative effort between the National Skin Centre (NSC) and Good Pharma Dermatology Pte Ltd. The product was NSC’s first foray into creating a pharmaceutical product for the public in partnership with the private sector. Formulated by researchers at NSC as an over-the-counter hypoallergenic moisturiser, Suu Balm is marketed by Good Pharma Dermatology, and is available at NSC and select retail stores across Singapore.

IMH and LKCMedicine discussed future collaboration, and ways to build a more robust working relationship in areas of research, learning and joint appointments.



NON-INVASIVE SKIN IMAGING TECHNOLOGYIn May 2015, NSC introduced confocal skin imaging technology for use on patients at the skin cancer screening clinic. Confocal imaging is a non-invasive screening procedure which complements traditional biopsies to diagnose skin cancer. In contrast with biopsies which sample skin from small areas at a time, confocal imaging allows doctors to take an image multiple times over a large area, enabling them to view the skin holistically. This further reduces the possibility of sampling errors. For patients with many lesions, imaging technology may prove useful as multiple lesions can be screened at the same time.

HOME PHOTOTHERAPY CARE FOR VITILIGO PATIENTSAssociate Professor Steven Thng, Senior Consultant at NSC, clinched the Singapore Clinician-Investigator Award at SHBC 2015 for his contribution to improving care for patients with vitiligo.

Nearly 70% of vitiligo patients require twice-weekly phototherapy sessions to see improvement in their condition within six months, yet many patients skip their regular treatment due to time constraints. Associate Professor Thng’s proposed solution of using a portable machine to allow home phototherapy treatment for patients produced positive results.

His study of 44 patients found that seven in 10 patients who underwent regular treatment at NSC followed through, while the rest became non-compliant halfway or turned up for treatment only once a week. For the home phototherapy group, nine in 10 complied with the prescribed treatment sessions: 70% of those who underwent home treatment showed at least a 50% improvement in skin colour.


NSC RESEARCH STUDENTSHIP FOR MEDICAL STUDENTSNSC established the NSC Research Studentship for medical students keen to explore clinical research. The students are mentored by the Centre’s dermatologists and have the opportunity to engage in supervised research projects. They will also receive sponsorship to attend conferences. Two candidates were awarded the studentship for the financial year.

HARNESSING TECHNOLOGY FOR EFFICIENCY LEVELLING UP CLEANING CAPABILITIESIn August 2015, TTSH became the first hospital in Singapore to bring in the “Cleanfix RA 660 Navi” Autonomous Scrubber and “Karcher BDP 50/2000” Ride-on Floor Burnisher to level up cleaning capabilities. This collaboration between Hospitality & Environmental Services and ISS Facility Service Pte Ltd aimed to implement more advanced cleaning technology to boost manpower productivity and operational efficiency. The Autonomous Scrubber is a “smart” robot that self-navigates and is capable of scrubbing floors 50% faster, helping to save two Full-time Equivalents (FTEs) annually. The Ride-on Burnisher polishes floors 80% faster, saving 2.2 FTEs annually.

RADIO-FREQUENCY IDENTIFICATION (RFID) FOR BETTER MANAGEMENT OF ASSETS TTSH Nursing deployed a RFID/barcode-based Item Management & Tracking System to better manage, track and audit its assets. This specifically helped the Central Sterile Supply Department/Theatre Sterile Supply Unit (CSSD/TSSU) automatically identify and track the movement of surgical sets within the hospital, from decontamination to distribution, to improve efficiency and increase patient safety.



VISI MOBILE MONITORING SYSTEM Continuous monitoring of vital signs is crucial to detecting early deterioration of a patient’s condition and facilitating early intervention or rapid response. TTSH Nursing introduced the ViSi Mobile Monitoring System, which is a lightweight, portable patient vital signs monitor featuring a full colour touch-screen display. It can be worn on the wrist and continuously tracks electrical activity of the heart, heart rate, blood oxygen level, pulse rate, respiration rate and non-invasive blood pressure (cNIBP). The system enables clinicians to receive information without limiting patients’ freedom to move around the hospital. The device is planned for areas where patients require hourly monitoring, such as post operations and during blood transfusions. TTSH Nursing began piloting this initiative in select wards in July 2016.

IMPROVING PATIENT EXPERIENCES AT NHGP NHGP has been working closely with our patients and stakeholders to transform the care experience to be hassle-free and centred on the needs of patients and families.

› Greater patient satisfaction after technology improvementsThrough its continual efforts to better patient touchpoints at our clinics, NHGP achieved an overall satisfaction score of 92.2% in the MOH Patient Satisfaction Survey in FY2015, a significant increase compared to 81% in the previous year. Of the nine polyclinics assessed, all have improved on their satisfaction scores and the six top rated polyclinics were from NHGP. Satisfaction leapt by more than 10 percentage points for Ang Mo Kio, Bukit Batok, Hougang, Jurong and Woodlands Polyclinics.

› Facilitating a more seamless experience To provide patients with a quicker, more convenient method to settle their bills, NHGP implemented multi-language self-payment kiosks that accept different modes of payment. Sitting queues for payment were also introduced for elderly patients, with trained service ambassadors on hand to provide assistance.

› Self-Help Appointment System In May 2015, NHGP introduced an online self-help appointment system on its corporate website and a mobile application ‘miHealthCare’. This enables patients to book same-day appointments to seek treatment for acute conditions such as cough and cold. They have the option to reschedule existing appointments for care services as well as monitor other appointments like lab and doctor consultations. This not only promotes better time management for patients, but also boosts the polyclinics’ productivity and efficiency.

Usage of NHGP’s self-help appointment system averaged at 34,000 transactions in the first quarter of 2016. Patients who accessed NHGP services by appointment in 2015 indicated a 15% improvement in satisfaction regarding consultation waiting times.


PRODUCTIVITY & INNOVATIONTTSH NURSING SHARED GOVERNANCE In March 2016, TTSH Nursing celebrated the Shared Governance Fiesta. The event not only highlighted the progress of the TTSH Nursing Shared Governance movement, it also recognised the efforts of the nursing councils and provided a platform for sharing of ideas. The Shared Governance Model comprises five key aspects: Nursing Practice; Nursing Education & Development; Nursing Quality & Research; Nursing Worklife, and Person-Centred Care. More than 80 ground-up initiatives by nurses were showcased during the Fiesta. Projects developed by unit councils in 2016 include:

› Surgical unit: Saving time through a medication drop-boxAt Ward 11D, the team streamlined the work process for the return of discharge medications. They eliminated the need for paper documentation and counting of drugs at the ward. Also implemented was a medication drop-box system that reduced the time taken for the return of unused medications to the pharmacy from five minutes to one minute per patient, resulting in 40 minutes saved per day. The initiative was introduced to all inpatient units.

› Stroke unit: Helping stroke patients on their journeyNurses from the stroke unit created an infographic to better educate their patients and families on a stroke patient’s journey. Featured on the wall of the unit, this initiative garnered much positive feedback and helped many patients manage their anxiety.

› Ward 13C: Empowering patients in self-careNurses from Ward 13C created a set of standard measurements and a chart to track fluid and food consumption of patients. Suitable patients were presented the chart — with categories clearly defined by pictures — so that they could note their own intake and output. 80% of patients who met the criteria have adopted this self-charting practice. Not only have they developed greater awareness of their own hydration and nutritional status, the medical team has also benefited with more accurate records of each patient’s fluid and food consumption.

IMH KITCHEN REVAMP IMH revamped its central kitchen and implemented a centralised meal portioning and dishwashing system. The revamp resulted in increased productivity and better patient care. With the portioning of food, its distribution and dishwashing now managed in the central kitchen by a dedicated team, staff in the ward including health attendants, healthcare assistants and even nurses were able to devote more time to the care of patients instead of having to help out with the kitchen work.

In February 2016, an Electronic Meal Ordering System was introduced to further improve the meal ordering process. The system captured individual patient’s dietary history and needs, allowing for easy access to information and convenient ordering of meals by nurses.

The revamped kitchen at IMH boosts productivity and

improves patient care.


DIRECT ADMISSIONS TO WARDS AT IMH IMH introduced direct admissions to make the process more convenient for patients. Patients from the Community Wellness Clinics in Geylang and Queenstown were previously sent to IMH’s Emergency services where they were re-examined before admission. Since March 2016, patients undergo the admission process, which includes financial counselling and bed allocation, in the Community Wellness Clinic and are accompanied by a staff from the clinic to the ward directly, bypassing Emergency Services. This removed an additional administrative step for patients, which resulted in a reduction of an average waiting time of two to three hours.

Since July 2015, remandees from the State Court sent to IMH for forensic evaluation were directly admitted to the Forensic wards, removing the need for them to be first examined at IMH’s Emergency Room. As a result, admission time to the wards improved from three hours to a maximum of one hour.

TTSH WORKFORCE COUNCIL – BETTER PEOPLE, BETTER CARE TTSH Workforce Council was set up in July 2015 to provide the hospital’s strategic leadership and direction for the planning, coordination and development of workforce strategies, initiatives and programmes. The Council aims to deliver value to TTSH staff and for them to deliver value to our patients as well as the population at large, leading to Better People, Better Care.

JOB REDESIGNTo ensure the sustainability of Singapore’s public healthcare sector, we must develop a future-ready workforce that can deliver more team-based care. Staff are empowered to perform at their maximum potential. Job redesign examines current job capabilities while envisioning the future potential of each job function, and each professional group to practise at the top of their licence.

NEW SOCIAL WORK FELLOWSHIP PROGRAMME In March 2016, TTSH Care & Counselling launched the Social Work Fellowship Programme in Palliative and End-of-Life Care. This programme provided formalised social work training and aims to enhance the clinical knowledge, skills and competency levels of medical social workers in the field of palliative care.

NHGP LAUNCHES SERVICE AMBASSADORS As part of service redesign and job enlargement of staff roles, NHGP piloted a new Service Ambassador (SA) concept in January 2016. Some of the existing Patient Service Associates (PSAs) and Health Attendants (HAs) were groomed to proactively create a patient-centric experience at our polyclinics by offering timely and appropriate assistance to patients and their caregivers. The pioneer batch of SAs hailed from Choa Chu Kang, Toa Payoh, Woodlands and Yishun Polyclinics.

NHG PHARMACY EXPANDS ROLES OF PHARMACY TECHNICIANSThe roles of Pharmacy Technicians at NHG Pharmacy are steadily expanding to include more clinical work and management of inventory. With simpler tasks such as picking and packing carried out via automation, pharmacy technicians now have more time to be involved in patient education and counselling.



EDUCATIONGROOMING THE HEALTHCARE PROFESSIONALS OF TOMORROW

Associate Professor Tham Kum YingAssistant Dean, Year 5 and Lead, Emergency MedicineLee Kong Chian School of Medicine; andEducation Director, Pre-Professional Education Office and Senior Consultant Emergency PhysicianTan Tock Seng Hospital

Medical students need to understand that caring for patients is not just about dealing with their health issues. Ethical and moral values are very important as well because the doctor-patient relationship must be founded on trust.

EDUCATION

Building of healthcare infrastructure by the Ministry of Health (MOH) is well underway. Inevitably, developing more care facilities will mean a greater need for manpower and capability-building. Delivering quality care requires people with not only the right skills but also the right attitude: those who are compassionate, and who care to go beyond when need be.

Education is undoubtedly a cornerstone of NHG to strengthen its role as a Regional Health System (RHS). Through programmes, partnerships and adoption of best practices from across the world, we encourage our healthcare professionals and support staff to build their skillsets and expertise to serve the needs of our population.

A CONSTANT PIPELINE OF HEALTHCARE PROFESSIONALS FOR THE FUTURE As the primary clinical training partner for Lee Kong Chian School of Medicine (LKCMedicine), NHG is actively involved in producing a new generation of clinicians, well-trained to manage the healthcare challenges of the future.

LKCMEDICINE WHITE COAT CEREMONY 2015 Ninety students enrolled in the five-year Nanyang Technological University (NTU) – Imperial Bachelor of Medicine and Bachelor of Surgery (MBBS) degree programme were conferred their white coats at the LKCMedicine White Coat ceremony in August 2015, symbolising the start of the students’ medical career. In his address to the students, Professor Philip Choo, Group CEO of NHG, challenged them to redefine the future of medicine, and to engage patients holistically by addressing their health, psychological and social needs for better wellness care.

Education has always played a pivotal role in the delivery of quality, affordable, and sustainable healthcare. Our educators’ dedication and commitment to nurturing our current and future workforce helps us strive for excellence in our pursuit to improve the health of our patients and the community.Associate Professor Nicholas ChewGroup Chief Education OfficerNational Healthcare Group

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FIVE YEARS ON In December 2015, LKCMedicine marked its fifth anniversary with a gala dinner and the launch of a commemorative book titled Making a Medical School. Held at the School's new Experimental Medicine Building, the celebration was attended by more than 300 guests, including LKCMedicine Governing Board Chairman, Mr Lim Chuan Poh; NHG Deputy Group CEO (Clinical), Associate Professor Chua Hong Choon; and Senior Management, staff and students from NTU, Imperial College London and LKCMedicine. The school was recognised for its role in pioneering a new generation of healthcare professionals to meet the evolving needs of the Singapore population.

A NEW PHD PROGRAMME In August 2015, LKCMedicine launched a new PhD by Research programme to contribute to an evolving healthcare system focusing on population health. The new programme will nurture the next generation of biomedical scientists as leaders in their respective fields; and train them to identify and deliver healthcare innovations and treatments to improve the quality of life for people in Singapore and around the world. Students from backgrounds as diverse as natural and clinical sciences, engineering and mathematics, will be equipped with research skills to tackle healthcare issues such as Metabolic Disorders, Infectious Diseases, Neurological and Psychiatric Disorders, and Skin Disease.

The PhD programme is delivered with several innovative features, including clinical attachments for students without a clinical background to provide a deeper understanding of local healthcare needs, laboratory rotations to broaden the students’ range of skills, and overseas attachments at academic medical centres for added exposure.

LKCMEDICINE RESEARCH COMMITTEE FORMED In March 2016, the LKCMedicine Research Committee, chaired by Vice-Dean for Research, Professor Russell Gruen, was established to drive strategic research initiatives and to operationalise various research strategies. The Committee is working closely with the School’s Management Board to develop research themes, interdisciplinary and clinical research strategy, and faculty appointments. It will also help guide research undertaken by LCKMedicine through a strict ethical and governance process, covering appropriate Institutional Review Board (IRB) and Institutional Animal Care and Use Committee (IACUC) approvals before the conduct of experiments. The Committee will further align the standards of research integrity and conduct, and compliance processes with those of NTU, Imperial College London, and the scientific guidelines of MOH and the Bioethics Advisory Committee.


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NEW PHARMACY RESIDENCY PROGRAMMES AT NHGIn January 2016, the inaugural Pharmacy Residency Programmes were launched as part of a national initiative to train and develop accredited specialist-pharmacists. The programmes provide a structured curriculum with five specialties accredited by the Pharmacy Specialists Accreditation Board. Currently, NHG helms three of the five specialties: Cardiology, Geriatrics, and Psychiatry.

FORENSIC PSYCHIATRY CLINICAL FELLOWSHIPThe Institute of Mental Health (IMH) launched the Forensic Psychiatry Clinical Fellowship Programme in February 2016 targeted at clinical specialists committed to pursuing a career in Forensic Psychiatry. The programme prepares psychiatrists to work in criminal and civil forensic mental health settings and they can be rotated to the Child and Adolescent forensic department and the National Addiction Management Services to gain further knowledge and experience.

STRENGTHENING MENTAL HEALTH SERVICES AT THE PRIMARY LEVELSeventeen General Practitioners (GPs) graduated from the Graduate Diploma in Mental Health (GDMH) Programme in April 2015. This brings the total number of GPs who have done the programme to 85. This cohort comprised doctors from different healthcare settings including polyclinics, community hospitals and private clinics.

COMMUNITY SERVICE PART OF NHG MEDICAL RESIDENCY CURRICULUMSince July 2015, doctors on their residency training with NHG are required to participate in community services to gain a better understanding of the community’s needs and concerns. The community engagement opportunities enable them to cultivate deeper and stronger doctor-patient relationships.

Medical residents visit homes to understand the needs of the community.

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The training provided them with the confidence to better manage patients with mental health conditions. Of the cohort, two joined IMH’s Mental Health-GP Partnership programme to manage patients discharged from IMH and those in need of help in the community.

INAUGURAL PSYCHIATRY RESIDENCY DAYIn January 2016, 31 long-stay patients from IMH visited Gardens by the Bay. Organised by residents from the NHG Psychiatry Residency Programme and supported by IMH staff, the event marked the inaugural Psychiatry Residency Day. The event allowed the doctors from the programme and IMH nurses to interact with patients under their care.

NHG EDUCATION ELECTIVEThe NHG Education Elective was introduced in January 2015, and again in July 2015 and January 2016, as a programme for NHG College’s junior faculty, to prepare and groom the next generation of education experts and leaders within our institutions. The programme, conducted over six months, introduces and equips junior faculty members with essential principles and concepts in health professions education.

STANDARD SETTING WORKSHOPA new workshop, conducted by Dr John Norcini, President and CEO of Faimer®, was introduced in January 2016 for our clinicians on Standard Setting, which seeks to equip them with the know-how to set standards and enhance the quality of assessments for learners.

NEW DIPLOMA FOR NURSESNHG is collaborating with Ngee Ann Polytechnic to develop a Specialist Diploma in Clinical Education for Nurses, which will be launched in April 2017. The Specialist Diploma will comprise two Post-Diploma Certificates (PDCs), of which PDC1 will be conducted by NHG College and PDC2 will be done by Ngee Ann Polytechnic. NHG College’s Nursing Training Review Committee (NTRC) completed the curriculum development for PDC1 and ran a pilot session for 28 nurses from NHG institutions in March 2016.

NHG SEAL LEADERSHIP PROGRAMMES In November 2015, 20 graduates from the second cohort of the Inspiring SEAL Leadership Programme (ISP) had their graduation ceremony during the NHG Leadership Learning Festival. SEAL represents the pedagogic philosophy of these programmes – Senior Management engagement, Experiential team bonding, Action-learning projects, and Leadership in practice. Graduates of SEAL Programmes are leaders at various job levels across NHG institutions trained to drive change strategically.

DEVELOPING OUR WORKFORCE NHG College is instrumental in facilitating the continuous learning and development of our workforce. It collaborates with renowned institutions and industry partners to raise the skills of our leaders, educators, healthcare professionals and staff.

In FY2015, NHG College conducted a total of 47 programmes for 1,732 healthcare professionals.


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NHG GROUP EDUCATION NHG GROUP EDUCATION CELEBRATES ITS 5TH ANNIVERSARY As NHG Group Education turned five in 2015, and introduced a new mission statement, “We are responsible for improving the health of our patients and the community through the education of our present and future healthcare workforce, healthcare partners, patients and caregivers.” It also introduced a new vision statement, ‘Inspiring Professionals, Imagining Tomorrow, Reinventing Healthcare’, to chart the future direction of healthcare education. Underpinning these efforts is a new conceptual framework called ‘Professionals for Tomorrow’s Healthcare’ (PTH), designed to assist NHG leaders in identifying the vital attributes and competencies required for healthcare professionals of tomorrow.

While core knowledge is essential, attributes such as systems thinking, teamwork, future-oriented thinking, and distributed leadership gain greater importance at the workplace, together with ethical conduct and ethos. Since its inception in August 2015, PTH has been shared through workshops, poster presentations and lectures at international conferences in the United States, Europe and Australia, and has received positive feedback for its relevance and adaptability to other professions.

EXTENDING NHG GROUP EDUCATION’S REACH INTERNATIONALLY

› Continuing Professional Development Programme In November 2015, the NHG Group Education Office conducted an inaugural Continuing Professional Development Programme (CPDP) for 250 programme directors and coordinators from Qatar’s Hamad Medical Corporation (HMC). The four-day workshop covered topics such as curriculum structure and design, assessment, evaluation, and quality of education, focusing on training and upskilling of HMC’s faculty in preparation for their new fellowship programmes in Cardiology, Renal Medicine, and Geriatric Medicine.

› International Talks Collaborating across borders, NHG’s Institute of Healthcare Quality (IHQ) trained healthcare leaders from MOH in Root Cause Analysis (RCA) and Failure Mode Effects Analysis (FMEA). The following talks were presented at international events:

› “Harm Detection: Use of Trigger Tools in Primary Care”, at the International Forum for Quality and Safety (Asia) in Hong Kong, and

› “People-Centred Integrated Services: Perspectives from NHG”, at the World Health Organization (WHO) Quality & Patient Safety (QPS) Hospital Management Course in Saitama, Japan.

NHG TEACHING EXCELLENCE AWARDSIn September 2015, 123 educators were recognised for their contributions towards the professional development of healthcare workers. The new NHG Teaching Award acknowledged senior staff of Allied Health Professionals who coach and inspire their younger colleagues.

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Photo: LKCMedicine

LEARNING FROM FIELD EXPERTS FAMILY MEDICINE EXPERTS VISIT NHGPTo get global perspectives on healthcare, National Healthcare Group Polyclinics (NHGP) routinely hosts overseas experts from various countries such as New Zealand, the United States of America, and Denmark.

In September 2015, Associate Professor Roar Maagaard, from the University of Aarhus and Immediate-Past President of the Danish College of General Practitioners, shared his expertise in healthcare structure, primary care funding and postgraduate medical training, based on his experience in the Danish-Nordic health systems.

In October 2015, Professor Kurt Stange, Professor and Director at the Center for Research in Family Practice and Primary Care in Case Western Reserve University, USA, met with Senior Management of NHGP to give his views on providing accountable care in Primary Care and shared his insights from his time as editor for the Annals of Family Medicine.

MOH HMDP VISITING EXPERTS SCHEMEUnder MOH’s Health Manpower Development Plan (HMDP) – Visiting Experts (VE) scheme, NHGP invited overseas experts in the fields of diabetic foot care and primary care research to share their expertise.

Professor Roger Jones, Emeritus Professor of General Practice at King’s College London and Editor of the British Journal of General Practice, visited NHGP in February 2016 under the scheme. During the visit, Professor Jones met with NHGP’s Senior Management to discuss primary care research and NHGP initiatives.

Professor Jones also visited Bukit Batok Polyclinic and Family Medicine Academy, conducted lectures and workshops on Research Methodologies and Medical Writing. He shared his views on research topics such as chronic disease management and diabetes management that NHGP could embark on.

In January 2016, NHGP hosted Dr Gerry Rayman, Consultant Physician and Head of Service at the Diabetes Centre, Ipswich Hospital NHS Trust. Dr Rayman shared his expertise on a wide range of topics, including screening and prevention of diabetic foot problems, patient education, management of diabetic foot ulcers, and new research in diabetic neuropathy. He also gave his input on the NHGP Diabetes Foot risk stratification, and interacted with clinicians and administrators from primary care, hospitals, community care, and the Agency for Integrated Care (AIC) on the continuum of foot care across various healthcare settings.

Dr Rayman met with NHGP Senior Management and MOH to discuss recommendations for a sustainable and integrated model for the management of diabetic foot conditions within the RHS. NHGP is working on implementing the recommendations to advance diabetic foot care in the primary care setting.

BENCHMARKING AGAINST BEST SYSTEMS AND PRACTICES Every year, Senior Management, clinicians and administrators from the NHG Group visit health systems around the world to gain insights on best practices, and to bring home lessons that can be applied to build a sustainable, relationship-based healthcare system.

In FY2015, representatives from NHG visited the United States of America, Thailand, New Zealand, Hong Kong, Sweden and Denmark to study their approaches on patient-centred care, chronic disease management, population health, and integrated care.

NUKA SYSTEM OF CARE (ALASKA & OREGON, USA)The Nuka System of Care is the healthcare system created, managed and owned by the Native people of Alaska to achieve physical, mental and emotional wellness.

The Nuka System focuses on:

› Customer Ownership“Patients” are referred to as “customer-owners” and recognised as “equals” to healthcare providers, sharing in the decision-making process.

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We cannot only focus on our clinical services because that is simply taking care of our patients today. Educating future mental health professionals ensures that we take care of the patients of tomorrow.Associate Professor Chua Hong ChoonDeputy Group CEO (Clinical)National Healthcare Group; andCEOInstitute of Mental Health

HONG KONG In Hong Kong, standardised assessment tools to identify appropriate post-discharge support services were studied. The Hospital Authority has tasks groups on Hospital Admission Risk Reduction Program for the Elderly (HARRPE) to improve the health of seniors in the community immediately after discharge. HARRPE uses telephone consultations with nurses, supervised by geriatricians, and collaborates with partners in the community.

The Virtual Hospital programme implemented by TTSH is based, in part, on HARRPE.

SIRIRAJ HOSPITAL, BANGKOK One of the key takeaways from the trip to Sriraj Hospital in Bangkok, Thailand was the Routine-to-Research (R2R) tool. R2R provides resources such as funding and methodology consultants to hospital staff to help them transform their daily knowledge into scientific research. The results from the research are then used to improve routine practice.

This integration of research and application can be adapted by NHG to improve healthcare practices. To formalise such learning through collaboration, TTSH signed a Memorandum of Understanding (MOU) with Sriraj Hospital in December 2015 to drive healthcare innovation and expertise.

› Relationship A strong relationship between the primary care team and the customer-owner is key to effecting change. Hence, the Nuka system emphasises the importance of understanding each customer-owner’s story, values and influencers to support them in their journey to health. To do this, staff attend a three-day intensive course where they learn how to interact with the customer-owners and their family, find ways to strengthen relationships, and understand how to deliver personalised care.

› Whole System Transformation Customer-ownership and relationship can impact the entire healthcare system, including workforce development, compliance, human resources, and finance.

Based on the learnings from the visit to the Nuka System of Care, an ‘on-boarding’ programme has since been developed for staff at Tan Tock Seng Hospital (TTSH) to teach and foster relationship-building.


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FORUMS & CONFERENCES ASIAN COMMUNITY MENTAL HEALTH LEADERSHIP (ACMHL) FORUM 2015In July 2015, IMH marked the completion of the three-year ‘Disaster Mental Health Programme for Communities in Asia’ with the 2015 ACMHL Forum in Bangkok. The forum was supported by the health ministries of Thailand, Indonesia and China. Eighteen best practice awards were presented in recognition of the efforts of community teams in Thailand, China and Indonesia. Two publications, Building Back Better: Case Studies in Resilience Building in English, and Bencana dan Kesehatan Jiwa Anak & Remaja (Disaster and Mental Health of Children & Adolescents) in Bahasa Indonesia, were also launched.

The three-year programme, supported by the Temasek Foundation, Singapore, has trained over 800 mental health professionals and community partners in Thailand, Indonesia and China, to develop and deliver community mental health programmes that support resilience after a crisis.

IMH WORLD BIPOLAR DAY FORUM 2016In March 2016, IMH celebrated World Bipolar Day with a public forum themed “Hope and Normalcy”, held at the Health Promotion Board. This forum attracted more than 180 participants – school counsellors, volunteers, caregivers, healthcare professionals, and persons recovering from mental illness.

IMH’s multidisciplinary team from the Mood Disorders Unit presented different therapies and medications used to manage bipolar disorder and shared on the resources and support available for patients and caregivers.

IMH facilitates disaster mental health programmes around the region.

NSC PUBLIC FORUM 2015 Titled ‘Be Clear About Rashes’ and held in October 2015, the NSC Public Forums (English and Mandarin) focused on educating the public on common rashes in adults and their treatments.

The English forum, chaired by Senior Consultant, Dr Anthony Goon, delved into commonly held misconceptions about various rashes, how to differentiate symptoms, and the importance of accurate clinical diagnosis in treating them effectively.

At the Mandarin forum, chaired by Senior Consultant, Dr Leow Yung Hian, the discussion centred on the various types of pigmentation and their treatments.

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TTSH CONDUCTS TRAINING ON OCCUPATIONAL HEALTH & SAFETY IN THAILANDIn 2012, the Temasek Foundation approached TTSH, at the request of Her Royal Highness (HRH) Princess Maha Chakri Sirindhorn of Thailand, to conduct a training programme for nurses and nurse leaders on Occupational Health and Safety. The inaugural training programme was conducted in January 2013.

Since then, TTSH’s nursing service has concluded two more programmes on Neurology Nursing and Nursing Management/Care under the patronage of the Office of HRH Princess Maha Chakri Sirindhorn. The Thai graduates of these programmes have gone on to share the skills learnt with their colleagues and peers in healthcare. Their achievements in the post-training evaluation are encouraging and demostrated the progressive proliferation of positive change to nursing in the region.

NSC UPDATE IN DERMATOLOGY & VENEREOLOGY 2015The NSC Update in Dermatology and Venereology 2015 was held in September 2015 at the Mandarin Orchard Hotel, Singapore. The biennial conference featured a comprehensive range of topics in dermato-venereology – from basic sciences to practical approaches to clinical problems and the future direction of the specialty. About 470 clinicians, researchers, nurses and pharmacists from Singapore and abroad attended the event.

The event consisted of seven symposia of different themes, three plenary lectures, and a session for Dermatology trainees to showcase their work.


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NHG-TTSH STUDENT FESTIVAL 2015The 2nd NHG-TTSH Student Festival was held in September 2015 at the TTSH Community Hall. Titled "Towards a New Healthcare Paradigm – Safe Care Saves Lives", the event focused on patient safety and attracted over 100 students from Medicine, Nursing, Pharmacy, and Allied Health.

The festival, organised by TTSH’s Pre-Professional Education Office, aims to promote collaboration among the different healthcare professions. Students experienced interviewing mock patients and the opportunity to participate in a poster competition.

From left to right: Mdm Kay Kuok, Chairman, NHG; A/Prof Chiam Peak Chiang, Vice Chairman Medical Board (Education), IMH; A/Prof Chua Hong Choon, CEO, IMH

IMH OPENS EDUCATION HUB In October 2015, IMH unveiled the newest addition to its growing education infrastructure – the Education Hub. CEO of IMH, Associate Professor Chua Hong Choon, also launched From Hurtful to Helpful, the second book in the Mind this Voice series. The event was attended by Chairman, NHG, Madam Kay Kuok; Group CEO, NHG, Professor Philip Choo; Vice Chairman Medical Board (Education), IMH, Clinical Associate Professor Chiam Peak Chiang; senior faculty and clinicians of IMH, and Senior Management from NHG.

The 875 sqm facility, funded by MOH, was designed to facilitate team-based learning and problem-based teaching for residents and students. Education Hub provides an environment that encourages collaborative learning between students from the different professional groups and gives them a head-start in working in multidisciplinary care, which is the future of healthcare delivery in Singapore.

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The higher prevalence of co-morbidities in chronic diseases in ageing populations here and across the region necessitates a shift in public healthcare from episodic to integrated care as a more effective and sustainable long-term strategy. We look forward to knowledge sharing with our regional partners so that together we can provide better care for our respective communities.Professor Philip ChooGroup CEONational Healthcare Group

SINGAPORE LAUNCHES TF HEALIn October 2015, over 40 healthcare leaders and public officials from more than 10 Asian countries gathered in Singapore to attend a healthcare governance and leadership executive programme.

The Temasek Foundation Healthcare Executives in Asia Leadership Programme (TF HEAL) serves as an international platform to share best practices and build networks of cooperation in the region.

The inaugural TF HEAL programme was established with a grant of S$589,000 from Temasek Foundation. Singapore’s two largest healthcare clusters, SingHealth and NHG, co-developed the curriculum and facilitated a five-day workshop on healthcare management insights and strategies.

A wide range of topical healthcare issues was covered including governance, leadership, quality, process improvement and management with a particular focus on policy implementation strategies.

Senior administrators and clinicians from both healthcare clusters shared their expertise in areas such as regional health systems, service integration, manpower and training, and the transformation of primary healthcare delivery. Participants also visited key healthcare facilities at SingHealth and NHG to see first-hand how healthcare concepts work on the ground.


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OUR PEOPLESYNERGY IN TEAMWORK

The highest quality of life rests in having meaningful work and relationships. Time has to be well spent both at home and at work. As leaders, we need to provide the best environment to enable our staff to do meaningful work and build meaningful relationships.

Dr Eugene Fidelis SohChief Executive OfficerTan Tock Seng Hospital

Our people are our most valuable resource and NHG continues to equip our workforce with skills, knowledge and practice. Besides being equipped professionally, our staff must have trust and build closer rapport and relationship with our patients, caregivers, and community partners. Together, we shall take ownership of our own lives and care for our population.

4P7R INITIATIVES 2015 Our culture building journey to develop the 4 Principles and 7 Simple Rules (4P7R) continues. The 4P7R guides and galvanises us as we evolve into a Regional Health System (RHS) for Singapore. This is in tandem with our vision of Adding Years of Healthy Life as we seek to better serve the healthcare needs of the community.

In 2015, two 4P7R eLearning modules were developed to enhance staff’s appreciation and application of the four Principles – Patient-Centred Care, Systems Thinking, Learning Organisation and Staff Engagement. In conjunction with the eLearning launch, a game competition was conducted, with participation from over 2,000 staff across all institutions.

The 4P7R Reward and Recognition Awards were also introduced to harness ground ideas and reinforce behaviour demonstration of the principles and rules. 54 entries were submitted by various NHG departments and teams, ranging from wards, clinics, administration, to cross-disciplinary teams. Winners were presented their awards at the annual 4P7R Symposium.

OUR PEOPLE

The 4P7R functions as the guiding principles and common language for us to attain a higher level of performance, to be an effective Regional Health System. Let us embrace each of the principles and rules, read it, learn it, memorise it and put it into practice in our daily life. In so doing, the 4P7R becomes part of our working DNA and collectively over time, we can have Better People, Better Care.Professor Chee Yam ChengChairman, Culture Building Steering Council (CBSC)National Healthcare Group

Practising the 4P7R helps the NHG Family work better collectively for our patients.

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NHG also provided a platform for staff to recognise the contributions of fellow colleagues and to put 4P7R into action, highlighting individuals who exemplified these values: making a difference to patient-centred care; applying systems thinking, learning and engagement of staff and partners to build a collaborative and cohesive healthcare system. Using “leaves” to symbolise hearts and placed on the “4P7R Tree”, NHG’s tree is now on display at our corporate office at Nexus@one-north.

STAFF ENGAGEMENT AT TOWNHALLOur RHS journey requires the alignment of our people towards organisational objectives. We increased the frequency of our Townhall sessions to encourage greater staff engagement and timely updates on key organisational development.

Each Townhall session comprised sharing by NHG Group CEO, Professor Philip Choo, and updates from the NHG Strategic Workstreams: Care Redesign & Patient Point of View; Staff Point of View; Leadership & Organisation Development; and Training for the Future. The sessions are a platform for management and staff to share their thoughts on NHG’s ongoing RHS journey and challenges ahead in our healthcare landscape.

TALENT MANAGEMENT To support NHG’s vision to create a sustainable healthcare model, Group Human Resource (GHR) collaborated with NHG College, our institutions and stakeholders to focus on transforming our workforce, and growing NHG’s leadership pipeline.

› The Inter-Professional Leadership Programme (IPLP) equips potential leaders across NHG with essential management skills to spur organisational change. Since its launch in March 2015, two well-received pilots were conducted with 63 staff trained. The curriculum comprised: › Leadership Essentials

› Effective Inter-Professional Communication Skills

› Healthcare Systems Thinking

› Change Management

› Group Human Resource and NHG College will continue to upskill the NHG workforce by: › Extending reach of IPLP – efforts will be

ramped up to cover the bulk of the junior management group, with at least five runs per year planned for FY2016 and beyond

› Exploring development of IPLP Advance for the next level of staff at senior managers to deputy directors

› Exploring inclusion of workplace learning into all our training programmes

› Embedding 4P7R into daily work, learning programmes and recognition frameworks


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RENEWAL OF NHG-HSEU COLLECTIVE AGREEMENT NHG and the Healthcare Services Employees’ Union (HSEU) signed a Collective Agreement (CA) in June 2016. The new CA spells better benefits for NHG staff. The enhancements include an upward revision of salary ranges for Administrative, Ancillary, Allied Health Support, Allied Health Professional and Pharmacist job families, along with salary adjustments for affected staff. In line with the Government's move to support re-employment of older workers, NHG raised the re-employment age limit to 67, one year ahead of legislation.

This is the sixth CA that NHG has signed with the Union, and will be valid till 31 March 2018. It represents a new approach where the negotiations comprised two segments: (i) items covering all six public healthcare clusters, and (ii) individual cluster-specific items. The setting of common CA priorities over time will ensure longer-term cost sustainability for the public healthcare sector as a whole.

NHG LEADERSHIP MOMENTS Organised by NHG College and Group Talent Management, the NHG Leadership Moments provide staff, Senior Management and partners with a platform to network, share knowledge and exchange best practices.

In September 2015, some 25 NHG staff participated in a sharing by NParks Management on their bid to inscribe Singapore Botanic Gardens as a UNESCO World Heritage Site. They learnt that staff cohesion, knowledge exchange and community engagement were instrumental during the inscription exercise, and which ultimately led to Singapore Botanic Gardens clinching the prestigious UNESCO World Heritage Site status.

In March 2016, over 170 staff and Senior Management from NHG institutions and community partners attended a session themed “Art of Collaboration”. The key takeaway was that for successful collaboration, the “Four Cs” of Capacity Building, Coordination, Communication and Continuity are necessary. The session underscored the need for partnerships between healthcare systems and social care systems to holistically manage the bio-psycho-social issues in the community, and achieve better outcomes for our patients and the population.

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NHG QUALITY DAY The 15th instalment of NHG Quality Day held at TTSH in September 2015 highlighted the sharing of best practices and innovations in line with NHG’s new model of care – a shift from illness to wellness care. The inaugural Exemplary Patient and Caregiver Awards (EPCA) acknowledged model patients and caregivers for their tireless support to fellow patients and hospital staff.

Individuals and teams were also honoured with the Excellence in Action Awards (EIAA), recognising those who inspired continuous improvement in their workplace, fostered camaraderie among colleagues, and provided excellent care to their patients. Celebrated in conjunction with the event was the graduation of the 35th to 37th cohorts of the Clinical Practice Improvement Programme (CPIP), with a total of 81 participants and 62 CPIP projects completed.

HEALTHCARE SUPPLIER AWARDS 2015In October 2015, the second edition of the Healthcare Supplier Awards was held. Jointly organised by NHG, National University Hospital (NUH), Khoo Teck Puat Hospital (KTPH) and Agency for Integrated Care (AIC), the event recognised vendors who contribute to improvements in the public healthcare sector. Vendors play an important yet unsung role by working alongside healthcare providers to co-develop technologies and services for better productivity and innovation in healthcare institutions. Eleven companies were honoured across three categories: Operational Excellence, Innovation, and Continuous Improvement.

Suppliers can play a strategic role to help us optimise our supply chain. We need new approaches to resolve our manpower shortages and improve our processes. We must collaborate, innovate and integrate with our partners for a sustainable healthcare future.Ms Lim Yee JuanGroup Chief Financial OfficerNational Healthcare Group


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NHG staff keeping fit together at NHG Family Day 2015

NHG COMMUNITY INITIATIVE Continuing its community outreach and to give back to the less fortunate, NHG HQ reached out to the Society for Aged Sick (SAS). Since July 2015, staff from NHG’s Health Services and Outcomes Research (HSOR), Group Corporate Communications, National Healthcare Group Pharmacy, National Healthcare Group Diagnostics, Group Human Resource and Central Regional Health Office have been volunteering regularly at the SAS nursing home in Hougang. They help residents with occupational therapy sessions and organise excursions. Volunteers also partnered students from the Yong Loo Lin School of Medicine and Lee Kong Chian School of Medicine to bring cheer to the elderly during the Lunar New Year. The CSR initiative seeks to improve the quality of care in nursing homes.

NHG FAMILY DAY 2015More than 1,000 staff and their families gathered at Resorts World Sentosa in August 2015 to celebrate NHG Family Day. Participants enjoyed activities at game stalls and instant photo booths. The event also saw NHG enter the Singapore Book of Records for achieving the "Largest Mass KPOPXfitness Workout" by staff.

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NHG HQ STAFF NIGHT 2016 The NHG HQ Staff Night was held in May 2016. Themed "Shanghai Night", the event featured the 2016 edition of NHG’s Got Talent, where staff staged creative performances highlighting health promotion and 4P7R values. Professor Philip Choo, Group CEO, NHG, handed out long-service awards and retirement gifts to recipients and presented lucky draw prizes to winners.

NHG strives to be an employer of choice by creating a corporate culture that rewards excellence and promotes individual, as well as team growth and development. We invest in our people through various development programmes, and take a holistic approach towards employee well-being by adopting family-friendly practices.Mrs Olivia TayGroup Chief Human Resource OfficerNational Healthcare Group

Health Minister Mr Gan Kim Yong at the MOH-NHG Engagement Townhall 2016

Winners of NHG's Got Talent.

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NHG KINDNESS MOVEMENT The inaugural NHG HQ Kindness Movement took place in November 2015 to encourage our staff to do their part in building a gracious workplace. Group Chiefs and Heads of Business Units led by example by giving out daisies to their staff. Singa, the mascot for the Singapore Kindness Movement, also visited various departments and distributed the book, 5 Amazing Benefits of Being Kind by Dr William Wan, General Secretary of Singapore Kindness Movement.

NHG HQ A.C.T.I.V.E DAY Over 250 staff attended NHG HQ A.C.T.I.V.E Day in January 2016. The event included a two-kilometre walk, a mass Zumba and aerobics workout. Staff also tested their fitness and coordination at exercise stations which included mini squash and hula hoop.

STRATEGIC COMMUNICATIONS SUMMIT 2015 In October 2015, some 30 staff from the NHG Group and Institutional Corporate Communications, and partners gathered for the annual Strategic Communications Summit. Organised by NHG Group Corporate Communications, it is a platform to enhance inter-institutional and departmental partnerships, with a focus on exploring publicity channels to raise awareness of NHG’s new sustainable healthcare model. Participants bonded and learnt how to adopt different communication techniques when collaborating with each other for future projects.


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EQUIPPING STAFF WITH PHOTOGRAPHY SKILLS More than 20 staff from NHG HQ and its institutions learnt to compose and take better photographs at a workshop held in December 2015. Organised by NHG Group Corporate Communications, the session’s trainer was Mr Henry Lim, a veteran photographer from TTSH. Apart from learning basic technical knowledge, staff picked up pointers on how to effectively convey the right message with the right image.

NHG HQ CHARITY CARNIVALThe NHG Family raised almost S$10,000 at the 2016 NHG HQ Charity Carnival, held in January. NHG Group Chiefs and Heads of Business Units supported the Carnival by donating items for a charity auction. Management and staff also sewed, baked, and did handicrafts. All proceeds from the Charity Carnival were donated to Peace Connect – a community care provider in Kampong Glam within the Central Region where NHG serves as the RHS.

WE WALK 50KM TOGETHERIn August 2015, some 500 NHG staff, together with patients from the Institute of Mental Health (IMH) and community partners including the Dover Park Hospice gathered at the MacRitchie Reservoir for the annual Inter-Institutional Activities Grand Finale. The 2015 edition included the new "We Walk 50km Together" team event and Community Walk, which were NHG’s efforts to commemorate Singapore’s 50th birthday and the Group’s 15th anniversary.

The "We Walk 50km Together" race saw five teams of 10 participants each, with representatives from NHG and institutions competing to finish a combined distance of 50 kilometres in the shortest time. NHG Senior Management took part in the Community Walk with staff, patients, caregivers and community partners to complete a 3.2-kilometre trail. Madam Kay Kuok, Chairman, NHG graced the event and gave away prizes.

NHG staff learnt how to convey messages with images.

NHG staff bonded through exercise at We Walk 50km Together.

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NHG LUNAR NEW YEAR LUNCH 2016 WITH MEDIANHG hosted a Lunar New Year Lunch for media in February 2016. It was an opportunity for NHG’s Senior Management, clinicians, Allied Health Professionals (AHP) and nursing heads from our institutions to network with our media partners – to share information on NHG’s RHS journey. Professor Philip Choo, Group CEO of NHG provided insights on "Creating a Sustainable Healthcare Model" in Singapore, which included:

› The need to change the way we deliver healthcare from ad-hoc, episodic care to relationship-based, integrated care to deal with challenges such as the ageing population, increasing burden of chronic illnesses, changing support structures, higher patient expectations, manpower constraints and rising costs;

› The need to create and adopt a sustainable healthcare approach that promotes the principles of public health – healthy behaviour and early interventions with primary care as the first line of defence, appropriate use of acute care, and Advance Care Planning;

› The need to collaborate with our community partners via the RHS, to expand upstream to pre-emptive care, and downstream to rehabilitation and active maintenance.

NHG COOKBOOK: EVERYDAY COOKING – EAT WELL, LIVE WELL In July 2016, NHG Group Corporate Communications launched a user-friendly cookbook containing 30 healthy, affordable, and delicious recipes contributed by NHG staff, with helpful tips from our dietitians. All the dishes are easy to cook, with the aim of encouraging our staff to make healthier food choices. Complimentary copies were distributed to staff across NHG and its institutions.


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NHG NURSES’ DAY NHG and its institutions — Tan Tock Seng Hospital, Institute of Mental Health, National Healthcare Group Polyclinics and National Skin Centre — celebrated Nurses’ Day in August 2015 with treats for over 1,000 nurses at the Tan Tock Seng Hospital Multi-Purpose Hall. The highlight of the event saw our nurses and management putting up a colourful fashion show. NHG’s Senior Management also designed mini decorative-tees for our nurses in appreciation of their hard work and dedication.

INTRODUCTION OF MOH IN-SERVICE SCHOLARSHIP (ISS)The MOH In-Service Scholarship (ISS) was introduced in 2015 to help enhance NHG’s manpower capabilities to:

a. meet the healthcare needs of an ageing population;

b. implement new healthcare strategies including early intervention, integrated care, and long-term care for the elderly;

c. enhance capabilities of existing professionals; and

d. build up our pool of healthcare professional leaders.

The ISS is open to Allied Health, Pharmacy and Nursing staff and supports their professional development through formal education programmes. The range of ISS-supported programmes covers National ITEC Certificates (NITEC) to Doctorate in Philosophy (PhD). Fifty-seven NHG staff were conferred in the inaugural batch of ISS awardees.

Ms Kitty Lee, Senior Medical Social Worker at TTSH, received the

Promising Social Worker Award 2015 from President Dr Tony Tan Keng Yam

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PROFESSOR JAMES BEST APPOINTED OFFICER OF THE ORDER OF AUSTRALIAProfessor James Best, Dean of the Lee Kong Chian School of Medicine and member of the NHG Board, was appointed Officer of the Order of Australia in the 2016 Queen’s Birthday Honours. The appointment recognises Australian citizens and other persons for their meritorious service to Australia and the world. Professor Best was recognised for his contributions to medicine, especially in the field of endocrinology, medical education, and for his efforts in rural and indigenous health.

AMEE INTERNATIONAL CONFERENCE 2015 Associate Professor Lim Wee Shiong, faculty advisor to HOMER (Healthcare Outcomes and Medical Education Research), was conferred the title Associate Fellow of the Association for Medical Education in Europe (AMEE) at the AMEE International Conference 2015. He was among the inaugural batch of 14 members of AMEE, who were recognised for their commitment to health professions education through scholarly contributions to the field.

DISTINGUISHED PSYCHIATRIST AWARD In 2016, Dr Leong Oil Ken, Senior Consultant from the Department of Community Psychiatry, IMH, was among the four winners of the Distinguished Psychiatrist Award (DPA) presented by the Singapore Psychiatric Association (SPA). This award acknowledges senior psychiatrists for their clinical, academic and research work as well as efforts in mentoring young psychiatrists. Dr Leong started working in IMH when he was first posted to the then Woodbridge Hospital as a medical officer in 1976. He retired in 2015 after 39 years of service with the hospital.

NTUC MAY DAY MODEL PARTNERSHIP AWARDNurse Clinician Mr Ong Seng Hong from IMH was conferred the NTUC May Day Model Partnership Award in May 2015. This Award recognises individuals and institutions, whose partnership strategies have enabled workers to take charge of their progression and development, leading to the transformation of Singapore’s economy. Mr Ong was acknowledged for his efforts in building up psychosocial rehabilitation services to better support patients living in the community.

NHGP’S FIRST NURSING LEADERSHIP PROGRAMME The inaugural two sessions of the Nursing Leadership Programme organised by NHGP’s Nursing Leadership Learning Community (NNLLC) were held in August and September 2015. With relationship-building as a key focus, NHGP’s nurse leaders took a personality test to learn about themselves, and participated in activities to develop better interpersonal skills.

Prof James Best at the LKCMedicine White Coat Ceremony 2015


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A/Prof Thomas Chee, Senior Consultant, Diagnostic Radiology Department, TTSH, conferred the National Outstanding Clinical Quality Champion Award at the NMEA 2015

AWARDS AND ACCOLADES Our people and partners continued to be recognised within NHG as well as in the community for their dedication and contributions to providing quality healthcare.

› 12 NHG Recognition Awards › 2 Lee Foundation NHG Lifetime

Achievement Awards

› 3 NHG Distinguished Achievement Awards

› 6 NHG Outstanding Citizenship Awards

› 1 NHG Distinguished Contributor Award

› 63 National Day Awards (NDA) 2015› 1 Meritorious Service Medal

› 1 Public Administration Medal (Silver)

› 1 Public Administration Medal (Bronze)

› 5 Commendation Medals

› 10 Efficiency Medals

› 45 Long Service Medals

› National Medical Excellence Award (NMEA) 2015› 1 National Outstanding Clinical Quality

Champion Award

› 1 President’s Award for Nurses 2015

› 19 Nurses’ Merit Awards 2015

› 3 Tan Chin Tuan Nursing Awards 2015

› 19 Healthcare Humanity Awards (HHA) 2015› 1 HHA Honourable Mention Awardee

› 18 HHA Winners

› PS21 Excellence in Public Service Awards (ExPSA) 2015› Best Practice Awards

› 1 Service Delivery

› 1 Organisation Development

› PS21 Star Awards

› 3 PS21 Star Service Awards

› 1 PS21 Star Service Team Award

› PS21 Excellence through Continuous Enterprise and Learning (ExCEL) Awards 2015› 2 PS21 Innovation Champion Awards (Merit)

› 11 MOH Long Service Awards 2015

› 1 May Day Model Partnership Award 2015

› 1 Promising Social Worker 2015

› 1 Best Contact Centre Customer Service Professional of the Year (Bronze) 2015

› 123 NHG Teaching Excellence Awards 2015

› 8 NHG Quality Improvement (QI) Awards

› 37 NHG Excellence in Action Awards (EIAA)

› Singapore Patient Action Awards (SPAA)› 1 Singapore Patient Engagement

Initiative Award (Team-based Project)

› 99 Development Awards

› 57 In-Service Scholarships (ISS)

› 35 Singapore Health & Biomedical Congress Scientific Competition Awards 2015

› 6 Singapore Primary Care Research Scientific Competition Awards 2015

› APEX 2015: Awards of Excellence – NHG Corporate Yearbook 2014 and Lifewise

120 | Our People

Continuing its community outreach and to give back to the less fortunate, NHG HQ engaged the Society for the Aged Sick (SAS). Since July 2015, staff from NHG’s Health Services and Outcomes Research (HSOR), Group Corporate Communications, National Healthcare Group Pharmacy, National Healthcare Group Diagnostics, Group Human Resource and Central Regional Health Office have been volunteering regularly at the SAS nursing home in Hougang, helping the residents with their occupational therapy, art therapy, and excursions.

“I played Mahjong with the residents, who were gracious and jovial whether they won or lost. I saw my grandma in them and I hope I will be as cheerful as them when I am at their age.”Rosemary SoongDirectorGroup Human Resource

TOUCHING LIVES IN THE COMMUNITY

"On one of my visits to SAS I interacted with an 80 year-old woman suffering from dementia. While I helped her with her exercises, we shared laughter and I really enjoyed the experience. I could also tell that the SAS staff cared about the residents and it was heart-warming to see their close relationship. It was a rewarding experience as it helped me to understand how to interact with the elderly."Lim Soh HarExecutive DirectorNational Healthcare Group Diagnostics

122 | Our People

“During my first visit to SAS, I helped the residents decorate pouches. I got to know the residents better: their names and ages, and learnt more about their families. Spending time with them and seeing them smile made me happy.”

Max WuSenior ExecutiveCentral Regional Health Office

"This CSR work is very meaningful for me. It reinforces the idea that we need to be positive, at work and in our personal lives, and appreciate what we have in life. It also makes me determined to spend more time with my family no matter how busy I am."

Elsie TohManager (Finance)National Healthcare Group Diagnostics

“We took the SAS residents to a coffee shop and I had the chance to talk to an old lady. She spoke of her younger days and I caught a glimpse of her former life and her yearning for the years gone by. While I am not confident to say that we brought anything meaningful to their lives in the few hours we were there, it certainly was beneficial for me to sit down with them, to empathise, to listen to the very people we hope to serve.”Li RuijieManagerHealth Services and Outcomes Research

“Helping the elderly at SAS brought back memories of my late father in the months before he passed away. It was an emotional but rewarding experience because I could see the eyes of the residents light up when they had someone new to talk to.”

Vicky SharmaSenior Executive Group Corporate Communications

"I could see the warmth of the staff and the genuine relationships they had built with the residents, which was one of friendship rather than patient-healthcare worker."Lynette LimSenior Executive (Finance)National Healthcare Group Diagnostics


Our People | 123

A total of 85.9 per cent of respondents was satisfied overall with public healthcare institutions last year, a 6.8 percentage point increase from 2014, according to a survey conducted by the Ministry of Health (MOH). The Patient Satisfaction Survey covered all public healthcare institutions including hospitals, national specialty centres and polyclinics. A total of 12,469 respondents was polled between November 2015 and February 2016.

The survey also found that 83.8 per cent of respondents rated the public healthcare institutions as having met or exceeded expectations, 3.2 percentage points higher than in 2014. About 84.9 per cent

NHG Institutions

Score in 2015 (%)

Score in 2014 (%)

TTSH overall satisfaction of public hospitals

86.1 78.9

IMH overall satisfaction of specialty centres

94.1 88.4

NHGP overall satisfaction of polyclinics

92.2 80.9

NSC overall satisfaction of national specialty centres

89.0 86.0

MORE SATISFIED WITH PUBLIC HEALTHCARE INSTITUTIONS

of respondents were willing to recommend the public healthcare institutions to others, an increase of 2.5 percentage points from 2014. When it came to affordability of services, 72 per cent of respondents rated it as “excellent” or “good”, 3.3 percentage points higher than in 2014. The public healthcare institutions were assessed on attributes in relation to seven touchpoints: doctors, nurses, Allied Health Professionals, care coordination, facilities, waiting time and billing issues.

The feedback indicated that respondents were generally satisfied with the medical staff and facilities. However, they also cited waiting time, procedures and facilities as areas that needed improvement.

Relationship is key to building trust with our patients and providing

accessible, affordable and quality healthcare services.

124 | Our People

C. WILLINGNESS TO RECOMMENDMore respondents said they would “strongly recommend” and “likely to recommend” the HCIs to others based on their experiences i.e. 84.9% in 2015 compared with 82.4% in 2014.

Willingness to recommend

Score in 2015 (%) Score in 2014 (%)

Strongly recommend 34.9 39.2

Likely to recommend 50 43.2

Neither recommend nor not recommend

11.2 12.5

Unlikely to recommend 3.1 2.9

Will not recommend 0.8 2.2

Willingness to recommend (based on top 2 ratings % who rated Strongly / Likely to recommend)

B. MEETING EXPECTATIONS83.8% of respondents rated the public healthcare institutions to be “better than expected” and “slightly above expectations” compared with ratings of 80.6% in 2014. ratings of 80.6% in 2014.

Overall expectations level Score in 2015 (%) Score in 2014 (%)

Better than expected 22.3 30.1

Slightly above my expectations

61.5 50.5

Neutral 11.9 16.2

Slightly below my expectations

2.9 2.3

Worst than expected 1.4 0.9

Overall expectations for all healthcare institutions (based on top 2 ratings % who rated Better than expected / Slightly above expectations)

Overall satisfaction level Score in 2015 (%) Score in 2014 (%)

Excellent 30.5 28.1

Good 55.4 51

Satisfactory 10.9 17.7

Poor 2.8 2.4

Very Poor 0.4 0.8

Overall satisfaction for all healthcare institutions (based on top 2 satisfaction ratings % who rated Excellent / Good)

A. OVERALL SATISFACTION LEVEL85.9% of respondents rated their overall satisfaction levels as “excellent” and “good”. This is an improvement of 6.8 percentage points compared to 2014.

KEY SURVEY RESULTS

Affordability of services Score in 2015 (%) Score in 2014 (%)

Excellent 29.5 20.3

Good 42.5 48.4

Satisfactory 19.1 22.2

Poor 6.5 7.5

Very Poor 2.4 1.6

Value for money (based on top 2 ratings % who rated Excellent / Good)

D. VALUE FOR MONEYRespondents were asked to rate the affordability of services provided by HCIs. In 2015, there was a 3.3 percentage point increase in the number of respondents who rated “excellent” and “good” compared to 2014.


Our People | 125

FINANCIAL YEAR 20151 APRIL 2015 - 31 MARCH 2016

BED COMPLEMENT BY HOSPITAL AND CLASS OF BEDas at 31 March 2016

Class A Class B1 Class B2 Class C Classless

NO. OF BEDS

0

2,200

2,000

1,800

1,600

1,400

1,200

1,000

800

600

400

200

2

152

509

22143

1,707

7524 17 4 8

616

12984187

68

Class A

Class B1

Class B2

Class C

Class-less

FY 2015

FY 2014

Change Change %

TTSH 75 152 509 616 129 1,481 1,481 0 0%

TTSH-CDC 2 4 22 84 187 299 299 0 0%

IMH 24 8 143 1,707 68 1,950 1,950 0 0%

Johns Hopkins

17 - - - - 17 18 -1 -6%

Total NHG 118 164 674 2,407 384 3,747 3,748 -1 0%

126 | Financials

AVERAGE BED OCCUPANCY RATE BY HOSPITAL

Apr 15 - Jun 15 Jul 15 - Sep 15 Oct 15 - Dec 15 Jan 16 - Mar 16

TTSH 91% 87% 89% 89%

TTSH-CDC 74% 71% 69% 72%

IMH 93% 93% 94% 95%

Johns Hopkins 59% 39% 28% 28%


AVERAGE PERCENTAGE

0

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

91%87% 89% 89%

74%71% 69%

72%

93% 93% 94% 95%

59%

28% 28%

39%


Financials | 127

TREND IN INPATIENT DISCHARGE


NO. OF INPATIENT DISCHARGES

0

16,000

14,000

12,000

10,000

8,000

6,000

4,000

2,000

13,25113,837

14,291

938 974 1,087

2,302 2,268

78

13,380

917

2,282

127

2,321

70 71

Apr 15 - Jun 15

Jul 15 - Sep 15

Oct 15 - Dec 15

Jan 16 - Mar 16

FY 2015

FY 2014

Change Change %

TTSH 13,380 13,251 13,837 14,291 54,759 53,890 869 2%

TTSH-CDC 917 938 974 1,087 3,916 3,578 338 9%

IMH 2,282 2,321 2,302 2,268 9,173 8,982 191 2%

Johns Hopkins

127 78 70 71 346 390 -44 -11%

Total NHG 16,706 16,588 17,183 17,717 68,194 66,840 1,354 2%

128 | Financials

TREND IN INPATIENT DAY


NO. OF INPATIENT DAYS

0

200,000

160,000

140,000

180,000

120,000

100,000

80,000

60,000

40,000

20,000

113,986 116,851

12,798

162,122 162,659

640

115,226

12,919

158,032

961

159,667

116,566

12,436

468

12,749

427

Apr 15 - Jun 15

Jul 15 - Sep 15

Oct 15 - Dec 15

Jan 16 - Mar 16

FY 2015

FY 2014

Change Change %

TTSH 115,226 113,986 116,566 116,851 462,629 444,015 18,614 4%

TTSH-CDC 12,919 12,798 12,436 12,749 50,902 49,024 1,878 4%

IMH 158,032 159,667 162,122 162,659 642,480 611,019 31,461 5%

Johns Hopkins

961 640 468 427 2,496 3,067 -570 -19%

Total NHG 287,138 287,091 291,592 292,686 1,158,507 1,107,125 51,384 5%


Financials | 129

Class A Class B1 Class B2 Class C

TTSH 5.9 6.9 7.1 9.1

TTSH-CDC 18.3 6.1 7.9 15.9

IMH (SHORT STAY) 12.2 14.1 15.8 24.7

JOHNS HOPKINS 7.2 - - -

IMH (LONG STAY)1 - - - 804.4

1 : IMH (Long Stay) relates to the average length of stay of long-staying patients who were physically discharged during the year.

Class A Class B1 Class B2 Class C

NO. OF DAYS

0

30.0

24.0

18.0

12.0

6.05.9

18.3

12.2

7.2 6.96.1

7.17.9

15.8

9.1

15.9

14.1

24.7

AVERAGE LENGTH OF STAY BY HOSPITAL AND CLASS OF BED

130 | Financials

Apr 15 - Jun 15

Jul 15 - Sep 15

Oct 15 - Dec 15

Jan 16 - Mar 16

FY 2015

FY 2014

Change Change %

TTSH 15,386 15,754 14,700 15,103 60,943 56,225 4,718 8%

Total NHG 15,386 15,754 14,700 15,103 60,943 56,225 4,718 8%

TREND IN DAY SURGERY


NO. OF DAY SURGERIES PERFORMED

0

20,000

16,000

14,000

18,000

12,000

10,000

8,000

6,000

4,000

2,000

15,386 15,754

14,700 15,103


Financials | 131


NO. OF ATTENDANCES

0

200,000

180,000

160,000

140,000

120,000

100,000

60,000

20,000

40,000

80,000

158,393

11,553

41,402

83,621

1,573

TREND IN SOC ATTENDANCE

Apr 15 - Jun 15

Jul 15 - Sep 15

Oct 15 - Dec 15

Jan 16 - Mar 16

FY 2015

FY 2014

Change Change %

TTSH 158,393 160,465 157,281 160,659 636,798 624,743 12,055 2%

TTSH-CDC 11,553 12,079 12,926 14,253 50,811 46,102 4,709 10%

IMH 41,402 41,108 39,886 40,325 162,721 160,261 2,460 2%

NSC 83,621 85,054 85,839 85,221 339,735 339,239 496 0%

Johns Hopkins

1,573 1,401 1,146 1,235 5,355 6,274 -919 -15%

Total NHG 296,542 300,107 297,078 301,693 1,195,420 1,176,619 18,801 2%

160,465

12,079

41,108

85,054

1,401

157,281

12,926

39,886

85,839

1,146

160,659

14,253

40,325

85,221

1,235

132 | Financials

Apr 15 - Jun 15

Jul 15 - Sep 15

Oct 15 - Dec 15

Jan 16 - Mar 16

FY 2015

FY 2014

Change Change %

TTSH 41,681 40,714 40,893 42,965 166,253 163,277 2,976 2%

Total NHG 41,681 40,714 40,893 42,965 166,253 163,277 2,976 2%

TREND IN A&E ATTENDANCE


NO. OF ATTENDANCES

0

60,000

50,000

40,000

30,000

20,000

10,000

41,681 40,714 40,89342,965


Financials | 133

TREND IN POLYCLINICS ATTENDANCE

0

400,000

300,000

350,000

250,000

200,000

150,000

100,000

50,000

250,383

271,611 277,080

270,489

346,728

249,161 263,500

265,159

200,906

Apr 15 - Jun 15

Jul 15 - Sep 15

Oct 15 - Dec 15

Jan 16 - Mar 16

FY 2015

FY 2014

Change Change %

Acute 254,495 249,161 250,383 270,489 1,024,528 957,195 67,333 7%

Chronic 258,389 263,500 271,611 346,728 1,140,228 988,983 151,245 15%

Non- morbid

270,767 265,159 277,080 200,906 1,013,912 1,027,196 -13,284 -1%

Total NHG 783,651 777,820 799,074 818,123 3,178,668 2,973,374 205,294 7%

254,495258,389

270,767

NO. OF ATTENDANCES


134 | Financials

DISTRIBUTION OF STAFFas at 31 March 2016 (FY2015)

FY 2015

FY 2014

Medical 904 921

Nursing 4,834 4,621

Allied Health 2,064 1,953

Ancillary 2,796 2,663

Administration 1,634 1,538

Total 12,232 11,696

40%(Nursing)

17%(Allied Health)

23%(Ancillary)

13%(Adminstration)

7%(Medical)


Financials | 135

FY 2015S$’M

FY 2014S$’M

Assets By Major Categories

Properties, Plant and Equipment 406 402

Trade and Other Receivables 572 534

Cash and Cash Equivalents 422 382

Other Assets 18 16

Total Assets 1,418 1,334

Liabilities by Major Categories

Trade and Other Payables 520 460

Other Liabilities 272 272

Total Liabilities 792 732

Capital and Reserves by Major Categories

Share Capital 233 233

Reserves* 392 369

Minority Interest 1 0

Total Capital and Reserves 626 602

Revenue by Major Categories

Patient and Patient Related Revenue 634 620

Government Subvention 1,026 943

Other Revenue 357 288

Total Revenue 2,017 1,851

Expenditure by Major Categories

Staff Costs 1,092 991

Medical Supplies and Consumables 277 254

Depreciation and Amortisation 95 82

Other Expenses 531 516

Total Expenditure 1,995 1,842

KEY FINANCIAL INFORMATION

* : Reserves include accumulated surpluses and specific reserves ring-fenced for capital investment, medical research, Regional Health activities as well as innovation and productivity improvements in the future.

136 | Financials

ABOUT NHG INSTITUTIONS

TAN TOCK SENG HOSPITAL11 JALAN TAN TOCK SENG, SINGAPORE 308433 TEL: 6256 6011 FAX: 6252 7282 WWW.TTSH.COM.SG

Tan Tock Seng Hospital (TTSH) is one of Singapore’s largest multidisciplinary hospitals with more than 170 years’ experience of pioneering medical care and development. The hospital has 36 clinical and Allied Health departments, 15 specialist centres and is powered by more than 7,000 healthcare staff. TTSH is accredited by the Joint Commission International (JCI) in recognition of its world-class patient care and the comprehensive range of high quality holistic healthcare services at its main hospital complex, the Communicable Disease Centre, TTSH Rehabilitation Centre and specialist clinics.

INSTITUTE OF MENTAL HEALTHBUANGKOK GREEN MEDICAL PARK, 10 BUANGKOK VIEW, SINGAPORE 539747 TEL: 6389 2000 FAX: 6385 1050 WWW.IMH.COM.SG

The Institute of Mental Health (IMH) is a 2,000-bed acute tertiary psychiatric hospital. Set amidst 23 hectares of serene surroundings, IMH offers a comprehensive range of psychiatric, rehabilitative and counselling services for children, adolescents, adults and the elderly. IMH was the first mental health institution in Asia to receive the JCI accreditation in 2005, a prestigious global accreditation standard for healthcare organisations.

138 | About NHG Institutions

NATIONAL SKIN CENTRE1 MANDALAY ROAD SINGAPORE 308205 TEL: 6253 4455 FAX: 6253 3225 WWW.NSC.COM.SG

The National Skin Centre (NSC) is an outpatient specialist dermatological centre with a team of dermatologists who have the experience and expertise to treat a wide variety of skin conditions. NSC has a comprehensive range of subspecialty services, and serves about 80 per cent of dermatology outpatients in Singapore. This has firmly established its position as a reputable dermatology centre in Singapore and the region. The Centre aims to facilitate subspecialisation and be the national focus for the treatment, research, and training on all aspects of skin diseases.

NATIONAL HEALTHCARE GROUP POLYCLINICSCONTACT CENTRE: 6355 3000 WWW.NHGP.COM.SG

National Healthcare Group Polyclinics (NHGP) forms the primary healthcare arm of National Healthcare Group (NHG). Its nine polyclinics serve a significant proportion of the population in the central, northern and western parts of Singapore. NHGP provides a comprehensive range of health services for the family, functioning as a one-stop health centre providing treatment for acute medical conditions, management of chronic diseases, women & child health services and dental care. The focus of NHGP’s care is on health promotion and disease prevention, early and accurate diagnosis, disease management through physician led team-based care as well as enhancing the capability of Family Medicine through research and teaching.

Through the Family Medicine Academy and the NHG Family Medicine Residency Programme, NHGP plays an integral role in the delivery of primary care training at medical undergraduate and post graduate levels. NHGP has also been awarded the prestigious JCI accreditation under the Primary Care Standards. NHGP manages the following nine polyclinics:

Ang Mo Kio PolyclinicBlk 723 Ang Mo Kio Avenue 8 #01-4136 Singapore 560723

Bukit Batok Polyclinic50 Bukit Batok West Avenue 3 Singapore 659164

Choa Chu Kang Polyclinic2 Teck Whye Crescent Singapore 688846

Clementi PolyclinicBlk 451 Clementi Avenue 3 #02-307 Singapore 120451

Hougang Polyclinic89 Hougang Avenue 4 Singapore 538829

Jurong Polyclinic190 Jurong East Avenue 1 Singapore 609788

Toa Payoh Polyclinic2003 Toa Payoh Lor 8 Singapore 319260

Woodlands Polyclinic10 Woodlands Street 31 Singapore 738579

Yishun Polyclinic30A Yishun Central 1 Singapore 768796

FAMILY MEDICINE CLINICS(NHG in public-private partnership with GPs)

Hougang Family Medicine Clinic @ Ci Yuan Community Club51 Hougang Avenue 9 #02-01, Ci Yuan Community Club Singapore 538776

NTUC Unity Family Medicine Clinic 264 Serangoon Central #01-205 Singapore 550264


About NHG Institutions | 139

NHG COLLEGE3 FUSIONOPOLIS LINK #03-08, NEXUS@ONE-NORTH (SOUTH LOBBY) SINGAPORE 138543 TEL: 6340 2351 FAX: 6340 3275 WWW.COLLEGE.NHG.COM.SG

NHG College plays an instrumental role in facilitating continuous learning and development of our workforce, as well as driving leadership development and systems improvement in NHG. It collaborates with renowned institutions and industry partners to build the collective capabilities of NHG leaders, educators, healthcare professionals and staff in managing the health of the population in the central region.

NATIONAL HEALTHCARE GROUP DIAGNOSTICS3 FUSIONOPOLIS LINK, #05-08, NEXUS@ONE-NORTH (SOUTH LOBBY) SINGAPORE 138543 CALL CENTRE: 6275 6443 (6-ASK-NHGD) FAX: 6496 6625 WWW.DIAGNOSTICS.NHG.COM.SG

National Healthcare Group Diagnostics (NHGD) is a business unit of NHG, providing quality laboratory and imaging services at the primary healthcare level. The first to introduce Tele-radiology in Singapore and via its extensive network of 33 static and mobile centres, NHGD provides one-stop imaging and laboratory services which are accessible, cost-effective, seamless, timely and accurate. In a continuous quest for quality excellence, NHGD received international accreditation such as ISO 15189:2003 (Medical Laboratory – particular requirement for quality and competence) and has also joined efforts with NHGP to attain the Joint International Commission (Ambulatory Care Standard) accreditation.

NHG PHARMACY3 FUSIONOPOLIS LINK #03-08, NEXUS@ONE-NORTH (SOUTH LOBBY) SINGAPORE 138543 TEL: 6496 6000 WWW.PHARMACY.NHG.COM.SG

National Healthcare Group Pharmacy (NHGPh), a business unit of NHG, manages the pharmacy services and retail pharmacies at all NHG Polyclinics. It is also the leading provider of pharmacy services in the long-term care sector. Armed with the mission to promote the safe, effective and responsible use of medication, its team of pharmacists provides clinical pharmacy services to help customers achieve the best results for their prescribed therapy by working with other members of the healthcare team. Conveniently located in heartlands, its retail pharmacies offer an array of quality and affordable healthcare essentials.

140 | About NHG Institutions

PRIMARY CARE ACADEMY (PCA)3 FUSIONOPOLIS LINK #05-10, NEXUS@ONE-NORTH (SOUTH LOBBY) SINGAPORE 138543 TEL: 6496 6683 / 6496 6682 FAX: 6496 6669 EMAIL: [email protected] WWW.PCA.SG

The Primary Care Academy (PCA) was set up to meet the professional training needs of primary healthcare professionals in Singapore and the region. It serves as a training facility for Family Physicians, nurses, Allied Health Professionals and ancillary staff in primary care. It also offers a platform for sharing of expertise and capacity building among community healthcare practitioners and leaders in the region.

NHG EYE INSTITUTETEL: 6357 8000 WWW.TEI.NHG.COM.SG

The NHG Eye Institute was set up to meet the increasing demand for eyecare 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. It also works with various organisations – such as the Singapore Eye Research Institute, National University of Singapore and clinical research organisations – to undertake clinical research programmes relevant to its patients.

JOHNS HOPKINS SINGAPORE INTERNATIONAL MEDICAL CENTRE11 JALAN TAN TOCK SENG SINGAPORE 308433 TEL: 6880 2222 FAX: 6880 2233 WWW.IMC.JHMI.EDU

Johns Hopkins International Singapore Medical Centre is a licensed 30-bed medical oncology facility in Singapore. It is a joint venture between NHG and Johns Hopkins International. It is the only fully-branded Johns Hopkins facility outside of USA, providing inpatient and outpatient medical oncology care, medical intensive care and laboratory services.

INSTITUTE OF GERIATRICS AND ACTIVE AGEINGCENTRE FOR GERIATRIC MEDICINE TEL: 6359 6100 FAX: 6359 6101

The Institute of Geriatrics and Active Ageing was set up to establish new directions for geriatric care in Singapore. Through research innovations and continuous education, the Institute aims to enable the delivery of holistic care to improve the health, independence, safety and quality of life for the elderly.


About NHG Institutions | 141

SHARING SOME BOUQUETS…

“Thank you for helping me throughout my Primary 6 year. I am now happier in school and less fearful. Thank you for always being there for me whenever I was scared or afraid and

for always being so caring and encouraging. You have helped me to overcome the biggest obstacle in my life. Continue to give others a happier life and put a smile on everyone’s faces, just as you have done for me!”

Compliment for Ms Kelly Yeo Senior Clinical Psychologist DCAP (REACH South) from Former REACH student

“I would like to thank Lab Tech,

Mr Jacob Ong, who took special

care when drawing my children’s

blood at an appointment at the

Yishun Polyclinic. They felt

no pain - thanks to Jacob for

a job well done!”

Mdm PhuaSingapore

“Dr Elsie Ng from Ang Mo Kio (AMK) Polyclinic is a very

good family doctor – she was very caring and addressed my concerns with patience. I was also very touched by the actions

of Mr Mah Choon Siong who works at the AMK Polyclinic Pharmacy. Seeing that I had

difficulty walking, he helped me to secure my queue number. Ms Mazni, who assisted me with my appointment, was courteous and friendly. It really made my day.”

Ms Tan Soon BoeyPatient

Ang Mo Kio Polyclinic

In your diverse roles as

doctors, nurses, Allied

Health Professionals, or

administrative and support

staff, you have each played

an important role in making

NHG’s vision of Adding Years

of Healthy Life come alive.

Mr Gan Kim Yong

Minister for Health

“My wife has been consulting the lymphoma clinic at NSC for the past four years. We are grateful for the professionalism and commitment of the doctors and admin staff despite the fact my wife is a subsidised patient. Their warmth and care helped my wife on her journey to recovery. Dr Mark Tang, Dr Tan Wee Ping and Prof Tan Suat Hoon as well as Heather Tan Hwee Ling have given us a lot of support and without the team, it would not be possible for my wife to give birth to a healthy child and for us to have a family that we could previously only dream of. ”Husband of Mdm Phua YQ

“I was hospitalised at TTSH

and noticed that the nurses

were dedicated, efficient and

unassuming and provided

excellent care to all the patients

in the ward. The nurses

addressed us by name – this

created an immediate sense

of togetherness. A few of the

nurses were non-Singaporeans

and I felt their varied cultural

backgrounds led to better

team synergy, and better service.”

Mr Neo Poh GoonPatient TTSH

“The TTSH and National Neuroscience Institute (NNI) teams are truly dedicated professionals. They showed me the best of care, and a warm human touch. They are the rays of light when patients and their families are at their lowest.Mr Heng Swee KeatMinister for Finance

“Believe in people. It makes a big difference to their

confidence, and in what they can achieve in contributing towards patient care.”

Ms N NirmalaSenior Nurse Manager

NHGP

“As a Medical Social Worker, you need to be able to wear different hats and have different skillsets to better interact with and care for your patients.”Ms Kitty LeeSenior Medical Social WorkerTTSHPromising Social Worker Award 2015

“We should always go the

extra mile for our patients

as nothing is impossible if

you really make the effort.”

Dr Alex Su

Senior Consultant

IMH

STAFF QUOTES“The human touch has no cost. But it has amazing value. We, as healthcare workers, can touch lives.

Brains can be trained with books, but volunteer work is ‘heart’ training.”

Dr Martin ChioSenior Consultant & Head

DSC Clinic, NSC

“In life we never stop learning,

and in learning, there are no

boundaries, no borders; it’s not

how often one falls, but how

quickly one rises up again that

makes the difference. Let us

create a culture of kindness

so that each day we come to

work not because we have to

but because we want to.”

Professor Low Cheng Hock

Advisor

NHG Culture Building Steering Council

NHG IS A REGIONAL HEALTH SYSTEM FOR SINGAPORE

STAY HEALTHY LIVE WELL - National Healthcare … Year Book...Khairunnisa Binte Abdul Halek, Jeannie...

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Transcript of STAY HEALTHY LIVE WELL - National Healthcare … Year Book...Khairunnisa Binte Abdul Halek, Jeannie...