GROUP CEO’S
MESSAGE
COVID-19 tested the public healthcare system to its maximum and collectively with the Government, agencies, partners, and citizens, we have reduced the crisis from a pandemic to an endemic state. Every one of you deserves a big “Thank you”.
Although life now has a good semblance of normalcy, the virus is unlikely to be stamped out for good. In fact, we can expect the virus to mutate and circulate longer with land, air, and sea travel now open. Its new variants of concern (VOC), such as Delta and Omicron, and multiple waves of infections past, present, and future will continue to keep us busy. Singapore with its high vaccination rate has managed to be in a stable state, and most aspects of life have returned to pre-COVID level. Social restrictions have been lifted except for public transport and visits to hospitals, and the flights for overseas work and vacation have increased with a new buzz of hope.
For us in healthcare, our deep involvement on the frontline for more than two years, has left scars of the COVID battle. Even so, with fortitude, resilience, and encouragement from the public and the world, we stand ready and prepared for any potential emergence of old and new viruses because it is our duty to do so. We will work closely with the Ministry of Health (MOH) to take care of our patients in all situations and circumstances, and to ensure best health outcomes for the populations we serve in the Central-North region of Singapore.
In other developments, MOH and Woodlands Health (WH) established the first stepped-up Community Care Facility (CCF) in September 2021 by repurposing the NTUC Health Nursing Home in Tampines. The 250-bed CCF provided timely care to patients who were stable, and had mild COVID-19 symptoms but whose underlying conditions or co-morbidities required closer monitoring. Two months later, Tan Tock Seng Hospital (TTSH) opened a 55-bed COVID-19 Treatment Facility (CTF) at Ren Ci Community Hospital (CTF@Renci) to care for elderly patients discharged from the National Centre for Infectious Diseases (NCID) but who still needed close attention. These facilities, in addition to others that opened later, helped augment the nation’s hospital capacity, and ensured better overall management of patient load and specialised care for more critical cases.
I am grateful to the medical and nursing teams from these Institutions and others, including Khoo Teck Puat Hospital (KTPH), National Skin Centre (NSC), National Healthcare Group Polyclinics (NHGP), and National Healthcare Group (NHG) HQ, who readily stepped up to help redesign care delivery, develop new workflows and clinical management strategies, and provide resources to the facilities. Added support from the Singapore Armed Forces (SAF), and various General Practitioner (GP) and community partners contributed to our ability to right-site care, without compromising quality and patient safety.
More than two years on, the COVID-19 pandemic has taught us valuable lessons that can further fortify the nation’s capabilities in emergency preparedness, and enhance national resilience. It is important to share the learnings and experiences, and with this in mind, NCID established a Gallery at its premises in September 2021, which showed the journey of our management of severe infectious disease outbreaks, including COVID-19.
Just as pandemics can be a challenging time for adults, for children, the period of masks and darkness was a confusing period for them too as they tried to make sense of the changes around them. To help the young understand the COVID-19 virus and adapt to endemic times, Professor Leo Yee Sin, Executive Director, NCID, wrote My Coronavirus Story. Supported by NHG and sponsored by the Tanoto Foundation, the picture book conveys the thoughts, feelings, and experiences of a child living during the pandemic. It was launched in December 2021 and is available at most public libraries and primary schools across Singapore. The book is a reference for future generations on public health, vaccination, and emphasises social responsibility in our fight against the virus, and the message of grit, hope, and resilience to gel as a community, and as a nation to combat any battle.
The collective leadership, collaborative spirit, and commitment displayed in tackling COVID-19 pandemic will serve us well as we move into the endemic phase, in building better health for our population.”
professor philip choo group chief executive officernational healthcare group
Healthier You, Healthier SG
The collective leadership, collaborative spirit, and commitment displayed in tackling COVID-19 pandemic will serve us well as we move into the endemic phase, in building better health for our population. It is a future where proactive health and preventive health as a community take centre stage. People are encouraged to own their health, to eat sensibly, exercise, and improve their well-being through daily living. By supporting each other, we are then able to prevent the onset of illness, and stem the progression of chronic diseases. This is the future of healthcare envisioned by MOH in its Healthier SG strategy.
NHG’s population health framework, River of Life, aligns with Healthier SG, and is a care transformation journey we embarked on more than three years ago through an Accountable Care Organisation (ACO) – Integrated Care Organisation (ICO) structure. Our three regional ICOs — Central Health (CH), Yishun Health (YH), and Woodlands Health (WH), supported by our Group Integrated Care (GIC) Office — have to-date formed several strong networks of care with like-minded partner providers to serve the care needs of their respective zonal population, and deliver joined-up, value-based, and person-centred care. These “Communities of Care” (CoCs) in familiar neighbourhoods target health and social interventions tailored to more specific demographics and needs, making holistic care within easy reach of residents.
Currently, NHG manages the health of about 1.5 million residents in Central-North Singapore with primary prevention as a focus. We have observed the demographics of our population aged 20s to 60s, and seen a significant co-relation between their risk profiles and their daily lifestyle choices. The incidence of chronic diseases has also been rising over time, even among younger people. This is a major challenge for Singapore, compounded by our rapidly ageing population. While our Institutions provide very good care, especially acute care, it is not a long-term or sustainable solution for us. Hence, we need a paradigm shift in care to effectively deliver ‘health’ to those we serve, beginning with tackling modifiable behaviours of individuals, and as a community.
Fundamental to shaping behaviours is relationship-based care and the trust it entails. This is where primary care plays a prominent role as a key driver of Healthier SG. We are encouraging polyclinics to be the first-line for physical wellness care, as well as mental health, and looking after the young by extending programmes into child and maternal care. GPs as key primary care partners of NHG are also crucial. They can influence, coach and guide patients to make lifestyle choices because of the trust they have built up with their patients. This means going beyond prescribing medicine to co-developing holistic health plans with patients and helping them to stay the course.
As part of transforming primary care, NHG is committed to supporting our GP partners on the Healthier SG enrolment programme with better access to community and cluster resources, developing shared-care protocols and care paths for patients, and enhancing the IT system for safe and secured sharing of patient data.
Regular dialogues with GPs, community partners, and residents are important for Healthier SG to achieve its aims. POPCollect (Population Health Collective), which we launched in May 2022, and the various focus group discussions we co-organised with MOH and Agency for Integrated Care (AIC) in July and August, have proven to be useful platforms. They were opportunities for like-minded stakeholders to co-learn and co-create care, and glean pertinent feedback for building healthier and happier communities.
Another key pillar of Healthier SG is enabling and engaging individuals to actively participate in their own health. To do this, it is critical to understand how motivations and attitudes influence residents’ health behaviours. On this front, YH is conducting a population health survey of 2,500 residents living in northern Singapore from July to December 2022. Done in collaboration with NHG, NHG Health Services and Outcomes Research (HSOR), WH, CH, and the Duke-NUS Medical School’s Programme in Health Services and Systems Research, the survey aims to establish a baseline for evaluation of our healthcare model and services. Its results will help us to determine and develop effective interventions to address the health needs, health behaviour and risks, health-seeking experience and service utilisation of our communities.
To support our data gathering, our Group Accountable Care (GAC) Office is building a Population Health Registry (PHR) that would have both resident-data and patient-data, in order to create a longitudinal record of the health, social, and lifestyle factors of all residents who live in the Central-North region, including patients of NHG Institutions. Dashboards are also in the pipeline to allow for the monitoring of resident population health outcomes at different levels.
Several of our integrated health-social programmes — including TTSH’s Project Carer Matters, YH’s Wellness Kampung, NHGP’s Enhanced Maternal Baby ToddleR And Child SurvEillancePLUS (EMBRACEPLUS), and Institute of Mental Health (IMH)’s Recovery-Oriented Transitional Care Model (ROTCM) — arose from insights we gathered on what matters to our patients and caregivers and their needs.
More recently, NHG with a S$2.6 million funding support from the Tanoto Foundation launched a Diabetes Reversal Programme. The Programme, unveiled on 5 August, seeks to control blood sugar levels in diabetes patients through behavioural change without the need for medication or surgery. A clinical trial would be conducted for an intensive weight management regime in reversing early diabetes in obese patients, as such real-world research can directly impact health outcomes.
An artist’s impression of WH’s specialist outpatient clinics.
Digital Transformation
In parallel with research studies and data gathering, giving access to a common set of accurate, up-to-date, and complete information across the populace, GPs, public healthcare clusters, MOH, and other providers would facilitate good and coordinated care.
On 30 July 2022, TTSH became the first hospital in our Cluster together with National Neuroscience Institute (NNI), Ang Mo Kio-Thye Hua Kwan Hospital, and Ren Ci Community Hospital to go-live with the Next Generation Electronic Medical Record (NGEMR) System. As more NHG Institutions go-live with NGEMR, it is my hope that our community of carers would enjoy more seamless access to clinical information so as to better coordinate care, enhance patient experience, and drive greater health for our population.
As we harness digital technology further, we must step up cybersecurity and make cyber safety a standard good practice to sustain public trust. In July 2021, we launched the NHG Cyber Safety Ambassador Programme, and to-date our Group Information Security Office (GISO) has enlisted more than 300 Ambassadors across NHG Institutions to help raise cybersecurity awareness and instil individual cyber hygiene. Our efforts towards securing IT solutions, data protection, and raising staff readiness to predict, respond, and mitigate potential cyber-threats will help secure the technology that our healthcare systems are built on.
Increasing Healthcare Capacity
In spite of disruptions from the COVID-19 pandemic, NHG was able to achieve several milestones in raising healthcare capacity to meet patients’ current needs.
WH marked its topping out milestone on 12 February 2022, and will progressively open from December 2023, first with specialist outpatient clinics. The remaining services, including emergency department and inpatient wards, will open from May 2024.
On 7 May 2022 NHGP officially opened Kallang Polyclinic. In line with Healthier SG, the polyclinic offers a range of healthcare services to help residents take charge of their health and well-being. These include RELATE (RELationship-based HeAlth & Social InTEgration) programme, where the polyclinic works closely with community partners to develop shared care plans to support elderly patients with complex medical and social needs, and the pilot use of a fully-automated SMARTVacc (Safety Manpower Productivity Accountability Real Time Analytics Vaccine) System, which monitors and dispenses vaccines inventory in real time. It is also the first NHG Polyclinic to introduce a Patient Advisory Council (PAC), which comprises residents from the neighbourhood who are also patients, to co-create care solutions.
As part of its efforts to enhance inpatient care and improve operational efficiency, IMH completed Phase One of its refurbishment and improvement project in November 2021. Under this first phase, a new Short Stay Unit (SSU) was created and five acute wards, including a child and adolescent ward, were refurbished. These will significantly boost IMH’s recovery-focused model of care, which advocates holistic and patient-centred treatment and management. Refurbishment of another five inpatient wards is on-going and expected to be ready in 2023.
Enhancing Mental Health Support
As we embark on Healthier SG, it is important that we ensure the well-being and health of our staff, especially in post-COVID-19 times. Research has shown that the person who is mentally healthier tends to have better outcomes.
Cluster and Institution-wide initiatives to monitor and promote overall health and staff well-being will continue, as would the protocols that assure staff they can safely seek redress from abuse they may face from patients and caregivers, and get the support they need.
Strengthening leadership for the future
As we shift to a higher gear to provide better health for our population through the GAC-GIC structure, we have also renewed leadership across NHG. I would like to thank Dr Elaine Tan who stepped down from her role as Chief Integrated Care (Clinical), GIC. Under her leadership, she facilitated new wellness, illness and community care models, and developed integrated care programmes that created positive impact on the community. Ms Ong Jing Fang has been re-designated Chief, GIC, and she stands in good stead to oversee and synergise GIC functions in support of Healthier SG.
I would like to congratulate Dr Karen Ng on being appointed Deputy Chief Executive Officer, NHGP. With her experience in helming NHGP’s clinical services, Dr Ng is well poised to drive an integrated system that is person-centred and relationship-focused, to support the exciting growth in our primary care transformation journey.
I would like to express my appreciation to Associate Professor Thomas Lew, who stepped down from his position as Group Chief Data & Strategy Officer in October 2022. A/Prof Lew was instrumental in driving NHG’s digital transformation journey, and bringing the NGEMR to fruition. Through his leadership, we have established a sound integrated IT foundation that would revolutionise delivery of care and improve health outcomes via implementation of sustainable and connected capabilities, and optimisation of data. Assistant Professor Eric Wong succeeds him and will spearhead NHG’s strategic capabilities across the IT Office, Health Informatics Office, Group Data and Data Protection Offices, and Information Security Office. Associate Professor Terence Tang was designated Group Chief Clinical Informatics Officer in November 2022 to augment leadership for the Group Health Informatics Office and develop strategic plans to drive care transformation projects.
The past year also saw the appointment of Deputy Group Chiefs to provide the necessary support to steer our organisation to new heights. Dr Tang Kong Choong was appointed Deputy Chief Executive Officer, TTSH & Central Health, to help manage Hospital Services and Corporate Services, and oversee the Nursing, Allied Health, and Pharmacy Divisions. Separately, my gratitude goes to Professor Benjamin Seet who relinquished his appointment as Assistant Chief Executive Officer, Corporate Services, TTSH & Central Health, in April 2022 to focus on his existing role as Deputy Group CEO (Education & Research), NHG.
To advance quality improvement and development, Dr Tung Yew Cheong was appointed Deputy Group Chief Quality Officer (GCQO) in July 2022, to work alongside fellow Deputy GCQO, Dr Wong Moh Sim. Both are assisting Associate Professor Tai Hwei Yee, GCQO to provide stewardship in the Group Quality Office. Ms Khoo Swee Lan was appointed Deputy Group Chief Human Resource Officer in October 2021 to help drive workforce transformation to address the challenges of our healthcare system and Healthier SG.
Celebrating NHG22
To commemorate NHG’s 22nd Anniversary this year, Group Corporate Communications (GCC) designed an attractive NHG22 Logo comprising the vibrant colours of NHG and our Institutions. They represent us rallying together to keep our patients well through our River of Life framework, designed to care for our population from Living Well to Leaving Well. I am confident that together with our partners, we are moving beyond providing illness care to wellness care, and to partner our CoCs to lead healthier lives.
As part of our NHG22 celebrations, GCC with support from NHG HQ and Institutions organised a NHG22 Walk•Run•Cycle Movement from August to October 2022, to promote bonding and healthy living. The Movement – which spurred NHG staff, family, friends, and community partners to clock in over 85,000 km through their walks/runs/cycles over the three-month virtual challenge – culminated in a physical finale event on 30 October. This big NHG Family bonding and community event attracted some 600 participants who hopefully will continue to exercise regularly. This Movement is reflective of NHG’s vision of Adding Years Of Healthy Life.
Let us continue to remain focused and undaunted, especially in the face of the evolving health landscape. Guided by, and grounded on our core values, we will forge ahead as ONE NHG to serve our nation and achieve better health for our population.