Ministry of Health: Nurses, pharmacists and other manpower are being increased

Senior Minister of State for Health and Ministry of Communications and Information, Singapore, Dr Boujli, speaks at Parliament on 6 March on family doctors.

The following is a translation of the Singapore Eye based on Parliamentary sources:

Mr Yip Hon Wing emphasised ensuring that the family doctors participating in the Healthy SG Programme GP clinics have the necessary resources and expertise to effectively cope with chronic diseases. Ms Wong also asked how the government intends to support the professional development of family doctors, especially as they may be involved in an increasing number of areas, such as social prescribing that influences patients' lifestyle choices to achieve better health outcomes and treat common mental health conditions. Dr. Saeed Harlan asked about retention programs for professionals who support the transition from the Healthy SG program to preventive care.

The Ministry of Health is working closely with Higher Education Institutions (IHLs) to increase local training channels. We are also committed to developing family physicians in primary and community care, with a greater emphasis on family medicine training, such as encouraging more doctors to participate in postgraduate family medicine training, such as the Graduate Diploma in Family Medicine and the Masters of Medicine in Family Medicine. Postgraduate training in family medicine has also been strengthened to help family physicians better cope with complex diseases in different age groups. The training is delivered in a variety of formats, including video conferencing and webinars, giving family doctors more flexibility to keep up with the latest developments in the field of family medicine.

At the same time, we are increasing the number of community nurses, pharmacists, and other allied health professionals and providing them with interdisciplinary training that will enable them to practice at the highest level of their licensure. We will also expand the role of community pharmacists and other allied health professionals in primary and community care to improve the delivery of community care. We will also train more people without medical training. These individuals can take on tasks such as arranging primary medical check-ups and coordinating referrals to community programs. Healthcare professionals can focus on clinical care.

To ensure patients receive consistent, high-quality care, the primary care team will be supported by a Healthy SG Plan Care Agreement. These care protocols clearly define clear processes, referrals, and data flows that guide family physicians in managing each health condition. During the launch of the Healthy SG program, 12 care protocols were issued for the management of common chronic diseases such as diabetes and high cholesterol, as well as preventive care measures such as smoking withdrawal and weight management. More care protocols will be developed in the future to cover more chronic diseases. We recognise that some GPs may have more experience in managing certain chronic conditions. Therefore, we will work closely with the College of Family Medicine (CFPS) of Singapore, the Centre for Connected Care (AIC) and the Healthcare Group to conduct training for family doctors and care teams for each care agreement. We will also strengthen our links with Community Assist Groups (COMIT) to provide non-pharmacological mental health support to patients with mental health needs to support family doctors in providing integrated care.

Dr Tan asked the Ministry of Health if it was reviewing the time required for a family doctor's office to provide comprehensive care. As we mobilize family doctors to work with their patients to develop a wellness plan, which may include lifestyle modifications and regular health screenings, we expect the proportion of patients to consult in the clinic for long periods of time will increase. This has been taken into account when planning for future primary care capacity. In order for family doctors to focus on optimising clinical care, we have taken a team approach to care in both the clinic and private family doctor practice. In the clinic, patients with chronic conditions are assigned to a multidisciplinary care team consisting of family physicians, care managers, and care coordinators.

In private family physician practice, PCNs take root and strengthen team care for chronic diseases, by integrating resources to organize core ancillary services provided by nurses and care coordinators who work with family physicians to manage the patient's condition. The number of clinics participating in the Large Primary Care Network (PCN) program has grown, from 340 clinics in 2018 to more than 1,000 clinics today.

Our healthcare group will also act as regional health managers, working with family physicians and other partners to address the health and social needs of residents in their districts and provide care in the community. For example, a family doctor may work with a specialist or hospital doctor to manage patients with more complex needs. Upon discharge, the hospital will refer the patient to their registered family physician to ensure continuity of care between the hospital space and the primary care space.

The following is the content of the question in English:

Mr Yip Hon Weng highlighted the need to ensure GPs in participating Healthier SG GP clinics have the necessary resources and expertise to effectively manage chronic conditions. Ms Ng Ling Ling also asked how the Government intends to support the professional development of GPs, especially in areas that they may be increasingly involved in, such as social prescriptions to influence patients’ lifestyle choices for better health outcomes and treatment of common mental health conditions. Dr Syed Harun asked about retention plans for healthcare professionals to support Healthier SG and the shift towards preventive health.

MOH is working closely with Institutes of Higher Learning (IHLs) to increase local training pipelines. We are also committed to the development of family doctors in primary and community care and have placed a stronger emphasis on family medicine training, such as encouraging more doctors to take up postgraduate Family Medicine training like the Graduate Diploma in Family Medicine (GDFM) and the Masters of Medicine in Family Medicine. Postgraduate training in Family Medicine is also strengthened to help family doctors be more equipped to manage a wider range of complex conditions across different age groups. Training is delivered through various modalities including video conferencing and webinar platforms, allowing GPs more flexibility as they keep up to date with the latest developments in family medicine.

At the same time, we are increasing the number of nurses, pharmacists and other allied health professionals in the community, and are providing interdisciplinary training to empower them to practise at the highest level of their licences. We will also expand the role of community pharmacists and other allied health professionals in primary and community care to improve care delivery in the community. We will also train more lay extenders. These are non-medically trained persons who can undertake tasks, such as arranging the initial health screening and coordinating referrals to community programmes. Healthcare professionals can then focus on clinical care.

Primary care teams will be supported with Healthier SG Care Protocols to ensure consistent, quality care for patients. These care protocols lay out clear processes, referrals and data flows to guide GPs in managing each health condition. Twelve care protocols were released during the launch of Healthier SG on the management of common chronic conditions, such as diabetes, high cholesterol and preventive health, such as smoking cessation and weight management. More care protocols will be developed to cover more chronic diseases in the future. We recognise that some GPs may have more experience in managing certain chronic conditions than others. Therefore, we will work closely with the College of Family Physicians Singapore (CFPS), AIC and healthcare clusters to roll out training for GPs and their care teams for each care protocol. We will also support GPs in the provision of holistic care for patients with mental health needs by strengthening the links to COMIT for non-pharmacological mental health support.

Sir, Dr Tan Wu Meng asked if MOH is reviewing the time required by GP clinics to deliver holistic care. As we mobilise family doctors to co-develop health plans with their patients, which can include adjustments to lifestyles and regular health screening, we expect that the percentage of patients requiring longer clinic consultations to increase. This has been taken into account when planning for future primary care capacity. To allow family doctors to focus on optimising clinical care, we have adopted a team-based care approach in polyclinics and private GP clinics. In polyclinics, patients with chronic conditions are assigned to multidisciplinary care teams comprising family physicians, nurse care managers and care coordinators.

In private GP clinics, PCNs anchor and strengthen team-based care for chronic diseases, by pooling resources to organise core ancillary services provided by nurses and care coordinators who work with GPs to jointly manage the patients’ conditions. The number of clinics participating in a PCN has grown, from 340 clinics in 2018, to more than 1,000 clinics today.

Our clusters will also step up as regional health managers, working with family doctors and other partners to address health and social needs of residents in their region and anchor care in the community. Family doctors may work with specialists or hospital doctors in the management of patients with more complex needs, for example. Upon discharge, the hospitals would refer patients to the family doctor they are enrolled with, to ensure continuity of care between the hospital space and the primary care space.

CF丨Editor

Edited by CF丨

Singapore Parliament丨Source

Singapore Parliament丨Source

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