Annual Report FY2018 The transformation of primary healthcare over the years has been catalysed by the ever-changing healthcare ecosystem, spurred in part by technology and innovation. In line with these changes, the National Healthcare Group Polyclinics (NHGP) continues to reinvent itself by keeping pace and leading the transformation of the primary healthcare sector. The cover of NHGP’s FY2018 Annual Report, hence, depicts cogwheels transforming into electronic circuits, representing NHGP’s passion to deliver patient-centred quality primary healthcare through the adoption of intelligent technologies and innovative solutions. The cogwheels and electronic circuits form a powerful symbol of healthcare — the heart, which is both a vital organ and where care and empathy reside. CONTENTS OUR VISION

To be the leading health promoting institution that helps advance Family Medicine and transform primary healthcare in Singapore.

OUR MISSION 04 06 08 GROUP CEO’S MESSAGE CEO’S MESSAGE NHGP SENIOR We will improve health and reduce illness through MANAGEMENT patient-centred quality primary healthcare that is accessible, seamless, comprehensive, appropriate and cost-effective in an environment of continuous learning and relevant research.

10 22 34 OUR VALUES CHAPTER 1 CHAPTER 2 CHAPTER 3 Integrity Respect STRENGTHENING ENHANCING INVESTING IN We are committed to We treat everyone PRIMARY CARE CAPACITY POPULATION HEALTH RESEARCH & EDUCATION the highest standards with honesty, decency CONTENTS of ethical conduct. and fairness. Compassion Collegiality Our paramount concern We nurture success by 52 58 is the welfare and well-being promoting collaboration, of our fellow human beings. participation and trust We sympathise with those struck between individuals and other CHAPTER 4 CHAPTER 5 with illness and suffering and healthcare organisations, INNOVATING FOR DEVELOPING will do our best to help alleviate within an environment BETTER CARE OUR PEOPLE their condition. of sharing and mutual respect.

Professionalism Social Responsibility We are committed to We contribute positively being the best in what we do and to the well-being 68 75 achieving the best possible of the community. outcome for our patients. APPENDICES SNAPSHOTS OF PATIENTS ATTENDANCE AND WORKLOAD IN FY2018 4 ANNUAL REPORT FY2018 5 Group CEO’s Message Transformation

GROUP CEO’S MESSAGE

SUPPORTING THE TRANSFORMATION OF THE FUTURE AHEAD PRIMARY CARE It is clear that the primary care ecosystem has At the heart of NHG’s transformative efforts is been underpinned by a strong spirit of cooperation primary care. It anchors care in the community, and knowledge-sharing in the past year. In the and brings care closer to patients’ homes through coming years, I look forward to NHGP continuing greater integration and coordination with tertiary, to work closely with and leveraging key enablers community, mental and social care. With the aim of within and beyond NHG to improve the population At the Committee improving the health of the population in the Central health of the Central region of Singapore. of Supply Debate in region, the National Healthcare Group Polyclinics March 2019, Minister (NHGP) has seen breakthroughs in the following The achievements for the year as well as the road areas in the past year, which you will be able to read ahead would not have been possible without the for Health Mr Gan within the pages of this Annual Report. invaluable guidance and support extended to us. I Kim Yong commended would hence like to thank our Chairman, Madam the success of Living Well — As part of moving care upstream, NHGP Kay Kuok, and the Board of Directors for their NHGP’s teamlet care has been actively integrating health promotion and astute leadership and support throughout the patient activation into its model of care. For example, years. I also wish to thank the Ministry of Health model, and noted that NHGP systematically stratifies patients’ health risks, for its direction as we navigate the dynamic the other polyclinic and guides them towards suitable health screenings healthcare landscape. Lastly, my heartfelt thanks clusters will also or fitness programmes in the community to help to Associate Professor Chong Phui-Nah, CEO of be rolling out team- prevent or delay the onset of chronic diseases. NHGP & Primary Care, the management team, and all staff for their vision, hard work and based care models. Living with Illness — As the first point of contact for dedication in bringing NHGP to greater heights. managing individuals with chronic diseases, NHGP’s teamlet care model is another transformative effort, which had led to greater continuity of care, and improved health outcomes for patients. At the Committee of Supply Debate in March 2019, Minister for Health Mr Gan Kim Yong commended the success of NHGP’s teamlet care model, and noted that the other polyclinic clusters will also be rolling out team- based care models. Also, with the introduction of the Primary Care Network (PCN) scheme by NHG in 2017, NHGP and our hospitals have engaged private General Practitioner (GP) clinics to form the Central- Much has been said about Singapore’s rapidly ageing been an impetus for our care transformation, as we North PCN to deliver holistic care through multi- population and its accompanying challenges, such recognise that healthcare can no longer afford to disciplinary teams. as the ever-growing demand for healthcare services, remain fragmented, facility-centric, doctor-based escalating costs, and an acute manpower shortage. and illness-centred. Instead, a systemic reform Leaving Well — In order to address patients’ end- was key to shift the way we deliver care to become of-life care needs, NHGP has also begun initiating In the face of these challenges, the National integrated, patient-centric, relationship-based and conversations on Advance Care Planning. This brings Healthcare Group (NHG) has identified ‘Three wellness-centred. It was with this in mind that NHG greater accessibility and convenience for patients and Waves’ as the main drivers of healthcare costs and established the ‘River of Life’ framework, which their family members, allowing them to discuss and Professor Philip Choo utilisation, namely Frailty, Chronic Diseases, and focuses on preventive care and helping everyone live complete their end-of-life plans at an early stage, in Group Chief Executive Officer Poor Lifestyle Habits. These ‘Three Waves’ have well at every stage of life. the community. National Healthcare Group 6 ANNUAL REPORT FY2018 7 CEO’s Message Transformation

CEO’S MESSAGE

To boost our primary care capacity, NHGP has Additionally, the Nephrology Evaluation Management collaborated with General Practitioners (GPs) and Optimisation (NEMO) programme, a collaboration to bring care closer to patients’ homes. Since between NHGP and the National University Health April 2018, NHGP has been growing its Central- System, was awarded the ExCEL Innovation Project North Primary Care Network, and now has Award under the Public Sector Transformation Awards more than 40 GPs in this network who are (PST) in July 2018. Our journey to shape supported by nurses and care facilitators, the future of primary allowing patients to receive holistic and Apart from our clinical duties, NHGP is proud to have care is far from over. coordinated care for their chronic conditions played a part in training the next generation of doctors. Some of our Family Physicians who have mentored the In the year ahead, EMBRACING TECHNOLOGY IN next generation of family physicians were recognised NHGP will continue PRIMARY CARE for their contributions by the College of Family its transformative Technology and digitalisation have played an Physicians Singapore (CFPS) in May 2019. journey and advance increasingly important role in NHGP’s journey towards shaping the future of primary care. In the LOOKING AHEAD Family Medicine to past year, enhancements to our systems were Our journey to shape the future of primary care achieve a world- made to ensure patients enjoy hassle-free visits is far from over. In the year ahead, NHGP will class relationship- to our polyclinics. For instance, our self-checkout continue its transformative journey and advance based primary care kiosks have been enhanced to enable booking of Family Medicine to achieve a world-class future appointments. This one-stop convenience of relationship-based primary care ecosystem. ecosystem. making payment and concurrently booking follow-up appointments saves time and improves patients’ How far we have come and how far we will go would overall experience. not be possible without the staunch support of various parties. Therefore, on behalf of the management In addition, patients now have the flexibility to team, I would like to convey my appreciation to NHG’s update their particulars at the self-registration Board and the Ministry of Health for the confidence kiosks, which will be updated concurrently in the and support, which have enabled us to achieve what patient management system. These improvements we have thus far. I would also like to say “thank you” are more than just mere process automations. and extend my heartfelt appreciation to NHGP’s While they may save time for patients, these senior management members and all staff for their improvements underpin NHGP’s commitment to contributions and commitment towards our collective create the best possible experience for patients, mission of transforming primary care. increase productivity, and achieve sustainability in In response to the increasing prevalence of chronic EXPANDING PRIMARY CARE CAPACITY the long run. diseases and Singapore’s ageing population, and in To cater to the growing demand for healthcare line with the National Healthcare Group’s (NHG) ‘River services, NHGP has redeveloped its existing CELEBRATING EXCELLENCE of Life’ framework, the National Healthcare Group polyclinics and will be managing new polyclinics to FY2018 also saw NHGP celebrating many Polyclinics (NHGP) continues to pursue innovative better serve the population. In June and November milestones and achievements. For example, and scalable ways to improve the accessibility, 2018, NHGP celebrated the official openings of the our efforts of embarking on and sustaining comprehensiveness and coordination of care it provides. redeveloped Ang Mo Kio and Yishun Polyclinics. job redesign to improve service delivery saw Associate Professor Chong Phui-Nah To this end, NHGP’s primary care transformation Looking ahead, four more polyclinics will be us winning the Excellence Award in the Talent Chief Executive Officer has seen various infrastructure developments and developed by NHGP in Sembawang, Kallang, Khatib Development Category at the Asian Hospital National Healthcare Group Polyclinics technological enhancements. and Serangoon. Management Awards (AHMA) in September 2018. & Primary Care 8 NHGP ANNUAL REPORT FY2018 9 Senior Management Transformation

NHGP SENIOR MANAGEMENT

From left: From left:

Dr Simon Lee Dr Tung Yew Cheong Chief Operating Officer and Director, Quality and Chief Clinical Informatics Patient Safety Officer Dr Gowri Doraisamy Ms Chen Yee Chui Director, Care Integration Chief Nurse, Nursing Services Dr Wee Wei Keong Dr Karen Ng Director, Health Promotion Director, Clinical Services and Preventive Care Mr David Kok Mr Donald Wai Director, Finance Director, Facility Development and Planning Office Associate Professor Chong Phui-Nah Ms Noraizah Zainal Abidin Chief Executive Officer, Deputy Director, NHGP and Primary Care Corporate Communications Mr Shawn Phua Ms Jaclyn Fam Director, Human Resources Deputy Director, Corporate Planning

From left:

Dr Lim Chee Kong Deputy Director, Clinical Services (Manpower) Ms Chan Soo Chung Executive Director, NHG Pharmacy Dr Irwin Chung Director, Primary Care Academy

From left: Dr Tang Wern Ee Head, Clinical Research Unit Dr David Ng Ms Lim Soh Har Head, Toa Payoh Polyclinic Executive Director, Dr Christopher Chong NHG Diagnostics Head, Ang Mo Kio Polyclinic Mr Kenneth Low Dr Kong Jing Wen Director, Dental Services Head, Hougang Polyclinic Dr Darren Seah Dr Evan Sim Director, Family Medicine Head, Woodlands Polyclinic Development Dr Kwan Pek Yee Head, Yishun Polyclinic Dr Jonathan Ting Head, Geylang Polyclinic 10 CHAPTER 1 ANNUAL REPORT FY2018 11 Strengthening Primary Care Capacity Transformation

CHAPTER 1 STRENGTHENING PRIMARY CARE CAPACITY

As the first line of care in the community, Primary Care is becoming even more crucial as Singapore’s population ages, and the prevalence of chronic disease rises. To this end, the National Healthcare Group Polyclinics is not just shoring up physical capacity to meet future demands, but also building partnerships and networks to shape the future of primary care.

CLINIC CLINIC 12 CHAPTER 1 ANNUAL REPORT FY2018 13 Strengthening Primary Care Capacity Transformation

BOOSTING CAPACITY Capacity enhancements enable NHGP to broaden and improve its services to meet growing primary care needs.

NHGP’s Gallery of Memories, located at Ang Mo Kio Polyclinic Level 2.

Senior citizens from Yio Chu Kang Community Club Zone 3 Residents’ Committee performed a social dance item for guests.

On 30 June 2018, redeveloped Memories. The Gallery displays Ang Mo Kio Polyclinic celebrated healthcare artefacts dating as far its official opening. Guest-of- back as the 1940s, and captures the The Ang Mo Kio Polyclinic team with Prime Minister Lee and ‘The Tree of Life’ quilt piece at the official opening of redeveloped Honour Prime Minister Lee Hsien 200-year history of primary care in Ang Mo Kio Polyclinic. Loong and Senior Minister of State Singapore. It also showcases NHGP’s for Health Dr Lam Pin Min graced efforts to innovate over the years, the event. To mark the redeveloped including the digitisation of patients’ Ang Mo Kio Polyclinic is the first polyclinic clinic’s official opening, a colourful medical records, the deployment of in Singapore with a wheelchair tilter for dental services. The tilter allows quilt, jointly created by patients, tele-health services in primary care, wheelchair users to receive treatment REDEVELOPMENT OF partners and staff of Ang Mo Kio and the transformation of its care directly from their wheelchairs. ANG MO KIO POLYCLINIC Polyclinic titled ‘The Tree of Life’, delivery model. Ang Mo Kio Polyclinic relocated was unveiled by Prime Minister Lee to a newer and bigger building and Dr Lam, together with Madam on 29 January 2018. The move to Kay Kuok, Chairman of National Ang Mo Kio Polyclinic has played an integral part in a larger premises would better Healthcare Group (NHG), and the healthcare landscape of the community since it serve the needs of a growing and Professor Philip Choo, Group CEO opened in 1981. We will continue to look at innovative greying population in Ang Mo Kio of NHG. The quilt is on permanent ways to deliver patient-centred care to the community and its neighbouring estates. display at the community plaza at in Ang Mo Kio through the provision of comprehensive Standing six storeys tall, the Ang Mo Kio Polyclinic. polyclinic added new services services as well as technological improvements to such as physiotherapy and In conjunction with the official opening provide a holistic and seamless patient experience. Guest-of-Honour Prime Minister Lee (third from the left) officiating the ceremony with podiatry to provide holistic care to Senior Minister of State for Health Dr Lam (second from the left) and representatives of redeveloped Ang Mo Kio Polyclinic, — Dr Christopher Chong, Family Physician, Associate Consultant and its patients. from NHG and NHGP. NHGP also opened the Gallery of Head of Ang Mo Kio Polyclinic 14 CHAPTER 1 ANNUAL REPORT FY2018 15 Strengthening Primary Care Capacity Transformation

REDEVELOPMENT OF YISHUN POLYCLINIC NHGP opened the doors of its redeveloped seven-storey Yishun Polyclinic on 2 July 2018 with an expanded Women’s & Children’s Clinic and newly introduced physiotherapy service. Yishun Polyclinic was the second NHG Polyclinic after Ang Mo Kio Polyclinic to be redeveloped and officially opened in 2018.

On 3 November 2018, Yishun Polyclinic celebrated its 20th anniversary in conjunction with its official opening. The event was graced by Guest-of-Honour Mr K Shanmugam, Minister for Mr Shanmugam with Yishun Polyclinic staff during the official opening of redeveloped Home Affairs and Law, and Member Yishun Polyclinic. of Parliament for Nee Soon GRC.

Mr Shanmugam, advisers of Nee Soon GRC, and representatives from MOH, NHG and NHGP with the ‘Seasons of Life’ art piece put together by NHGP staff, patients and community partners.

A mosaic art piece, titled This art piece celebrates the vibrancy and adaptability ‘Seasons of Life’, was unveiled of our healthcare ecosystem to support our patients by Minister Shanmugam, and the community in their different seasons of life. advisers of Nee Soon GRC, and senior management — Dr Kwan Pek Yee, Family Physician, Principal Staff and Head of Yishun Polyclinic representatives from NHG and NHGP.

The collaborative piece was put together by NHGP staff, patients and community partners using stained glass and commonly used medical items, such as vaccination bottle caps and medicine spoons.

Deputy Head of Yishun Polyclinic Dr Lim Ziliang (front row, left) and Head of Yishun Polyclinic Dr Kwan Pek Yee (front row, second from left) leading the clinic tour Guest-of-Honour Mr Shanmugam (centre) officiating the ceremony with advisers of Nee Soon GRC and representatives from NHG and NHGP. during the official opening. 16 CHAPTER 1 ANNUAL REPORT FY2018 17 Strengthening Primary Care Capacity Transformation

STRENGTHENING PRIMARY CARE FOR THE CENTRAL REGION OF SINGAPORE

EXPANDING OUR PRIMARY CARE CAPACITY

2020

Polyclinic in Kallang NHG’s Polyclinic will be co-located in a 10-storey building with Kwong Wai Shiu Hospital’s chronic sick unit.

Advisers of Sembawang GRC, Grassroots Organisations and representatives from NHGP, SportSG, NEA, NParks and MOH at the groundbreaking ceremony of Bukit Canberra.

Polyclinics in Khatib EXPANSION OF and Serangoon POLYCLINIC NETWORK The new polyclinics in Sembawang Khatib and Serangoon To further strengthen primary care Polyclinic will expand Singapore’s 2021 The first NHG for Singapore’s Central region so public primary care Polyclinic sited within network to a total of 30 to that patients can be managed in the an integrated sport 32 polyclinics by 2030. community and closer to home, the and community hub. Ministry of Health (MOH) announced the building of new polyclinics. 2025 The new polyclinics to be managed by NHGP will be located in Sembawang, Kallang, Khatib and Serangoon.

Sembawang Polyclinic will be co-located within Bukit Canberra, an upcoming integrated sport and community hub. This will be NHG’s first polyclinic sited within a NHGP’s booth at the family carnival offered tips on healthy eating. hub. When ready, Bukit Canberra will be jointly managed by Sport Singapore (SportSG), the National On 1 July 2018, at a family carnival Grassroots Organisations, officiated Environment Agency (NEA), the organised by SportSG, Mr Ong the groundbreaking ceremony of National Parks Board (NParks), Ye Kung, Minister for Education Bukit Canberra with advisers of and MOH. and Adviser to Sembawang GRC Sembawang GRC. 18 CHAPTER 1 ANNUAL REPORT FY2018 19 Strengthening Primary Care Capacity Transformation

FORGING PARTNERSHIPS With the goal of raising the level of holistic care for better health outcomes, NHGP LOWRES works closely with General Practitioners and Family Medicine Clinics to bring care closer to home.

Piloted by the Ministry of Health NHGP’s primary care ecosystem (MOH) in 2012, Primary Care operates as a ‘Hub-and-Spoke’ The aim of the CN-PCN Networks (PCNs) bring care model. NHGP acts as the Primary is to drive better chronic closer to patients’ homes. Under Care Hub, and the GP Networks disease management, this model, networks of General (also termed Primary Care support earlier Practitioners (GPs) are supported Network or PCN) and Family intervention and reduce by nurses and care facilitators. Medicine Clinics (FMCs) are Additionally, patients are able to the various spokes. This model complications. use the ancillary and support increases the overall primary — Dr Gowri Doraisamy, Family services provided by the PCN. This care capacity in the Central Physician, Senior Consultant, and way, patients can receive holistic region of Singapore, and Director of Care Integration at NHGP and coordinated care for their supports the nation’s long-term chronic conditions. healthcare needs.

CENTRAL-NORTH PRIMARY CARE NETWORK GENERAL PRACTITIONERS (AS OF 31 MARCH 2019)

DOCTOR (LICENSED DOCTOR (LICENSED CLINIC NAME CLINIC NAME CLINIC MANAGER) CLINIC MANAGER) Ang Mo Kio Toa Payoh Tan Chin Beng Melvyn AMK Family Clinic Low Mun Heng Gerard L & L Family Medicine Clinic CN-PCN’s first visionary exercise with its GP members discussing their vision for CN-PCN. Lim Kim Show Life Family Clinic Lee Kong How E Medical Clinic & Surgery Goh Sze Yi Prudence Family Clinic Raymond Ong Ong Medical Clinic CENTRAL-NORTH The CN-PCN builds on the (CME) talks, and are eligible to Goh Bee Teng B.T. Goh Family Clinic & Surgery Geylang PRIMARY CARE NETWORK GPs’ existing infrastructure attend courses at NHGP’s Primary Woodlands Since April 2018, NHG has been and established doctor-patient Care Academy. James Cheong C3 Family Clinic @ Aljunied Crescent Mark Low Chee Wah Doctors Clinic & Surgery growing its CN-PCN. The network relationships. This strategic Chee Weng Sun Japan Clinic And Surgery Tan Wen-Hui SATA Commhealth Woodlands has 30 GPs as at 31 March 2019. collaboration leverages the skill On 17 November 2018, 24 GPs As part of this CN-PCN, GPs are sets and patient engagement of attended a CME talk covering Hougang Mok Boon Rui Pinnacle Family Clinic (Woodlands) supported by ancillary services GPs with leadership and clinical the management of heart failure Eng Soo Kiang Unity Family Medicine Clinic Nah Kwang Meng Dr Nah & Lee Family Clinic such as nurse counselling, and governance provided by NHGP. in primary care and the latest Loh Wai Leong Jeffrey The Family Physician Clinic Seow En Hao EH Medical diabetic eye and foot screenings, guidelines on hypertension. The Lok Ying Fang Family Care Medical Centre Sorinder Singh Woodlands Medical Centre which may not be readily available Beyond offering shared support GPs also did a visioning exercise on in their current clinic setting. services to GPs, one of the how they envisioned CN-PCN would Goh Chiew Kai Central 24-Hr Clinic (Woodlands) Sia Chong Ming Sia & Yeo Hougang Clinic Suitable NHGP patients with stable CN-PCN’s vital roles is to ensure be in three to five years’ time, and Heng Kuo Leng John First Medical Clinic & Surgery Ng Suat Tong Tai Seng Clinic hypertension, lipid disorders, that GPs remain connected to the the roles they hope to play. Loh Foo Keong Jeffrey Lian Clinic Adele Seet Wei Min Daily Medical Centre diabetes or asthma, and who are larger healthcare landscape. Yishun also Community Health Assist A GP retreat was also held on Siew Boon Liong Glenn Comfort Clinic & Surgery Gideon Hong Eu Gee Greenlink Medical Clinic Scheme (CHAS) holders, can be Partner GPs are kept informed of 2 March 2019 to look at ways to Eugene Ung Meridian Medical & Dental Centre transferred to CN-PCN GPs so that the latest evidence-based clinical overcome the key challenges Ong Chee Meng Robert Central 24-Hr Clinic (Yishun) they can manage their conditions guidelines through quarterly identified during the visioning Cheong Wei Ling Sterling Clinic & Surgery Tan Buay Imm Sincere Medical & Dental Clinic closer to their homes. Continuing Medical Education exercise. 20 CHAPTER 1 ANNUAL REPORT FY2018 21 Strengthening Primary Care Capacity Transformation

These efforts to engage GPs in the CENTRAL-NORTH PRIMARY CARE NETWORK FRAMEWORK CN-PCN will go a long way towards improving the way healthcare is delivered. With primary care as the foundation of Singapore’s healthcare system, the CN-PCN will serve as a key pillar in NHGP’s efforts to bring patient-focused care closer to home.

Since its launch, several programmes have been added to further enhance the reach PATIENT and impact of the CN-PCN. One Selected NHGP patients with chronic conditions can be referred of these is to improve diabetes to CN-PCN GPs for continued care by making diabetic retinal management of their chronic conditions closer to their homes. photography and diabetic foot screening more accessible to patients.

CN-PCN CN-PCN’s GP members in a discussion on how the vision for CN-PCN could be fine-tuned. Network of GPs

CN-PCN & RESOURCES CN-PCN offers its GP partners anciliary services as well as medical education and training Training Offers courses conducted by NHGP’s Primary Care Academy at preferential rates.

Nurse Counselling Offers nurse counselling support, including patient education and Medical Education patient case discussions. Organises quarterly continuing Medical Education talks.

Administrative Provides administrative Health Screenings support for shared services Offers mobile diabetic retinal photography One of the activities held for CN-PCN’s GPs was a Lunar New Year Lo Hei Luncheon and CME Talk on 16 February 2019. and managing and tracking of patients’ clinical and and diabetic foot process indicators. screenings services.

Under CN-PCN, NHG extends shared services and resources to GPs to support them in delivering appropriate levels of right- sited care to patients. 22 CHAPTER 2 ANNUAL REPORT FY2018 23 Enhancing Population Health Transformation

CHAPTER 2 ENHANCING POPULATION HEALTH

The National Healthcare Group Polyclinics (NHGP) is committed to creating and catalysing a health- promoting ecosystem for patients and the community. With the goal of preventing or delaying the onset of chronic diseases, NHGP has designed health promotion into healthcare delivery, to promote self-empowerment of our patients and better population health in the future. 24 CHAPTER 2 ANNUAL REPORT FY2018 25 Enhancing Population Health Transformation

EMPOWERING AND ACTIVATING PATIENTS With the goal of empowering and activating patients, NHGP has various initiatives to equip patients with the knowledge, skills and confidence to take ownership of their health outcomes.

control, and a higher proportion went for diabetic foot and eye screenings, as well as cancer screenings. Also, fewer patients made visits to the Emergency Department for diabetes- and hypertension-related problems. The study also showed that the teamlet care model resulted in improved care for patients with diabetes that could lead to reduced healthcare resource use.

Apart from managing patients with chronic conditions, the teamlets at Yishun Polyclinic also started seeing patients Patient Service Associate Ms Enrica Kalyani explaining how the chronic care plan works to a patient. Mr Leon Stewart (right), a patient of Ang Mo Kio Polyclinic, being attended to by his teamlet with dementia from July members, Dr Tricia Chang (centre) and Ms Evonne Oh (left). 2018. Patients with dementia receive care from a dedicated CHRONIC CARE PLAN which can be used to offset the Such targets include good TEAMLET CARE MODEL To assess the effectiveness of multi-disciplinary team and Designed to empower and cost of the following year’s plan. blood sugar control, optimal NHGP’s teamlet care model is the care model, a study was receive regular assessments, incentivise patients with chronic As of 31 March 2019, 90 per management of blood pressure anchored on relationship-based conducted from 1 July 2015 to counselling services, and diseases to better manage their cent of CCP patients at Yishun or cholesterol levels, and healthcare. Dedicated teams known 31 December 2016 involving coordinated access to dementia conditions, NHGP’s Chronic Care Polyclinic received rebates for completing annual diabetic foot as teamlets — each comprising about 20,000 patients from services in the community. Apart Plan (CCP) was first piloted in meeting their care plan targets. and retinopathy screenings. two family physicians, a care Ang Mo Kio Polyclinic, Toa from allowing for continuity Yishun Polyclinic in April 2017. In manager, and a care coordinator Payoh Polyclinic, Woodlands of care, such an arrangement January 2019, the programme was — are supported by allied health Polyclinic and Yishun enables the management of extended to Ang Mo Kio Polyclinic. Patients on the Chronic Care Plan are able to: professionals to provide customised Polyclinic. The results of the patients with dementia to be and holistic care based on a study, released on 17 August anchored within primary care, NHGP’s CCP offers patients with patient’s medical conditions. This 2018, showed that teamlet and minimises the need for the chronic diseases listed under the Achieve health goals with customised care plan model of care allows patients to patients with diabetes had elderly to visit hospital specialist Chronic Disease Management receive comprehensive, coordinated significantly better diabetes outpatient clinics. Programme (CDMP) an annual and continuous care from the same treatment plan and a payment healthcare team so that risks and option for a year’s worth of Receive rebates for meeting health goals complications can be identified early chronic disease treatment. and prevented or managed. In the past, there were no designated doctors or nurses CCP covers consultations with to look after my health. Now, with the teamlet care doctors, nurses and allied health -5% First piloted in Toa Payoh model, the clinical team is able to better understand professionals, laboratory tests, Enjoy 5% savings on chronic care services Polyclinic in 2015, this care model my medical history, monitor my health progress closely, diabetic foot screenings as well as has now been implemented in all and provide the best care plan for me. This gives me the diabetic retinopathy screenings. NHG Polyclinics. As at 31 March opportunity to work on improving my health together Skip the payment queue 2019, NHGP has a total of about with my healthcare team. Patients who meet the care plan 120,000 patients being cared for by targets set by their healthcare its teamlets. — Mr Leon Chester Stewart, patient from Ang Mo Kio Polyclinic team are rewarded with rebates, 26 CHAPTER 2 ANNUAL REPORT FY2018 27 Enhancing Population Health Transformation

Patients are also taught to seek A total of 2,020 patients from Patients learn treatment early. Through regular Ang Mo Kio Polyclinic have carbohydrate foot surveillance, the multi- been identified and flagged for counting in a session that disciplinary team can promptly weight management since the equips them detect foot problems and provide implementation of TRIM. with the skills early treatment. to eat healthily. LIGHTER LIFE ADVANCE CARE PLANNING NHGP first launched the six-month In line with MOH’s efforts to risk-stratified weight management encourage Advance Care Planning programme, Lighter Life, at Ang (ACP) conversations earlier and Mo Kio Polyclinic in October more upstream in patients’ care 2018. This programme aims continuum, NHGP piloted its first to help eligible NHGP patients ACP Clinic in October 2017 at with chronic conditions such as Toa Payoh Polyclinic. The second diabetes and hypertension to ACP Clinic started in Ang Mo Kio achieve weight loss in a healthy Polyclinic in June 2018. The ACP way. The programme equips them programme gives patients and their to confidently self-manage their family members greater accessibility conditions with strong peer and and convenience to discuss community support. Throughout and complete their ACP in the the programme, patients are community. As of FY2018, NHGP’s monitored and coached on areas Senior Podiatrist Nicholas Andrew Hulme assessing a patient with diabetes for feet ulcers. ACP programme has reached out to such as exercise and lifestyle almost 800 patients and facilitated habits by a multi-disciplinary more than 150 ACP discussions. primary care team comprising DM FOOT STEP The enhanced screening and foot a family physician, nurse, One such initiative is the NHGP strongly encourages all care protocol will be progressively To further raise awareness of the dietitian, physiotherapist, clinical Medication Clinic, a pre-consult patients with diabetes to go for introduced to all NHG Polyclinics importance of ACP, NHGP partnered psychologist, and health experts. medication reconciliation service annual foot screening at any NHG by the end of 2020. final-year students from Nanyang aimed at reducing medication Polyclinic. With the goal of further Technological University’s (NTU) Wee discrepancies during transitions of reducing the risk of foot ulcers The DM Foot STEP team comprises Kim Wee School of Communication care. The medication reconciliation and lower extremity amputation, family physicians, diabetic foot and Information to set up roadshows service was made available at all NHGP piloted the Diabetes screening and foot surveillance at Ang Mo Kio Polyclinic in January NHG Polyclinics in August 2018. Mellitus (DM) Foot Screening nurses, wound care nurses, and 2019 and Geylang Polyclinic in At the Medication Clinic, the & Surveillance, Treatment & podiatrists, all of whom work in February 2019. pharmacist checks and prepares Escalation Protocol (STEP) at close collaboration with hospital the medication list, which the Yishun Polyclinic in May 2017. specialists from regional hospitals. TRIM patient can share with other As of March 2019, nearly 800 They teach self-help skills so that NHGP launched the Tiered-Risk doctors and pharmacists during patients have benefited from patients can prevent and manage Interventions for Managing Weight medical consults. The pharmacist closer surveillance and prompt their own foot problems through (TRIM) at Ang Mo Kio Polyclinic in can also resolve any issue the management. regular foot checks. June 2018. TRIM enables NHGP’s patient may have regarding care team to activate patients by medication. systematically identifying those with health risks, and then starting A medication list to help patients keep To promote the use of the Singapore has one of the highest rates of lower- contextualised conversations track of the medicines they are taking. medication list, NHG Pharmacy extremity amputations in the world due to diabetes. with them as part of their care. launched the ‘Know Your Medicines, Early identification and intervention of those at risk These patients are then referred MEDICATION Get It Right’ campaign during to NHGP’s health promoters in RECONCILIATION National Pharmacy Week 2018 in will prevent complications and reduce the number of the clinic for health coaching NHGP together with the National October. The goal was to create lower-extremity amputations. and connected to intervention Healthcare Group (NHG) Pharmacy awareness among patients and Mdm Saudah Marwan, a patient from Ang — Dr Donna Tan, Family Physician, Associate Consultant and Assistant Director, programmes in NHGP and the Mo Kio Polyclinic, is having her BP taken at worked on several initiatives to caregivers about the benefits of Clinical Services community. one of the Lighter Life sessions. educate patients on their medications. keeping an updated medication list. 28 CHAPTER 2 ANNUAL REPORT FY2018 29 Enhancing Population Health Transformation

RIGHT CARE, RIGHT PLACE, RIGHT TIME The two Mobile BMDs are available at Ang Mo Kio Polyclinic, In FY2018, NHGP continued its efforts to help patients receive appropriate care in the Geylang Polyclinic, Woodlands community and closer to home. Polyclinic and Yishun Polyclinic. This service has brought greater convenience to patients and TELE-DERM TELE-ECG It enables patients to perform residents in the community. An initiative jointly launched by A collaboration between NHGP wound dressing changes at NHGP and the National Skin and Tan Tock Seng Hospital’s home while their healing NEW HBA1C ANALYSER Centre (NSC) in December 2016, Cardiology Department, Tele-ECG progress is monitored remotely AND TEST Tele-DERM brings specialist care has helped to improve patient- by nurses. Patients send digital In diabetes care for patients, closer to patients’ homes. Through centred care by right-siting wound images to nurses for HbA1c is used to monitor a secure web portal, NHGP Family avoidable referrals to the cardiology assessment, and follow-up patients’ blood sugar level. Physicians discuss skin care cases specialist outpatient clinics (SOCs). care is conducted over the and treatment options with NSC As of 31 March 2019, almost 80 phone. In FY2018, there were In June 2018, NHGD rolled out dermatologists, allowing patients per cent of the Tele-ECG cases more than 1,900 Tele-Wound Representatives from NHG, NHGP and Silverhope Clinic Pte Ltd at the Handover Ceremony. new HbA1C analysers at all with mild to moderate skin issues seen were treated at NHGP without consultations done. NHG Polyclinics. Each allows to be cared for appropriately in having to be referred to SOCs. samples to be processed at a rate the community. In FY2018, the TELE-CONSULTATIONS Hougang FMC was the third and The Mobile BMD provides that is 88 per cent faster than number of NHGP attendances for TELE-WOUND MONITORING The Tele-Consultations Home last FMC — after Ang Mo Kio FMC accessible and affordable before, thus reducing patients’ dermatology-related conditions Piloted in June 2016 and Monitoring initiative led by and Unity FMC — that NHG has osteoporosis screening in the wait times. averaged nearly 10,000 a month. established at all NHG Polyclinics NHGP’s Nursing Services handed over to private General primary healthcare setting. It is About 45 per cent of patients since June 2017, Tele-Wound allows patients to consult Practitioner partners after equipped with a best-in-class NHGD also introduced the HbA1c who underwent Tele-DERM were Monitoring is a service that allows Care Managers (nurses successful collaborations. Dual Energy X-ray Absorptiometry variant Point-of-Care-Testing treated at NHGP without having to self-management and remote trained in chronic disease (DEXA) technology unit, which (POCT) at all NHG Polyclinics be referred to the NSC. wound monitoring. management) over the phone. During the three years of captures bone scans of both the in October 2018. The test has These consultations involve close collaboration, Hougang lower spine and the hip. This reduced the turnaround time helping patients monitor their Polyclinic has referred about technology is a gold standard for for results from one week to conditions, advising them on 4,000 patients with chronic the assessment of bone mineral an hour, bringing about more post-insulin titration, assisting diseases to Hougang FMC. and susceptibility to fracture. convenience to patients. on medication refills, and more. Such a service avoids The handover ceremony was the need for patients to make graced by Madam Kay Kuok, trips to the polyclinics. In Chairman of NHG. Also present FY2018, more than 11,500 Tele- were Professor Philip Choo, Group Consultations were conducted. CEO of NHG, Associate Professor Chong Phui-Nah, CEO of NHGP HOUGANG FMC HANDOVER and Primary Care, Dr Michael Family Medicine Clinic (FMC) Yee, Director of Silverhope Clinic brings together the strengths and Pte Ltd, and Dr Victor Teo and experiences of public healthcare Ms Ong Yipin, former directors of providers and the capacity and Silverhope Clinic Pte Ltd. capabilities of private healthcare. Such collaborations have helped MOBILE BMD the FMC to provide comprehensive To support and promote the team-based care to manage chronic importance of bone health, diseases within the community. the National Healthcare Group Diagnostics (NHGD) procured and On 13 September 2018, NHG deployed a second Mobile Bone successfully marked the transfer Mineral Densitometry (BMD) in Senior Staff Nurse II Ms Faridah Mohamad Yusoff conducting a Tele-Wound consultation of ownership of Hougang FMC March 2019. The first BMD was NHGD’s Mobile BMD allows patients to have their osteoporosis screening done closer with a patient. to Silverhope Clinic Pte Ltd. introduced in 2012. to home. 30 CHAPTER 2 ANNUAL REPORT FY2018 31 Enhancing Population Health Transformation

FROM HEALTHCARE TO HEALTH WORLD PODIATRY DAY 2018 To celebrate World Podiatry Day To encourage patients to lead healthier lives, NHGP organised many activities to 2018, a fun and interactive booth engage and educate the community in FY2018. was set up for patients and staff on 12 April 2018 at Woodlands Polyclinic and Ang Mo Kio Polyclinic. The goal of the celebration was to create awareness of good foot health among patients and staff. Through footcare brochures, posters, foot models and different types of footwear, participants obtained first-hand knowledge of how to take care of their feet. NHGP podiatrists and physiotherapists at the ‘Get Up! Get Shoes! Get Fit!’ roadshow at Geylang Polyclinic. WORLD MENTAL HEALTH DAY 2018 In conjunction with World Mental Conducted by NHGP Psychologists, WORLD DIETITIANS’ Health Day 2018, NHGP worked the ‘Does Kindness Matter? Love DAY 2019 with TOUCH Community Services Yourself for Better Diabetes On 16 March 2019, an NHGP staff and participants at a Diabetes Support Group session at Ang Mo Kio Polyclinic. and the Singapore Kindness Health’ mental health talks were event titled ‘Diabetes Self- Movement to deliver talks on delivered to residents of TOUCH management: Because it mental and physical well-being, Home Care @ Ang Mo Kio and Matters!’ was conducted at WORLD DIABETES DAY 2018 The Ang Mo Kio Polyclinic can have an impact on diabetes with a focus on mental health residents of Ang Mo Kio on 12 Yishun Polyclinic for 50 patients As a lead-up to World Diabetes Day Diabetes Support Group held management. The session also and diabetes. and 20 October 2018 respectively. to celebrate World Dietitians’ 2018, NHGP organised a series of a session on 6 October 2018. included a talk on how to meet The informative sessions covered Day 2019. The session covered activities to educate patients on the The session included talks on diabetes control targets. the impact of stress and mental self-management skills for importance of managing diabetes how to tackle insomnia, its health on diabetes, and steps those with diabetes and through eating well and staying relationship with stress and On 8 November 2018, a healthy to improve mental and physical pre-diabetes. A patient also physically active. diabetes, and how sleep problems lifestyle event was conducted at well-being through adhering to shared how she overcame her Geylang Polyclinic and Yishun self-management strategies for personal challenges to gain Polyclinic. Titled ‘Get Up! depression and diabetes. good diabetes control. Get Shoes! Get Fit!’, NHGP’s podiatrists put up exhibits to educate patients on foot care. NHGP’s physiotherapists also conducted an exercise session to combat the negative impact of inactivity on diabetes.

On 10 November 2018, a talk and practical session, titled ‘Get Fit, Be Fit and Stay Fit’ was conducted at Toa Payoh Polyclinic. Besides sharing the importance of various aspects of fitness in relation to managing diabetes, the Ms Soon Jiaying, Senior Clinical event also cleared doubts that Psychologist, delivering the ‘Does Kindness Matter? Love Yourself for Dr Wong Mei Yin, Principal Clinical Psychologist, sharing practical strategies to improve the audience had on medications Better Diabetes Health’ talk at TOUCH sleep quality at the ‘Kiss Insomnia Goodnight’ talk. and laboratory results. Home Care @ Ang Mo Kio. A patient sharing how she manages her diabetes. 32 CHAPTER 2 ANNUAL REPORT FY2018 33 Enhancing Population Health Transformation

HEALTH FAIR FOR IN THE MEDIA Patients and caregivers ANG MO KIO RESIDENTS In FY2018, NHGP leveraged exercising NHGP and National Skin Centre mainstream media to spread together at the co-organised a fundraising health messages to the population, community plaza fair on 21 April 2018 to support the covering topics such as chronic at Ang Mo Kio Polyclinic. Ang Mo Kio Family Service Centre. disease management and adopting At the event, NHGP doctors and healthier lifestyles. psychologists gave health talks, and NHGP dietitians hosted a Media coverage in FY2018 included cooking demonstration. the following:

• Various media interviewed Dr Karen Ng, Director, Clinical Services, on 17 August 2018. Dr Ng shared how NHGP’s teamlet care approach offers patients access to a dedicated team of healthcare professionals.

• Vasantham News interviewed HEALTH PROMOTION AND World Heart Day 2018 Colorectal Cancer Dr Jaganmohan Raja, Deputy PREVENTIVE CARE In September 2018, NHGP partnered Awareness Month 2019 Head of Woodlands Polyclinic, In FY2018, various roadshows the Singapore Heart Foundation Roadshows were conducted at all on 18 and 19 June 2018. to raise awareness of and Singapore Polytechnic (SP) to six polyclinics to raise awareness A nurse guiding children on proper Dr Raja shared how a heart specific diseases, such as organise a series of roadshows on of colorectal cancer in March 2019. hand hygiene. attack comes about, and how to cardiovascular diseases, heart disease prevention. Through posters and interactive identify its early symptoms. Diabetes Mellitus, and activities, patients were educated colorectal cancer, were Held at all six NHG Polyclinics, the on lifestyle practices to reduce the WORLD HAND HYGIENE • Channel 8 News interviewed conducted. Through these interactive awareness roadshow risk of colorectal cancer, and learnt DAY 2018 Dr Kong Jing Wen, Head of roadshows, more than 1,200 comprised a board game developed skills to identify food products with In conjunction with World Hougang Polyclinic, on 31 May patients and their family by interns from SP, which was used high dietary fibre. Hand Hygiene Day 2018, Guest-of-Honour Dr Koh Poh Koon, 2018 on common vaccines, during members have learnt to better to teach patients and family members Member of Parliament for Ang Mo Kio NHGP organised hand hygiene GRC, preparing Rainbow Brown Rice Salad which Dr Kong reminded viewers manage their health. how to eat healthily while dining out. Health Promotion Efforts roadshows at all six polyclinics with Senior Dietitian Ms Wong Yuefen. to go for influenza vaccination. In addition, healthy cooking from 8 to 15 May 2018. An demonstrations were conducted activity booth at each clinic was at the Eat Well cart in Ang Mo Kio also set up for patients and Polyclinic and Yishun Polyclinic caregivers to learn the six steps with the aim of educating patients of handwashing. on the benefits of a healthy diet. In collaboration with the Health WORLD KIDNEY DAY 2019 Promotion Board, group exercises In conjunction with World Kidney were also held regularly at Ang Mo Day 2019, NHGP organised a talk Kio Polyclinic’s community plaza titled ‘Understanding Chronic for patients and their caregivers. Kidney Disease’ on 7 March 2019 NHGP also partnered the National at Geylang Polyclinic. The talk Library Board to launch the Read@ highlighted the risk factors of NHGP at Ang Mo Kio Polyclinic kidney disease, tips on kidney and Yishun Polyclinic in October protection, and the importance of and November 2018 respectively. regular screening and follow-up. Patients are now able to read Booklets on kidney protection curated health-related ebooks on and healthy eating were also Dr Karen Ng sharing how NHGP’s teamlet care model empowers patients to look after their the NLB mobile app while waiting to distributed to patients. health better during a media interview on 17 August 2018. Patients getting tips on eating healthily when dining out. see the doctor. 34 CHAPTER 3 ANNUAL REPORT FY2018 35 Investing in Research & Education Transformation

CHAPTER 3 INVESTING IN RESEARCH & EDUCATION

Building research capacity and capability is key to driving innovation and improvement in primary care. Equipping healthcare professionals with the skills and knowledge strengthens the ability to deliver care, and better prepares the National Healthcare Group Polyclinics to meet long-term needs and future challenges. 36 CHAPTER 3 ANNUAL REPORT FY2018 37 Investing in Research & Education Transformation

BUILDING RESEARCH CAPACITY AND CAPABILITY SINGAPORE PRIMARY CARE SCIENTIFIC RESEARCH NHGP recognises the need to cultivate talent in research to contribute to effective COMPETITION clinical practices. Through primary care research, staff have the opportunity to The Singapore Primary Care drive innovation and improve care for patients. Scientific Research Competition 2018 was organised in collaboration with the Singapore Health and Biomedical Conference (SHBC) PRIMARY CARE FORUM 2018 2018 to provide a platform to NHGP held its 11th annual Primary showcase as well as to foster a Care Forum on 26 and 27 October culture of research in primary 2018. Titled ‘Primary Care: care. The competition also provided Integration & Innovation for the recognition for the research efforts Future’, it focused on innovations of healthcare professionals working and improvements that will in primary care. For the list of transform primary care. The 2018 abstracts accepted for the SHBC Forum was held in conjunction Scientific Competition 2018, please with the Singapore Health and refer to Appendix A. Biomedical Congress (SHBC). Guest-of-Honour Mr Amrin Amin, The following NHGP winners were Senior Parliamentary Secretary, announced at the opening ceremony Winners of the Oral Category: (From left) Dr Lee Eng Sing, Ms Julia Zhu and Ministry of Home Affairs and of SHBC 2018 on 25 October 2018. Dr Wee Wei Keong. Ministry of Health, delivered the opening address. ORAL CATEGORY Thought leaders present at the event included Professor Gold Award Silver Award Bronze Award Martin Marshall, Professor of Guest-of-Honour Mr Amrin (centre) and guests speakers, Professor Marshall (second from left) and Professor Dunbar (second from right) during the Primary Care Forum 2018. Healthcare Improvement from Dietary behaviour among Effectiveness of nurse-led wound Concordance between clinical University College London, as polyclinic patients with clinic on clinical outcomes for diagnoses for selected chronic well as Professor James Dunbar, pre-diabetes patient with chronic leg ulcer conditions in clinical notes and Honorary Professor at the in primary healthcare: a quasi- patient-reported conditions Centre for Population Health Dr Wee Wei Keong experimental study Research, Deakin University, Director, Dr Lee Eng Sing Health Promotion & Ms Julia Zhu Family Physician, Senior Consultant and Research Advisor to Preventive Care Nurse Clinician II, and Deputy Head, Clinical Research the Australian Health Policy Nursing Services Unit Collaboration, Victoria University.

A General Practitioners (GPs) POSTER CATEGORY symposium was held on the second day of the event, during which GPs from across Gold Award Silver Award Bronze Award Singapore shared how they managed patients effectively in a The association between illness The effect of parity and Exploring illness perception primary care setting. perceptions, medication beliefs breastfeeding experience on and symptoms severity and adherence to inhaled asthma breastfeeding self-efficacy, as possible correlates of controller among older adults: a perception of milk supply and anxiety change expectancy cross-sectional study in primary care exclusive breastfeeding in primary care

Dr Liu Changwei Ms Jacqueline Giovanna De Roza Ms Soon Jiaying Family Physician, Senior Clinical Psychologist, The session on adult vaccinations in the tropics during the Primary Care Forum was given Nurse Clinician I, Associate Consultant, Geylang Polyclinic Clinical Services by Dr Barnaby Edward Young, Consultant, National Centre for Infectious Diseases, Tan Tock Geylang Polyclinic Seng Hospital. 38 CHAPTER 3 ANNUAL REPORT FY2018 39 Investing in Research & Education Transformation

POSTER PRESENTATIONS IPRAMHO 2019 NHG-LKCMEDICINE CSPP CONTRIBUTIONS BY The following pages highlight the have been published in journals and Ms Goh Ling Jia, Assistant Nurse FY2018 NHGP STAFF TO NEW various research programmes presented at local and international International Forum Clinician, Hougang Polyclinic, A joint programme between MEDICAL KNOWLEDGE undertaken by NHGP staff that conferences in FY2018. on Quality and Safety and Ms Tan Pek Hoon, Senior NHG and LKCMedicine, the in Healthcare Nurse Manager, Yishun Polyclinic, NHG-LKCMedicine Clinician- Ms Blessy Koottappal Mathew, attended the Asia Pacific Diabetes Scientist Preparatory Programme Oral and Poster Presentations by NHGP Staff at Local and International Conferences Nurse Clinician II, Toa Payoh in Pregnancy Conference & (CSPP) exposes clinicians to Polyclinic, Ms Wong Yuefen, Senior Integrated Platform for Research research opportunities early in 23RD WORLD ORGANISATION 22ND WONCA WORLD ASIA PACIFIC MEDICAL Dietitian, Ang Mo Kio Polyclinic, in Advancing Metabolic Health their career through research OF NATIONAL COLLEGES, CONFERENCE 2018, SEOUL, EDUCATION CONFERENCE and Ms Tan Hue Min, Oral Health Outcomes of Women and Children training and project experience. ACADEMIES AND ACADEMIC SOUTH KOREA (APMEC) 2019, SINGAPORE Therapist, Toa Payoh Polyclinic, (IPRAMHO) International Meeting In FY2018, there were two ASSOCIATIONS OF GENERAL PRACTITIONERS FAMILY October 2018 January 2019 presented their quality and safety on 11 January 2019. Their poster, selected programme participants PHYSICIANS (WONCA) Rolling out the CARPET: improvement projects at the ‘Dietary Risk Assessment of — Dr Vivek Bansal, Family EUROPE CONFERENCE Patients’ Preferences for International Forum on Quality and the Singapore Child’, won the Physician, Woodlands Polyclinic, Dry Powder Inhalers preparing a health-literate Safety in Healthcare in Amsterdam ‘Best Poster’ award. and Dr Quek Jing Sheng, NHG May 2018 ready workforce Dr Tang Wern Ee from 2 to 4 May 2018. Family Medicine Resident. Dr Predeebha Kannan Adult learners: what every Family Physician, Senior Consultant, HOMER GRANT FY2018 Education Director, Deputy Director, trainer should know about Primary Care Academy and SingHealth Nursing The NHG-HOMER (Health Dr Vivek’s research project Family Medicine Development and learning styles Head, Clinical Research Unit Family Medicine Development Conference 2018 Outcomes and Medical Education studied the uptake and practice Inter-professional education in Another quality improvement Research) Grant FY2018 of secondary prevention of Dr Angelia Chua Hwee Ling A Challenge in Managing action: from design to delivery project, ‘Diabetic Foot Screening is a competitive grant that patients with a previous stroke Family Physician, Consultant, Difficult Dermatology Case Yishun Polyclinic Course – A Blended Learning supports health professions episode in Singapore’s primary in Primary Care: Scabies Dr Dong Lijuan Crustosa Approach to Reduce Out-of-Clinic education research. care setting. Dr Quek’s research 7TH ASIAN CONGRESS OF Assistant Director, Time for Healthcare Professionals project looked at understanding Nursing Services DIETETICS 2018, HONG KONG Dr Chia Liang Yoong in Primary Care’, led by Ms Yeoh Dr Darren Seah, Family Physician, the journeys of patients with Resident Physician, 2ND ASIA PACIFIC DIABETES IN July 2018 Ang Mo Kio Polyclinic Hui Ling, Trainer, Primary Care Consultant and Director of Family asthma who present for nebuliser PREGNANCY (APDIP) Academy, was put together to Medicine Development, was therapy at a polyclinic. CONFERENCE & IPRAMHO Can nutrition booths change 22ND EAST ASIAN FORUM allow nurses and trainers to spend awarded a grant for his research INTERNATIONAL MEETING perception, readiness to OF NURSING SCHOLARS 2019, SINGAPORE more time on patient care. This on the impact of tele-dermatology NMRC CS/CISSP change and knowledge on fruit (EAFONS) 2019, SINGAPORE project won the third prize in the as a learning tool for Family In FY2018, Dr Lee Eng Sing, Family and vegetables consumption? – January 2019 SingHealth Nursing Conference Medicine Residents to diagnose Physician, Senior Consultant, and Experience from the Polyclinics January 2019 2018 Poster Category held on and manage dermatological Deputy Head of Clinical Research Dietary Risk Assessment of the Nurses’ perception of individual 5 April 2018. problems in primary care. Unit, was awarded the Clinician Ms Chan Sau Ling Singapore Child Dietitian, professional development plan (Best Poster Award) Scientist/Clinician Investigator Yishun Polyclinic in a primary healthcare setting Salary Support Programme in Singapore: a qualitative study Ms Goh Ling Jia (CS/CISSP) by the National PRIMARY HEALTH CARE Assistant Nurse Clinician, Medical Research Council (NMRC). RESEARCH CONFERENCE, Ms Keely Lim Xue Qi Hougang Polyclinic MELBOURNE, AUSTRALIA Staff Nurse I, Yishun Polyclinic Postpartum dietary and In this research collaboration, August 2018 physical activity-related Dr Lee works with researchers beliefs and behaviours among from the Institute of Mental Impact of advanced practice women with recent gestational Health to validate the World nurse-led intervention on Diabetes Mellitus: a qualitative Health Organization Disability knowledge and safe practices study Assessment Schedule 2.0 for Muslim patients with Diabetes Mellitus during Dr Teh Kailin among those with mental and Family Physician, Associate Consultant, Ramadan in the primary Ang Mo Kio Polyclinic physical illness in Singapore. care setting

Ms Michelle Lee Cai Feng Assistant Nurse Clinician, Ang Mo Kio Polyclinic

Dr Amy Khor (in blue jacket), Senior Minister of State, Ministry of Health, listening to Ms Goh Ling Jia explaining her poster at the IPRAMHO International Meeting. 40 CHAPTER 3 ANNUAL REPORT FY2018 41 Investing in Research & Education Transformation

Publications with Contributions by NHGP Staff in Peer-Reviewed Journals

DIABETES AND VASCULAR JOURNAL OF FAMILY DIABETES METABOLISM ENDOCRINE RESEARCH ADVANCED SKIN WOUND CARE FAMILY PRACTICE DISEASE RESEARCH MEDICINE AND PRIMARY CARE RESEARCH AND REVIEWS

April 2018 May 2018 July 2018 July 2018 September 2018 January 2019

Long-term prospective Exploring patient and caregiver A review on interventions Transforming Primary Care Association of diabetes Excess visceral adiposity observation suggests that perceptions of primary to reduce medication – the way forward with the treatment with long-term is associated with diabetic glomerular hyperfiltration healthcare sector home care for discrepancies or errors in TEAMS2 approach. glycemic patterns in patients retinopathy in a multi-ethnic is associated with rapid simple acute wounds. primary or ambulatory care with Type 2 Diabetes Mellitus: a Asian cohort with longstanding decline in renal filtration setting during care transition First author prospective cohort study. Type 2 diabetes. function: a multi-ethnic study. First author from hospital to primary care. A/Prof Chong Phui-Nah Ms Goh Ling Jia Family Physician, Senior Consultant Co-author Co-authors Assistant Nurse Clinician, Chief Executive Officer Dr Tang Wern Ee Co-authors First author National Healthcare Group Polyclinics & Nursing Services Family Physician, Senior Consultant Dr Simon Lee Tang Wern Ee Dr Kee Kok Wai Primary Care Family Physician, Consultant Family Physician, Senior Consultant Family Physician, Associate Consultant Education Director, Chief Operating Officer and Education Director, Co-author Family Medicine Development and Toa Payoh Polyclinic Co-author Chief Clinical Informatics Officer Family Medicine Development and Ms Julia Zhu Head, Clinical Research Unit Head, Clinical Research Unit Nurse Clinician II, Dr Tang Wern Ee Nursing Services Family Physician, Senior Consultant Dr Tang Wern Ee Education Director, Family Physician, Senior Consultant Dr Kwan Pek Yee Family Medicine Development and Education Director, Family Physician, Principal Staff Head, Clinical Research Unit GAMES FOR HEALTH JOURNAL Family Medicine Development and Head, Yishun Polyclinic JOURNAL OF DIABETES Head, Clinical Research Unit INTERNATIONAL JOURNAL September 2018 January 2019 July 2018 OF NEPHROLOGY JOURNAL OF Gain in adiposity over three DIABETES COMPLICATIONS Play and learn with patients The association of serum July 2018 — designing and evaluating JOURNAL OF MEDICAL creatinine and estimated years is associated with INTERNET RESEARCH progressive renal decline in October 2018 a serious game to enhance glomerular filtration rate Projecting the burden of MEDICAL INFORMATICS multi-ethnic South-East Asians nurses’ inhaler teaching variability with diabetic Chronic Kidney Disease in with Type 2 diabetes. PAX4 R192H is associated with techniques: a randomised retinopathy in Asians with a developed country and its younger onset of Type 2 diabetes controlled trial. June 2018 Type 2 diabetes: a nested implications on public health. Co-authors in East Asians in Singapore. case-control study. Validation of a natural language Dr Simon Lee Co-author Co-author Family Physician, Consultant Co-authors Ms Cindy Lee processing algorithm for Co-authors Dr Lim Chee Kong Chief Operating Officer and Dr Simon Lee Nurse Educator I, detecting infectious disease Dr Tang Wern Ee Family Physician, Senior Consultant Chief Clinical Informatics Officer Family Physician, Consultant Nursing Services symptoms in primary Family Physician, Senior Consultant Deputy Director, Clinical Services Chief Operating Officer and care Electronic Medical Education Director, Dr Tang Wern Ee Chief Clinical Informatics Officer Family Medicine Development and Family Physician, Senior Consultant Records in Singapore. Head, Clinical Research Unit Education Director, Dr Tang Wern Ee BIOMED CENTRAL Family Medicine Development and PUBLIC HEALTH Co-author NEPHROLOGY DIALYSIS Family Physician, Senior Consultant Dr Kwan Pek Yee Head, Clinical Research Unit Ms Teo Sok Huang TRANSPLANT Education Director, Family Physician, Principal Staff Family Medicine Development and January 2019 Research Fellow, Head, Yishun Polyclinic Clinical Research Unit Dr Kwan Pek Yee Head, Clinical Research Unit July 2018 Family Physician, Principal Staff Head, Yishun Polyclinic Screen viewing behaviour and Risk of progressive chronic sleep duration among children INDIAN JOURNAL OF aged two and below. kidney disease in individuals with PSYCHOLOGICAL MEDICINE early-onset Type 2 diabetes: a Co-author prospective cohort study. January 2019 Dr Angelia Chua Family Physician, Consultant Co-author Illness perception of anxiety Yishun Polyclinic Dr Tang Wern Ee Family Physician, Senior Consultant patients in primary care in Education Director, Singapore. Family Medicine Development and Head, Clinical Research Unit First author Dr Wong Mei Yin Principal Clinical Psychologist Clinical Services 42 CHAPTER 3 ANNUAL REPORT FY2018 43 Investing in Research & Education Transformation

LEARNING SESSIONS HEALTH MANPOWER DEVELOPMENT PLAN VISITS In its continuous journey to learn from others and share experiences, NHGP organised and took part in various learning activities both locally and overseas. Canada Dr Low Kang Yih, Family Physician, The team also designed a Dr Lim Chee Kong, Family Physician, Associate Consultant, Ang Mo Kio pre-consult assessment form Senior Consultant, and Deputy Polyclinic, also visited the Austin incorporating behavioural Director, Clinical Services, visited Health Hospital in Melbourne and health techniques for primary OVERSEAS EXPERTS St Paul’s Hospital, Providence Royal Prince Alfred Hospital in Sydney healthcare providers to facilitate WORKSHOPS Healthcare from 28 May to 8 June to learn about their care programmes conversations with their patients. NHGP hosted two overseas 2018, to learn more about its Kidney for obesity and Diabetes Mellitus. experts, Professor Martin Care Clinic (KCC), the longest-running Netherlands and London Marshall and Professor programme of its kind in Canada. United States of America Dr Tricia Chang, Family Physician, James Dunbar, from 22 to KCC’s interdisciplinary clinics care for In September 2018, a team from Associate Consultant, Ang Mo Kio 24 October 2018. During the more than 1,200 patients in varying NHGP and the National Healthcare Polyclinic, went on a six-week learning sessions, Prof Marshall talked stages of chronic kidney disease. Group Pharmacy visited the Mountain trip to the Netherlands and London about the healthcare system The multi-disciplinary team there View Consulting Group in Seattle, from October to November 2018. in the United Kingdom, and supports and educates individuals and Washington. There, they learnt implementation research, clinical families living with kidney disease to about interventions that healthcare In the first half of the trip, Dr Chang service redesign and quality delay disease progression. providers can use to help patients visited the University of Maastricht improvement in primary care. with chronic conditions improve to learn about the health systems Australia compliance with their disease and research culture in General Prof Dunbar, on the other Together with NHG, four NHGP management regimes and change Practice in the Netherlands. During hand, shared his expertise staff visited the Australian Capital unhealthy behaviours. One such the second half of the trip, she in diabetes prevention, and Territory Health in Canberra, and programme is Real Behaviour was attached to the department the MAGDA (‘Mothers After the Austin Hospital and Frankston Change in Primary Care, which offers of Primary Care and Population Gestational Diabetes in Australia’) Hospital in Melbourne from 9 10-minute interventions to help Health at the University College trial and its implications on to 20 July 2018 to learn about empower patients to manage their London, where she was exposed how to manage gestational NHGP hosted Prof Marshall (seated, with tie), who shared about the importance and Australia’s Advance Care Planning chronic health conditions better. to the division of eHealth, and saw diabetes in primary care. evolution of general practice in the United Kingdom. (ACP) system. The visit offered how they used new information insights into the Australian team’s During the visit, the team also had and communication technologies efforts to support ACP in hospitals, the opportunity to shadow clinic to improve health. Dr Chang also primary care and the community, sessions conducted by a group of attended a women’s health module for and lessons about palliative care behavioural health consultants led medical students and visited General services and the residential aged by Dr Melissa Baker, Behavioural Practitioners to learn about their care facilities in Australia. Health Education Program Director. Quality and Outcomes framework.

NHGP hosted Prof Dunbar (back row, seventh from right), who shared insights on population-based quality-improvement initiatives NHGP team with Dr Baker (left) during their visit to the Mountain NHGP and NHG staff at the Claire Holland House during the in diabetes care. View Consulting Group. visit on ACP. 44 CHAPTER 3 ANNUAL REPORT FY2018 45 Investing in Research & Education Transformation

Visits to Yishun Polyclinic Between September 2018 and March 2019, Yishun Polyclinic hosted several visits. These included Tan Tock Seng Hospital, SingHealth Polyclinics, National Skin Centre, and Singapore Armed Forces (Regional Medical Centre Project Team). During these visits, the Yishun team shared the operational workflows as well as learning points from the setting up of the new clinic. On 29 November 2018, Minister

Khaw Boon Wan, Coordinating Minister Khaw (fourth from right) paid a visit to Yishun Polyclinic to experience the new Minister for Infrastructure and clinic setting. Minister for Transport, toured the new Yishun Polyclinic to learn about Dr Evan Sim (seated front row, centre), Family Physician, Principal Staff and Head of Woodlands Polyclinic, and his clinical team hosted NHGP’s use of innovative technology delegates from Thailand’s Ministry of Health. to improve productivity.

VISITS TO NHGP

Visit to Woodlands Polyclinic On 30 August 2018, Woodlands Polyclinic hosted Thailand’s Ministry of Health, comprising personnel from the Health Workforce Development, College of Public Health and Nursing, and Primary Health Care Centres. The delegates toured Woodlands Polyclinic and discussed Singapore’s healthcare and primary care system.

Visits to Hougang Polyclinic On 16 August 2018, Hougang Polyclinic hosted a group of 35 senior officers from Vietnam who were on a study trip to learn about the primary healthcare system in Singapore.

Hougang Polyclinic also hosted Professor Keith Harding and Associate Professor Steven Thng on 22 March 2019. They discussed SHINe participants’ visit to Ang Mo Kio Polyclinic. NHGP’s wound management framework, on-going training for Visits to Ang Mo Kio Polyclinic On 5 June 2018, NHGP hosted the SHINe is an umbrella group Wound Care Nurse Clinician Ms Julia Zhu (third from right) led the visit by Prof Thng (far right), Executive Director, Skin Research Institute of Singapore, and Prof Harding staff on wound management, and The newly redeveloped Ang Mo Kio Singapore Healthcare Improvement comprising members of healthcare (second from right), Medical Director, Welsh Wound Innovation Centre, to Hougang Polyclinic. methods employed to care for Polyclinic hosted a number Network (SHINe) learning series at organisations. SHINe members are patients with wounds, especially of visits by healthcare partners Ang Mo Kio Polyclinic for participants committed to delivering better care chronic wounds. and ministers. from various healthcare institutions. and lower healthcare cost to patients. 46 CHAPTER 3 ANNUAL REPORT FY2018 47 Investing in Research & Education Transformation

Apart from giving an overview of PCA TRAINING PCA also partnered the National the polyclinic, participants were ACCREDITATION AND Silver Academy (NSA) to offer brought on a clinic tour to learn OUTREACH courses for seniors (Singaporeans about NHGP’s teamlet care model, In July 2018, NHGP’s PCA was and Singapore Permanent Residents as well as the use of technology in re-accredited as a recognised aged 50 and above), who can enjoy enhancing a patient’s journey. training provider under the NSA subsidies for eligible courses. Agency for Integrated Care (AIC) PCA participated in NSA roadshows Mr Edwin Tong, Senior Minister Caregivers Training Grant. One to showcase the Academy’s public of State for Law and Health, and of the courses approved and courses and workshops, providing Minister Khaw Boon Wan, visited funded by AIC is the quarterly opportunities for lifelong learning. Ang Mo Kio Polyclinic on 7 and Care of the Elderly course, which 25 September 2018 respectively. equips caregivers with the skills NKF SYMPOSIUM Apart from learning about NHGP’s and knowledge of caring for At the National Kidney Foundation teamlet care model, Minister Khaw the elderly in the community. Symposium, held on 24 October also visited the Gallery of Memories 2018, Dr Irwin Chung, Director, to learn about the history of primary In September 2018, NHGP’s PCA, presented the topic ‘Tapestry care in Singapore. PCA was also re-accredited as of Care for the Chronically Ill in the a life support training centre. Community’. He touched on the full Additionally, a team of Health PCA was also accredited as spectrum of healthcare services Ministries and Non-Government a Basic Cardiac Life Support and healthcare offered by NHGP, Organisations delegates from (BCLS) and Automated External including initiatives on population various countries visited Ang Mo Defibrillator (AED) instructor and community health. A PCA booth Kio Polyclinic on 27 November 2018 training centre in September 2018. was also set up to share information as part of the Ministry of Health’s on numerous community- inaugural Ministerial Conference These new accreditations enable related training programmes on Diabetes. The delegates were PCA to build internal capability, with participants from various given a tour, which focused on develop a pool of qualified life community services, healthcare NHGP’s efforts in supporting support instructors, and run institutions, and voluntary welfare Senior Minister of State Mr Tong (centre) and representatives from the Ministry of Health (MOH) visited Ang Mo Kio Polyclinic. diabetes intervention and its training courses and workshops. and social service organisations. teamlet care model.

TRAINING OPPORTUNITIES NHGP’s Primary Care Academy (PCA) conducted several workshops in FY2018, including the following workshop for NHGP’s clinicians. For the full list of workshops conducted, please refer to Appendix B.

Child Development Masterclass On 18 August 2018, PCA conducted a Masterclass in Child Development for NHGP’s clinicians. The course covered topics such as the use of strategies and therapies to address a child’s unique needs; use of techniques to assess a child’s growth development, including communication milestones; and recommendations to parents to Mr Amrin Amin (eighth from left), Dr Amy Khor (centre) and NHGP senior management hosted foreign delegates at Ang Mo Kio Polyclinic for promote healthy development in Ms Angeline Yeo (right), Training Consultant, PCA, teaching participants Bed Bathing the Ministerial Conference on Diabetes. infants and young children. techniques for immobile family members during the Care of the Elderly course. 48 CHAPTER 3 ANNUAL REPORT FY2018 49 Investing in Research & Education Transformation

NURTURING THE NEXT GENERATION ACHIEVING PROFESSIONAL STANDARDS NHGP runs comprehensive teaching and learning programmes to develop the next To keep pace with the increasingly complex healthcare landscape, NHGP embraces generation of medical professionals to ensure holistic, patient-centred care. lifelong learning as a way to continue to deliver the best evidence-based care for patients, and to support staff in their professional learning and growth.

STUDENT ASSISTANTSHIP Under the SAP, these final-year PROFESSIONAL FAMILY MEDICINE Master of Medicine in Dr Olivia Chan PROGRAMME LKCMedicine students worked DEVELOPMENT CONVOCATION Family Medicine Resident Physician Fifty-one students from with clinic teams and were closely OPPORTUNITIES Organised by the College of Eighteen NHGP doctors passed Woodlands Polyclinic LKCMedicine’s first Student supervised by their clinical To ensure its healthcare Family Physicians (Singapore) the Master of Medicine (MMed) in Dr Nurul Azyan Assistantship Programme (SAP) teachers. Mini-projects that looked professionals are kept up to date and [CFPS], the Family Medicine Family Medicine (FM) examinations Resident Physician in Family Medicine were posted at various aspects of care delivery upskilled, NHGP organises medical Convocation Ceremony was held on in November 2018, undergoing Woodlands Polyclinic to Ang Mo Kio Polyclinic, at the polyclinics were conducted. forums every two months. These 17 November 2018, during which either a three-year NHG FM Dr Candice Lee Hougang Polyclinic, Toa Payoh These included patient’s research forums also provide a 41 NHGP doctors were recognised. Residency Programme or NHGP Resident Physician Woodlands Polyclinic Polyclinic, Woodlands Polyclinic perceptions of their illnesses, platform for research presentations Five of them attained Fellowships Programme B. The respective and Yishun Polyclinic for three knowledge and satisfaction and discussions. For the list of from CFPS, 18 were conferred programmes prepare the doctors Dr Rasminder Kaur weeks between February and of services to improve patient medical forums conducted in FY2018, a Masters of Medicine (MMed) for the breadth of exposure to MOPEX April 2018. experiences and clinical care. please refer to Appendix C. in Family Medicine (FM), and acquire the competencies required Woodlands Polyclinic 20 doctors received their to practise as Family Physicians. Dr Rajagopal Ramaswami Graduate Diploma in FM. Senior Resident Physician Yishun Polyclinic Fellowship College of Family Dr Lim Wei Khoon Physicians (Singapore) Dr Chara Fan Resident Physician Resident Physician Yishun Polyclinic Five NHGP doctors completed Ang Mo Kio Polyclinic the 24-month Advanced Training Dr Keith Tan Dr Tan Beng Soon Resident Physician Programme in Family Medicine Resident Physician Yishun Polyclinic and passed the summative exit Ang Mo Kio Polyclinic Dr Christine Sim examinations in 2018. Dr Rajni Gupta MOPEX Family Physician Yishun Polyclinic Ang Mo Kio Polyclinic Dr Khong Haojun Dr Jonathan Ting Family Physician Family Physician, Associate Consultant Ang Mo Kio Polyclinic Geylang Polyclinic Graduate Diploma in Dr Liu Sha Family Medicine Dr Liu Chang Wei Resident Physician Geylang Polyclinic Family Physician, Associate Consultant Twenty NHGP doctors passed Geylang Polyclinic Dr Gloria Khoo the Graduate Diploma in Family Resident Physician Medicine (GDFM) examinations Dr Sim Sai Zhen Hougang Polyclinic Family Physician in July 2018. The GDFM is a post- Hougang Polyclinic Dr Ng Chia Hau graduate training programme that Family Physician equips family doctors in Singapore Dr Kee Kok Wai Hougang Polyclinic Family Physician, Associate Consultant with skills to enhance their level of Toa Payoh Polyclinic Dr Afzana Ismail patient care. Resident Physician Dr Wan Jinhui Hougang Polyclinic Family Physician, Associate Consultant Woodlands Polyclinic Dr Lim Hui Ting Resident Physician Dr Tan Yi Rui Toa Payoh Polyclinic Resident Physician Ang Mo Kio Polyclinic Dr Loh Yi Bing Resident Physician Dr Ashis Pandey Toa Payoh Polyclinic Resident Physician Ang Mo Kio Polyclinic LKCMedicine students posing for a group photo with their NHGP educators. 50 CHAPTER 3 ANNUAL REPORT FY2018 51 Investing in Research & Education Transformation

Dr Terence Peter Lo NHGP BEST FAMILY Both awards were given out during Resident Physician MEDICINE TRAINERS’ the Appreciation for NUS Medicine Ms Wu Liqin Ang Mo Kio Polyclinic Senior Staff Nurse AWARD Clinical Teachers event held on 20 Ang Mo Kio Polyclinic Dr Chia Liang Yoong Dr Kee Kok Wai, Family Physician, November 2018. These awards were Ms Esther Zhang Resident Physician Associate Consultant, Toa Payoh given based on evaluation by NUS Ang Mo Kio Polyclinic Assistant Nurse Clinician Polyclinic, and Dr Jeremy Foo Fung Medicine students throughout the Ang Mo Kio Polyclinic Dr Sze Kai Ping Ms Tan Chwee Yan Resident Physician Yee, Family Physician, Associate postings in AY 2017/2018. This event Senior Staff Nurse Geylang Polyclinic Consultant, Yishun Polyclinic was organised by NUS Medicine Hougang Polyclinic became the proud recipients of the to appreciate the hard work that Dr Ang Dun Yong Ms Aslina Asbil MOPEX NHGP Best Family Medicine (FM) their clinical teachers put in for the Senior Assistant Nurse Geylang Polyclinic Trainers’ Award 2018. academic year. Nursing Services Dr Deepa Govindasamy Ms Manimekalai Resident Physician The annual award recognises DR WM. VICTOR Senior Assistant Nurse Hougang Polyclinic the significant contribution JOHNSTON AWARD Nursing Services Dr Lim Weixin made by these FM Trainers Dr Lee Eng Sing, Family Physician, NHGP’s NHG Teachers’ Day award recipients. Ms Nisha Menon Resident Physician for their initiative, passion and Consultant, and Deputy Head Senior Staff Nurse Hougang Polyclinic Nursing Services dedication in teaching. The of Clinical Research Unit, NHG TEACHING AWARD FOR NHG OUTSTANDING Dr Krishnapriya Govindasamy Ms Siok Lai Fong Resident Physician trainers were evaluated by medical received the inaugural Dr WM. SENIOR DOCTORS 2018 NURSE TEACHERS 2018 Principal Assistant Nurse Hougang Polyclinic undergraduates and FM residents Victor Johnston Award in Family Nursing Services Dr Richard Lee Dr Toh Ying Hui on their presentation content, Medicine given by Schulich School Ms Nurhabibah Samirah Family Physician, Consultant Ms Piloppina D/O Savurimuthoo MOPEX Senior Staff Nurse I teaching style, approachability of Medicine and Dentistry at Woodlands Polyclinic Senior Assistant Nurse Hougang Polyclinic Ang Mo Kio Polyclinic and creativity. Generous with Western University, Canada. This Nursing Services Dr Gregory Kang their time and effort in facilitating award recognises outstanding Ms Rina Foo Ms Tuty Anida Masuri MOPEX (SAF) NHG TEACHING AWARD Senior Staff Nurse II Senior Assistant Nurse Toa Payoh Polyclinic continuous learning, both doctors students in the Family Medicine FOR ALLIED HEALTH Toa Payoh Polyclinic Nursing Services are role models in the field of Masters and PhD programmes for EDUCATORS 2018 Dr Low Xhu Khie Ms Cuadra Christine Simon Ms Christine Chern Resident Physician undergraduate and post-graduate their academic achievement and Senior Staff Nurse I Nurse Clinician Woodlands Polyclinic medical training. research merit. Ms Chan Sau Ling Yishun Polyclinic Toa Payoh Polyclinic Dietitian Dr Chuah Hui En Clinical Services Ms Fiona Hashim Resident Physician NHGP NURSING BEST NHG TEACHING AWARD Staff Nurse Woodlands Polyclinic Toa Payoh Polyclinic CLINICAL INSTRUCTOR NHG Teachers’ Day was held on NHG INTER-PROFESSIONAL Dr Wadu Mesthri Nisansala AWARD 21 August 2018. The theme for TEACHING AWARD 2018 MOH IN-SERVICE Ms Tan Pao Ling Dulmini Gamage SCHOLARSHIP AND Senior Staff Nurse Resident Physician Ms Tan Lizin, Senior Staff this year’s celebration was ‘The Toa Payoh Polyclinic Woodlands Polyclinic Nurse, Ang Mo Kio Polyclinic, Magic of Education’, to reflect Dr Lim Pui San NHGP SCHOLARSHIP Family Physician, Principal Staff Several NHGP staff received the Ms Wang Xiuhong Dr Teh Kim Khiam bagged the NHGP Nursing the role of clinical teachers and Toa Payoh Polyclinic Senior Staff Nurse Resident Physician Best Clinical Instructor Award educators in touching hearts MOH In-Service Scholarship and Toa Payoh Polyclinic Yishun Polyclinic 2018. This award recognises and transforming minds. NHG TEACHING AWARD FOR NHGP Scholarship in FY2018. Ms Karmini Sechan Dr Mogilan S/O Mohan her outstanding contribution in NURSING PRECEPTORS 2018 These scholarships equip staff Assistant Nurse Clinician Woodlands Polyclinic Resident Physician providing effective clinical teaching with essential competencies and Yishun Polyclinic NHG TEACHING AWARD FOR to students and newly recruited JUNIOR DOCTORS 2018 Ms Tan Peck Hoong leadership capabilities to meet Ms Tang Wing Sze Dr Santharuby A S Andiappan Senior Staff Nurse I future healthcare needs. Senior Staff Nurse Resident Physician nurses to help them achieve the Ang Mo Kio Polyclinic Woodlands Polyclinic Yishun Polyclinic desired learning goals. Dr Gabriel Ding Family Physician Ms Jessica Zhu Ms Zuhairah Mohamed Amin Senior Staff Nurse II Senior Staff Nurse Dr Elizabeth Seitoh Yu Ting Geylang Polyclinic Ms Hasnah Samad Resident Physician NUS MEDICINE DEAN’S Toa Payoh Polyclinic Woodlands Polyclinic Staff Nurse Yishun Polyclinic Dr Steven Chao AWARDS 2018 Ang Mo Kio Polyclinic Ms Cuadra Christine Simon Family Physician Ms Chen Yan Senior Staff Nurse Dr Chen Sixian Dr Steven Chao Chien Chih, Toa Payoh Polyclinic Senior Staff Nurse I Ms Magdalene Lee Woodlands Polyclinic Yishun Polyclinic Resident Physician Family Physician, Toa Payoh Senior Staff Nurse Yishun Polyclinic Dr Chu Chun Hong Ang Mo Kio Polyclinic Ms Tan Cheng Gek Polyclinic, received the NUS Family Physician Ms Wan Lili Dr Trisha Upadhyaya Senior Staff Nurse I Senior Staff Nurse Medicine Dean’s Award for Toa Payoh Polyclinic Ms Nurhabibah Samirah Yishun Polyclinic Resident Physician Yishun Polyclinic Mohd Ghalib Yishun Polyclinic Teaching Excellence, and Dr Teo Dr Norizuan Rashid Senior Staff Nurse Yi Lyn, Family Physician, Yishun Family Physician Ang Mo Kio Polyclinic Polyclinic, clinched the Junior Woodlands Polyclinic Doctor Award. 52 CHAPTER 4 ANNUAL REPORT FY2018 53 Innovating for Better Care Transformation

CHAPTER 4 INNOVATING FOR BETTER CARE

Innovation is critical in the pursuit of better care. In the face of challenges, the National Healthcare Group Polyclinics (NHGP) is constantly looking at ways to innovate, optimise care and resources, and leverage technology and science. NHGP’s efforts go towards not just improving the care delivery model for today, but also advances its mission to create a world-class and future-ready relationship-based primary care ecosystem. 54 CHAPTER 4 ANNUAL REPORT FY2018 55 Innovating for Better Care Transformation

INNOVATING FOR A FUTURE-READY PRIMARY CARE Enhanced Self-Registration Kiosks In FY2018, NHGP was recognised for its various initiatives to leverage innovation to Since April 2018, patients have provide the best care possible for its patients. been able to use self-registration kiosks to update their own particulars during or prior to registration for a same-day appointment. The new feature gives patients the convenience of updating their particulars at any time. The information entered by patients is updated concurrently and seamlessly into the patient Dr Susan Lim management system for more receiving the accurate patient records. Minister for Health Award from Minister for Health Mr Gan Kim Yong.

MOH Appreciation & Patients can do so by donning a cuff Awards Ceremony 2018 and pressing a button. With these Dr Susan Lim Pui San, Family machines, staff previously deployed Physician, Principal Staff, and to man the blood pressure counter a member of the Collaborative can now assist patients who may Mr Ben Lau, Manager, Operations (left), representing NHGP at the Dr Lim and Ms Chong were recognised for their efforts at the PST Prescribing (CP) Standing have more urgent needs. More AHMA award ceremony. award ceremony. Committee, was presented the importantly, it empowers patients Minister for Health Award 2018 at the with the know-how to take and self- AWARDS Ministry of Health (MOH) Appreciation monitor their readings at home. The and Awards Ceremony on 7 self-help blood pressure machines AHMA 2018 PST Awards 2018 The programme, of which Dr Lim November 2018. This award is the will be progressively rolled out to all Upon arrival at the polyclinic, patients can register themselves using the Self- At the 2018 Asian Hospital Ms Chong Hui Jia, Operations Chee Kong, Family Physician, highest accolade conferred by MOH. NHG Polyclinics in FY2019. Registration Kiosks. Management Awards (AHMA), Manager at Ang Mo Kio Polyclinic, Senior Consultant, and Deputy NHGP’s Operations team was was presented the Star Manager Director of Clinical Services, was Dr Lim’s work in the committee has Enhanced Self- Enhanced conferred the Excellence Award in Award at the Public Sector Co-Director, was recognised for its been critical in developing practice Checkout Kiosks Payment Management the Talent Development category. Transformation (PST) Awards significant contributions in delaying standards, competencies and NHGP introduced enhanced self- In April 2018, the Electronic The entry, titled ‘Ancillary Staff 2018 ceremony on 4 July 2018. the progression of diabetic educational frameworks for CP. checkout kiosks at Yishun Polyclinic Polyclinic Outpatient System Talent Management — Job Her selflessness in driving and kidney disease in Singapore. This, in turn, plays a vital role in in July 2018. These kiosks accept a (ePOS) at NHGP was enhanced Redesign Initiatives and Core implementing improvements for facilitating care transformation for variety of payment modes, including to allow for the automated Training Frameworks for Improved better patient care has made Since April 2017, the NEMO community and hospital care, and cash, Apple Pay and Samsung Pay. closing of patients’ unpaid bills. Service Delivery of Patient Care’, Ms Chong well known to all staff Programme has evolved into will enable service innovation and The kiosks are also equipped with This includes auto-deduction was selected from 451 entries at Ang Mo Kio Polyclinic. the national Holistic Approach continuity through team-based care. smart routing logic, which allows from applicable schemes, such submitted by 123 healthcare to Lowering and Tracking patients to book future appointments. as the Medical Claims Pro- institutions throughout Asia. In addition to the Star Manager Chronic Kidney Disease INNOVATIONS This one-stop convenience of making ration System and MediSave. Award, the Nephrology Evaluation, (HALT-CKD) Programme, and payment and follow-up appointments With the job redesign, ancillary staff Management and Optimisation has been implemented across Self-Help Blood Pressure saves up to 10 minutes from the The enhancement, together gained the capabilities to undertake (NEMO) Programme, a all polyclinics in Singapore. Monitoring Machine overall wait time. These enhanced with the introduction of duties traditionally managed by collaboration between NHGP In March 2019, NHGP installed self-help self-checkout kiosks have also automation and centralisation professionals, including assisting and the National University blood pressure monitoring machines at been made available at Ang Mo Kio of the process, has significantly patients to complete the Asthma Health System, was Ang Mo Kio Polyclinic. Such machines Polyclinic, Hougang Polyclinic, Toa reduced the man hours spent on Control Test and Coronary Risk also awarded the ExCEL allow patients to take their own blood Payoh Polyclinic and Woodlands managing these outstanding bills Screening questionnaires. Innovation Project Award. pressure readings easily. Polyclinic as of March 2019. for greater productivity. 56 CHAPTER 4 ANNUAL REPORT FY2018 57 Innovating for Better Care Transformation

IMPROVING CARE CSISG 2018 CSCC EXERCISE Through this exercise, NHGP was To ensure a safe environment for staff and patients in the delivery of high-quality care, NHGP scored 71.7 points in 2018, Toa Payoh Polyclinic led in able to experience a potential NHGP places an emphasis on workplace safety and quality. an increase from 70.4 points in the Casualty Station & Civilian National Emergency situation and 2017, in the Customer Satisfaction Clinic (CSCC) on 9 March 2019 learn how to effectively set up the Index of Singapore (CSISG). The as part of MOH’s Emergency polyclinic to provide medical or survey, done by the Singapore Preparedness Exercise. psychological support. NHGP QUALITY DAY Management University’s Institute NHGP held its NHGP Quality of Service Excellence, studies Day 2018 on 21 September the customer satisfaction level of 2018. Themed ‘Cultivate. Ideate. consumers in Singapore. Innovate’, the event aimed to highlight the importance of MOH PES FY2018 innovation and encouraged staff to NHGP achieved a composite continue the good work of quality patient satisfaction score of improvement. The event also 89 per cent in MOH’s Patient included two insightful sharing Experience Survey (PES) 2018 sessions by keynote speakers: with Woodlands Polyclinic Mr Peter Ho, CEO of HOPE Technik, attaining the highest score of and Ms Lim Choon Heong, Head, 93.5 per cent amongst all NHG Agile and Operational Excellence at Polyclinics. Held from July to DBS Bank. December 2018, the survey assessed patients’ experience A total of 22 awards were given at public healthcare institutions out during the event. For the list and helped identify areas of quality improvement projects for improvement. completed in FY2018, please refer to Appendix D. SECURITY PREPAREDNESS As part of NHGP’s efforts for NHGP’s security preparedness exercise at Woodlands Polyclinic.

NHG QUALITY DAY NHGP Quality Award 2018 awardees were applauded for exemplifying quality and care security preparedness, a security On 19 September 2018, the in NHGP. exercise was conducted on National Healthcare Group (NHG) 1 December 2018 to simulate a celebrated its Quality Day 2018, state of heightened security at themed ‘Empowering Staff, Woodlands Polyclinic. Staff took Celebrating Joy in Improvement’. on roles as security personnel, Eight NHGP staff were awarded patients and visitors, and the Excellence in Action Award used hand-held detectors and for their service excellence undercarriage mirrors to screen and contribution to improve in-bound visitors and vehicles. work practices, while three NHGP patients and caregivers WSH ROADSHOWS received the Exemplary Patient To promote Workplace Safety and Caregiver Award for their and Health (WSH) awareness inspirational efforts in improving among staff, the WSH committee quality of care. organised roadshows across the six polyclinics and Headquarters from 5 to 22 March 2019. Themed ‘Take 5’, the roadshows taught staff the five-step approach to examine risks and employ risk-reduction strategies in Deserving awardees from NHGP at the NHG Quality Day. the work environment. NHGP’s emergency preparedness exercise at Toa Payoh Polyclinic. 58 CHAPTER 5 ANNUAL REPORT FY2018 59 Developing Our People Transformation

CHAPTER 5 DEVELOPING OUR PEOPLE

The National Healthcare Group Polyclinics’ (NHGP’s) journey towards care transformation begins with its people. Recognising the role that staff play in propelling the organisation forward in its shared mission, NHGP has in place staff development, appreciation and recognition programmes to motivate and inspire its employees. 60 CHAPTER 5 ANNUAL REPORT FY2018 61 Developing Our People Transformation

CELEBRATING EXCELLENCE NATIONAL DAY AWARDS 2018 NHG OUTSTANDING CITIZENSHIP AWARD Staff achievements, including the various efforts in innovation and service excellence, are On 21 November 2018, eight celebrated within NHGP to inspire everyone to greater heights. NHGP staff received the National Dr Tung Yew Cheong Family Physician, Day Awards. Senior Consultant Director, Quality and Patient Safety

At a celebratory dinner organised by the Lastly, Dr Winnie Soon, Family COMMENDATION MEDAL College of Family Physicians Singapore Physician, Consultant, was given (CFPS), Associate Professor (A/Prof) the College Teachers’ Award in Ms Lim Voon Hooi Assistant Director, NHG YOUNG ACHIEVER AWARD Chong Phui-Nah, CEO of NHGP and recognition of her commitment to Nursing Services Primary Care, received the FCFP(S) CFPS for teaching Family Medicine. Dr Christopher Chong Dr Valerie Teo Appreciation Plaque (Cluster) in Family Physician, Family Physician, Associate Consultant LONG SERVICE MEDAL Associate Consultant appreciation of her continued support Head of Ang Mo Kio Polyclinic Deputy Head of Ang Mo Kio Polyclinic of CFPS’ training activities in NHGP. NURSES’ MERIT AWARD 2018 A/Prof Chong Phui-Nah Dr Kong Jing Wen Dr Kee Kok Wai CEO, NHGP and Primary Care Family Physician, Family Physician, Dr Evan Sim, Family Physician, Two nurses from NHGP, Associate Consultant Associate Consultant Principal Staff and Head of Ms Julia Zhu, Nurse Clinician, Ms Faridah Akhbar Head of Hougang Polyclinic Toa Payoh Polyclinic Woodlands Polyclinic, received and Ms Christine Chern, Assistant Senior Staff Nurse I, Woodlands Polyclinic the FCFP(S) Appreciation Plaque Nurse Clinician, were among 100 (Polyclinic) on behalf of Woodlands nurses who received the Nurses’ Ms S Sankara Ammal A/Prof Chong (right), receiving the award Polyclinic. Dr Richard Lee, Family Merit Award on 18 July 2018. Senior Staff Nurse II, NHG DEVELOPMENTAL AWARD Contact Centre from Mr Sim Beng Khoon, Director, Physician, Consultant, received the Ms Zhu, who specialises in wound Workplace Health and Outreach Division, FCFP(S) Appreciation Certificate management, and Ms Chern, who HMDP ADMIN Ms Chia Kai Li Health Promotion Board, at a ceremony Ms Sharon Chen Senior Staff Nurse on 23 June 2018. (Organiser) for being the key provides direct care to patients EFFICIENCY MEDAL Deputy Director, Operations Ang Mo Kio Polyclinic organiser who helped arrange for with chronic diseases, have a Ms Mohanambal D/O Sundravelu NATIONAL STEPS the FCFP(S) Clinical Assessments combined nursing experience of Ms Cynthia Wong HMDP MEDICAL Dr Lim Chee Kong Senior Staff Nurse Senior Manager, Hougang Polyclinic CHALLENGE 2018 at Woodlands Polyclinic. more than 40 years. Human Resource Family Physician, NHGP emerged as winners in Senior Consultant Ms Anita Tan the Health and Social Services A/Prof Chong (right) Ms Jerlynn Goh Clinical Services Senior Nurse Manager and Ms Chen Yee Senior Executive, Dr Tricia Chang Toa Payoh Polyclinic category, and was ranked sixth Chui, Chief Nurse, Human Resource Family Physician, NHGP (left), with Ms Rajwant Kaur D/O nationally in the National Steps Associate Consultant Nurses’ Merit Award Gurdev Singh Khakh Challenge™ Season 3 Corporate Ms Fadzilah Hasanbasri Ang Mo Kio Polyclinic Senior Staff Nurse 2018 recipients Senior Dental Assistant, Toa Payoh Polyclinic Challenge, organised by the Ms Julia Zhu Ang Mo Kio Polyclinic Dr Low Kang Yih Health Promotion Board. (second from left) Family Physician, SNDP TEAM-BASED and Ms Christine Ms Rosidah Basri Associate Consultant Chern (second from Ang Mo Kio Polyclinic Ms Xie Shuqin Patient Care Assistant, Assistant Nurse Clinician This challenge was part of NHGP’s right). Woodlands Polyclinic Dr Marvin Chan Ang Mo Kio Polyclinic efforts to encourage staff to lead by Family Physician, example. NHGP also held its own Associate Consultant Ms Hamha Mohamed Hamzah Hougang Polyclinic Assistant Nurse Clinician ‘Walk To Win!’ to encourage staff Hougang Polyclinic to walk at least 7,500 steps a day. Dr Kee Kok Wai Family Physician, Ms Palaniammal Vellasamy The top team ‘walked the talk’ by NHG AWARDS 2018 Associate Consultant Nurse Manager clocking 29,000 steps on average. On 11 May 2018, five NHGP Toa Payoh Polyclinic Toa Payoh Polyclinic staff members and three NHGP HMDP TEAM-BASED Ms Chia Gui Kow teams were recognised for their Assistant Nurse Clinician Dr Winnie Soon Woodlands Polyclinic COLLEGE OF FAMILY contributions to public healthcare at Family Physician, PHYSICIANS SINGAPORE To be credible to our patients as primary the National Healthcare Group (NHG) Consultant Ms Quek Imm Pin Ang Mo Kio Polyclinic Senior Nurse Clinician AWARDS healthcare professionals, we need to be their role Awards Ceremony. Several NHGP Yishun Polyclinic On 19 May 2018, four NHGP staff staff members also received the Ms Sheena Ng models, walk the talk, and show them that lifestyle Executive members were acknowledged for change is possible. MOH Health Manpower Development Clinical Services their efforts to provide personal and Plan (HMDP) and Strategic Nursing comprehensive care to patients. — Dr Wee Wei Keong, Director of Health Promotion and Prevention Care Department Development Plan (SNDP) awards. 62 CHAPTER 5 ANNUAL REPORT FY2018 63 Developing Our People Transformation

CULTIVATING THE NHGP SPIRIT NHG TEAM RECOGNITION AWARD With the goal of ensuring that NHGP is future-ready, NHGP regularly engages staff to ensure that they are up-to-date on the latest developments and to strengthen bonds.

SILVER The Digital Transformation of Primary Care The study showed that better data quality and a positive patient experience is derived through the introduction of self-help services and automation. With proper planning and incorporation of proven processes, the proliferation of new technology promises even greater benefits for patients, healthcare staff, and healthcare organisations.

The team behind the ‘The Digital Transformation of Primary Care’ project, who won the Silver Award at NHG Team Recognition Award.

SILVER DM Foot STEP UP (Foot Screening & Surveillance, Treatment and Escalation Protocol for Ulcer Prevention) Diabetes Mellitus (DM) Foot STEP A/Prof Chong, CEO of NHGP and Primary Care, addressing Woodlands Polyclinic staff at one of the Townhall sessions conducted. promotes proactive self-checks through targeted patient education, sustained foot surveillance, and TOWNHALL SESSIONS Activities such as mass Zumba The event saw Woodlands Polyclinic seamless preventive and early During FY2018 CEO Townhall workout, Captain’s Ball and claiming the CEO Challenge Trophy treatment by a multi-disciplinary sessions, A/Prof Chong Phui-Nah, Telematches fostered inter- for the second year in a row, while team. Through regular foot CEO of NHGP and Primary Care, polyclinic team bonding and Ang Mo Kio Polyclinic came in surveillance, the multi-disciplinary team can promptly detect foot shared NHGP’s progress in its built a culture of active living. second and Headquarters and problems and provide early primary care transformation journey Geylang Polyclinic tied for third spot. treatment. The team behind the ‘DM Foot STEP UP’ project, who won the Silver Award at NHG Team with staff. Recognition Award. During such sessions, she gave an overview of the improvements BRONZE achieved following teamlet Streamlining of patient journey: AMK THK Hospital Discharge empanelment, the successful to Primary Care Follow-up at redevelopment of Ang Mo Kio AMK Polyclinic Polyclinic and Yishun Polyclinic, The modified discharge process looked at initiating arrangement and right-siting efforts under for patients of AMK Thye Hua the Central-North Primary Kwan (THK) Hospital to have Care Network. their consultation done in Ang Mo Kio (AMK) Polyclinic and lab investigations done prior to doctor’s NHGP ACTIVE DAY FY2018 visit. This way, patient waiting times Six hundred staff from NHGP, and clinic visits were reduced. the National Healthcare Group A Pharmacy-led medication Diagnostics (NHGD), and the reconciliation was also done prior National Healthcare Group to consult to minimise medication The team behind the ‘Streamlining of patient journey: AMK THK Hospital Discharge transcription error. to Primary Care Follow-up at AMK Polyclinic’, who clinched the Bronze Award at NHG Pharmacy (NHGPh) turned up at Team Recognition Award. the OCBC Arena for NHGP’s annual Active Day on 23 February 2019. Woodlands Polyclinic team posing with their CEO Challenge Trophy. 64 CHAPTER 5 ANNUAL REPORT FY2018 65 Developing Our People Transformation

CORPORATE RUN 2018 On 20 October 2018, a total of 190 NHGP staff took part in the Civil Service Club (CSC) Run 2018 at Gardens by the Bay. The run is part of NHGP’s annual Corporate Run activity to encourage staff to be physically active.

NHGP DINNER & DANCE 2018 Close to 1,000 staff from NHGP, NHGD, and NHGPh gathered for NHGP HQ staff gathered to celebrate the inaugural NHGP Admin Day. NHGP’s annual Dinner and Dance event on 24 November 2018. The event’s ‘Groovy 60s’ theme NHGP ADMIN DAY 2018 saw staff dressed in colourful On 2 May 2018, NHGP celebrated NHGP staff at the CSC Run 2018 event. retro outfits. Staff and guests its inaugural Admin Day to enjoyed dynamic performances celebrate its administrative by NHGP Senior Management staff, who are mostly based at members and polyclinic teams. Headquarters. NHGP CEO The night ended on a high note A/Prof Chong thanked for the winning performance administrative staff for their teams, and staff who walked hard work and dedication. away with lucky draw prizes. WORLD FAMILY DOCTOR DAY 2018 NHGP celebrated World Family Doctor Day 2018 at various The team formed by Ang Mo Kio Polyclinic locations on 19 May 2018 to and Toa Payoh Polyclinic won the Best Clinic Performance at the NHGP Dinner & appreciate doctors for their Dance 2018. professionalism and commitment in delivering quality primary healthcare. Yishun Polyclinic medical team celebrating World Family Doctor Day 2018.

OPERATIONS DAY 2018 On 14 July 2018, NHGP’s Operations staff gathered to celebrate Operations Day. The event recognises operations staff for their tireless effort in improving patient experience and patient care. In line with the drive towards innovation, the day’s programme was powered by electronic gadgets such as mobile registration, live-streaming, mobile games, e-learning, and a mobile lucky draw. NHGP Senior Management members, decked in retro outfits, getting ready for their stage performance. Staff taking part in games using their mobile phones. 66 CHAPTER 5 ANNUAL REPORT FY2018 67 Developing Our People Transformation

NURSES’ DAY Nurses from Woodlands VOLUNTEER APPRECIATION Polyclinic dressed as angels. CELEBRATION 2018 Their outfits won them the DAY FY2018 NHGP CEO A/Prof Chong, Best Dressed Award. On 16 February 2019, some 60 clinic heads, and nurses volunteers and staff came together of NHGP came together to celebrate the annual Volunteer to celebrate Nurses’ Appreciation Day organised by Day on 4 August 2018. NHGP. Held in conjunction with Themed ‘A Fairy Tale!’, the Lunar New Year festivities, the the event was filled event was themed ‘Our Sunshine’ with fun and laughter. and honoured the selfless contributions and achievements of NHGP’s Guiding Hands Volunteers NHGP FAMILY over the past year. APPRECIATION DAY 2018 Dr Simon Lee, Chief Operating NHGP held its Family Officer of NHGP, graced the Guiding Hands Appreciation Day on 4 occasion and presented the Long Service December 2018. NHGP iCARE Volunteer Awards 2018 award recipients Mr Sunny Soo (left) CEO A/Prof Chong to outstanding volunteers and Mr Joseph graced the occasion and who demonstrated NHGP’s Ong (right). presented seven Book CARE attributes of Confidence, Prizes to children of Attentiveness, Respect and NHGP staff. To recognise Empathy. The ‘Guiding Hands Long the dedication and Service’ awards were presented to I volunteer in NHGP because I enjoy serving the contributions of family Mr Joseph Ong Ah Yee and community at large. Also, it is an avenue where I can members who made it Mr Sunny Soo Siong Guan, who learn valuable lessons about how passion, willingness possible for NHGP staff have been NHGP volunteers for 12 to try, eagerness to learn, and commitment to to focus on their work, years. Certificates of Appreciation contribute to society can help each of us excel despite seven family members were also presented to those who the challenges we may face. received the ‘Stand By Staff from Yishun Polyclinic celebrated Nurses Day to recognise the contributions that nurses had volunteered more than 72 Me’ Award. make to improve the health of patients. hours in 2018. — Mr Sunny Soo, Guiding Hands Volunteer

A/Prof Chong with staff and their family members who received the ‘Stand By Me’ Award. Staff and volunteers at the Volunteer Appreciation Day event. 68 ANNUAL REPORT FY2018 69 APPENDICES Transformation

APPENDIX A ABSTRACTS BY NHGP STAFF AND COLLABORATORS FOR SHBC

NO. ABSTRACT TITLE AUTHORS NO. ABSTRACT TITLE AUTHORS

1 Predictors of Depression Outcome Expectancy in Primary Care. Mr Mah Siew Chung, Ms Shannon Chin, 15 Analysis of Prevalence of Obesity in Patients with Type 2 Diabetes Dr Jaganmohan Raja Ramasamy, Dr Neesha Maganlal, Mr Lim Kok Kwang, Mr Ooi Say Leong, with HbA1c › 9% Followed-up at Woodlands Polyclinic from July 2016 Dr Evan Sim Ching Sing & Mr Tang Chee Kai Dr Wong Mei Yin, Ms Soon Jiaying & Mr Yap Chee Khong to June 2017.

2 An Exploration of Possible Correlates of Expectancy of Change for Mr Gary Soh, Ms Joyce Lim, Mr Lim Kok Kwang, 16 The Association Between Multi-Morbidity and Health-Related Quality of Life: Dr Sim Sai Zhen, Dr Lee Eng Sing, Ms Jiang Yilin, Sleep Difficulties in Primary Care. Mr Ooi Say Leong, Dr Wong Mei Yin, Mr Yap Chee Khong, A Cross-Sectional Survey in the Singapore Primary Healthcare Setting. Ms Teo Sok Huang & Ms Kyreen Lee Ms Soon Jiaying & Mr Mah Siew Chung 17 Diagnosing Dementia in Primary Care: Evaluating the Differences in Patient Dr Valerie Teo, Ms Tan Bee Yan, Dr Victoria Leung, 3 Illness Identity of Patients with Depressive Symptoms in Primary Care. Ms Soon Jiaying, Mr Benjamin Low, Characteristics Between Those Who are Diagnosed in Primary Care Versus Ms Kim Wu, Dr Teh Kailin, Ms Jiang Yilin & Mr Lim Kok Kwang, Mr Ooi Say Leong, Dr Wong Mei Yin, Those Who are Referred for Specialist Assessment. Dr Sabrina Wong Mr Yap Chee Khong & Mr Mah Siew Chung 18 Uptake of Hepatitis B Vaccination Amongst the Seronegative Subjects in Dr Jonathan Ting, Dr Tan Ngiap Chuan, Dr Adrian Ee, 4 Can Nutrition Booths Change Perception, Readiness to Change and Ms Chan Sau Ling Primary Care: A Three-Year Observation Study in a Developed Endemic Ms Eileen Koh & Ms Sankari Usha Knowledge on Fruit and Vegetables Consumption? — Experience Community. from the Polyclinics.

A Successful Multi-Faceted Strategy to Improve Hand-Hygiene Compliance Ms Nisha Menon, Dr Khong Haojun, Educational Impact of Video-Screening on Healthy Behaviour Changes for Mr Won Tin Chiang & Dr David Ng 19 5 Rates in NHG Polyclinics. Ms Chew Geok Lan, Ms Lily Lang & Patients in Polyclinics. Dr Christopher Chong 6 A Case Series on Family-Centred Care of Post-Stroke Patients with Complex Dr Vivek Bansal & Dr Tan En Yu Needs in Primary Care. 20 Bacterial Contamination on Nursing Attire: A Review. Ms Goh Ling Jia, Ms Julia Zhu & Ms Nisha Menon

7 Simplifying Feedback for Improved Learner Reflection. Dr Jason Chan & Dr Liu Changwei 21 Evaluating the Effectiveness of Tepid Sponging in Reducing Fever in Ms Goh Ling Jia, Ms Julia Zhu & Ms Suja Thomas Paediatrics: Systematic Review and Meta-Analysis. 8 A Cross-Sectional Survey to Assess the Lifestyle Practices of Mr For Wei Chek, Ms Soh Ying Hua & National Healthcare Group Polyclinics (NHGP) Clinicians and Dr Wee Wei Keong 22 Efficiency of Vision Screening Test Using Snellen Chart for Four-Year-Olds Ms Goh Ling Jia & Ms June Lim Non-Clinicians. in Singapore.

9 An Audit of Statin Use for Primary Prevention in Elderly Patients Aged 75 and Dr Goh Kar Cheng, Dr Ashwin Motha & Dr Tan Jinxuan 23 Nurse Triaging in Hougang Polyclinic: Elements for Implementation of a Ms Goh Ling Jia & Ms Sandra Chua Above in a Government Polyclinic. Focused In-Clinic Training Session.

10 Patient Feedback on the ‘My Challenges Tool’ in Counselling Patients with Ms Nor Shawiyah Haron, Ms Christine Chern, 24 Tele-Wound Monitoring Service: Factors Influencing the Uptake in Ms Goh Ling Jia Poorly Controlled Type 2 Diabetes Mellitus. Ms K Nanda Kumari, Ms Arumugam Vasantha, Hougang Polyclinic. Ms Tan Pao Ling, Ms Ong Hui Chin, Ms Fadzlina Sujak, Dr Ian Koh, Dr David Ng & Tele-Wound Monitoring Service for Patients with Low-Risk Non-Infected Ms Goh Ling Jia, Ms Julia Zhu & Ms Lim Voon Hooi Ms Rajwant Kaur D/O Gurdev Singh Khakh 25 Wounds: A Retrospective Study in NHGP. 11 Accuracy of Home Blood Pressure Devices for Monitoring of Blood Pressure Ms K Nanda Kumari, Ms Nor Shawiyah Haron, — A Retrospective Review. Ms Christine Chern, Ms Arumugam Vasantha, 26 Developing Workplace Learning in Primary Healthcare Nursing. Ms Wendy Ong Ms Rajwant Kaur D/O Gurdev Singh Khakh, Ms Tan Pao Ling, Ms Ong Hui Chin, Ms Juraidah Yusof 27 The Effectiveness of Entrusted Professional Activities in Competency-Based Ms Yeo Loo See, Ms Goh Ling Jia, Dr Dong Lijuan & & Dr David Ng Training — Are We Bridging the Gaps? Ms Christie Anna D/O Money Samuel

12 Effectiveness of Medication Reconciliation Service (MRS) in Improving Dr Kee Kok Wai, Ms Cheryl Char & Mr Anthony Yip 28 Characteristics of Chronic Wounds and Factors Affecting Quality of Life Ms Julia Zhu, Dr Dong Lijuan, Ms Goh Ling Jia, Medication Adherence Among Patients Transiting Their Care from Hospital Among Patients with Chronic Wounds in Primary Healthcare. Mr Masnoon Saiyed, Dr Thirunavukkarasu Sathish, to Primary Care Setting in Singapore. Dr Ram Bajpai & Dr Josip Car

13 Reflective Experience of Family Medicine Residents Towards Learning and Dr Richard Lee & Ms Jiang Yilin 29 Evaluating the Correlation Between the Shoulder Pain and Disability Index Ms Cindy Soh Action Plans: A Quasi-Experimental Study. and the Bournemouth Questionnaire in Patients with Shoulder Pain: A Pragmatic Randomised Study.

Effectiveness of a Team-Building Workshop to Improve Teamlet Functioning Dr David Ng, Dr Lim Ziliang, Ms Angela Lim, 14 Factors Affecting Patient Enablement in an Asian Setting: Dr Jason Chan, Dr Mitesh Shah & Dr Andrew Fang in Polyclinics. Ms Joyce Tan, Ms Yeo Loo See, Ms Wong Theng Theng 30 A Mixed-Methods Study. & Dr Predeebha D/O P N Kannan 70 ANNUAL REPORT FY2018 71 APPENDICES Transformation

APPENDIX B LIST OF PRIMARY CARE ACADEMY WORKSHOPS CONDUCTED IN FY2018

NO. ABSTRACT TITLE AUTHORS MEDICAL KNOWLEDGE PATIENT CARE / CLINICAL & PROCEDURAL SKILLS M.Med OSCE Exam Preparation Surgical Procedures for the Primary Healthcare Physician 31 The Effect of Parity and Breastfeeding Experience on Breastfeeding Ms Jacqueline Giovanna De Roza, Ms Roslinda Sadon, Self-Efficacy, Perception of Milk Supply and Exclusive Breastfeeding. Ms Fong Mew Keng, Ms Eileen Koh, Ms Stephanie Teo M.Med Slide Exam Preparation Management of Joint & Soft-Tissue Conditions in Primary Care & Ms Ang Bee Leng GDFM OSCE Exam Preparation Common Eye Conditions Update and Eye Examination Techniques for Family Physicians 32 To Reduce the Percentage of Recurrent Ulceration in Podiatry High-Risk Mr Nicholas Andrew Hulme Diabetic Patients, from 10% to 0% Within 12 Months at Yishun Polyclinic. Interpretation of Spirometry Results INTERPERSONAL COMMUNICATION Diabetic Foot Screening Facilitation for Effective Clinic Communication 33 Diagnostic Accuracy of Artificial Intelligence in Dermatology: Dr Kong Jing Wen & Dr Eugene Tan Advanced Wound Management Workshop for Registered Nurses A Scoping Review. Enhancing Critical Communication Skills that Matter & Doctors Consultation Skills for Primary Care Physicians Early Childhood Nutrition Workshop 34 Study to Improve the Rate of Smoking Cessation Counselling by Healthcare Dr Kung Jian Ming, Dr Jaganmohan Raja Ramasamy, Staff Given to Smokers Aged 18 Years and Above Who Attended Woodlands Mr Tang Chee Kai & Ms Tan Lay Khim Standardised Patient Training Foundation Chronic Disease Management Polyclinic from August 2016 to January 2017 to 100%. Engaging Patient on Lifestyle Behavioural Change * BCLS & AED Full Certification Multi-Pronged Intervention of Percutaneous Injury in Dental Clinics from Ms Lily Lang 35 BCLS & AED Re-Certification 2013 to 2017. PRACTICE-BASED LEARNING BCLS + AED Instructor Course * The Association Between Illness Perceptions, Medication Beliefs and Dr Liu Changwei, Ms Jacqueline De Roza & 36 Teaching 101 for Busy Healthcare Professionals Adherence to Inhaled Asthma Controller Among Older Adults: Dr Tan Ngiap Chuan Advanced Course on Wound Management for Registered Nurses * A Cross-Sectional Study in Primary Care. Mentoring — A Guide by the Side Developmental Assessment * 37 Analysis of Chronic Kidney Disease and Obesity in Diabetics Aged 40 to 65 Dr Neesha Maganlal, Dr Jaganmohan Raja Ramasamy, Advancing Ethics and Professionalism in Primary Care Foundation Course in Women’s Health * Years with HbA1c 9% to 10% in Team-Based Care at Woodlands Polyclinic. Ms Wong Theng Theng & Ms Jeanette Wong Team-Based Care Training Advanced Course in Women’s Health * Analysis of the Uptake of PAP Smear Cases in Woodlands Polyclinic Over Dr Premdhevi Mahalingam Venkatesan & Diabetic Retinophotography (DRP) for New Nurses * 38 Care Coordinator’s Training 2 Years and the Factors Affecting a Consistent Uptake. Dr Gabriel C Gonzales Family Planning Workshop Masterclass on Tackling Antibiotic Prescription Dilemmas in 39 Effectiveness of Teaching Medical Leadership in a Polyclinic in Singapore. Dr David Ng, Dr Tan Khai Wei & Dr Lim Pui San Primary Care * Materclass in Child Development 40 Study of Prevalence of Insulin Therapy in Patients with Type 2 Diabetes with Dr Jaganmohan Raja Ramasamy, Dr Neesha Maganlal, SUPPORT FOR CLINICAL DELIVERY HbA1c › 9% Followed-up at Woodlands Polyclinic from June 2016 to Ms Zuhairah Mohamed Amin & Mr Tang Chee Kai Paediatric Dermatology Workshop Use of Medical Terminology in Work Activities (WSQ) June 2017. Mindfulness Basics for Primary Healthcare Professionals * Basic Health Parameters for Clinical Ancillary Staff 41 Exploring Illness Perception and Symptoms Severity as Possible Correlates Ms Soon Jiaying, Ms Jerlyn Ang, Mr Lim Kok Kwang, Introduction to Research of Anxiety Change Expectancy in Primary Care. Mr Yap Chee Khong, Dr Wong Mei Yin & Urgent Care Awareness & Fall Prevention Workshop Introduction to Qualitative Research in Primary Care Mr Mah Siew Chung English-Chinese Medical Translation Course 42 The Association Between Multi-morbidity and Healthcare Utilisation: Dr Sim Sai Zhen, Dr Lee Eng Sing, Ms Jiang Yilin, Generating and Making Sense of Qualitative Data: Know the Elderly: Workshop for Frontliners A Cross-Sectional Survey in the Singapore Primary Healthcare Setting. Ms Teo Sok Huang & Ms Kyreen Lee A Step-by-Step Guide * Understanding Diabetes, Hypertension and Lipid Disorders: Workshop for Frontliners 43 Positive Predictive Value and Negative Predictive Value of Abbreviated Dr Yong Yan Zhen, Dr Marvin Chan, Dr Kong Jing Wen, Mental Test Towards the Diagnosis of Dementia in a Primary Care Setting Ms Irene Kong, Ms Sundravelu Mohanambal, COURSES FOR THE PUBLIC AND COMMUNITY Geriatric Primer in Community Care in Singapore. Ms Sharon Foo, Ms Yvonne Deborah Tan, Dr Tan Ze Jia & Dr Yao Feng Yuan General Practitioner’s Assistant Courses — Basic & Advance Simplified Use of Medical Terminology Basic First Aid Workshop Writing in Plain Language for Patient Education Materials 44 Caregiver Burden Amongst Caregivers of Patients with Dementia: Dr Lim Ziliang, Ms Tan Bee Yan, Ms Jiang Yilin & What are the Associated Factors? Dr Sabrina Wong Care for the Elderly Train the Trainer for Essential Skills for Clinical Ancillary Staff CPR + AED Train the Trainer (Annual Skill Competency ) * 45 Effectiveness of Nurse-Led Wound Clinic on Clinical Outcomes for Patient Ms Julia Zhu, Ms Goh Ling Jia & Ms Lim Voon Hooi with Chronic Leg Ulcer in Primary Healthcare: A Quasi-Experimental Study. Falls Prevention & Use of Ambulatory Aids for Diagnostics Staff Service Communications Foundation Course for Frontline Clinic Staff Public Health Talks Healthcare Languaging — Navigating Healthcare *

Discovering Self & Engaging Others for Effective * New Facilitative Learning * 72 ANNUAL REPORT FY2018 73 APPENDICES Transformation

APPENDIX C APPENDIX D MEDICAL FORUMS AND WORKSHOPS CONDUCTED BY NHGP IN FY2018 QUALITY IMPROVEMENT PROJECTS COMPLETED IN FY2018

DATES TOPICS SPEAKERS / TRAINERS NO. PROJECT TITLE CLINIC PROJECT LEADER/S

17 May 2018 De-prescribing in the Elderly Dr Tan Huei Nuo 1 To Increase Influenza Vaccination Uptake in Children Aged 6 Months to Less Than AMK Ms Li Shen Senior Consultant; 3 Years (35 Months) from 2% to 20% in a Period of 6 Months at Ang Mo Kio Polyclinic. Deputy Head of Department, Centre for Geriatric Medicine, Tan Tock Seng Hospital 2 To Reduce Consumable Spending of Masks by 50% for Ang Mo Kio Dental Clinic AMK Ms Suyriati Mohd Isa in 7 Months. Ms Tan Keng Teng Principal Pharmacist (Clinical), Tan Tock Seng Hospital 3 To Improve the Decentralised Storage of Spacers and Masks in Ang Mo Kio Polyclinic. AMK Ms Letchmi Sanggaradas

19 July 2018 Rethinking So-Called ‘Difficult’ Patients — Dr Lim Wen Phei To Increase the Productivity of ATDPS at Pharmacy Services Centre (PSC) Ms Fanny Tan, Ms Goh Chern En Tips on Managing Patients and Oneself Consultant, 4 AMK by 20% (Part 2). & Ms Toh Li Li Psychological Medicine Department, Tan Tock Seng Hospital 5 To Reduce the Number of Ad Hoc Trips Offsite to Replenish Medication Supply by 50%. AMK Mr Matthew Lin & Ms Pang Xin Xian 20 September 2018 ACP De-Mystified: Dr Wu Huei Yaw Initiating End-of-Life Conversation in Primary Care Senior Consultant, Department of Palliative Medicine, 6 To Increase the Percentage of Active Patients Getting Diabetic Foot Screening GL Dr Wang Libin & Tan Tock Seng Hospital Within the Preceding 1 Year from 70% to 100% in Geylang Polyclinic Within a Ms Jiang Cuifang Period of 6 Months. Ms Josephine Goh Min Lee Medical Social Worker, National Healthcare Group Polyclinics 7 To Improve the Uptake of Group Education for Patients in Geylang Polyclinic. GL Ms Ko Ying Si

8 To Reduce the Waiting Time to Less Than 25 Minutes for at Least 95% of the Patients GL Ms Huang Yufang & 15 November 2018 Are You Unbreakable? Dr Faith Chia Collecting Medication in Geylang Polyclinic Pharmacy. Ms Tan Sui Ping Consultant, Department of Rheumatology and Immunology, To Decrease Nebulisation Rate in Patients With Asthma. Ms Elizabeth Chan Tan Tock Seng Hospital 9 HOU

To Increase the Influenza Vaccine Uptake Rate in Those Aged 65 and Above. Dr Lydia Chee 31 January 2019 Have You Taken Your Dose of Exercise Today? Dr Wang Ming Chang 10 HOU Associate Consultant; Sports & Family Physician, 11 To Optimise the Uptake of Pap Smears Among Patients With Chronic Conditions at HOU Dr Valerie Chiang National University Hospital Sports Centre Hougang Polyclinic. 12 To Improve the Percentage of Low-Risk Patients Referred to Open Access HOU Dr Ding Si Yan 28 March 2019 Effective Communication Strategies: Dr Jeremy Foo Oesophagogastroduodenoscopy (OGD). What Works in a Consult? Family Physician, Associate Consultant, Yishun Polyclinic, National Healthcare Group Polyclinics 13 To Increase Efficiency and Accuracy of the Billing Processes Related to St. Andrew’s HOU Ms Janet Teng Nursing Home by 50% at Hougang NHG Diagnostics Laboratory. Dr Teo Yi Lyn Family Physician, Yishun Polyclinic, 14 To Reduce Sunlove Nursing Home’s Residents Visit to Hougang Polyclinic by National Healthcare Group Polyclinics Doing In-House Blood Taking in 6 Months’ Time (in Collaboration With Sunlove HOU Ms Janet Teng Nursing Home).

15 To Reduce Time Taken to Complete Administrative Duties in the Repackaging HOU Ms Evelyn Soh & Process by 70% at Bukit Batok and Hougang Polyclinic Pharmacies — Adopting Best Ms Suzanna Leong Practices & Innovating.

16 To Optimise Time Spent in Patient’s Education on Stool Occult Blood Kit Testing HQ Ms Eileen Lim in NHG Diagnostics.

17 To Increase Uptake of Cancer Screening (Mammogram, Pap Smear, Fit Tests) HQ Ms Jayalakshmy Aarthi in Hougang Polyclinic.

18 To Reduce the Time Between Registration and Laboratory Test for Patients Coming TPY Dr Nasir Jameel Iqbal to Toa Payoh Polyclinic With a Memo for Blood Test(s).

19 To Increase the Influenza Vaccine Uptake Rate Among Staff in Toa Payoh Polyclinic. TPY Dr Gan Wei Chun 74 ANNUAL REPORT FY2018 75 APPENDICES Transformation

NO. PROJECT TITLE CLINIC PROJECT LEADER/S SNAPSHOTS OF PATIENTS ATTENDANCE AND WORKLOAD IN FY2018 20 To Improve Ways on Nurses Handling Routine Assignments in the Dressing Room. TPY Ms Wang Xiuhong & Ms Amy Han

21 To Update the Written Asthma Action Plan in Asthma Patients Who Have Been Started TPY Dr Gregory Kang & on or Had a Change in Dose of Preventers in Toa Payoh Polyclinic. Dr Vittal Sunil Pawar TOTAL NUMBER OF PATIENTS

22 To Increase the Percentage of Adult Dental Patients (Aged 16 and Above) Discharged WDL Ms Serene Zhang OTHERS With a Set of Bitewings (Taken Within 3 Years) to 100% in 9 Months. INDIAN 34,000 23 To Increase the Actualisation Rate of Diabetic Retinopathy Photography in WDL Ms Cassandra Kwek Type 2 Diabetes. 56,000 5% 10% 24 To Increase the Uptake of Screening Mammogram in Women Aged 50–69 Years in WDL Dr Moses Tan Woodlands Polyclinic Over 6 Months. MALAY CHINESE 25 To Increase Diabetic Foot Screening Rate in Woodlands Polyclinic. WDL Ms Renganathan Tharsan 88,000 15% 70% 409,000 26 To Reduce the Number of Repackaging Near Misses by 50%. WDL Mr Al Matriano

27 To Reduce Missed Prescription-Related Interventions at Capturing Counters by WDL Ms June Koh 50% from May 2018 to February 2019 in Woodlands Pharmacy.

28 To Reduce the Time From Triage to Bronchodilator Nebulisation for Patients With WDL Dr Kung Jian Ming & Ms Jia Shuli Mild to Moderate Exacerbation of Asthma Or COPD From 23 Minutes to 10 Minutes Within 6 Months at Woodlands Polyclinic. 587,000 29 To Increase the Percentage of Patients With One Glycaemic Test Ordered Within YIS Ms Ng Sze Ern & Mr Patrick Ee 6 Months for Patients Newly Diagnosed With Pre-Diabetes in Yishun Teamlets from 58% to 100%. PATIENTS BY DIFFERENT AGE GROUPS GENDER RATIO 30 To Increase the Uptake of the Zarit Burden Interview to Screen for Caregiver Stress YIS Dr Michelle Ee in Carers of Patients With Dementia. OF PATIENTS 31 To Improve the Percentage of Screening for Post-Stroke Depression Using PHQ9 YIS Dr Jobina Soh Questionnaire at Yishun Polyclinic. 9% 0-5 32 To Improve the Uptake Rate of Influenza Vaccine Among Patient With Diabetes YIS Dr Gan Hui Shuang at Yishun Polyclinic. 33 To Improve the Percentage of Pneumococcal Vaccination Uptake in COPD Patients YIS Dr Sharlene Seet 8% at Yishun Polyclinic. 6-18 MALE

23% 288,000 19-39

37% 40-64

23% FEMALE

65 & above 299,000

NOTE As numbers are rounded up for greater clarity, small rounding differences may arise. 76 SNAPSHOTS OF PATIENTS ATTENDANCE ANNUAL REPORT FY2018 77 AND WORKLOAD IN FY2018 Transformation

ATTENDANCE FIGURES TYPES OF VISIT BY DIFFERENT AGE GROUPS NUMBER OF VISITS (’000) NUMBER OF PATIENTS (’000) TOTAL DAILY 73 12 99 28 9 38 ATTENDANCE AVERAGE

0-5 2,326,000 8,300 85 25 6 40 17 5

6-18 214 122 36 102 56 25

TOP 10 PRIMARY DIAGNOSES 19-39 199 483 224 110 157 114 Age Groups (Years)

40-64 J06.9 243,454 100 436 212 53 120 96

65 & E11.9 235,344 above

AVERAGE NUMBER OF VISITS PER PATIENT I10 172,475 ACUTE ACUTE CHRONIC WELL & OTHER SERVICES TOTAL Cases with short onset of symptoms, such as upper respiratory tract infections and sprains. 0-5 2.6 1.3 2.6 3.7 E78.5 61,899 CHRONIC 6-18 2.1 1.5 1.2 2.3 Conditions that require long-term follow-up and, in general, regular medications and Diagnosis management of risk factors. For example, R68 19-39 2.1 2.2 1.5 2.7 hypertension, asthma, lipid disorders, chronic 52,996 obstructive lung disease and diabetes. (J06.9) Acute upper respiratory (A09.9) Other specified non-infective infection, unspecified gastroenteritis and colitis 40-64 1.8 3.1 2.0 4.2 WELL & OTHER SERVICES (E11.9) Type 2 Diabetes Mellitus (L98.9) Disorder of skin and

Age Groups (Years) A09.9 47,242 65 & Includes non-doctor consultations, without complication subcutaneous tissue, unspecified 1.9 3.6 2.2 5.5 developmental assessment, investigative

above Number of visits visits and other administrative procedures. (I10) Essential (primary) (T14.3) Dislocation, sprain and hypertension strain of unspecified body region L98.9 45,971 CHRONIC PATIENTS BY AGE GROUP AND COMPLEXITY (E78.5) Hyperlipidaemia, (Z00.1) Routine child health unspecified examination Age Groups SIMPLE MODERATE COMPLEX SIMPLE CHRONIC T14.3 36,615 (R68) Other general symptoms (P59.9) Neonatal jaundice, (Years) % % % 1 chronic Primary Diagnosis (PD) or and signs unspecified Secondary Diagnosis (SD). 0-5 89 11 0 6-18 82 17 1 MODERATE CHRONIC Z00.1 32,142 19-39 74 22 4 2–3 chronic diagnoses (PD & SD). 40-64 34 39 26 COMPLEX CHRONIC P59.9 29,169 % 65 & 4 or more chronic diagnoses (PD & SD). above 16 36 49 Total 38 34 29 0 5 10 15 20

NOTE NOTE As numbers are rounded up for greater clarity, small rounding differences may arise. As numbers are rounded up for greater clarity, small rounding differences may arise. 78 SNAPSHOTS OF PATIENTS ATTENDANCE ANNUAL REPORT FY2018 79 AND WORKLOAD IN FY2018 Transformation

CONSULT WAITING TIME SNAPSHOTS OF DENTAL PATIENTS

DENTAL CLINIC PERCENTILE NUMBER OF VISIT TYPE 50th 95th DENTAL VISITS IN FY2018 Walk-in 10 mins 53 mins 136,000 Appointment 7 mins 47 mins

HEADCOUNT NUMBER OF DENTAL PROCEDURES IN FY2018

JOB CATEGORY FY2018

Administrative 167

Allied Health 1 48 TOTAL Ancillary 448 66,000 135,800 201,800 Dental 2 99 Fillings Dental Check-ups, and Extractions Scaling and Polishing Medical 2 232 BASIC DENTAL PROCEDURES BY NUMBER OF VISITS (DAILY AVERAGE) IN FY2018 Nursing 284

NHG Diagnostics 305

NHG Pharmacy 208

TOTAL 1,791

NOTE 1Allied Health category excludes all Pharmacy staff. Pharmacists, pharmacy technicians, pharmacy assistants, pharmacy store 236 485 keepers, and retail pharmacy staff are subsumed under NHG Pharmacy. Fillings Dental Check-ups, 2Medical and Dental categories include Medical Officers and Dental Officers from the Ministry of Health Holdings. and Extractions Scaling and Polishing

NOTE NOTE As numbers are rounded up for greater clarity, small rounding differences may arise. As numbers are rounded up for greater clarity, small rounding differences may arise. National Healthcare Group Polyclinics 3 Fusionopolis Link Nexus @ one-north #05-10 South Tower Singapore 138543

Contact Centre: (65) 6355 3000 Email: [email protected] Website: www.nhgp.com.sg