SPEECH BY PROF KENNETH MAK, DIRECTOR-GENERAL OF HEALTH, MINISTRY OF HEALTH, AT THE 32ND SINGAPORE PHARMACY CONGRESS, 9 SEPTEMBER 2023, 10.00AM, AT GRAND COPTHORNE WATERFRONT HOTEL

Dr Vivianne Shih, President, Pharmaceutical Society of Singapore

Associate Professor Camilla Wong, Chief Pharmacist, Ministry of Health

Mr Wang Kaiye, Chairperson, 32^nd Singapore Pharmacy Congress Steering Committee, Pharmaceutical Society of Singapore

Distinguished Guests and Speakers

Ladies and Gentlemen

     Good morning. It is a pleasure to be with you today at the 32^nd Singapore Pharmacy Congress, and this is really a milestone for all of you. It’s the first time, I understand, that you have had your physical Congress again since the COVID-19 pandemic, and it is a wonderful opportunity to see so many of you. I think this marks a very good sign, that we are now able to come back together, and we will continue to have many more in-person interactions to further the goals of the Society, and also further the achievements that we want to have within the pharmaceutical community.

2.     The theme of this year’s congress is “Reimagining Possibilities – The Pharmacist’s DNA”. To me, it reflects how the pharmacy profession is constantly evolving and transforming to remain relevant, positively impacting the health of our population and nurturing a competent pharmacist workforce. And as you probe new care models, as we do so in the entire healthcare ecosystem, talking about DNA forces us to also talk about what is core and essential to us, what we come back to as our basic tenets of what our pharmacy profession is. That is the essence of what DNA is; what is actually necessarily immutable, which evolves and changes just as DNA might, but what the core values are in our profession. And as you reflect on the achievements, where we go and push the boundaries, this might be also a timely opportunity for you to reflect on what the distinctives that mark the pharmaceutical profession are, to help you to hold true to continue to identify with it as you morph and evolve new understanding in terms of what pharmacists can do in our medical system.

3.     As the healthcare landscape continues to develop to tackle these new challenges that we have, such as a rapidly ageing population and rising healthcare expenditure, it is crucial that as part of that DNA, we embrace innovation, that we are not necessarily only inward-looking but we are outwardly focused on the challenges ahead of us, and we are committed and determined to find new ways to overcome these challenges. New care models will proliferate, and they are critical in promoting preventive care and encouraging our public to take charge of their own health so that they can lead long and healthy lives.

New opportunities for pharmacists in Healthier SG

4.     In July 2023, the Ministry of Health (MOH) launched what we think is very important to us, Healthier SG, a new national campaign that reinforces the importance of preventive care in our community. It is a major reform of our healthcare system. It focuses on promoting a healthier lifestyle and improving the overall wellbeing of the population.

5.     Under Healthier SG, pharmacists are well-poised to take on key community partnership roles. Working within the community, pharmacists are highly accessible to the public, and you can help educate patients on many things, including medication management and overall health. Pharmacists can also identify and encourage residents to go for nationally recommended health screenings and vaccinations, to detect health issues early and protect themselves from vaccine-preventable diseases. Pharmacists can also work closely with family doctors in this new, evolving, and strengthened healthcare system to support patients who are keen to take that active role in their own health, keen to quit smoking and adopt healthy behaviour.

Piloting new care models to empower pharmacy practice

6.     To further involve our pharmacists in patient-centered care, MOH has rolled out many new and evolving innovations. The Pharmaceutical Care Services (PCS) is one of these innovations. We rolled this out in eight senior care centers since March 2022. These services aim to empower and support patients with polypharmacy, and their caregivers, to manage their medications independently. Pharmacists conduct in-depth reviews with individual patients and clients, and provide them with a consolidated medication list via the National Electronic Health Record and HealthHub. They also educate patients on their medications, assisting them in managing any potential side-effects.

7.     I am happy to share that patients and caregivers alike have given feedback that they feel more confident in managing their medications after consulting their pharmacist. In line with Healthier SG, the PCS programme will be expanded to more primary care locations, such as general practitioner (GP) clinics, polyclinics and retail pharmacies, to improve its accessibility to patients and caregivers.

8.     I am heartened to see community pharmacy providers evolve their practice to pioneer collaborative care models with GP clinics or telemedicine providers. iRx Clinical Pharmacy is one such community pharmacy provider. Before patients see their family doctor, the pharmacist will interview them to ascertain an in-depth clinical history and address their doubts about their medications. Equipped with this information, doctors can devote more consultation time to discuss the patients’ conditions, therapy options, and other aspects with them.

9.     Another example is Guardian Pharmacy, which has recently partnered telemedicine provider Speedoc. In this model, community pharmacists will triage patients’ conditions, conduct history-taking, and refer patients to consult the Speedoc doctor via teleconsultation where necessary. After the consultation, pharmacists will dispense and counsel patients on medications prescribed by the doctor. Through this doctor-pharmacist partnership, patients receive seamless end-to-end care at their convenience.

10.     The roles of pharmacists in direct patient care have also expanded beyond their clinical practice to include taking up leadership roles in the development, implementation, and assessment of clinical guidelines. For instance, pharmacists from the clusters jointly developed the National Surgical Antibiotic Prophylaxis Guidelines with infectious diseases physicians, surgeons and anaesthesiologists. It aims to align practices and optimise the use of antibiotics for surgical prophylaxis for the prevention of surgical site infections while reducing adverse events in Singapore.

11.     At our public hospitals and national specialty centres, pharmacists have also advanced pharmacy practice by leveraging technology. Pharmacists at the Singapore General Hospital (SGH) have developed an augmented intelligence logic model that enables timely individualised antibiotic treatment tailored to the unique profile of patients, reducing inappropriate antibiotics prescriptions.

12.     Pharmacists in our healthcare clusters are also supporting the GPs operating within their region and integrating them more closely with the overall health system. The National Healthcare Group (NHG) Pharmacy has started a drug information hotline that provides GPs with up-to-date information on medications, to enable GPs to make informed decisions on treatment options for their patients.

13.     As we move along the Healthier SG journey, I look forward to seeing more of such innovative efforts from the pharmacy workforce, where you practise at the top of your skills, and endeavour to shift care out from hospitals and back into the community.

Innovations in training and building a future ready pharmacy workforce

14.     As the roles of pharmacists evolve, you are required to work with other healthcare professionals in a more collaborative and integrated manner. Last month, the National University of Singapore (NUS) rolled out a new interdisciplinary common curriculum for Healthcare Professional Education, designed by its Department of Pharmacy in collaboration with the Alice Lee Centre for Nursing Studies, Faculty of Dentistry, Saw Swee Hock School of Public Health, and Yong Loo Lin School of Medicine. This aims to ensure that the learning outcomes of preventive care and ageing in place are aligned across for all healthcare students. Above all, these interactions embrace team-based care, which is so important now in the evolving and expanding new healthcare system that we have.

15.     Since the introduction of the Development Framework for Pharmacists and the NUS Bachelor of Pharmacy Programme in 2020, the Singapore Pharmacy Council’s Pre-Registration Training Development Committee has revised the pre-registration pharmacists training and assessment framework, promoting seamless transition from school to practice. This helps better prepare graduates through experiential learning that scaffolds professional activities across the direct and indirect patient care settings.

16.     Besides building a future ready Pharmacy Workforce, PSS has recently partnered with the Ministry of Manpower to develop customised training programmes to upskill healthcare associates who provide care for migrant workers, to empower them in assisting in care roles such as medication management and addressing queries from patients.

Closing

17.     In closing, pharmacists play an extremely important and critical role in care delivery and continue to play increasingly crucial roles in preventive care and community health. The theme for today’s Congress is truly apt in reminding us how the pharmacy profession has been evolving to address both perennial and emerging challenges, while at the same time, holding strong to its core. It is vital that we continue to develop the pharmacy profession and rethink how we can further upskill, so that we can serve our population to the best we can.

18.     Thank you very much for the invitation to join you here today, and I wish all of you an enriching congress ahead.