The Tripartite Workgroup for the Prevention of Abuse and Harassment of Healthcare Workers has recommended the adoption of a standardised zero-tolerance policy against the abuse and harassment of healthcare workers in any form, as it released its findings and recommendations today.

2. The Workgroup was established in April 2022 to spearhead a coordinated national effort to prevent the abuse and harassment of healthcare workers in the public, private, and community care sectors. Co-chaired by Professor Chua Hong Choon, Deputy Group Chief Executive Officer (Strategy & Transformation) of the National Healthcare Group, and Dr Benjamin Koh, Deputy Secretary (Development) in the Ministry of Health (MOH), it comprises representatives from MOH, Healthcare Services Employees’ Union, public healthcare clusters, community care partners and private healthcare providers. Senior Parliamentary Secretary for Health, Mdm Rahayu Mahzam, is the advisor for the Workgroup.

Findings and Recommendations of the Tripartite Workgroup to Prevent Abuse and Harassment of Healthcare Workers

3. The Workgroup has completed an extensive engagement with more than 3,000 healthcare workers, and more than 1,500 members of the public, through surveys and focus group discussions. The key findings are:

a) More than two in three healthcare workers said they had witnessed or personally experienced abuse or harassment in the past year. Half of them, or a third of all healthcare workers, witnessed or experienced abuse or harassment at least once a week. Frontline healthcare workers such as pharmacists, patient service associates, and nurses are more likely to experience abuse and harassment.

b) The most common forms of abuse and harassment are shouting, threats by patients and/or caregivers to file complaints or take legal action against the healthcare workers, and demeaning comments.

c) Healthcare workers experiencing abuse and harassment sometimes rationalise these as being part of their job.

d) Healthcare workers often empathise with patients’ circumstances and do not take action against them. As a result, abuse and harassment are often under-reported.

The engagement findings and the Workgroup’s recommendations can be found in the Annex.

4. The Workgroup recommends adopting a standardised zero-tolerance policy against the abuse and harassment of healthcare workers in any form, using a three-pronged framework of Protect, Prevent and Promote:

a) Protect healthcare workers who face abuse and harassment;

b) Prevent situations that lead to abuse and harassment; and

c) Promote positive relationships between healthcare workers and patients/ caregivers.

5. To protect healthcare workers from abuse and harassment and build a supportive culture where they feel safe to work and confident to report abuse and harassment, it is important to establish the following:

i. A clear and common definition of abuse and harassment, which includes any inappropriate behaviour or communication that causes a healthcare worker to experience distress, harassment, threat or discrimination, regardless of intention;

ii. An effective reporting and escalation protocol;

iii. A supportive culture of reporting; and

iv. Clear consequences that are implemented and enforced. This may include issuing a warning to the perpetrator; disengaging by refusing unreasonable requests or in cases when the patient does not require any urgent medical care, discharging the abusive patient; and disengaging from abusive caregivers or visitors by preventing them from entering the premises.

6. The Workgroup also recommends that institutions train their staff to prevent potential abusive situations by equipping them with the skills and knowledge to manage and de-escalate challenging situations and deterring potential offenders through the enforcement of consequences.

7. The Workgroup recommends that the public healthcare sector leads by example, and the public healthcare institutions have agreed to strengthen their existing processes and implement this standardised zero-tolerance policy. MOH will work with public healthcare clusters to develop the details in the second half of 2023. Private healthcare institutions and community care organisations will be encouraged to refer to the parameters of this policy, when it is ready, and adapt it to their processes and operating models where feasible.

8. In the second half of 2023, MOH Holdings will launch a national public education campaign, to promote positive relationships of trust and respect between healthcare workers, patients and their caregivers. The objective of the campaign is to align expectations of healthcare workers’ roles, and promote respect for healthcare workers.

9. Healthcare manpower is a vital resource and MOH is committed to grow, nurture and support them. We encourage members of the public to partner with us in creating a safe and conducive working environment for our healthcare workers to carry out their duties effectively.

MINISTRY OF HEALTH

17 MARCH 2023

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