SPEECH BY DR LAM PIN MIN, SENIOR MINISTER OF STATE, MINISTRY OF TRANSPORT AND MINISTRY OF HEALTH, AT THE SINGHEALTH DUKE-NUS EDUCATION CONFERENCE OPENING CEREMONY, 27 SEP 2019

Mr Goh Yew Lin, Chairman-Designate, Duke-NUS Governing Board

Professor Ivy Ng, Group CEO, SingHealth

Professor Thomas Coffman, Dean, Duke-NUS

Assoc Prof Mark Leong, Assoc Prof Tay Yong Kwang, Co-organising Chairpersons of the Conference

Distinguished Guests

Ladies and Gentlemen

1.     It gives me great pleasure to join you today at the SingHealth Duke-NUS Education Conference. This year’s theme of “Building Resilience and Well-being in Healthcare Education through Interprofessional Collaboration” is a timely one and I am glad that a diverse and passionate group of healthcare educators will be sharing best practices, experiences and ideas on this important topic.

Building Singapore’s Healthcare Professional Workforce2.      The Global Burden of Disease 2017 Study published in The Lancet ranked Singapore favourably as the country with the highest life expectancy [1]. Our life expectancy at birth has risen from 76.1 years in 1990 to 84.8 years in 2017 [2]. This was made possible in part due to early prevention, better treatment and disease management.

3.     However, longer life expectancies also bring us face to face with the ailments and frailty that comes with old age. Our Health-Adjusted Life Expectancy was 74.2 years in 2017, which implies that the years spent in some form of disability was around 10 years. The largest contributors to Singapore’s combined burden of early death and disability were cardiovascular diseases, cancers, musculoskeletal disorders and mental disorders [3]. As a result, we have been expanding our health and social services across Singapore, as well as increasing the supply and capabilities of our healthcare professionals to care for the population.

Developing Competent Educators4.     As we continue to build up our healthcare ecosystem to meet the needs of our population, we need the support of a workforce equipped with the necessary skills to promote health and manage patients with multiple and complex needs, in both acute and community settings. In this light, healthcare education and training play a crucial role in helping our workforce stay relevant and sustainable.

5.     On an average day, SingHealth provides training to over 1,200 medical, nursing, pharmacy and allied health students and more than 970 medical residents. In addition, SingHealth groomed more than 60 per cent of the total target number of Clinician Scientists in Singapore in 2018.

6.    Beyond clinical skills training, SingHealth also plays a critical role in equipping healthcare administrators with the competencies to support care delivery. In December 2018, SingHealth was accredited by SkillsFuture Singapore as an Approved Training Organisation. SingHealth is also developing a new suite of WSQ-certified service excellence courses, which are open to all healthcare administrators in Singapore. The courses aim to equip frontline healthcare staff with service delivery skillsets aligned to the national benchmark.

7.      I am also pleased to share that in June 2019, the SingHealth Duke-NUS Institute of Medical Simulation was accredited by the Society for Simulation in Healthcare. The Society, which is the world’s largest healthcare simulation accreditation body, assesses based on four criteria - Assessment, Research, Teaching and Education and Systems Integration. The SingHealth Duke-NUS Institute of Medical Simulation with training facilities in the Singapore General Hospital, Changi General Hospital, Sengkeng General Hospital and KK Women’s and Children’s Hospital campuses, is currently the first and largest simulation institute in Southeast Asia to attain full accreditation.

Building Resilience and Well-being in Healthcare Education8.     While we develop and educate our healthcare professionals, we must also look after their well-being. Healthcare professions are highly challenging careers. Our people work in a fast-paced, complex and evolving environment, where decisions can make all the difference to care outcomes of a patient.

9.     They also practise in an environment that is increasingly complex, with the advent of technology, proliferation of social media use, an increasingly educated population and rapid medical advances. Due to the nature of the work, there are also occasional periods where healthcare professionals may be required to work long hours.These conditions could potentially lead to burn out among our healthcare professionals.

10.     A multipronged approach is needed to promote the well-being of healthcare staff, and help them achieve a state of personal fulfilment and engagement that leads to joy in work and improves the care provided to patients. It is heartening to note that our public hospitals have in place cluster- and institutional- level committees and workgroups to improve staff well-being. For example, the National Healthcare Group runs the Staff Support Staff (3S) Programme, while SingHealth Duke-NUS Institute of Patient Safety and Quality offers the Resilience in Academic Medicine (RAM) Train-the-Trainer Programme. The RAM Programme, which aims to build a strong pool of master trainers across SingHealth has trained close to 80 doctors, nurses, allied health professionals and administrators. They will then go on to cascade the learnings to their colleagues.

11.   In January 2018, Changi General Hospital (CGH) introduced the ReXilience Programme, which aims to strengthen the resilience of healthcare professionals and organisations by raising awareness of the importance of mental and emotional well-being. To date, CGH has trained close to 750 participants from various sectors including healthcare, transport, and finance.

12.    There are also initiatives in place to help healthcare educators identify signs of distress or burnout early. One example is the ‘Casa’ initiative by SingHealth Internal Medicine Residency Programme, which aims to promote a nurturing and collegial work environment. Each Casa consists of about 20 Residents and two mentors who meet once every two months to share their concerns and provide peer support to one another. The sessions also allow the mentors to pick up any signs of distress or burnout in their group members early. To date, more than 160 SingHealth Residents have participated in the Casa initiative.

Recognising Outstanding Educators13.     This morning, I would like to extend my appreciation to all the educators in SingHealth and Duke-NUS who have worked tirelessly to groom the next generation of healthcare professionals. There are constant challenges in balancing teaching, research and service provision but you have remained committed to your calling.

14.      I would also like to congratulate the recipients of the Golden Apple Awards, which recognise and honour outstanding educators in SingHealth and Duke-NUS Medical School who have demonstrated excellence in teaching the next generation of healthcare professionals. This year, the Programme Excellence Award will be presented to two inter-agency teams who have developed evidence-based training programmes that promote enhanced engagement, achievement and learning in healthcare education.

15.      One of the programmes is the Palliative Care Course for Social Workers. Previously, social workers would pick up clinical and psychosocial skills in end-of-life care on the job. To provide social workers with the necessary competencies at the onset, the project team comprising medical social workers from the National Cancer Centre Singapore, National University Hospital, Singapore General Hospital, Tan Tock Seng Hospital, Dover Park Hospice, Children’s Cancer Foundation, Fei Yue Community Services, and Lien Centre for Palliative Care came together to develop a course covering the foundational principles and practice of palliative care course in 2015. To date, the team has trained 114 social workers from both health and social care sectors. They have also developed an advanced curriculum that covers advanced knowledge and skills in the areas of clinical assessment, intervention management and leadership in palliative care.

16.     The other programme is the Emergency Airway Management Course, developed by emergency medicine doctors from the National Healthcare Group, National University Health System and SingHealth to train residents, nurses, respiratory therapists and paramedics to relieve airway obstruction during medical emergencies. Launched in 2008, the programme has benefitted over 600 local and overseas healthcare professionals.

17.     Both teams have shown exemplary qualities deserving of the awards they will receive later.

CLOSING18.     In closing, I would also like to convey my appreciation to all educators here today for your commitment to healthcare education. We hope our healthcare professionals will be inspired to contribute to healthcare education for future generations. Thank you and I wish all of you a fulfilling time at the Conference.

[1] www.thelancet.com/gbd

[2] [3] Epidemiology & Disease Control Division, Ministry of Health, Singapore; Institute for Health Metrics and Evaluation. The Burden of Disease in Singapore, 1990-2017: An overview of the Global Burden of Disease Study 2017 results