Speech by Mr Chee Hong Tat, Senior Minister of State, Ministry of Health, at the SingHealth Duke-NUS Education Conference, 29 Sep 2017

Mr Peter Seah, Chairman, SingHealth

Mr Kai Nargolwala, Chairman, Duke-NUS

Professor Thomas Coffman, Dean, Duke-NUS,

Professor Ivy Ng, Group CEO, SingHealth

Distinguished Guests

Ladies and Gentlemen

1.            It gives me great pleasure to join you today at the SingHealth Duke-NUS Education Conference.

BUILDING A FUTURE-READY HEALTHCARE WORKFORCE

2.            Under the Healthcare 2020 Master Plan, Singapore has made steady progress to enhance the accessibility, quality and affordability of healthcare for Singaporeans. A recent study by The Lancet medical journal ranked Singapore first among 188 countries in terms of progress towards meeting the UN’s health-related Sustainable Development Goals.  This is a good recognition of the hard work by our healthcare professionals and the quality of our healthcare system, but we must not rest on our laurels.  With an ageing population, we will face a higher incidence of chronic diseases and an increasing demand for healthcare services of higher levels of complexity. We have to plan ahead to meet the long-term healthcare needs of our population.

3.            As we continue to build the healthcare ecosystem to support our seniors to age in place and work on care transformation to anchor care in the community, we need the support of a workforce equipped with the necessary skills to manage patients with multiple and complex needs. In this light, healthcare education plays a crucial role in helping our workforce stay relevant and sustainable.  

DEVELOPING CAPABILITIES BEYOND COMPETENCIES

4.            The SingHealth Duke-NUS Academic Medical Centre (AMC)’s healthcare institutions   have a long history in providing for the nation’s healthcare education and training needs. Institutions such as Singapore General Hospital and KK Women’s and Children’s Hospital handle about 50 per cent of the nation’s clinical teaching load annually. On an average day, more than 650 medical, nursing, pharmacy and allied health students, as well as close to 1,000 medical residents, are trained at the SingHealth healthcare institutions.

5.            Training for students and junior doctors is largely focused on building knowledge and competencies necessary to carry out clinical duties. The challenge is to take this one step further especially during post-graduate training to develop healthcare professionals who are also able to work well with other groups of professionals to deliver quality care to patients.

6.            Earlier this year, SingHealth launched five colleges for doctors, dentists, nurses, allied health professionals and administrators. The Colleges of Clinical Medicine, Clinical Nursing, Allied Health, Oral Health, and Healthcare Administration & Leadership will prepare our healthcare workforce by equipping each profession with the relevant capabilities to meet the evolving needs of the healthcare landscape.

7.            Likewise, healthcare educators need to expand their capabilities, embrace new pedagogical methods and keep abreast of the latest developments in healthcare education. The SingHealth Duke-NUS Academic Medicine Education Institute (AM•EI) has rolled out training frameworks for different competencies, domains and levels to enhance educators’ capabilities. To date, the Institute has offered more than 5,500 training places to educators from across the healthcare continuum.

8.            It is encouraging to see the innovative use of technology in healthcare education. These include simulation technologies and virtual reality learning, which have been incorporated in our under-graduate and post-graduate courses.  They augment the traditional teaching methods and allow students to learn more effectively.  I had a chance to visit some of these facilities, and I think it is a good use of technology that would make a difference. How do you combine that with the more traditional teaching methods - which are still very important. It is not about replacing the traditional methods but about augmenting and supplementing.

DEVELOPING INTERPROFESSIONAL COLLABORATIVE PRACTICE

9.            Inter-Professional Education, or IPE, is an important step in developing a collaborative and practice-ready healthcare workforce. Healthcare professionals need to go beyond your area of specialisation and collaborate with other healthcare and also non-healthcare professionals, to provide integrated quality care for patients.

10.          Practical experience is necessary for learners to hone their individual and collective skills, and to work together effectively across boundaries and across disciplines. I am heartened to know that new Inter-Professional Collaborative Practice initiatives will be introduced in the SingHealth Duke-NUS Academic Medical Centre for both existing and new training programmes.

11.          At the National Neuroscience Institute, the Stroke Inter-Professional Education programme aims to improve stroke care outcomes through enhanced inter-professional training, where different healthcare professionals such as doctors, nurses, pharmacists, physiotherapists, occupational therapists and medical social workers, can train together. This develops team competence, beyond individual competence, so that the team can become more effective and achieve better health outcomes for patients. Other examples include the IPE Common Care Pathway for Childhood Asthma in KKH, and SGH’s Learning for Inter-Professional Patient-Centric Approach to Diabetes Management. I hope the positive experiences with these IPEs will encourage all healthcare institutions, including those beyond the SingHealth group, to introduce more IPEs in other areas.

12.          The tenets of inter-professional education are relevant to healthcare providers even before they enter the workplace. For example, undergraduate medical, nursing, and pharmacy students at NUS have joint learning and training sessions on inter-professional communication and teamwork, as well having advanced care planning lessons concurrently with social work students. This is also the approach for training our students during their clinical attachments in the public healthcare institutions. I encourage and support this as it is reflective of the kind of work environment that they will be operating in, when they join the healthcare workforce.

13.          To enable our healthcare providers to expand their roles and deliver better care for patients, including in community settings, MOH will amend our existing policies to allow Advanced Practice Nurses (APNs) and registered therapists to assess seniors’ needs and suitability for subsidised community rehabilitation at Senior Care Centres and Day Rehabilitation Centres. This will make it more convenient for seniors when they receive rehabilitation care in the community, as they no longer need to be assessed by a doctor in the Specialist Outpatient Clinic (SOC).  It also benefits the SOCs as they can focus on other patients with more pressing healthcare needs.  We will do a review after the initial experience, to see if we can expand the list further to include other nurses beyond the APNs.  

14.          MOH will review our rules to empower experienced enrolled nurses by expanding their roles to include more complex duties, such as administering oral medications, injections, and wound care. These tasks are currently performed by registered nurses.  By allowing all groups of professionals to practise at the top of their licence, we will maximise the potential and contributions of our healthcare workforce.  Similarly, we will empower APNs and pharmacists to prescribe medication in collaboration with doctors.  This will help to facilitate care transformation in the community and hospitals by providing a holistic service, and better continuity which fosters team-based care by different groups of healthcare professionals working together as a team.

15.          These ideas were proposed by the different groups of healthcare workers and the Healthcare Services Employees Union (HSEU) when I met them during focused-group discussions over the past months.  We have translated the proposals into policy changes.  I thank our colleagues and our brothers and sisters from the Union for the suggestions, and for their continued support as valued partners in our healthcare transformation journey.  Please keep the ideas coming, I will support you to make the policy changes and system changes if these can contribute to better patient care and better health outcomes for Singaporeans.

RECOGNISING OUTSTANDING EDUCATORS

16.          Let me now pay tribute to our outstanding educators for their dedication and contributions.  Today, we will be awarding the AM•EI Golden Apple Awards to 16 clinical educators. These educators are recognised for their efforts to transform healthcare teaching and inspiring their students and colleagues.

17.          One of them is Dr Tan Eng Loy from SGH, who has mentored many O&G doctors in his years of clinical practice. He has contributed to the training of obstetricians and gynaecologists through practical and effective training methods. This includes his innovative practice of organising regular quick obstetric drills for residents to have hands-on practice for emergencies that may not be commonly seen during normal clinical practice. For his commitment to grooming the next generation of doctors in his field, Dr Tan will receive the Outstanding Educator Award.

18.          Ms Anuradha D/O Ramasamy from the National Heart Centre Singapore is a trailblazer in nursing education. She developed a Geriatric Nursing Course for Cardiac Nurses to equip fellow colleagues with the essential knowledge, skills and attitudes required to care for the elderly. To date, more than 80 NHCS staff and staff from other healthcare institutions have attended the programme. For this commendable effort, Ms Anuradha will receive the Outstanding Young Educator award.

19.          I am glad that our administrators are also recognised for their contributions to healthcare education – not just our frontline healthcare professionals but also those who support them. Dr Scott Compton from Duke-NUS will be awarded the Generativity Award for Educators. Besides leading the Duke-NUS educational programme, Dr Compton is also widely recognised as an expert in educational research, and has guided many faculty members on education research projects.  

20.          Besides these three educators, there are 13 other educators, please join me in extending our warmest congratulations and sincere appreciation to all award recipients! 

21.          Thank you and I wish all of you a fruitful conference.