Speech by Mr Gan Kim Yong, Minister for Health, at Singapore Trauma Conference 2015 on 18 April 2015

Introduction

1.           I am delighted to join you here today for the 9^th Singapore Trauma Conference. To our guests from abroad, a very warm welcome to Singapore.

Trauma Trends in Singapore

2.           The theme for the conference is “Trauma Through The Ages”, which highlights the history of Trauma Management on a global scale, as well as its evolution in Singapore. The focus is also on the fact that trauma and injury can affect anyone, across all ages.

3.           As a group, injuries and various types of trauma form the top condition for hospitalization in Singapore. In 2013, approximately 28,000 patients required admission for trauma in our public acute hospitals. Trauma affects the very young as well as senior citizens. On average, three children a week suffer a moderate or severe injury in Singapore, mostly due to falls at home and in public places¹. With our ageing population, trauma in the elderly is also coming to the forefront. In 2013, those above the age of 65 years accounted for about half of all deaths from trauma[1].

A Multi-pronged Approach to Manage Trauma in Singapore

4.           In Singapore, we adopt a multi-pronged approach to manage trauma covering prevention, the acute phase and rehabilitation phase. For acute trauma care, all public acute hospitals in Singapore have in place processes and multidisciplinary specialist-led trauma teams for the care of major trauma patients[2].   

Recovery and re-integration into society

5.           After stabilization and surgical care, trauma patients often go through a phase of organized rehabilitation services to optimise recovery to lead productive lives. Rehabilitation should thus be planned for early in the acute phase of trauma care, and can extend to the post-acute phase in community hospitals, to day rehab and home therapy in the community following discharge.

6.           Older patients, for example, who suffer from hip fracture after their falls are managed in hospitals such as Changi General Hospital (CGH), Tan Tock Seng Hospital (TTSH) & Khoo Teck Puat Hospital (KTPH) through an Integrated Care Pathway that puts in place care by a multidisciplinary team, which works to ensure all patients are reviewed by the therapists and encouraged to ambulate as early as post-op Day One if possible. This is because there is evidence that early rehabilitation accelerates functional recovery in hip fracture patients, and increases their chance of returning home after discharge. This has resulted in a shortened average length of stay by about 2 to 6 days in these hospitals.  

7.           In addition, to support increased rehabilitation needs, we have been adding rehabilitation capacity across our healthcare sector. In 2014, we added more than 200 Community Hospital (CH) beds and going forward, we will more than double our number of CH beds by 2020.

Trauma Prevention

8.           Even as we strive to improve trauma care in Singapore, we must recognize that trauma prevention plays an integral role to reducing the burden of trauma. In our elderly, preventing falls can help avoid fractures and the consequential loss of mobility and reduced quality of life.  The Health Promotion Board (HPB) and several of our healthcare institutions have introduced falls prevention programmes for the elderly. These include the addition of falls risk screening as part of HPB’s Community Functional Screening Programme in 2012, and the Strength Training Exercise Programme (STEP), a group exercise training programme to reduce the risk of falls amongst elderly in our community. In the young, it is equally important to recognize that close supervision can prevent unfortunate incidents such as drowning and unintentional falls from height.

Beyond Healthcare

9.           Trauma is an issue that extends beyond healthcare, and hence tackling the prevention of trauma requires close collaboration with other ministries and agencies. For example, a recent multi-site study of adults who had sustained road traffic injuries show that rear-seat passengers were less likely to wear a seatbelt than drivers and front-seat passengers. This could be one potential target for road safety that would lead to a reduction in injuries, lives lost, and healthcare costs.

10.       MOH will continue to work with relevant agencies on efforts to reduce trauma, as guided by evidence and ongoing data collected by the National Trauma Registry. Set up in 2011, the National Trauma Registry helps inform service planning and supports research to provide better care for trauma patients.

Conclusion

11.       I would also like to take the opportunity to thank the Organizing Committee of this conference for putting together this exciting programme, and bringing together experts to help tackle the many issues of trauma management, across the ages. This conference serves as a useful opportunity to allow practitioners and thought leaders to come together to share ideas and experiences on trauma management.

12.       I wish you all a productive and enjoyable conference. Thank you.

[1] Extracted from National Trauma Registry Annual Registry Report 2012-2013.

[2] As defined in the Minimum Standards for Acute Care for Trauma Patients in Singapore, by the National Trauma Committee.