DELIVERING CARE BEYOND HOSPITALS

     To support the growing needs of our ageing population, we will continue to expand our healthcare capacity by adding more beds and recruiting more healthcare manpower.

2.    To encourage and support care away from acute hospitals, the Ministry of Health (MOH) will expand Mobile Inpatient Care @ Home (MIC@Home) to deliver hospital-level acute care in our patients’ homes, and facilitate the transition to step-down and rehabilitative care. We will also encourage care for mental health to take place in community-based settings where appropriate. Even as we shift care beyond hospitals, we will continue to invest in infrastructure to ensure we can future-proof and meet demand.

Expansion of Healthcare Capacity

3.    There are more than 11,000 public hospital beds today. To meet the needs of our population, MOH will expand hospital capacity by about 4,000 beds from now to 2030.

a) The new Tan Tock Seng Hospital (TTSH) Integrated Care Hub (ICH) and Woodlands Health have started operations since October 2023 and December 2023 respectively, and will progressively ramp up services. When fully completed this year, TTSH-ICH will have about 600 beds, and Woodlands Health will open up to 700 beds by end 2025, and eventually 1,000 beds when fully opened.

b) Sengkang General Hospital and Outram Community Hospital will progressively increase their capacity by converting some non-clinical spaces into hospital wards from 2026.

c) The Singapore General Hospital (SGH) Emergency Medicine Building is slated to open in 2024, and the SGH Elective Care Centre by 2027. The SGH Emergency Medicine Building will have about 150 beds, while the SGH Elective Care Centre will have 300 beds.

d) Works are in progress for the new redeveloped Alexandra Hospital and new Eastern General Hospital Campus at Bedok North, comprising a new integrated general and community hospital. Alexandra Hospital will progressively open its new areas from 2028/2029 while Eastern General Hospital Campus will do so from 2029/2030.

New healthcare facilities

4.    MOH plans to establish a new not-for-profit private hospital catering primarily to Singaporeans from 2030. Industry consultation for the new model is ongoing. The hospital will provide cost-effective quality care, with stronger governance over its doctors’ clinical practices through a singularly licensed model.

5.    MOH has also commenced planning for a new integrated general and community hospital in Tengah Town to serve the growing population in the Western region. The hospital, to be operated by the National University Health System (NUHS), is targeted to be ready in the early 2030s.

6.    With the addition of a new integrated general and community hospital in Tengah and the new Eastern General Hospital Campus, we will have a total of 13 public acute hospitals and 12 community hospitals¹ in the early 2030s.

7.    To further reduce the strain on our hospital capacities, five Transitional Care Facilities (TCFs) currently operating at various locations nationwide, offering a total of about 700 beds to receive medically stable patients from the public healthcare institutions (PHIs) who need time to recover and are waiting to finalise their long-term care arrangements. Since the first TCF started its operations in 2022, TCFs have alleviated the PHIs’ load by receiving about 4,000 patients each year.

Growing our polyclinic network

8.    We are on track to expand our network of polyclinics to 32² by 2030.

New Polyclinics

a) Khatib Polyclinic will open in mid-2024;

b) Five polyclinics, located in Bidadari, Kaki Bukit, Serangoon, Tengah and Yew Tee, are scheduled to be completed by 2027; and

c) Two polyclinics, in Bishan and Taman Jurong, are scheduled to be completed by 2030.

Redevelopment of Polyclinics

a) The redeveloped Pasir Ris Polyclinic will open by the end of 2024.

b) Six polyclinics will be redeveloped by 2030. They are Bukit Merah³, Clementi, Jurong, Outram³, Queenstown, and Toa Payoh polyclinics.

Mobile Inpatient Care @ Home

9.    MOH has been exploring various measures to alleviate the tight bed capacity situation in our public hospitals, while ensuring patient care and safety are not compromised.

10.    Since 2022, MOH through the MOH Office for Healthcare Transformation (MOHT), has been running a sandbox for Mobile Inpatient Care @ Home (MIC@Home) to offer eligible patients the option to be cared for in their own home instead of a hospital ward. These include patients with conditions such as skin infections, urinary tract infections and congestive heart failure with fluid overload.

11.     The care that patients receive at home, as well as their care outcomes, are comparable to that received in hospitals. The MIC@Home care teams typically comprise doctors, nurses, pharmacists, therapists, and other healthcare professionals to provide patients with holistic clinical care, including intravenous medication and blood tests, with a combination of teleconsultations and home visits. During their MIC@Home stay, patients’ conditions are monitored remotely by the care teams. If a patient deteriorates, care escalation protocols will be triggered, including the option for the care team to activate emergency medical services.

12.    The outcomes of the sandbox have been positive so far. By providing inpatient care at home, we have observed improved patient satisfaction, better recovery, and reduced risk of hospital-acquired infections and complications. As of end-2023, more than 2,000 patients have benefited from this service, which translates to around 9,000 hospital bed days saved.

13.    MIC@Home will be mainstreamed and offered as part of the public hospitals’ regular services from 1 April 2024. With this, MIC@Home patients will be supported by subsidies, MediShield Life, MediSave and Integrated Shield Plan coverage, if applicable, no different from a physical inpatient stay.

14.    As of January 2024, there are 104 MIC@Home beds. We aim to provide up to 300 MIC@Home virtual beds in 2024. By doing so, we hope to further augment our bed capacity in the public hospitals by providing an alternative option for eligible patients to receive care from the comfort of their own homes.

Shift of Mental Health Care Delivery into Community Settings

15.    A whole-of-government and whole-of-society approach is necessary to tackle the spectrum of mental health issues. To help reduce stigma, encourage early intervention and foster strong social support networks, we will bring mental health support closer to where people live, study, work and socialise.

Tailoring care based on the Tiered Care Model

16.    The Tiered Care Model was announced in October 2023, as part of the National Mental Health and Well-being Strategy. It will guide the delivery of mental health services according to the severity of mental health needs and apply across various settings. There will be four levels of mental health support, from mental health promotion, self-help and peer support at Tier 1, to the most intensive level of care in hospitals and specialist clinics at Tier 4. Based on the severity of their symptoms, appropriate care interventions can be tailored to suit individuals at different care settings.

17.    To guide mental health providers in care delivery according to the Tiered Care Model, a Practice Guide will be developed by end-2024. It will standardise triaging, referral and care coordination processes across service providers in different tiers, to ensure seamless care delivery across providers.

Expanding capacity of mental health services in the primary and community care setting

18.    We will continue to expand capacity in the primary and community care settings to support mental health needs.

a. We aim to extend mental health services to all 32 polyclinics and 1,350 Healthier SG General Practitioner (GP) clinics by 2030. Today, 19 out of the existing 25 polyclinics provide mental health services. In addition, over 450 GPs have been trained to support persons with mental health needs under the Mental Health General Practitioner Partnership (MHGPP).

b. We will grow the number of community outreach teams (CREST) and community intervention teams (COMIT) run by social service agencies, from 73 CREST teams and 29 COMIT teams today, to 90 CREST teams and 50 COMIT teams by 2030. This includes expanding the number of CREST and COMIT teams catering to youths to 15 teams each.

c. To make it easy for individuals to seek help, we will raise awareness of first-stop touchpoints in the community settings as the first go-to places for help. These first-stop touchpoints will identify the individual’s mental health needs and provide the appropriate services, including information, immediate mental health support, or referrals.

Enhancing manpower competencies to support community-based care

19.    The National Mental Health Competency Training Framework was introduced to enhance the capabilities of practitioners across the various tiers of care. The framework complements existing professional standards for mental health professionals such as psychologists and counsellors. It provides guidance to service providers in acquiring the necessary competencies aligned with the Tiered Care Model.

20.    To further uplift capabilities of practitioners providing Tier 3 support, an onboarding course will be developed by MOH and the Ministry of Social and Family Development, in collaboration with National University of Singapore, Nanyang Technological University, and Singapore University of Social Sciences. The course will equip participants with skills to provide Cognitive Behavioural Therapy for a range of common mental health conditions, including depression, anxiety disorders, schizophrenia, obsessive compulsive disorders and insomnia. We aim to upskill 80 practitioners a year through these courses starting from this year.

MINISTRY OF HEALTH
6 MARCH 2024

¹ Currently, there are 10 public acute hospitals include general hospitals and specialty centres with acute care inpatient facilities (excluding psychiatric hospital); 10 public and VWO community hospitals.

² Currently, there are 25 polyclinics.

³ Bukit Merah and Outram Polyclinics will be consolidated into one polyclinic after the redevelopment.