Speech by 2nd Permanent Secretary Mr Ng How Yue, Ministry of Health, at the 27th Singapore Pharmacy Congress, 23 Sep 2017

Dr Vivianne Shih, Chairperson, 27^th Singapore Pharmacy Congress Organising Committee,

Ms Ng Hong Yen, President, Pharmaceutical Society of Singapore,      

Associate Professor Lita Chew, Chief Pharmacist,

Distinguished guests and speakers,

Ladies and Gentlemen,               

Good morning.

1.      It gives me great pleasure to be with you today at the 27^th Singapore Pharmacy Congress. I would also like to warmly welcome our distinguished overseas speakers to Singapore.

2.       The theme of this year’s congress is “Innovate. Impact. Inspire”. It serves as a timely message to our healthcare professionals – that we must constantly seek to improve care delivery; innovate and increase productivity and be cost efficient, strive to create value and positively impact the health of our citizens and residents, and work to inspire and educate our workforce. These are important priorities in the face of the evolving healthcare landscape.

3.         In our healthcare, Singapore is confronted with several challenges today. First, our population is rapidly ageing. By 2030, one in four residents will be over 65 years old. We expect an increase in chronic diseases and polypharmacy. Secondly, our healthcare expenditure has risen by approximately 2.5 times over the past 5 years, and the pressure for cost increase will persist.  We also have to cope with manpower constraints and a shrinking workforce. It is therefore critical for us to transform the delivery of pharmaceutical care so that we can keep our healthcare system and costs sustainable in the long run.

Aligning the pharmacy profession to Healthcare 2020 and Beyond

4.         In 2015, the Chief Pharmacist’s Office at the Ministry of Health (MOH) led the development of the National Pharmacy Strategy (NPS). This is a 10-year plan that is closely aligned with MOH’s key strategic shifts of Beyond Hospital to Community, Beyond Quality to Value to patients and Beyond Healthcare to Health. The National Pharmacy Strategy envisions transformation in the delivery of pharmaceutical care and medication management to a person-centric care model. The pharmacy care model will focus on providing quality care for the population, advancing preventive care within the community, promoting safe and effective medication use, and playing an active role in care integration for patients across their healthcare journey. Let me share the progress on some of the initiatives so far.

Transformation of the Pharmacy Profession – Quality and Innovation

6.         Predictive tools and digital health help to enhance productivity and effectiveness of care. Pharmacists are already making breakthroughs through the implementation of novel predictive tools. One such example is the Vancomycin App developed by NUS and used in KTPH to allow personalised dosing of a critical antibiotic used to treat serious infections in patients with chronic kidney disease and altered drug disposition. This helps to maximise efficacy by ensuring that appropriate and targeted concentrations of the antibiotic are achieved, while minimising toxicity.

7.         Pharmacists are also embracing the potential benefits of translational research. Research feeds and shapes the way medicine is practised, and is key to advances in patient care. Pharmacy researchers in the area of Infectious Diseases from various hospitals, including SGH, TTSH and NUH, have collaborated to study the pharmacokinetics and pharmacodynamics of important antibiotics. These projects will produce useful results to help optimise the use of antibiotics for best patient outcomes, while minimising the development of resistance.

8.         Another productivity enhancer launched in March this year was to allow chronic disease patients under the NHG polyclinics to pick up their medications from various 7-Eleven stores across Singapore at their own convenience.

Transformation of the Pharmacy Profession – Role of Pharmacists in the Community                                                                                  

9.         The Ministry will also continue in our efforts to build a strong primary care sector. Community pharmacists are amongst the most accessible healthcare professionals, and hence play a critical role in keeping the community well. There are numerous services that have been initiated, transforming community pharmacy practice from being supply-centric to patient-centric.

10.       The Pharmaceutical Society of Singapore recently launched the “Start to S.T.O.P” (Speak To Our Pharmacists) programme, a smoking cessation initiative in collaboration with NHG Pharmacy, Guardian, Unity, and Watsons. Patients identified to be at risk during Coronary Risk Screening sessions will be referred to the participating community pharmacies for smoking cessation counseling. This collaboration taps on the expertise of community pharmacists and increases our overall capacity for preventive care.

11.       I am also heartened that the community pharmacists stand united with the nation’s War on Diabetes. Several diabetes care programmes run by community pharmacists have been launched to help combat diabetes and heart disease. The Diabetes Risk Assessment service by Guardian that was started in July 2016 involves pharmacists advising the public on the effects of diet and lifestyle habits and identifying those potentially at high risk for further health screening. Another diabetes care service, by Watsons, involves pharmacists following up with patients, educating them to achieve better sugar control and reducing risk factors for heart diseases. Through these programmes, pharmacists collaborate with other healthcare professionals to mitigate and delay disease complications and improve our people’s health.

12.       Moving forward, community pharmacists can play greater roles in disease and medication management, especially in multi-disciplinary collaborative practice models for low to moderate risk patients. Patients can access such services right in the community, to help them optimise medication use. This will allow for right-siting of services, and reduce congestion in the polyclinics and hospitals. I am happy to share that the Pharmaceutical Society of Singapore will launch the Medication Therapy Management Training Programme at this Congress. This training programme aims to standardise practices of medication management in chronic diseases, and build capacity and capability in the community sector. I believe this will help greatly in the shift from hospital to the community.

Transformation of the Pharmacy Profession – Inspire to Build a Confident Workforce

13.       Under the National Pharmacy Strategy, the Ministry also aims to develop a confident pharmacy workforce to help drive service and care transformation. We are developing pharmacy practitioners through the Advanced Practice Competency Framework, which articulates a pharmacist’s scope of practice and defines the knowledge, skills and attributes that are required in advanced practice. This framework serves as a broad-based developmental tool. It will enable pharmacists to systematically identify areas for continuous professional development and acquire new competencies to advance their practice. For pharmacists to attain advanced level specialty specific clinical skills, we have launched the National Pharmacy Residency Programmes last year. As of today, a total of 19 pharmacists have enrolled in the 12-month accredited national programmes and nine of them have completed their training as at June 2017.

14.       Pharmacy technicians partner pharmacists to ensure safe medication use. In line with the enhanced Pharmacy Technicians Career Development Framework that was set up in 2014, the Ministry has collaborated with Nanyang Polytechnic on a SkillsFuture Earn and Learn Programme that leads to an Advanced Diploma Programme in Pharmaceutical Sciences. This 18-month structured programme was launched earlier this year with the aim of strengthening the core competencies of pharmacy technicians to enable role expansion. There are 24 candidates currently enrolled in the programme.

Conclusion

15.       In summary, the Ministry and pharmacy profession are working together to take on the emerging challenges faced by Singapore in order to continue to provide good healthcare for our people. I am confident we have a good plan of action to transform to a quality, efficient, person-centric care system. We should ensure that our healthcare system gets better all the time, and also aim to inspire future generations with innovative minds and caring hearts to improve public health and delivery of care for all Singaporeans.

16.       Finally, I wish you a fulfilling and enriching experience at this congress. Thank you.