Speech by Mr. Gan Kim Yong, Minister for Health, at the Singapore Trauma and Acute Care Conference, 20 April 2018

Mrs Chew Kwee Tiang, Chief Executive Officer, Khoo Teck Puat Hospital

Professor Kenneth Kwek Yung Chiang, Chief Executive Officer, Singapore General Hospital

Associate Professor Nicholas Chew, Chairman, Medical Board, Woodlands Health Campus

Associate Professor Thomas Lew, Chairman, Medical Board, Tan Tock Seng Hospital

Associate Professor Pek Wee Yang, Chairman, Medical Board, Khoo Teck Puat Hospital

Distinguished guests,

Speakers,

       Good morning. In its 12^th edition this year, the Singapore Trauma Conference has been rebranded to become the Singapore Trauma and Acute Care Conference (STACC) to reflect the increasing complexity, and the need for a multi-disciplinary approach in trauma care. The theme for this year – “Building Partnerships, Advancing Care and Improving Outcomes” is an apt one. Indeed, these are important themes to focus on and it is timely for us to explore ways to further improve patient outcomes following traumatic injuries.

PREVALANCE AND MEASURES TO PREVENT TRAUMA

2.     Trauma can affect people across all ages. It is a leading cause of death worldwide and the burden associated with trauma is high. Patients who have sustained severe physical injuries often require a longer stay within the acute and community hospitals to receive treatment and they may need further community-based rehabilitation care post-discharge. This may be further complicated by emotional trauma, such as post-traumatic stress and caregiver stress.

3.     In Singapore, trauma continues to be the fifth leading cause of death, with the majority of severe trauma injuries occurring among those aged 65 and above. While motor vehicle accidents and falls remain the top two causes of severe trauma injuries, the proportion of severe injuries resulting from motor vehicle accidents have been decreasing since 2012^[1]. In both categories, there are opportunities to mitigate risks and reduce incidence. For example, the incidence of severe head injuries amongst motorcyclists in Singapore and other countries has decreased with the mandatory use of safety helmets. Further, results from a multi-hospital study on seatbelt compliance led by Singapore General Hospital (SGH) in 2016^[2] highlight how wearing seatbelts can help protect not only the driver but also their loved ones. We should all do our part to reduce the incidence of traumatic injuries.

4.     With an ageing population, greater focus will need to be placed on falls prevention. Due to decreased flexibility and a sense of balance, as well as overall frailty, falls in the elderly can occur and they have serious implications. To create a safer home environment for our seniors to reduce risk of falls, the Health Promotion Board (HPB) launched a Falls Prevention Awareness Campaign in December 2017^[3]. The campaign provided advice for seniors and their caregivers on several fall preventive measures such as the installation of grab bars in bathrooms, keeping floors free of clutter, and using non-slip mats.

5.     HPB has also launched two simple exercise programmes to help the elderly maintain an active lifestyle. Targeted at seniors, these exercises help to improve strength, balance and flexibility. Not only does this help in delaying age-related loss of muscle mass and strength, it also reduces the risk for falls and prevents the loss of mobility and independence. Seniors are also encouraged to participate in FIT+, a 12-week community exercise programme, to maintain and improve their strength, balance and flexibility. Over 50,000 seniors have participated in FIT+ since its introduction in 2015.

EFFORTS TO DELIVER EXCELLENT CARE AND IMPROVE OUTCOMES

6.     Aside from preventive measures to reduce the incidence and the burden of trauma, it is equally important to improve the quality of care provided so as to improve outcomes for trauma patients. This includes the continual efforts to improve pre-hospital emergency care by the Singapore Civil Defence Force (SCDF) and the adoption of advanced practices in the acute hospitals such as haemostatic resuscitation and damage control surgery. We have also continued to enhance the competency of our doctors through courses such as the Advanced Trauma Life Support (ATLS) course, Definitive Surgery Trauma Care (DSTC) course and the Definitive Anaesthesia Trauma Care (DATC) course. On this note, I would like to thank Tan Tock Seng Hospital (TTSH) for organising the DSTC course for the last 13 years, since 2005, and the DATC since last year.

7.     The delivery of high quality trauma care also requires dedicated, multi-disciplinary teams to work together in a tightly coordinated way. Success does not lie solely in the hands of surgeons or emergency physicians, but also nurses, rehab therapists and other allied health professionals, case managers and trauma coordinators who work together tirelessly and often behind the scenes.

8.     The Ministry of Health will continue to work with stakeholders to improve the quality of trauma care provided in Singapore. In 2008, the Ministry appointed the National Trauma Committee (NTC) which introduced and implemented the Minimum Standards of Trauma Care. Today, every acute hospital that manages trauma is expected to meet this set of standards. The Ministry had also appointed the National Trauma Unit to maintain the National Trauma Registry (NTR). The comprehensive data collected by the NTR will allow a clearer image of the national burden of trauma and better inform and guide policy planning to improve trauma care.

CONCLUSION

9.     In closing, let me take this opportunity to commend the Organising Committee in their efforts to organise this year’s conference in conjunction with the 4^th Asia Trauma Congress. On top of facilitating the sharing of expert knowledge, this is an excellent platform to foster international collaborations amongst healthcare professionals in Asia to further improve trauma care. I wish you an enriching and productive time at the STACC 2018. Thank you.

MINISTRY OF HEALTH

^[1] From 26.1% (in 2012) to 17.6% (in 2016).

^[2]SGH-led study reinforces importance of fastening seatbelts

^[3] HPB had launched two Falls Prevention Campaign. The first, which introduced 5 tips for falls prevention, was launched in July 2016 while the second, which shared home safety tips, was launched in December 2017.