Transforming the primary care landscape: Engaging the GP community and our stakeholders in the journey

08 Oct 2011

The Ministry of Health (MOH) is holding a national Primary Care Workplan Seminar on the afternoon of Saturday, 8 October to seek the views and inputs of General Practitioners (GPs) in co-developing the Primary Care Masterplan. Consultation efforts will continue after the Seminar and we urge interested GPs to share their views with the Ministry. We hope to finalise the Masterplan by early next year.

Current primary care landscape

2     The Primary Care Survey (PCS) 2010 is a survey that collects information on the profile of patients seen by GPs in the public and private sector. The survey covered all 18 Polyclinics, and a randomly selected sample of 407 Private GP Clinics, which was proportionately stratified by geographical regions in Singapore. All 18 Polyclinics and some 365 Private GP Clinics participated in the survey, achieving an overall response rate of 90%. The PCS 2010 was commissioned by the MOH, with support from the College of Family Physicians and the Singapore Medical Association.

3     Findings showed that the demand for primary care has grown in tandem with the growth in population, with primary care attendances in 2010 18% higher than that in a similar survey in 2005. This is commensurate with the 19% growth in total population over this period.

4     Private GP Clinics remain the main provider of primary care services, seeing 81% of primary care attendances. The remaining 19% of attendances are seen by Polyclinics.

5     However, when it comes to chronic conditions, 45% of chronic attendances are seen by Polyclinics, while the remaining 55% are seen by Private GP Clinics.

6     While polyclinics attended to 45% of chronic patients on the survey day, it deployed only 14% of all resident GPs in Singapore.

7     Please see Annex A for the breakdown of the above findings.

Transforming our primary care sector for better care

8     A growing and ageing population, longer life expectancies, and changing lifestyles are contributing to a greater demand for chronic care. The Ministry is proposing changes to the primary care sector to better empower our family physicians to deliver holistic, quality and continuing care for patients with chronic diseases.

Moving towards team-based care for better management

9     A multi-pronged approach is proposed to transform primary care and enhance chronic disease management in the community. Apart from enabling infrastructure and reviewing financing, this includes a shift towards team-based care, which brings together GPs, nurses, allied health professionals and other healthcare providers in an integrated services delivery model. This will enhance primary care providing easier access and more holistic care for patients thereby facilitating better management of chronic ailments.

10    Preliminary ideas to support GPs in providing better care to their patients include:

•     Community Health Centres (CHCs) which aim to provide off-site ancillary support services (such as health education, Diabetic Retinal Photography and Diabetic Foot Screening) to GPs;
•     Family Medicine Clinics (FMCs) bringing together doctors, nurses, allied health professionals and other related services in an integrated service delivery model to enable resource sharing, economies of scale and team-based care; and
•     Medical Centres (MCs) to provide ambulatory procedures (such as day surgery for cataract removal) in the community.  Specialists will also work with GPs to co-manage patients with more complex but stable conditions as part of shared care programmes, to enable the right-siting of stable patients from acute hospitals’ Specialist Outpatient Clinics (SOCs).

Shaping the future of primary care together

11   This is an important journey for the healthcare community and we hope that GPs will play an active role in shaping these changes.

12   GPs can continue to share their feedback through the following channels: email to MOH (MOH_conversations@moh.gov.sg), AIC Primary Care Pages (http://www.primarycarepages.sg) and the SMA Portal (http://www.sma.org.sg).

13   An Information Paper on the PCS 2010 is available at the MOH website (http://www.moh.gov.sg/mohcorp/publicationsinfopapers.aspx?id=26774).