UPDATE ON NATIONAL STRATEGY FOR PALLIATIVE CARE

        The Ministry of Health (MOH) will increase home palliative care capacity by 50% to 3,600 places by 2025, and inpatient and day hospice capacity by around 15% and 12% respectively by 2025. This was announced by Minister for Health, Mr Ong Ye Kung, at the official opening of Tan Tock Seng Hospital Integrated Care Hub today.

2.     MOH launched the refreshed National Strategy for Palliative Care in July 2023 to expand and improve palliative care in Singapore, enabling more people to fulfil their wish to pass on with dignity and comfort. Since then, we have made significant progress in increasing palliative care capacity, enhancing support measures for home discharge, enhancing financing and increasing awareness of palliative care.

Increasing palliative care capacity

3.     As Singapore prepares to become a “super aged” society, the need for palliative care is expected to increase. To meet increasing needs, MOH is working with providers to expand palliative care capacity. Since the launch of the refreshed National Strategy for Palliative Care in July 2023, home palliative care capacity has been increasing, and we are on track to add another 1,200 places by 2025. This brings the total number of home palliative care places to 3,600 by 2025. This is almost double the number of home palliative care places since the National Strategy was launched.

4.    Inpatient and day hospice capacities are also expected to increase by around 15% and 12% respectively by 2025. The total capacities will be about 300 inpatient beds and 140 day hospice places by 2025.

Enhanced support measures for home discharge

Launch of the Equipment Rental Scheme for palliative care patients

5.    Currently, patients who wish to pass on at home face difficulty obtaining timely access to equipment due to unreliable equipment supply, inadequate support to navigate the equipment rental options, and high rental cost. Home palliative care providers also face challenges coordinating the administrative and logistical arrangements to meet the short turnaround time for equipment delivery.

6.    To better support families whose loved ones wish to pass on at home, MOH will introduce an Equipment Rental Scheme (ERS) to provide affordable and timely access to equipment such as hospital beds and oxygen concentrators. MOH has set aside $23 million over the next three years for the ERS, which will be launched by October 2024, and is expected to benefit more than 12,000 Singaporeans on home palliative care over the next three years.

7.    The ERS will support Singaporeans by providing eligible palliative care patients with means-tested subsidies to offset the cost of equipment rental for home-based care. All eligible palliative care patients with a prognosis of one year or less will benefit from ERS subsidies according to the revised palliative care subsidy framework and will receive at least 50% subsidy, regardless of their monthly per capita household income. Subsidies will be applied to the cost of weekly equipment rental, essential consumables, and delivery. Please refer to the Annex for details.

Smoothen compassionate discharge

8.    For patients who wish to pass on at home, MOH has standardised and streamlined the compassionate discharge processes across all public hospitals. More resources have also been made available for clinicians and caregivers to facilitate the compassionate discharge process. In addition, more hospital staff have been trained to manage compassionate discharge. With this, we expect patients to experience smoother discharges, and their families to be better supported in the process.

Enhanced financing for palliative care

9.    MOH has also significantly enhanced financing for inpatient palliative care, home palliative care, and day hospice care. Since February 2024, the lifetime MediSave withdrawal limit has been removed for all home palliative and day hospice patients who use their own MediSave. The MediShield Life daily claim limits for inpatient palliative care have also been raised from $250 to $460 for general inpatient palliative care, and from $350 to $500 for specialised inpatient palliative care. This helps to improve affordability for patients.

10.    MOH also announced in July 2023 that the palliative care subsidy framework would be enhanced from the fourth quarter of 2024. All Singapore Citizens would receive subsidies of at least 50% regardless of their monthly per capita household income. Details of the financing framework are in the Annex.

Increasing palliative care awareness

11.    MOH is working with partners to raise awareness of palliative care. Together with the Ministry of Social and Family Development and Public Service Division, MOH launched the “Plan Today” campaign to raise awareness of pre-planning and end-of-life matters through roadshows and mobile clinics in different parts of Singapore.

12.    There are also ongoing efforts with stakeholders such as the Singapore Hospice Council (SHC), to engage the public to normalise conversations on death and dying. SHC has trained a pool of more than 80 ambassadors to advocate palliative care and create a social support system. All these efforts aim to bring these conversations into communities and homes.

13.    The implementation of the National Strategy for Palliative Care is a multi-year effort and will require all stakeholders to play their part. As we continue to see progress made, we will continue to work with palliative care providers to grow their workforce in tandem. We hope that more healthcare professionals will make the choice to join the palliative care sector. Together, we can empower more Singaporeans to live well and leave well.

MINISTRY OF HEALTH
19 MARCH 2024