What Singapore can learn from Hong Kong in community nursing

Senior Minister of State for Health, Dr Amy Khor, talking to nursing students at Shatin Hospital's Palliative Day Care Centre.
Senior Minister of State for Health, Dr Amy Khor, talking to nursing students at Shatin Hospital's Palliative Day Care Centre.PHOTO: MINISTRY OF HEALTH

HONG KONG - A two-day study trip to Hong Kong has reaffirmed Singapore's move to develop community nursing to cope with an ageing population amid a manpower crunch, said Senior Minister of State for Health Amy Khor.

Singapore can learn from how community nursing which was started in 1967 in Hong Kong, has evolved over the years, from simple care by community nurses in the homes to sub-acute care services.

As Singapore looks into developing community nursing, the Hong Kong trip was instructive as it showed how Singapore can build up its "competencies and core capabilities of our community nurses", said Dr Khor in an interview from Hong Kong on Tuesday.

"This will help us in determining the type of training and education as well as how we can design the community nursing teams. The Regional Health Systems with their regional presence will be best placed to initiate and drive this community nursing teams," said Dr Khor who visited public hospitals in the New Territories East Cluster on Monday and Tuesday.

Earlier in March, Dr Khor said with healthcare shifting away from acute hospitals and into people's homes, the Ministry of Health is looking for ways to get nurses to follow suit. Currently, only 4,900 of Singapore's 34,000 or so practising nurses are in the community care sector. The ministry aims to add 900 more by 2020.

Dr Khor said the trip reaffirmed the belief that "nursing really can play a pivotal role in leading care transformation. And that is in anchoring care in the community so that we transform care from one that is being very acute-centric to one that is person-centric, population-based, in order to better meet the health care needs of our population".

To attract people to join the nursing profession, Dr Khor said there will be opportunities for community nurses in career progression and rotation for them to be in an acute-care setting, so that they can update their clinical skills. The Ministry is also looking at implementing flexible working hours for nurses across all hospitals.

Like Singapore, Hong Kong's government warned that the city will face a critical manpower shortage in the next decade. A study released by the government two weeks ago said the city will face a shortfall of 1,669 general nurses in 13 years.

Dr Khor said community nursing in Hong Kong is largely driven by the hospital clusters, which is what Singapore is looking into.

She said that the Ministry is looking at having several community nursing teams in the three integrated clusters that serve the different geographical regions, and each team will have between 10 and 15 nurses.

"We are looking at probably having more than 200 (for the three clusters) of these community nurses being housed and of course driven from the Regional Heath Systems by 2019," said Dr Khor.  

Besides understanding how community nursing is practised and integrated within the regional clusters in Hong Kong, Dr Khor also saw how nurses in Hong Kong are highly respected.

"In Hong Kong, the nurses are almost all locals. And I think they say that the places in universities are always oversubscribed. Parents apparently have very high respect for the nursing profession and many parents actually do encourage their children to join the nursing profession. Parents think this is an absolutely secure job. And of course its highly-respected," said Dr Khor.

"One of the things that community nurses shared with us on why do they want to join community nursing - it is very satisfying especially when they have worked in acute-care sector before. In acute care sector it is episodic, within a short period of time they get discharged. There's not so much relationship building. In community care sector, there is relationship building and you get direct satisfaction seeing positive outcomes from your patients."