Forum: Help take load off hospital emergency departments

The increased use of acute medical services at hospital emergency departments corresponds to the 27.5 per cent rise in non-emergency calls for emergency medical services from 2021 to 2022 (More fire-related deaths in 2022 although fewer blazes reported; spike in vehicle fires: SCDF, Feb 13).

As an emergency medicine specialist, I have seen how this has resulted in longer waiting times in emergency departments and extremely tight bed situations in the acute hospitals, leaving patients lodged in the emergency department for a long time before finally being sent up to the ward.

It is understandable that the public may struggle to determine what medical condition constitutes an emergency and, as such, many people feel that going to an emergency department is the safer option.

This has resulted in emergency departments seeing many patients with non-life-threatening conditions such as high blood pressure, minor fractures and food poisoning.

There are several resources available to the public to address these conditions. Minor scrapes, sprains and mild infections can be effectively managed by conveniently located general practitioners. Some of these clinics are open after working hours and even 24 hours.

For conditions where services like X-rays, blood tests, intravenous drips, stitching and casting for fractures may be warranted, people can consider going to the urgent care centres that have been set up by both the public and private sector.

Urgent care centres have been around for years in America and Australia, aimed at reducing the load in accident and emergency (A&E) departments and decentralising acute care. But they are a relatively recent entity in Singapore, having been set up in the past two years. 

There are public urgent care centres in Alexandra Hospital and Kampung Admiralty, and one run by National University Hospital catering to children. The private sector runs two urgent care centres. 

These facilities are staffed by emergency medicine specialists and nurses who can handle many conditions and are equipped to do most investigations that patients would have normally gone to the A&E for.

Through better awareness of the healthcare facilities available to patients and collaborative efforts between public and private healthcare, limited healthcare resources can be more effectively used.

Let’s keep the emergency departments for actual accidents and emergencies. These are the patients who simply cannot afford to wait.

Sanjeev Shanker (Dr)

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