TTSH and KTPH join hands to offer holistic care

The first of three regional clusters to be set up caters to people in central and northern areas

People living in the central and northern parts of Singapore can expect more comprehensive healthcare services with the setting up of the regional cluster that brings together Tan Tock Seng Hospital (TTSH) and Khoo Teck Puat Hospital (KTPH).

Professor Philip Choo, head of the new regional cluster - the first of three to be officially set up - said the two hospitals would make good partners as they care for different segments of the population.

The move is part of a nationwide reorganisation of public healthcare services into three regional clusters, each with at least two acute hospitals, a medical school, several polyclinics as well as other facilities such as specialist centres and community hospitals.

The public sector has until January next year to consolidate them.

TTSH and KTPH both have bed occupancies about 10 percentage points higher than at other public hospitals, but the similarity ends there.

Patients at TTSH tend to be older and the challenge for the hospital is to keep them fit so they do not return with the same problem.

KTPH, on the other hand, has a younger population in its catchment and its focus has been to go out to residents offering health screening and other programmes.

In the past, hospitals looked after patients who came through their doors, but care stopped once they were discharged. In future, they will be expected to care for the community around them, with each cluster having a full range of services, from polyclinics providing primary care to hospitals offering acute care and community hospitals providing rehabilitation.

As part of the same cluster, they can bring the full spectrum of care to the two million people within the central cluster's catchment area, said Prof Choo. "We're now a regional care system and I'm responsible for the population," he said.

In the past, hospitals looked after patients who came through their doors, but care stopped once they were discharged.

In future, they will be expected to care for the community around them, with each cluster having a full range of services, from polyclinics providing primary care to hospitals offering acute care and community hospitals providing rehabilitation.

Prof Choo expects government funding to change to mirror a more holistic approach. When that happens, it will be in the interest of clusters to invest in preventive and rehabilitative care, to keep people healthy and out of hospitals, the most expensive component in the healthcare system.

He said: "Whatever can be done outside the hospital, should be done outside."

The focus will shift to keeping people healthier for longer, including those with chronic illnesses.

For those who need care, the central cluster will work with the bigger nursing homes in the area to offer "slow rehabilitation" to patients who need it.

Today, most rehabilitation is done at community hospitals, where patients would stay for about a month. But Prof Choo said some people would benefit from longer rehabilitation of up to three months.

 

Nursing homes, which now provide long-term stay to patients, could turn some of their attention to rehabilitation. This would free up community hospitals and benefit patients if they are able to live at home independently.

His hospital chiefs "must see the whole ecosystem: how to keep the population well, how to maintain those with illness and how to look after patients who are frail".

They also need to provide alternatives to a hospital for the dying.

Nursing homes could provide end-of-life care, he said, or people could live at home until the very end with help from home care services, an option that most would prefer.

A version of this article appeared in the print edition of The Straits Times on October 23, 2017, with the headline 'TTSH and KTPH join hands to offer holistic care'. Print Edition | Subscribe