Plans afoot to improve healthcare workers' well-being

Current workflow models for healthcare workers will be reviewed and measures will be put in place to improve their well-being, especially for junior doctors, said Senior Minister of State for Health Koh Poh Koon yesterday.

Healthcare staff, especially young doctors, have been bearing the brunt of the Covid-19 waves as they log long hours and suffer fatigue, leading to increased resignation rates.

Dr Koh told Parliament yesterday during the debate on his ministry's budget that 20 per cent of all junior doctors have exceeded the stipulated 80-hour work week due to the nature of clinical work or exigencies of service.

To improve work hours, he noted that some have proposed night float systems - where doctors take turns to take on night shifts for a few days at a stretch without covering daytime work - while others man the day shift.

"Doctors may feel more refreshed when they start their night shifts with a full day's rest, although there are possible trade-offs in requiring more manpower to do a shift system, more hand-offs between team members, which carries some risks of omission in tasks and possibly reduced learning experiences," Dr Koh noted.

He added that the system has so far been trialled in two large departments, with plans to do so in smaller departments curtailed due to Covid-19.

"When the situation allows, we intend to restart the trials," said Dr Koh.

However, aside from the issue of work hours, he stressed that it is important not to "lose sight" of the important considerations inherent in the nature of the work of doctors.

"With shorter working hours a week, a junior doctor may have to undergo a longer apprenticeship to acquire the necessary competencies," he added.

Dr Koh pointed out that the workload and nature of clinical work now are different compared with yesteryear. With an ageing population, there will be more cases of chronic diseases, with more expectations for "collaborative and consultative care".

Therefore, there is a wider need for transformation in the current care delivery arrangements, and junior doctors should not be stretched beyond "what is physiologically possible and risk compromising patient safety".

He added that he recently met junior doctors from the Singapore Medical Association's Doctors-in-Training Committee and others from all three healthcare clusters to discuss the challenges they faced, and the trade-offs of possible workflow changes.