TTSH emergency department patients can soon be referred to GPs for follow-up

(From left) Associate Professor Ian Leong, Clinical Director at the Division of Central Health at TTSH; Associate Professor Thomas Lew, Chairman of the Medical Board at TTSH; Ms Loh Shu Ching, executive director at  the Division of Central Health at
(From left) Associate Professor Ian Leong, Clinical Director at the Division of Central Health at TTSH; Associate Professor Thomas Lew, Chairman of the Medical Board at TTSH; Ms Loh Shu Ching, executive director at the Division of Central Health at TTSH; Adjunct Associate Professor David Foo, Clinical Lead for Primary Care at TTSH; Dr Lee Yik Voon, president of the Singapore Medical Association and GP partner under the Community Right Siting Programme.PHOTO: TAN TOCK SENG HOSPITAL
Adjunct Associate Professor David Foo (left), Clinical Lead for Primary Care at TTSH and Dr Eng Soo Kiang of Unity Family Medicine Clinic shake hands to signify the partnership between the hospital and primary care partners at TTSH on Sept 22, 2018.
Adjunct Associate Professor David Foo (left), Clinical Lead for Primary Care at TTSH and Dr Eng Soo Kiang of Unity Family Medicine Clinic shake hands to signify the partnership between the hospital and primary care partners at TTSH on Sept 22, 2018.PHOTO: TAN TOCK SENG HOSPITAL

SINGAPORE - Starting next month (October), patients who have received treatment at Tan Tock Seng Hospital (TTSH) Emergency Department need not wait up to a few months for a follow-up appointment with a specialist at the hospital.

Instead, they might be referred to a general practitioner (GP) clinic, family medicine clinic or polyclinic near them – as quickly as within a week – if their condition is stable and can be managed with the help of a GP.

The pilot scheme by TTSH, called GPNext, will cover 14 medical conditions for a start, such as lower back pain, asthma and urinary tract infection.

These come under five clinical specialities: urology, general surgery, orthopaedics, general medicine, as well as respiratory and critical care medicine.

Announced on Saturday (Sept 22), GPNext is one initiative under TTSH’s partnership with primary care partners to better manage patients with chronic but stable conditions and minor emergencies within the community.

Adjunct Associate Professor David Foo, who is the clinical lead for primary care at TTSH, said patients who have seen a doctor at the emergency department and later a GP, but still need to consult a specialist will have their appointments expedited.

Besides GPNext, a team of 48 TTSH specialists from 20 clinical specialities was formed recently to serve as dedicated communication channels between GPs and the hospital.

This benefits patients as GPs can speak to the specialists about patients’ condition, rather than having to refer them for a specialist appointment, which takes a longer time.

Called the Coordinating Advisory Care Team, it aims to empower primary care partners to manage patients with more complex needs. 

 
 

Prof Foo said the GPs will be able to reassure the patients that their consultation is backed by expert advice.

“It is really a win-win situation for the hospital, GP partners and patients, if we can consolidate the care centred around the patient,” he said.

Dr Eng Soo Kiang of Unity Family Medicine Clinic welcomed the new scheme, saying: “A lot of my patients have multiple problems, especially the older ones.”

“I can learn a lot from the specialists, internalise them, and eventually I can answer the patients’ queries straightaway,” he added.

Two other programmes started earlier by TTSH have grown over time.

One of the programmes enables patients from specialist outpatient clinics who have chronic but stable conditions to be cared for at GP clinics.

Under the Community Right Siting Programme, the number of partner GPs has increased from 10 in 2014 to 120 today.

The number of conditions they can manage has also increased from three to 30. These include more common chronic diseases such as diabetes, hypertension, ischaemic heart disease and osteoporosis.

More than 3,000 patients have benefited from the programme, saving about 12,000 trips to TTSH specialist outpatient clinics since 2014.

The hospital provides training and support such as diagnostic and lab services to these partner GPs. 

If a patient’s condition worsens, he or she may be referred back to TTSH. 

Another scheme for moderately-stable patients was launched in April last year, and has benefited 72 people so far.

Shared Care helps to reduce the number of times these patients have to return to specialist outpatient clinics, thus freeing up appointment slots and reducing wait time for other patients.

Dr Eng, who has been part of the Community Right Siting Programme for four years, said that some benefits to patients include cutting down of unnecessary visits to the emergency departments and specialists, and reduced caregiver burden.

He added: “There is also more satisfaction to the GP partners, and happier patients too.”