adding years of healthy life

National Healthcare GroupAnnual Report 2002/03

Adding years of healthy life

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NHG Annual Report 2002/03

Our VisionAdding years of healthy life to the people of Singapore.

Our MissionWe will improve health and reduce illnessthrough patient-centred quality healthcare that is accessible and seamless,comprehensive, appropriate and cost-effective; in an environment of continuouslearning and relevant research.

Our ValuesIntegrityProfessionalismCompassionRespectCollegialitySocial Responsibility

Contents

Chairman’s message 4CEO’s message 8Board of Directors 12Senior Management 14Introduction 16Developing patient centred capabilities 17Building a strong infrastructure 20Laying a foundation of good corporate governance 22Milestones 24About NHG 36Statistics 40Key financial information 45

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The current climate of fiscal prudence and cost control hasunderlined for us the importance of choosing and setting theright goals. At our inception in 2000, we focussed ondelivering quality, patient centred care through integratingclinical specialities, processes, systems and people to deliverseamless and cost effective patient care.

These original aims have served us well. In the last 12 months,we stayed strongly on course with these objectives, and willcontinue to build on them through our three strategic thrusts.

Developing Patient-Centred CapabilitiesWork continues apace in clinical and service integration toenable us to deliver on this strategic thrust. We saw promisingoutcomes from the seven disease management workgroupsand the Cancer, Eye and Heart institutes. Clinical pathwaysand protocols were set in place to facilitate patient recordstransfers, key to coordinating patient care from primaryprevention to ongoing long-term maintenance for patients.

Satellite specialist clinics were set up in selected polyclinics tobetter serve our patients. The Direct Access Scheme, whichallows seamless patient transfers from polyclinics and GPs toour hospitals and back, was further refined, to save time andcost by giving patients the appropriate level of care.

We have also embarked on a journey to harmonise ourprocesses and optimise IT resources to enable us to deliverconsistent and seamless care to patients regardless of theinstitution they visit, and to keep costs low.

Building A Strong Infrastructure The delivery of good, sound care must rest on a stronginfrastructure in four key areas: quality and innovation, processharmonisation, people and IT consolidation.

We continued to promote a culture of continuous clinicalimprovements, teaching and training our people concepts onhealth systems and processes, measurement for improvement,change management and managing variation in clinicalpractices and frameworks.

Going forward, we want to ingrain the culture of continualclinical improvement through identifying and empoweringclinical champions to lead in projects that significantly impactthe quality and delivery of care and patient safety.

Chairman’s message

In quality improvements, Alexandra Hospital (AH), NationalUniversity Hospital (NUH), Tan Tock Seng Hospital (TTSH) and NHG Polyclinics were certified under the Quality,Environmental, Health & Safety (QEHS) management systemsand ISO. In addition, AH, NUH, TTSH and Institute of MentalHealth (IMH) also attained the Singapore Quality Class status.

The Ministry of Health also endorsed our dedication in puttingpatient safety first when it asked for the NHG point prevalencestudy of adverse events to be extended to all healthcareinstitutions in Singapore.

We consolidated IT operations across our institutions inJanuary 2003 into the new NHG IT Division, a move tomaximise our ability to harness IT for efficiency and realise costsavings through synergies in manpower, equipment, processesand elimination of duplication.

The launch of NHG College in July 2002 boosted our ability totrain staff to their full potential. The NHG Endowment Fund setaside $4.7 million for training and research this year, anincrease of $1.8 million compared to last year.

Our standing as an employer among the medical fraternity isgaining strength, shown by 55 percent house officers opting tojoin NHG as medical officers (MOs) this year. In a parallel effortto retain doctors in the public sector, we also started theFamily Physician scheme for MOs who prefer to practice inprimary care.

Setting A System for Good Corporate GovernanceWe placed priority on building a system for clear leadershipand accountability. Over the last three years, we worked oninstilling a common vision and mission across the cluster andfine tuned the harmonisation of our human resources andfinancial processes.

Key performance indicators (KPIs) were set for themeasurement of performance across the cluster. We alignedperformance management practices based on cluster-widecore competencies rather than specific institutions.

We had smooth transition of leaders at some of our institutionsunder the Cluster Healthcare Leadership scheme, where the bestperson for the job is the main consideration. The scheme providesfor a shared sense of vision and mission among key staff.

In the area of management and accountability, our financialframework sees continuing improvement in budgeting,compliance, costing and devolution of financial authority to department heads and the institutions to encourage greater accountability.

Financial data was made available for monitoring and analysis.We have also put in place a rigorous framework for utilisationmanagement through close scrutiny of capital purchases andpractice better comparisons.

Building A Strong Identity and CultureWe forged closer ties throughout the cluster with events likethe NHG Quality Week and NHG Family Day, where over10,000 staff and family were present. The nascent NHG spiritof collegiality and teamwork we have built thus far was tested,and passed with flying colours, as we pulled and pooledresources to fight the SARS scourge as a team.

The spirit of collegiality was evident among members of theNHG family when our hospitals and staff willingly assumednew roles and responded in a flexible, innovative andcourageous manner to the demands of the situation.

SARS drove home the true meaning of being in the healthcareindustry. As the dangers and perils of being a healthcareworker became terrifyingly real throughout the crisis, ourdoctors, nurses and other healthcare staff at NHG rose to theoccasion, putting their patients’ interest ahead of their own,living up to NHG’s motto of being a patient-centredorganisation. I am very, very proud of them.

The Path AheadThe uncertain economic times makes it difficult to predict thepath ahead with any certainty. But there are some clear keyareas that we must continue to focus on to stay competitiveand healthy in providing public healthcare.

We will continue to focus on keeping healthcare costs low andaffordable without compromising quality in care to serve ourcustomers, the Singaporean public. This is very clearly ourmission as providers of public healthcare.

We continue to face rising costs resulting from advances intechnology, an ageing population and public demand for betterand higher quality care.

Michael Lim Choo SanChairman

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There are many ways to cut costs without compromising onquality. We will continue to turn the microscope on ourprocesses, services, purchases and deployment of manpower,just to name a few areas, that will help us keep costs down.The savings we made simply by switching to a cheaper brandof latex gloves is a good example of how this can be done.Taken by itself, the projected savings of $300,000 may notseem much in a large cluster like ours but the accumulatedsavings over many areas will be significant for now and in thelong run.

We must continue to leverage on IT to better managehealthcare costs and to achieve our aim of delivering patientcare that is appropriate, seamless and holistic.

We must focus our efforts in carrying out researches andstudies to better manage health through preventive medicine.

We must ensure that every dollar we spend is spent wiselyand is maximised in the goods and services we receive fromour vendors and contractors.

In the year ahead, the programmes and plans we have put inplace to integrate our clinical and administrative processes, toimprove the quality and capability of our people and to weedout unnecessary duplication will continue apace. We willpersist to foster a common NHG culture and to identify areasof improvement for the benefits of clustering and integration.We cannot afford to let up.

I am proud that the NHG family has evolved over the last threeyears and come out stronger, more cohesive and committed.We have achieved some progress towards realising ourobjectives, but we must persevere and continue our efforts inproviding patient-centred quality healthcare that is accessibleand seamless, comprehensive, appropriate and cost effective.

The SARS episode clearly demonstrated the ability of ourhealthcare workers to come together and prevail in the faceof adversity. It is in this spirit of unity that NHG will moveahead to fulfil our vision of “adding years of healthy life to thepeople of Singapore”.

Michael Lim Choo SanChairmanNational Healthcare Group30 August 2003

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The prospect of an ageing population and more peopledeveloping chronic illnesses at an earlier onset makes itimportant for us to proactively intervene with early treatmentand education for patients.

Our Disease Management (DM) programmes adopt a holistic,multidisciplinary and team-based approach to treat and studythe prevention of top chronic diseases in Singapore – heartfailure, diabetes, osteoporosis, asthma, stroke, psychiatricillnesses and vascular disease. Using “best practices” clinicalguidelines and pathways to develop tools and means, ourdoctors and healthcare professionals have been able toencourage disease prevention and maintenance of healthamong patients. Key performance indicators for eachprogramme are identified and used as yardsticks for futureevaluation.

These DM programmes are made possible by our increasinglyintegrated healthcare delivery systems and the comprehensiveknowledge base that comes with it. We tap into expertise andresources across our institutions and the continuum of care -from primary prevention to ongoing long-term maintenance forindividuals with chronic health conditions.

Integrated Care Services (ICS), launched in 2001 to providepatients with seamless transfer from one level of care to thenext, led to dramatic shortening of waiting times for transfers.By 2002, standard operational procedures had been set up tohelp mediate difficult cases and improve efficiency, leading to adramatic reduction in waiting time for nursing homes from 60days in May 2001 to 13.5 days in December 2002.

Maximising Quality Care and Safety for PatientsOur quality improvement efforts showed significant break-throughs. Process standards are now clearly defined andservice is consistently delivered in a safe working environment.

For example, the NHG Clinical Practice ImprovementProgramme (CPIP), launched in March 2002, is designed togroom a critical mass of clinical champions across NHGinstitutions who can lead and manage quality care and safetyprojects in a culture of continuous clinical improvements.

This year, two CPIP workshops in March and November 2002took clinical leaders through a series of courses on systemsand processes, measurements, change management andvariations in clinical practice and teamwork, among others.

To reinforce the skills they had picked up, participants had tocomplete an improvement project within six to nine months

after the course. To date, we have completed some 25improvement projects which affect the quality of patient careand safety.

Two other initiatives significantly enhanced safety for ourpatients. The first, a study of adverse events at NHG, involvedreview and analysis of over 1,500 charts across AlexandraHospital (AH), National University Hospital (NUH), NationalNeuroscience Institute (NNI) and Tan Tock Seng Hospital(TTSH). It proved so useful it prompted the Ministry of Healthto extend the study to all other healthcare institutions in Singapore.

The second was the launch of the Electronic HospitalOccurrence Reporting (eHOR) system at AH, TTSH, Institute ofMental Health (IMH), NNI and NHG Polyclinics, following itssuccessful pilot at NUH in 2001. The system allows staff toreport incidents online, reducing the need for paperwork andgranting relevant personnel quick, easy access to information.

Quality standards continued to be an important part of NHG’spriorities. Key quality benchmarks-ISO 9000 (qualitymanagement system), ISO 14000 (environmental managementsystem) and OHSAS 18001 (health and safety managementsystem) standards – were rolled out concurrently in our keyinstitutions. I am pleased to report that AH, NUH, TTSH andIMH have all achieved these certifications and SingaporeQuality Class status.

Not stopping there, Patient Focus Group sessions were alsoorganised to garner feedback about patients’ needs and theiropinions on the NHG Direct Access Scheme. We will continueto conduct these sessions twice yearly because patients’feedback is instrumental in helping us to improve continuously.

Empowering and Motivating StaffWe believe in empowering staff to continuously improve theirdaily work. Using innovation and quality circles, medical andadministrative staff scored some real improvements in workprocesses, such as putting in place the auto-registrationsystem in AH that helped reduce patient registration waitingtime; and at TTSH, to reduce turnaround time for a dischargedbed to be readied for the next patient. Manpower development is our cornerstone for grooming staffto their full potential. To groom a core group of leaders for thecluster, more than 100 management staff from across NHGinstitutions were placed under the Cluster HealthcareLeadership scheme of service. It assesses and rewards staffperformance using cluster wide benchmarks. Performancemanagement practices for all staff across NHG were also

Since NHG’s inception in March 2000, we have workedpassionately towards offering cost effective, patient-centredhealthcare, spurred on by our vision of “adding years ofhealthy life to the people of Singapore”.

In FY 2002, with good progress achieved in laying thefoundation, we focused on delivering some of our promisedimprovements and changes.

Making Patients Our FocusOur core focus on building care around our patients hasguided us in continually developing and refining programmesand services for better care.

For example, our virtual institutes were able to integrate clusterwide resources to provide more seamless and accessiblepatient care. The Cancer Institute opened a new RadiotherapyCentre and commenced Medical Oncology and ChemotherapyServices at TTSH.

The Heart Institute launched its Adult Congenital Heart DiseaseProgramme, the Chest Pain Clinic and 24-hour primaryPercutaneous Transluminal Coronary Angioplasty (PTCA)services at NUH.

The Eye Institute (TEI) launched an island-wide screeningprogramme in November 2001, aimed at helping 25,000elderly people detect eye problems early for appropriatetreatment. This programme is expected to complete by endApril 2003.

Children also received eye screening in joint programmes withthe Health Promotion Board’s (HPB) National MyopiaPrevention Programme. TEI partnered GPs under our NHGPartners programme to pioneer the Mobile Diabetic RetinalPhotography for Family Physicians. GPs can now tap into TEI’sresources to conduct high-tech fundus examinations fordiabetic patients who are at risk of developing eye problems.

NHG also took many specialists services outside traditionalhospital confines into the wider community to give ease ofaccess and convenience to our patients. For example, TheChildren’s Medical Institute (CMI) opened its first specialistoutpatient clinic at Woodlands Polyclinic, with plans foranother at Jurong Polyclinic.

Obstetrics and Gynaecological (O&G) services were offered atJurong Polyclinic and extended additional O&G services wereprovided at the Hougang Polyclinic. Another clinic is plannedfor Woodlands.

CEO’s message

Tan Tee HowChief Executive Officer

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aligned, with designated core and professional competenciesbeing the common gauge for appraisal and recognition.

Career paths for Medical Officers (MOs) were clearly mappedusing a comprehensive Human Resources frameworkspanning recruitment, compensation, training anddevelopment, and welfare. Two significant achievements werethe introduction of a single salary range based on merit, and apreference-driven posting system where MOs can indicatetheir choice of postings.

For the first time, we introduced the Cluster Bonus in FY 2002,where a modest flat sum was paid to every staff. The intent isto reward good work and encourage cross-institutioncollaboration and mobility as NHG matures as a group.

NHG College was opened in July 2002 to bolster our efforts tohelp our staff develop to their full potential. It is made up ofthree institutes – Institute of Medical Education & Training(IMET), Institute of Nursing Education & Training (INET) andInstitute of Management & Allied Health Sciences (IMAS). TheCollege liaises with local and overseas universities and traininginstitutes to offer healthcare management and professionaltraining courses. Within six months, it had provided more than12,000 hours of training to NHG staff.

Using tax savings from the cluster’s not-for-profit status, staffdevelopment efforts received a $4.7 million boost from theNHG Endowment Fund, set aside for training and researchpurposes such as the Health Manpower DevelopmentProgramme (HMDP), Specialty Development Programme andPostgraduate sponsorship, to name a few.

For example, this year NHG awarded HMDP fellowships to 53Clinicians, 37 Nursing and Allied Health practitioners, and twoAdministrators. These programmes help our staff tocontinuously upgrade their skills and keep pace with rapidchanges in the healthcare industry to provide the right care forour patients.

The Specialty Development Fund is set up for mastersprogrammes and post-graduate training for clinical nursing.

Synergising Cluster Systems and ProcessesWe continued to consolidate our resources for bettermanagement and planning to sharpen our customer-centricservice focus. This revolves around our concept of “OnePatient, One Process, One IT System”.

The NHG Group Purchasing Office, formed in October 2002,actively reviews cluster procurement strategy. We work jointlyto identify key areas where centralised purchasing gives usbetter procurement options such as switching to cheaperalternatives without compromising clinical practices, andsharing cost information across our institutions.

A Utilisation Management Workgroup, formed to identifypractice variations among Diagnosis Related Groups (DRGs)across institutions, saw active sharing among the relevantworkgroups and committees, prompting action to reduceunnecessary tests and procedures in patient care.

We also focused on cost savings through optimal use ofresources. For example, the new integrated pharmacydispensing system, iPharm, was developed to improvepharmacy services and cater to increased information needs.

Patients in our polyclinics also saw significant improvements inservice. The Patient Management Patient Accounting (PMPA)system replaced a 15 year-old patient management system.The new system now features a single point for registration,payment and online access to patient information, and forpatients, a single bill for each visit.

IT is one of our cornerstones in maximising resource use andoperational efficiency. In January 2003, all IT departmentsacross the cluster were unified under the NHG IT Division. InFebruary 2003, work started to consolidate finance and healthinformation systems. The new system will go “live” with thefirst institution by April 2004.

With consolidated systems and resources, staff across thecluster will gain access to common databases, medicalrecords and administrative processes, enabling better serviceand care delivery to patients. Such streamlined processes willhelp us to eliminate costs by removing duplication andimproved efficiency.

Harmonising of processes across institutions included a majorHR exercise where more than 80 percent of our HR policieswere integrated.

For good corporate governance, one of our needs is a soundand transparent HR administration across the cluster. Wedeveloped a comprehensive Cluster HR Policy Manual whichcovers some 120 policy subjects. The next step is to developthe cluster human resource information system which coversfive HR modules in the areas of data management, leave,benefits, payroll and training.

Identifying and Building a Shared CultureOur change journey also involves the critical area of building ashared culture and common identity among all staff. Each staffmust share a common identity, value system and sense ofpurpose if we are to deliver seamless and integrated care toour patients.

Culture building is an ongoing process which began at clusterinception. It is reinforced with each programme to integrate ourexpertise and resources, harmonise our processes, orassemble teams to tackle issues and problems across ourinstitutions, or simply from staff get together to celebratesignificant occasions.

We embarked on an exercise to forge a common identity andculture, essential in an organisation where over 10,000 peoplework across 15 institutions to reach the common goal ofpatient centred care.

We appreciate the effort of our staff and bring them togetherwhenever possible in venues other than work. The secondNHG Family Day, held at Sentosa, brought together our staffand their loved ones for a day of fun-filled activities.

The Path AheadIn the last three years, we have made significant progress inachieving what clustering had set out to do: improvehealthcare quality in a cost effective manner; focus care on thepatient across the continuum, make that care seamless byintegrating and refining our processes and informationsystems, and developing clinical guidelines.

A key objective of all this work – to drive healthcare costs downeven as we improve our delivery of care and service – continuesto be our main area of focus for now and the long term.

In 2004, we embark on a new strategic plan that setsdirections for the next phase of development. The next threeto five years are crucial for us as we deliver what we promised– accessible, seamless, comprehensive, appropriate and costeffective healthcare.

Teamwork Won Against SARSIf the spirit that helped us win the fight against SARS is anymeasure of the professionalism, teamwork and commitment ofour people, we will make it.

I am proudest of all of the dedication, steadfastness anddiligence of every member of the NHG family when thisdisease hit us. SARS severely tested our prized values ofcompassion, collegiality, respect, integrity, professionalism and social responsibility towards our patients.

The disease had no precedent anywhere. Faced with anenemy that threatened to overwhelm not just us but ournation’s healthcare system, they responded to a man, ensuringthat as a cluster, we fought a good fight. They put downinstitution divisions or differences, stayed on the job, sharingand consulting at many levels. This gave us a collectiveresponse to the severe demands that SARS placed on ourresources and people.

It put our nascent but growing cluster spirit to severe test. I say this with deep satisfaction – I am proud of our staff, theypassed with flying colours.

We could have wished that this calamity did not befall us buthaving courageously faced it off this time, we are much betterprepared as a team – mentally, emotionally and professionally– to meet any future challenge. Singapore earned global praisefor its effective strategies to fight SARS and I am proud thatour staff played no small part in it.

With their continued support, we will do our best to “add yearsof healthy life to the people of Singapore”.

Tan Tee HowChief Executive OfficerNational Healthcare Group30 August 2003

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Mr Michael Lim Choo San (1)Chairman, National Healthcare Group

Associate Professor Loong Si Chin (2)Director, National Healthcare Group

Associate Professor Cheong Pak Yean (3)Director, National Healthcare Group

Dr Michael Yap Hock Leong (4)Director, National Healthcare Group

Dr Lim Chien Wei, John (5)Director, National Healthcare Group(w.e.f. 15 April 2003)

Dr Teoh Hoon Cheow (6)Director, National Healthcare Group

Mr Benedict Cheong Thiam Beng (7)Director, National Healthcare Group(w.e.f. 15 April 2003)

Mr Ng Ooi Hooi (8)Director, National Healthcare Group(w.e.f. 15 April 2003)

Dr Grace Lee Siew Luan (9)Director, National Healthcare Group(w.e.f. 15 April 2003)

Mr Alexander Chan Meng WahDirector, National Healthcare Group

Mr Koh Poh TiongDirector, National Healthcare Group

BG (ret’d) Associate Professor Lionel LeeDirector, National Healthcare Group(until 14 April 2003)

Mr Lim How TeckDirector, National Healthcare Group(until 14 April 2003)

Dr Ling Sing LinDirector, National Healthcare Group(until 14 April 2003)

Mr Soh Kim SoonDirector, National Healthcare Group

Mr Tan Yong SoonDirector, National Healthcare Group(until 14 April 2003)

Board of Directors

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Senior Management Members

Dr Lim Suet Wun (1)Deputy Chief Executive Officer, NHGCEO, TTSH

Dr Shanta Emmanuel (2)CEO, NHG Polyclinics

Mr Tan Tee How (3)CEO, NHG

Mr Chua Song Khim (4)CEO, NUH

Mr Liak Teng Lit (5)CEO, AH

Mr Leong Yew Meng (6)CEO, IMH/WH

Associate Professor C Rajasoorya (7)Chairman, Medical Board, AH

Professor Goh Chee Leok (8) Director, NSC

Dr Chumpon Chan (9)Acting Director, NNI (w.e.f 23 January 2003)

Professor Chee Yam Cheng (10)Chairman, Medical Board, TTSH (until 30 June 2003)Assistant CEO (Clinical), NHG (w.e.f 1 July 2003)

Mr Joe Sim (11)Chief Corporate Development Officer, NHG (w.e.f 1 October 2002)Acting CEO, New Ventures, NHG (w.e.f 1 March 2003)

Associate Professor Lim Yean Teng (12)Chairman, Medical Board, NUH (w.e.f 1 January 2003)

Professor Philip Choo (13)Chairman, Medical Board, TTSH (w.e.f. 1 July 2003)

Dr Luisa Lee (14)CEO, New Ventures, NHG(until 28 February 2003)

Ms Lim Yee Juan (15)Chief Financial Officer, NHG

Professor John Wong (16)Chairman, Medical Board, NUH (until 31 December 2002)Dean, Faculty of Medicine, NUS (w.e.f 1 June 2003)

Professor Lee Eng Hin (17)Dean, Faculty of Medicine, NUS (until 31 May 2003)

Associate Professor Wong Kim Eng (18)Chairman, Medical Board, IMH/WH (w.e.f 1 July 2002)

Dr Colin Quek (19)Chief Information Officer, NHG

Dr Jason Cheah (20)Chief Project Officer, NHG

Mr Augustin LeeChief Corporate Development Officer, NHG(until 30 June 2002)

Mr Ng LangChief Human Resource Officer, NHG (w.e.f 1 June 2002)

Ms Nellie YeoChief Quality Officer, NHG

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Introduction

Since inception, the National Healthcare Group (NHG) hasaimed to integrate our delivery of care and services through athree-pronged strategy – develop patient centred capabilities,build a strong infrastructure and underpin the first two prongswith a system of good corporate governance.

Our yardstick for success is how our policies, decisions andactions directly benefit our patients, for example, lower bills,shorter stays, better treatment or health management. Wefocussed on making our care and services better, faster andsafer than before and always at affordable cost to the public.

While clinical improvement, safety and quality issues arecomplex, challenging areas involving complex processes, aswell as people and culture issues, NHG had neverthelessmade significant progress in these areas in FY 2002 due tothis concerted effort.

Develop Patient Centred Capabilities Work in FY 2002 focussed on strengthening the schemes andprocesses aimed at delivering patient care that according toour core values – accessible, seamless, comprehensive,appropriate and cost effective care that bring direct benefits toour patients. It ultimately results in increased public confidencein NHG and by extension, to the public healthcare system.

We focussed on critical behind the scenes areas like cost,quality and clinical integration and highly visible programmeslike the Direct Access Scheme, Disease Management Groups,extended operating hours at NHG Polyclinics and integratingour services for cancer, eye and heart patients through ourvirtual institutes.

Build a Strong Infrastructure The second prong in our strategy is to build a stronginfrastructure and supporting processes that form the core ofNHG’s operations framework. FY 2002 saw critical focus onfour key areas – Quality and Innovation, ProcessHarmonisation, Human Resources Policies and ITConsolidation and the launch of projects in these areas.

Setting Clear Principles of Corporate Governance The principles and strategies for a cluster wide system ofcorporate governance were further refined and strengthened in FY 2002. Management continued to work on the keycomponents – setting clear goals, providing leadership,business direction, setting performance benchmarks andbuilding a shared culture.

Efforts to inculcate a common vision and mission statementcontinued apace, underscored by the smooth transition of keyleaders at a number of institutions. Common performancebenchmarks were put in place across institutions. Efforts tobuild a shared internal culture continued while work towardsbuilding a common external brand identity were also started.

Facing Down Challenges to NHGThe challenges that NHG faced in FY 2002 were endemic to the healthcare industry as a whole. These include rising costs,variations in quality of care delivery, the rising incidence of chronicillness, an ageing population and addressing the needs andissues that arise from a diverse, more well informed population.

While most of these are ongoing challenges and issues thatrequire long term effort to ameliorate or resolve, NHG’s gimlet-like focus on our three prong strategy stood us in good stead inmeeting present and future issues arising from these challenges.

The end of FY 2002 also saw NHG living with Singaporethrough a national crisis by facing off a new and unfamiliarenemy, the Severe Acute Respiratory or SARS virus. Ourdedicated and innovative staff, whose efforts have beencentral to our success so far, rose courageously to thechallenge. Their selfless response and never-say-die attitudehelped the nation through the crisis and even now, they arepreparing to face the next challenge that the SARS virus andother deadly diseases can potentially bring.

The nascent but growing sense of shared purpose andcommon destiny enabled NHG to pull the necessary resourcesto ride through this crisis.

Building the delivery of services and care around the patientrequires a mindset change and significant progress has beenmade. The key elements of patient centred care involveintegration of clinical processes and service, management ofresources and finance, and healthcare promotion programmes.Overarching these is continuous improvement in the quality ofservice and care.

Programmes to integrate clinical services, improve quality andsafety saw further advances and consolidation in FY 2002.These include the Clinical Practise Improvement Programme,Disease Management programmes for seven major illnesses,further integration of the capabilities of the virtual institutes,NHG Partners programme for general practitioners (GPs) andintegration of other clinical pathways and protocols.

Building A Culture of Continuous Improvement The Clinical Practice Improvement Programme (CPIP), launchedin early 2002, is aimed at grooming clinical leaders to takeleadership in change management and healthcare design and improvement.

Over the next three years, clinical leaders will undergo a seriesof training programmes that cover clinical concepts andprocesses, measurements for improvement, changemanagement and managing variation in clinical practice andteamwork. They must also complete a project within six tonine months. The first such showcase for completed projectswas the 1st CPIP Graduation Ceremony held in November 2002.

Programmes to improve patient safety also got underway. TheNHG Point Prevalence Study of Adverse Events was completedwith the review of over 1,500 patient charts across AlexandraHospital (AH), National University Hospital (NUH), NationalNeuroscience Institute (NNI) and Tan Tock Seng Hospital (TTSH).

The eHOR, or Electronic Hospital Occurrence Reportingsystem, was also rolled out across AH, NNI, TTSH and theInstitute of Mental Health (IMH) and NHG Polyclinics (NHGP)following a successful pilot at NUH.

NHG’s Quality, Environmental, Health and Safety (QEHS)Management Systems also made big strides. AH, NUH, TTSH and NHGP were certified to the ISO 9000 (qualitymanagement system), ISO 14000 (environmental managementsystem) and OHSAS 18001 (health and safety managementsystem) standards. Discussions are underway with our otherinstitutions yet to be certified.

In addition, AH, NUH, TTSH and IMH also achieved SingaporeQuality Class status.

Holistic Disease Management Programmes An integrated approach to managing chronic illnesses took offwith the Disease Management (DM) programme, launched inOctober 2000. Unlike the old diagnosis and management ofcases in isolation, the programme takes an integratedapproached. Multidisciplinary teams from our institutionsdesign and implement integrated approaches to managingseven chronic illnesses common in Singapore - Diabetes,Asthma, Stroke, Vascular Disease, Psychiatric Illness,Congestive Heart Failure and Osteoporosis.

The teams have made significant headway in developing toolsand implementing processes within the NHG institutions. Keyperformance indicators for each programme have been identifiedand measured to serve as baseline for future evaluation. Twocross clinical committees – the Respiratory-Medical IntensiveCare Units Steering Committee and the Molecular DiagnosticService Workgroup were set up in FY 2002.

The results of careful disease management are significantlymore telling than isolated diagnosis and treatment. Eachworkgroup has programmes and tools to:

encourage disease preventionpromote correct diagnosis and treatmentstandardise procedures between GPs, polyclinics and hospitalsimprove follow-up care

From 2001 to 2002, the Asthma workgroup significantlyincreased the take-up rate of preventive measures amongasthma patients at NHG Polyclinics, resulting in a reducednumber of cases needing treatment.

A chronic care programme for diabetic patients introduced in2000 is telling. After six months, 36.5% of patients on theprogramme achieved an optimal blood sugar level comparedto 9.5% before they started, translating into fewer healthcomplications in the long term. Those who were not on theprogramme showed no significant improvement at the end ofsix months.

Developing patientcentred capabilities

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TCI@TTSH also started its Medical Oncology andChemotherapy Services in November 2002 and the CancerGeriatric Risk Counselling clinic was started in March 2003.

THI@NUH launched its Adult Congenital Heart Disease (ACHD)programme in January 2003 to provide continuous specialisedcare for paediatric CHD patients who grow to adulthood. THIalso set up the Congestive Heart Failure programme to reducereadmission rates, the Chest Pain Clinic in September 2002and provides 24-hour PTCA (Percutaneous TransluminalCoronary Angiography) since December 2002.

At TEI, doctors broke new ground with the first micro incisionvitreoretinal surgery, and the first two cases of maculartranslocation, a revolutionary procedure for wet maculardegeneration, in South East Asia.

More Specialist Services Reach the HeartlandsThe Children’s Medical Institute (CMI) started its specialistsoutpatient clinic in Woodlands Polyclinics in October and thesecond clinic at Jurong opened in July 2003. CMI alsolaunched the Children’s Asthma and Allergy Network (I CAN)Programme in December 2002 to educate patients, theirfamilies, and the general public, on effective management of asthma.

Obstetrics and gynaecological clinics were also set up inHougang (May 2002) and Jurong East (August 2002), bringingconvenience and cost savings to patients.

Improvements to Integrated Care ServicesIntegrated Care Services (ICS) is a joint project undertaken by the Ministry of Health, National Healthcare Group andSingapore Health Services to ensure a seamless flow of carefor elderly patients.

ICS serves as a centralised agency for the handling of referralsto nursing homes, collaborate with healthcare professionals,community-based organisations and families for patients whoare waiting for placements and prioritise the limited resourcesavailable for the most needy.

The initiatives in place since its inception in May 2001 include:

Improvements to referral system from hospital to nursinghomes by– improving waiting time to nursing home from 60 days in

May 2001 to 13.5 days in December 2002– streamlining the operational workflow – establishing an electronic referral system to nursing homesMonitoring bed utilisation in nursing homes Providing feedback to MOH on means testing, operationalsystems and policies on vertical integration of careSetting up a hotline number to assist public, patients’ familiesand MPs with the elderly care issues and access to step downservicesEnsuring that hospitals and nursing homes adopt MOHguidelines on infection control for nursing home residents

GP Partners Get Fast, Easy Referrals Through DirectAccess Scheme (DAS)The NHG Partners programme continued to strengthen NHG’srelationship with GPs in Singapore and extend NHG’s reach toa wider swath of the population. Our GP partners tap intoNHG resources and can offer their patients an enhancedservice not available otherwise. The most significant of these isthe DAS, which provides for:

Same day appointments to Specialist Outpatient Clinics forurgent casesSame week appointments to Specialist Outpatient Clinics forsemi-urgent casesDirect admission to hospital wards, by-passing the hospitalA&E departmentsDiagnosis reports and discharge summaries given to thereferring GP for effective follow-up

A total of 1,400 GPs have signed up with the programme,directly benefiting their patients with priority referrals and directaccess to NHG institutions. In FY 2002, 88 percent of GPsreferred at least one patient to NHG under the programme, asignificant jump from 63 percent in FY 2001, when the schemestarted.

Extended Hours and Complete Care for ChronicDisorders at NHG PolyclinicsThe night service at NHGP, with opening hours extended to9.30 pm on weekdays, was started in January 2001 and rolledout to the polyclinics in Clementi, Jurong, Toa Payoh andWoodlands through FY 2002.

This service provides accessible and affordable healthcare forneedy Singaporeans at night.

NHGP’s Chronic Care Programme for patients with illnesseslike diabetes, high blood pressure and lipid disorders alsoyielded good results. With a team-based multidisciplinary careapproach, we follow up closely with patients to providetreatment and lifestyle counselling, educating and enablingpatients to manage their own conditions as well.

Within two years, those on the programme saw substantialimprovements in their physical and clinical indicators, such astheir weight, body mass index (BMI), blood pressure, bloodsugar levels and cholesterol or lipid levels. Reduction in clinicalindicators signify that patients’ conditions are under controland their risk of complications from these diseases, such asheart disease, stroke, blindness and kidney disease, is lowered.

Integrated Services for Cancer, Eye and Heart Patients at All HospitalsSignificant progress was also made in developing new clinicalprogrammes and improving patients access to such care andservices. The Cancer Institute (TCI), The Eye Institute (TEI) andThe Heart Institute (THI), which synergise the expertise andfacilities across all NHG hospitals, made significant progress. TCI@TTSH started operations with one linear accelerator, withplans for a second in October 2003. Plans are also underwayto install three machines in NUH to cater for the presenttreatment shortfall up to 2005.

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NHGÕs commitment to provide cost effective, quality healthcaresaw key infrastructural and development initiatives beinglaunched in many areas. These behind the scenes activities,not always apparent to our patients, are critical to ensuringseamless operations and yield significant costs savings forNHG that translate into lower patient bills.

Process Harmonisation and Consolidation of IT OperationsHarmonising our processes and consolidation of disparate ITsystems across our institutions represent a key cornerstone ofour ability to provide seamless care and manage costs. Whencompleted, the projects will bring greater efficiency, systemand operational resilience and cost savings.

The net result will be faster turnaround for patients at theclinics and hospitals, more knowledge and information sharingthroughout the group to reduce duplicated efforts and cutcosts through more effective use of resources and infrastructure.

In January 2003, IT departments and staff across all NHGinstitutions merged into a single IT Division. The departmentwas put to the test as early as March, at the start of the SARSoutbreak and the new found cohesion among staff from variousinstitutions enabled them to respond quickly to the situation.

Consolidation also smoothened ongoing work to build anddevelop shared IT applications. Examples of upcomingfunctionalities are:

An integrated pharmacy system between AH, NUH and NHG PolyclinicsA single point for registration and consolidated bill payment for polyclinic servicesA single internet portal allowing NHG institutions to post theirevents online and utilise e-payment functions The Electronic Inpatient Medical Record System whichimmediately flags contra indications for prescriptionsThe use of handheld devices with wireless technology whichassists doctors to access patient records, order blood andother laboratory tests, review x-rays and scans, wirelessly atthe point of care A single information system to provide patient information for clinicians across the group

Strengthening the Financial Framework The management of costs and keeping healthcare costaffordable to our patients without compromise on quality is akey cornerstone of NHGÕs mission.

A rigorous framework to optimise resources use, through closemonitoring of capital purchases and Diagnosis Related Group(DRG) analysis is in place. Financial responsibility amonginstitutions is emphasised through devolution of financialauthority to department heads.

Among the many cost management plans being put in place,realising costs savings through standardisation and jointpurchasing, for example of common drugs and supplies,brought quick results. Focus in this area is widening topatented drugs and expensive medical items. In anotherproject, the cluster saved some $300,000 by switching brandsof rubber gloves.

To optimise resource use, a Utilisation ManagementWorkgroup made up of clinicians and operations staff fromacross the cluster studies DRG details. Practice variationsacross institutions are identified and shared with the relevantworkgroups in each institution for their follow up action.

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Building a strong infrastructure

Attracting and Keeping the Best Manpower development continues to take centre stage inNHG. The focus is on creating a conducive environment todevelop staff to their fullest potential through a system ofrecruitment, compensation and benefits, performancemanagement, training, development and staff welfare whichare benchmarked against best practices.

Initiatives launched since clustering were further refined andstrengthened in FY 2002.

A Performance Bonus System was implemented for theCluster Healthcare Leadership (CHL), a core of seniormanagement staff under common NHG employment whoshare a common sense of mission and vision and who driveNHGÕs cluster strategy and initiatives. Their deployment tovarious NHG institutions allows talent-sharing across the clusterThe Total Performance Management (TPM), a competency-based system, was implemented to provide a consistent andtransparent staff appraisal system across the cluster and torecognise and reward performanceKey Performance Indicators (KPIs), set to measure performance,rewards institutions for their collective achievements in criticalfunctional areas. The use of KPIs help to instill a culture ofquality among staffSpecialty Development Fund (SDF) awards, worth a total of$500,000 were given to groom outstanding nursing and alliedhealthcare professionals to specialise in their chosen fieldsThe Health Manpower Development Programme (HMDP),which provides fellowships to doctors, nurses, allied healthprofessionals and administrators to undergo intensive trainingand attachment at renowned clinical centres of excellenceabroad, has grown. In FY 2002, 92 awards worth $3.1 millionwere given, compared to 76 awards in 2001.

Becoming the Employer of ChoiceMany other initiatives make NHG a popular choice among newmedical professionals. NHG scored above the Singapore normin 13 out of 14 indicators in an employee climate survey by theInternational Survey Research in 2002. The indicators includedrewards, recognition, management, training and development,job satisfaction and career advancement.

This is nowhere better reflected than in NHGÕs success inattracting Medical Officers (MOs) to join us. The proportion ofmedical graduates from National University of Singapore optingto start their medical career in NHG has increased from 20percent in 2001 to 45 percent in 2002 and 55 percent in 2003.

We have achieved this through the introduction of innovativeinitiatives such as the introduction of a ÒPreference-DrivenÓsystem, which gives MOs a choice of their training preferenceduring their posting exercise. We also have comprehensiveOrientation Programmes for new House Officers (HOs) &overseas MOs; Core Training Programmes for MOs to upgradetheir professional skills; as well as the allocation of a PersonalTraining Fund account for MOs and Registrars to tap on fortheir professional training and development.

Another attraction is the introduction of two new career schemes;namely the Resident Physician (RP) Scheme and the FamilyPhysician (FP) Scheme. The RP Scheme provides an attractivecareer track for doctors who wish to remain practising in ahospital setting without specialising in any field. RP can lookforward to progression to Senior RP and Principal RP.

The Family Physician Scheme has provided a rewarding andstructured career path in our polyclinics. MOs start as FP,progress to Senior FP, Consultant FP and Senior ConsultantFP. The Scheme has benefited 36 doctors since it waslaunched in 2002.

In 2002, 95 percent of NHGÕs top performers chose to remainin service with us.

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Laying a foundation of good corporategovernance

The Management has proceeded on the premise that a clearsystem of governance and steady leadership would providedirection and thrust to the many changes that must take placefor the NHG cluster to fulfill its goal of delivering quality,seamless, accessible and affordable patient centred care.

The business direction and strategic thrusts for NHG ismapped in a three-year strategic workplan. Two key prongs ofthis workplan are to put in place a performance and incentivemanagement system, and to build a shared culture andidentity.

The key elements of performance and incentive managementsystem are already in place, namely:

Balanced Scorecard that sets common cluster key performanceindicators across institutions, and Rationalisation of pay and incentive structures

The effort to build a shared culture and identity – whichinvolves the complex process of breaking down silo mindsetsand working together to develop a common service andpatient-first culture has been ongoing since inception. Itunderpins work taken across the cluster on key areas likeintegration of clinical and administrative processes, resourceoptimisation, HR policies and so on where staff from acrossinstitutions are brought together to achieve common goals.

The strategic directions and the will to drive through neededchanges is clearly evident in the foregoing account. Supportedby a clear and transparent governance system, NHG will beable to fulfill our stated mission and goals and to prepare usfor the future.

Unified Effort Against SARSSpecial mention must be made about the battle to containSARS. On 22 March 2003, when the Ministry of Healthdesignated TTSH as the SARS hospital, the response fromNHG institutions was swift and professional.

The headway made at unifying the hearts and minds of staff,unifying processes, sharing expertise, equipment and facilitiesprior to SARS was a key weapon in the battle. It enabled NHGto respond with the full resources of the entire cluster, ratherthan the limited resources of any single institution. Some of theswift and effective responses included:

Transfer of non-SARS patients from TTSH to other hospitals.The latter accepted patients directly on 24 hour notice,coordinated the logistics and established new clinics with noincrease in waiting time for patientsHealthcare workers were redeployed among institutions whereneeded, with many volunteering to work in TTSHStrict infection control measures were put in place at allhospitals and clinicsNHG IT staff created a single database on SARS-relatedpatients and cases, which gives dynamic, real time patientinformation. Called SARSWeb, the project was developed on29 March 2003 and went live at all NHG institutions within aweek. SARSWeb was also made available to all public andprivate hospitals in Singapore and MOH

Through the crisis, the sense of solidarity was strong amongstaff of NHG institutions. While TTSH focused its effort onSARS, the rest of institutions provided the backup and supportnecessary to take up all the other areas of work which wereequally necessary and critical to the battle. Without this senseof unity and common purpose, the outcome might have beenvery different.

Battling SARS has further underscored and validated NHG’sefforts to create and shape a united organisation with a sharedculture and identity that can focus its attention, expertise andresources to meet the challenges that are coming.

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Selfless Dedication and Professionalism of Healthcare WorkersDespite their own fears for themselves and their families,doctors, nurses and other healthcare workers put theirpatients’ needs before their own in the face of the SARS crisis.

“As the days went by, I forgot the fear as I threw myself into thetask of taking care of SARS patients … I did not see myself asa foreigner working here but as a nurse in the ICU. The differenceswere not there. We all worked as one. It was a very good feeling.”Ms Deanna Santos Buno, staff nurse, TTSH

“When I’m in the hospital, I have a job to do – that is to takecare of the patients. They become my focus and I don’t get tothink of my own fear.”Dr Chan Poh Chong, TTSH

“When it gets too much and I feel a need to cry, I go to a quietcorner. I don’t want my nurses seeing me cry. I have to bestrong for them. In fact, we all have to be strong for the sakeof our patients.”Ms Catherine Chua, unit nursing officer, TTSH

“There is fear for sure, sadness and anxiety to see all those whoare seriously ill – but there is also a sense of satisfaction whenyou have looked after patients who recover and go back home.”Ms Choo Yee Mee, nurse clinician, TTSH

“I tell myself I have a job to do and that the patients need us…Should anything happen to me, this will be my legacy.”Ms Jamie Lim, nurse clinician, TTSH

“I’m proud to do my part by keeping the hospital clean. I hopea cleaner environment will help to make the patients feel betterand recover faster.”Ms Devi A/P Arumugam, cleaner, TTSH

The public too showed they understood the sacrificesthat healthcare workers had made and showed their appreciation.

“Our hearts are comforted to know that you’re there.”Ahmad Arif Lim

“School was closed but my six-year-old still learnt a valuablelesson. From the heart rending efforts of our own healthcareworkers to those of the late Dr Carlo Urbani of Italy, themeaning of the work ‘hero’ is etched in her mind. And in herheart, a prayer goes out every night for those who continue tofight so that the rest of us can be safe.” Jean Tan and Shayna Toh

“If fear is common and powerful, I am sure that healthcareworkers experience it 10 times more intensely, given that theymay well be inches away from the SARS virus everyday.Healthcare workers have a simple way out: walking away.Instead, they chose to face their fear and act despite it. I haveheard that doctors and nurses who recovered after beinginfected jumped straight back into work at the hospital wards,putting themselves at risk once more.

This is not a situation that we had any choice about being inbut, amidst this adversity, let us admire the beauty of thehuman spirit at work.”Samuel Yong Soon Keong

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Milestones

Digestive Disease CentreA new Digestive Disease Centre was opened on 2 May 2002.

Image-Guided Sinus Surgery TTSH’s Otorhinolaryngology Department is the only one inSingapore to introduce image-guided sinus surgery using anelectromagnetic system designed for ENT, funded by MOHthrough Health Service Development Programme (HSDP) , in2002. Using an electromagnetic field to pinpoint the location ofa probe, it makes minimally invasive sinus surgery safer andmore accurate.

Occupational Therapy DepartmentThe Occupational Therapy Department started outpatient JointProtection Group programme in June 2002.

Institute of Mental Health/WoodbridgeHospital

Cognitive-Behavioural Therapy In 2002, IMH started the Cognitive-Behavioural Therapy (CBT)groups for anxious children and launched the Kucinta Cat CBTManual for these children, adapted to suit local context fromDr Philip Kendall’s Coping Cat Workbook. CBT groupprogrammes for adults with anxiety and panic disorders werealso developed in 2002.

Collaboration with NUH Paediatrics DepartmentTo make child psychological services more accessible, twoclinical psychologists from IMH conducted assessment andtherapy sessions at the outpatient paediatrics clinic at NUH.

Behavioural Medicine Clinics The Mood Disorders Clinic was started in 2002. SleepDisorders, Psychotherapy and Weight Management serviceswere added later.

Family/Marital Therapy ClinicMedical Social Work opened its second family and maritaltherapy clinic in January 2003 to meet the demands for maritalcounselling and patient support.

National Neuroscience Institute

Integration Of Neuroscience Services In SingaporeTwo neuroscience centres – the National NeuroscienceInstitute (NNI) and Singapore General Hospital’s (SGH) BrainCentre were integrated on 1 June 2002 to pool limitedresources and expertise, and allowed better clinicalneuroscience services to be developed and delivered. It alsoallowed for better coordination and more consistency intraining resources and clinical teaching material.

Neuro-Oncology ClinicThe Neuro-Oncology Clinic was set up to provide radiotherapy,chemotherapy and surgery for patients with gliomas andmetastatic brain tumours. In this weekly clinic, patients arelooked after by the unit’s team of oncologists, neurosurgeons,neuroradiologists and case manager.

National Skin Centre

Enhanced Dermatological ServicesNSC installed several non-ablative laser rejuvenation systems,reported to have minimal morbidity and complicationscompared to conventional carbon dioxide laser resurfacing.The Centre started clinical studies to assess the efficacy ofsuch systems to treat wrinkles and scars; and scientific studiesto assess the efficacy of the Intense Pulse Light (IPL) system inthe treatment of various dermatological disorders.

Psychodermatology ClinicThe Psychodermatology Clinic started in 2002 with a visitingpsychiatrist from TTSH, handles the psychological aspects ofskin disorders, from providing accurate psychodermatologydiagnoses to managing patients with anxiety and obsessivecompulsive dermatoses.

NHG Polyclinics

Night Clinics in NHG PolyclinicsIn January 2001, NHG Polyclinics pioneered the nightpolyclinic service to cater to working people who may needconsultation for themselves or their family members after officehours. In 2002, NHG Polyclinics opened two more night clinicsat Woodlands and Toa Payoh, adding to those in Jurong andClementi Polyclinics.

Dr Lily Neo at the launch of “I CAN!” programme in CMI, NUH Newly opened Wellness Centre in NUH

NEW SERVICES

Alexandra Hospital

New Clinics at Alexandra HospitalThese were a Digestive Health Clinic at Choa Chu KangPolyclinic, an Osteoporosis Clinic, and a CardiopulmonarySleep Monitoring Unit to provide one-stop services for patientswith sleep disorders.

Orthopaedic Geriatric ServiceThe new Orthopaedic Geriatric Service aims to shorten thelength of inpatient stay and improves the overall medicalmanagement of elderly patients.

National University Hospital

Ethics Consult ServiceNUH started the Ethics Consult Team to work with healthcareproviders, patients and family members on difficult medicaldecisions involving complex moral and ethical issues.

“I CAN !” Programme The Children’s Medical Institute (CMI), NUH, set up theChildren’s Asthma and Allergy Network and launched the “I CAN!” Programme in December 2002 to improveunderstanding of asthma and allergic conditions in childrenthrough patient education talks, activities and materials.

Satellite Specialist Services From August 2002, NUH offered Obstetrics and Gynaecology(O & G) specialist services at Jurong Clinic for Women,Hougang and Choa Chu Kang Polyclinics for women. InOctober 2002, CMI also started specialist paediatric servicesin Woodlands Polyclinic.

New Clinics at NUHThe Clinic for Human Reproduction, for infertile couples,opened in July 2002.

The Adult Congenital Heart Disease Clinic, within the Medicineand Cardiac Specialist Clinic, opened in January 2003.

The Wellness Centre provides health screening packages todetect common chronic illnesses like heart disease, stroke,hypertension and cancers. Within the centre is the TravelScreening and Vaccination Clinic, which provides pre-travelhealth advice, immunisations and consultations for travel-related needs and illnesses.

GP Liaison Centre NUH’s General Practitioner Liaison Centre (GPLC) gives familydoctors a one-stop shop for fast and hassle-free access totertiary medical care. It provides direct patient admission,urgent, semi-urgent and non-urgent outpatient appointmentsand referrals.

Auditory Verbal Therapy ServiceThe Auditory Verbal Therapy (AVT) service started at the ENTClinic in December 2002 to help hearing-impaired childrenprepare for integration into normal mainstream schools, usingaids such as aided residual hearing or cochlear implants toacquire speech and language skills.

Tan Tock Seng Hospital

United Against SARSTan Tock Seng Hospital (TTSH) became the designated hospitalfor the isolation and treatment of all SARS cases in Singaporeon 22 March 2003. The Emergency Department was convertedto a SARS screening area and all the Outpatient Services wereclosed except for urgent and acute cases.

Hyperbaric Oxygen TherapyPatients with non healing wounds got a chance at a cureinstead of amputations, with the "Hyperbaric Oxygen Therapy”(HBOT) medical treatment, launched on 14 November 2002.Operated by BaroMedical Services (Asia) Pte Ltd incollaboration with TTSH, the Hyperbaric Medicine Centre is thefirst and only civilian centre that provides HBOT.

LASIK CentreTTSH and The Eye Institute (TEI) together opened a new LASIKCentre for laser vision correction surgery, with Dr BalajiSadasivan, Minister of State (Health & Environment), as officialguest on 6 April 2002. Since the LASIK service started inJanuary 2000, over 1,000 LASIK surgeries have been doneand about 300 more using customised wavefront LASIK.

Consultation session in psychodermatology clinic, NSC

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NEW FACILITIES AND EQUIPMENT


New Porta-CabinThe physical and emotional needs of the parents of paediatriccancer patients received some sensitive handling from NUH.The two storey porta-cabin, placed next to the PaediatricInpatient Cancer Centre, houses four bedrooms, a living room,pantry, an Internet surfing area, and educational and researchresources on paediatric cancer, providing families with a havento rest and to meet other families undergoing the sameexperience.

STAR LaboratoryThe new Skills Training And Research (STAR) Laboratory nowprovides NUH doctors with a conducive environment formedical research, training and education. Doctors use the upto date facilities and equipment to perform experimentalsurgery, test surgical instruments, and research on cadavers.Research on small animals is also carried out with strictadherence to international guidelines on animal research.


Artificial Limb Centre The Artificial Limb Centre at TTSH completed its renovations inJanuary 2003. Safety standards and cleanliness within theworkshop were improved.


Neuro Rehabilitation UnitA 24-bed Neuro Rehabilitation Unit (NRU), set up in April 2002,provides a new, dedicated neuro-rehabilitation service forpatients. The Unit offers specialised rehabilitation ofneurologically disabled patients, under the care of physiatrists,to speed up discharge, or until transfer to rehabilitation or stepdown care.

Southeast Asia’s First 3tesla MRI ScannerSoutheast Asia’s first high field MRI scanner was installed andcommissioned at NNI’s Neuroradiology Department in June2002. The $4.8 million 3T MRI scanner considerably improvesdiagnosis and treatment of complex neurological conditionsand was funded under HSDP to enhance neurological servicesin Singapore.

NHG Polyclinics

Renovation of Ang Mo Kio PolyclinicAng Mo Kio (AMK) Polyclinic was closed from 2 August 2002for a $2.5 million facelift, its first since being built in 1981. Theclinic reopened in January 2003 with a better-equipped healtheducation cum conference room, staff room, lift, X-rayservices, and a retail pharmacy which stocks daily healthcareand beauty essentials.

First Primary Healthcare Museum In SingaporeThe Gallery of Memories at Bt Batok Polyclinic was opened on1 October 2002 by Mr Moses Lee, Permanent Secretary forHealth. The Gallery is Singapore’s first Primary HealthcareMuseum and documents the history of modern medical care inSingapore from 1819, when Sir Stamford Raffles arrived, totoday. It contains a wealth of visuals and more than 100artifacts from the past.

PMPA System in PolyclinicsNHG Pharmacy developed the computerised PatientManagement Patient Accounting (PMPA) system to capture allpatient particulars and services rendered at each service point.At the end of his visit, the patient receives a consolidated billfor payment.

The system also gives healthcare personnel online access to acentral patient database for important medical informationthrough integration with the pharmacy, laboratory and hospitalsystems, and the support of drug allergy and medical alerts.All patients who visit polyclinics only need to register or updatetheir particulars and contact details once.

The $950,000 PMPA system was piloted at Choa Chu KangPolyclinic and fine-tuned to minimise waiting time anderadicate loop-holes. The system was rolled out to all at theend of March 2003.

The Cancer Institute

TCI @TTSHThe Cancer Institute at TTSH was opened on 22 February2003 by Dr Balaji Sadasivan, Minister of State, Health andEnvironment. TCI augments the hospital's extensive patientcare services and clinics, and offers a one-stop service forcancer patients.

The Radiotherapy Centre, TCI@TTSH started operations on 1October 2002, and can treat 35 patients a day. With its latesttechnology, the centre provides accurate treatment tomaximise cancer control and minimise the volume of normaltissue treated.

Chemotherapy treatment delivery also started at TCI@TTSH on1 October 2002, with specially trained oncology nurses to lookafter patients with adjuvant breast and colon cancers.

TCI@NUH The Bone Marrow Transplant (BMT) Clinic, TCI@NUH offersstem cell transplants to patients with haematologicmalignancies such as leukaemias, lymphomas or myelomas;and non-malignant conditions such as thalassaemia and auto-immune disorders. The clinic also provides post-transplantcare.

Started in the NUH Cancer Centre in January 2003, the PunchBiopsy Service, previously only available at the O & G clinic,was introduced at TCI@NUH for gynaecology and oncologypatients. The Radiotherapy Centre, TCI@NUH performed its first TotalBody Irradiation treatment in July 2002. This new procedurecan irradiate the whole body to help suppress the patient’simmune system and prevent rejection of donor bone marrow,or to kill abnormal cells that escape other therapies such assurgery, chemotherapy or local irradiation.

The Eye Institute

Diabetic Retinopathy ProgrammeIn April 2002, TEI collaborated with NHG Partners to providedirect access (same day/next working day appointments) toTTSH for proliferative DM retinopathy patients and less thanthree weeks’ appointment for patients with diabeticmaculopathy.

Second level reading of borderline photographs, and trainingand audits for the Diabetic Retinal Photography (DRP) readers,were also made available to these partners. The collaborationprovides quicker treatment for diabetics where diabeticretinopathy commonly leads to irrevocable blindness.

Mobile Diabetic Retinal Photography for Family PhysiciansTEI and NHG Partners also launched a mobile DRP service forGPs in April 2002. Based in TTSH, a DRP screening team canbe deployed to the GP clinics to provide on-site screening. ByMarch 2003, 42 sessions were held and 686 patients havebeen screened.

Ultrasound Biomicroscope Procedure From August 2002, TEI’s clinics at NUH started using a veryhigh resolution bio-microscope – the UltrasoundBiomicroscope (UB) - to monitor and image the anteriorsegment of the eye. Unlike conventional ultrasound devices,the UB allows angles to be seen and measured objectively.

NHG Diagnostics

Imaging and Laboratory Services at NHG PolyclinicsIn 2002, NHG Diagnostics (NHGD) took over the imaging andlaboratory operations at six NHG polyclinics. It also startedultrasound services at Yishun, Ang Mo Kio and Chua ChoaKang Polyclinics, and night mammography screening atClementi and Toa Payoh.

NHGD also took over two x-ray services previously managedby SGH at Choa Chu Kang and Woodlands, and one atYishun managed by Medirad, a private x-ray vendor. Anotherfive x-ray services were set up at Hougang, Toa Payoh, Ang Mo Kio, Yishun and Jurong Polyclinics.

First NNI 3tesla MRI scanner in Southeast Asia Patient registering at night polyclinicAn NHG GP Partner using TEI’s mobile diabetic retinal photographyservice in his clinic

Dr Balaji at the opening of TCI@TTSH

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SYSTEMS & SUPPORT SERVICES

NHG

Clinical Guidelines Flipcharts for GPsGPs received an easy reference flipchart with guidelines for the14 most commonly seen conditions: Diabetes Mellitus,Hypertension, Hyperlipidaemia, Chest Pain, Atrial Fibrillation,Transient Ischaemic Attack, Bronchial Asthma, ChronicObstructive Pulmonary Disease (COPD), Hepatitis B Carriers,Thyroid, Ante-Natal Care, Care of Older Women, Depressionand Schizophrenia.

Airway Shared Care ProgrammeUnder this programme, GPs who refer asthma patients to thehospitals will receive an initial diagnosis report from thehospital on their patient’s condition. This allows for betterfollow-up care by the GPs post discharge.

SMS to Remind Patients of Appointments NHG institutions started using Short Message Service (SMS)to remind patients of their medical appointments at thehospitals’ Specialist Outpatient Clinics a day earlier. The SMSservice also allows patients to check subsequentappointments.

Alexandra Hospital

HIP Studio on the AH websiteAH’s Home for Independent Persons (HIP) Studio is designedas a small HDB flat for older persons living alone. The HIPStudio is on AH’s website and serves as a teaching-cumdemonstration site to provide tips on safe and independentliving for the elderly.


Angel Heart ServiceNUH, with Comfort Transportation, launched the Angel HeartService in October 2002 – a dedicated taxi chaperone serviceto ferry patients to hospital for their appointments. TheComfort drivers are given training in Basic First Aid. Patientswho cannot afford the taxi fares get help from the NUHEndowment Fund.

New Modes of PaymentNUH introduced four new, easy, 24-hour, island-wide paymentmodes in April 2002 – via Self-service Automated Machines(SAM), vPost Electronic Billing and Payment, AXS Stations andat Singapore Post branches. A SAM machine was alsoinstalled at the Main Lobby to minimise queues at thecashiers.

Medicine Delivery and Top-Up ServicesTwo time saving ways to get medicine were introduced inJanuary 2003 – the Medicine Delivery Service which sendsmedicines to patients at their homes or offices, and theMedicine Top-Up Service, through which patients orderprescribed medicines via fax or phone and collect later.

NHG Pharmacy

NHG Pharmacy Goes OnlineNHG Pharmacy launched its website atwww.pharmacy.nhg.com.sg. It features health articles,information on its pharmaceutical services and the “Ask-the-Pharmacist” online service, where pharmacists answerquestions on drug-related concerns.

Integrated Pharmacy Information SystemThe Integrated Pharmacy Information System (IPHARM),developed with AH, is a new dispensing system whichstreamlines dispensing workflow and captures details likepatient data and medication record history for easy reference.

NetCare Internet Services

Medical Online ServicesNetCare Internet Services developed the TTSH onlinepharmacy - the pharm+ezy website – to offer a range ofhealthcare products and supplements online with payment viacredit cards. NetCare also worked with Nanyang Polytechnicto develop a health education system using web servicestechnology.

NHG College

NHG College InauguratedNHG College, a new centre for training and developing staff inhealthcare administration and service was launched by HealthMinister Lim Hng Kiang in July 2002. Since opening, it hasorganised 90 courses totalling 19,500 hours, with participantsrating the College at over 90 percent. Professor Low ChengHock was appointed President of NHG College.

The College taps expertise from renowned training institutionslocally and abroad and has a video conferencing system withlinks to similar systems in TTSH and AH. Video conferencingcan now be carried out “live” within NHG or to external parties.

NHG Diagnostics

Imaging and Laboratory CentresNHGD established six mammography-screening centres,accredited by the Health Promotion Board (HPB). In 2002,NHGD screened 16,000 patients.

The modern, comfortable diagnostic centres offer X-ray andlaboratory services in one physical location to give patients aone-stop service and better workflow for staff.

In 2002, NHGD performed over 700,000 laboratory tests, and40,000 mammograms, x-ray and ultrasound examinations.

BREAKTHROUGH ACHIEVEMENTS


Singapore’s First Artificial Disc Replacement Surgery Pro-Disc, a new method to replace damaged discs that cause chronic low-back pain is under trial in NUH. Well-established in Europe, the Pro-Disc replacementprovides better mobility than spinal fusion.

Researcher Doubles In-Vitro Fertilisation Success Rate Dr Fong Chui Yee, Department of Obstetrics and Gynaecology,NUH, succeeded in growing embryos for up to six days in thelaboratory before implantation into the woman’s womb,substantially increasing the chances of pregnancy for manywomen with difficulty conceiving.

New Technique May Replace Heart Transplants Dr Eugene Sim, Senior Consultant, Department of Cardiac,Thoracic and Vascular Surgery (CTVS), NUH, heads a currentstudy on how muscle stem (myoblast) cells are able to improveheart function. The CTVS team is also working on using thesemyoblast cells to carry needed genes to the heart cells, toproduce protein for growth of new blood vessels.

Safer Method of Detecting Down’s SyndromeA safer and faster method to detect Down’s Syndrome inunborn babies is being studied by Dr Manesh Choolani,Department of Obstetrics and Gynaecology, NUH, and histeam. The new method reduces the risk of miscarriage as itinvolves a blood check and no contact with the baby.


First Artificial Cervical Disc Replacement Surgery The first artificial cervical disc replacement surgery was doneat NNI on 5 November 2002. Disc degeneration is painful andoften difficult to treat. The disc replacement surgery offerspatients faster recovery and shorter hospital stay.

First Asian Study on Homocysteine Level and Risk of Stroke In August 2002, NNI and NUS conducted the first Asian studyon the link of homocysteine (Hcy) levels to the incidence ofstroke in young Asian adults. The study showed high Hcylevels may play a part in causing ischaemic strokes in youngAsians – a significant finding for early detection and treatment.

Hydrocoils In Endovascular Treatment Of Aneurysms Trufill DCS hydrocoils, platinum coils used to treat intercranialaneurysms, were deployed in a live demonstration during the4th Advanced Neuroradiology Course held at the NNI inDecember 2002. A safer alternative to surgery, hydrocoilsresult in less post-operative pain as a craniotomy or opening ofthe skull is not needed.

NUH partners Comfort to offer Angel Heart Service to transport patientsfor appointments

Clinical guidelines flipchart for NHG GP PartnersHealth Minister Lim Hng Kiang at the launch of NHG College Radiographer assisting patient with x-ray at NHG Diagnostics imaging centre

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Awards TTSH received ISO 9001 (1994) in January 2000 and ISO9001:2000 Certification in March 2003. Other achievements byTTSH in the last FY include:

February 2002 First hospital to achieve double certification for ISO 14001 andOHSMS

July 2002 Singapore Quality Class

November 2002Three out of Best Five Clinical Practice ImprovementProgramme Projects awarded by NHG

NHG Polyclinics

Triple ISO AchievementNHG Polyclinics was the first primary healthcare provider toreceive three ISO certificates - ISO 9001 (quality managementsystem), ISO 14001 (environmental management system) andOHSAS 18001 (health and safety management system)


Staff HonorsRTC radiation oncologists Dr Thomas Shakespeare and DrMichael Back from TCI, won two prizes for research at thisyear's Annual Scientific Meeting by the Royal Australian andNew Zealand College of Radiologist held in October 2002.

Dr Thomas Shakespeare won the prestigious "Novartis BestPoster Presentation" for the first study to investigate patients'decision-making in the choice of radiotherapy for palliativetherapy of bone metastases. Dr Michael Back won the "DrChris Atkinson Award" for best presentation in QualityAssurance in radiation oncology.

Ms Emily Ang, Assistant Director of Nursing, TCI, received theprestigious President’s Star Award.

NHG College

Accreditation for NHG CollegeUnder NHG College, Institute of Medical Education andTraining (IMET) was accredited a centre for Advanced CardiacLife Support (ACLS Provider). In addition, Institute of NursingEducation and Training (INET) received accreditation from theSingapore Nursing Board for its Renal Dialysis Nursing Coursefor RNs. It is now applying for accreditation with NationalResuscitation Council to conduct Basic Cardiac Life Support(BCLS) and Life Support Course for Nurses (LSCN Provider).

TRAINING & EDUCATION

NHG

Allied Health ScholarshipIn April 2002, NHG started a scholarship for studentsinterested in a career in Allied Health - physiotherapy,occupational therapy, diagnostic radiography and radiationtherapy. Upon graduation, scholars would serve their bonds atNHG.

Launch of Biomedical Research FellowshipMr Philip Yeo, Chairman of the Agency for Science,Technology and Research (A*STAR), delivered the inauguralNHG Lecture at the Gala Dinner on 17 August 2002. Mr Yeoannounced a new research initiative, the Biomedical ResearchFellowship, a two year sponsored research programme, tosupport doctors in overseas research.

This initiative aims to cultivate a pool of clinician-scientists tobridge the gap between laboratory science and clinicalapplications. A*STAR will sponsor up to 12 medical doctors ayear. Fellows who have completed the training will serve theirparent hospitals in Singapore for two years with a majoremphasis in research.

First NHG Scientific CongressDr Balaji Sadasivan, Minister of State for Health andEnvironment, inaugurated the first NHG Scientific Congressbased on the theme “Years to Life, Life to Years”, held from17-18 August 2003. The two-day congress highlighted recentadvances, development and trends in Geriatrics, Paediatrics,Obstetrics & Gynaecology, Oncology, Cardiology, Dentistry,Dermatology and Minimally Invasive Surgery.

ACHIEVEMENTS AND AWARDS

NHG

Advanced Training Overseas For 92 HealthcareProfessionalsOn 19 July 2002, Minister Lim Hng Kiang presentedHealthcare Manpower Development Programme awards to 53clinicians, 37 allied health professionals and nurses and twoadministrators. There were more awards this year as well as anew category for administrators.

Lifetime Achievement Award for Professors Feng Pao Hsiiand Lim PinProfessors Feng Pao Hsii and Lim Pin were honoured with TheLee Foundation – NHG Lifetime Achievement Award 2002 on17 August 2002. Prof Feng is an Emeritus Consultant with theDepartment of Rheumatology, Allergy and Immunology atTTSH and Adjunct Professor with the Faculty of Medicine,NUS. “Father of Rheumatology” Prof Feng, was recognised forhis significant contribution to the medical profession andcommunity.

Prof Lim Pin is a Senior Consultant with the Department ofMedicine, NUH and University Professor, NUS. He wasrecognised for his momentous contribution to the literature inthe field of endocrinology and metabolism.

Alexandra Hospital

AwardsAH received a string of awards last FY. These are:

24 April 2002ASEAN Energy Efficiency Award

12 July 2002Family Friendly Firm

29 August 2002PS 21-MFE Organisation Excellence

1 September 2002OJT Centre for a period of three years

6 November 2002Singapore Environmental Achievement Award 2002

13 November 2002Occupational Health and Safety Management System(OHSMS)

23 November 2002Re-certified with CAP Accreditation

9 December 2002National Innovation and Quality Circles Award


Awards NUH is the first Singapore hospital to achieve three ISOcertifications - 9001, 14001 and OHSMS - at one go, inDecember 2002. Besides this feat, staff earned numerousother accolades. They are:

July 2002Dr Lee Yung Seng, Associate Consultant, CMI, won YoungResearcher Award

July 2002Dr Allen Yeoh, Consultant, CMI, won Singapore Youth Award 2002

August 2002Dr Denise Goh, Associate Consultant, CMI, first Singaporeanto be certified in Genetics by American Board of MedicalGenetics

October 2002CTVS received accreditation for higher surgical training

November 2002Dr Adrian Low, Cardiac Department, won CCT 2002 Award forExcellence

November 2002Enterprise Challenge Award

Doctors Thomas Shakespeare and Michael Back, TCI, won prizes for theirresearch

Dr Chia Sing Joo, TTSH with his CPIP project team discussing how toreduce the rate of negative appendicectomy

Mr Philip Yeo delivered the first NHG lectureThe Lee Foundation-NHG Lifetime Achievement Award 2002 went toProfessors Lim Pin and Feng Pao Hsii

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Wavefront & Advanced LASIK CourseThe first Wavefront & Advanced LASIK course, sponsored by Bausch & Lomb (S) Pte Ltd, was held in TTSH on 23 June 2002. Organised by TEI, the course familiarisedLASIK surgeons with the challenges of Wavefront LASIK and highlighted methods of providing maximum patient satisfaction.

Clinical Ophthalmology Course For The Family PhysicianOn 20 July 2002, TEI organised a Clinical Ophthalmology Coursefor The Family Physician at TTSH, attended by 90 GPs andpolyclinic medical officers. They received a hands-on, patient-oriented practical session on clinical examination techniques.

Advanced Course in Vitreoretinal SurgeryThe first Advanced Course in Vitreoretinal Surgery, organisedby TEI, was held in TTSH from 23-24 September 2002. Thecourse featured lectures, panel discussions, video presentationand live surgeries that demonstrated these new techniques.

Public Talks and Forums on EyecareTEI set up a series of talks at various community clubs inJanuary 2003 to educate the public on identifying and treatingvarious common eye diseases. Public forums were also held atNUH and TTSH on the viability of LASIK and CustomisedWavefront-Guided LASIK.

20/20 Eyecare DayThe 20/20 Eyecare Day, a joint effort between TEI andSingapore Women’s Association was held on 12 October2002 at NUH to provide free eye screening for NUS Alumnimembers and staff and family of NUS and NUH. ‘Caring forYour Eyes’, a book written, edited and published by TEIdoctors, sold 1,600 copies and proceeds went to SWA’sVisioncare Programme.

The Heart Institute

Echo Singapore 2002Organised by THI, Echo Singapore 2002 was held from 31October – 2 November 2002 at NUS. This second annualconference on cardiovascular ultrasound featured lectures andin-depth discussions of controversial topics inechocardiography and cardiovascular medicine, interactivecase studies facilitated by audience response systems, and“live” demonstration sessions.

International Symposium on Surgical Options in Heart Failure ManagementTHI organised the International Symposium on SurgicalOptions in Heart Failure Management from 10-11 February2003 to share the developments in cardiac surgery andsurgical options in heart failure management.

Adult Congenital Heart ProgrammeTHI launched Singapore’s first Adult Congenital Heart Disease(TACHD) programme on 6 January 2003, aiming to be the referralbase for congenital heart patients who grow into adulthood,training cardiologists in the care of adults with congenital heartdisease, pulmonary hypertension management and otherrelated issues.

The first successful implantation of an ASD closure device for the TACHD programme was done on 21 February 2003.

Heart Failure ProgrammeThe NHG Cardiac Disease Management Workgroup, led byAssociate Professor Lim Yean Teng, embarked on acomprehensive Heart Failure Disease ManagementProgramme from November 2002.

Cardiac Surgical Unit in ArmeniaProfessor Lee Chuen Neng, Programme Director at THI,spearheaded the project to develop a Cardiac Surgical Unit inErebouni Medical Centre, in Yerevan, capital of Armenia. Theproject is in tandem with the institute’s humanitarian vision ofdeveloping Cardiac Surgery in less-developed areas such asMongolia, Medan, Surabaya, Makassar and Jogjakarta.

NHG Pharmacy

Public Education Programmes on Safe MedicatingNHG Pharmacy organised a series of public education eventson responsible self-medication and safe use of medicines. A“Spring Clean Your Medicine Chest” project was held at theSouth West Community Development Council Community HealthFairs at JTC Summit and Jurong Point, and Women Inspire 2002at Suntec City. The public were invited to bring their medicinesand health supplements for a free check-up by pharmacists.

Johns Hopkins – NUH International Medical Centre

Oncology Preceptorship ProgrammeJohns Hopkins-NUH co-organised the OncologyPreceptorship Programme with Bristol-Myers Squibb toprovide opportunity for physicians in the region to upgradetheir skills and knowledge, and position Singapore as aregional medical hub for South East Asia.

Two doctors from Ho Chih Min Medical Centre, Vietnam, metwith the faculty from Johns Hopkins-NUH and NUH over thefive-day programme, taking part in case conferences, andtumour board and department presentations.

Singapore Annual Oncology Symposium and Public Forum 2002From 25-27 October 2002, Johns Hopkins-NUH and TCIorganised the Annual Oncology Symposium at the RegentSingapore Hotel, with a panel of expert speakers from theUSA, Taiwan, Japan and Singapore. This was followed by apublic forum on gastric and colorectal cancers.


Action for Training in Emergency CareThe Emergency Department of TTSH received a grant ofUS$10,000 for the project: Action for Training in EmergencyCare in Cambodia. The Project teaches life support courses inthe Sihanouk Hospital Centre of Hope, Phnom Penh, with theaim to make it a training centre for life support courses likeBasic Cardiac Life Support, Advanced Cardiac Life Supportand Life Support Training Course for Nurses.


NHG-KCL Intensive Course in Research Methods NHG organised the first NHG Intensive Course on ResearchMethods, together with the prestigious King's College London(KCL) from 2-12 April 2002. Held at the NNI, the intensivecourse gave insights into medical research, problems andpitfalls. The lecture series addressed specific and topicalissues such as infectious diseases, health economics, trans-cultural and qualitative research, bridging specialities throughresearch, and research in primary care.

MOU with Howard Florey Institute & University of Melbourne In July 2002, NNI signed a three-year Memorandum ofUnderstanding (MOU) with Australia’s Howard Florey Institute(HFI) and the University of Melbourne’s Centre forNeuroscience. The MOU provides for laboratories at NNI withsenior researchers from the HFI and Melbourne Universityworking with their Singaporean co-investigators to developnew treatments for brain disorders.

Fourth Stroke Conference The Fourth Stroke Conference, held in November 2002 andorganised by NNI and supported by the ASEAN NeurologicalAssociation, promoted the development of stroke services andstroke-related research in South East Asia.

ASEAN Congresses of Neurosurgical Nursing andNeurological SurgeryNNI co-organised the fifth ASEAN Neurosurgical NursingCongress and the 10th ASEAN Congress of NeurologicalSurgery in December 2002.

National Skin Centre

Dermatology Update 2002 CongressThe first Dermatology Update 2002 Congress was held atNSC from 9-10 November 2002 with Dr Stephen Katz, aworld-renowned research dermatologist from National Instituteof Health, USA, as keynote speaker.


Nurse Attachment ProgrammeNurses Emily Ng and Tan Jee Ling of TCI spent four weeks inJune 2002 at the Sidney Kimmel Comprehensive CancerCentre in Baltimore, Maryland. The attachment enabled themto update their clinical skills and learn new practices inoncology nursing.

The Eye Institute

National Annual Update for Optometrists and Opticians TEI and Singapore Polytechnic jointly organised the firstNational Annual Update For Optometrists and Opticians on 23May 2002 at TTSH, attended by over 200 people. The themewas “Enhancing Eye Care Through Shared Care”.

Dermatology Update 2002 Congress at NSC “Spring Clean Your Medicine Chest” public education event organised byNHG Pharmacy

International Symposium on Surgical Options in Heart Failure Managementby THI

NHG-KCL intensive course on research methods held at NNI

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Fund RaisingTCI’s Endowment Fund was one of four beneficiaries of theSingapore Million Dollar Duck Race 2002. TCI received$250,000 of the record $1.2 million raised. During theweekend of the race, TCI staff set-up booths at island-widelocations to sell tickets to the public. Colleagues from TTSH,AH, NHG Polyclinics and NHG HQ also showed their supportby selling tickets and helping out during the day of the race.

Donor ReceptionTCI held its Endowment Fund Donor Reception on 14 March2003 to honour donors and volunteers, and report on fundusage over the past year. Professor Saraswati Sukumar ofJohns Hopkins University’s School of Medicine was the mainspeaker for the event.

NetCare Internet Services

Improved Database Services NetCare launched an event registration service to helpinstitutions manage registration and payment for theirhealthcare forums and seminars. It also developed a platformfor NHG institutions to post their events and use e-paymentfunctions. The Secure Sockets Layers (SSL) accelerator wasinstalled to encrypt credit cards details, enhancing safety.

A GP information system was built to help NHG Partnersmaintain a database of GP partners and their activities, includingContinuing Medical Education (CME) participation at NHG, andpatient referrals to the institutions. An e-notification service wasset up to link the database to route CME registration details to programme organisers and reminders to GPs.

NetCare also developed the NUH research portal as aninformation service for the Office of Biomedical Research tosupport and facilitate research-oriented processes. It serves asa platform for clinicians and researchers to search and updateresearch projects.

In December 2002, NHG Pharmacy organised its first publicforum, “Manage Your Health Today for Healthier Tomorrow”. Its pharmacists gave public talks organised by the SingaporeHeart Association, Osteoporosis Society, National LibraryBoard and National Kidney Foundation on health andmedication related issues.

STAFF AND INTERNAL INITIATIVES

NHG

NHG Partners Celebrates First AnniversaryOn 19 May 2002, NHG celebrated the first anniversary of theNHG Partners Programme with a CME talk and a receptionattended by over 200 GP Partners. Over 1,200 doctors joinedthe Partners programme. They referred over 400 patients toNHG hospitals each month under the Direct Access Scheme,for fast track admission to wards.

New Appointments Professor Kua Ee Heok stepped down as CEO of IMH on 30June 2002, on completing his term. He was succeeded by MrLeong Yew Meng from 1 July 2002. Associate Professor WongKim Eng became Chairman of Medical Board, IMH on thesame day.

Professor John Wong stepped down as Chairman of MedicalBoard, NUH. He was succeeded by Associate Professor LimYean Teng with effect from 1 January 03.

Third NHG Quality WeekCEO, NHG launched NHG’s third Quality Week at TTSH on 10September 2002 with the theme “Quality: Our Commitment,Your Trust”.

Active Day at NHG NHG joined in the national Active Day with CEO leading staff ina line-dancing session. The event was organised by theWorkplace Health Promotion Workgroup.

NHG Health-A-Thon 2002Over 10,000 staff and family members thronged the PalawanBeach in Sentosa on 24 August for the NHG Health-A-Thon2002. The fun-filled programme lasted from 2pm to midnightand included games and telematches. The highlight of theevent was Mr & Ms NHG Baywatch contest with participantsfrom the different NHG institutions.

NHG Running ClubAbout 50 NHG staff members joined over 6,000 participants inthe Standard Chartered Marathon for a 42km run on 8December 2002. The NHG Running Club was formed soonafter to encourage staff to get fit and represent NHG incompetitions. Training sessions are held twice to thrice a weekand families and friends are welcome to join in.

Integration of NHG ITAs at 1 January 2003, IT departments and staff across allNHG institutions merged into a single IT Division. This effortbrought together NHG's current 150 staff to align ITprocesses, synergise resources and architectures, create long-term cost savings, and achieve an IT infrastructure andorganisation that goes beyond the capabilities of any singleinstitution.

Desktop support, network management, data centreoperations and applications maintenance, were consolidated,and a Finance-Hospital Information System for the wholecluster was created.

Blood Donation DriveThe Red Packets blood donation drive was launched a weekbefore Chinese New Year. A team from the NUH BloodDonation Centre went to TTSH, IMH, Choa Chu KangPolyclinic and NHG HQ to collect staff donations.

NHG Polyclinics

Family Physician SchemeNHG Polyclinics launched the Family Physician Scheme on 1November 2002 for Family Physicians who want to stay inprimary healthcare. It features a distinct career trackincorporating job-exposure opportunities at various levels; aperformance driven remuneration and incentive package; andopportunities for training and development. All NHG Polyclinicsdoctors have opted for the scheme.

Work Redesign Model by NHG PolyclinicsNHG Polyclinics is the first healthcare organisation to submit a Work Redesign blueprint to SPRING for evaluation. Theblueprint covers job redesign and other job scopes in NHGPolyclinics to make them more enriching. The pilot will run inToa Payoh Polyclinic later in 2003.

Singapore Million Dollar Duck Race 2002 raised $250,000 for TCIEndowment Fund

NHG Partners celebrate first anniversary NHG Health-A-Thon 2002 held at Sentosa

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About NHG

NUH believes that new cures and treatmentscan be discovered through continuing medicalresearch, training and education. It activelysupports clinical teaching for undergraduatemedical students and postgraduate trainingfor specialist doctors. The hospital also servesas a clinical and research base for the medicaland dental faculties of the National Universityof Singapore.

Tan Tock Seng HospitalTan Tock Seng Hospital (TTSH) wasestablished in 1844 through the generosity of Mr Tan Tock Seng and other 19th centurylocal philanthropists. Over the years, TTSHhas played a critical role in providinghealthcare to Singaporeans, developingmedical services and training local healthcareprofessionals.

Today, TTSH is Singapore’s second largesthospital with a total of 1,499 beds. Itcomprises the main hospital complex at JalanTan Tock Seng and two other campuses: theCommunicable Disease Centre (CDC) alongMoulmein Road and the TTSH RehabilitationCentre housed at Ang Mo Kio CommunityHospital.

TTSH is an acute care general hospital with 17clinical disciplines. Of these, TTSH's specialstrengths are in Geriatric Medicine, InfectiousDiseases, Rehabilitation Medicine, RespiratoryMedicine, and Rheumatology, Allergy andImmunology. It is also a major referral centrefor Emergency Medicine, Diagnostic Radiology,Ophthalmology (Eye), Otorhinolaryngology(Ear, Nose and Throat), Orthopaedic Surgery,General Medicine and General Surgery.

In the midst of the SARS outbreak in 2003,TTSH was designated the hospital treatingSARS patients with specialised equipment toeffectively contain the virus.

Institute of Mental Health/Woodbridge Hospital Originally opened in 1928 as The MentalHospital, the hospital was subsequentlyrenamed Woodbridge Hospital (WH) in 1951.In 1993, WH moved into new premises with

well designed landscape and modern facilitiesfor psychiatric care.

The Institute of Mental Health (IMH) wasformed in the same year as part of WH'sefforts to coordinate and oversee research,training for clinicians in psychiatry and runmental health education programmes for thegeneral public.

Today, IMH/WH is a 2,542-bed acute tertiarypsychiatric hospital offering multi-faceted andcomprehensive range of psychiatric servicestargeting to meet the special needs of children& adolescents, adults, and the elderly.

Specialised clinics and programmes treatmore specific disorders, such as the Stressand Anxiety Clinic, Mood Disorder Clinic,Eating Disorders Clinic, Sleep Disorder Clinic,Sexual Dysfunction Clinic, Early PsychosisIntervention Programme (EPIP) and CommunityAddictions Management Programme (CAMP).

IMH/WH's Community Psychiatric Servicesprovide integrated and accessible care topatients through six outpatient satellite clinicslocated in different parts of Singapore, threeDay Centres running an extensive range oftherapeutic activities, and a team ofCommunity Psychiatric Nurses who offerhome visits.

Its Child Guidance Clinic (CGC) andBehavioural Medicine Clinic (BMC) are co-located in Health Promotion Board (HPB)Building with four other satellite BMCs sitedin various parts of Singapore.

IMH/WH also undertakes clinical researchand teaching. A wide range of mental healtheducation programmes are organised topromote mental wellness and encourageprevention, early detection and treatment ofmental disorders among members of thepublic. IMH/WH's faculty pool of psychiatristsand psychologists are authors of many well-known lay publications on mental well being.

Johns Hopkins-NUH InternationalMedical Centre Johns Hopkins-NUH International MedicalCentre (JH-NUH) is a partnership betweenJohns Hopkins Medicine and the NationalUniversity Hospital (NUH) of Singapore. Itdraws on their common mission of research,education and patient care.

JH-NUH functions as a private hospital withinNUH, providing healthcare managed byJohns Hopkins for local and internationaloncology patients.

Johns Hopkins and NUH physicians workhand-in-hand with Johns Hopkins-trainedoncology nurses to provide high qualityhealthcare to patients with complex medicalconditions in both outpatient and inpatientsettings. Physicians from Johns Hopkins andNUH also collaborate on joint research toadvance medical care and on trainingmedical leaders of the future.

National Neuroscience InstituteNational Neuroscience Institute (NNI) was setup in June 1999 as an international specialistcentre for the care and management ofdiseases affecting the brain, spine, nerve andmuscle, mainly for stroke, epilepsy, dementia,neuromuscular disorders, Parkinson's diseaseand movement disorders, sleep disorders,spine injury and disorders, brain tumours, andhead injury or trauma.

NNI offers a complete range of medicalservices with state-of-the-art medical facilitiesand imaging technologies. It has the onlydedicated Neuroradiology and Neuro-intensiveCare Unit in Singapore.

The institute provides specialist services forthe treatment of neurological diseases atmajor hospitals in Singapore, namely TanTock Seng Hospital, Singapore GeneralHospital, National University Hospital, ChangiGeneral Hospital and KK Women’s & ChildrenHospital.

Incorporated on 15 March 2000, the NationalHealthcare Group (NHG) owns and managesan integrated healthcare delivery network,serving the northern and western parts ofSingapore. Our network comprises thefollowing institutions:

Alexandra HospitalNational University HospitalTan Tock Seng HospitalInstitute of Mental Health/Woodbridge HospitalNational Neuroscience InstituteNational Skin CentreNHG PolyclinicsThe Cancer InstituteThe Eye InstituteThe Heart InstituteJohns Hopkins – NUH International Medical Centre NHG College NHG Diagnostics NHG Pharmacy NetCare Internet Service

With 11,000 staff and $1 billion in annualrevenue, NHG provides a complete range ofhealthcare services, from outpatient familymedicine consultations to surgeries anddiagnostic services.

A Board of Directors comprising professionalsfrom within and without the healthcare sectoroversees and directs the management of NHG.The Board is assisted by five committees:Human Resource, Finance, Audit, IT Steeringand NNI Executive Committees.

NHG is a not-for-profit organisation, withdevelopment, research and buildingprogrammes supported financially by ourEndowment Fund.

Cost effective healthcare services for allThe inevitable result of advanced medicalscience and technology is rising healthcarecosts, due to new cures and medicalequipment for previously life-threateningdiseases. NHG’s challenge is to ensure thebest possible outcome for patients whilekeeping healthcare costs as low as possiblefor all Singaporeans.

To cap rising healthcare costs, the Governmentsubsidises the provision of basic healthcareservices by NHG institutions to lower incomeSingaporeans. The subsidy levels vary accordingto the complexity of the procedure and choiceof accommodation, from 80 percent for C classwards to 20 percent for B1 accommodation.

NHG institutions also provide healthcareservices to full fee-paying private patients whoare allowed to name a specialist of their choiceand are accommodated in airconditionedsingle rooms. Apart from these privileges,private and subsidised patients enjoy thesame quality of care. To ensure adequatebeds for subsidised patients, a cap of 6percent of beds for each hospital areallocated to private patients.

NHG institutions provide financial counsellingto all patients to help them make an informedchoice about their accommodation options.An additional effort to contain healthcarecosts is the maximum cap on revenue earnedby NHG imposed by the Government foreach subsidised patient.

NHG adopts cost management initiatives toensure that costs are kept as low as possiblewithout compromising the quality of care.These include:

Bulk purchasing, bundling and alternativesourcing of drugsRigorous reviews of all major capitalexpenditure items for financial viabilityIdentification and review of clinical supplies,equipment or practices that are of significantcost or volume

Now in our third year of operation, NHG hasset a strategic path for delivering holistichealthcare. In line with our vision to “add yearsof healthy life to the people of Singapore”, we are committed to improving health andreducing illness through patient-centredquality healthcare that is accessible andseamless, comprehensive, appropriate andcost effective, in an environment ofcontinuous learning and relevant research.

Alexandra HospitalAlexandra Hospital (AH) was established in1971. Between 1991 and 2000, it underwentmajor refurbishment and upgrading, equippedwith new modern facilities and expandedmedical services.

Along with a new structure and strategicfocus came a new team of medical andadministrative staff. A stream of innovativeprogrammes has been steadily introduced toprovide patient-centred and holistic qualityhealthcare. An example of this is AH’s Healthfor Life Centre which focuses its operationson pre-emptive health measures, such ashealth screening packages to identify thosewho are prone to illnesses and educationprogrammes on lifestyle and eating habits.

AH believes in providing holistic care to itspatients through the three elements of sight,scent and sound. The pride of AH is its lush,lovingly landscaped gardens, which provide anatural, therapeutic atmosphere for patients –a unique feature among hospitals in Singapore.

National University HospitalSince its inception in 1985, the NationalUniversity Hospital (NUH) has grown into a946-bed, acute-care, tertiary hospital. Itsinpatient facilities comprise 30 wards, sixintensive care units, 20 operating theatres,and one delivery suite with eight deliveryrooms and a four-bed first stage room.

Through 21 clinical, three dental and sixparamedical departments, as well as anumber of specialist outpatient clinics andspecialised service centres, NUH provides acomprehensive range of key services to meetthe growing needs of patients.

NUH strives to deliver appropriate specialisedcare and support to all its patients. As thefirst healthcare institution in Singapore toachieve three prestigious ISO certifications atone time, the hospital is fully committed tosafe quality care and service to its patients,staff and community.

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About NHG

TEI aims to allow medical cross-accreditationbetween hospitals and clinics, continuingmedical education, registrar training, qualityand activity benchmarking and researchactivities.

The Institute also works with organisationssuch as the Singapore Eye ResearchInstitute, National University of Singapore,and clinical research organisations forsignificant clinical research programmesrelevant to our patients.

The Heart InstituteThe Heart Institute (THI) was set up toprovide integrated and seamless medicalcare to cardiac patients, available atAlexandra Hospital, National UniversityHospital, Tan Tock Seng Hospital and NHGPolyclinics.

Medical professionals and clinicians in thevarious medical institutions under THI offer acomprehensive range of cardiac servicesfrom inpatient cardiac treatment in thehospitals to outpatient cardiac support, eg.cardiac rehabilitation and primary carecardiac care in the polyclinics.

The Heart Institute’s role includes:

Care for patients with cardiac conditionsthrough shared care programmesCoordinate the development of cardiologyand cardiothoracic services in the NHGcluster to minimise duplication andinefficienciesSet and maintain common clinical standardsfor cardiology and cardiothoracic services inthe cluster Optimise the sharing of medical expertisethrough cross-credentialling of specialists inthe clusterPlan and conduct cluster-wide educationalprogrammes for patients, nurses, medicalstudents and doctors in the principles andpractice of cardiovascular diseasesCoordinating cardiovascular research acrossthe cluster

NHG CollegeNHG College was formed in July 2002 todevelop staff to their fullest potential andkeep them abreast of the latest developmentin healthcare and medicine.

The aims and objectives of the College are:

To provide an intellectually stimulatingenvironment where the cluster’s topprofessionals and educators come togetherto prepare for higher training and to assumeleadership roles in clinical practice andmanagement To plan, coordinate and / or offer trainingprogrammes designed to take full advantageof the cluster’s integrated research, educationand practice resourcesTo cultivate the culture for lifelong learning toadvance the practice of cost effectivehealthcare

In order to transform these objectives intoprogramme realities, the College is organisedinto three institutes:

Institute of Medical Education & Training (IMET)Institute of Nursing Education & Training (INET)Institute of Management & Allied HealthScience (IMAS)

NHG Diagnostics NHG Diagnostics (NHGD) is a businessdivision of NHG aimed at providing qualityone-stop imaging and laboratory services thatare accessible, comprehensive and costeffective to Singaporeans.

In line with NHG’s belief that prevention isbetter than cure, NHGD provides timely andaccurate imaging and laboratory services toenable intervention of illnesses at as early astage as possible.

NHGD services are manned by well-trainedlaboratory technologists and radiographers,and strongly supported by its strategic partnersin Alexandra Hospital, National UniversityHospital and Tan Tock Seng Hospital.

Its laboratory services are now available at allnine NHG Polyclinics while X-ray services areavailable at the polyclinics in Choa Chu Kang,Clementi, Hougang, Toa Payoh andWoodlands.

NHG PharmacyNHG Pharmacy operates the retail pharmaciesin all nine NHG Polyclinics. It provides a highstandard of pharmaceutical care and offers awide range of affordable, quality healthcareproducts tailored to the customers' needs. It also invests in IT infrastructure to improveoperational effectiveness and quality ofinformation.

Monthly promotional activities, regular publicworkshops and campaigns on healthcare, allpromote greater awareness of the need for ahealthy lifestyle.

NetCare Internet ServicesNetCare Internet Services is an NHG businessunit which runs the NetCare portal – aninnovative patient based e-healthcare service.

NetCare provides personalised healthinformation and services to patients over theInternet, such as their personal medicaldossiers (with information on visit histories,upcoming appointments, outstanding billsand prescriptions), and online medical reportand appointments requests. Patients andprofessionals can pay their bills or register forevents online, and pay for purchases made atthe online pharmacy.

NetCare also supports many healthcareprocesses, especially those requiringcoordination between multiple and disparatehealthcare providers within and outside NHG,such as the e-referral for nursing homes thatNetCare developed for the Integrated CareServices.

NNI aims to be an international training andresearch institute of excellence in the field ofneuroscience. It coordinates and providespostgraduate training, fellowship programmeand continuing medical education for localand overseas graduates. To complement thepatient care services and academic curriculum,NNI also conducts basic, applied and clinicalneuroscience research in Singapore.

National Skin Centre Although it officially began operations on 1November 1988, the National Skin Centre’s(NSC) history dates back to its predecessor,the Middle Road Hospital, a well knowncentre for treating skin and sexuallytransmitted diseases.

NSC is an outpatient specialist dermatologicalhospital with dermatological specialists underone roof, both to facilitate sub specialisation,and to be the national focus of treatment,research and training for all aspects of skindiseases.

The centre aims to be the national andregional referral centre for the diagnosis andtreatment of complex skin diseases. It is alsorecognised as a dermatological trainingcentre for local and foreign skin specialistsand paramedical personnel due to its activeeducational programmes for undergraduates,postgraduates, professionals and the public.

NSC is a restructured hospital running bothsubsidised and private clinics and is committedto providing cost effective, specialised carefor medical skin conditions in an environmentof intensive medical research and qualityeducation.

NHG Polyclinics NHG Polyclinics form the primary healthcarearm of NHG. The nine polyclinics spread overthe northern and western parts of Singaporecater to a large portion of the population.

The focus of NHG Polyclinics’ care is healthpromotion and disease prevention, early andaccurate diagnosis, good management ofdiseases, and the continuation of care of

patients in the community after theirdischarge from hospitals following treatmentof the acute phase of their illnesses.

They work actively with our NHG Hospitalsand Specialist Centres to develop anintegrated and seamless healthcare servicefor NHG Patients. This is typified by the DirectAccess Scheme which has since served asthe model for a similar healthcare networkdeveloped with NHG’s GP Partners.

To ensure that needed Singaporeans havebetter access to family healthcare services,NHG Polyclinics have pioneered the settingup of four Night Clinics, two SaturdayAfternoon Clinics, and lunchtime service at all nine Polyclinics.

Each NHG Polyclinic provides a full andcomprehensive range of health services forthe family including comprehensive treatmentfor acute medical conditions and chronicdiseases incorporating care from the healthcare team such as diabetic foot care servicesincluding podiatry, diabetic retinalphotography care, specialists services suchas obstetrics and gynaecology andgastroenterology.

NHG Polyclinics are one-stop family healthcentres, equipped with good support facilitiessuch as laboratory services, X-ray servicesand mammography and ultrasonograms.Many NHG Polyclinics offer dentaltreatments, and even psychiatric outpatientcare. Pharmacies in NHG Polyclinics carry acomprehensive range of drugs and non-medical items.

NHG Polyclinics is the first primary healthcareprovider to be awarded three internationallyfully recognised integrated certifications,namely ISO 9001, 14001 and OHSAS 18001.These standards ensure a safe andconsistent level of family healthcare for allpatients at all of the nine Polyclinics.

The Cancer InstituteThe Cancer Institute (TCI) aims to providequality professional care to cancer patients

and to champion the screening for, andprevention of the disease, through anintegrated, comprehensive and seamless and efficient system.

TCI's cancer services are available atAlexandra Hospital, National UniversityHospital, Tan Tock Seng Hospital, JohnsHopkins – NUH International Medical Centreand NHG Polyclinics.

TCI fosters a close working relationship withgeneral practitioners, hospices, cancersupport groups, academic institutions andindustry in the following areas:

health screening programmes and publichealth educationeasy, quick access for referrals and diagnosis of cancer specialised multidisciplinary management of cancer cases through the tumour clinicsinvolving primary physicians in the co-management of cancer patientsproviding palliative care to patients andsupport to their familiesencourage interactions between scientistsand doctors to explore new avenues incancer treatmentfacilitate easy access to new and promisingtherapeutics agents from pharmaceuticalcompanies for clinical trials

The Eye InstituteThe Eye Institute (TEI) was established tooversee the provision of eye servicesthroughout NHG as demand for suchservices rises. TEI is available at AlexandraHospital, National University Hospital, TanTock Seng Hospital and NHG Polyclinics.

With the merging and integrating of allexisting eye units and services in NHGhospitals under one umbrella, patients areable to visit the hospital nearest to theirhomes for any eye services.

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NHG a/r 02 f/a 9/12/03 4:37 PM Page 38

41


40

Statistics 2002/03

SOC attendance by institution11

9,11

6

124,

276

106,

044

28,6

44

6,23

2

9,56

9

36,2

38

2,07

1

67,2

67

119,

776

101,

285

5,88

4

28,4

66 36,3

45

8,94

7

64,5

41

2,00

8

119,

854

94,4

76

29,2

81

6,09

6

8,40

9

37,4

26

62,9

67

2,22

6

99,0

38

5,58

0

27,3

82 35,1

98

9,31

7

66,2

55

1,82

3

No. of Attendances

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

Jan 03 – Mar 03Oct 02 – Dec 02Jul 02 – Sep 02Apr 02 – Jun 02

National University HospitalTan Tock Seng HospitalTan Tock Seng Hospital – CDCAlexandra Hospital

Woodbridge HospitalNational Neuroscience InstituteNational Skin CentreJohns Hopkins – NUH International Medical Centre

Inpatient days by institution

0

50,000

100,000

150,000

200,000

250,000


64,0

98 73,1

99

6,49

6 22,6

61

208,

474

208,

960

196,

109

187,

405

14,8

82

601

62,3

05 74,6

04

60,6

68 75,4

50

7,16

6 21,9

83

13,8

99

827 5,26

4 19,9

85

14,8

42

591 5,06

6

22,2

67

12,8

00

72,5

02

60,0

76

697

No. of Patient Days

Bed complement by hospital and class of bed as at 31st March 2003

430

2,19

4

0

500

1,000

1,500

2,000

2,500

ClasslessCB2B1A

133

80

6 9 30 10-

164

196

5 37 68

30

348

368

44

142 21

2

75

120

85

164

38

181

89

11 36 38 42

No. of Beds

Bed occupancy rate by hospital and class of bed

0

10

20

30

40

50

60

70

80

90

100


%

83.6

7

79.8

9 83.6

3

62.1

4

90.5

7

88.8

6

90.0

0

77.9

7

80.7

7

56.1

3

84.7

9

95.5

1

64.0

0

78.5

0

79.0

3

63.8

1

82.8

2

85.0

5

78.0

082.2

7

63.8

0

90.4

8

99.8

2

66.0

0


Woodbridge HospitalNational Neuroscience InstituteJohns Hopkins – NUH International Medical Centre

National University HospitalTan Tock Seng HospitalAlexandra Hospital


National University HospitalTan Tock Seng HospitalTan Tock Seng Hospital – CDC

Alexandra HospitalWoodbridge HospitalNational Neuroscience Institute

NHG a/r 02 f/a 9/12/03 4:37 PM Page 40

43


Trend in polyclinics attendances

193,

329

222,

027

109,

207

194,

029

222,

900

103,

862

186,

956

105,

560

218,

684

211,

097

105,

526

215,

487

0

50,000

100,000

150,000

200,000

250,000


Attendances

Trend in day surgery

No of Day Surgeries Performed

4,94

2

6,82

7

1,84

2

12

5,16

8

7,16

5

2,04

0

14

5,12

2

6,65

3

2,43

1

14

4,92

2

6,65

5

2,43

0

18

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000


National University HospitalTan Tock Seng HospitalAlexandra HospitalNational Neuroscience Institute

AcuteChronicOthers

42


Average length of stay by hospital and class of bed as at 31st March 2003

0

50

100

150

200

250

CB2B1A

No. of Days

3.8

5.0

1.8 4.0

18.7

5.5 7.5

3.4 5.2

4.9

3.3 10

.1

4.3

4.7

5.9 8.0

4.7

25.0

6.0

5.0 7.0

7.9

5.4 7.9

222.

2

Trend in A&E attendances

No of Attendances

22,9

90

33,4

06

11,4

16

22,2

44

33,3

80

22,4

09

32,5

29

24,7

23

10,5

45

32,0

14

11,5

50

11,0

80

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000




National University HospitalTan Tock Seng HospitalAlexandra Hospital

NHG a/r 02 f/a 9/12/03 4:37 PM Page 42

45


Key Financial Information for NHG Group (Proforma)

FY2002 S$'M

Assets by Major CategoriesProperties, Plant and Equipment 428 Trade and Other Receivables 106 Cash and Cash Equivalents 673 Other Assets 63 Total 1,270

Liabilities by Major CategoriesTrade and Other Payables 584 Other Current Liabilities 62 Non Current Liabilities 43 Total 689

Capital/ Reserves by Major CategoriesShare Capital 537 Reserves 44 Total 581

Revenue Breakdown by Major CategoriesNet Patient Revenue 460 Subvention 579 Other Revenue 70 Total 1,109

Expenditure by Major CategoriesManpower 645Supplies and Consumables 173Other Operating Expenses 139Rental and Utilities 71Depreciation 55 Total 1,083

44


Distribution of Staff as at 31st March 2003

12% (1,377)

40% (4,457)

12% (1,364)

15% (1,626)

21% (2,297)

Doctors (1,377)Nurses (4,457)Paramedics (1,364)Ancillary (2,297)Administration (1,626)

Total (11,121)

NHG a/r 02 f/a 9/12/03 4:37 PM Page 44

National Healthcare Group6 Commonwealth LaneLevel 6 GMTI BuildingSingapore 149547

Tel: (65) 6471 8900Fax: (65) 6471 2129www.nhg.com.sg

NHG a/r 02 f/a 9/12/03 4:37 PM Page 46

adding years of healthy life

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