Incidence of Patients Waiting for Triaging at Hospital Emergency Departments and Public Education Efforts Launched

7 Mr Yip Hon Weng asked the Minister for Health (a) whether an update can be provided on the situation where ambulances are delayed as patients cannot be triaged by hospital staff due to peak caseloads at hospitals’ emergency departments; and (b) what are the Ministry’s measures and strategies to inform the public to seek medical assistance away from hospitals’ emergency departments in non-emergency cases.

The Senior Minister of State for Health (Dr Janil Puthucheary) (for the Minister for Health): Sir, our hospital emergency departments, while busy, are able to triage patients promptly to prioritise treatment for urgent cases and preserve valuable medical capacity.

Sometimes, a hospital emergency department may face a spike in urgent cases, for example, when the hospital is handling multiple patients from a major incident. In such a case, protocols for ambulance diversions to other hospitals will be activated. Occasionally, a number of ambulances may arrive at the same emergency department at approximately the same time. In such situations, other than ambulance diversions, the hospital will work with the ambulance crew to triage and activate additional hospital resources to unload the ambulances as expeditiously as possible.

Currently, 40% of emergency department attendances are not life-threatening nor urgent. To encourage these patients to seek care at the general practitioner (GP) clinics for non-urgent conditions, the Ministry of Health (MOH) introduced the GPFirst programme in 2014. Under this programme, if the patient is first seen by a participating GP and is assessed to require further care at the Accident and Emergency (A&E) department, the hospital will reduce A&E fees by $50. Currently, more than 1,000 GP clinics, including all Healthier SG clinics, participate in the GPFirst programme.

MOH has also set up Urgent Care Centres for urgent but non-life-threatening medical conditions, and NurseFirst, a non-emergency helpline where residents can receive useful medical advice.

Mr Speaker: Mr Yip.

Mr Yip Hon Weng (Yio Chu Kang): I thank the Senior Minister of State for his reply. I also note that the Health Minister had shared at the MOH Committee of Supply that he is working with urgent care clinics as well as GPFirst clinics to deal with non-emergency cases.

My supplementary question is this: since we are a very digitally connected country, is the Ministry exploring partnerships with telehealth providers to create a more accessible and efficient healthcare network for non-emergency cases? And secondly, are there any best practices from other countries that can be adapted to inform Singapore's public awareness campaigns for seeking appropriate medical care?

Dr Janil Puthucheary: Sir, the short answer is yes to the first part. Telehealth is something that we spoke about at some length within the Committee of Supply debate and we will continue to explore partnerships with telehealth providers to see how we can make that available as a channel for health-seeking behaviour.

As for best practices from around the world, certainly, we are studying what is being done in the public health education space. We also have to contextualise such messages and public education campaigns for our local context. Each city and each healthcare system is different, but the way in which people have a relationship with their GP, have a relationship with the hospitals or the way in which they seek help when they are unwell will be culturally contextual, will be appropriate to our social context.

We will look at those best practices, but the most important aspect is that we continue to reinforce locally some key messages – which is that you should reserve going to the emergency department for urgent, certainly, serious and life-threatening cases. We should call the ambulance for urgent, serious and life-threatening cases.

And for things which are not urgent, conditions that have been there for a while, which are clearly not serious or life-threatening, then we should consider accessing some of the other channels that I spoke about in my reply. NurseFirst, which is a helpline for seeking advice from an experienced nurse practitioner; attending an urgent care clinic; seeking help from a GP or a polyclinic; not going by ambulance to a hospital emergency department for conditions which are not urgent, not serious and not life-threatening.