Number of eldercare centres to be doubled by 2025, expand their services

Singapore aims to almost double the number of eldercare centres to 220 by 2025 as the Ministry of Health (MOH) expands the scale and scope of the services of such centres.

MOH also plans to double the number of nursing home beds to more than 31,000 in the next 10 years.

Between 2010 and 2020, MOH had raised capacity by 70 per cent to 16,200 beds from about 9,600, said Health Minister Ong Ye Kung on Monday morning (June 13).

He was speaking at the Agency for Integrated Care's (AIC) annual Community Care Work Plan Seminar, a hybrid event held at Pan Pacific Singapore. AIC was set up by the Government to coordinate eldercare services.

With Singapore facing an ageing population, where many more aged sick will need to be looked after, eldercare centres will take the pressure away from the acute hospitals and nursing homes, he said.

The pool of community care providers will also need to be beefed up.

To date, Singapore has 119 eldercare centres.

They are go-to points for seniors, and provide services such as active ageing programmes, befriending and information on and referral to care services.

But the scope of eldercare centres will be increased, Mr Ong said.

Eventually, each centre should be responsible for 1,000 to 4,000 seniors, and work with community networks such as grassroots organisations and general practitioners (GPs) to address seniors' health and social needs.

Currently, seniors visit their GPs or polyclinics once every few months for their chronic conditions. In between these visits, they can go to these centres to take part in health-related activities or enrol in active ageing programmes.

But MOH would like these centres to help seniors monitor their vitals, do simple health screenings and link up with other service and healthcare providers, Mr Ong said.

The escalating strains of an ageing population have impacted the community care sector tremendously, he said, adding that this sector has grown significantly over the years and will continue to do so.

There is also a need to expand good-quality end-of-life care at home, in centres and in hospices, said the Health Minister.

"Over the last few years, we have tested and integrated new models of care between hospital and home. We will have to do more for palliative care to be further anchored in the community," Mr Ong said.

And nursing homes will be a key partner.

"Nursing home residents will not want to go through multiple transitions to hospital and back towards the end of their lives, as it can be very distressing," he noted.

MOH will work with the nursing homes to build up their staff's skills and confidence in managing end-of-life journeys, including attending to residents' health symptoms, facilitating advance care planning and providing emotional support to residents and their family members.

In his speech, Mr Ong cited manpower constraints as a major concern for community care providers. The sector needs to retain as well as attract new staff.

First, salaries must be competitive. MOH's Community Care Salary Enhancement exercise has committed about $290 million to raise the pay of community care organisations' staff from 2020 to 2023.

"This will ensure that their salaries remain competitive against the public healthcare sector and the market," Mr Ong said.

Second, MOH and AIC will continue to invest in skills development of the sector's workforce. AIC's learning institutes have scaled up their offerings, with more than 18,000 training places available annually.

Third, MOH is also working on transforming existing roles through job redesign for non-clinical manpower and digitalisation, to increase productivity and value of the jobs.

MOH is embarking on a Community Care Digital Transformation Plan to help remove repetitive and administrative tasks, Mr Ong said.

Finally, Singapore will still need to rely on foreign healthcare workers. This will help to complement the local workforce.

"I am a big believer in using technology and digital health to improve preventive care, but community care is inherently a very high touch sector. There is a limit to replacing physical manpower with technology and digital solutions," Mr Ong said.

He also stressed the need for the community care sector to be Covid-19-ready.

The pandemic has affected seniors to a larger extent, with the community care sector bearing disproportionate responsibility for it. This sector must stand ready to deal with new infection waves, new variants of concern or even a new pandemic, he said.

Since February, more than 4,700 nursing home residents infected with Covid-19 have been cared for on site.

Currently, more than 80 per cent of nursing homes, including the two inpatient hospices, are under the Care@Nursing Home programme.

Mr Ong added: "MOH hopes to work with the remaining homes so that by the time the next wave arrives, they are all ready.

"For residents who are at higher risk or have more complex conditions, be assured that they will still be transferred to acute hospitals."

Nursing homes also must continue to actively accept transfers of patients from acute and community hospitals. Since April, the sector has been accepting about 300 new admissions each month from acute and community hospitals.

Most importantly, Singapore needs to ensure that seniors get their booster shots.

For those above 60 years old and have not received their primary series, the incidence of severe illness and death after Omicron infection is almost close to four in 100. For those not boosted nine months after their primary series, the incidence rate is one in 100. For those boosted, the incidence rate drops to three in 1,000.

"Omicron is therefore a dangerous disease for seniors who are not fully vaccinated and boosted," Mr Ong said.