Community health centres: More than a supporting role

Community health centres: More than a supporting role
Ms Kuah, a long-time diabetes patient, used to visit a polyclinic but has now switched to a community health centre. She is one of about 13,000 patients who have benefited from the nursing and allied health services provided by CHCs.
PHOTO: The Straits Times

A few months ago, Ms Kuah Lay See, 55, went to her family doctor for a check-up and was advised to go for an eye screening.

The long-time diabetes patient knew the score - she had been to a polyclinic before to check for damage to the retina.

Diabetes can affect the small blood vessels in the eye, and this may lead to blindness.

But her doctor referred her to a community health centre (CHC) in Jurong East. It was the first time she had heard of the place. There, she got her eye scan and blood test done very quickly, said Ms Kuah, who works for an organic food produce retailer.

The results were sent to her general practitioner (GP) within two weeks for review and follow-up.

"I was a bit flustered because I couldn't find the place at first," she said in Mandarin. "But the staff were friendly; they asked me to rest and have a drink before doing the test. It was like seeing a friend."

Ms Kuah is one of about 13,000 patients who have benefited from the nursing and allied health services provided by CHCs, which were set up to support private GPs in managing patients with chronic ailments.

The first centre was set up in 2010, and there are now six islandwide, including a mobile clinic, run by different operators.

Services include diabetic retinal photography, diabetic foot screening and nurse counselling on topics like diet and medication. Some centres may offer additional services, such as diagnostic imaging.

Patients must be referred by their GP to use the services at a CHC, which does not accept walk-ins. They pay about the same rates as they would at a polyclinic. People who are on the Community Health Assist Scheme can also use their card to enjoy subsidised rates.

The Agency for Integrated Care (AIC) oversees the development of all the centres.

CHCs can play an important part in community care - except that many patients and doctors are unaware of them. Dr Wong Kirk Chuan, AIC's deputy chief executive officer, said "more can be done to publicise the services and locations of the CHCs".

"We are widening the information-sharing to include our grassroots partners," he said.

"It is our hope that as the awareness of CHCs and their services widens, the number of referrals will grow further."

So far, the service has been publicised in healthcare publications, e-newsletters and the Singapore Silver Pages, an online resource for community care, said Dr Wong.

The CHCs are also contacting GPs in their respective neighbourhoods to promote their services.

Sata CommHealth, which runs the Jurong East CHC, makes regular visits to GP clinics to engage and inform doctors about its services.

This has helped to widen its network of GPs who refer patients to the centre to 63, up from 41 in 2014, and a far cry from when it began operations in 2013 with only six doctors referring patients.

The effort has translated into more patients - last year, the centre handled an average of 92 a month, compared with the monthly average of 21 for November 2013 to December 2014.

Physiotherapy is the service most in demand, making up 74 per cent of referrals. This is followed by diabetic retinal photography at 14 per cent and diabetic foot screening at 9 per cent. "It is encouraging that our referral numbers went up by quite a lot last year," said Ms Seet Kuen Noi, senior operations manager at Sata CommHealth. "But it is still below what we are able to do. We can see more patients, and hope to see more."

To boost awareness among residents and GPs, Sata CommHealth will be holding its first "open house" for the Jurong East CHC later this month.

One GP who recently started referring patients to CHCs is Dr Pauline Neow, who practises at Mei Ling Clinic in Queenstown. She has referred about 10 patients since March, mostly for diabetic retinal photography.

Previously, she would refer them to the polyclinic.

About two or three patients were found to have abnormalities after getting tested at the CHC - including Ms Kuah, who is due to see an eye specialist.

Dr Neow said: "My patients were a bit sceptical at first. They had never heard about the CHC.

"But the feedback from them so far has been very positive."

For instance, it is easy for patients to get an appointment at their preferred time and date.

Going there is convenient too, as she can refer patients to a centre that is near their home, or when the mobile clinic is scheduled to be in the patient's neighbourhood.

"I just look at the schedule provided online and choose a date when the bus is parked at the patient's doorstep," said Dr Neow.

Another plus point is the short waiting time. When Ms Kuah went to the polyclinic for her eye test, the process took a few hours.

"I had to take one day of leave to go to the polyclinic, even though I did not need to see a doctor there."

But she was able to sidestep this problem at the CHC, as she was given an appointment on a Saturday.

"For a routine check-up or test, I think going to the CHC is more convenient and faster," she said.

This article was first published on January 5, 2016.
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