Key changes to the palliative-care sector

SINGAPORE - The palliative-care sector has been given a booster shot, with the Ministry of Health (MOH) investing in four areas - improving the quality of care, expanding services, ensuring affordability and raising awareness.

Health Minister Gan Kim Yong announced this at the sixth Palliative Care Conference at Singapore Polytechnic on June 28.

Today, between 5,000 and 6,000 people receive three types of palliative care - inpatient service, day-care activities and home-care assistance - in the community, said an MOH spokesman.

MOH projected that by 2020, more than 10,000 will require palliative care. Here are the key changes announced by Mr Gan:

National Guidelines For Palliative Care

This new document spells out what is required for individualised patient care; how caregivers and families should be supported, including the bereavement period; what is required for good staff and volunteer management; and what is needed for safe care.

MOH will partner the Singapore Hospice Council, the umbrella body for palliative care in Singapore, to promote and implement these guidelines in different care settings.

Care providers will get help to meet these guidelines, such as through voluntary self-assessment tools, staff-training programmes and quality-improvement projects.

Manpower and training

From this month, a new graduate diploma in palliative medicine will allow more doctors to be trained in palliative care. The one-year part-time course is launched by the Chapter of Palliative Medicine Physicians, in partnership with the division of Graduate Medical Studies at the National University of Singapore.

Home-care capacity

The capacity of home palliative care will be increased by at least 1,000 more places by 2020, up from about 5,000 now.

Services will also be extended to patients with end-stage organ failure and not only to cancer patients.

Inpatient capacity

Beds for palliative care will be increased to at least 360 by 2020, from just 147 now. There are also plans to set aside more beds in community hospitals for patients on palliative care.

End-of-life care at nursing homes

Staff at 14 nursing homes will be trained in advance care planning, geriatric care and end-of-life care.

The homes have a total of 2,800 beds. The training will be conducted by the National Healthcare Group and Alexandra Health System.

Medisave withdrawal limits

From Jan 1 next year, the daily withdrawal limit for those staying in hospices will go up from $160 to $200, and the lifetime limit for home palliative care will rise from $1,500 to $2,500.

However, this cap will be lifted for those with terminal illness, such as cancer or end-stage organ failure. These patients can use as much as they want from their Medisave accounts.

Home palliative care funding

From this month, home palliative care providers will be funded based on the number of patients they look after, instead of the number of visits they make, reflecting a shift of focus on outcomes.

This move enables providers to plan and deliver patient-centric services. They also get greater flexibility to test new models of care.

Public education

The Agency for Integrated Care will work with voluntary welfare organisations to raise awareness of advance care planning, with an aim of reaching out to 1,500 seniors in the community.

It also aims to train at least 150 people at voluntary organisations in the next three years as advocates for advance care planning.

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