SingHealth Impact Report 2024/25

2011

Eastern Community Health Outreach (ECHO) programme launched
The Eastern Health Alliance first introduced the ECHO programme in Changi-Simei - a caring initiative that brought health screening and personal health coaching right to our community’s doorstep. Building on its success, we expanded the programme in 2012 to reach residents in Tampines and eventually all 17 constituencies in the East.

2013

Introduction of Community Coordinators/Community Assistants (2023: Redesignated as Wellbeing Coordinators [WBCs])
Our SingHealth WBCs are dedicated health and social-care integrators who provide holistic, person-centred care for residents. Today, we have 100 WBCs working as part of multi-disciplinary teams across diverse care settings. Most of these caring professionals serve in our SingHealth Healthier SG (HSG) teams, where they connect with residents through home visits and at Community Health Posts (CHPs).

2014

Introduction of Patient Navigators (PNs)
PNs provide vital support to residents, especially seniors with complex health and social needs, guiding them through the healthcare system and ensuring smooth transitions between different types of care. Through their dedicated work, we see fewer hospital readmissions, enabling more residents to receive care comfortably in the community while better managing their health conditions.

SingHealth RHS Office established
Regional Health Systems are part of a nationwide effort to drive population health and deliver appropriate integrated care in the right setting, at the right time. To support this important work, the RHS Office was established to coordinate and oversee the various programmes under our care.

GPFirst programme established
GPFirst, an initiative by Changi General Hospital (CGH), encourages residents in the East to visit their trusted General Practitioners (GPs) for mild to moderate medical conditions, instead of going straight to the emergency department.

2015

EAGLECare (Enhancing Advance Care Planning, Geriatric Care and End of Life Care in Nursing Homes in the East) established
EAGLECare, established by CGH, partners with nursing homes to provide compassionate support in advance care planning, geriatric, geriatric care and end-of-life care. Through this programme, nursing home residents receive personalised care that respects their wishes and preferences, helping them stay comfortable in familiar surroundings and avoiding unnecessary hospital visits.

The team’s dedication was recognised with the National Clinical Excellence Team Award 2023. Their commitment to dignified care showed remarkable results from 2020 to 2022: they honoured 99% of enrolled residents’ treatment preferences and helped 91% of residents fulfil their wish to spend their final moments in their nursing home.

2016

ESTHER Network Singapore launched
ESTHER Network advocates a philosophy of person-centred care, focusing on what matters to residents with complex care needs. Our goal is simple: to help residents to live confidently and independently in the community. Our ESTHER coaches - health and social-care providers who work closely with residents – ensure that the care provided aligns meaningfully with the residents’ life goals.

CareLine launched
CareLine, a personal care telephone service pioneered by CGH, provides round-the-clock health and social support to vulnerable seniors who need urgent assistance. We are proud that more than 20,000 seniors have enrolled for the service. Working hand-in-hand with 131 community partners across Singapore, we help our seniors safe and healthy in the comfort of their own home.

2017

Official introduction of SingHealth Community Nurses
Our Community Nurses bring care right to our residents’ doorsteps through various Ministry of Health (MOH) RHS programmes. These include the Hospital-to-Home Programme, which helps residents transition smoothly back home after hospital stays, and the MOH RHS-led Community Nursing Pilot.

First Community Nurse Post (CNP) launched in the East (2023: Renamed CHPs)
CHPs are touchpoints in the community for residents to access healthcare services and nursing consults. They are conveniently located within Active Ageing Centres, Community Clubs, Residents’ Network Centres or other public spaces within the neighbourhood.

SingHealth Partners Primary Care Network (PCN) officially appointed
The PCN scheme brings private GP clinics together to provide more comprehensive, team-based care for our community. Through these networks, patients benefit from the combined expertise of healthcare teams working together to help them manage their chronic conditions.

As of 2025, ten PCNs serve residents across Singapore, with SingHealth Partners PCN being the largest, comprising 287 HSG PCN GP clinics.

Reorganisation of RHS Office to SingHealth Office of Regional Health (SORH)
To better meet the health and social needs of residents, our renewed priorities are:

Keep Well: Keeping the population well through health promotion, education and screening
Get Well: Facilitating timely discharges and seamless transitions for patients moving from acute hospitals and specialised outpatient clinics to primary and/or community care settings
Age Well: Helping our seniors age with confidence and ensuring they remain well-supported in the community

2019

Establishment of the SingHealth Community Hospitals Office of Learning (SCHOOL)
SCHOOL augments our efforts to provide integrated health and social care for our community. Working closely with partners like the Agency for Integrated Care, and Institutes of Higher Learning such as the Singapore University of Social Sciences and Ngee Ann Polytechnic, SCHOOL develops and delivers valuable training programmes for community health and social workers and volunteers.

SCHOOL has equipped more than 1,000 learners from the health and social care sectors with skills to better serve our community.

Launch of SingHealth Community of Practice in Social Prescribing (SCOMP) by SingHealth Community Hospitals (SCH)
In 2023, SingHealth Community Hospitals introduced the SCOMP platform to foster a dynamic and collaborative ecosystem where health and social care providers work together to advance social prescribing in the community. Today, close to 1,000 health- and social-care practitioners have joined this community as members.

2021

HealthUP! pilot launched in Tampines
HealthUP! empowers residents to take charge of their health and wellbeing, working closely with trusted partners like Sport Singapore, the Health Promotion Board and People’s Association. Through this initiative, residents benefit from personalised preventive health recommendations, enjoy access to a wide range of healthy living activities and health trackers, and receive support from our dedicated WBCs.

2022

Rollout of Mobile Inpatient Care-at-Home (MIC@Home) services
Through this initiative, eligible patients can receive hospital-level care in the comfort of their own homes. The hospital’s care team provides comprehensive care through remote clinical monitoring, 24/7 access to the clinical team via video or phone calls, regular home visits and home treatment. Since 1 April 2024, this service has been fully implemented across four SingHealth institutions, bringing quality care closer to home.

2022

SingHealth Centre for Population Health Research and Implementation (CPHRI) officially launched
CPHRI is SingHealth’s nexus for population health research, innovation, implementation science and evaluation. Its five strategic themes focus on important population segments across life stages:

Maternal and child health, and vulnerable adolescents
Hypertension and diabetes
Complex needs
Pre-frailty and frailty
Ageing in the community

Community Ageing in Place Ecosystem (CAPE) project, led by CPHRI in partnership with AIC, the Housing & Development Board and Singapore University of Technology and Design
The multidisciplinary and multi-sectoral project brings together different expertise to create supportive environments for seniors in their existing neighbourhoods, with an in-built process to evaluate these ecosystems. Currently piloting in Marine Parade and Bedok, the project addresses the challenges of a declining old-age support ratio through social and healthcare integration, built environment modifications, and strategic technology implementation to support healthy ageing and assisted living.

1st Asia Pacific Social Prescribing Conference and launch of SCHOOL
Organised by SCH, the conference brought together international social prescribing practitioners and local population health experts to improve social prescribing practices and encourage more care providers to include social prescriptions in their care plans.

During this inaugural conference, we officially launched the SingHealth Community Hospitals Office of Learning (SCHOOL), which was first established in 2019.

2023

SingHealth Centre of Person-Centred Care (CPCC) launched
The CPCC transforms healthcare by focusing on a person-centric approach, aimed at delivering health and social care that truly matters to patients. It brings together SingHealth’s person-centred care initiatives, promoting this approach through staff and patient education, while expanding person-centred care practices and efforts across our health system.

During this inaugural conference, we officially launched the SingHealth Community Hospitals Office of Learning (SCHOOL), which was first established in 2019.

HealthUP! officially launched
The movement has since expanded to Changi, Simei, Siglap, Bedok and Chai Chee.

Reorganisation of Community Nurses and WBCs into SingHealth HSG Teams, in support of the national HSG initiative
In July 2023, our Community Nurses and WBCs joined forces as part of multi-disciplinary SingHealth HSG Teams. They work closely with Primary Care Providers and Community Care Providers to provide place-based integrated care right where our residents live, helping them achieve their health goals in the community.

2024

Family Nexus@Punggol launched
Family Nexus@Punggol is a welcoming one-stop centre nestled within Punggol Polyclinic that integrates health services with navigation to relevant social services and programmes. Families visiting the polyclinic can easily discover and access various health and social programmes, all conveniently located under one roof.

Family Nexus@Our Tampines Hub launched
A one-stop wellness hub with community-based health and social services programmes, conveniently co-located to support families in the region. It also serves as a community space for families to meet, interact and build connections with each other.

SingHealth EatWELL Strategy launched
The Strategy, developed from the national EatWise framework, makes it easier for our community to access affordable, seamless and comprehensive nutrition care. Through this approach, we aim to help residents stay healthy by reducing chronic diseases and malnutrition, while adding more healthy years to their lives and improving their overall wellbeing.