Speech by Dr Janil Puthucheary, Senior Minister of State, Ministry of Health, At the Singapore-international Physiotherapy Congress, One Farrer Hotel, 13 July 2024, 11.00am

Associate Professor Kwah Li Khim, President, Singapore Physiotherapy Association,

Dr Poonam Pal, Organising Chairperson, Singapore-International Physiotherapy Congress 2024,

Distinguished speakers and guests,

Ladies and Gentlemen,

1. Good morning. Thank you for inviting me to join you at the 13th Singapore International Physiotherapy Congress. As someone who has worked with members of your profession, I'm always worried if I'm going to be judged as to whether I was compliant to the rehab programme, was I doing my exercises and maintaining the correct posture, as I recover from my injury. Thank you to the physiotherapists who have helped me. Long may your profession continue to thrive and care for us.

2. This year's conference theme, "Advancing the Frontiers of Physiotherapy: Towards a Healthier SG," highlights the commitment of physiotherapists in fostering a healthier Singapore, working with us in our plans to move upstream, think about a healthier population and put in place measures for preventive healthcare to keep people healthy.

3. Continual learning and redesigning of how physiotherapy is provided is crucial for you as physiotherapists to remain relevant in an evolving healthcare landscape. Today, I will speak on three areas of change. First, how we empower our residents, clients and patients towards preventative care. Second, what we are doing in terms of a national structure to enable timely, data-driven and person-centric care, and third, taking charge of the change that needs to happen for better care.

Self-empowerment for better health

4. To empower Singapore residents to take active steps towards preventative care, we launched Healthier SG last year. Transforming our healthcare system by taking a proactive approach in preventing illnesses. What we want to do is to empower everyone to adopt healthier lifestyles, build relationships of trust with their healthcare providers, and as far as possible, manage their chronic diseases in the community, closer to home.

5. Singaporeans are encouraged to enrol with a family doctor and together co-develop a personalised health plan based on their health conditions and support them to take action towards achieving their health goals. And for the residents to have the Health Plan available with them via the HealthHub app, a digital platform which provides health information, and interfacing with the care plan and care records that their healthcare providers will access and use to guide them.

6. In alignment with Healthier SG, physiotherapists can and I hope, do emphasise more on preventative care and holistic well-being. You are experts in human movement science and advocates for healthy living through physical activity, and you are well positioned to care for the patients far beyond the hospital setting. You can and you do empower people to make informed decisions about their health, to self-manage in certain conditions and situations where it is appropriate to do so. For example, the MOH Musculoskeletal Workgroup, which includes physiotherapists from the healthcare clusters and community care organisations, has developed Musculoskeletal Patient and Family Education Materials and leveraged technology by publishing them on HealthHub app. These type of resources include self-help tips and guidance, and exercise videos to be conducted at home, for those with mild chronic conditions, and conditions which affect large numbers of people, such as low back pain.

7. As part of what we are doing for Healthier SG, we hope that Singaporeans will access information on suitable lifestyle activities and track their healthy lifestyle behaviours such as step count and physical activity, and again trying to provide them with the means to do so through apps like the Healthy 365. The Singapore Physiotherapy Association (SPA) has been working with the Health Promotion Board to review home exercise videos for seniors on the app. These exercise videos include a range of exercises suitable for seniors at different fitness levels, allowing them to track their physical activity levels and enjoy the convenience of these interventions within their home. It is that participation with the professionals in your community, that will make sure that these are therapeutic interventions that address the needs of our clients and patients in an effective way.

8. SPA also participates actively in various health screening initiatives. For example, they work with the National University of Singapore and Singapore Institute of Technology and participating in the Public Health Service's annual health screening. Held in the heartlands such as community clubs, these allow physiotherapy students and physiotherapists to conduct mobility screening, give general advice on physical activities and falls prevention strategies, and to especially focus these efforts on older residents and help them make adjustments for healthier and safer lifestyles.

Redefining rehabilitation - A more harmonised and seamless approach

9. Even as we empower people to manage their own health, we also have to support you, the professionals, to provide good rehabilitation those who need it. So we have a national structure to enable timely, data-driven, and person-centric care. This is part of our commitment to create an accessible and quality healthcare system, and MOH has worked with clinicians, academics, and other national agencies to develop the National One-Rehab Framework.

10. One-Rehab aims to help people receive the right care, at the right time and place throughout their rehab journey. We will improve access to rehab care by recommending standardised rehab pathways and criteria to guide resource allocation, and tracking harmonised end-to-end rehab outcomes. By considering each patient's unique rehab needs and circumstances, as well as their own goals and aspirations, we can develop a seamless rehab care plan, tailored to each patient and client, to help them get the most appropriate rehab closer to their home and improve their quality of life, as one combined collaborative health and social profession.

11. These care plans will be supported by data provided by clinicians such as yourselves. These data allow us to then analyse and look at how we have improved rehab outcomes, and where we have perhaps some way to go. In the longer term, we can use the data to benchmark ourselves against international rehab standards.

12. Data is only useful if it's collected correctly. To date, close to 2,000 healthcare professionals have attended One-Rehab workshops, which aim to help clinicians use the framework, to align their understanding of One-Rehab and its philosophy, and ultimately allow us to collect high-quality, appropriate data. Of course, many of these attendees at these sessions have been physiotherapists.

13. To further enhance rehab in the community as we right-site care, we have also formed a One-Rehab Community Rehabilitation Transformation Workgroup. Our recommendations are three groups - (i) around evidence-based clinical practices, starting with stroke rehab, (ii) guidance on how practitioners and employers can work together to co-drive professional development and to create a conducive workplace for learning, and (iii) third group is support mechanisms for more value-based rehab care, including how providers can help their clients participate fully along their rehab journeys towards their goals. These recommendations will help organisations and clinicians to in turn help their clients and caregivers to regain their function and independence in a way that is meaningful to them.

Taking charge of the change to be made

14. While Healthier SG and One-Rehab were initiated by MOH, the ground-up initiatives led by the professions and professionals are just as important. You as a community of physiotherapists are in a good position to identify care needs and use holistic approaches that directly address these needs.

15. For example, SingHealth, NHG and NUHS jointly organised the Visiting Expert Programme on designing holistic exercise programmes for those with chronic conditions.

16. Following recommendations from the Visiting Expert, physiotherapists from the three clusters are now collaborating with ActiveSG, the Singapore Institute of Technology, and training providers to train health and exercise professionals, fitness champions and well-being coordinators. So you have identified the training gap and opportunities, with the profession just next to yours, and extending your care, expertise and interventions into the wider community through adjacent professions and interventions. We at MOH very much would like to see more of these profession-driven needs assessment, identifying training gaps and interventions, and I think that makes sure that these are things that our residents, clients and patients really need. What we try to achieve with ActiveSG is to establish a support network for stroke survivors to remain physically active and to live well, to reintegrate into the activities of the day. With this consolidation of knowledge, expertise, ground-up initiatives and national efforts, Singapore has the potential to be in the forefront of rehab care, in this example, post-stroke rehab targeting physical activity and exercise, very important for this particular group of patients.

17. I am heartened to see in your materials, there is a list of very wide-ranging presentations encompassing different aspects of physiotherapy in this year's Congress. From changing models of care through cross-disciplinary collaboration, to harnessing technology like tele-rehab and gamified wearables, these wide variety of innovations show your commitment of your profession and colleagues to improve care in Singapore.

Closing

18. In closing, I would like to thank the physiotherapy community for supporting this collective vision towards a healthier Singapore. We hope we can continue to strengthen our partnerships, and deliver a resilient and value-based healthcare system for our people, whether they are healthy or suffering from an illness, and take that approach towards our entire population. Thank you.