CGH’s GPFirst scheme sees 10% drop in non-urgent A&E cases

SINGAPORE — A programme by Changi General Hospital (CGH) aimed at getting those who are mildly ill to consult their general practitioners (GPs) first instead of heading straight to the hospital has seen some promising results.

Since its implementation in late January, the hospital has seen a drop of 10 per cent in non-emergency cases at its emergency department, freeing up resources to deal with more serious cases. The median wait time for what CGH calls Priority 2 (P2) cases — typically fractures, lacerations or pneumonia — has shortened from 29 to 24 minutes. Overall, total Accident and Emergency (A&E) attendance has fallen 8.6 per cent and the number of self-referrals has fallen 11.8 per cent.

Before implementing the scheme, the hospital saw about 450 non-emergency patients at its A&E each month for issues as minor as cuts, a cough or cold and even constipation. Since their cases were not considered urgent, patients with such conditions could end up waiting for more than two hours for treatment. On average, CGH sees about 11,700 cases at its A&E department each month.

Under the GPFirst scheme, CGH encourages non-emergency cases to visit any of its 157 GP partners in the eastern part of Singapore. If the GP determines that a visit to the A&E is necessary, he or she will refer the patient to CGH and the patient will get a S$50 subsidy towards the A&E fees.

CGH hopes to extend this scheme to the remainder of the estimated 280 GPs in the east.

A GP is able to attend to many non-emergency cases, from stitching up cuts quickly with a glue gun to managing mild dengue cases.

Dr Lim Kim Show, medical director of Bedok Family Medicine Centre, said at a media conference yesterday that he could run blood tests for suspected dengue cases in 15 minutes to an hour and, if a case does not appear serious, the patient can head home and return to the clinic for another blood test the next day.

Added Professor Mohan Tiru, CGH’s chief of A&E: “I think one of the important things is for patients to form a relationship with their family practitioners … Instead of going to the emergency department for every small thing, now they see one regular doctor who knows them, their problems, their history and their family history.”

Associate Professor Lee Kheng Hock, president of the College of Family Physicians Singapore, told TODAY this change in the way patients use the healthcare system could free up beds in hospitals.

Having a go-to GP can help patients better manage their condition, especially those with chronic illness, thus reducing the likelihood of their needing to be hospitalised, he said.

CGH said it had shared its numbers and programme information with the Health Ministry and other health clusters.

Next month, the Eastern Health Alliance, which manages CGH, will launch a mobile app for GPs on 12 commonly-seen medical conditions that can help them decide whether to refer a patient to A&E.