Singapore hospitals resume elective surgery deferred due to Covid-19, take steps to cut duration of stay

Hospitals had first deferred non-urgent or elective procedures in February 2020. - The Straits Times/ANN

SINGAPORE, March 26 (The Straits Times/ANN): Non-urgent elective operations that were deferred during the pandemic have resumed in the past year as the Covid-19 situation here improved, said the Ministry of Health (MOH).

Hospitals cut back on elective procedures amid an increase in Covid-19 hospitalisations caused by the BA.4 and BA.5 sub-variants, Health Minister Ong Ye Kung said in July 2022.

Hospitals had first deferred non-urgent or elective procedures in February 2020 before these were gradually resumed after the April-June circuit breaker.

Hospitals and specialist outpatient clinics were again asked by MOH to free up their capacity in May 2021 by postponing non-urgent operations and appointments.

Urgent medical attention was still given to those who required it.

Hospitals in Singapore reported a bed crunch during the coronavirus pandemic. Data from MOH shows demand for beds remains high.

MOH told The Straits Times that most public hospitals and national specialist centres reported around 3 per cent to 5 per cent postponement of non-urgent procedures in 2021, based on available data.

Singapore’s three healthcare clusters – SingHealth, the National Healthcare Group (NHG) and the National University Health System (NUHS) – said they are now performing elective procedures that had previously been deferred.

They did not specify how many non-urgent elective procedures were delayed due to Covid-19, or how many have since been performed.

However, NHG medical board group chairman Lim Tock Han said the group has attended to most of its non-urgent elective operations by increasing its capacity for day surgery and short stay ward beds.

Professor Terrance Chua, group chairman of the SingHealth medical board, said SingHealth institutions have progressively rescheduled such procedures.

Some hospitals that evolved their procedures during the pandemic continue to use these to keep ward capacity and resources available to meet any surge in demand, such as in another outbreak or pandemic.

NUHS said it developed new initiatives supported by technology and service innovations, such as teleconsultations and its NUHS@Home recovery programme, which offers some patients the option of receiving acute hospital care and services at home instead of at the hospital.

Other hospitals have ramped up the use of minimally invasive methods for elective procedures, which require patients to stay in the hospital for less than a day, thus helping to free up beds for those facing more serious conditions.

During the pandemic, Alexandra Hospital expanded the use of keyhole surgery, where procedures are performed through a small incision in the skin, for more complex operations.

Retired warehousing executive Nah Siow Khoon said he had felt some discomfort in his bladder area in early 2020, and was diagnosed with groin hernia in February that year.

The 86-year-old, who has a history of pneumonia, was scheduled to undergo surgery in March 2020, but this was pushed back due to the Covid-19 situation.

He eventually had a keyhole procedure done in October 2020, which alleviated his pain and left him with just a small scar, which he compared to the size of a mosquito bite.

Most complex groin hernia cases are typically done as traditional open operations, which entail longer post-operation hospital stays, taking up inpatient beds and resources, said Alexandra Hospital deputy head of general surgery Sujith Wijerathne.

But new less invasive procedures allow for 95 per cent of cases to be discharged on the same day with no surgical complications, he added.

“We are doing more and more complex cases as day surgery nowadays,” Dr Sujith said.

“Patients are benefiting from that, and it decreases the burden on the inpatient set-up that our restructured hospitals have.” - The Straits Times/ANN