SAF Medical Governance System

The Singapore Armed Forces (SAF) Medical System is underpinned by a three-tier medical governance framework. This comprises the SAF Medical Advisory Board, the SAF Specialist Advisory Boards and the SAF Visiting Consultants.

The SAF Medical Advisory Board (MAB) is chaired by Professor Tan Ser Kiat1 and consists of medical professionals who hold senior management appointments in Singapore's healthcare clusters and restructured hospitals. The MAB advises the SAF on key medical policies and strategies on its health services. It also facilitates mutual collaborations between the SAF and our public healthcare sector, such as in the areas of Sports Medicine and Cardiology.

The SAF Specialist Advisory Boards (SABs) provide guidance on the development of medical best practices in clinical specialty fields which are important and relevant to the SAF. The five SABs have been established, namely: Cardiology (headed by Associate Professor Terrance Chua, Deputy Medical Director, National Heart Centre Singapore), Emergency Medicine (headed by Associate Professor Eillyne Seow, Divisional Chairman, Division of Ambulatory and Diagnostic Medicine, Tan Tock Seng Hospital), Preventive Medicine (headed by Associate Professor Goh Kee Tai, Director, WHO Collaborating Centre for Environmental Epidemiology, Ministry of Health), Psychiatry (headed by Professor Kua Ee Hock, Senior Consultant, Department of Psychological Medicine, National University Hospital) and Respiratory Medicine (headed by Professor Lim Tow Keang, Senior Consultant, Division of Respiratory and Critical Care Medicine, National University Hospital). They serve as a benchmark to align the medical care in the SAF to a standard comparable to that of our national healthcare system.

The SAF Visiting Consultants are a group of senior and highly experience clinicians who advise the SAF on the formulation of its medical screening standards and medical classification guidelines.

Review of the SAF Medical System

The SAF conducts regular reviews of its medical policies and protocols to ensure that they are in line with best practices. The latest review was conducted in 2012 and was co-led by Brigadier General Benedict Lim (Commandant SAFTI Military Institute) and Associate Professor Eillyne Seow (Divisional Chairman for Ambulatory and Diagnostic Medicine in Tan Tock Seng Hospital and Senior Consultant Emergency Physician). The review focused on the SAF's peacetime emergency medical support system and its medical screening and classification system.

The review affirmed that the SAF has a good and responsive emergency medical support system to manage soldiers who sustained injuries. Specifically, the review committee endorsed the SAF casualty evacuation policy to evacuate the soldier to the nearest medical facility with the appropriate level of care at the shortest possible time, which can either be the restructured hospital or an SAF medical centre.

The review committee also concluded that the SAF has a fundamentally robust medical screening and classification system. The standards are evidencebased and benchmarked against national and international guidelines. This enabled our soldiers to be appropriately graded so that they undergo training which is commensurate with their medical status.

Establishing Collaborations with National Partners

The SAF has been partnering the National Heart Centre Singapore (NHCS) since 2012 to provide advanced cardiac screening for our soldiers. This is an initiative which complements the enhancement to the SAF cardiac screening protocol in 2011, which saw the introduction of advanced cardiac screening tests such as calcium scoring and echocardiography for servicemen with specified cardiovascular risk factors. SAF servicemen who require specialist cardiology evaluation or cardiac investigations after screening by the SAF medical officer will be referred to NHCS. This allows an expeditious determination of the serviceman's cardiac fitness status.The SAF is currently in discussion with Jurong Health Services (Jurong Health) to collaborate in the area of emergency medical services. Jurong Health will run the new Ng Teng Fong General Hospital, which will be sited close to the SAF's main training area in the western part of Singapore. It is therefore in both the SAF's and Jurong Health's interest to mutually understand the potential requirements and the emergency medical capabilities that the new hospital can offer. In the long term, this strategic partnership will encompass a sustainable programme for the hospital's specialists to train SAF's personnel in the provision of emergency medical care and serves as a benchmark for the SAF emergency medical support system.

The SAF is in the final stages of evaluating the collaboration with a civilian healthcare group to deploy Family Physicians in selected SAF medical centres. They will deepen the clinical experience level at SAF medical centres in managing servicemen with more complex medical conditions. By complementing the SAF's existing health services, this model of healthcare mirrors the concept of primary care delivery in our national system, where polyclinics have Family Physician clinic services running alongside general medical services. The Family Physicians will also be able to provide clinical mentorship to the younger NSF doctors.1 Professor Tan Ser Kiat is the immediate past Group CEO of Singapore Health Services (SingHealth), a Member of the Public Service Commission and the current President of the Singapore Medical Council.