Roots of NHS
Neighbourhood Health Service (NHS) is a local community service project initiated by a group of medical students from National University of Singapore's Yong Loo Lin School of Medicine (NUS Medicine). During its initial stages, NHS focused on providing door-to-door health screenings aimed at the early detection and intervention of chronic diseases. The greater vision is to integrate back into the healthcare system low-income and elderly residents who have fallen through the cracks. Many of these residents that NHS serve live in rental flats.
In 2008, NHS conducted its first health screening at Taman Jurong. Over the years, NHS has partnered other faculties in NUS, such as social work students from the Faculty of Arts and Social Sciences, as well as nursing students, to provide more holistic care for the residents. 2016 marked the tenth year since NHS' inception.
Preparation for NHS 2016
In September and October last year, NHS visited two regions in Singapore that have a significant population of elderly and low-income residents. Screenings were targeted at residents aged 40 and above, and were conducted with the objective of identifying those at risk of common chronic conditions, such as hypertension, diabetes mellitus and hyperlipidaemia, to allow for early intervention. A week after door-to-door publicity efforts were carried out, the screenings were held for two days at each location. Residents who were less mobile were identified and teams were dispatched to conduct the health screening in their homes. By doing so, NHS hopes to make such health services more accessible and convenient. In 2016, NHS reached out to residents in Taman Jurong and Marine Terrace, where a total of 643 residents participated in the free health screenings.
Each resident was accompanied by a volunteer as key clinical values, such as body mass index, waist-hip ratio, blood pressure and capillary blood glucose levels were measured. Phlebotomy services were also provided to measure the fasting blood sugar level and lipid profile of the residents. Additionally, faecal immunochemical tests, dental checks, eye screenings, and free referrals for mammograms, pap smears and hearing tests were also made available. Abnormal results were then followed up on at the doctor's consultation station and referrals were given when necessary. NUS social work students also ran a station that allowed them to speak to residents on health, social and financial issues to gain an insight into their socio-economic well-being and to refer them to appropriate organisations for help, if necessary.
Major highlights of the 2016 screenings
Health education
In 2016, NHS adopted a new element of personalised health education for residents, recognising that personal empowerment will go a long way in self-management of healthy lifestyles and diseases. Health education is tailored for each resident, based on the findings from the screening, so that they can be educated on the chronic conditions that they may be more susceptible to. Volunteers utilised educational videos and health information sheets specific to each resident to educate them on how to live a healthy lifestyle and better manage their existing chronic conditions. At the end of the screening process, each resident took home with them an individual health report which contained their own screening results for future reference and follow-up.
NHS mobile app
Another highlight of last year's screenings was the development and incorporation of the iOS-based NHS mobile app, an initiative that has greatly revolutionised the registration, screening and follow-up processes. The app, easily downloadable onto the smartphones of volunteers and communal iPads provided by the NHS committee, enabled volunteers to register residents during pre-publicity efforts, as well as to quickly record screening values for specific residents as they went along the various stations on screening day. The digital records were then easily accessible, facilitating the committee in retrieving and updating information. The software was designed to create a convenient database for easy future reference, and came in especially handy in our follow-up, which is a crucial element in NHS screenings. This enabled us to reach out to residents who are at risk of certain conditions and monitor any progress they may have made.
Post-screening follow-up
Residents who participated in the screening sessions also had the opportunity to undergo a free phlebotomy service, which served as a blood test to measure their fasting blood glucose, cholesterol and triglyceride levels. In previous years, the blood test results would be mailed out to the residents. Last year, however, the NHS Follow Up committee chose to embark on a new initiative: post screening follow-up (PSFU) sessions. With the help of some volunteers, the committee managed to personally deliver the phlebotomy results to the residents' doorsteps, and used the opportunity to explain and interpret the results, as well as provide personalised advice for residents to make improvements to their diet and lifestyle.
This idea was conceived based on feedback that some older residents were illiterate and unable to interpret the values and understand the technical terms in the report, or were unsure of concrete steps they could take to improve their health after taking the test. As a result, the PSFU sessions were a considerable success, seeing that both the residents and volunteers enjoyed the increased interaction time. Residents were also left with a better understanding of their test results and became more empowered to take the steps necessary to improve their health.
Partnership with NDCS
In addition, given that dental health is a growing area of focus and importance, NHS was fortunate to be able to collaborate with the National Dental Centre of Singapore (NDCS) for NHS 2016 – a move that was well received by the residents. Staff members from NDCS were very warm, welcoming and well prepared, and NHS looks forward to a continued partnership with them in the years to come.
In conclusion
With the conclusion of NHS 2016, we would like to extend our thanks to those who have made our project possible. As NHS is a voluntary non-profit initiative, we rely on the goodwill of the medical community, including our mentors who have offered us invaluable guidance throughout the project and our volunteers who took time off their weekends to serve the residents with big hearts and smiles. We would also like to give special thanks to the organisations which we partnered, and our sponsors for their generous donations.
It is our hope that this project will encourage more students to involve themselves with the community, adopt a holistic approach in caring for their future patients, as well as widen their horizons on the social and financial issues that patients often face beyond their medical problems. Only with this continued mission and support from volunteers, grassroots and organisations can NHS improve continuously, and help meet the healthcare needs of our community.
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