We work closely with our partners to help you transit from the hospital to the community. We facilitate the continuity of your care closer to home to aid your ongoing recovery.
CareHub is a one-stop call and care centre that manages and monitors patients holistically in the community. As a post discharge transitional care programme, CareHub ensures that enrolled patients can continue to receive the coordinated care they require when they are discharged home. When patients are stable, and where necessary, the CareHub team will help them navigate across care providers to ensure continuity of care within the community.
The Outpatient to Community programme benefits patients in our Specialist Outpatient Clinics (SOCs). For medically stable patients, the programme aims to appropriately-site them to primary care closer to their homes, and for patients with complex conditions, it aims to deliver seamless care through appointment consolidation and management under a primary physician or specialist.
Patients with well-controlled chronic conditions and do not require specialist care will be appropriately transitioned from Specialist Outpatient Clinics (SOCs) to a primary care partner in the community which is closer to home. The key primary care partners under this programme include GPs on our Primary Care Networks, National University Polyclinics, St Luke's Community Clinic, and Family Medicine Clinics (FMCs).
This programme also helps patients with multiple chronic conditions and who are seen by two or more specialties in Specialist Outpatient Clinics consolidate their appointments so that they are taken care of by only one primary physician. This physician can either be a family physician from one of our primary care partners or a specialist from NUHS.
Patients will be managed holistically, with inputs from other specialists as needed. The physician will also be supported by a multi-disciplinary team of nursing, allied health professionals and case managers.
Designed to help patients with work-related diseases or injuries return to work more quickly, the Return to Work (RTW) programme is designed for early intervention from a multi-disciplinary team. Patients are more likely to return to work earlier, and realise the health, emotional and financial benefits that come with it.
To find out more about the Return to Work service, kindly contact 6772 2002.