SINGAPORE — At the National University Health System (NUHS), nurses are defined not by tasks, but by the critical decisions they make and the impact they lead, from shaping care models that connect hospital, home and community, to extending support into patients’ everyday lives.
Anchored in this year’s Nurses’ Day theme “Our Future of Nursing - Shaping 2030 & Beyond”, this shift signals an expanded role for nurses as drivers of change. They are advancing innovation, integrating technology, and continuously rethinking how care is delivered across the continuum, with patients at the centre of every decision.
NUHS is rethinking how nursing manpower is deployed to meet evolving healthcare needs, with flexible models that build a more agile and resilient workforce while creating meaningful career pathways at every stage of a nurse’s journey.
The Nurse-On-Demand work model is redefining manpower deployment by bringing greater agility to daily operations. Designed to match the right nurse with the right competency at the right time and place, it enables wards to respond quickly to staffing gaps or surges in demand through a digitally coordinated pool of available nurses who can pick up these contingency jobs during their rest days based on their availability and skillsets, replacing traditional callbacks. Since its pilot across two wards at NTFGH in April 2025, the model has been expanded hospital-wide and to Jurong Community Hospital, with nearly half of the contingency jobs taken up through this initiative as of June 2026.
Beyond efficiency, it also gives nurses greater autonomy and flexibility, allowing them to take on additional shifts on their own time when they have the capacity to help. Not only does this reduce the strain of unexpected recalls and support better work-life balance, but it also creates opportunities for cross-learning and strengthens competencies across different clinical areas. At the same time, it helps ensure continuity of care and safeguards patient safety during sudden manpower shortages by enabling timely deployment of suitably trained nurses where they are needed most. (Please refer to Annex for more details of each nursing initiative).
Since May 2025, NUHS has been strengthening workforce sustainability by retaining nurses beyond retirement through a structured re-employment approach. Staff are engaged up to 24 months before retirement to match them with roles aligned to their abilities, experience and organisational needs, rather than automatically returning to previous positions. To date, 89 nurses have been rehired into a range of roles across NUHS, creating meaningful opportunities for senior nurses to remain active while supporting evolving care demands, enhancing patient care and knowledge transfer, and retaining valuable clinical expertise. Early feedback has been encouraging, with 98 per cent of surveyed retiring nurses expressing willingness to continue working and a strong interest in staying engaged, thereby contributing to a more sustainable and future-ready nursing workforce.
Across NUHS, technology is reshaping how care is delivered, starting with the way nurses manage complex processes.
The Inpatient Virtual Operating Centre (iVOC) at Ng Teng Fong General Hospital (NTFGH) is a virtual command post that centralises non-physical discharge tasks, shifting discharge management from a fragmented, ward-based process to a standardised, real-time tracked system. By pooling discharge coordination across wards, it reduces duplication and inefficiencies while easing the administrative and cognitive burden on bedside nurses, enabling them to focus more on clinical care and patient interaction. Patients also benefit from a smoother discharge experience with fewer last-minute delays. First introduced in one ward in April 2025 and scaled to a second ward in October 2025, the model has demonstrated strong early outcomes, including an approximate 53 per cent relative increase in discharges before 1130hrs across both wards, alongside improved operational efficiency.
At Alexandra Hospital (AH), nurses are extending care beyond the physical Emergency Department (ED) through the Virtual ED, starting with virtual post-discharge follow-up for selected ED patients in May this year. Nurses identify higher-risk patients and conduct check-ins within 48 hours to assess recovery, reinforce care instructions, and detect early deterioration, with the ability to guide patients to primary care, arrange prescriptions, or escalate cases when required. Focusing on more complex cases such as abdominal pain and fractures, this approach strengthens patient safety while enhancing nurses’ clinical assessment and care coordination capabilities.
The Virtual ED is part of the broader NUHS Virtual Care Centre (VCC) initiative led by AH. The VCC enables nurses to deliver care remotely through telehealth, remote patient monitoring and virtual care coordination. By leveraging real-time patient information and standardised workflows, it supports seamless transitions across care settings, improves right-siting of care, and reduces unnecessary hospital visits. At the same time, it creates new opportunities for nurses to develop expertise in virtual care delivery while supporting the delivery of safe, seamless care beyond traditional healthcare settings.
Since March 2026, the NUHS@Home nursing team has streamlined care delivery through the use of a portable infusion pump to administer intravenous (IV) antibiotics, bringing hospital-level treatment into patients’ homes. Patients recovering from infections such as cellulitis require IV antibiotics up to three times daily. This means multiple nursing visits that disrupt patients’ routines and strain nursing resources. But with this lightweight pump that delivers the medication at pre-set intervals, nursing visits have been reduced from three 45-minute sessions to a single 45-minute daytime check-in. To date, 35 patients have been treated using the pump,primarily those requiring three-times daily antibiotics, out of 93 cellulitis admissions inMarch and April 2026.
Even as technology transforms healthcare, NUHS nurses remain deeply committed to person-centred care. By combining clinical expertise with empathy and communication, they ensure that every patient feels seen, heard and supported, delivering care that goes beyond treatment to build trust, dignity and holistic well-being.
At National University Hospital (NUH), this is exemplified through a nurse-led Harmonised Compassionate Discharge pilot that supports patients at the end of life. Once led mainly by the palliative care team, more nurses in different wards are now empowered to take on the pivotal role of guiding patients and families through the final transition from hospital to home. Supported by structured training and clear protocols, they ensure it is a journey defined by dignity, comfort and respect for individual wishes.
Through clear communication and meticulous planning, nurses partner with patients, families and community care providers to ensure continuity of care, from arranging equipment and caregiver training to facilitating transfers and preparing families for what to expect. Since its launch from November 2025 to January 2026, the initiative has benefitted 13 patients and generated 63 hospital bed days savings. Families and next-of-kin surveyed reported improved confidence and reduced caregiver stress, allowing them to focus on spending meaningful time with their loved ones during their final days.
To enhance breastfeeding support, National University Polyclinics (NUP) has introduced a Lactation Consultant Service delivered by nurses who are International Board-Certified Lactation Consultants, bringing specialised care closer to home. Building on its existing lactation service, this expanded offering supports more complex breastfeeding challenges such as low milk supply, mastitis and blocked ducts, enabling comprehensive community-based care instead of hospital visits. Currently, five certified consultants are deployed across five NUP polyclinics, with more nurses undergoing certification. Between February and May 2026, the service supported 60 mothers, and there are plans to scale it to all eight polyclinics by the end of the year.
At the community level, NUHS is transforming care through its Step-up/Step-down (Shared Care) model, which integrates early intervention, recovery support, and strong community partnerships. Step-Up Care focuses on early detection, with community partners such as Active Ageing Centres (AACs), Community Case Management Service and volunteers identifying residents in need and escalating them to NUHS community nurses for timely assessment and care planning, facilitating direct admissions to services such as NUHS@Home or the hospital where clinically indicated, bypassing the Emergency Department where appropriate. Step-Down Care then supports recovery and chronic condition management, with NUHS community nurses providing clinical oversight within the community and working alongside community providers to support residents’ health, well-being and social engagement through an integrated model of care.
A key strength of this model is the involvement of trusted non-clinical community partners - the “Shared Care” component - whose close relationships and cultural understanding enable early engagement, ensuring residents receive coordinated support beyond clinic visits while allowing nurses to focus their expertise where it is most needed. Between November 2024 and December 2025, the model has handled more than 580 clinical escalations, with 83 per cent managed successfully without requiring emergency department visits. This highlights its role in facilitating early intervention while reducing avoidable hospital utilisation.
What we are witnessing is a continued progression in the role of nursing. Our nurses are no longer anchored to a single setting - they are orchestrating care journeys across multiple settings and touchpoints, ensuring continuity of care,” said Dr Catherine Koh, Group Chief Nurse, NUHS. “As technology reduces administrative burden and simplifies workflows, nurses can focus more on clinical decision-making, patient relationships and outcomes, while placing greater emphasis on empowering health through preventive care. At the same time, we are building a profession where nurses can grow, lead and find long-term meaning in their careers, because the future of care will be defined not just by innovation, but by the people who drive it.”
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