SINGAPORE — A serious illness can be a challenging journey for both patients and their loved ones. For patients, comprehensive palliative and supportive care means relief from symptoms and emotional stress, maximising their quality of life while living with their illness. For caregivers and families, it translates to crucial support through coordinated care, ensuring their loved ones receive comfort while navigating the complexities of care.
Recognising this, the National University Hospital (NUH) continues to expand its palliative and supportive care services, ensuring patients receive compassionate and holistic support at every stage of illness. This commitment was highlighted at the “NUH Showcase: Empowering Living Well & Leaving Well” exhibition on 21 March 2025. The event brings together healthcare professionals and community partners to explore ways to improve accessibility and quality of palliative care.
At the forefront of NUH’s efforts is the Palliative Care Nursing Network (PCNN), a nurse-led initiative launched in early 2024. This programme equips and empowers frontline nurses across inpatient and outpatient settings to conduct comprehensive assessments of palliative needs and manage symptoms using evidence-based protocols.
For complex cases, specially trained Palliative Care Resource Nurses provide advanced interventions, ensuring timely and effective symptom relief. This tiered system leverages nurses' close position at the patient's bedside, enabling more immediate and continuous palliative care interventions.
Another key milestone is the development of the Compassionate Removal of Mechanical Ventilator (CRMV) protocol1, led by Advanced Practice Nurses in collaboration with doctors and other healthcare professionals. Now implemented across all Intensive Care and High Dependency units in NUH, this standardised approach simplifies the complex aspects of CRMV with a greater emphasis on compassionate care, empowering nursing staff to conduct the CRMV process with enhanced focus on respecting patients’ wishes, comfort and dignity.
Adj A/Prof Karen Koh, Chief Nurse, NUH, explained, “Nurses play a pivotal role in palliative care, offering both clinical expertise and emotional support. Our nursing team spends the most time with patients and their families, allowing us to develop deep understanding and build trusting relationships. The PCNN harnesses this unique position, empowering nurses with specialised training and resources to deliver compassionate care and advocate for their patients' needs, when they need it the most.”
At the Khoo Teck Puat - National University Children's Medical Institute at NUH, the Paediatric Palliative Care Service (PPCS) provides family-centred, multidisciplinary support for children with serious illnesses, starting from the prenatal stage through infancy and young adulthood.
PPCS distinguishes itself with its collaborative approach, providing care for a broad spectrum of ages and medical conditions, including unborn babies, newborns, toddlers and young adults. By working closely with obstetricians, neonatologists, and other specialists, the PPCS team supports parents in making informed decisions about care and helps prepare families for the medical and emotional challenges ahead.
Since its inception in late 2020, the PPCS has seen a steady increase in its patient numbers from 29 in 2021 to 53 last year. This is partly attributed to a rise in early referrals from diverse specialties, allowing for timely development of personalised care plans together with the family. Beyond symptom management, the team addresses psychological and emotional well-being, recognising the profound impact of illness on the entire family.
Through extensive collaboration with charity and community partners, PPCS enhances emotional and social support, offering meaningful experiences both in and out of the hospital, such as art therapy and family bonding activities.
A key feature of NUH’s model is the seamless transition for young patients entering adulthood. Adolescent with life-limiting conditions can continue to receive high-quality medical and palliative care within the same institution, ensuring continuity and stability during a critical life stage.
At NUH, holistic palliative and supportive care extends beyond medical treatment to involve vital contributions from the allied health and operations teams. For instance, dietitians and speech therapists work in tandem to enhance patients' quality of life by maintaining comfort and managing symptoms like nausea, appetite loss or difficulties with swallowing. Dietitians design individualised meal plans that balance clinical needs with patient enjoyments. Speech therapists ensure patients can safely and comfortably consume these diets, using techniques such as modification of food textures to enable patients to savour flavors even when swallowing is a challenge.
To support families transitioning to home care, NUH’s inpatient operations team launched the EquipRENT service in November 2024. This one-stop, in-house programme provides hassle-free access to essential medical equipment such as hospital beds, wheelchairs, oxygen concentrators, and commodes. By eliminating deposits and upfront payments, the programme ensures quick access to vital equipment. While available to all patients, the programme especially benefits those transitioning to home or community palliative care, reducing delays due to equipment wait times and facilitating smoother post-discharge care for families. In its pilot phase, EquipRENT has served 21 patients with positive feedback. NUH will continue to review the programme’s effectiveness and explore ways to expand its reach.
To broaden access to palliative care, NUH signed a Memorandum of Understanding (MOU) on 21 March 2025 with five insurers and six home care service providers (please see Annex A for full list), to initiate collaborations to broaden supportive and palliative care services.
One potential area of focus is to enable more terminally ill patients to receive care at home, addressing concerns about out-of-pocket expenses and access to professional home-based palliative care. This aims to provide patients with greater control over their end-of-life journey, allowing them to spend their final days in the familiar comfort of their own home, surrounded by loved ones.
Adj A/Prof Mark Puhaindran, Chairman, Medical Board, said, "Palliative and supportive care is not just about medical treatment – it is about ensuring patients and families receive the care and dignity they deserve in life’s most difficult moments. This requires strong partnerships and a commitment to continuous improvements. By working together with insurers and home care providers, we can expand access to home-based care, reduce financial concerns, and strengthen the support system for patients and their families at every stage of their journey.”
The ongoing initiatives reflect NUH’s commitment to optimising the quality of life for patients with serious illnesses by providing accessible, coordinated and compassionate palliative care. The exhibition further highlighted key programmes from Emergency Medicine, Intensive Care, Nephrology, and Geriatric Medicine, alongside contributions from the National University Cancer Institute, Singapore and the National University Heart Centre, Singapore (please see Annex B for more details). Together, these programmes demonstrate NUH’s holistic approach to addressing the evolving needs of patients and their families.
To download the PDF version of the media release, click here.
1The protocol includes a guide with clear directions to nursing staff in delivering compassionate care during the CRMV process, as well as medication guidelines to address symptoms management.
