Geriatric Oncology Supportive Clinic (GOSC) 

Older adults with cancer present unique challenges due to their heterogeneous health status. Standardised treatment approaches are often unsuitable for older adults who may have multiple competing medical diagnoses. 

To address this, the Department of Palliative Medicine pioneered the first local Geriatric Oncology Supportive Clinic (GOSC) in 2019, focusing on promoting earlier supportive care and ensuring appropriate treatment for elderly cancer patients.

Our research efforts received recognition through the National Medical Research Council Clinician Scientist Individual Research Grant New Investigator Grant (NMRC-CS-IRG-NIG) in 2024, supporting our continued study into GOSC's role in maintaining and enhancing patients' quality of life during cancer treatment.

Breathlessness Ecosystem 

Launched in 2023 with the generous support from the Lien Foundation, the Breathlessness Ecosystem brings together expertise from TTSH Departments of Cardiology, Respiratory and Rehabilitative Medicine, TTSH Physiotherapy and Occupational Therapy, Ren Ci Community Hospital.

The Ecosystem serves the multi-faceted needs of patients suffering from chronic breathlessness due to progressive (non-cancer) heart and lung diseases. By weaving a network of palliative and rehabilitative services across tertiary care, intermediate care and community services, it provides patients with more comprehensive support.  

• A key feature is the ICARE (Integrated Care for Advanced REspiratory Disorders) programme, an inpatient palliative rehabilitative programme at Ren Ci Community Hospital for patients who benefit from both medical support and rehabilitation therapies.
• Other interventions include R.I.S.E. (Restitutive. Integrative. Supportive. Empowering) - a 12-week outpatient programme with Dover Park Hospice Day Care. It empowers individuals with chronic non-cancer lung diseases manage breathlessness and continue living meaningful lives.

In line with Healthier SG’s focus on preventive health and patient empowerment, this Ecosystem provides touchpoints for National Healthcare Group (NHG) primary care physicians and specialists to refer their patients to appropriate palliative rehabilitation programmes in the community. Through early interventions, palliative rehabilitation will empower individuals to manage their symptoms, preserve daily function, and prevent unplanned hospitalisation. 

Eligible patients under the care of NHG will be stratified by their disease severity and extent of frailty, to receive services that best match their needs.

Humanistic, Empathetic Alleviation of Suffering in the ICU (HEALS-ICU)

The HEALS-ICU model is a collaborative approach that brings together intensivists, ICU nurses, palliative care specialists, medical social workers, art and music therapists, and other allied healthcare professionals. Together, they ensure that humanistic care, comfort, dignity, and compassionate communication are integrated into every ICU patient’s journey. 

The model is built on the belief that compassionate, whole-person care should begin at ICU admission—not only at the end of life. Through the regular use of simple symptom checklists, early involvement of expert support, planning for care beyond the ICU, and fulfilling patients’ wishes for a compassionate discharge to pass away at home, this team-based approach transforms ICU into a space which emphasises the marrying of evidence-based care and human connection.

National Neuroscience Institute (NNI) – Palliative Medicine 

In collaboration with NNI, and with the support of the Lien Foundation, the Neuro-Palliative Ecosystem aims to establish a comprehensive care framework integrating palliative care into the care of individuals with neurodegenerative illnesses. 

This endeavour is structured around four fundamental pillars: 

• Regular screening and fortnightly multidisciplinary team review to evaluate patient requirements and initiate customised support for patients and their caregivers
• Enhancing the proficiency of NNI personnel through a certified Neuro-Palliative care course facilitated by the Lien Centre for Palliative Care.
• Upskilling community partners in the identification and management of neurological conditions.
• Fortifying connections between hospitals and community partners to ensure prompt access to suitable care facilities, with the goal of providing seamless care and alleviating distress for patients and caregivers.