SINGAPORE - Doctors at some Public Health Preparedness Clinics (PHPCs) are getting staff to perform additional shifts and hiring people in order to extend their operating hours and ease the strain on their colleagues in the healthcare system.

The Ministry of Health (MOH) announced on Tuesday night (Feb 22) that from Feb 25 to March 10, selected PHPCs across the island will operate up to 11pm on weekdays, from 2pm to 5pm on weekends, and from 8pm to 11pm on weekend nights.

This is an attempt to spread out peak patient load at private clinics, said MOH, adding that it encourages those who require medical attention to consult a primary care doctor first rather than rushing to the emergency departments in hospitals.

But for some PHPCs, choosing to extend operating hours - which is done on a voluntary basis - means putting additional strain on already taxed staff.

At Kenneth Tan Medical Clinic in Punggol, weekend operating hours have more than doubled to 11 hours as part of the scheme. The clinic will now operate from 2pm to 5pm on weekends, in addition to the current period of 8am to 1pm on Sundays.

"My clinic has been extremely busy. On top of our regular chronic patients and vaccinations, we have seen increasing numbers of Covid-19 cases," said Dr Kenneth Tan, who added that he has been seeing about twice the usual number of patients.

He said his clinic has coped by getting staff to perform additional shifts, and asking friends of staff to help with tasks such as registering patients and doing data entry.

"Our staff are already quite stretched and they have families and commitments. The limiting factor is the manpower, front-liners and clinic assistants - we don't have enough people to do data entry and document Covid-19 infections," explained Dr Tan.

He added that patients have been understanding and supportive, some of them helped out by waiting at home and going to the clinic when it was less congested.

He is grateful to such patients. He said: "I think that really helps reduce stress for our staff and helps us deliver quality patient care. We believe that this is just a phase in the Covid-19 pandemic, and this wave will pass soon, so it's important for all of us to do our part."

Dr Leong Choon Kit, head of Mission Medical Clinic, said that extending the hours of its two PHPCs in Hougang and Upper Serangoon by opening on weekends will result in about 25 per cent more slots for patients. They will now open from 8pm to 11pm on weekends.

"We are busy and tired but two extra weeks is manageable. It's a national request, and we want to support it to help the public," he said, adding that his clinic has encouraged its staff to work the extra hours.

"I am prepared to operate by myself if my staff are not able to come in," added the family physician, who noted that one of his staff is already under isolation at home.

Bigger chains are stepping up as well. A spokesman for Raffles Medical, which operates 33 PHPCs, said many of its clinics have been open till 9.30pm daily, and five which previously operated till 1pm on weekends have extended their hours to 9.30pm as well, ramping up manpower and resources to meet patients' needs.

Dr John Cheng, head of primary care at Healthway Medical Group, which operates 43 PHPCs, said that the group has plans to extend the operating hours of some of its clinics, but could not say how many as details are still being worked out.

He highlighted that two main challenges need to be overcome. 

First, it has to ensure that the group’s healthcare workers have sufficient time off work to get adequate rest amid their heavy workload. Second, many healthcare workers are battling symptoms of illness themselves.

"This further strains our manpower situation on the ground," said Dr Cheng.

Dr Tan Teck Jack, chief executive of Northeast Medical Group, said seven of his group's eight clinics will be extending their hours, but details of this have yet to be finalised

The chain is hiring more manpower, while existing staff are trying their best to meet current needs, said Dr Tan, adding that the group's staff and doctors have already been staying back beyond normal hours to provide accessible care.

"As many families are affected by Covid-19, our staff often go beyond the healthcare needs to address and coordinate resources for affected families. Most of our healthcare workers are already putting in personal sacrifices to serve our patients, so we hope for the public's understanding as longer waiting times may be expected in the coming days," he said.

Asked why his group was choosing to extend its hours despite the already heavy workload, he said: "Hospitals are over-congested and it will endanger lives. Our clinics are located in the neighbourhoods, it is our duty to extend the hours to help our patients."

The latest moves come amid increased strain on Singapore's healthcare system, as the nation saw a record 26,032 Covid-19 cases on Tuesday.

The Straits Times visited 15 clinics in the Tampines, Simei and Bedok estates on Wednesday afternoon (Feb 23) and observed that most clinics experienced a queue of around five to 10 patients.

In Tampines, Healthway Medical Centre, a PHPC, had a queue which extended beyond the waiting area of the clinic.

Madam Er Lay Ping, 45, was one of the patients awaiting her turn for registration. The administrative assistant, who had been queueing for 15 minutes, said: “I’m just here to get medication for my flu and cough. If I have to take another test and it’s positive, then so be it.”

But as a safety measure, patients who had tested positive from self-administered antigen rapid tests (ART) were not required to queue and were attended to as soon as possible. 

At Northeast Medical Group's clinic in Simei, Mr Wong Zhi Hong, 30, was waiting for his turn to take an ART. He had been exhibiting flu-like symptoms but received a negative result on his self-administered ART.

"I've heard that people often receive false negatives on ARTs. I thought it would be safer if I came down to a clinic to get a second result," he said.

When asked why he did not choose to go to a quick-test centre (QTC) instead, the account executive said that it was more convenient to visit the clinic as it was nearer to his home.

"I don't mind waiting and paying a bit of money. Additionally, there are certified doctors so testing is more reliable."