Charity Trustees' Report
Review of Financial Year 2006/07 by Charity Trustees

Principle Funding Sources
The Home Nursing Foundation (HNF) is funded by the Government and from public donations. The HNF collects a nominal fee from the family members of the patient, based on the family financial background and their ability to pay.

Staffing
Nurses are recruited locally and have to go through an orientation and attachment program to equip them with the skills to provide nursing care for the elderly sick. The administration staff attend training programs for personal and technical development.

As of 31 March 2007, the breakdown of staff strength was as follows:

Nursing Operations Review
The HNF provides an island-wide home nursing service to patients who are incapacitated and homebound. This service is provided by our team of dedicated staff nurses working from our island-wide network of nine home nursing centres and supported by our centrally located Headquarters in Toa Payoh Central. Each one of our staff nurses makes an average of six home visits daily to attend to the elderly sick and carries out an average of two nursing procedures at each visit.

During the first home visit, our nurse will make an assessment of the patient’s medical condition and home environment, identify the medical problems and needs and then plan and implement an appropriate care programme for the patient. Besides the provision of nursing care, our nurses also train, educate and motivate the family members to actively participate in the total care of their loved ones.

For Financial Year (FY) 2006/07, from 1 April 2006 to 31 March 2007, our team of nurses made 30,416 home nursing visits to provide nursing care to 4,341 homebound patients and carried out a total of 62,267 nursing procedures. Compared to FY 2005/06, the number of home nursing visits made in FY 2006/07 had increased by 1,091 visits or 4%, whilst the number of patients had decreased
by 93 patients or 2%. (Please refer to Page 18 for statistics on nursing operations). However, for FY 2007/08, we project an increase in both our patient figures and number of home visits to be made.

For FY 2007/08, we forecast an increase of 10% in the number of home visits made from 30,416 to 33,500; and an increase of 4% in the number of patients from 4,341 to 4,500. These projections are reasonable in that we are embarking on an intensive awareness campaign in FY 2007/08 to increase public awareness of our services through road-shows and seminars, and also strengthen relationships with restructured hospitals and polyclinics to increase patient referrals. In view of a rapidly ageing population and with demand for affordable home nursing care to complement conventional hospitalisation, we believe that our workload will continue to increase over the next few years.

Beyond the realm of providing home nursing services, a significant area in which the HNF has assisted our patients was the securing of a $70,551 sponsorship from SembCorp Industries Ltd’s Trailblazer-Wong Kok Siew Fund in December 2006. This one-year sponsorship of free medical requisites such as nasogastric feeding tubes and urinary catheterisation sets, helped to alleviate the financial burden of our needy
bed-bound stroke patients. As of end March 2007, $18,528 had been disbursed from the Fund and 273 patients had benefited from the sponsorship.

Calendar of Events/Projects
This is a chronology of the events/projects that HNF embarked on in FY 2006/07

Technology
The Mobile Patient Database System (MPDS) was rolled out in December 2006 as a pilot project. All HNF nurses were equipped with Personal Digital Assistants (PDAs) that are integrated with the centralised patient information system. The teething problem of nurses getting to grips with mastering the functions of the PDA was tempered with the benefits brought about by the MPDS. The upshot was greater productivity and efficiency through time saved.

With the implementation of the MPDS, nurses saved more than 20 minutes in patient data documentation compared to the previous paper-based procedures. Nurses could upload patient data on the move via wireless hotspots. With more time in hand, more home nursing visits could be scheduled daily.

In addition, the HNF also embarked on an Enterprise Resource Planning (ERP) system to streamline operations and enhance organisational efficiency. With the implementation of the ERP system in the later half of 2007, data collation and the management of volunteer, donor and patient information will become much easier and more efficient.

Review of the Financial State and Explanation of Major Financial Transactions
The HNF spent about $3,000,000 in running our operations to advance our mission of providing high quality health services for the frail, semi and nonambulant elderly.

We spent around $100,000 in the implementation of the MPDS to equip our nurses so as to provide better care and service catering to the increasing needs of the elderly patients. This project was funded by the kind donation from the Lien Foundation in FY 2005/06.

The HNF was one of the recipients of an ambulance from Loyang Tua Pek Kong.

The HNF received about $2,000,000 from public donations and support from the Government amounted to $840,000.

Future Plans and Commitments
There are many challenges on the horizon, the most crucial being a rapidly ageing population and the pressing need for affordable step-down care to be accessible and available to the stratum of the population who could not afford expensive hospitalisation especially the lower income group. Currently, HNF nurses work from their offices located in the various restructured hospitals and polyclinics. These offices, also known as Home Nursing Centres (HNCs) are where our nurses do their paperwork and plan their daily case load. From there, they disperse to visit their patients in the sectors they are assigned.

• Centralisation of Nursing Operations
  Due to economic reasons, SingHealth and the National Healthcare Group are not renewing the leases for our HNCs in the hospitals and polyclinics. In order not to affect daily operations and to continue the smooth delivery of our home nursing services, we have had to relocate all our nurses back to our Toa Payoh Headquarters. This relocation will take place in the later half of 2007 where the administrative and medical operations will be streamlined making both more seamless and efficient. In addition, this recall will benefit HNF as we are putting into plans the establishment of a training centre for care-givers, a call centre for extended services and a medical supply store after undergoing a major renovation.
  
• Training Centre for Care-givers
  As our patients are homebound elderly suffering from chronic illnesses like stroke, heart disease, diabetes and high blood pressure, the strain of taking care of them can be telling on their family members especially if they are not well-versed with care-giving techniques. Currently, during their home visits, our nurses will teach family members on how to take care of their loved ones. With the setting up of a training centre for care-givers, we are addressing the need for trained care-givers and reinforcing those who were briefly taught by nurses before their loved ones were discharged from hospitals. The aspect of care-giving does not encompass just the physical but also the emotional. In an environment where are-givers get to interact with other care-givers, they can share their experiences, provide a listening ear for each other and also pick up important tips from our nurses.
  
• Call Centre for Extended Services
  Helming the call centre will be experienced, empathetic and trained frontline staff who are quick to understand the needs of patients and/or their family members calling up requiring home nursing services or information. Currently, home visits provided by our nurses are up to as late as 9pm. However, should the need arise, we will be equipped to extend our services to 24 hours.
  
• Social Enterprise
  In the pipeline is the setting up of a medical requisites supply store where embers of the public can purchase medical requisites from HNF at a cost of 10% to 20% cheaper than outside retailers. The objectives of this social enterprise are two-fold i.e. to stand on our own feet without overly depending on public donations and fundraising, and also as a supply conduit for our needy patients who require medical requisites, thus stretching their dollar for other expenses.

In order to consolidate our standing as the community’s leading home nursing provider, it is essential for the HNF to continue reaching out to our fellow Singaporeans through greater awareness programmes and beefing up relevant services, thus expanding our patient base and increasing our workload. The HNF’s strategic plans for the next three years are to deal with the challenges of an impending increase in demand for home nursing whilst simultaneously promoting active ageing through talks and events.

We see the HNF expanding and remaining the number one home nursing provider where the needy aged sick can always turn to like a beacon in the high seas.

Statement of Accounts
Financial statements for the Financial Year ended 31 March 2007 are attached from Page 22 onwards

Reported by:

Mr Kong Mun Kwong
Board Trustee
Home Nursing Foundation

Mr Bertie Cheng
Board Trustee
Home Nursing Foundation