Singapore’s rapidly ageing population has created several challenges for its healthcare sector. The strain is still being felt today, as staffing shortages continue to plague the healthcare system.

The Census of Population 2020 reports an upward trajectory in the number of citizens aged 65 and above, forming an astounding 15.2 per cent of the resident population in 2020, an increase from 9 per cent in 2010. These statistics are coupled with sluggish growth in other age groups, postulating a clear demand spike in healthcare services and a foreseeable shrinking workforce. As such, the Government is emphasising the importance of supporting intermediate and long-term care operators (ILTC) like nursing homes, centre-based services and community hospitals, in key areas such as funding, capacity and manpower.  

Key Challenges the ILTC Workforce Faces

1. Recruitment: Shortage of Qualified Employees

Reliance on foreign workers

According to the Ministry of Manpower (MOM), vacancies for registered/assistant nurses have gone without takers for at least half a year -- the highest amongst professional, manager, executive and technician (PMET) jobs. The MOM also noted that Singaporeans are generally not keen on nursing and care-giving jobs due to public perception of the profession, uncompetitive salary, limited career advancement, and irregular work hours. As such, ILTC operators have been depending on foreign workers or temporary employees to fulfil manpower demands – a solution that has become increasingly difficult with current travel restrictions and the Government’s continual tightening of foreign worker supply.  

Establish career pathways

Organisations need to make concerted efforts to create clear career pathways and advancement opportunities to make ILTC a more attractive career to local workers. For instance, Tan Tock Seng Hospital (TTSH) has a robust HR programme to target university students via structured industry placements. These are often conducted in collaboration with Institute of Technical Education (ITE), polytechnic work-study diplomas or university attachment programmes. Structured internship programmes promising exposure and on-the-job training are typically favourable to undergraduates, and can help the hiring organisation alleviate short-term manpower needs. Notably, positive internship experience also opens doors for organisations to hire full-time employees.

Salary revision

In 2020, our Government announced it was setting aside S$150 million over three years to help institutions improve the competitiveness of salaries of community nurses.  This was in addition to the S$350 million that the Ministry of Health (MOH) had given between 2012 and 2017 to most community care providers to support the increment of their employees’ salaries. 

2. Employee Retention

Working conditions & wellness

A study that was done on Singapore’s Long-term Care (LTC) sector polled 250 workers on their top-of-mind concerns about working in this sector. This study revealed that whilst passion was a strong motivating factor, professionals in this sector worked an average of 50 hours a week and were often under physical and mental stress. As such, it comes as no surprise that burnout and dissatisfaction remain as key complaints. This is evidenced by the short average tenures amongst LTC care workers, with around 55 per cent of workers and an average tenure of 2.8 years.

As nurses and caregivers form the backbone of the healthcare sector, human resource (HR) departments must pay special attention to the mental well-being of their employees, ensuring they are supported and heard. This is especially critical as employees now work longer hours to keep up with the fast-changing Government advisories amidst the COVID-19 pandemic.

For instance, TTSH has implemented a Staff Support Staff Programme (3S) and Wellness Committee to promote overall well-being of fellow colleagues, provide peer support via help hotline.  

Ling Kwang Home for Senior Citizens (LKHSC) has similarly taken measures to strengthen their internal support system. Last year, an employee engagement survey was conducted to provide a baseline for companies’ managements to review organisational values and highlight areas of improvement. 

3. Workflow Improvement and Automation

Digital transformation is about constantly reassessing opportunities to do things better, faster, and more accurately. Organisations are able to leverage digital technologies to streamline processes, collaborate better with stakeholders, and deliver services more effectively to beneficiaries.

While machines have replaced humans in other labour-scarce industries, this is less feasible for healthcare providers – a profession powered by compassion and human touch. Nonetheless, there is an increasing need for organisations to raise productivity levels by redesigning their workflows, so as to reduce manpower requirements where possible.

Management involvement

The journey towards digital transformation is never easy. Management’s involvement is crucial to ensure success in the organisation’s transformation efforts. They have to define the vision and the desired outcome measured by the stipulated KPIs, and be involved and work alongside the execution team to understand the progress and push ahead with their digital transformation. In all changes, successful implementation requires buy in from employees. Hence, it is important to have an effective internal communication framework to align employees’ expectation with the firm’s objectives. 

The Government has various programmes and grants to assist organisations in the journey. One successful example is Thye Hua Kwan Nursing Home (THK). By utilising grants such as the Community Silver Trust and the Healthcare Productivity Fund, THK is able to adopt new technologies to maximise the potential of their workforce. THK has also undertaken a number of innovative projects to reduce man hours, and automate work processes.


It remains certain that the demand-supply imbalance of ILTC workers will only continue to escalate, but outcomes are determined by the preparedness of organisations to manage the above challenges.

RSM has been serving organisations in the healthcare and not-for-profits sectors. We help them overcome challenges and enable them to thrive through customisable services with insightful, practical, and effective advice.

To find out more and how our healthcare practice team can help you, please reach out to our professionals.


Sabrina Tay
Partner & Industry Lead – Healthcare Practice; CPA Talent Leader
T+65 6715 1318
[email protected]

Keith Tan
Director & Deputy Industry Lead, Healthcare Practice
T+65 6594 7895
[email protected]