How Singapore Reimagines Care Through Design

As Singapore grapples with the challenges of an ageing population and rising chronic health conditions, design is emerging as a powerful catalyst for reimagining the nation’s care and wellness systems. At the forefront of this transformation is Tamsin Greulich-Smith, Director of the DesignSingapore Council’s School of X, who has spent years championing design-led innovations to improve lives. In this insightful conversation, she explains how human-centered design is shaping national healthcare strategy, empowering communities and driving collaborative, ground-up solutions, from COVID-era co-design initiatives to bold new visions like Healthier SG.

How has Singapore’s “City in a Garden” vision influenced the country’s approach to designing for physical and mental well-being?

On a national level, Singapore has embraced livability and greening as reflected in its vision to be a “Garden City”, which was first articulated in 1967 by then Prime Minister, Mr Lee Kuan Yew. As part of it, HDB estates as well as private developers, were mandated to set aside spaces for trees and greenery in their projects to avoid Singapore becoming a concrete jungle. This has since been an active means of creating a more calming environment as well as softening the impacts of high-density urban living on peoples’ health through absorption of air pollutants, softening of background noise levels, etc.

What role does nature and biophilic design play in Singapore’s healthcare and public infrastructure?

National Parks has created healing gardens in their public spaces, and recently opened the first healing garden attached to a hospital, adjacent to Woodlands Hospital. Khoo Teck Puat Hospital also brought biophilic healing design into the care environment more than 10 years ago with its concept of a hospital in a garden, and a garden in a hospital. When they took over the site for construction, it was located next to a pond in Yishun, which the hospital team brought into the design of the space. So very specifically in our hospitals, we see the healing use of nature as a means of enhancing care outcomes.

What urban and infrastructural design strategies are in place to promote everyday physical activity in Singapore?

Infrastructural-wise, fitness parks are commonplace in our housing estates to remove barriers to exercise and increase accessibility to fitness equipment for all ages as a health prevention measure. Increasingly, the fitness areas in our parks are also featuring well-being aspects, such as massage stones, to further enhance health benefits. Covered walkways are designed to encourage physical activity by removing a deterrent to walking. The walkways protect pedestrians from harmful UV rays, keep people cooler in the hot Singapore climate and provide shelter from the tropical downpours so that people can keep walking, no matter the weather conditions. Across public agencies, there is an effort to keep people well.

How does Singapore design integrated environments that bring health, care and community together?

In terms of dedicated sites, there are several nationally that bring human-centered, integrated environments together with the aim of improving health and well-being. Kampung Admiralty is designed to better meet the needs of an ageing population, while Kallang Sports Hub is an expanding space that embeds exercise and active living into the heart of the precinct. Enabling Village is also a beautiful example of space design for improved quality of life. It has been carefully designed to enable people of all abilities and disabilities to feel able and empowered to independently access the campus. Again, featuring biophilic design to create a calming environment, with running water and the sounds of nature lowering stress levels.

How is design thinking helping Singapore tackle healthcare challenges at a national level?

Design and innovation are integrated into our national care efforts in a variety of ways, including across all of our Regional Health Systems and our social service sector. To design for future population needs, we need to look at the systems level changes required, at the strategic enablers that will drive those changes and at the specific interventions on the ground that would support the changes in being adopted and realized. Design can play a role in each of these areas. At the highest level, both the Ministry of Health and Ministry of Social and Family Development have dedicated innovation functions, exploring new ways of creating impacts for those they serve. This requires determined effort to challenge existing norms and assumptions, before devising new approaches. Design thinking is a great method for working through this process and reframing fundamentals. The Ministry of Health’s Office for Healthcare Transformation (MOHT), for example, has utilized a design-led approach from the outset of its establishment to gain insights into stakeholder needs and drive relevant innovation. We can’t design solutions for transformative adoption if we don’t first understand the needs of those we are designing for.

Can you give examples of how design-led initiatives have shaped responses to real-world healthcare and social challenges?

This has been reflected in the MOHT’s initiatives in different ways, such as “Design4Impact”, a national and collaborative effort launched during the COVID-19 pandemic to mobilize the population to design solutions to pressing care needs at the time. The MOHT spearheaded a partnership with the National Council of Social Service (NCSS), DesignSingapore Council and the National University of Singapore to leverage grounds-up co-design to support specific health and well-being needs during that challenging period. The solutions that emerged from the program, which addressed complex care challenges, such as supporting mental health or tackling social isolation amongst the elderly, have gone on to be trialed and implemented. One example of this is Garden2Gather, which uses gardening as a way to start conversations on mental health. It was launched in 2022 in the Boon Lay neighborhood.

At a sector level, we are seeing design-led efforts shaping strategic priorities. For example, in 2022, the NCSS launched its new strategic road map. I was privileged to be part of the committee tasked with its development, and I was delighted that the process drew upon human-centered, empathic design to inform emerging and future needs of both beneficiaries and the 450-plus social service agencies delivering care across Singapore. It is heartening to see that design is recognized by our public agencies as a relevant and helpful tool in determining how best to meet changing population needs. A design-led approach has directly shaped the future strategic direction of the national social service ecosystem, and its implementation is being enabled through a variety of dedicated initiatives and resources, also fueled by design. The NCSS 4ST Partnership Fund is one such example. It provides financial grants for co-designing solutions to improve the quality of life of families, youth or persons with mental health conditions.

How is design helping to shape the future of care in Singapore, particularly in light of the country’s ageing population?

One of the significant reforms in the health system was introduced in 2023, in the form of Healthier SG, to better meet the needs of our ageing population and the increasing burdens from chronic conditions. As Healthier SG shifts focus to prevention and encourages personal management of one’s health to reduce long-term healthcare demands, this requires collaborative design across organizational boundaries and into new domains to create fresh, sustainable health solutions.

At School of X, we recently ran a design sprint for one of our regional healthcare systems, along with two social service agencies, as they seek to explore how to collaborate to activate communities that care, from the ground up. This is part of their integrated efforts to develop a more holistic and preventative model of care for Singapore, which requires a more robust and granular ecosystem approach.

Design for the future of care in Singapore is strategic, human-centered and innovative. It requires even greater levels of co-design and collaboration as we bring to life the vision for the future, which tackles health before it declines and supports the nation in coming together to achieve a healthier population.