16 Annual Report 2015 - Healthy Living NT Report 2015-16 final_… · Annual Report 2015/16 Page 4 The Board of Healthy Living NT has been pro-active in the area of corporate governance

Diabetes Association of the NT Inc.

trading as

Annual Report

2015-16

2015

-16

Contents

President’s Report 1

The Board 3

Governance and Planning 4

Corporate Governance Statement 6

Organisation Chart 8

Staff 9

Bill Raby Diabetes Fellowship 10

Good Health Alliance NT 11

Membership 12

Advocacy & Support 13

Collaborations and Service Partnerships 14

Service Agreements 15

Service Distribution 16

National Diabetes Services Scheme 17

Free Syringe Scheme 19

Education Service Overview 20

Diabetes Client Education Services 22

Cardiac Client Education Services 25

Ancillary Education Services 28

Outreach Health Services - MOICD Program 29

AHP Mentoring 32

Information and Resources 33

Health Professional Training and Support 34

Community Education and Support 37

Youth Services 38

Health Promotion 39

Sponsors and Supporters 40

Treasurer’s Report 41

Audited Financial Statements 44

President’s Report

Annual Report 2015/16 Page 1

2015/16 has again been a significant year for growth and development for Healthy Living NT. I thank members and the community at large for their support and contributions to the Association over the year. 2015/16 has also been a year of significant change for Healthy Living NT highlighted by our strategic move towards health promotion and acquisition of the Life. Be In It brand. Over the mid to long term, Healthy Living NT aims to make a positive impact on the prevention of chronic disease as well as continuing our current role in assisting people with chronic disease.

During the year, Healthy Living NT reviewed and refreshed the Bill Raby Diabetes Fellowship after 10 years of operation. In June 2016, a revised Fellowship was launched with a new Board of Governors and objectives realigned to more relevant and contemporary goals. In addition to provision of support for health professional CPD, the Fellowship now offers funding to two new groups: • Youth affected by diabetes – to support activities which promote learning about how to best manage

diabetes as soon as possible after diagnosis, and • Community-based organisations - to support the development of community-based solutions aimed at

supporting healthier lifestyles and improving community awareness of healthy lifestyles.

Advocacy

Advocacy continues to consume a large portion of the Association’s resources, both at an individual level and generally on behalf of people with diabetes. Healthy Living NT maintains a proactive presence at national level to ensure representation of the needs of people with diabetes living in rural and remote Australia, including Indigenous people. Equitable access to services and responsiveness to the particular needs of special groups feature highly on Healthy Living NT’s agenda. During 2015/16 the NDSS underwent the most material changes in its 29 year history with the transfer of the supply and delivery of NDSS products from diabetes organisations in each State and Territory to the established Community Services Obligation (CSO) distribution network to community pharmacy NDSS Access Points.

Some of the changes to the NDSS caused Healthy Living NT to elevate concerns for people living in rural and remote areas without ready access to a pharmacy. In collaboration with the NT Department of Health, Healthy Living NT successfully sought approval from the Commonwealth Department of Health to continue as an NDSS Access Point from 1 July 2016 onwards. Similarly the probable disadvantage accruing to remote area Indigenous health services from the delisting of blood glucose test strips from the PBS became a major area of advocacy, resulting in modifications to the NDSS.

Healthy Living NT is a member of the Good Health Alliance NT, an alliance of all major preventable chronic disease non government organisations in the NT. This alliance works to reduce the impact of chronic diseases on the Northern Territory population by facilitating a united approach on areas of common interest through advocacy, active collaboration, support for primary prevention and the formation of strategic alliances.

Service Delivery

Healthy Living NT is a broad based service provider, performing services on behalf of external funders and providing direct services to its member and constituent base. All major services are directly accessible from our offices in Darwin and Alice Springs, with product and information services available at 33 Access Points in NT urban and regional centres. Phone/mail/email services and specific outreach programs are available to other areas. Services provided under formal external agreements include: • Diabetes education and cardiac rehabilitation services in Darwin and Alice Springs, funded by the NT

Department of Health (NT DoH); • Outreach diabetes education and cardiac rehabilitation services to remote indigenous communities in the NT,

funded under the Medical Outreach Indigenous Chronic Disease (MOICD) program by the Commonwealth Department of Health (DoH), and administered by the NT Primary Health Network;

• Provision of subsidised blood glucose testing strips, syringes and pen needles and insulin pump consumables and information services used by people with diabetes, funded under the National Diabetes Services Scheme (NDSS) by the Commonwealth Department of Health (DoH), and administered by Diabetes Australia Ltd;

• Provision of free syringes and pen needles to people with diabetes using insulin and non-insulin injectable medications through payment of the NDSS patient co-payment by the NT Government through NT DoH.

Collectively in 2015/16 delivery under these service contracts produced a total of 6,094 client education episodes, 1,103 health professional up-skilling episodes, 1,255 community member engagements and 3,797 NDSS product service occasions. By harnessing the synergies of each service into seamless service provision to people with diabetes, heart and other chronic conditions, Healthy Living NT seeks to maximise the value-add of each service and the overall collective benefit to the consumer.

President’s Report


The Association was pleased to continue delivery of urban diabetes education and cardiac rehabilitation services under service agreements with NT DoH. These services are delivered from bases in Darwin and Alice Springs. These services, whilst coming under increasing cost pressure, are vital services that actively promote health awareness and support people with chronic conditions to be healthy. During the year, Healthy Living NT continued delivery of a range of diabetes, cardiac and dietetic education services to remote indigenous communities in the NT through a Service Deed with the NT Primary Health Network primarily under the federally funded MOICD program. Under this program, Healthy Living NT delivered 638 days of remote service to 48 communities across the NT.

Healthy Living NT continued its role as the NT Agent for the National Diabetes Services Scheme (NDSS), a role it has fulfilled since the Scheme was created in 1987. The NDSS is a Commonwealth scheme which provides a range of diabetes information services and subsidises the cost of supplies including blood glucose testing strips, syringes and pen needles and insulin pump consumables used by people with diabetes, to help them manage their diabetes. The NDSS product subsidy significantly reduces the direct cost of managing diabetes where it really counts – the person with diabetes. Healthy Living NT was pleased to be able to continue to add a part-time diabetes nurse educator position to the diabetes education service through NDSS funding.

In June 2016, Healthy Living NT was re-appointed as the NDSS Agent in the NT for a further 4-year period for the delivery of NDSS services, in addition to a number of direct product supply agreements for provision of NDSS product to remote communities and NDSS registrants.

Resources and Information

The information and resource needs of people with diabetes and related chronic conditions is a high priority for the Association and is a particularly important requirement for people living in rural and remote areas who are not able to easily access services. The ongoing delivery of Territory Way, Healthy Living News and the continued development of Healthy Living NT’s website (www.healthylivingnt.org.au) offered members, community members and health professionals full access to information, resources and products.

Expansion of physical resources also featured during the year, with the splitting of Darwin staff over two premises.

Governance

The Board of Healthy Living NT has been active in corporate governance during 2015/16 through the work of its Governance Policy Committee. This Committee oversaw the review of the Strategic Plan (2014-2017), the currency of a formal Risk Management review and governance policy development. Good governance practice is vital to charitable, community based organisations such as Healthy Living NT.

Acknowledgements

To my colleagues on the Board, I extend my particular thanks and appreciation for your input and the time that you have freely devoted over the year. Organisations such as Healthy Living NT cannot survive without the support of major sponsors and volunteers who freely give time, effort and support. To those volunteers who rarely receive public recognition, thank you. I would like also to formally record my appreciation and acknowledgment to the staff of Healthy Living NT for their sustained work, effort and commitment over what has been a particularly busy year. To the Bernborough Club of the NT, major sponsors, commercial Access Points, the NT Primary Health Network and the NT Government, we extend our recognition and gratitude for your support and assistance throughout the year. I also wish to acknowledge the contribution of Mr Alasdair McGregor OAM for his stewardship of the Bill Raby Diabetes Fellowship from 2005-2015. In recognition, Alasdair was awarded Life Membership of the Association.

A strong Association means a strong advocate for people with diabetes. 2016/17 is shaping to be a major year of development and consolidation of services. I commend this report to you and encourage you to become more involved in the activities of your Association.

RON O’BRIEN President 2015/16

http://www.healthylivingnt.org.au/

The Healthy Living NT Board


As at 30 June 2016, Healthy Living NT’s Board comprised:

President & Public Officer Ron O’Brien

Vice President Mary Fox

Vice President Yvonne Rowan

Secretary/Treasurer Paul Gooding, OAM

Members Vivekanand Mohan-Ram

Rob Hall

Ruth Quinn

William De Decker

Josie Bacus

Retiring Board Members during 2015/16 Nil

Bill Raby Diabetes Fellowship

Board of Governors Chair

Mr Alasdair McGregor, OAM (to June 2016)

Ms Sharron Noske (from June 2016)

Board Advisory Committees:

Diabetes Education Service Advisory Committee

Chair: Dr Peter Beaumont

Cardiac Rehabilitation Service Advisory Committee

Chair: Dr Marcus Ilton

Honorary Life Members:

Tom Usher

Paul Gooding, OAM

Ian Loftus

Mary Fox

Alasdair McGregor OAM

Governance and Planning


The Board of Healthy Living NT has been pro-active in the area of corporate governance in 2015/16. A Board established Governance Policy Committee has overseen a number of governance and planning activities.

Strategic Planning

Commitment to ongoing strategic planning is a firmly established process of the Association’s corporate governance. During the year, the Board oversaw the annual review of Healthy Living NT’s Strategic Plan (2014-2017) based on four long term strategic goals. Significant changes adopted in the 2016 review included greater emphasis on health prevention within our strategic objectives, aligning with acquisition of the Life Be In It brand in the NT.

Specific business objectives support these goals and focus on annual priorities underpinned by annual budget and resources.

Healthy Living NT Strategic Goals 2014-2017 (updated June 2016)

Goal 1: Making members and the community core to the organisation, through:

• Provision of a diverse range of services and support.

• Committed advocacy for people with diabetes and for the broad determinants of health at an individual, NT and national level.

• Provision of responsive, quality information and active communication.

Goal 2: Providing leadership for strategic advocacy related to primary and secondary prevention, through:

• Representation to influence policy development and service provision at a national and NT level.

• Pursuing equity and access for high risk groups of people, particularly people living in regional and remote areas.

• Representation of sector needs and requirements through the Good Health Alliance NT.

• Promoting a holistic approach to a healthier and healthy lifestyle.

Goal 3: Delivering a portfolio of quality services, through:

• A broad range of services to consumers, community and practitioners on behalf of funding bodies, based on best practice and evidence based protocols.

• Examining the feasibility of integrated services to clients and the community through collaboration with other practitioners.

• Identification of other relevant services.

Goal 4: Enhancing the sustainability and viability of the organisation, through:

• Ethical practices and adoption of contemporary business standards in all aspects of governance including succession planning and risk management.

• Identification, assessment and implementation of business development and income generation opportunities.

• Quality financial management practices, including accountability and transparency.

• Effective interaction with key stakeholders.

• Utilising contemporary technologies.

• Employing highly qualified staff.



Board Performance Evaluation

Board performance evaluation forms part of the annual planning and evaluation cycle of governance. Evaluation is based on the Board’s collective performance against its responsibilities and charter and is used to improve Board performance through identifying under-performing areas. The evaluation also provides opportunity to individual Board members to assess their own performance and contribution and to support continuous quality improvement.

A Quality Approach

A detailed Quality Improvement Plan based on Quality Improvement Council’s 6th Edition of the QIC Health and Community Services Standards and embracing all aspects of the organisation is evaluated annually by the Board.

Risk Management Review

A formal Risk Management Review for the Association was approved by Board in August 2006, and is reviewed bi-monthly with update as risk profiles change. The Review identifies:

• Thirteen significant business risks • Their ranking in importance • A framework for identifying and managing risks including a number of risk control initiatives.

Risk assessment and management is an ongoing process; risk monitoring has been established as a standing item on all Board meeting agendas.

The Board also annually reviews the currency of Healthy Living NT’s occupational health and safety risk profile against an annual review of safety performance.

Policy Development

Significant attention has been devoted to policy development for the Association to enhance good governance and best practice in all facets of management and administration. Examples of this include the Ethical Practice and Relationships Guidelines Policy and the Corporate Governance Statement shown on the following page.

Policy review, development and implementation are on-going processes that will ensure the Association has a sound basis for future development.

Board Meeting Attendance

A summary of Board Meeting attendance for the 2015/16 financial year is shown below. The listing includes Board Members elected at either of the Association’s 2014 or 2015 Annual General Meetings (held in October annually) and who served on the Board for any period during the 2015/16 financial year (1 July 2015 - 30 June 2016). The Board met on six occasions in 2015/16 for scheduled meetings (two of which were face to face meetings held in Darwin and Alice Springs respectively). The Executive Board also met on seven occasions during the year. Collectively, Board Members devoted over 500 hours of unpaid time attending Board and associated Committee meetings, valued conservatively at $50,000 in-kind contribution.

No Board Member received any remuneration for services provided in 2015/16. The sponsored Board position aimed at engaging younger members with the governance of the Association was unfilled in 2015/16.

No. of Meetings

Attended

6 5

6 5

6 3

6 5

6 4

6 5

6 6

6 5

4 2

Board Meeting Attendance

Mary Fox

Ron O'Brien

Rob Hall

Ruth Quinn

Josie Bacus

Yvonne Rowan

William De Decker

Paul Gooding

Vivekanand Mohan-Ram



Corporate Governance Statement

This statement reflects the corporate governance principles and polices adopted by the Diabetes Association of the NT Inc., trading as Healthy Living NT, and followed in the 2015/16 financial period.

The Board of Healthy Living NT believes the principles of good corporate governance underpin the values and behaviour of the organisation(1).

Lay solid foundations for management and oversight

The Board of Healthy Living NT has confirmed five major roles:

• Legal role – to ensure the Constitution is upheld, that good governance is practiced and that the organisation complies with relevant regulatory bodies and legislation;

• Planning and Policy – to approve and monitor the Strategic Plan and to approve and monitor relevant policy;

• Accountability – to ensure that the performance of the Board and the Chief Executive Officer is reviewed against key performance indicators, the Strategic Plan, budget and against best practice governance;

• Public Relations – to represent the mission and present the image of the organisation; and

• Risk Management – to identify major risks facing the organisation, to oversee the development of risk management techniques to deal with those risks and to monitor performance against risk management strategies.

The Board has an established set of delegations of authority in place formalising the functions reserved to the Board and those delegated to management.

Structure the Board to add value

The Board is elected bi-annually from, and by, its membership. Commencing from the 2015 AGM, two-year Board terms were adopted, with 50% of the Board retiring annually. All Board Members are required to act in the best interests of the Association and, as honoraries, receive no remuneration.

The Board ensures that it is composed of a broad cross-section of members, including an appropriate mix of qualifications, skills and experience and representation from Central Australia and other distinct groups. The Association’s Constitution provides the Board with authority to appoint additional Board Members who, by virtue of their special qualities or otherwise, could assist in achieving the objects of the organisation. Mary Fox and Vivekanand Mohan-Ram were re-appointed to Board under this provision in November 2015.

In addition the Board retains a series of specialist advisory committees comprised of a range of medical specialists and other external stakeholders to provide expert advice on particular issues.

Promote ethical and responsible decision-making

During the year the Board monitored adherence to an Ethical Practice and Relationships Guidelines Policy applying to all people representing Healthy Living NT including Board Members, staff and volunteers. The policy also outlines the organisation’s expectations in doing business with external suppliers and stakeholders.

This code of conduct encompasses areas such as active compliance with statutory requirements, fair and equitable dealing, conflict of interest, efficient use of resources and assets, confidentiality and privacy, commercial relationships and reporting mechanisms for unlawful or unethical behaviour.

Safeguard integrity in financial reporting

Financial statements are presented to the Board bi-monthly for their review and consideration. A clear division of responsibility and authority exists between purchase and payment authorisation, the integrity testing of payment claims and the preparation of payments. A formal set of financial and personnel delegations are in place.

During 2015/16, the Board continued its practice of commissioning the Association’s Auditor to undertake quarterly financial reviews. The Board is responsible for recommending to the members the appointment of the external auditor at the Annual General Meeting.

(1) The ASX Principles of Good Corporate Governance and Best Practice Recommendations were used as guidelines.



Make timely and balanced disclosure

The Constitution of the Association prescribes the documents and information that are freely available to members. Access is enhanced by the publication of key documents and information in an exclusive member area on the Association’s website.

The Board is committed to accuracy, openness and timeliness in reporting, including statutory reporting and balanced, detailed reporting of performance under Service Agreements with external stakeholders. The collection of a relevant range of raw data and synthesis of this data in a meaningful and accurate manner within reports provides reviewers with the opportunity to assess transparency.

Respect the rights of members

The Board is committed to upholding the rights of members which are clearly defined in the Constitution of the Association. The Board facilitates members’ effective exercise of their rights through quarterly and annual communications, the provision of balanced and understandable information and the use of technology to allow remote members to participate in general meetings.

The ability of members to exercise their rights was further enhanced in 2015/16 with the ongoing development of the website and application of a formal communication plan.

Recognise and manage risk

The Board has a formal Risk Management policy and a comprehensive risk management framework.

The framework provides a systematic application of policies to identify, rank and treat risks and for Board and management to monitor those risks. The framework includes action plans to reduce the identified gaps in current risk management practice and facilitate an ongoing review and reporting mechanism to the Board.

Encourage enhanced performance

The Board is committed to the fair review and active encouragement of Board and management effectiveness, and assesses individual and collective performance against key performance indicators and the achievement of goals in the Strategic Plan.

A formal Board Performance Evaluation policy and Board induction program are in place and operational.

Recognise the legitimate interests of stakeholders

As a charitable organisation dedicated to providing benefit and service to people with diabetes, related chronic conditions and the community and, as the provider of significant externally funded services, Healthy Living NT recognises and values its relationships with all stakeholders, including the community, clients, staff, Government, honoraries and volunteers.

The Board values the integrity of the Association and its dealing with stakeholders. As such, the Board has endorsed and is constantly reviewing Healthy Living NT’s policies and procedures that uphold the reputation of the organisation. Internal and external guidelines, polices and procedures include:

• Corporate Guiding Values Statement

• Ethical Practice and Relationships Guidelines Policy

• Privacy and Confidentiality Policy

• Public Privacy Statement

• Occupational and Office Health and Safety Policy

• Complaints Resolution Policy

• Discrimination and Sexual Harassment Policy

A series of specialist advisory committees provides a formal access framework for external stakeholders to promote their legitimate interests.

Organisation Chart


HLNT Board* Executive Board:

President and Public OfficerVice Presidents (Darwin & Alice Springs)

Treasurer/Secretary

* General Board Members

Healthy Living NT Organisation Chart – May 2016

Chief Executive Officer1.0 FTE

Legend: Policy/Advice

Direct Reporting

Clinical/Program Reporting/Relationship

Manager Education Services/Cardiac and Diabetes Nurse Educator

1.0 FTE

Finance and Administration Manager

1.0 FTE

• Client Services Co-ordinator 1.0 FTE

• Finance & Amin Officer 1.0 FTE

• Admin Officer 1.0 FTE

• Information Officer 1.0 FTE

• Customer Service Officers 2.0 FTE(1* DRW & 1*ASP)

• Diabetes Nurse Educators 4.0 FTE

• Cardiac Nurse Educators 4.0 FTE

• Nutrition Educators (APD) 1.3 FTE

CA Education Services TE Education Services

This chart shows structure and reporting relationships.

• Diabetes Nurse Educators 1.4 FTE

• Cardiac Nurse Educators 1.4 FTE

• Nutrition Educator (APD) 0.4 FTE

• Service Co-ordination 0.2 FTE


Board of Governors

Board Sub-Committees

• Governance Policy• Investment (in recess)

Board Advisory Committees

• Diabetes Education• Cardiac Rehabilitation

Projects

• Project Staff 0.0FTE

GHANT Secretariat0.2 FTE

Health Promotion

• Manager 1.0FTE (Physical Activity)

• Nutrition Educator APD (0.2FTE)

• Program staff 0.0 FTE

• Contractors as required

Staff


The role of staff in a small and dedicated operation such as Healthy Living NT is vital to the organisation’s growth and well-being. Healthy Living NT has been very well served by its staff over the year and they are to be commended for their work, effort and commitment. Staff members employed by the Association as at 30 June 2016 were:

Chief Executive Officer Anne Kemp (Bachelor of Arts)

Manager - Education Services Chrissie Inglis

(RN - Bachelor of Nursing, Bachelor of Coronary Care Nursing; Grad Cert Diabetes Education)

Finance and Administration Manager

Mary Lawler (Bachelor of Business)

Health Promotion Manager Navin Chandra

(Bachelor of Sports Science and Education)

Client Service Coordinator Annette Wortlehock

Information Officer Irawan

(Bachelor of Science)

Finance/Administration Officer Sissy Arndt

Admin Assistant Ruth Eberhardt

Service Location Darwin Alice Springs

Diabetes Nurse Educators

Leanne Kuchel (RN - Bachelor of Nursing,

Grad Cert Diabetes Education, CDNE)

Susan De Lacy (RN, RM,

Grad Cert Diabetes Education, CDNE)

Coralie Cross (RN - Grad Cert Diabetes Education, CDNE)

Vicki Eastaway (RN - Grad Cert Diabetes Education, CDNE)

Lisa Tarca (RN - Bachelor of Nursing

Grad Cert Diabetes Education)

Cardiac Nurse Educators

Annette Warren (BA (Hons); Dip Ed

RN - Bachelor of Nursing Grad Cert Critical Care)

Martin Reilly (RN – Crit. Care Cert)

Marcia George OAM (RN – Doctor of Nursing, RM

Grad Cert ICU and CCU Nursing)

Jo Howard (RN, Bachelor of Nursing)

John Pearman (Registered Nurse)

Nutrition Educators

Gerard Wong (Bachelor of Nutrition and Dietetics,

APD)

Tess Mitchell(1)

(Bachelor of Nutrition and Dietetics APD)

Elleni Vassilakoglou (Bachelor of Nutrition and Dietetics,

APD)

Customer Service Officers Stephanie Kurz Donna Hacche

(1) This position is employed by the NT Department of Health, on secondment to Healthy Living NT for 2 days per week.

Maintenance of Continuing Professional Development for our health professional staff is critical given the specialised role they play in supporting other health professionals, training and provision of advice to clients.

Volunteers

Much of the work conducted by Healthy Living NT can only be done through the help and support of volunteers. We gratefully acknowledge the input and hours dedicated by volunteers, ranging from Board Members who provide strategic input and guidance, to those volunteers who cheerfully assist in the preparation of information packs and the packing and dispatch of Territory Way.



The Board of the Association established a Fellowship in 2005 to recognise Bill Raby’s contribution to the well-being of people with diabetes in the NT. From 2005-2015, the Fellowship supported health professionals resident in the NT to increase their knowledge of diabetes through financial support for Continuing Professional Development. Over this period, the Fellowship offered funding support of over $97,000 to 30 health professionals for diabetes CPD activities. 80% of approved applicants completed their CPD successfully. Notably:

• 71% (17) of successful completions resulted in the health professional attaining a Graduate Certificate in Diabetes Education and Management

• 87% (20) of successful completions were from health professionals practising outside the greater Darwin region.

During 2015/16, the Board of Healthy Living NT undertook a review of the Fellowship. In June 2016, a revised Fellowship was launched with objectives realigned to more relevant and contemporary goals. In addition to provision of support for health professional CPD, the Fellowship now offers funding to two new groups:

• Youth affected by diabetes – to support activities which promote learning about how to best manage diabetes as soon as possible after diagnosis, and

• Community-based organisations - to support the development of community-based solutions aimed at supporting healthier lifestyles and improving community awareness of healthy lifestyles through small preventive chronic disease health projects.

These new Fellowship objectives more closely reflect Healthy Living NT’s consumer base and strategic move into the health promotion arena through its acquisition of the Life Be In It brand in the NT.

The Fellowship is administered by an independent Board of Governors, appointed by Healthy Living NT on an honorary basis for their expertise/eminence in their particular field. With the reorientation of the Fellowship and new objectives, a new Board of Governors consistent with revised objectives was appointed by the Healthy Living NT Board in June 2016. The Fellowship Governing Board comprises:

• Ms Sharron Noske (Chair) – Senior Manager, PwC Indigenous Consulting • Mr Gerry Wood – Member of the NT Legislative Assembly • Ms Sue Korner – COO, Central Australian Health Service • Mr Will De Decker – University student and HLNT Board Member with special interest in young people with

diabetes • Healthy Living NT President (Mr Ron O’Brien) or nominated delegate

Healthy Living NT extends its sincere appreciation and thanks to former Governors, Mr Alasdair McGregor, OAM – former NT magistrate, Dr Diane Howard – Endocrinologist and Dr Christine Connors – NT DoH for their outstanding service and commitment during the Fellowship’s formative years. The Fellowship’s high level of success in the first ten years was substantially due to Governor’s ongoing contribution and stewardship. In recognition of his distinguished service as Chair of the Board of Governors for the Fellowship’s first ten years, Healthy Living NT bestowed Life Membership of the Association upon Alasdair McGregor OAM.

The functions and responsibilities of the Board of Governors include acting as sole arbiter on applications, award of Fellowships and assessment of outcomes, providing strategic advice on the development and direction of the Fellowship, and assisting with promotion of the Fellowship. The Fellowship is supported by Healthy Living NT through commitment to minimum Fellowship funding of $10,000 per annum, and provision of Fellowship secretariat, administration, promotion and financial management.

In 2015/16, one Bill Raby Diabetes Fellowship totalling $1,000 was awarded to Aboriginal Health Practitioner, Sherrelle Khan to assist with the cost of attending the 2016 Australian Diabetes in Pregnancy Society’s Conference.

Good Health Alliance NT


The Good Health Alliance NT celebrated its twelfth year of operation in 2015/16. This Alliance, initiated by Healthy Living NT, comprises membership of all major chronic disease non government organisations in the NT, including:

• Diabetes Association of the NT Inc. • National Heart Foundation (NT Division) • Asthma Foundation of the NT Inc. • Cancer Council of the NT Inc. • National Stroke Foundation • Kidney Health Australia

The purpose of the Alliance is to collectively advocate for improved chronic disease prevention and management services in the NT.

NT chronic disease non government organisations are committed to a common cause. We have a strong track record of informal collaboration which has been enhanced through the Chronic Disease Network. Additionally, the Alliance brings together a range of assets and strengths including independence of action, national affiliations, a consumer base and experience in working in a culturally and geographically diverse environment. The Alliance is a champion for the cause of chronic disease prevention and best practice management.

The Alliance offers a unique and innovative opportunity for government, health service providers and non government organisations to work together in chronic disease prevention and management in the NT. In 2015/16 Alliance members funded the operation of a small secretariat to enhance Alliance management and advocacy capacity.

The Alliance is represented on a number of inter-sectoral and Government committees and forums.

Strategic Goals

1. Advocating for strategic and committed and long term investment and evidence based Public Health policy.

2. Actively contributing to the Chronic Conditions Prevention and Management Strategy.

3. Facilitating the promotion of common health messages.

Membership


As a member-based organisation, committed to improving the lives of people with diabetes in the NT, Healthy Living NT maintained sound performance in 2015/16. In addition to a range of discounted products and eight educational magazines per year, Healthy Living NT Members receive a range of value added benefits including enhanced resource access on our website.

One of the prime benefits of Healthy Living NT membership is our quarterly magazine, Territory Way. Territory Way is designed to provide members with management, educational and product advice with particular relevance to the NT. An active reader feedback mechanism assists to incorporate reader preferences and information needs into the publication. Territory Way is also distributed to all politicians, GP and allied health practices, health clinics and relevant government and community organisations in the NT.

Membership numbers of 1,123 were marginally lower than 2014/15 (1,300). Members comprised people with diabetes using insulin - 26%, people with diabetes (no insulin) - 67% and organisation or general community members - 7%. Membership fees have not increased since 1999 and income from membership fees in 2015/16 was marginally higher than 2014/15. 52% of consumer members are at pension subscription rate (compared to 55% in 2013/14) and 70% of members were aged 60 years or above. A profile of Healthy Living NT membership by region is shown in the chart below.

Advocacy and Support


Advocacy continues to consume a large portion of the Association’s resources, both at an individual level and generally on behalf of people with diabetes/chronic conditions. Major advocacy issues during the year include:

• National Diabetes Services Scheme (NDSS) – During 2015/16 the NDSS underwent the most material changes in its 29 year history with the transfer of the supply and delivery of NDSS products from diabetes organisations in each State and Territory (including Healthy Living NT) to the established Community Services Obligation (CSO) distribution network to community pharmacy NDSS Access Points. Aimed at cost efficiency, this decision sought to more closely align the NDSS and PBS supply chains. This change had the potential to negatively impact NDSS registrants in the NT, particularly those living in rural and remote areas without ready access to a pharmacy and those engaging in formal diabetes education services through Healthy Living NT where product use forms an important facet of self-management education. In 2014/15, 41% of NDSS products dispensed directly to registrants and 29% of accessing registrants in the NT were serviced directly from Healthy Living NT via counter, web, phone and mail order sales. In collaboration with the NT Department of Health (NT DoH), Healthy Living NT sought approval to continue as an NDSS Access Point from 1 July 2016 onwards. This was agreed by the Commonwealth Department of Health (DoH). Healthy Living NT entered into an NDSS Access Point Agreement with DoH for the 2016-2020 period.

• Other supply scheme changes – A number of other changes occurred to diabetes product supply in relation to the NDSS:

Self Blood Glucose Monitoring (SBGM) for people with type 2 diabetes not using insulin. As a result of the PBAC review of the efficacy of SBGM, limitations to subsidised blood glucose test strips for people with type 2 diabetes who are not using insulin are being implemented from 1 July 2016.

o Healthy Living NT believes these restrictions will not limit access to SBGM to people with type 2 diabetes not using insulin who genuinely require or benefit from this form of management regimen as a broad range of exemptions and prescriber discretion is allowed.

De-listing Blood Glucose Test Strips (BGTS) from the PBS. As a result of decisions to more closely align the NDSS and PBS supply chains, BGTS (which were listed on both supply schemes) were de-listed from the PBS with effect from 1 July 2016. Whilst this change would have minimal impact on the majority of Australians with diabetes, it posed a potential high negative impact on remote Indigenous Australians who access BGTS through their Remote Area Aboriginal Health Service (RAAHS) under S100 or CTG exemptions. Under provisions of the Section 100 of the National Health Act 1953, patients of approved RAAHS can receive free PBS medicines from the Aboriginal Health Service without a prescription.

o The change would have imposed an additional cost on RAAHS to purchase BGTS through the NDSS (patient co-payment) as well as an additional administrative burden in the form of individual ordering on behalf of each registrant, impacting ~80 remote Indigenous clinics in the NT. Healthy Living NT, together with the NT Department of Health and AMSs, collaboratively lobbied the Commonwealth Department of Health for the retention of BGTS on the PBS for the purpose of RAAHS and CTG supply. Whilst these submissions were not successful in the retention of BGTS on the PBS for S100 purposes, the Commonwealth Department of Health agreed to changes to the NDSS that enabled continued provision of free BGTS to RAAHS without need for prescription/individual order.

o Healthy Living NT manages NDSS product supply to RAAHS clinics supply in the NT, SA and QLD whilst Diabetes WA supplies RAAHS clinics in WA, NSW and Tasmania.

• National Chronic Disease Strategy – Healthy Living NT has participated in a number of consultations conducted by the Commonwealth Department of Health in the development of this strategy

• Drivers Licenses – for people with diabetes and cardiac conditions remains a perennial issue needing to be addressed by education staff, often in liaison with Endocrinologists and the Motor Vehicle Registry. People who require endocrine review, particularly those seeking commercial licenses, often face extended waiting times for appointments which can contribute to delays in obtaining licenses. New national guidelines due shortly are anticipated to adopt a more evidence-based approach to license restrictions due to medical conditions

Collaborations and Service Partnerships


Healthy Living NT is committed to working in partnership with other organisations wherever possible. Healthy Living NT maintains a number of national affiliations including membership of the National Association of Diabetes Centres.

Health professionals employed by Healthy Living NT maintain strong affiliations with the Australian Diabetes Educators Association, the Australian Cardiovascular Health and Rehabilitation Association and the Dietitians Association of Australia. In addition to membership of the Good Health Alliance NT, Healthy Living NT is also a core member of the NT Chronic Disease Network and is represented on the CDN Steering Committee.

During the year, Healthy Living NT worked collaboratively with a number of organisations including Darwin Podiatry, BodyFit NT, the Preventable Chronic Conditions Unit (NT DoH), NT Primary Health Network (PHN), NT DoH Community Care Centres, Cardiology Outreach Team, Aboriginal Medical Services, Baker IDI, Charles Darwin University and Menzies School of Health Research.

Collaborative Service Partnerships

Healthy Living NT is committed to working in a collaborative partnership framework with indigenous and non-indigenous health service providers. In 2015/16, Healthy Living NT also:

• Worked collaboratively in the Northern Territory Diabetes in Pregnancy Partnership (funded under a NHMRC Partnership Grant). This is a collaborative project between the Menzies School of Health Research, Baker IDI, NT Department of Health, Healthy Living NT and Aboriginal Medical Services Alliance Northern Territory (AMSANT).

• Supported the delivery of multi-disciplinary monthly public paediatric diabetes clinics at Healthy Living NT in Darwin in association with the RDH Paediatric and Diabetes teams, which include twice-yearly visits from a visiting Paediatric Endocrinologist from Queensland.

• Supported the NT Chronic Disease Network (CDN) annual conference and managed Conference seed funds on behalf of NT DoH. The 2015 Conference, Connecting the Care Across the Lifespan, was held in Darwin in September 2015

• Provided diabetes, cardiac and dietetic outreach services to a number of Aboriginal Medical Services and Departmental Remote Clinics under the MOICD funding initiative.

• Provided regular scheduled cardiac education services to Congress.

• Regularly engaged with the RDH diabetes team and the RDH Cardiac team.

• Provided scheduled cardiac and dietetic services to Danila Dilba Health Service.

• Provided scheduled diabetes education services to Darwin Correctional Centre.

• Continued arrangements with the CDU School of Psychological and Clinical Studies for clinical placements of their Provisional Psychologists completing their Masters course within Healthy Living NT programs. These students assist in the running of the Cardiac Rehabilitation Program, as well as take direct referrals for individual client appointments from the health professional staff at Healthy Living NT.

• Worked collaboratively with the new Cardiology Outreach Services and Cardiac Care Coordinator positions to augment current services and communication.

• Worked collaboratively with Diabetes Australia Ltd in relation to NDSS matters.

• Supported the Lilla Sports Festival for Indigenous children from four remote Central Australian schools, in partnership with the legal firm, Gadens.

• Commenced stakeholder engagement to support Healthy Living NT’s role in health promotion and active recreation.

• Conducted a pilot AHP mentoring program in partnership with two remote clinics.

• Continued its support for the type 1 fundraising efforts of the Juvenile Diabetes Research Foundation (JDRF).

Service Agreements


Healthy Living NT delivers a number of services and projects in the Northern Territory on behalf of external funders. All services provided by Healthy Living NT comply with relevant national and/or Territory legislation including the NT Carers Act 2006, Working with Children and mandatory reporting of domestic violence. External funders are shown below:

Services: Funder

• National Diabetes Services Scheme Diabetes Australia Ltd/Commonwealth Department of Health (DoH)

• Product supply to veterans Department of Veterans’ Affairs

• Diabetes Education – Top End NT Department of Health (NT DoH)

• Cardiac Education – Top End NT Department of Health (NT DoH)

• Free Syringe Program NT Department of Health (NT DoH)

• Diabetes and Cardiac Education – Alice Springs NT Department of Health (NT DoH)

• Diabetes, Cardiac and Dietetic Education Outreach Health Services / MOICD – NT Primary Health Network /Commonwealth DoH (DoH)

• Minor service agreements Varied minor agreements and projects

Healthy Living NT welcomes the opportunity of delivering services and projects in partnership with external funders and organisations. By harnessing the synergies of each service into seamless service provision to people with diabetes, heart and other chronic conditions, Healthy Living NT seeks to maximise the value-add of each service and the overall collective benefit to the consumer.

Healthy Living NT sources of income from services (internal and external) are shown in the chart below.

NDSS, $483,268 , 18%

NT DoH Darwin Diabetes Education,

$348,034 , 13%

NT DoH Darwin Cardiac Education,

$130,569 , 5%NT DoH Alice

Springs Cardiac & Diabetes Education,

$288,509 , 11%

MOICD Program, $887,029 , 33%

HLNT Direct Income, $362,942 ,

14%

Special Projects, $164,186 , 6%

2015/16 Income by Source

Service Distribution


National Diabetes Services Scheme


Healthy Living NT is the NT agent for the National Diabetes Services Scheme (NDSS). The NDSS is an initiative of the Australian Government administered with the assistance of Diabetes Australia Ltd (DAL). It supplies subsidised essential blood glucose testing strips, syringes and pen needles used in the injection of insulin and injectable non-insulin blood glucose lowering medication, insulin pump consumables and information and support services on diabetes management to people with diabetes. The NDSS product subsidy significantly reduces the direct cost of managing diabetes where it really counts – the person with diabetes.

Product Access

In 2015/16, Healthy Living NT delivered 26,602 NDSS products on over 3,797 occasions, through a network of 35 outlets throughout the NT and Kununurra in WA covering all urban centres. In addition to Healthy Living NT offices in Darwin and Alice Springs, NDSS products and services were available at a range of 33 pharmacy Access Points – in excess of 90% of total pharmacies in the NT.

• United Discount Chemist Palmerston • Gove Pharmacy • Katherine Amcal Pharmacy • United Discount Chemist Northside Alice Springs • Amcal Max Casuarina Night & Day • Northlakes Amcal Pharmacy • Darwin Discount Pharmacy • Kununurra Pharmacy – WA • United Discount Chemist Alice Springs • Karama Amcal Pharmacy • Humpty Doo Amcal Pharmacy • Palmerston Amcal Pharmacy • Hibiscus Chemmart Pharmacy • Stuart Park Amcal Pharmacy • Chemist Warehouse Berrimah • Better Health Pharmacy Coolalinga • Casuarina Square Amcal Pharmacy • Bardens Amcal Pharmacy Parap • Chemist Warehouse Ludmilla • Bardens Amcal Pharmacy Galleria Darwin • Nightcliff Amcal Pharmacy • Bardens Amcal Pharmacy CBD Plaza Darwin • Save Mart Pharmacy Winnellie • Chemist Warehouse Casuarina • Tennant Creek Pharmacy • Howard Springs Amcal Pharmacy • Durack Amcal Pharmacy • Better Health Pharmacy Mitchell Street • Terrace Amcal Pharmacy Katherine(*) • Berry Springs Country Wellness Pharmacy(*) • Pharmasave Casuarina Village(*) • Northpharm Royal Darwin Hospital(*) • Palmerston GP Superclinic Pharmacy(*)

Five new (*) Access Points were appointed and established in 2015/16. Most Access Points offer a fully integrated service that includes the complete range of Healthy Living NT products and education and information material.

Healthy Living NT also directly supplied a number of indigenous health providers and clinics in urban and remote locations with a range of diabetes products and services.

Registrant Support Services

Through Healthy Living NT, the NDSS delivered information and a range of Registrant Support Services to people with diabetes to assist them with managing their diabetes. This includes the provision of 945 Starter Packs for people newly diagnosed with diabetes, 226 Gestational Starter Packs and associated follow-up letters and material, a range of education services and a range of tailored information sheets and support communications targeted to particular age groups. Replacement NDSS cards were also issued to a total of 2,590 registrants.

Healthy Living NT was also pleased to be able to continue to provide a part-time diabetes nurse educator position to the diabetes education service through NDSS Registrant Services funding. Additionally Healthy Living NT educators provided training to Access Point staff on a regular basis throughout the year.

Registrations

NDSS registrations in the NT as at 30 June 2016 were 14,295, including 1,197 new registrants in 2015/16 and growth of ~3.3% over the previous year, after taking into account the removal of registrants following National Death Index data cleansing during the year. Of total NT registrations, 42% comprise people of Indigenous descent and 28% comprise people who manage their diabetes through the use of insulin, including people with type 1, type 2 and Gestational diabetes.

The number of registrants accessing product through the NDSS in the NT has traditionally been below the national average. This is due to a variety of factors including generally lower rates of SBGM and the high proportion of Indigenous clients who are registered with the Scheme (42%) but who obtain their diabetes supplies primarily through their local health clinic through Section 100 exemptions and/or monitor at lower frequency than non indigenous Australians.



7,518 8,135 8,843 9,376 9,768 10,078 10,353

2,642 2,884

3,035 3,317

3,587 3,754 3,942

-

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16

2015/16 NDSS Registrations - by insulin status

Non Insulin Treated Diabetes Insulin Treated Diabetes

Type 1 - All Insulin, 789, 6%

Type 2 - Insulin, 3092, 22%

Type 2 - No Insulin, 10,069, 70%

Gestational - Insulin, 29, 0%

Gestational - No Insulin, 244, 2%

Other - Insulin, 32, 0%

Other - No Insulin, 40, 0%

2015/16 - Registrants by Diabetes Type and Management

The NT has a higher proportion of people with type 2 diabetes when compared to Australian NDSS registrations (NT = 91% vs Australia = 86%). Additionally, type 2 NDSS registrations in the NT are markedly different to the national profile with 56% of people with type 2 diabetes aged below 60 years, compared to only 34% nationally. This is best illustrated in the chart overleaf.



0%

5%

10%

15%

20%

25%

30%

35%

0-15 yrs 16-20 yrs 21-29 yrs 30-39 yrs 40-49 yrs 50-59 yrs 60-69 yrs 70-79 yrs 80-89 yrs 90+ yrs

Type 2 NDSS Registrants by Age Group (%) - NT vs. Australia

Type 2 NT Type 2 Australia

NDSS Agreement

The 2011-2016 NDSS Head Agreement between the Commonwealth Department of Health (DoH) and DAL for product distribution and service delivery finished on 30 June 2016. DAL entered into a new 4-year NDSS Agreement (2016-2020) in June 2016 for the delivery of ongoing NDSS services only and Healthy Living NT subsequently entered into a new NDSS Agency Agreement in respect of the NT with DAL.

Concurrently Healthy Living NT additionally entered into the following NDSS-related agreements directly with the Commonwealth DoH:

• Agent Direct Deed • NDSS Access Point Agreement • Rural and Remote Distribution Agreement

NT Free Syringe Scheme Overview

Under an agreement with Healthy Living NT, the NT Department of Health funds the provision of free syringes and pen needles to NT residents who:

• Are NDSS registrants and have insulin requiring diabetes or are prescribed injectable non-insulin blood glucose lowering medication or

• have another chronic medical condition requiring the use of needles or syringes in its management.

In practice, this means the NT Government pays the patient co-payment on syringes and pen needles ($8 or $5 per box of 100) for eligible NT residents registered with the NDSS or the full cost of needles or syringes supplied to people with other chronic medical conditions requiring these products. The Scheme, administered by Healthy Living NT, is well supported by people with diabetes as it further reduces the cost of diabetes management in a practical manner and lessens the economic need for people with diabetes to re-use their needles and syringes. In dollar terms, the NT Government saved NT residents with diabetes ~$50,000 in 2015/16.

The results of the scheme’s operation in the NT in the 12 months to 30 June 2016 were:

• The overall volume of needles and syringes sold was 7,379 (boxes of 100) representing an increase of 4.5% over the previous 12 months (n = 7,050).

• Products were supplied to 5,007 NDSS registrants, averaging out at approximately 1.5 boxes per accessing registrant. Whilst the ratio of product/registrant is on par with 2014/15, the number of people accessing the scheme over the previous 12 months has increased by 4.7% (2014/15=4,774).

• 40% of product was sold to registrants who held some form of Commonwealth concession card. Pen needles comprised over 98% of total sales, with syringes making up the remainder.

• There was no demand for free products to people with another chronic medical condition.

Education Service Overview


Education Services

Healthy Living NT delivers a range of service contracts which provide education to people with diabetes and cardiac disease as well as support services and health promotion.

Healthy Living NT provides these services under varying service agreements. These include:

• Diabetes Education and Cardiac Rehabilitation Services in Darwin and Alice Springs, funded by the NT Department of Health (NT DoH)

• Outreach Health Services - Remote Diabetes, Cardiac and Nutrition Education Services under the Medical Outreach – Indigenous Chronic Disease Program (MOICD), funded by the NT PHN under an agreement with the Commonwealth DoH

• NDSS funding contribution to the overall diabetes education service effort, supporting a 0.5 FTE diabetes nurse educator position and the AHP mentoring pilot project

• Danila Dilba Dietitian Education Services

• Darwin Corrections Diabetes Service

• NT Department of Sports and Recreation (DSR) Active Recreation Organisations Program

These service agreements enable a pool of health professional and health promotion staff to be employed to cover services and an increased capacity within the service to cover all contracts.

Education and Health Promotion Staffing

The Education and Health Promotion team involves health professionals employed at both our Darwin and Alice Springs offices. At June 2016 the team consisted of:

Darwin

• 1.0 FTE Education Manager who is both a Diabetes and Cardiac Educator within the Darwin office,

• 3.0 FTE Diabetes Educators,

• 3.8 FTE Cardiac Educators

• 1.5 FTE Dietitians

• 1.0 FTE Health Promotion Manager

Alice Springs

• 2.0 FTE Diabetes Educator

• 1.0 FTE Cardiac Educator

• 0.4 FTE Dietitian position (provided directly by NT DoH).

Urban diabetes education and cardiac rehabilitation services, particularly those based in Darwin, have faced significant funding pressure in view of increased demand arising from growing populations. The limited funding for these services has meant that restrictions have been put into place regarding flow of clients through the service with prioritisation of appointments. These restrictions have included a move to review education by group (Touching Base) for the majority of clients and in the case of the Darwin cardiac services, a reduction in the staffing to the service.

In 2015/16, Healthy Living NT commenced transition to a new client Electronic Record System covering urban services.

Advisory Committees

The Board of Healthy Living NT has established Advisory Committees to provide medical, consumer and local advice to the Board and service staff in the delivery of education services. These committees did not meet in 2015/16 due to pressures of service delivery and scheduling of the committee members.

Over the last few years, a number of committees and groups have been formed within the Department and the NT Medicare Local/Primary Health Network to assist in cross sectorial management of clients, consistency of messages and coverage of education services. Healthy Living NT education staff participate in these Steering/ Operational Committees and feedback of Healthy Living NT services occurs through these channels.

Education Service Overview


2015/16 Education Overview

In 2015/16, a total of 6,094 clients with diabetes, cardiac and other chronic conditions were provided with education services:

• 3,878 clients with diabetes were provided with education across all services (2014/15 = 4,158)

• 2,067 clients with heart conditions were provided with education across all services (2014/15 = 2,406). An additional 419 client episodes were recorded in the provision of maintenance exercise classes

• 47 clients with a range of chronic conditions (diabetes, heart disease, respiratory disease, cancer and kidney disease) were provided with specific nutrition education under MOICD (2014/15 = 133)

• 3,298 (54%) of all clients seen were of Indigenous descent (2014/15 = 52%)

Diabetes Clients

48% of clients with diabetes were educated through the NT DoH Darwin service, 14% through the DoH Alice Springs service, 33% through the MOICD service, 5% through Darwin Corrections. There were an additional 13 client appointments for psychology.

1,541 (40%) of diabetes clients seen across all services were of Indigenous descent.

Cardiac Clients

14% of clients with cardiac conditions were educated through the NT DoH Darwin service, 13% through the Alice Springs NT DoH service, 72% through the MOICD service. There were an additional 16 client appointments for psychology. 1,612 (79%) of cardiac clients seen across all services were of Indigenous descent.

MOICD, 1276, 33%

DoH Darwin Service, 1869,

48% DoH Alice Springs

Service, 541, 14%

Darwin Corrections,

179, 5%

Psychology , 13, 0%

2015/16 Diabetes Client Breakdown - All Services

MOICD , 1489, 72%

DoH Darwin Service,

297, 14%

DoH Alice Springs Service,

265, 13%

Psych cardiac, 16, 1%

2015/16 Cardiac Client Breakdown - All Services

Diabetes Education Services


Diabetes Education Service (NT DoH Service Agreement)

Diabetes education services are provided directly from Darwin and Alice Springs locations, with a telephone support service operating in the remainder of the NT. The services are funded primarily by the Northern Territory Department of Health, supplemented by NDSS funding (for group education and resources) and supported by Healthy Living NT through additional funding, management and administration expertise.

Healthy Living NT operates and develops diabetes education services based on national best practice guidelines and quality standards, including those published by the Australian Diabetes Educators Association, the CARPA Treatment Manual and the RACGP Diabetes Management in General Practice. Healthy Living NT is an Accredited Diabetes Centre under the National Association of Diabetes Centres.

Newly Diagnosed Education

The purpose of Healthy Living NT’s education packages for the newly diagnosed is to provide the client with a comprehensive understanding of their diabetes, sufficient for them to commence immediate self-management initiatives.

Healthy Living NT’s preference is for education delivery for newly diagnosed type 2 & IGT clients to be conducted in a group session of 2.5 hours. Women with gestational diabetes (GDM) are educated in a group session of 1.5 hours. This provides efficiencies in the education service by enabling the same basic information to be imparted to a group of people; it has the added benefit of showing the person newly diagnosed with diabetes that they are not isolated in their condition or concerns.

Initial group education sessions called Getting Started are scheduled: • 2 times per month for new type 2 and IGT clients from our Darwin office, a once a month after hours session

held at Palmerston and a once a month from our Alice Springs office; • weekly groups for new GDM clients held at the Darwin office.

Individual initial education is provided to: • all new/newly diagnosed clients with type 1 diabetes or those with type 2 diabetes commencing insulin

therapy • all Alice Springs GDM clients • any client for whom English is not a first language and where an interpreter may be required • any client with physical or mental impairment e.g. deafness, impaired vision, lack of mobility etc • any client who cannot, or does not wish to, attend a group education session

Review Education

Review education for those with type 2 diabetes is provided individually to clients after their first group initial appointment. If a client requires further individual reviews post initial education as assessed by the educators or their GP, they are booked as needed. However the majority of type 2 and IGT clients are encouraged to attend the new Touching Base Groups. While Healthy Living NT believes ongoing review education and regular annual contact is a very important part of managing diabetes over the lifespan, service funding is insufficient to support the full extent of services in Darwin.

Clients undergoing insulin stabilisation are often reviewed on a weekly basis (face to face or phone) until optimum management has been obtained and clients who have GDM are reviewed initially on a weekly basis.

Education Venues

Scheduled client education services are delivered from a variety of venues, including directly from:

• Healthy Living NT’s Tiwi and Alice Springs offices • Palmerston Community Care Centre

• Darwin Private Hospital (on request)

A telephone education service is available NT wide and home visits are assessed and delivered on a defined needs basis in urban areas.

Healthy Living NT also provides the clinical consult spaces and the dietitian in an ongoing arrangement with the RDH Paediatrics team for the Paediatric Diabetes Clinic and specialist visiting Endocrinology clinic. The regular Paediatric Clinics are held monthly and the Paediatric Endocrinology Clinics twice a year with the visiting Paediatric Endocrinologist from Queensland.



2015/16 Diabetes Client Overview (NT DoH Service Agreement)

In 2015/16 the diabetes education service directly assisted 2,410 people with diabetes, an average of 201 per month. 78% of clients were educated by the Darwin service, an average of 158 clients per month (reduced 15% from 2014/15); 22% of clients were educated by the Alice Springs service, an average of 45 clients per month (reduced 16% from 2014/15).

New clients represented an overall 25% of clients (Darwin 27% and Alice Springs 23%); Review clients comprised the remaining 75%.

New Clients diagnoses breakdown:

• 231 diagnosed with Type 2 in Darwin and 100 in Alice Springs (331 in total, 16% reduction from 2014/15)

• 198 diagnosed with GDM in Darwin and 0 in Alice Springs (8% decrease from 2014/15)

• 32 diagnosed with IGT in Darwin and 20 in Alice Springs (20% decrease from 2014/15)

• 25 diagnosed with Type 1 in Darwin and 2 in Alice Springs (8% increase from 2014/15)

The total number of review client episodes decreased in Darwin 14%, primarily due to the restructuring of the diary and the encouragement of the majority of the review clients to attend Touching Base groups (rather than individual review appointments). The total number of review clients in Alice Springs decreased similarly, however this was due largely to not having the Diabetes Educator position filled over a period of a few months. 15% of review consultations were done via the phone. Other notable factors in 2015/16 include:

• Overall, 48 clients commenced insulin in a community setting provided by Healthy Living NT in collaboration with the client’s GP, requiring 314 review consultations (63 commenced and 445 reviews in 2014/15)

• 814 letters sent to Medical Officers and 37 interpreters used during consultations

• 128 clients seen were of Indigenous descent

• The Provisional Clinical Psychologists saw 5 clients with diabetes plus 8 review appointments (not counted in totals of reviews)

• 62 clients attended Touching Base groups

An overriding protocol of the diabetes education service is that all clients should have a referral from a Medical Officer as it ensures better client care and continuity of care within a multi-disciplinary team. In 2015/16, a total of 572 referrals were received for new clients who attended. The 2015/16 sources of referral are shown below:

(*) referrals from other allied health professionals

GP/ AMS/ DMO,

345, 60%

Physician/ Pediatrician,

5, 1%

Hospital MO, 22, 4%

Obstetrician/ ANC, 195, 34%

Other (*), 5, 1%

2015/16 Source of Referrals



* Referrals from other allied health professionals ** Indigenous clients educated through the MOICD and other programs are not counted in this section

Diabetes Client Services 2015/16 DOH Service Agreement

No. 15/16

% %

Change 2014/15

No. 15/16

% %

Change 2014/15

No. 15/16 % %

Change 2014/15

Total New Clients: 486 26% -18% 122 23% -16% 608 25% -17%

Type 1 diabetes 25 5% 47% 2 2% -75% 27 4% 8% Type 2 diabetes 231 48% -20% 100 82% -5% 331 54% -16%

GDM (Gestational Diabetes) 198 41% -8% 0 0% 198 33% -8% IGT (Impaired Glucose Tolerance) 32 7% -3% 20 16% -38% 52 9% -20%

Educated individually 133 27% -4% 99 81% -20% 232 38% -11% Educated by Group 353 73% -22% 23 19% 5% 376 62% -21%

Time since diagnosis < 3 months 261 54% -8% 32 26% -35% 293 48% -12% Appointment Booking Time Exceeded 0 0% 0 0% 0 0%

Did Not Attend 62 13% -30% 19 16% -41% 81 13% -33%Referred by

GP/ AMS/ DMO 247 53% -20% 98 93% -18% 345 60% -19%Physician/Pediatrician 4 1% -20% 1 1% 0% 5 1% -17%

Hospital MO 19 4% -27% 3 3% 50% 22 4% -21%Obstetrician/ANC 195 42% 2% 0 0% 195 34% 2%

Other (*) 2 0% -78% 3 3% -70% 5 1% -74% Total Referrals 467 96% -21% 105 86% -21% 572 94% -21%

Total Review Clients: 1,383 74% -14% 419 77% -16% 1,802 75% -14%

Type 1 100 7% 8% 28 7% 40% 128 7% 13% Type 2 875 63% -20% 380 91% -14% 1255 70% -18%

GDM 321 23% -15% 1 0% 322 18% -14% IGT 30 2% -39% 5 1% -85% 35 2% -57%

Insulin Stabilisation Initial 38 3% -25% 10 2% -17% 48 3% -24% Insulin Stabilisation Review 219 16% -23% 95 23% -41% 314 17% -29%

Educated by Phone 212 15% -12% 50 12% 0% 262 15% -10% Seen by DNE 779 56% -24% 239 57% 0% 1018 56% -19%

Seen by Dietitian 547 40% -6% 211 50% -4% 758 42% -5% Appointment waiting time >10 mins 4 0% -81% 4 1% 8 0% -62%

Did Not Attend 199 14% 15% 74 18% 45% 273 15% 22% Touching Base Attendance 57 4% 185% 5 1% 62 3% 210%

Review Reminders Sent 661 48% 26% 99 24% -27% 760 42% 15%

Total Clients 1,869 78% -15% 541 22% -16% 2,410 100% -15%

General Aboriginal/TSI clients ** 85 5% 29% 43 8% -17% 128 5% 8%

Letters to Medical Officers 611 33% -34% 203 38% 46% 814 34% -23% Clients seen externally 194 10% 8% 0 0% 194 8% 8% Significant Others Seen 165 9% -32% 41 8% -52% 206 9% -37%

Interpreters Used 37 2% -42% 0 0% 37 2% -44% Phone Information -

Health Professionals 272 72% -1% 25 81% 92% 297 73% 3% General Public 104 28% 12% 6 19% 100% 110 27% 15%

Information Packs - Insulin 19 3% -77% 4 5% -33% 23 3% -74% Type 2 275 45% -31% 64 74% -9% 339 48% -28%

Type 2 Insulin 25 4% -60% 5 6% 30 4% -52% GDM 245 40% -14% 0 0% 245 35% -14%

IGT 51 8% -14% 14 16% -50% 65 9% -25%Total 615 -31% 87 -16% 702 -29%

Total 2014/15Alice Springs Darwin

Cardiac Education Services


Cardiac Education Service (NT DoH Service Agreement)

Cardiac education and rehabilitation services are provided directly from Darwin and Alice Springs locations, with a telephone support service operating for the remainder of the NT. The services are funded primarily by the NT Department of Health, supported by Healthy Living NT through access to management and administration expertise and resources.

Base funding for the service has not increased since the service began in 2002 and the cost of these services cannot maintain employment of a 1.0 FTE Cardiac Educator. As new cardiac services are provided through the NT DoH, further service gaps are occurring as client numbers increase. Service restrictions mean that not all potential clients are seen in Phase 1 by Healthy Living NT staff for recruitment into Phase 2 Cardiac Rehabilitation in Darwin. Healthy Living NT relies on the staff of the public and private hospitals to recruit for Phase 2 Cardiac Rehabilitation services. This has resulted in numbers in the Phase 2 services not increasing at the same rate as possible new clients, with many not even aware of the services available.

Healthy Living NT operates and develops cardiac rehabilitation services based on national guidelines and quality standards, specifically Recommendations for Cardiac Rehabilitation published by the National Heart Foundation (1998 and updated 2004).

Memorandums of Understanding are in operation with:

• Royal Darwin, Darwin Private and Alice Springs Hospitals regarding access and support for in-patients

• NT Cardiac to cover implied referrals for all inpatients in RDH and DPH

• Alice Springs Hospital to cover implied referrals for inpatients

Purpose and Mode of Education

Healthy Living NT cardiac services provide a range of cardiac rehabilitation and education services which aid people with heart conditions to get back into the community and to improve their lifestyle. The program is run in three phases: the inpatient program (Phase 1); the outpatient program (Healthy Heart Program) (Phase 2); and the maintenance program (Phase 3). Cardiac education services to people with a cardiac condition in the NT comprised:

• Phase 1 inpatient education for clients admitted with a cardiac condition in Royal Darwin Hospital, Alice Springs Hospital and Darwin Private Hospital.

• Phase 2 Healthy Heart Program for cardiac patients discharged from hospital, those returning from cardiac intervention procedures interstate and patients referred from GPs. The program focuses on secondary prevention and is designed to promote the continuance of lifestyle modification and self management education and deliver appropriate physical activity after a cardiac event.

• Information packages for those unable to attend a Phase 2 program covering education and exercise guidelines are provided. Individual appointments are available either face to face or via telephone. Remote clinics can also access this telephone service for their clients.

• Phase 3 maintenance commencing at the completion of Phase 2 and involving follow up on cardiac risk factors, education and information days and a continuing exercise program in Alice Springs.

• A telephone support service which is available throughout the phases. • Phase 2 education in the cardiac rehabilitation program in Darwin and Palmerston includes the support of a

CDU Clinical Psychology Masters student undergoing their placement at Healthy Living NT • Phase 3 education is now provided through the drop-in style self management group sessions called Touching

Base offered in both Darwin and Alice Springs.

Education Venues

Scheduled client education services are delivered from a variety of venues, including directly from:

• Healthy Living NT’s Tiwi and Alice Springs offices • Palmerston Community Care Centre

• Darwin Private Hospital • Royal Darwin Hospital

• Alice Springs Hospital • Central Australian Aboriginal Congress (Main Clinic)



2015/16 Cardiac Client Overview (NT DoH Service Agreement)

In 2015/16, Healthy Living NT provided cardiac education and rehabilitation services to 569 new clients (Phase 1 and Phase 2 clinics). Additionally, Phase 2 clients attending the Healthy Heart programs (93), attended 319 times, Phase 3 clients attending education sessions attended 22 times, there were 419 maintenance exercise attendances in Alice Springs (reflecting an average 11 attendees each session) and 17 clients seen in external clinics. Excluding indirect episodes, there were 1,010 cardiac client episodes in 2015/16.

Direct client episodes were recorded as follows:

• 430 client episodes were recorded in Phase 1 – 48% in Darwin and 52% in Alice Springs. This is a decrease of 26% from 2014/15 (the Cardiac educator position in Darwin was vacant for a 2 month period and since January is 0.8 FTE).

• Of the 430 clients educated, each were seen an average of 1.3 times during their acute hospital admission

• 121 clients were educated in Phase 2 – 66% Darwin and 34% Alice Springs which is a 13% decrease from 2014/15

• 93 clients were educated in the Healthy Heart Program – 79% Darwin and 21% Alice Springs

• 28 clients were educated in individual appointments

Other notable statistics in 2015/16 include:

• 186 (43%) of total Phase 1 and 2 clients were of Indigenous descent

• 313 indirect service client episodes were also recorded. Indirect service was provided via phone or information pack to clients or their significant others (not including information packs provided in Phase 1 or HHP or health promotion activities)

• The information response rate to referrals was calculated as a percentage dealt with within 10 days of receipt. 95% of referrals received in Darwin and 100% in Alice Springs were acted upon within this time frame.

• 177 clients in Phase 1 also had diabetes (41%)

• 158 clients (27%) in Phase 1 were educated about an intervention they were about to have interstate

• The direct access percentage for the Darwin Cardiac Educator to go to RDH was 55%

• The direct access percentage for the Alice Springs Cardiac Educator to go to ASH was 79%

• The Provisional Clinical Psychologists individually saw 4 clients with a cardiac condition, plus 12 review appointments, as well as attending the Healthy Heart Program 33 times.

• 22 attended Touching Base groups

Alice Springs Hospital, 236 , 32%

Royal Darwin Hospital, 232 , 31%

NT Cardiac, 10 , 1%

Danila Dilba / Congress,

28 , 4% GP, 11 , 2%

Royal Adelaide Hospital, 99 , 13%

Flinders Medical Centre,

80 , 11% Interstate Hospitals,

32 , 4%

Other, 11 , 2%

2016/16 - Source of Cardiac Referrals



Cardiac Client Services 2015/16

DOH Service Agreement

No. % Change 2014/15



Phase 1 - In-patient educationNo. of cl ients educated in Phase 1 208 -27% 222 -25% 430 -26%

Tota l times cl ients seen 298 -23% 281 -22% 579 -22%Average times cl ients seen / admiss ion 1.4 6% 1.3 4% 1.3

Discharge plan input 202 -29% 175 -15% 377 -24%Signi ficant Others per episode 56 -48% 52 8% 108 -31%

Primary DiagnosisMyocardia l Infarction 79 -35% 33 -23% 112 -32%

Unstable Angina 56 2% 45 350% 101 55%Acute Coronary Syndrome 135 -23% 78 47% 213 -7%

Arrhythmia 38 -14% 37 -21% 75 -18%Heart Fa i lure 21 -36% 64 -31% 85 -33%

Rheumatic Heart Disease 0 2 2Pacemaker 1 0% 3 0% 4 0%

Internal Defibri l lator 0 -100% 0 0 -100%Angioplasty/Stent * 6 -33% 0 6

Other 7 -67% 36 -49% 43 -53%Phase 2 - RehabilitationHealthy Heart Program

Cl ients seen in HHP 73 -17% 20 -20% 93 -18%Tota l times sess ions attended 262 -12% 57 -26% 319 -15%

Tiwi 187 -5% - 187 -5%Palmerston 75 -26% - 75 -26%

Average number of sess ions attended 3.6 2.9Tota l number of education sess ions held 67 -26% 20 -20% 87 -25%

Tota l number of exercise sess ions held 67 -26% 38 -10% 105 -20%No. completing the ful l 4 weeks 39 -33% 12 -33% 51 -33%HHP Cl ients from Phase 1 Urban 22 -54% 15 -6% 37 -42%

No. returning to or repeating the course 122 130% 122 130%Signi ficant others attending (episodes) 28 -67% 4 300% 32 -63%

Phase 2 Individual Appointments No. receiving individual appointments 7 -63% 21 200% 28 8%

No. Signi ficant others attending 2 -50% 10 43% 12 9%

Total Phase 2 Clients 80 41 121 -13%Phase 3 - Maintenance

Touching Base education 20 11% 2 -87% 22 -33% maintenance exercise attendance (A/S) 419 -3% 419 -3%

Other Service IndicatorsNo. of ATSI people educated ** 55 -14% 131 -36% 186 46%

No. cl ients seen external ly 0 17 -58% 17 -58%No. of interpreters used 1 -50% 7 0% 8 -11%

No. of invi tations sent to join HHP 114 -26% 50 16% 164 -17%No. of Phase 2 packs sent to remote locations 97 3% 5 -83% 102 -17%

Letters to Medica l Officers 36 -68% 21 -25% 57 -60%% referra ls sent information within timeframe 95% 100% 0%

Total Phone contacts - HPs, clients and public 316 58 374Information Packs

Phase 1 - urban 154 1% 107 10% 261 4%Phase 1 - rura l 13 -13% 87 -28% 100 -26%

Phase 2 - urban 80 -25% 41 28% 121 -13%Phase 2 - rura l 97 3% 5 -83% 102 -17%

Total 344 -0.3 240 -14% 584 -10%Source of Referrals

ASH 0 236 -24% 236 -24%RDH 232 -14% 0 232 -14%DPH 0 -100% 0 0 -100%

NT Cardiac 10 -71% 0 10 -71%Dani la Di lba / Congress 10 150% 18 80% 28 100%

GP 9 -40% 2 -60% 11 -45%RAH 0 99 36% 99 36%FMC 64 -3% 16 45% 80 4%

Interstate Hospi ta ls 25 -7% 7 -13% 32 -9%Other 9 350% 2 100% 11 267%

Total 359 -15% 380 -10% 739 -12%

Darwin Alice Springs Total 2015/16

*Angioplasty/stent provided in Darwin commenced early 2014. ** No. of ATSI educated does not include external clinics.

Ancillary Education Services


Dietetic Education Services for Danila Dilba Health Services (DDHS)

Healthy Living NT provided dietetic education services to DDHS from July-December 2015. The service ceased in 2016 due to DDHS funding constraints.

The dietitian services were provided once a week at the main clinic, delivering individual education consultations for people with one of the five chronic conditions (diabetes, heart disease, respiratory disease, renal disease and cancer).

From July to December 2015, 73 clients were educated by the Dietitian over 22 service days. Multiple chronic conditions were recorded for each client.

• 100% of clients were of Indigenous descent.

• 20 significant others were seen with the clients

Diabetes Services at Darwin Corrections Centre

In early 2015, Healthy Living NT was approached by the Darwin Corrections Centre to provide sessional services into the prison. These services are funded directly by the prison service.

In 2015/16, 179 clients received education through the service, with 89% of these clients having type 2 diabetes and 93% being of Indigenous descent. 64% of clients educated were newly referred with the remaining 36% seen as reviews, often for insulin titrations.

Type 1, 5, 3%

Type 2, 160, 89%

IGT, 14, 8%

Clients seen by diabetes diagnosis

Outreach Health Services


Outreach Health Services (OHS)

Healthy Living NT is contracted to the NT Primary Health Network to deliver a range of outreach health services under programs such as the Medical Outreach Indigenous Chronic Disease (MOICD) and HACC. These programs provide diabetes, cardiac and nutrition education services to remote communities throughout the Northern Territory, aiming to increase access and expanded primary health care provided to people in rural and remote Indigenous communities for the treatment and management of chronic disease.

In 2015/16, Healthy Living NT visited 49 remote communities, towns and Aboriginal Medical Services for a total of 638 days inclusive of diabetes, cardiac and dietetic education services. Services provided into communities were often delivered with other allied health professionals such as podiatrists and exercise physiologists. All educators work as part of a multidisciplinary care team with the local Primary Health Care providers and feed back and coordinate care with both this team and any relevant specialists involved in the care of that person.

Communities and Aboriginal Medical Services provided with education services through MOICD and OHS services were:

• Ali Curung (Diabetes) • Milikapiti (Cardiac)

• Ampilatwatja (Cardiac) • Milingimbi (Diabetes and Cardiac)

• Angurugu (Diabetes and Cardiac) • Minjilang (Diabetes and Cardiac)

• Barunga (Cardiac) • Minyerri (Cardiac)

• Batchelor (Diabetes and Cardiac) • Miwatj (Diabetes and Cardiac)

• Belyuen (Diabetes and Cardiac) • Murray Downs (Diabetes)

• Beswick (Cardiac) • Nguiu (Cardiac)

• Binjari (Diabetes and Cardiac) • Ngukurr (Cardiac)

• Borroloola (Diabetes and Cardiac) • Numbulwar (Diabetes and Cardiac)

• Bulman (Cardiac) • Oenpelli (Diabetes and Cardiac)

• Canteen Creek (Diabetes) • Palumpa (Diabetes and Cardiac)

• Daly River (Diabetes and Cardiac) • Pirlangimpi (Cardiac)

• Elliott (Diabetes) • Ramingining (Diabetes and Cardiac)

• Endeavour Medical Clinic (Diabetes) • Ski Beach (Diabetes and Cardiac)

• Epenarra (Diabetes) • Santa Teresa (Cardiac)

• Gapuwiyak (Diabetes and Cardiac) • Tennant Creek (Cardiac)

• Hermannsberg (Cardiac) • Timber Creek (Diabetes and Cardiac)

• Jabiru (Diabetes and Cardiac) • Umbakumba (Diabetes and Cardiac)

• Jilkminggan (Cardiac) • Utopia (Cardiac)

• Kalkarindji (Diabetes and Cardiac) • Wadeye (Cardiac)

• Kintore (Cardiac and Dietitian) • Warruwi (Diabetes and Cardiac)

• Lajamanu (Diabetes and Cardiac) • Wurli Wurlinjang (Diabetes and Cardiac)

• Lake Nash (Diabetes and Cardiac) • Yarralin (Diabetes and Cardiac)

• Maningrida (Cardiac) • Yirrkala (Diabetes and Cardiac)

• Marthakal Homelands (Diabetes and Cardiac)



The 638 delivered service days represented 85% of total scheduled service days (748 days). Of the 15% of service days which were not delivered, 41% were due to cancellations by clinics which were unable to be rescheduled and only 7% were due to environmental/natural disasters. Due to a key staff member leaving in Central Australia, Healthy Living NT was unable to service some week long trips until a replacement staff member was sourced.

Additionally, a total of 252 clinic health professional staff were provided in-services totalling 109 hours while Healthy Living NT educators (diabetes, cardiac and dietitian) were visiting (refer pages 34-36).

Diabetes Client Services

Under the MOICD program, the Diabetes Nurse Educators provided 270 days of service to 32 communities and delivered education to 1,276 clients with diabetes. One Educator is qualified to provide both diabetes and cardiac education. Education was provided according to client and clinic need.

• 111 clients (9%) were educated within a group setting

• 55 family members/significant others were also seen with diabetes clients,

• 220 case conferences were conducted, and

• 1,247 clients (98%) were of Indigenous descent.

The average length of service day was 8.1 hours, comprising an average of 6.0 clinical hours per day and 2.1 hours of travel time per day. The length of clinical hours has reduced from previous years, reflecting the new PHN travel policy.

Type 1, 8, 0%

Type 2, 1101, 86%

GDM, 9, 1% IGT,

26, 2% Other, 21, 2%

Groups, 111, 9%

People seen by diabetes diagnosis



Cardiac Client Services

Under the MOICD program, the Cardiac Nurse Educators provided 352 days of service to 43 communities and delivered education to 1,489 clients with cardiac conditions.

• 777 (52%) were newly referred clients, with 696 (48%) seen for review appointments

• 271 clients (18%) were educated within a group setting

• 196 family members/significant others were also seen with cardiac clients

• 352 (29%) additionally had diabetes

• 53 were seen for education prior to a planned cardiac procedure/operation and 96 were seen within 6 months of returning to their community post a cardiac event/procedure/operation (cardiac rehabilitation client group)

• 230 case conferences were conducted

• 1,451 clients (97%) were of Indigenous descent

The average length of service day was 8.5 hours, comprising an average of 6.3 clinical hours per day and 2.2 hours of travel time per day.

Dietetic Client Services

Under the MOICD program, Healthy Living NT supplied an Accredited Practising Dietitian to one Central community for 13 days of service. The dietitian provided nutrition education to 47 clients with a chronic condition(s).

• Client chronic conditions recorded were: o Diabetes 40 (85%) o Heart Disease 11 (23%) o Kidney Disease 13 (28%) o Cancer 0 (0%) o Respiratory Disease 0 (0%) o Other 5 (11%)

• 4 significant others were also seen

• All education was delivered as individual appointments

• All clients were of Indigenous descent

The average length of service day was 9.1 hours, comprising an average of 5.4 clinical hours per day and 3.7 hours of travel time per day

ACS, 442, 30%

Heart Failure, 144, 9%

Arrhythmia, 100, 7%

RHD, 235, 16%

Other, 297, 20%

Group, 271, 18%

People seen by cardiac diagnosis

AHP Mentoring


Aboriginal Health Practitioner Mentoring Pilot Project

From strategic engagement undertaken with key external stakeholders in 2014, Healthy Living NT had identified areas in which further work could be undertaken in this area that would meet needs identified by key stakeholders. These findings indicated opportunity to work in collaboration with Aboriginal Medical Services (AMS) to:

• Deliver professional development – training and workshops

• Assist in developing collaborative practice models

• Provide mentorship and a support network

• To assist in the education of Aboriginal Health Practitioners by educating people within the communities

Healthy Living NT took these findings into account in formulating the structure of a supported mentoring partnership. This partnership sought to form a collaboration and longer term connections with existing Aboriginal Health Practitioners (AHPs) who are already practising in their community/clinic in remote areas around the NT.

The role of AHPs as part of a larger multi-disciplinary primary health care team overseeing chronic disease/diabetes care varies from clinic to clinic and is in turn influenced by remoteness. A greater proportion of AHPs are more likely to be employed in remote or very remote clinics; these same remote or very remote clinics are also likely to employ a lower proportion of doctors. Thus, within these remote and very remote clinics, AHPs are likely to have a more significant role in primary health care/chronic disease/diabetes care and hence a greater need for support and upskilling in chronic disease/diabetes care.

The NDSS approved funding for Healthy Living NT to run a pilot mentoring project targeting the AHP in rural and remote areas around the NT. The aim of the project was to continue to increase the awareness of NDSS and management of diabetes/diabetes literacy in the community for AHPs working in remote communities of the NT.

This was achieved through the formation of mentoring relationships between individual Healthy Living NT Credentialed Diabetes Nurse Educators (CDNEs) and Aboriginal Health Practitioners (AHPs). This included:

• initial consultations with stakeholders, clinics and communities to identify which communities have suitably qualified AHPs who wanted to be a part of this pilot project,

• negotiation with these clinics and communities appropriate ways to deliver the mentoring. The clinic through its manager needed to formally agree to the mentoring relationship and assist with establishing a supportive environment for the project, and

• placement of Healthy Living NT CDNEs in remote communities to buddy-up with the AHPs during their normal clinical and community practice. This mentoring gives a more individualised and extended education opportunity to the Aboriginal Health Practitioner, within the context of their everyday work practice and within the context of their particular community i.e. a culturally safe environment.

This approach optimised the relevance of the relationship and underpins culturally safe clinical practice.

In this pilot project, Healthy Living NT engaged two AHPs working in two very remote communities in the NT in a mentoring relationship that provided:

• two 1-week intensive visits by CDNEs to AHPs in their community during Jan-June 2016,

• ongoing telephone support and access between visits, and

• most importantly, ongoing support and relationships after the pilot project has been completed (funded from non-NDSS sources).

For the pilot, AHPs working in Yirrkala Community, which is serviced by the Miwatj Aboriginal Medical Service and Wurli Wurlinjang Aboriginal Medical Service (Wurli) agreed to participate.

Healthy Living NT believes that the initial two AHP mentoring pilot programs have been a success. The pilot has upskilled two AHPs in two remote ATSI communities in the NT by increasing confidence, knowledge and skill around diabetes. These clinics cover a potential 12,250 people in the community.

The pilot was also successful in enhancing the ability of two AHPs to treat clients within Aboriginal communities in the absence of a CDNE. It has allowed ongoing partnerships between the AHPs and CDNEs. The program also provided CDNEs with the ability to enhance their cultural knowledge, increasing culturally safe practice and they have a greater understanding of the AHP role in community. Healthy Living NT has sought further funding to continue this model of engagement and collaboration.

Information and Resources


The information and resource needs of people with diabetes, cardiac and related chronic conditions is a high priority for the Association and is a particularly important requirement for people living in rural and remote areas who are not able to easily access services.

Healthy Living NT’s fully interactive website (www.healthylivingnt.org.au) allows members, health professionals, people with diabetes or cardiac conditions and the public to obtain services, information and product from us irrespective of their location.

Four editions of Healthy Living NT publications, Territory Way (member newsletter with a distribution in excess of 1,500/issue) and three editions of Healthy Living News (health professional newsletter with a distribution in excess of 500/issue) were produced in 2015/16. The production of both publications represents a considerable resource commitment by the organisation.

During the year, Healthy Living NT distributed over 702 diabetes information packs and 584 cardiac information packs. All information packs include a range of Healthy Living NT produced sheets and are supplemented by national information sheets developed by the Diabetes State and Territory Organisations and the National Heart Foundation.

Additionally this year Healthy Living NT collaborated with the NT Department of Health to produce a new food resource called Nutrition for Diabetes in Pregnancy. The project also included distribution of the FeltMum resource around the Northern Territory.

http://www.healthylivingnt.org.au/

Health Professional Support and Training


In addition to the range of client services, Healthy Living NT provided training and support to health professionals throughout the NT. 1,303 health professionals were educated or assisted through the year, an average of 109 per month (2014/15= 1,394). 38% were assisted via phone consultation whilst the remainder were assisted in a face to face setting.

411 health professionals were educated in formal training environments, involving 87 hours by Healthy Living NT staff from the Darwin and Alice Springs urban services. Another 252 health professionals were given education through the MOICD program taking 109 hours. NDSS Access Point training was delivered jointly by Healthy Living NT health professional and administration staff.

A listing of formal health professional training provided is shown below (listed per health professional involved).

Health Professional Education Activities 2015/16Darwin and Alice Springs Organisation Activity Health Professionals Numbers TimeNT Nutrition Meeting Changing face of diabetes Dietitians 35 4HLNT, NT DoH Diabetes in general care settings RNs Physio, dietitian, GP 25 4HLNT, NT DoH Diabetes in general care settings RNs Physio, dietitian, GP 25 8HLNT, NT DoH Diabetes in general care settings RNs Physio, dietitian, GP 25 16Flinders/ CDU Nutrition students 65 3PHN, RDH, HLNT Dietary Management of Gestational Diabetes Endo, GPs, DNE, Midwifes 23 2

Batchelor College Cardiac Conditions and Management Students and staff 16 8Bodyfit NT HLNT Service overview Eps and Physiotherapists 15 2Menzies Diabetes in pregnancy stakeholder forum RNs Midwives, AHW, 50 1Golden Glow Nursing Insulin and Devices RNs 7 1Pharmaceutical Society Aus. Diabetes devices and products Pharmacists 14 3HLNT, NT DoH Diabetes in general care settings RNs, Community nurses 25 12Calvary Silver Circle Services Meter issues Carer 1 0.5Private Home Nursing Insulin injection techniques RN 1 1Private Home Nursing Insulin injection techniques RN 1 0.5Central Clinic HLNT Service overview GPs, Practice Staff 9 1Mall Medical Centre HLNT Service overview GPs, Practice Staff 8 1NDSS Access Points AP after hours NDSS training Pharmacy staff 8 4Bath St GP Clinic HLNT Service overview GPs, Practice Staff 1 1CARHDS Feltman Medications BGL monitoring RNs 4 3ASH Cardiac Posters for Med East ward RN 1 3ASH Ward cardiac inservice RNs 2 0.5ASH ICU - rhythm analysis RNs 2 0.5NDSS Access Points AP after hours NDSS training Pharmacy staff 8 4Heart Foundation Cardiac Mentor program Various HPs 40 3

Total 411 87

Health Professional Education Activities 2015/16MOICDOrganisation Activity Health Professionals Numbers TimeManingrida HC Finding your focus in cardiac education CDN 1 1

Numbulwar HC Q and A Cardiac updates A/CM, RANs 3 1.5

Ski Beach HC Commencement and titrating insulin GP registrar 1 0.5

Yirrkala HC Puberty and menopause with T2 diabetes RAN 2 0.5

Barunga HC Group work, living with a chronic condition GP, Aboriginal Liaison 2 1

Binjari HC Diabetes care and management CDN 1 0.5

Wurli HC Diabetes self management AHW 1 0.5

Wurli HC Self care principles and local cultural knowledge CDE 1 0.4

Pirlangimpi HC Criteria for diagnosis of ARF RAN, AHW 2 0.5

Jabiru HC Diabetes and cardiac disease AHW 1 1



MOICDOrganisation Activity Health Professionals Numbers TimeMilingimbi HC Understanding complications AHP 1 0.5

Milingimbi HC Reviewing diabetes assignment RAN 1 1

Milingimbi HC Injection technique for LA Bicillin RAN 1 0.5

Maningrida HC Referrals AHP 2 0.4

Maningrida HC Injection technique for LA Bicillin RAN 1 0.5

Maningrida HC CARPA CV risk assessment tool CDN 1 0.5

Ski Beach HC Functional tests for people with ECG changes GP, RN 2 0.5

Gapuwiyak HC Key health messages for diabetes care Aged care Manager 1 0.6

Gapuwiyak HC Cardiovascular risk assessment and CARPA RN, AHP 10 0.8

Timber Creek HC Cardiac conduction system AHP 1 0.5

Yarralin HC Cardiac conduction system AHP 1 0.4

Marthakal Homelands Insulin and what to do with the OHA’s RAN, AHP 3 1

Marthakal Homelands Effects of diabetes on the heart RAN, AHP 3 1

Warruwi HC Smoking cessation and cardiac clients Community worker 1 0.5

Oenpelli HC GDM client consultation Midwife 1 1

Jabiru HC Clarifying client priority CDN 1 0.4

Kalkarindji HC Liasing about current status of clients CDE 1 0.5

Lajamanu HC Liasing about current status of clients CDE 1 0.5

Wadeye HC Cardiac referrals and reviews Midwife 1 0.4

Wadeye HC Cardiac care in the NT Cardiac co-ord 1 0.4

Wurli HC ARF/RHD RN 1 0.45

Wurli HC Cardiac medications and sitting in consults Med student 1 1.5

Binjari HC Client reviews Med student 1 1

Binjari HC Echo terminology Med student, GP registrar, RAN 6 0.45

Binjari HC Key health messages in managing diabetes RNs, AHP 3 1

Binjari HC Self care principles and local cultural knowledge RNs, AHP 3 1

Gapuwiyak HC Q & A on RHD, diagnostic criteria for ARF AHWs,RANs, CM, podiatrist 10 1

Gapuwiyak HC Diabetes management RAN, AHP 2 0.5

Ramingining HC Diabetes management Chronic Disease RN 1 0.2

Angurugu HC Diabetes management CD, RN, RAN 3 1

Umbakumba HC Diabetes management CD, RN, RAN 3 1

Numbulwar HC Ongoing client management RAN 1 0.5

Maningrida HC Cardiac education AHP 1 0.4

Minjilang HC HLNT services Dietitian 1 0.4

Minjilang HC Cardiac risk assessment Psychologist 1 0.5

Borroloola HC Type 1 insulin regimens RAN 1 0.5

Milingimbi HC Diabetes recommended management targets RAN 1 1

Wadeye HC Cardiac educators role and education outlines RNs, AHPs 15 1

Wurli HC Commonly prescribe medications in CVD AHPs 8 1

Palumpa HC Cardiac risk factors and lifestyle modification Medical student 1 2

Kalkarindji HC Type 2 diabetes and medications CDN 1 0.5

Lajamanu HC Developing collaborative working relationship CDE. Midwife 2 1

Lajamanu HC Developing collaborative working relationship RN 1 1

Miwatj HC ECG information exchange RNs, AHP 5 1

Yirrkala HC 12-Lead ECGs & electrode placement RNs 5 1

Ski Beach HC 12-Lead ECGs & electrode placement RNs, AHP 5 1

Minjilang HC General diabetes discussion medical student 1 0.5

Marthakal HC Activity Pathophysiology of diabetes AHP 3 3

Marthakal HC Heart Disease AHP 6 2

Timber Creek HC Health outcomes (heart) RNs 4 1

Milingimbi HC Diabetes medications GP, RN 2 1

Yarralin HC Diabetes medications RAN 1 0.5

Binjari HC Cardiac assessment Medical student 1 1

Binjari HC Role of cardiac education Medical student 1 1

Health Professional Education Activities 2015/16 continued



MOICDOrganisation Activity Health Professionals Numbers TimeWurli HC Diabetes management CD RN, AHP 3 1.5

Borroloola HC Cardiac resynchronisation therapy RNs 2 1

Lajamanu HC Diabetes management CM, RANs, GP, Pod 6 1

Lajamanu HC New age anticoagulants GP 1 1Oenpelli HC Diabetes management AHP 1 0.5Jabiru HC Insulin and Byetta AHP 1 1Kalkarindji HC Diabetes medications CM, AHP 1 0.5Barunga HC ECG Analysis – Ischaemic Changes AHP, RAN 6 1Angurugu HC Diabetes medications AHP 1 1Angurugu HC Cardiac assessment Phyiso 1 0.5Numbulwar HC Education resources RAN 1 0.5Umbakumba HC Diabetes medications RAN 1 0.5Gapuwiyak HC Rhythm strip analysis Med student, RANs, AHP, GP 10 1Ramingining HC Education resources, NDSS CD Coord, CDN 2 10Yirrkala HC Role of cardiac education CM 1 0.5Yirrkala HC Education resources CM 1 0.4Ski Beach HC Diabetes medications RAN 1 0.8Belyuen HC Diabetes medications GP 1 0.5Marthakal HC A&P heart AHP 1 1.5Marthakal HC Diabetes management AHP 1 1Ali Curung HC Management of GDM in communities RN 1 0.6Ali Curung HC CARPA and diabetes diagnosis RN 1 0.6Oenpelli HC Byetta GP 1 1Maningrida HC Education resources RAN 1 1Jabiru HC Education resources RNs, AHP 5 1Borroloola HC Cardiac medications Aged care manager 1 0.6Wurli HC Observing of clinic Medical student 1 1Binjari HC Role of cardiac education RAN 1 1Wurli HC Role of cardiac education CDN, RAN, AHP 3 1.5Barunga HC Education resources RAN 1 1Jilkminggan HC ECG analysis RANs, AHP 3 3Nguiu HC Recall lists Cardiac co-ord 1 1Kalkarindji HC Education resources AHP, A/CM 2 0.6Bulman HC Physical activity and cardiac benefits AHP 1 1Elliott HC Chronic disease CDN 1 1Milingimbi HC Cardiac risk factors Aged care manager 1 1Tennant Creek HC Role of cardiac education RN 1 1Tennant Creek HC Role of cardiac education CM 1 1Yarralin HC Chest auscultation RN 1 0.6Kintore HC Mentoring with diabetes clients CNE 1 1Yirrkala HC Insulin titration RAN 1 1Endeavour Medical Centre NDSS changes GP, CM 1 1Miwatj HC Role of cardiac education RN 1 0.5Yirrkala HC Cardiac assessment CM, RAN 2 2Marthakal HC BGL monitoring and diabetes in pregnancy AHP & AHP trainees 2 1Marthakal HC Blood pressure AHP 2 0.5Borroloola HC Heart Failure Aged care manager 1 0.5Oenpelli HC Heart rate AHP 1 0.2Binjari HC Diabetes complication screening RAN, AHP 2 1Binjari HC Q & A on cardiac issues RANs 2 1Wurli HC Self care RN, AHP 2 0.5Kalkarindji HC Education resources AHP 1 0.5Angurugu HC Role of cardiac education RAN, Dentist 2 1Gapuwiyak HC Q&A on diabetes medication AHP. RANs 8 1

Total 252 109

Health Professional Education Activities 2015/16 continued

Community Education and Support


In addition to client services and health professional training, Healthy Living NT also delivered a variety of education to community groups. Over 1,250 people were provided with community education in structured programs, as shown in the table below. Members of the general public were also given information from health professionals via the phone. Print media, Facebook, twitter and our Healthy Living NT website were also avenues used to engage with the wider Northern Territory population for health promotion, education and awareness. Additionally 409 people from the general public were given education by a health professional either face to face in our offices or via the phone (excluding general assistance).

Community Education and Health Promotion Activities 2015/16 Darwin and Alice Springs Organisation Activity Numbers Time Darwin Airport staff Diabetes: General health and travelling 5 3

St Johns Ambulance Diabetes: s&s, management 10 4

Anula primary school Type 1 in school 7 4

Kormilda College Kormilda School Talk 9 4

Chung Wah Society Healthy Eating for Older clients 45 4

Braitling Primary School Type 1 in school 20 2

Office of Children and Families Type 1 talk 12 4

HLNT, RDH, Medtronic Insulin Pump workshop 9 2

Lifestyle Solutions Type 1 client 8 2.5

ARRCS Diabetes Staff In-Service 12 2

Town Council Live Lighter Campaign stall 30 2

Life without Barriers Type 2 diabetes 6 2

Yeperenye Shopping Centre Diabetes Week Stall 44 2

Lifestyle solutions Diabetes and diet information 20 3

Alice Springs Airport Diabetes and diet information 7 4

Life without Barriers Supermarket tour 1 1

Coles Supermarket tour 1 1

Centralian Senior College Health Expo 200 2

Life Withour Barriers Diabetes in the workplace 4 3

St John Ambulance volunteers Diabetes, risk factors, management 20 2

Rotary Club Type 2 diabetes 38 3

Jingili Primary school Type 1 in school 14 2.5

O'Loughlin School Type 1 in school 15 2

Howard Springs Type 1 in school 3 2

Wanguri Primary Type 1 in school 20 2

Centralian Middle School School Expo 395 4

Yeperenye Shopping Centre Heart Week awareness 300 4

Total 1,255 73

Youth Support Services


Support activities targeting youth health promotion needs and high need groups such as children, adolescents and young adults with diabetes also form an important part of Healthy Living NT services. Services specific to youth under 18 years are shown in the table below. There were also 84 episodes of clinical services to youth under 18 years.

Schools were further supported with talks to the teaching staff where children with type 1 and 2 are students. This is done on an as requested basis and three schools wanted additional assistance through in-services to their staff. School visits are done in collaboration with the parents and schools involved.

HLNT Involvement with youth <18 2015/16 (Non Clinical) Organisation Activity Attendees Hours Office of Children’s and Families Type 1 talk 12 4

Centralian Senior College Health Expo 200 2

Centralian Middle School School Expo 395 3 Total 607 9.0

HLNT Involvement with youth <18 2015/16 (Clinical) Organisation Activity Attendees Hours HLNT: Public Paeds Clinic Paeds clinic 3 4

HLNT: Public Paeds Clinic Paeds clinic 4 4


HLNT: Public Paeds Clinic Paeds clinic (with QLD Paediatric Endocrinologist) 25 8



HLNT: Public Paeds Clinic Paeds clinic (with QLD Paediatric Endocrinologist) 15 8

HLNT: Public Paeds Clinic Peads Endo Talk: Adolescent 6 1

HLNT: Public Paeds Clinic Peads clinic 3 4

HLNT: Public Paeds Clinic Peads clinic 6 4 Total 84 45

HLNT Involvement with youth <18 2015/16 School talks supporting teachers with students with diabetes School Activity Attendees Hours Braitling Primary School Type 1 in school 20 2

Anula Primary school Type 1 in school 7 4

Kormilda College Type 1 and 2 in school 9 4

Jingili Primary school Type 1 in school 14 2.5

Jingili Primary school Reviewing school diabetes management plan 2

O'Loughlin School Type 1 in school 15 2

Howard Springs Type 1 in school 3 2

Wanguri Primary Type 1 in school 20 2 Total 88 20.5

Health Promotion


Active Recreation Organisations Program

In 2016 Healthy Living NT expanded its focus to include the promotion of healthier lifestyles for the whole of the Northern Territory population. This expansion included Healthy Living NT acquiring the Life. Be in it brand for the Northern Territory.

From March - June 2016 Healthy Living NT commenced initial scoping and stakeholder engagement under funding from the Northern Territory Department of Sport and Recreation (DSR). Healthy Living NT has employed a 1.0 FTE Health Promotion Officer and is additionally supporting this initiative with 0.2 FTE Dietitian and administrative support.

Under the health promotion program, Healthy Living NT will be delivering and supporting new physical activity and healthy lifestyle programs for the general population within the Northern Territory. A listing of some of the engagement is below.

Organisation Purpose Outcome Hours

NT DoH Phys ica l Activi ty and Nutri tion Meet and col laborationDiscussed new ini tiative and poss ible future col laboration

2.5

Healthy Conversation Darwin Meet and col laborationDiscussed on poss ible col laboration in terms of supporting events

1

Paediatrician RDH Meet and col laboration Discussed i ssues including chi ldhood obes i ty 1.5

Life. Be in it South Austra l ia SA programsLearnt about Come and Try Day and Li fe games . Learnt about thei r organisation and establ i shed contacts

3.5

Palmerston Ci ty Counci l COPALLearnt about COPAL programs and how we can get involved with Pa lmerston Heal th Promotion Activi ties

1.5

Life. Be in it NT (formerly) Enquire on past programmes Learnt about past programs 0.5

Northern Terri tory Insti tute of Sports Understand NTIS programsLearnt about change in focus and how NTIS i s working with chi ldren and parents

1.5

Senior Specia l i s t Paediatrician RDH Understanding referra l pathwaysDiscussed referra l pathways and poss ible future program ideas targetting obes i ty in chi ldren

1.5

People in Parks Foundation Active in Parks onl ine platform Discussed their current webs i te and investigated i ts poss ible use in the NT

1.5

Life. Be in it Tasmania Mini Sport Program Learnt about Mini -Sport program 0.5

YMCA Meet and col laborationLearnt about YMCAs projects and s trategic di rection, discussed col laboration

1.5

Darwin Ci ty Counci l BikeBus and Active PathsDiscussed BikeBus program and Active Paths and Bikes in Schools

2

NT DoH Phys ica l Activi ty and Nutri tion Meet and col laborationDiscussed on BikeBus program and poss ibi l i ty of other active transportation options

1.5

Ci ty of Darwin Fun Bus Mobi le and Fun in the ParksDiscussed ass is ting with phys ica l activi ty during these sess ions

2

Total 22.5

Stakeholder Engagement

Sponsors and Supporters


Organisations such as Healthy Living NT cannot survive without the support of major sponsors, supporters and volunteers who freely give time, effort and support. Our special thanks and acknowledgment go to the following organisations and individuals that have assisted us in our work throughout the year:

Abbott Diabetes Care Dr A Cotterill

Access Points (refer page 17) Dr E Ellis

Alice Springs Hospital Dr DM Howard

Alice Springs Physiotherapy Dr M Ilton

Alice Springs Town Council Dr N Kangaharan

Alice Springs & Darwin Running and Walking Clubs Dr L Maple-Brown

Asthma NT Dr A Whybourne

Bernborough Club of the NT First Class Graphic Design

Bill Raby Diabetes Fellowship Governors Flag International

BodyFit NT Gary Higgins MLA

Cancer Council of the NT Kidney Health Australia

Central Australian Aboriginal Congress Life. Be in it NT Inc.

Central Australian Health Service National Heart Foundation

Charles Darwin University NT Cardiac Services

Coles Supermarkets NT Interpreter Service

Diabetes NSW NT Primary Health Network

Danila Dilba Health Services Nutrition and Physical Activity Strategy Unit

Darwin City Council OAMPS Insurance

Darwin Corrections Centre Palmerston Super Clinic

Community Benefits Fund Palmerston CCC

Darwin Podiatry Palmerston City Council

Darwin Private Hospital Palmerston Podiatry

Department of Health (Commonwealth) Professor Timothy Skinner

Department of Health (NT) Royal Darwin Hospital

Department of Sport and Recreation (NT) Top End Health Service

Diabetes in Pregnancy Partnership Woolworths Supermarkets

Diabetes SA Wurli Wurlinjang Health Clinic

DoH Preventable Chronic Disease Unit Yeperenye Shopping Centre

Dr P Beaumont Yirrkala Health Clinic

Dr S Chitturi YMCA

Treasurer’s Report


From the Treasurer

Financially, Healthy Living NT recorded a minor net deficit of ($4,688) from 1 July 2015 to 30 June 2016. (2014/15 = $236,231) This deficit result was significantly lower than the deficit projected in the annual budget.

Overall income was marginally higher than the previous year whilst expenditure was tightly managed. The overall operating deficit for 2015/16 was due to factors such as an additional pay in 2015/16, staff recruitment costs and expenses associated with the establishment of a second office in Darwin to accommodate our staff. Sustainability of charitable organisations such as the Diabetes Association of the NT is always a challenge, and the Board is focussed on ensuring long term organisational viability.

Overall assets and liabilities remain well balanced and robustly managed, demonstrated by healthy cash reserves and the Association’s current Asset/Liabilities ratio of 2.67:1 (2014/15=2.73:1). In 2015/16 the Association was able to significantly reduce the level of its commercial business loan for unit (No. 4) in the Casi House complex. This unit complements the Association’s ownership of adjoining unit, No. 5. Both units are leased and net income from these leases is offset against the business loan.

Membership subscriptions were slightly increased on 2014/15 whilst actual membership numbers declined slightly.

During the year, the Board established a special fund to quarantine employee provisions from general investments in order to provide transparency in funds management and heightened accountability.

The Association is in a sound financial position. The audited financial statements for 2015/16 form part of this report. A précis of Healthy Living NT’s financial statements and other key performance indicators is shown below, including comparison over previous years.

Financial Statement 2016 % Change 2015 2014 2013 2012 2011 2010Summary $ (From 2015) $ $ $ $ $ $

Profit and LossIncome 2,668,297 1.5% 2,628,789 2,027,791 2,009,468 1,980,092 1,528,616 1,553,144

Expenditure 2,672,985 11.7% 2,392,558 1,883,731 1,950,225 1,790,479 1,515,249 1,523,556Surplus/(Deficit) 4,688-$ -102.0% 236,231$ 144,060$ 59,243$ $189,613 $13,367 $29,588

Balance SheetTotal Assets 1,779,484 0.8% 1,765,926 1,774,128 1,188,337 1,046,441 795,649 800,471

Total Liabil ities 666,436 2.8% 648,190 892,623 450,892 368,239 307,060 325,249Assets/Liabil ities Ratio 2.67:1 2.73:1 1.99:1 2.64:1 2.84:1 2.59:1 2.46:1

NET ASSETS 1,113,048$ -0.4% 1,117,736$ 881,505$ 737,445$ 678,202$ 488,589$ 475,222$ Key Performance

IndicatorsHealthy Living NT

Membership (no.) 1,123 -13.6% 1,300 1,258 1,265 1,375 1,453 1,433Membership (Gross $) 28,778 14.2% 25,192 23,146 28,082 28,946 30,288 30,508

Product Sales (Gross $) 117,621 4.3% 112,789 132,644 144,831 128,614 140,216 127,683NDSS

Registrations (no.) 14,295 3.3% 13,832 13,355 12,693 11,878 11,019 10,160Gross Income $ 483,268 3.3% 467,783 460,414 392,577 362,621 321,427 303,463

SPaff 21 23 19 19 16 14 14

The following charts show the growth and stability of the Association over time and are a reflection of the prudent and stable management of the organisation.

PAUL GOODING Treasurer 2015/16



0200,000400,000600,000800,000

1,000,0001,200,0001,400,0001,600,0001,800,0002,000,0002,200,0002,400,0002,600,0002,800,0003,000,000

$ $ $ $

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

$

HLNT Income and Expenditure 2001 - 2016

Income Expenditure

$-

$200,000

$400,000

$600,000

$800,000

$1,000,000

$1,200,000

$1,400,000

$1,600,000

$1,800,000

$2,000,000

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

$

HLNT Assets and Liabilities 2001 - 2016

Total Assets Total Liabilities

$-

$100,000

$200,000

$300,000

$400,000

$500,000

$600,000

$700,000

$800,000

$900,000

$1,000,000

$1,100,000

$1,200,000

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

$

HLNT Net Assets 2001 - 2016



Cash on Hand, $923,658, 55%

Receivables, $109,492, 6%

Pre-payments , $6,430, 0%

Stock, $26,972, 2%

Buildings, $539,570, 32%

Plant & Equipment, $52,717, 3%

Intangibles, $33,260, 2%

HLNT Assets 2015/16

Payables, $137,652.00, 21%

Grants in advance, $186,703.00, 28%

Employee Leave Provisions,

$232,385.00, 35%

Business Loan -Current,

$109,696.00, 16%

HLNT Liabilities 2015/16

THE DIABETES ASSOCIATION OF THE NORTHERN TERRITORY INC.

Trading as HEALTHY LIVING NT

SPECIAL PURPOSE FINANCIAL REPORT

30 JUNE 2016

CONTENTS PAGE BOARD'S REPORT 2 INDEPENDENT AUDITOR’S REPORT 3-4 ASSETS AND LIABILITIES STATEMENT 5 INCOME AND EXPENDITURE STATEMENT 6-7 STATEMENT OF CASH FLOWS 8 NOTES TO THE FINANCIAL STATEMENTS 9-14

THE DIABETES ASSOCIATION OF THE NORTHERN TERRITORY INC. T/A HEALTHY LIVING NT

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ASSETS AND LIABILITIES STATEMENT AS AT 30 JUNE 2016 Notes 2016 2015 $ $ CURRENT ASSETS Cash assets 2 923,658 961,961 Receivables 3 109,492 78,292 Other 4 6,430 7,496 Inventories 5 26,972 27,322 ------------ ------------ TOTAL CURRENT ASSETS 1,066,552 1,075,071 ------------ ------------ NON-CURRENT ASSETS Plant and equipment 6 679,672 649,331 Intangibles 7 33,260 41,524 ----------- ----------- TOTAL NON-CURRENT ASSETS 712,932 690,855 ------------ ----------- TOTAL ASSETS 1,779,484 1,765,926 ------------ ----------- CURRENT LIABILITIES Payables 8 137,652 169,712 Unexpended grants 9 186,703 92,215 Provisions 10 232,385 225,497 Interest bearing liabilities 11 23,892 23,892 ---------- ----------- TOTAL CURRENT LIABILITIES 580,632 511,316 ---------- ----------- NON CURRENT LIABILITIES Interest bearing liabilities 11 85,804 136,874 ---------- ---------- TOTAL NON CURRENT LIABILITIES 85,804 136,874 ---------- ---------- TOTAL LIABILITIES 666,436 648,190 ------------ ---------- NET ASSETS 1,113,048 1,117,736 ======= ====== MEMBERS’ FUNDS Retained surplus 12 1,113,048 1,117,736 ------------ ------------- TOTAL MEMBERS’ FUNDS 1,113,048 1,117,736 ======= ======= The accompanying notes form part of this financial report.


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INCOME AND EXPENDITURE STATEMENT FOR THE YEAR ENDED 30 JUNE 2016 2016 2015 $ $ INCOME Conference travel 682 721 Administration Fees 101,998 104,777 Donations 11,935 13,667 Fundraising 10 0 Grants - NT DoH - Diabetes Education 348,034 338,291 - Cardiac 134,329 130,569 - Alice Springs 288,509 280,432 - Free Syringe 56,656 55,071 - Nutrition for Diabetes 20,525 0 - NT DSR – Active Recreation 30,000 0 Medical Outreach Indigenous Chronic Disease 887,029 944,118 Home blood glucose monitors 22,444 24,741 Interest 11,252 17,858 Literature 5,004 9,530 HIC Medicare Claims 7,466 8,366 Mail order postage 1,075 503 Medical aids sales 77,501 66,408 National Diabetes Services Scheme Operations 433,969 424,181 Other GST products 12,672 12,110 Projects 113,661 95,188 Subscription/membership fees 28,778 25,192 Sundry income 1,496 1,931 Training 60 280 Profit on sale of assets 4,489 0 Rent – CASI House 67,403 68,855 IHMS Consultation 1,320 6,000 ------------ ------------ Total Income 2,668,297 2,628,789 ------------ ------------ EXPENDITURE Advertising 22,871 30,833 Accounting 14,226 18,449 Amortisation 27,669 21,445 Audit fees 17,378 18,944 Bank fees 6,429 7,015 Bad debts 2,280 536 Cleaning 17,715 11,999 Computer and email expenses 68,423 42,239 Conference fees and travel 42,107 48,856 Cost of goods sold 75,711 70,284 Consultants 1,700 1,000 The income and expenditure statement should be read in conjunction with the accompanying notes.


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INCOME AND EXPENDITURE STATEMENT (Cont’d) FOR THE YEAR ENDED 30 JUNE 2016 2016 2015 $ $ EXPENDITURE (Cont’d) Depreciation 65,182 49,702 Education consumables 2,936 1,214 Education Resource/Library 1,860 1,890 Electricity 21,233 17,255 Freight 15,980 14,394 Fundraising 525 165 GHANT Membership 2,980 2,893 Insurance 11,855 7,139 Interest 8,319 12,380 Legal expenses 21,672 6,232 Management fee – CASI House 4,659 0 Motor vehicle expenses 11,531 15,913 NDSS expenditure- direct 14,232 13,526 NDSS – Access Points 591 52 Office expenses 9,732 4,358 Office amenities 2,394 2,384 Office Security 2,185 2,769 Telephone/fax 27,955 23,905 Territory Way newsletter 20,978 31,749 Postage 9,754 9,121 Printing and stationery 26,076 33,208 Projects 165,869 145,755 Rent 113,890 104,331 Repairs and maintenance 15,450 14,121 Rates and taxes 12,874 13,163 Recruitment expenses 55,111 20,363 Salaries 1,501,001 1,400,495 FBT 10,659 12,123 Specialist Sessional Services 12,491 12,424 Subscriptions 735 997 Superannuation 171,615 124,700 Staff training 10,193 3,976 Sundry expenses 53 0 Workers compensation 14,357 12,446 Web Site maintenance 9,549 5,815 ------------ ------------ 2,672,985 2,392,558 ------------ ------------ (DEFICIT) / SURPLUS FOR THE YEAR (4,688) 236,231 ======= ======= The income and expenditure statement should be read in conjunction with the accompanying notes.


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STATEMENT OF CASH FLOWS YEAR ENDED 30 JUNE 2016 Notes 2016 2015 $ $ CASH FLOWS FROM OPERATING ACTIVITIES Receipts from customers, projects and administration 856,274 1,234,406 Payments to suppliers and employees (2,595,571) (2,207,864) Interest received 11,252 17,858 Interest paid (8,319) (12,380) Government grants 1,859,570 1,458,027 ------------ ------------- NET CASH FLOWS PROVIDED BY / (USED IN) OPERATING ACTIVITIES 13(b) 123,206 490,047 ------------ -------------

CASH FLOWS FROM INVESTING ACTIVITIES Payments for acquisition of property, plant and equipment (101,034) (78,969) Payments for intangibles (19,405) (24,582) Proceeds from sale of property, plant and equipment 10,000 0 ---------- ---------- NET CASH FLOWS PROVIDED BY / (USED IN) INVESTING ACTIVITIES (110,439) (103,551) ---------- ----------

CASH FLOWS FROM FINANCING ACTIVITIES Repayment of borrowings (51,070) (60,194) ---------- ---------- NET CASH FLOWS PROVIDED BY / (USED IN) FINANCING ACTIVITIES (51,070) (60,194) ---------- ---------- NET (DECREASE)/INCREASE IN CASH HELD (38,303) 326,302 Add opening cash brought forward 961,961 635,659 ---------- ---------- CLOSING CASH CARRIED FORWARD 13(a) 923,658 961,961 ====== ====== The statement of cash flows should be read in conjunction with the accompanying notes.


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NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2016 NOTE 1. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES This financial report is a special purpose financial report prepared in order to satisfy the financial reporting requirements of the Associations Act (NT). The board has determined that the Association is not a reporting entity. The financial report covers The Diabetes Association of the Northern Territory Inc. as an individual entity. The Association is an association incorporated in the Northern Territory under the Associations Act (NT). The financial report has been prepared on an accrual basis and is based on historical costs and does not take into account changing money values or, except where specifically stated, current valuations of non-current assets. The following significant accounting policies, which are consistent with the previous period unless otherwise stated, have been adopted in the preparation of this financial report. Operating Grants Operating grants received are brought to account as income in the period to which the grant relates. Grants received in advance are carried forward as a liability in the statement of financial position at year end. Revenue All revenue is stated net on amount of goods and services tax (GST). Subscriptions Subscriptions are brought to account on a cash basis and receivables relating to subscriptions are not recognised. Inventories Inventories are valued at the lower of cost and net realisable value. Cost is determined on the first in, first out basis, and comprises the cost of purchase including costs of bringing the inventories to location. Cash For the purposes of the statement of cash flows, cash includes cash on hand and in banks, and money market investments readily convertible to cash, net of outstanding bank overdrafts.


-10-

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2016 NOTE 1. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Cont'd) Income Tax The Association is exempt from income tax. Goods and Services Tax (GST) Revenue and expenses and assets are recognised net of the amount of GST, except where the amount of GST incurred is not recoverable from the Australian Taxation Office. In these circumstances the GST is recognised as part of the cost of acquisition of the asset or as part of an item of the expense. Receivables and payables in the Statement of Financial Position are shown inclusive of GST. Property, Plant and Equipment Plant and equipment are carried at cost. Depreciation is provided on a straight-line basis on all plant and equipment at rates calculated to allocate the cost of the asset against revenue over the estimated useful life of each asset to the Association, as follows:

2016 2015

Furniture, fittings and equipment 5 years 5 years Renovations 5- 8 years 5-8 years Computers 2-3 years 2-3 years Buildings 40 years 40 years Motor Vehicles 6 years 6 years Leases Lease payments under operating leases, where substantially all the risks and benefits remain with the lessor, are charged as expenses in the periods in which they are incurred. Employee Entitlements Provision is made for employee entitlement benefits accumulated as a result of employees rendering services up to the reporting date. These benefits include wages and salaries, annual leave and long service leave. Liabilities arising in respect of wages and salaries, annual leave and long service leave and any other employee entitlements expected to be settled within twelve months of the reporting date are measured at their nominal amounts. All other employee entitlements are measured at the present value of the estimated future cash outflows to be made in respect of services provided by employees up to the reporting date. In determining the present value of future cash outflows, the interest rates attaching to government guaranteed securities which have terms to maturity approximating the terms of the related liabilities are used. Employee entitlement costs in respect of wages and salaries, non-monetary benefits; annual leave, long service leave, sick leave, other leave entitlements and superannuation contributions are expensed in the Statement of Financial Performance. Comparatives Where required comparatives have been restated to facilitate meaningful comparison to current year results.


-11-

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2016 2016 2015 $ $ NOTE 2. CASH ASSETS Cash on hand 500 500 Westpac Operating Account 188,498 68,495 Westpac Investment Account 433,038 686,321 Future IT Development 32,812 71,624 Building Fund 101,776 100,472 CDN 0 33,814 Board designated reserve 742 735 Employee Provisions Fund 166,292 0 ----------- ---------- 923,658 961,961 ====== ====== NOTE 3. RECEIVABLES Trade debtors 98,756 67,556 Bond - Alice Springs Office 2,697 2,697 Sundry debtors 8,039 8,039 ---------- ---------- 109,492 78,292 ====== ====== NOTE 4. OTHER Prepayments 6,430 7,496 ===== ===== NOTE 5. INVENTORIES (CURRENT) Medical supplies - at cost 26,972 27,322 ====== ====== NOTE 6. PLANT AND EQUIPMENT Furniture, fittings and equipment at cost 407,508 345,048 Accumulated depreciation (320,123) (305,696) ---------- ---------- 87,385 39,352 ---------- ----------- Office Renovations 226,517 220,067 Accumulated Depreciation (173,800) (165,460) ----------- ---------- 52,717 54,607 ----------- ---------- Buildings – at cost 630,359 630,359 Accumulated Depreciation (90,789) (74,987) ---------- ----------- 539,570 555,372 ---------- ----------- Closing written down value 679,672 649,331 ====== ====== CASI House Unit 5/25 Vanderlin Drive acquired 30 Nov 2004 $247,500 (GST Inclusive) CASI House Unit 4/25 Vanderlin Drive acquired 10 March 2014 $412,500 (GST Inclusive)


-12-

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2016 2016 2015 $ $ NOTE 7. INTANGIBLES Strategic Plan 13,175 13,175 Amortisation (13,171) (9,424) --------- --------- 4 3,751 --------- --------- Website 39,600 39,600 Amortisation (34,858) (22,380) --------- --------- 4,742 17,220 --------- --------- HLNT Client Database 43,987 24,582 Amortisation (15,473) (4,029) --------- --------- 28,514 20,553 --------- --------- 33,260 41,524 ====== ====== NOTE 8. PAYABLES (CURRENT) Trade creditors, accruals and payroll liabilities 103,590 151,668 Bond Casi House 14,516 14,516 GST (net) 19,546 3,528 ---------- ----------- 137,652 169,712 ====== ====== NOTE 9. UNEXPENDED GRANTS (CURRENT) Bill Raby Fellowship 11,191 1,931 CDN Conference Fund – NT DoH 69,384 36,624 NT DoH Nutrition for Diabetes 11,475 32,000 GHANT 17,717 18,120 Adolescent Support Group 3,412 3,503 NDSS 0 37 Chronic Disease – Common wealth DoH 73,524 0 ---------- ---------- 186,703 92,215 ====== ====== NOTE 10. PROVISIONS CURRENT Provision for employee entitlements Annual Leave 116,427 112,605 Long Service Leave 115,958 112,892 ---------- --------- 232,385 225,497 ====== ====== Number of employees at year end 21 23 === ===


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NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2016 2016 2015 $ $ NOTE 11. INTEREST BEARING LIABILITIES CURRENT Westpac – Loan 4 CASI House 23,892 23,892 ====== ====== NON-CURRENT Westpac – Loan 4 CASI House 85,804 136,874 ====== ====== Unused credit facility at 30 June 2016 $87,416 NOTE 12. MEMBERS’ FUNDS Retained surplus at the beginning of the financial year 1,117,736 881,505 (Deficit)/Surplus for the year (4,688) 236,231 ------------ ------------- Retained surplus at the end of the financial year 1,113,048 1,117,736 ======= ======= NOTE 13. STATEMENT OF CASH FLOWS a) Reconciliation of cash Cash balance comprises:

- Cash at bank 923,658 961,961 ====== ======= b) Reconciliation of the operating surplus to the net cash flows from operation

Operating (deficit) / surplus (4,688) 236,231 Depreciation and amortisation 92,851 71,147 Net gain on disposal of property, plant and equipment (4,489) 0 Changes in assets and liabilities: Inventories 350 (1,484) Prepayments 1,066 (3,574) Receivables (31,200) 371,966 Payables (32,060) 41,237 Unexpended grants 94,488 (290,454) Provisions 6,888 64,978 ------------ ------------ Net cash flows (used in) / provided by operations 123,206 490,047 ======= ======


-14-

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2016 NOTE 14. RELATED PARTIES DISCLOSURES Transactions with Diabetes Australia Ltd are carried out under normal commercial terms and conditions under the NDSS Agency Agreement. Healthy Living NT resigned its membership of the Federation on 15 October 2008 with effect from 29 May 2009. NOTE 15. SEGMENT INFORMATION The Association is involved in the provision of health care education and assistance to people with diabetes, people with a cardiac condition and their health professionals. This is carried out in the Northern Territory of Australia. NOTE 16. LEASING COMMITMENTS 2016 2015 $ $ (a) Operating Lease Commitments Being for rent of offices and computer software and equipment Payable – minimum lease payments: - not later than one year 171,142 158,584 - later than 1 and not later than 2 years 53,886 23,124 - later than 2 and not later than 5 years 33,437 0 ---------- ----------- 258,465 181,708 ====== ====== Area 9 IT Solutions lease for Infrastructure & Managed IT Services expired on 31 December 2013 and is ongoing. The Alice Springs property lease expires 31 December 2016. Darwin property: Unit 1 & 2 Tiwi Place lease expired and is ongoing. Unit 2/5 Tiwi Gardens Road lease expires 19 July 2018. Chubb – Monitoring and Preventative Maintenance for Darwin and Alice Springs lease ongoing. WebResource Internet Technology provides web site maintenance the contract is currently ongoing. NOTE 17: ASSOCIATIONS DETAILS The principal place of business of the association is: The Diabetes Association of the Northern Territory Inc. Trading as (Healthy Living NT) Shop 2, Tiwi Place Tiwi, NT 0810

GUIDING VALUES

To pursue high standards of professionalism, ethics and quality in all facets of Healthy Living NT’s operations, through:

• Fairness, honesty, confidentiality and compassion.

• Mutual respect for all individuals, their roles and the organisation.

• Continuous quality improvement in all activities.

• Involvement with, and responsiveness to, community diversity.

• Working collaboratively.

www.healthylivingnt.org.au

ABN: 11 374 693 055

Healthy Living NT is the trading name of the Diabetes Association of the Northern Territory Incorporated.

Darwin: Shop 1 & 2 Tiwi Place, Tiwi NT 0810 PO Box 40113, Casuarina NT 0811 Phone: 08 8927 8488 Fax: 08 8927 8515 Email: [email protected]

Alice Springs: Jock Nelson Building 7/16 Hartley St, Alice Springs NT 0870 Phone: 08 8952 8000 Fax: 08 8952 7000 Email: [email protected]

Healthy Living NT is the registered NT licence holder for

Documents

16 Annual Report 2015 - Healthy Living NT Report 2015-16 final_… · Annual Report 2015/16 Page 4 The Board of Healthy Living NT has been pro-active in the area of corporate governance