17 annual report 2016 - healthy living nt report 2016-17 final... · treasurer’s report : 40...

Diabetes Association of the NT Inc.

trading as

Annual Report

2016-17

2016

-17

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

Services Overview 20

Diabetes Client Education Services 22

Cardiac Client Education Services 25

Ancillary Education Services 28

Outreach Health Services - MOICD Program 29

Information and Resources 32

Health Professional Training and Support 33

Community Education and Support 36

Youth Services 37

Health Promotion 38

Sponsors and Supporters 39

Treasurer’s Report 40

Audited Financial Statements 43

President’s Report

Annual Report 2016/17 Page 1

2016/17 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. Notably 2016/17 has also been a year of evolution as Healthy Living NT worked to formally embed preventative health into our activities and services following acquisition of the Life. Be In It brand in 2015/16. As well as our customary role in assisting people with chronic disease, over the mid to long term, Healthy Living NT aims to make a positive impact on the prevention of chronic disease.

Supporting our increased community and preventative health focus, the Bill Raby Diabetes Fellowship was revised after 10 years of operation with objectives realigned to more relevant and contemporary goals and target groups. In 2016/17, the new Fellowship Board awarded over $20,000 in funding grants as follows: • Over $5,400 to support 8 youth with diabetes to attend NT and interstate diabetes camps and for 2 youth to

purchase computer tablets to support diabetes management and engage with others with diabetes, and • Over $14,000 to support 6 community organisations to improve community capacity to promote healthier

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 nationally 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. Material changes to the NDSS implemented in July 2016 caused Healthy Living NT to elevate concerns for people living in the NT. Healthy Living NT’s resultant appointment by the Commonwealth Department of Health as an NDSS Access Point recognises the strong synergy between Healthy Living NT’s diabetes education services and NDSS product supply as well as the number of people with diabetes living remotely in the NT without ready access to a community pharmacy. Similarly, modifications to the NDSS offset any probable disadvantage accruing to remote area Indigenous health services from the delisting of blood glucose test strips from the PBS.

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.

In April 2017, the Commonwealth Government extended the NDSS to include fully subsidised access to Continuous Glucose Monitoring products for youth with type 1 diabetes aged less than 21 years. This is a significant program to support young people better manage their diabetes.

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 and 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, cardiac and dietetic 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 education and information services for NDSS registrants, funded under the National Diabetes Services Scheme (NDSS) by the Commonwealth DoH, administered with the assistance of Diabetes Australia;

• 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;

• Provision of Active Recreation programs to the community, funded by the NT Department of Sport and Recreation (now Tourism and Culture);

• Provision of subsidised blood glucose testing strips, syringes and pen needles, insulin pump consumables and continuous glucose monitoring products as an NDSS Access Point, under an agreement with Commonwealth DoH;

• Distribution of NDSS products to Remote Area Aboriginal Health Services in the NT, QLD and SA, under an agreement with Commonwealth DoH;

President’s Report


Collectively in 2016/17 delivery under these service contracts produced a total of 6,410 client education episodes, 1,541 health professional up-skilling episodes and 3,074 community member engagements in addition to NDSS service and production interactions. By harnessing the synergies of each service into seamless service provision to people with diabetes, heart and other chronic conditions, in combination with preventative health activities, Healthy Living NT seeks to maximise the value-add of each service and the overall collective benefit to the consumer.

The Association was pleased to renew urban diabetes education and cardiac rehabilitation services under service agreements with NT DoH for a five-year period (2017-2022). These services, delivered from bases in Darwin and Alice Springs, 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 the federally funded MOICD program, delivering 671 days of remote service to 49 communities across the NT.

In 2016/17 Healthy Living NT also achieved formal accreditation under the Quality Improvement Council’s Health and Community Services Standards.

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.

The Association also supported the development of a diabetes health app, Emojifit. This highly visual app developed by Charles Darwin University is designed to assist people with type 2 diabetes manage their health and achieve actions such as increased physical activity, taking medications etc. It is an innovative means of client self management support and engagement using contemporary systems and methods of communication.

During the year, as a beneficiary of the NT Government’s Immediate Works Grant program, Healthy Living NT also undertook a major refit of its Darwin premises. We extend our appreciation for this generous program.

Governance

The Board of Healthy Living NT has been active in corporate governance during 2016/17 through the work of its Governance Policy Committee. This Committee oversaw the development of a new Strategic Plan (2017-2020), 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 also wish 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. We farewelled our senior Dietitian, Gerard Wong during the year and thank him for his tremendous contribution to the Association over 10 years.

To the Bernborough Club of the NT, major sponsors, commercial Access Points, the NT Government and the NT Primary Health Network, we extend our recognition and gratitude for your support and assistance throughout the year. I also wish to acknowledge Mr Vivekanand Mohan-Ram for his contribution to the Board since 1998/99; on retirement, V was awarded Life Membership of the Association.

A strong Association means strong advocacy for people with diabetes, their families and the health of the community at large. 2017/18 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 2016/17

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

The Healthy Living NT Board


As at 30 June 2017, 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 Rob Hall

Ruth Quinn

William De Decker

Josie Bacus

Benjamin Smith

Retiring Board Members during 2016/17 Vivekanand Mohan-Ram

Bill Raby Diabetes Fellowship Board of Governors

Ms Sharron Noske (Chair)

Ms Sue Korner

Mr Gerry Wood

Mr William De Decker

Mr Ron O’Brien

Honorary Life Members:

Tom Usher

Paul Gooding, OAM

Ian Loftus

Mary Fox

Alasdair McGregor OAM

Vivekanand Mohan-Ram

Governance and Planning


The Board of Healthy Living NT has been pro-active in the area of corporate governance in 2016/17. 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 development of Healthy Living NT’s new Strategic Plan (2017-2020) based on four long term strategic goals. This new Strategic Plan builds on the significant changes adopted in the 2016 review including 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 an annual budget and resources.

Healthy Living NT Strategic Goals 2017-2020 (updated June 2017)

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:

• An effective and collaborative relationship with funders.

• 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.

• Engagement of suitably qualified team members.



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

In 2016/17 Healthy Living NT underwent external quality assessment and was formally accredited under the Quality Improvement Council’s Health and Community Services Standards (6th edition). This accreditation is current to June 2020.

Risk Management Review

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

• Twelve 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 is a standing item on all Board meeting agendas. The Board also annually reviews the currency of Healthy Living NT’s health and safety risk profile against a 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 2016/17 financial year is shown below. The listing includes Board Members elected at either of the Association’s 2015 or 2016 Annual General Meetings (held in October annually) and who served on the Board for any period during the 2016/17 financial year (1 July 2016 - 30 June 2017). The Board met on six occasions in 2016/17 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 2016/17. The sponsored Board position aimed at engaging younger members with the governance of the Association was unfilled in 2016/17.

Board Meeting Attendance No. of Meetings Attended

Ron O'Brien 6 6

Yvonne Rowan 6 6

Mary Fox 6 4

Paul Gooding 6 6

Vivekanand Mohan-Ram 2 2

Rob Hall 6 5

William De Decker 6 5

Ruth Quinn 6 6

Josie Bacus 6 6

Benjamin Smith 4 2



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 2016/17 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. Two-year Board terms were adopted in 2015, 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 Benjamin Smith were appointed to Board under this provision in November 2016.

In addition the Board retains the ability to obtain external 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 2016/17, 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 2016/17 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 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 and Statement • Privacy Breach Policy and Procedure • Occupational and Office Health and Safety Policy • Consumer Charter • Complaints Resolution Policy

• Board Member and Officer Interests Policy • Discrimination and Sexual Harassment Policy • Workplace Behaviour Policy

The Board retains the ability to obtain specialist advice and mechanisms 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

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

• 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)

• Office Assistant 1.0 FTE

• Diabetes Nurse Educators 4.0 FTE

• Cardiac Nurse Educators 4.0 FTE

• Nutrition Educators (APD) 1.2 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

Bill Raby Diabetes Fellowship

Board of Governors

Board Sub-Committees

• Governance Policy• Investment (in recess)

Board Advisory Committees

• Diabetes Education (in recess)• Cardiac Rehabilitation (in recess)

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 2017 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)

Information Officer Tammy Lindsay (Cert IV Leadership & Management – Communications)

Finance/Administration Officer Sissy Arndt (Certificate IV in Bookkeeping; Certificate IV in Accounting)

Administration Officer Ruth Eberhardt

GHANT Secretariat Glenys Tarrant

Service Location Darwin Alice Springs

Diabetes Nurse Educators

Leanne Kuchel (RN - Bachelor of Nursing,

Grad. Cert. Diabetes Education, CDNE)

Julie Nunn (RN – Bachelor of Nursing,

Dip. of Management, Master of Health Science,

Grad. Cert. Diabetes Education, CDNE) Susan De Lacy

(RN, RM, Grad. Cert. Diabetes Education, CDNE)

Kaye Faul (RN - Bachelor of Nursing

Grad. Cert. Diabetes Education) Martin Reilly

(RN - Crit. Care Cert; Grad. Cert. Diabetes Education) Diabetes and Cardiac Educator

Cardiac Nurse Educators

Annette Warren (RN - Bachelor of Nursing; Grad. Cert.

Critical Care, BA (Hons) Dip. Ed.)

Jo Howard (RN - Bachelor of Nursing)

Elizabeth Fitzgerald (RN - Bachelor of Nursing,

Grad. Cert. Cardiovascular Nursing)

John Pearman (RN)

Chris Williams (RN - Post Grad. Dip. Nursing)

Nutrition Educators

Elleni Vassilakoglou (Bachelor of Nutrition and Dietetics,

APD)

Tess Mitchell(1)

(Bachelor of Nutrition and Dietetics, APD)

Anastasia Grasso (Bachelor of Nutrition and Dietetics,

APD)

Customer Service Officers Shani Williams 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 in supporting our operations.

Good Health Alliance NT


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 provision of financial support of over $97,000 to 30 health professionals for diabetes CPD activities.

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. 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 William De Decker – University student and HLNT Board Member with special interest in young people with

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

In 2016/17, the Fellowship Board awarded over $21,000 in funding grants as follows:

• Over $5,400 to support eight youth with diabetes to attend NT and interstate diabetes camps and for two youth to purchase computer tablets to support diabetes management and engage with others with diabetes,

• $1,000 to a health professional to support their attainment of a Graduate Certificate in Diabetes Education, and

• Over $14,000 to support to six community organisations to improve community capacity to promote healthier lifestyles.

Notable community health promotion grants include:

• $2,000 each to the Willowra and Ti-Tree communities to provide ongoing support and health promotion activities to community members with diabetes and their families,

• $2,000 to the Gapuwiyak Culture and Arts Aboriginal Corporation to enable more trips out on-country with artists and their families to promote emotional wellbeing through cultural reconnection and healthy living with increased exercise and traditional foods,

• $1,500 to Council of the Ageing NT to support a program of exercise classes for seniors in Palmerston to promote flexibility, balance, physical confidence and competency,

• $4,712 to the Smile A Mile Toy Library for the purchase of play equipment to support rural and remote children’s health and well-being and

• $2,500 to the Red Cross in Tennant Creek to support a vegetable growing and healthy cooking project.

Healthy Living NT extends its sincere appreciation and thanks to Fellowship Governors for their service throughout the year.

Good Health Alliance NT


The Good Health Alliance NT celebrated its thirteenth year of operation in 2016/17. 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 2016/17 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, 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 2016/17. In addition to a range of discounted products and four 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 993 were marginally lower than 2015/16 (1,123). 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. 55% of consumer members are at pension subscription rate (compared to 52% in 2015/16) and 72% 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 largely reflected implementation of new guidelines and supply arrangements which were under development in the previous period. They include:

• National Strategic Framework for Chronic Conditions – Following a lengthy consultation period, this Framework was released by the Commonwealth Department of Health in May 2017. The Framework moves away from a disease-specific approach by recognising that there are often similar underlying principles for the prevention and management of many chronic conditions. The Framework will better cater for shared health determinants, risk factors and multi-morbidities across a broad range of chronic conditions. Its increased focus on prevention is welcomed by Healthy Living NT.

• National Diabetes Strategy Implementation Plan – Healthy Living NT is a member of the National Diabetes Strategy NT Advisory Group auspiced by the NT Department of Health.

• Drivers Licences – the impact of diabetes and cardiac conditions on a person’s ability to drive is a perennial issue addressed by education staff, often in liaison with GPs, specialists and the Motor Vehicle Registry. People who require endocrine review, particularly those seeking commercial licences, often face extended waiting times for appointments which can contribute to delays in obtaining licences. Healthy Living NT welcomed the release of new national guidelines in October 2016 which adopted a more evidence-based approach to licence restrictions due to medical conditions.

• National Diabetes Services Scheme (NDSS) – Following the decision to transfer the supply and delivery of NDSS products from diabetes organisations in each State and Territory to community pharmacy NDSS Access Points under the Community Services Obligation (CSO) PBS distribution network, Healthy Living NT sought approval to become an NDSS Access Point from 1 July 2016 onwards. This was agreed by the Commonwealth Department of Health (DoH) and Healthy Living NT entered into an NDSS Access Point Agreement with DoH for the 2016-2020 period. This recognises the strong synergy between Healthy Living NT’s diabetes education services and NDSS product supply as well as the number of people with diabetes living remotely in the NT without ready access to a community pharmacy. Healthy Living NT also undertook short term responsibility for ongoing supply to community pharmacy Access Points in July 2017 during the supply chain transition period.

A decision to de-list Blood Glucose Test Strips (BGTS) from the PBS in order to more closely align the NDSS and PBS supply chains also took effect from 1 July 2016. Whilst this change would not impact 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 PBS S100 or CTG exemptions. While submissions to retain BGTS on the PBS for S100 purposes were unsuccessful, the Commonwealth Department of Health agreed to changes to the NDSS that enabled continued provision of free BGTS, pen needles and syringes to RAAHS without need for prescription or individual registrant order.

Under this arrangement, Healthy Living NT managed NDSS product supply to 129 RAAHS clinics in the NT, SA and QLD during 2016/17, delivering over 10,300 units of product in 335 supply episodes.

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 2016/17, 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).

• In December 2016 HLNT finalised the Nutrition for Diabetes in Pregnancy Resource in collaboration with NT DoH. The project also included distribution of the FeltMum resource around the Northern Territory. These resources are now available at specialist and primary health care clinics throughout the NT.

• 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 visiting interstate Paediatric Endocrinologists.

• Collaborated with Charles Darwin University and Decision Support Analytics in the development and roll-out of a diabetes health app, Emojifit. This highly visual app is designed to assist people with type 2 diabetes manage their health and achieve goals. It is an innovative means of client self management support and engagement using contemporary systems and methods of communication.

• Supported the NT Chronic Disease Network (CDN) annual conference and managed Conference seed funds on behalf of NT DoH. The 2016 Conference, Protection, prevention, promotion, was held in Alice Springs in September 2016 in partnership with the Public Health Association of Australia. Additionally, Healthy Living NT entered into a Sponsorship Agreement with the Commonwealth Department of Health to administer financial support to assist Indigenous health practitioners and indigenous presenters attend the CDN Conference. The value of this sponsorship was $80,000 and it supported the attendance at the annual conference of 47 Indigenous health professionals or community officers from around Australia.

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

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

• Provided scheduled diabetes education services to Darwin Correctional Centre and separate regular scheduled cardiac education services to Congress.

• Collaborated across sectors as a member of the National Diabetes Strategy NT Advisory Group

• 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.

• Continued stakeholder engagement to support Healthy Living NT’s role in health promotion and active recreation, working closely with schools and early childhood centres.

• Conducted AHP mentoring programs 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)

• Active Recreation Program NT Department of Sport and Recreation (NT DSR)

• NDSS Access Point Commonwealth Department of Health (DoH)

• NDSS Rural and Remote Clinic Supply Commonwealth Department of Health (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, in combination with preventative health activities, 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, $507,754, 17%

NT DoH Darwin Diabetes Education,

$356,317, 12%

NT DoH Darwin Cardiac Education,

$130,569, 5%

NT DoH Alice Springs Cardiac &

Diabetes Education, $295,376, 10%

Outreach Health Services Program,

$837,080, 28%

NT DSR Active Recreation Program,

$120,000, 4%

HLNT Direct Income, $443,593,

15%

Special Projects, $318,721, 10%

2016/17 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). The NDSS provides:

• Access to 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 continuous glucose monitoring products, 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.

NDSS Agreements

A new NDSS Head Agreement between the Commonwealth Department of Health (DoH) and DAL was signed in June 2016 for a 4-year term (2016-2020) for the delivery of ongoing NDSS services. Under this new Agreement, NDSS product supply and distribution was transferred to the PBS supply chain. Healthy Living NT subsequently entered into a new Agency Agreement with DAL for NDSS services in the NT in July 2016.

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

• Agent Direct Deed • NDSS Access Point Agreement (product supply) • Rural and Remote Clinic Supply Agreement (product supply)

During the transition phase under the new NDSS Head Agreement, Healthy Living NT supported:

• the changeover in supply chain arrangements including distribution of NDSS product to community pharmacy Access Points during transitional delays, and

• the renewal of community pharmacy NDSS Access Point agreements directly with DoH.

Product Access

In 2016/17, over 35,861 NDSS product units were distributed to NDSS Registrants from NT Access Points comprising Healthy Living NT offices in Darwin and Alice Springs, 33 community pharmacy Access Points (2015/16=26,602 units). Of the total, 49% (17,413 units) of NDSS products were distributed directly by Healthy Living NT through:

• Over the Counter sales to diabetes education clients and mail order sales to remote registrants (41%), and • Orders from 129 Remote Area Aboriginal Health Services (RAAHS) in the NT, QLD and SA on behalf of people

with diabetes in their care (59%).

Community pharmacy NDSS Access Points are located in all urban centres and Kununurra in WA as shown in the below table. Most Access Points offer a fully integrated service that includes the complete range of Healthy Living NT products and education and information material.

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

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 809 Starter Packs for people newly diagnosed with diabetes, 318 Gestational Starter Packs and associated follow-up letters and material, a range of education services, tailored information sheets, topic-specific resources and support communications targeted to particular age groups. Replacement NDSS cards were also issued to a total of 2,086 registrants.



NDSS Registrant Services funding supported a diabetes nurse educator position (1.0 FTE) to the diabetes education service. Healthy Living NT educators also provided training to Access Point staff on a regular basis and undertook a variety of NDSS community awareness and health professional upskilling activities throughout the year.

Registrations

Following National Death Index data cleansing during the year, NDSS registrations in the NT as at 30 June 2017 were 14,814, including 1,132 new registrants in 2016/17. Of total NT registrations:

• 42% comprise people of Indigenous descent and • 29% comprise people who manage their diabetes through the use of insulin, including people with type 1, type

2 and Gestational diabetes (increasing from 26% in 2011/12).

8,135 8,843 9,376 9,768 10,078 10,353 10,577

2,884 3,035

3,317 3,587 3,754 3,942 4,237

-

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17

2016/17 NDSS Registrations - by insulin status

Non Insulin Treated Diabetes Insulin Treated Diabetes

Type 1 - All Insulin, 804 , 6%

Type 2 - Insulin, 3,340 , 23%

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

Gestational - Insulin, 57 , 0%

Gestational - No Insulin, 317 , 2%

Other - Insulin, 36 , 0%Other - No Insulin, 38 , 0%

2016/17 - 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=92% vs Australia=87%). Additionally, type 2 NDSS registrations in the NT are markedly different to the national profile with 54% of people with type 2 diabetes aged below 60 years, compared to only 30% nationally. This is best illustrated in the chart below.

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

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

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 ~$55,000 in 2016/17.

The results of the scheme’s operation in the NT in the 12 months to 30 June 2017 were:

• The overall volume of needles and syringes sold was 9,161 (boxes of 100) representing an increase of 24% over the previous 12 months (n=7,379). This substantial increase is largely attributable to all NT remote area health clinics now accessing pen needles and syringes through the NDSS on behalf of individual NDSS registrants in their community. Historically, not all NT remote health clinics were accessing supplies through the NDSS.

• Products were supplied to 4,934 NDSS registrants, averaging out at approximately 1.8 boxes per accessing registrant (2015/16=1.5 boxes/accessing registrant). Whilst the ratio of product/registrant has increased, the number of people accessing the scheme over the previous 12 months decreased slightly by 1% (2015/16=5,007). Again, this is attributable to the number of remote area health clinics accessing product collectively on behalf of people with diabetes in their community (rather than accessing product through each individual NDSS registrant).

• 63% 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.

Services Overview


Overall HLNT Services

Healthy Living NT delivers a range of service contracts including both direct education to people with diabetes and cardiac disease as well as support services, physical activity programs 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 diabetes nurse educator and the AHP mentoring pilot project

• 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 2017 the team consisted of:

Darwin

• 1.0 FTE Education Manager who is both a Diabetes and Cardiac Educator,

• 3.0 FTE Diabetes Educators,

• 3.8 FTE Cardiac Educators

• 1.4 FTE Dietitians

• 1.0 FTE Health Promotion Manager

Alice Springs

• 1.5 FTE Diabetes Educator

• 1.5 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 and cardiac interventional services. 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. Healthy Living NT recognises that our service delivery does not meet demand in the Darwin/Palmerston area and have reported this for a number of years to funders.

Quality Improvement

This year Healthy Living NT went through a quality accreditation process, undertaking the QIC Assessment. Healthy Living NT was awarded Quality Accreditation under the Quality Improvement Council Health and Community Services Standards for three years.

Services Overview


2016/17 Services Overview

In 2016/17, a total of 6,410 people have accessed direct services through Healthy Living NT. This comprises:

• 3,833 clients with diabetes were provided with education across all services (2015/16 = 3,878)

• 2,086 clients with heart conditions were provided with education across all services (2015/16 = 2,067). An additional 227 client episodes were recorded in the provision of maintenance exercise classes

• 58 clients with a range of chronic conditions (diabetes, heart disease, respiratory disease, cancer and kidney disease) were provided with specific nutrition education under MOICD (2015/16 = 47)

• 433 clients participating in physical activity and lifestyle modification activities via specific health promotion programs delivered through Healthy Living NT’s Active Recreation services (Mini Movers, seniors’ activity program, Fun in the Parks days).

Additionally, Healthy Living NT has been involved in Community Health Promotion activities (3,074 participants) and Health Professional education information (1,541 health professionals)

3,018 (50%) of all clients seen through the diabetes, cardiac and MOICD education services were of Indigenous descent (2015/16 = 54%)

Diabetes Clients

50% of clients with diabetes were educated through the NT DoH Darwin service, 17% through the DoH Alice Springs service, 29% through the MOICD service, and 4% through Darwin Corrections. 1,297 (34%) of diabetes clients seen across all services were of Indigenous descent.

Cardiac Clients

16% of clients with cardiac conditions were educated through the NT DoH Darwin service, 11% through the Alice Springs NT DoH service and 73% through the MOICD service. 1,663 (80%) of cardiac clients seen across all services were of Indigenous descent.

Diabetes Education Services


Diabetes Education Service (urban 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 NT Department of Health, supplemented by NDSS funding (for the Getting Started Group, the Gestational Diabetes Group and NDSS 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.

For people with newly diagnosed type 2 and pre-diabetes, Healthy Living NT’s preference is for education delivery in an initial 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: • Fortnightly for new type 2 and pre-diabetes clients (Darwin office), a monthly after hours session (Palmerston)

and a monthly session (Alice Springs office); and • Weekly groups for new GDM clients held at the Darwin office.

Individual initial and review 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 people 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 pre-diabetes 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 consultation space and a dietitian in an ongoing arrangement with the RDH Paediatric 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 visiting interstate Paediatric Endocrinologists.



2016/17 Diabetes Client Overview (urban NT DoH Service Agreement)

In 2016/17 the diabetes education service directly educated 2,551 people with diabetes, an average of 212 per month. 74% of clients were educated by the Darwin service, an average of 158 clients per month (an increase of 5% from 2015/16); 26% of clients were educated by the Alice Springs service, an average of 55 clients per month (an increase of 23% from 2015/16).

New clients represented an overall 26% of clients (Darwin 29% and Alice Springs 20%); review clients comprised the remaining 74%.

New client diagnoses were as follows:

• 247 diagnosed with Type 2 in Darwin and 104 in Alice Springs (351 in total, 6% increase from 2015/16)

• 233 diagnosed with GDM in Darwin and 2 in Alice Springs (19% increase from 2015/16)

• 18 diagnosed with IGT (pre-diabetes) in Darwin and 8 in Alice Springs (50% decrease from 2015/16)

• 24 diagnosed with Type 1 in Darwin and 8 in Alice Springs (19% increase from 2015/16)

• The total number of review client episodes increased in Darwin 2% and in Alice Springs increased 28%.

Other notable factors in 2016/17 include:

• Overall, 31 clients commenced insulin in a community setting provided by Healthy Living NT in collaboration with the client’s GP, requiring 238 review consultations (a decrease of 35% initiations from 2015/16)

• 866 letters sent to Medical Officers and 68 interpreters used during consultations

• 83 clients seen were of Indigenous descent

• 52 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 2016/17, a total of 597 referrals were received for new clients who attended. The 2016/17 sources of referral are shown below:

(*) referrals from other allied health professionals

GP/ AMS/ DMO,

319, 53%

Physician/ Pediatrician,

2, 0%

Hospital MO, 15, 3%

Obstetrician/ ANC,

231, 39% Other (*),

30, 5%

2016/17 Source of Referrals



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

Diabetes Client Services 2016/17 NT DoH Service Agreement

No. 16/17

% %

Change 2015/16

No. 16/17

% %

Change 2015/16

No. 16/17 % %

Change 2015/16

Total New Clients: 545 29% 12% 129 20% 6% 674 26% 11%

Type 1 diabetes 24 4% -4% 8 6% 300% 32 5% 19% Type 2 diabetes 247 45% 7% 104 81% 4% 351 52% 6%

GDM (Gestational Diabetes) 233 43% 18% 2 2% 235 35% 19% IGT (Impaired Glucose Tolerance) 18 3% -44% 8 6% -60% 26 4% -50%

Educated individually 120 22% -10% 109 84% 10% 229 34% -1% Educated by Group 425 78% 20% 20 16% -13% 445 66% 18%

Time since diagnosis < 3 months 334 61% 28% 21 16% -34% 355 53% 21% Appointment Booking Time Exceeded 0 0% 0 0% 0 0%

Did Not Attend 61 11% -2% 24 19% 26% 85 13% 5%Referred by

GP/ AMS/ DMO 232 47% -6% 87 86% -11% 319 53% -8%Physician/Pediatrician 1 0% -75% 1 1% 0% 2 0% -60%

Hospital MO 13 3% -32% 2 2% -33% 15 3% -32%Obstetrician/ANC 231 47% 18% 0 0% 231 39% 18%

Other (*) 19 4% 850% 11 11% 267% 30 5% 500% Total Referrals 496 91% -4% 101 78% -4% 597 89% -4%

Total Review Clients: 1,349 71% 2% 528 80% 28% 1,877 74% 8%

Type 1 94 7% -6% 68 13% 143% 162 9% 27% Type 2 679 50% -22% 399 76% 5% 1078 57% -14%

GDM 528 39% 64% 1 0% 529 28% 64% IGT 27 2% -10% 29 5% 480% 56 3% 60%

Insulin Stabilisation Initial 21 2% -45% 10 2% 0% 31 2% -35% Insulin Stabilisation Review 141 10% -36% 97 18% 2% 238 13% -24%

Educated by Phone 201 15% -5% 162 31% 224% 363 19% 39% Seen by DNE 715 53% -8% 377 71% 58% 1092 58% 7%

Seen by Dietitian 613 45% 12% 186 35% -12% 799 43% 5% Appointment waiting time >10 mins 14 1% 250% 0 0% 14 1% 75%

Did Not Attend 207 15% 4% 71 13% -4% 278 15% 2% Touching Base Attendance 21 2% -63% 31 6% 52 3% -16%

Review Reminders Sent 447 33% -32% 123 23% 24% 570 30% -25%

Total Clients 1,894 74% 5% 657 26% 23% 2,551 100% 9%

General Aboriginal/TSI clients ** 37 2% -56% 46 7% 7% 83 3% -35%

Letters to Medical Officers 623 33% 2% 243 37% 20% 866 34% 6% Clients seen externally 163 9% -16% 0 0% 163 6% -16% Significant Others Seen 90 5% -45% 15 2% -63% 105 4% -49%

Interpreters Used 65 3% 76% 3 0% 68 3% 84% Phone - (info from HLNT HPs)

Health Professionals 350 87% 29% 156 85% 524% 506 86% 70% General Public 54 13% -48% 27 15% 350% 81 14% -26%

Information Packs - Insulin 26 4% 37% 13 16% 225% 39 5% 70% Type 2 294 44% 7% 59 74% -8% 353 47% 4%

Type 2 Insulin 18 3% -28% 0 0% 18 2% -40% GDM 299 44% 22% 1 1% 300 40% 22%

IGT 37 5% -27% 7 9% -50% 44 6% -32%Total 674 10% 80 -8% 754 7%

Total 2016/17Alice Springs Darwin

Cardiac Education Services


Cardiac Education Service (urban 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.

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

Base funding for the services has not increased since the service began in 2002. Healthy Living NT employs a 0.8FTE position in Darwin and a 1.0FTE position in Alice Springs. The extremely restrictive funding for the Darwin service is reflected in reduced human resources and means that many eligible cardiac clients are not seen by Healthy Living NT. The increases in tertiary services available (angioplasties etc) and numbers of clients seen through the Darwin cardiac public and private systems cannot be catered for through the Darwin urban cardiac rehabilitation service and there are growing service gaps each year. An agreement with Charles Darwin University to help support Cardiac Rehabilitation with Clinical Psychology Masters students ceased as the University was not able to sustain clinical supervision. Healthy Living NT believes that the value of psychology involvement in the program provided significant benefits to clients.

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) as follows:

• 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. The delivery of the Phase 2 HHP in Darwin and Alice Springs is different to cater for different populations and facilities. Towards the end of this 2016/17 period, a review and change in structure was enacted in Alice Springs to try to refocus the energy of the group towards the Phase 2 clients.

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

• Phase 3 maintenance commences at the completion of Phase 2 and involves referral to ongoing education opportunities through Touching Base and a continuing exercise program in Alice Springs.

• A telephone support service which is available throughout all phases.

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)



2016/17 Cardiac Client Overview (urban NT DoH Service Agreement)

In 2016/17, Healthy Living NT provided cardiac education and rehabilitation services to 572 new clients (Phase 1 and Phase 2 clinics). Additionally, 111 Phase 2 clients attended the Healthy Heart program for 342 episodes. Phase 3 client education included attendance at Touching Base group sessions (30) and 227 maintenance exercise attendances in Alice Springs (reflecting an average 5.4 attendees each session). 28 clients were seen in external clinics. Excluding indirect episodes, there were 1,070 cardiac client episodes in 2016/17.

Direct client episodes were recorded as follows:

• 370 Phase 1 clients, seen 443 times, an average of 1.2 times per client (a reduction of 14% from 2015/16)

• 144 clients were educated in Phase 2 programs– 74% Darwin and 26% Alice Springs which is a 19% increase from 2015/16

111 clients were educated in the Healthy Heart Program – 82% Darwin and 18% Alice Springs

33 clients were educated in individual appointments

Other notable statistics in 2016/17 include:

• 174 (34%) of total Phase 1 and 2 clients were of Indigenous descent

• 339 information packs were given out from the Darwin service and 243 from Alice Springs

• 393 phone contacts were made with health professionals, clients and the public

• 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.

• 145 clients in Phase 1 also had diabetes (39%)

• The direct access percentage for the Darwin Cardiac Educator to go to RDH was 53%

• The direct access percentage for the Alice Springs Cardiac Educator to go to ASH was 81%

• 30 clients attended Touching Base groups

Alice Springs Hospital, 160 , 23%

Royal Darwin Hospital, 180 , 25%

NT Cardiac, 14 , 2%

Danila Dilba / Congress,

26 , 4% GP,

14 , 2%

Royal Adelaide Hospital, 120 , 17%

Flinders Medical Centre,

153 , 22%

Interstate Hospitals,

29 , 4%

Other, 5 , 1%

2016/17 - Source of Cardiac Referrals



*Angioplasty/stent services provided in Darwin only. ** No. of ATSI educated does not include external clinics.

Cardiac Client Services 2016/17

NT DoH Service Agreement

No. % Change 2015/16



Phase 1 - In-patient educationNo. of cl ients educated in Phase 1 210 1% 160 -28% 370 -14%

Tota l times cl ients seen 242 -19% 201 -28% 443 -23%Average times cl ients seen / admiss ion 1.2 -20% 1.3 -1% 1.2

Discharge plan input 209 3% 144 -18% 353 -6%Signi ficant Others per episode 91 63% 24 -54% 115 6%

Primary DiagnosisMyocardia l Infarction 68 -14% 36 9% 104 -7%

Unstable Angina 74 32% 43 -4% 117 16%Acute Coronary Syndrome 142 5% 79 1% 221 4%

Arrhythmia 19 -50% 27 -27% 46 -39%Heart Fa i lure 13 -38% 38 -41% 51 -40%

Rheumatic Heart Disease 0 2 2Pacemaker 1 0% 0 -100% 1 -75%

Internal Defibri l lator 4 1 5Angioplasty/Stent * 22 267% 0 22

Other 9 29% 13 -64% 22 -49%Phase 2 - RehabilitationHealthy Heart Program

Cl ients seen in HHP 91 25% 20 0% 111 19%Tota l times sess ions attended 290 11% 52 -9% 342 7%

Tiwi 172 -8% - 172 -8%Palmerston 118 57% - 118 57%

Average number of sess ions attended 3.1 2.6Tota l number of education sess ions held 90 34% 20 0% 110 26%

Tota l number of exercise sess ions held 90 34% 42 11% 132 26%No. completing the ful l 4 weeks 54 38% 9 -25% 63 24%HHP Cl ients from Phase 1 Urban 35 59% 18 20% 53 43%

No. returning to or repeating the course 0 -100% 0 0 -100%Signi ficant others attending (episodes) 95 239% 4 0% 99 209%

Phase 2 Individual Appointments No. receiving individual appointments 15 114% 18 -14% 33 18%

No. Signi ficant others attending 3 50% 9 -10% 12 0%

Total Phase 2 Clients 106 38 144 19%Phase 3 - Maintenance

Touching Base education 18 -10% 12 500% 30 36% maintenance exercise attendance (A/S) 227 -46% 227 -46%

Other Service IndicatorsNo. of ATSI people educated ** 62 13% 112 -15% 174 -6%

No. cl ients seen external ly 0 28 65% 28 65%No. of interpreters used 0 -100% 0 -100% 0 -100%

No. of invi tations sent to join HHP 181 59% 46 -8% 227 38%No. of Phase 2 packs sent to remote locations 71 -27% 57 1040% 128 25%

Letters to Medica l Officers 262 628% 21 0% 283 396%% referra ls sent information within timeframe 95% 100% 0%

Total Phone contacts - HPs, clients and public 316 77 393Information Packs

Phase 1 - urban 111 -28% 89 -17% 200 -23%Phase 1 - rura l 51 292% 59 -32% 110 10%

Phase 2 - urban 106 33% 38 -7% 144 19%Phase 2 - rura l 71 -27% 57 1040% 128 25%

Total 339 2.7 243 1% 582 0%Source of Referrals

ASH 0 160 -32% 160 -32%RDH 180 -22% 0 180 -22%DPH 0 0 0

NT Cardiac 14 40% 0 14 40%Dani la Di lba / Congress 2 -80% 24 33% 26 -7%

GP 13 44% 1 -50% 14 27%RAH 0 120 21% 120 21%FMC 136 113% 17 6% 153 91%

Interstate Hospi ta ls 26 4% 3 -57% 29 -9%Other 5 -44% 0 -100% 5 -55%

Total 376 5% 325 -14% 701 -5%

Darwin Alice Springs Total 2016/17

Ancillary Education Services


Diabetes Services at Darwin Corrections Centre

Healthy Living NT delivered diabetes education twice a month during 2016/17 to the Darwin Corrections Centre. These services are funded directly by the prison service.

In 2016/17, 163 clients received education through the service, with 82% of these clients having type 2 diabetes and 147 (90%) being of Indigenous descent. 52% of clients educated were newly referred with the remaining 48% seen as reviews, often for insulin titrations.

Aboriginal Health Practitioner Mentoring Program

In 2015/16, Healthy Living NT received funds through the NDSS to run two Aboriginal Health Practitioner Mentoring Pilot programs. In this pilot project, Healthy Living NT engaged two Aboriginal Health Practitioners (AHP) working in two very remote NT communities in a mentoring relationship with two Healthy Living NT Credentialed Diabetes Nurse Educators (CDNE). This included:

• 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).

From the success of the pilot program, further NDSS funds were allocated in 2016/17 to support this initiative to continue.

In the period July – December 2016, AHPs from the two health clinics based in Marthakal Homelands and Jabiru were engaged in the mentorship program. While the partnership at Jabiru went well, the Marthakal partnership ended early due to the AHP resigning from her position so she could fulfil her cultural obligations.

The January – June 2017 period encountered additional problems with the recruitment of AHPs to the mentoring partnership. Mentoring arrangements proposed at Borroloola did not proceed due to impact of Cyclone Alfred on the township and health services.

Healthy Living NT also explored supporting the Aboriginal Medical Services (AMS) that employ their own Credentialed Diabetes Nurse Educators to undertake the mentoring program with their employed AHPs, with Healthy Living NT support. Two AMS’ in the Katherine region have expressed interest in this arrangement in 2017/18. Healthy Living NT will continue to explore this option as it provides extended options for delivering the Mentorship Program.

The risks posed by staff turnover, cultural factors and extreme weather conditions are all rated as medium to high in the Mentoring Risk Assessment with only limited mitigation strategies available. This is a reflection of the realities of service provision in remote areas.

Type 1, 7, 4%

Type 2, 133, 82%

IGT, 23, 14%

Clients seen by diabetes diagnosis

Outreach Health Services


Outreach Health Services (OHS)

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

In 2016/17, Healthy Living NT visited 49 remote communities, towns and Aboriginal Medical Services for a total of 671 days inclusive of diabetes, cardiac and dietetic education services. Services provided into communities are generally 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 • Jabiru • Oenpelli

• Ampilatwatja • Jilkminggan • Palumpa

• Angurugu • Kalkarindji • Peppimenarti

• Barunga • Kintore • Pirlangimpi

• Anyinginyi • Lajamanu • Ramingining

• Batchelor • Lake Nash • Ski Beach

• Belyuen • Maningrida • Santa Teresa

• Beswick • Marthakal Homelands • Timber Creek

• Binjari • Milikapiti • Umbakumba

• Borroloola • Milingimbi • Utopia

• Bulman • Minjilang • Wadeye

• Canteen Creek • Minyerri • Warruwi

• Daly River • Miwatj main • Wurli Wurlinjang

• Endeavour Medical Clinic • Murray Downs • Yarralin

• Epenarra • Nguiu • Yirrkala

• Gapuwiyak • Ngukurr

• Hermannsberg • Numbulwar

Legend:

Diabetes Education

Cardiac Education

Nutrition Education

The 671 delivered service days represented 86% of total scheduled service days (703 days).

During the period there were changes in the communities serviced including:

• the cessation of diabetes educator services to the Katherine West communities (as KWHB employed their own diabetes educator). This cessation of diabetes services to the Katherine West communities also impacted on provision of cardiac education services as sole practitioner travel to isolated communities is not supported under HLNT’s OH&S policy.



• the cessation of diabetes educator services to Elliott (due to logistics and no other service provider to travel with) and

• the reintroduction of diabetes and cardiac services to Peppimenarti.

Additionally, a total of 214 clinic health professional staff were provided in-services totalling 112 hours while Healthy Living NT educators (diabetes, cardiac and dietitian) were visiting (refer to page 33 for more details).

Diabetes Client Services

Under the MOICD program, the Diabetes Nurse Educators provided 247 days of service to 32 communities and delivered diabetes education to 1,119 clients. Education was provided according to client and clinic need.

• 92 clients (8%) were educated within a group setting

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

• 129 case conferences were conducted, and

• 1,067 clients (95%) were of Indigenous descent.

The average length of service day was 8.2 hours, comprising an average of 6.1 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 PHN travel policy.

0

500

1000

1500

2000

Diabetes Cardiac Dietitian

Num

ber

MOICD 2016/17

Service days

Clients

Type 1, 4, 0%

Type 2, 947, 85%

GDM, 23, 2%

IGT, 25, 2%

Other, 28, 3%

Groups, 92, 8%

People seen by diabetes diagnosis



Cardiac Client Services

Under the MOICD program, the Cardiac Nurse Educators provided 344 days of service to 45 communities and delivered cardiac education to 1,514 clients.

• 803 (53%) were newly referred clients, with 711 (47%) seen for review appointments

• 301 clients (20%) were educated within a group setting

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

• 334 clients (28%) additionally had diabetes

• 40 clients were provided with education prior to a planned cardiac procedure/operation and 73 were seen within 6 months of returning to their community post a cardiac event/procedure/operation (cardiac rehabilitation client group)

• 137 case conferences were conducted

• 1,489 clients (98%) were of Indigenous descent

The average length of service day was 8.4 hours, comprising an average of 6.3 clinical hours per day and 2.1 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 14 days of service. The dietitian provided nutrition education to 58 people with a chronic condition(s).

• Chronic conditions recorded were: o Diabetes 47 (81%) o Heart Disease 21 (36%) o Kidney Disease 14 (24%) o Cancer 0 (0%) o Respiratory Disease 0 (0%) o Other 24 (41%)

• 3 significant others were also seen

• All education was delivered as individual consultations

• All people were of Indigenous descent

The average length of service day was 9.4 hours, comprising an average of 5.7 clinical hours per day and 3.7 hours of travel time per day.

ACS, 486, 32% Heart Failure,

95, 6%

Arrhythmia, 96, 6%

RHD, 285, 19%

Other, 251, 17%

Group, 301, 20%

People seen by cardiac diagnosis

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.

Four editions of Healthy Living NT publications, Territory Way (member newsletter with a distribution in excess of 1,400/issue) and four editions of Healthy Living News (health professional newsletter with a distribution in excess of 500/issue) were produced in 2016/17. The production of both publications represents a considerable resource commitment by the organisation.

During the year, Healthy Living NT distributed over 754 diabetes information packs and 582 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, Healthy Living NT joined in collaboration to promote a new diabetes management app called Emojifit. This app is specifically designed to increase confidence in self management of type 2 diabetes.

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. In 2016/17, Healthy Living NT focussed on increasing social media engagement, primarily through Facebook. The number of likes increased 496% over the period. There was a monthly average reach of 4,518 people and engagement with the Facebook page has also increased.

No.

of c

licks

/vie

ws/

post

s

No.

of L

ikes

Health Professional Support and Training


Healthy Living NT also provides training and support to health professionals throughout the NT. 1,541 health professionals were educated or assisted through the year (2015/16= 1,303). 46% were assisted via phone consultation whilst the remainder were assisted in a face to face setting.

292 health professionals were educated in formal training environments, involving 381 hours by Healthy Living NT urban education staff. Another 214 health professionals were provided education through the MOICD program involving 112 hours by Healthy Living NT remote education staff. Additionally, Healthy Living NT has continued the Aboriginal Health Practitioner Mentoring Program; this intensive 1:1 support is not listed within this section refer page 28.

Health Professional Education Activities 2016-17Darwin and Alice Springs Organisation Activity Health Professionals Numbers HoursNDSS Access Points NDSS & pump supplies presentation Pharmacy staff 7 2Deakin Uni Diabetes Student Placement Student DE 1 53RDH ACS, Cardiac Rehab Grad Nurses 28 1.5Bath St GP Clinic NDSS changes and HLNT Service overview GPs, Practice Staff 5 1.5Central Clinic NDSS changes and HLNT Service overview GPs 3 1NT DoH Diabetes in general care settings RNs, Community nurses 18 4NT DoH Diabetes in general care settings RNs, Community nurses 18 2HLNT, NT DoH Diabetes in general care settings RNs, Community nurses 18 2Juninga Type 2 diabetes RN, Carers 12 2CDU Dietitian student placement Dietitians 3 2.5Deakin Uni Diabetes Student Placement Student DE 2 2.5Palmerston Medical Centre NDSS changes and HLNT Service overview GPs, Practice Staff 8 1.5Top End Medical - Stuart Park NDSS changes and HLNT Service overview Practice Staff 1 1.5Cavenagh Medical Centre NDSS changes and HLNT Service overview GPs, Practice Staff 4 1.5Batchelor Institute Cardiac overview AHP students and lecturer 18 8RDH ACS, Cardiac Rehab Grad Nurses 27 2Remote DNE Observing clinics DNE 1 6Remote DNE Mentoring DNE 1 1NDSS Access Points NDSS & pump supplies presentation Pharmacy staff 3 2NDSS Access Points NDSS & pump supplies presentation Pharmacy staff 12 3Deakin University Group education observation and presentation Dietitian students 2 10Batchelor Institute Cardiac education for AHP students AHP students and lecturer 28 8University of Wollongong Group education observation Dietitian students 2 4.5Central Clinic Ketone testing Practice nurse 1 0.5RDH Physio Department Cardiac Rehab and HLNT services Physios 17 1NT DoH Diabetes in general care settings RNs, Community nurses 25 1.5Griffith University Group education observation Dietitian student 1 2RDH Diabetes team meeting Effect of protein and fat in Type 1 diabetes Endos, DNE, Dietitian 8 1Flinders University Dietitian student placement Dietitian student 1 250Moil Medical Centre NDSS changes and HLNT Service overview GPs, Practice Staff 1 0.5Care Point Medical Clinic NDSS changes and HLNT Service overview GPs, Practice Staff 4 1Territory Medical - Nightcliff NDSS changes and HLNT Service overview GPs, Practice Staff 12 0.5

Total 292 381



Organisation Activity Health Professionals Numbers HoursNguiu HC Cardiac case scenarios Medical student 1 2

Minyerri HC Post op cardiac management EP 1 1

Wadeye HC RHD CDN, RHD RAN 2 1

Oenpelli HC Byetta medication CDN 1 0.5

Oenpelli HC NDSS changes CM 1 0.5

Marthakal HC Monitoring and recording observations AHP & AHP trainees 2 1

Marthakal HC Cardiac pathophysiology AHP 3 1.5

Yirrkala HC Insulin initiation RAN 11 1

Yirrkala HC NDSS changes CM 1 0.5

Angurugu HC Heart sounds RAN 1 1

Wurli HC Diabetes self management CD RN, AHP 1 1.5Wurli HC Mentoring for Credentialing CD RN 1 1Palumpa HC Cardiac education and lifestyle change RN, AHP 2 1Timber Creek HC Cardiac assessment AHP 1 1Barunga HC Take Heart DVD RAN, AHP, EP 4 1.5Lake Nash HC Insulin initiation GP, RN, CNE 3 1Ramingining HC Cardiac consults PCD educator 1 3Marthakal HC Diabetes self management AHP trainee 1 3Marthakal HC Warfarin and arrhythmias AHP trainee 1 1.5

Nguiu HC Cardiovascular disease AHP 1 1

Nguiu HC Self management AHP 1 1Umbakumba HC 12-Lead ECG interpretation RN 1 1Binjari HC Foods and INR levels AHP 1 0.5Canteen Creek HC Insulin administration RN, AHP 3 1Borroloola HC NDSS changes RAN 1 0.5Daly River HC Prevention of type 2 diabetes AHP 2 1Palumpa HC Type 2 diabetes in pregnancy RAN 1 0.6Gapuwiyak HC Changes in 12-lead ECGs RN 1 0.5Palumpa HC Resouces Reception, driver 2 0.5Ali Curung HC NDSS supplies CM 1 0.5Ali Curung HC Insulin administration GP 1 0.5Ali Curung HC Needle length CM 1 0.4Milikapiti HC LAB injection technique CM, AHP 2 1Jabiru HC Cardiac education CM, AHP 2 1Oenpelli HC Scabies and ARF Skin HP 1 0.5Nguiu HC Warfarin and arrythmias AHP, RAN, CD Coord, GP 4 1Wadeye HC Cardiac resources RAN 1 1Timber Creek HC Warfarin and arrythmias AHP, RAN, GP 3 1Yarralin HC Warfarin and arrythmias AHP, RAN 2 1Timber Creek HC Diabetes education RAN 1 0.5Yarralin HC Pathology and diabetes RAN 1 0.5Miwatj HC Bydureon medication RAN 1 0.5Ski Beach HC Bydureon medication RAN, GP 2 1Yirrkala HC Bydureon medication RAN, Co-ord, GP 5 1Ski Beach HC ECGs Admin staff 1 0.4Bulman HC Smoking cessation AHP 2 1Ngukurr HC Cardiac resources AHP 1 1Lajamanu HC Heart anatomy and physiology AHP, Aged Care staff 6 2Gapuwiyak HC 6 min walk test RAN, Student GP 2 1Angurugu HC Diabetes management AHP 1 1Numbulwar HC Type 2 diabetes in pregnancy RAN 1 0.6Lake Nash HC Healthy food and physical activity AHP 1 1Lake Nash HC BD Safety needles GP, RAN, CNE, DE 6 1Binjari HC Diabetes medicaitons RN student 1 1Wurli HC Type 1 assessment RAN 1 1Gapuwiyak Diabetes information AHP 1 1Ramingining Diabetes information AHP 1 1Peppimenarti Education resources AHP, RAN, Student 4 1.5Minjilang LAB injections RAN 1 0.4

Health Professional Education Activities 2016-17 MOICD



MOICD continuedOrganisation Activity Health Professionals Numbers HoursGapuwiyak Diabetes information AHP 1 1Ramingining Diabetes information AHP 1 1Peppimenarti Education resources AHP, RAN, Student 4 1.5Minjilang LAB injections RAN 1 0.4Tennant Creek Cardiac assessments and resources New cardiac RN 1 5Ali Curung Diabetes management Medical stundent 1 1Ali Curung Education resources CDN 1 0.4Ali Curung Type 2 in children CM 1 1Ali Curung Insulin pump therapy RAN 1 0.5Ali Curung Medications and dialysis GP 1 0.4Ali Curung Diabetes foot resources POD 1 0.2Milingimbi ARF RAN 3 1Milingimbi GDM RAN, AHP 3 1Milikapiti RHD Grad Nurse 1 1Wurli Diabetes medications RAN 1 1Ramingining GDM AHP 1 0.5Ramingining NDSS information AHP 1 0.5Ramingining HLNT services NTG staff, ALPA staff 2 0.5Gapuwiyak GDM and NDSS RAN 1 1Marthakal Diabetes questions AHP 2 1Marthakal Diabetes information AHP 2 1Borroloola LAB injections GP, RAN, AHW 9 1.5Belyuen Diabetes medications AHP 1 1Batchelor Diabetes resources AHP 1 1Oenpelli LAB injections RAN 1 0.5Oenpelli Diabetes medications RAN 1 0.5Warruwi Diabetes medications RAN 1 1Angurugu GDM AHW, RAN 2 1Numbulwar LADA diagnosis RAN 1 0.5Umbakumba Diabetes management AHP, Student 2 1Yirrkala Warfarin resources Clinic staff 6 0.5Yirrkala Diabetes medications Chronic Co-ord 1 0.5Ski Beach Diabetes medications GP 1 0.5Bulman Education resources Indigenous Com. Worker 1 1Minyerri Smoking cessation Indigenous CBW AOD 1 0.6Milingimbi GDM RAN 1 0.6Marthakal Diabetes resources GP, RAN 1 1Marthakal Diabetes resources RAN 1 0.5Ski Beach Diabetes medications RAN, AHW student 3 1Yirrkala NDSS information RAN, Co-ord 2 0.5Miwatj Diabetes medications GP, RAN 2 1Peppimenarti Target BGLs RAN 1 1Peppimenarti Diabetes medications RAN, CM 3 1Tennant Creek PPM information RAN 1 1.5Ramingining Needle information RAN 1 0.5Umbakumba Steroids and hyperglycaemia RAN 1 0.5Daly River Diabetes medications RAN 1 1Palumpa Needle information RAN 1 1Jabiru Diabetes medications AHP 1 0.5Milingimbi Diabetes medications 4xRAN, CM 5 1Milingimbi Diabetes medications Chronic co-ord 1 0.4Wadeye Adult education principles RAN 1 2Binjari Healthy food CM 1 0.5Wurli Diabetes medications GP, RAN, AHP 3 1Santa Teresa Cardiac rehabilitation personal trainer 1 0.5Ampilatwatja PPM information RAN 3 1Utopia PPM information RAN 4 1Ramingining GDM Midwife 1 0.5Ramingining Injection technique RAN 1 0.5Jilkminggan Cardiac surgery procedure RAN, EP 1 1Canteen Creek PPM and AICD RAN 1 1

Total 214 112

Community Education and Support


In addition to client services and health professional training, Healthy Living NT also delivered a variety of support to community groups, totalling 3,074 contacts and more than 130 hours of staff time. These figures do not include specific health promotion programs delivered through Healthy Living NT’s Active Recreation services (Mini Movers, seniors’ activity program, Fun in the Parks days) which are detailed on page 38. The more structured activities are listed below. Additionally 271 people from the general public were given education by a health professional either face to face in our offices or via the phone.

Community Education and Health Promotion Activities 2016-17Darwin and Alice Springs Organisation Activity Numbers HoursCentra l ian Senior School School Expo 350 1.5Town Counci l - BP checking Live l ighter Campaign 30 2Centra l ian Middle School Heal th Expo 350 2Menta l Heal th Stress Less in the Park 500 3HLNT World Diabetes Day 80 4HLNT Happy Heal thy Chris tmas 12 2Al ice Springs Type 1 Support Group Type 1 Information 50 3Aranda House (DASA) Diabetes 7 1ITEC Type 1 diabetes 2 1.5ITEC Type 2 diabetes and prevention 3 1.5HLNT Sugar in drinks display 190 10.5Heart Foundation Nutri tion 18 2Mi l lner Primary school Heal thy Eating for young kids 6 2Hibiscus Shopping Centre National Diabetes Week 80 6Palmerston Girl s Academy Heal th Expo 50 4Palmerston Dani la Di lba Heal th Promotion and Centre Opening 100 2NT DoH Aged Care Morning Tea 50 2Darwin Ci ty Counci l Senior Womens Heal th Expo 50 12HLNT, Darwin Runners club JDRF Walk for a cure 50 6Li fe Without Barriers Diabetes 20 1ITEC Type 1 diabetes 8 1.5DASA Feltman 14 1.5Arid lands Sugar in drinks display 10 1.2CSC Sugar in drinks display 62 1Acacia Hi l l School Healthy Living Expo 140 3Al ice Springs Type 1 Support Group Fun run 100 3Casuarina Senior col lege Health and Wel lbeing Expo 52 6Heart Week BP management/ Sa l t 125 18MiFant Cardiac ri sks and pathophys iology 11 1Nightcl i ff Middle School Nightcl i ff school feis ta 138 7ARRCS Diabetes in the Elderly ta lk 15 2.5Palmerston Senior Col ledge Palmerston Senior Col ledge Heal th expo 57 3.5Macki l lop Cathol ic School Type 1 School Ta lk 65 2Li festyle Solutions Type 1 education 4 1.5Ess ington School Type 1 education 5 0.8Bus l ink Healthy Living , diabetes prevention 50 3HLNT Kids group 40 3Dripstone Middle School Panel of Heal th Profess ionals 180 4

Total 3074 132.5

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 86 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 conducted in collaboration with the parents and schools involved. These figures do not include specific health promotion programs delivered through Healthy Living NT’s Active Recreation services (Mini Movers, Fun in the parks days), which are detailed on page 38.

HLNT Involvement with youth <18 2016-17 (Non Clinical)Organisation Activity Attendees HoursCentralian Senior School School Expo 350 1.5

Centralian Middle School Health Expo 350 2

Millner Primary School Healthy Eating and Drinking for young kids 6 2

Palmerston Girls Academy Health Expo 50 4

HLNT, Darwin Runners club JDRF Walk for a cure 50 6

Acacia Hill School Healthy Living Expo 140 3

Casuarina Senior college Health and Wellbeing Expo 52 6

Nightcliff Middle School Nightcliff School feista 138 7

Palmerston Senior Colledge Palmerston Senior College Health expo 57 3.5

HLNT Kids group 40 3

Dripstone Middle School Panel of Health Professionals 180 4

Total 1413 42.0

HLNT Involvement with youth <18 2016-17 (Clinical)Organisation Activity Attendees HoursHLNT: Public Paeds Clinic Paeds clinic (QLD Paediatric Endocrinologist) 10 8HLNT: Public Paeds Clinic Peads clinic 4 4HLNT: Public Paeds Clinic Peads clinic 7 4HLNT: Public Paeds Clinic Peads clinic 4 4HLNT: Public Paeds Clinic Peads clinic 3 4HLNT: Public Paeds Clinic Paeds clinic (QLD Paediatric Endocrinologist) 10 8HLNT: Public Paeds Clinic Peads clinic 1 2HLNT: Public Paeds Clinic Peads clinic 4 4

HLNT: Public Paeds Clinic Peads clinic (NSW Paediatric Endocrinologist) 10 8



HLNT: Public Paeds Clinic Peads clinic 3 4






Total 86 78

School Activity Attendees HoursMackillop Catholic School Type 1 School Talk 65 2

Essington School Type 1 education 5 1

Total 70 3

HLNT Involvement with youth <18 2016-17 School talks supporting teachers with students with diabetes

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.

Under the Life. Be in it initiative, Healthy Living NT has been involved in a number of activities throughout Darwin, Palmerston and Alice Springs, supported by a grant from the Sport and Recreation Development Division of the Department of Tourism and Culture, NT Government. A total of 44 different episodes of activities were delivered through the 2016/17 period with 1,284 participants, comprising:

• 1,045 (81.4%) youth

• 239 (18.6%) adults

• 637 (49.6%) female

• 647 (50.4%) male

Key activities delivered included:

• Fun in the Park days. These were done in conjunction with other services including the Darwin City and Alice Springs Town Councils and the George Brown Botanical Gardens (230 community members)

• Seniors activity program. Healthy Living NT ran a 4 week physical activity and nutrition program for senior participants (26 participants). This was held at the Council of the Ageing (COTA)

• Mini Movers Program. These programs target children aged 2-5 years and help with fundamental motor skills, stimulate hand-eye coordination and promote social interaction. 3 programs were run through childcare centres and at the George Brown Botanical Gardens (177 children)

• Scope an active transport program and opportunities in Darwin and Alice Springs school. This initiative involved schools and their communities interested in promoting physical activity in how children get to and from school. One school in Alice Springs was interested in exploring this further (19 community members)

• Ongoing health promotion and physical activity initiatives particularly focussed on youth (832 children) • Further development of social media in networking and dissemination of active recreation information (see

page 32)

Activities 2016/17 No. of Activities

Total no. of Participants

M F M F

4 230 20 30 110 70

1 80 10 10 40 20

4 26 0 26 0 0

6 58 6 12 27 13

6 95 11 26 53 5

5 24 0 5 16 3

1 19 3 1 8 7

1 27 4 8 7 8

1 185 2 3 90 90

1 50 2 8 20 20

1 52 2 5 21 24

1 31 1 8 7 15

2 70 3 7 31 29

2 93 1 8 37 47

6 168 0 9 81 78

1 32 1 4 12 15

1 44 1 2 20 21

Total 44 1284 67 172 580 465

People under 18Adults

Fun in the Park Days Programs

Healthy Hol iday Fun

Phys ica l Activi ty and Nutri tion for Seniors - COTA

Mini Movers - Gray Early Chi ldchood Centre

Mini Movers - Darwin Botanic Gardens

Mini Movers - Mi l lner Chi ldcare Centre

Scoping of Active Paths program in Ross Park Primary, Al ice Springs

Scavenger hunt for chi ldren with diabetes at Jingi l i Water Gardens

Dripstone Middle School

Pa lmerston Senior School Heal th Expo

Manunda Terrace Early Chi ldhood Centre

Outs ide School Care NT

Casuarina Senior Col lege

Dundee Beach Primary School

Casuarina Square Activi ty

Moulden Primary School Activi ty

Holy Spi ri t Primary After School Care

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 Department of Health (Commonwealth)

Access Points (page 17) Department of Health (NT)

Alice Springs Hospital Department of Tourism and Culture (NT)

Alice Springs Physiotherapy Diabetes in Pregnancy Partnership

Alice Springs Town Council Diabetes SA

Alice Springs & Darwin Running and Walking Clubs First Class Graphic Design

Asthma NT Kidney Health Australia

Bernborough Club of the NT National Heart Foundation

Bill Raby Diabetes Fellowship Governors (page 10) NT Cardiac Services

Cancer Council of the NT NT Council of the Ageing

Central Australian Aboriginal Congress NT DoH Preventable Chronic Disease Unit

Central Australian Health Service NT DoH Nutrition & Physical Activity Strategy Unit

Charles Darwin University Palmerston CCC

Coles Supermarkets Palmerston City Council

Community Benefit Fund Professor Timothy Skinner

Darwin City Council Royal Darwin Hospital

Darwin Corrections Centre Top End Health Service

Darwin Podiatry Woolworths Supermarkets

Darwin Private Hospital Yeperenye Shopping Centre

Decision Support Analytics YMCA

Department of Education (NT)

Treasurer’s Report


From the Treasurer

Healthy Living NT recorded a surplus of $160,563 from 1 July 2016 to 30 June 2017 (2015/16=-$4,688). This surplus was higher than projected in the annual budget due to a number of one-off extraordinary income items:

• The inclusion of the NT Government’s Immediate Work Grant in-kind contribution as income ($80,237) and

• Income from a commercial settlement resolved in the Association’s favour ($28,388).

Ordinary overall income was marginally higher than the previous year whilst expenditure was tightly managed. 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 3.60:1 (2015/16=2.67:1). In 2016/17 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 were leased in 2016/17and net income from these leases is offset against the business loan.

Membership subscriptions and membership numbers declined over the previous year.

The Association is in a sound financial position. The audited financial statements for 2016/17 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 2017 % Change 2016 2015 2014 2013 2012Summary $ (From 2016) $ $ $ $ $

Profit and LossIncome 3,016,366 13.0% 2,668,297 2,628,789 2,027,791 2,009,468 1,980,092

Expenditure 2,855,803 6.8% 2,672,985 2,392,558 1,883,731 1,950,225 1,790,479Surplus/(Deficit) 160,563$ 4,688-$ 236,231$ 144,060$ 59,243$ $189,613

Balance SheetTotal Assets 1,763,418 -0.9% 1,779,484 1,765,926 1,774,128 1,188,337 1,046,441

Total Liabil ities 489,807 -26.5% 666,436 648,190 892,623 450,892 368,239Assets/Liabil ities Ratio 3.6:1 2.67:1 2.73:1 1.99:1 2.64:1 2.84:1

NET ASSETS 1,273,611$ 14.4% 1,113,048$ 1,117,736$ 881,505$ 737,445$ 678,202$ Key Performance

IndicatorsHealthy Living NT

Membership (no.) 993 -11.6% 1,123 1,300 1,258 1,265 1,375Membership (Gross $) 20,528 -28.7% 28,778 25,192 23,146 28,082 28,946

Product Sales (Gross $) 82,364 -30.0% 117,621 112,789 132,644 144,831 128,614NDSS

Registrations (no.) 14,814 3.6% 14,295 13,832 13,355 12,693 11,878Gross Income $ 507,754 5.1% 483,268 467,783 460,414 392,577 362,621

Staff (no.) 22 21 23 19 19 16

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 2016/17



0200,000400,000600,000800,000

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

$ $ $ $

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

$

HLNT Income and Expenditure 2001 - 2017

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 2017

$

HLNT Assets and Liabilities 2001 - 2017

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 $1,300,000 $1,400,000

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

$

HLNT Net Assets 2001 - 2017

NET ASSETS



Cash on Hand, $862,671 , 49%

Receivables, $101,254, 6%

Pre-payments, $7,003 , 0%

Stock, $20,816 , 1%

Buildings, $523,810, 30%

Plant & Equipment, $221,457, 13%

Intangibles, $26,407, 1%

HLNT Assets 2016/17

Payables, $121,641, 25%

Grants in advance, $131,692, 27%

Employee Leave Provisions,

$212,354, 43%

Business Loan -Current, $24,120,

5%

HLNT Liabilities 2016/17

THE DIABETES ASSOCIATION OF THE NORTHERN TERRITORY INC.

Trading as HEAL THY LIVING NT

SPECIAL PURPOSE FINANCIAL REPORT 30JUNE 2017

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 9-15

THE DIABETES ASSOCIATION OF THE NORTHERN TERRITORY INC. TIA HEALTHY LIVING NT

BOARD'S REPORT

Your Board members submit the financial report of The Diabetes Association of the Northern Territory Inc. trading as Healthy Living NT for the financial year ended 30 June 2017.

BOARD MEMBERS The names of the Board members throughout the year and at the date of this report are:

Ron O'Brien Mary Fox Yvonne Probin-Rowan Vivekanand Mohan-Ram (*) Josie Bacus (*)Retired November 2016

PRINCIPAL ACTIVITIES

Paul Gooding OAM Robert Hall William De Decker Ruth Quinn Benjamin Smith

The principal activities of the Association during the financial year were:

- to provide benefits and services to people affected by diabetes; - to provide education services to people affected by diabetes and people with a cardiac condition, - to distribute diabetes supplies and services under the National Diabetes Services Scheme; - to promote the study of the causes of diabetes; and - to distribute information regarding diabetes.

SIGNIFICANT CHANGES No significant changes in the nature of Association activities occurred during the year.

OPERATING RESULT The surplus for the year was $160,563 (2016: deficit of $4,688).

STATEMENT BY THE BOARD

The board has determined that the association is not a reporting entity and that this special purpose financial report should be prepared in accordance with the accounting policies outlined in Note 1 to the financial statements.

In our opinion the financial report as set out on pages 5-15:

(1) Presents fairly the financial position of The Diabetes Association of the Northern Territory Inc. as at 30 June 2017 and its performance for the year ended on that date.

(2) At the date of this statement, there are reasonable grounds to believe that The Diabetes Association of the Northern Territory Inc. will be able to pay its debts as and when they fall due.

This statement is made in accordance with a resolution of the Members of the Board and is signed for and behalf of the Members of the Board by:

n~ ~ ................................ . Paul Gooding Treasurer

Date: t4 /Cir~ lo '1- ~

-2-

Nair Watkins CHARTERED ACCOUNTANTS

First Floor 83 Coonawarra Road Winnellie NT 0820

Postal Address PO Box 36268 Winnellie NT 0821

Telephone: (08) 8923 6300 Facsimile: (08) 8923 6311

Nair Watkins Pty Ltd ABN 17 092 428 521

INDEPENDENT AUDITOR'S REPORT TO THE MEMBERS OF THE DIABETES ASSOCIATION OF THE NORTHERN TERRITORY INCORPORATED TRADING AS HEALTHY LIVING NT

I have audited the accompanying financial report, being a special purpose financial report, of The Diabetes Association of the Northern Territory Incorporated trading as Healthy Living NT, which comprises the assets and liabilities statement as at 30 June 2017, the income and expenditure statement, statement of cash flows for the year then ended, notes comprising a summary of significant accounting policies and other explanatory information and the board's report.

Board's Responsibility for the Financial Report

The board of the association is responsible for the preparation and fair presentation of the financial report, and has determined that the basis of preparation described in Note 1 is appropriate to meet to the requirements of the Associations Act (NT) and is appropriate to meet the needs of the members. The board's responsibility also includes such internal control as the board determines is necessary to enable the preparation and fair presentation of a financial report that is free from material misstatement, whether due to fraud or error.

Auditor's Responsibility

My responsibility is to express an opinion on the financial report based on my audit. I conducted my audit in accordance with Australian Auditing Standards. Those standards require that I comply with relevant ethical requirements relating to audit engagements and plan and perform the audit to obtain reasonable assurance whether the financial report is free from material misstatement.

An audit involves performing procedures to obtain audit evidence about the amounts and disclosures in the financial report. The procedures selected depend on the auditor's judgement, including the assessment of the risks of material misstatement of the financial report, whether due to fraud or error. In making those risk assessments, the auditor considers internal control relevant to the association's preparation and fair presentation of the financial report, in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the association's internal control. An audit also includes evaluating the appropriateness of accounting policies used and the reasonableness of accounting estimates made by the board, as well as evaluating the overall presentation of the financial report.

I believe that the audit evidence I have obtained is sufficient and appropriate to provide a basis for my audit opm1on.

Independence

In conducting my audit, I have complied with the independence requirements of Australian professional ethical pronouncements.

Liability limited by a scheme approved under the Prof essional Standards Legislation 3

~ Chartered ~ Accountants

NUMBER ONE IN NUMBERS

INDEPENDENT AUDITOR'S REPORT TO THE MEMBERS OF THE DIABETES ASSOCIATION OF THE NORTHERN TERRITORY INCORPORATED TRADING AS HEALTHY LIVING NT- Contd.

Basis for Qualified Auditor's Opinion

The Association only records amounts received from sales takings when they are banked, as it is not practical to establish control over sales takings prior to its initial entry. My audit relating to such income was therefore limited to ensuring that the amounts banked are properly recorded in the accounts. Accordingly, I do not express an opinion on whether all income has been banked and I cannot determine the effects of such adjustments, if any, as might have been determined to be necessary had this limitation not existed.

Qualified Auditor's Opinion

In my opinion, except for the effects on the financial report of such adjustments, if any as might have been determined to be necessary had the limitation referred to in the qualification paragraph above not existed, the financial report of The Diabetes Association of the Northern Territory Incorporated trading as Healthy Living NT presents fairly, in all material respects the financial position of The Diabetes Association of the Northern Territory Incorporated trading as Healthy Living NT as at 30 June 2017 and of its financial performance and its cash flows for the year then ended in accordance with the accounting policies described in Note I to the financial statements and the Associations Act (NT).

Basis of Accounting and Restriction on Distribution

Without modifying my opinion, I draw attention to Note I to the financial report, which describes the basis of accounting. The financial report has been preparecl to _assist The Diabetes Association of the Northern Territory Incorporated trading as Healthy Living NT to meet the requirements of the Associations Act (NT). As a result, the financial report may not suitable for another purpose.

Nair Watkins

Lloyd Nair Registered Company Auditor Darwin Date: September 2017

4

THE DIABETES ASSOCIATION OF THE NORTHERN TERRITORY INC. TI A HEAL THY LIVING NT

ASSETS AND LIABILITIES STATEMENT AS AT 30 JUNE 2017

CURRENT ASSETS Cash assets Receivables Other Inventories

TOTAL CURRENT ASSETS

NON-CURRENT ASSETS Plant and equipment Intangibles

TOTAL NON-CURRENT ASSETS

TOTAL ASSETS

CURRENT LIABILITIES Payables Unexpended grants Provisions Interest bearing liabilities

TOTAL CURRENT LIABILITIES

NON CURRENT LIABILITIES Interest bearing liabilities

TOTAL NON CURRENT LIABILITIES

TOT AL LIABILITIES

NET ASSETS

MEMBERS' FUNDS Retained surplus

TOT AL MEMBERS' FUNDS

The accompanying notes form part of this financial report.

Notes

2 3 4 5

6 7

8 9 10 11

11

12

2017 $

862,671 101,254

7,003 20,816

------------991,744

------------

745,267 26,407

771,674

1,763,418

121,641 131,692 212,354

23,892

489,579

228

228

489,807

1,273,611

1,273,611

1,273,611

2016 $

923,658 109,492

6,430 26,972

------------1,066,552

------------

679,672 33,260

712,932

1,779,484

137,652 186,703 232,385

23,892

580,632

85,804

85,804

666,436

1,113,048

1,113,048

1,113,048

-5-


INCOME AND EXPENDITURE STATEMENT FOR THE YEAR ENDED 30 JUNE 2017

INCOME Conference travel Administration Fees Donations Fundraising Grants - NT DoH - Diabetes Education

- Cardiac - Alice Springs - Free Syringe - Nutrition for Diabetes

- NT DSR - Active Recreation - NT DoB - CBF Small Com Org - NT DoB - Immediate Works Grant - Commonwealth DoH

- CDN Conference Remote Clinic Distribution Medical Outreach Indigenous Chronic Disease Home blood glucose monitors Interest Literature RIC Medicare Claims Mail order postage Medical aids sales National Diabetes Services Scheme Operations NDSS Mies. Income I Co Payments Other GST products Projects Subscription/membership fees Sundry income Training ·Profit on sale of assets Rent - CASI House IHMS Consultation Deed of settlement

Total Income

EXPENDITURE Advertising Accounting Amortisation Audit fees Bank fees Bad debts Cleaning Computer and email expenses Conference fees and travel

Note 2017 $

490 98,494 11, 185

0

356,317 137,525 295,376

58,004 11,475

120,000 4,000

17 80,237

73,524 97,122

837,080 17,926 6,814 2,869 4,395 1,015

49,704 507,754

57,857 11 ,847 52,363 20,528

1,631 73

6,848 63,005 2,520

28,388 ------------3,016,366

------------

20,868 0

18,076 17,375 4,380

0 18,855 48,251 39,119

2016 $

682 101,998

11,935 10

348,034 134,329 288,509

56,656 20,525 30,000

0 0

0 0

887,029 22,444 11,252 5,004 7,466 1,075

77,501 433,969

0 12,672

113,661 28,778

1,496 60

4,489 67,403

1,320 0

------------2,668,297 ------------

22,871 14,226 27,669 17,378 6,429 2,280

17,715 68,423 42,107

The income and expenditure statement should be read in conjunction with the accompanying notes.

-6-


INCOME AND EXPENDITURE STATEMENT (Cont'd) FOR THE YEAR ENDED 30 JUNE 2017

EXPENDITURE (Cont'd) Cost of goods sold Consultants Depreciation Education consumables Education Resource/Library Electricity Freight Fundraising Health Promotion Programs GHANT Membership Insurance Interest Legal expenses License Fees Management fee - CASI House Motor vehicle expenses NDSS expenditure- direct NDSS _ Co-Payments - Free Syringes NDSS - Co-Payments - FS, BGTS, & ICPs NDSS - Access Points Office expenses Office amenities Office Security Telephone/fax Territory Way newsletter Postage Printing and stationery Projects Rent Repairs and maintenance Rates and taxes Recruitment expenses Salaries FBT Specialist Sessional Services Subscriptions Superannuation Staff training Sundry expenses Workers compensation Web Site maintenance

SURPLUS/(DEFICIT) FOR THE YEAR

2017 $

53,096 22,967 62,935

3,675 716

16,508 11,681

555 19,111 3,070

13,759 4,156 4,299 9,364 5,051

17,074 6,981

56,428 56,536

0 12,736 2,509 1,984

25,525 34,601 10,580 32,801

218,829 120,989

12,063 15,138 23,521

1,589,841 14,717 13,911

325 169,213

6,973 9

13,662 990

2,855,803

160,563

2016 $

75,711 1,700

65,182 2,936 1,860

21,233 15,980

525 0

2,980 11,855 8,319

21,672 0

4,659 11,531 14,232

0 0

591 9,732 2,394 2,185

27,955 20,978

9,754 26,076

165,869 113,890

15,450 12,874 55,111

1,501,001 10,659 12,491

735 171,615

10,193 53

14,357 9,549

2,672,985

( 4,688)

The income and expenditure statement should be read in conjunction with the accompanying notes.

-7-


STATEMENT OF CASH FLOWS YEAR ENDED 30 JUNE 2017

Notes 2017 $

CASH FLOWS FROM OPERATING ACTIVITIES

Receipts from customers, projects and administration 1,796,530 Payments to suppliers and employees (2,801,099) Interest received 6,814 Interest paid (4,156) Government grants 1,159,405

------------NET CASH FLOWS PROVIDED BY I (USED IN) OPERATING ACTIVITIES 13(b) 157,494

------------

CASH FLOWS FROM INVESTING ACTIVITIES

Payments for acquisition of property, plant and equipment (133,682) Payments for intangibles (11,223) Proceeds from sale of property, plant and equipment 12,000

----------NET CASH FLOWS PROVIDED BY I (USED IN) INVESTING ACTIVITIES (132,905)

----------

CASH FLOWS FROM FINANCING ACTIVITIES

Repayment of borrowings (85,576) ----------

NET CASH FLOWS PROVIDED BY I (USED IN) FINANCING ACTIVITIES (85,576)

----------

NET (DECREASE)/INCREASE IN CASH HELD (60,987)

Add opening cash brought forward 923,658 ----------

CLOSING CASH CARRIED FORWARD 13(a) 862,671 ~=====

2016 $

856,274 (2,595,571)

11,252 (8,319)

1,859,570 -------------

123,206 -------------

(101,034) (19,405) 10,000

----------

(110,439) ----------

(51,070) ----------

(51,070) ----------

(38,303)

961,961 ----------923,658 ========

The statement of cash flows should be read in conjunction with the accompanying notes.

-8-


NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2017

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.

-9-



NOTE L 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:

Furniture, fittings and equipment Renovations Computers Buildings Motor Vehicles

Leases

2017

5 years 5- 8 years 2-3 years 40 years 6 years

2016

5 years 5-8 years

2-3 years 40 years 6 years

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.

-10-



NOTE 2. CASH ASSETS

Cash on hand Westpac Operating Account Westpac Investment Account Future IT Development Building Fund Board designated reserve Employee Provisions Fund

NOTE 3. RECEIVABLES

Trade debtors Bond - Alice Springs Office Sundry debtors

NOTE 4. OTHER

Prepayments

NOTE 5. INVENTORIES (CURRENT)

Medical supplies - at cost

NOTE 6. PLANT AND EQUIPMENT

Furniture, fittings and equipment at cost Accumulated depreciation

Office Renovations Accumulated Depreciation

Buildings - at cost Accumulated Depreciation

Closing written down value

2017 $

500 26,004

522,576 42,915

102,483 745

167,448

862,671

98,557 2,697

0

101,254

7,003

20,816

422,348 (331,579)

90,769

313,006 (182,318)

130,688

630,359 (106,549)

523,810

745,267

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)

2016 $

500 188,498 433,038

32,812 101,776

742 166,292

923,658

98,756 2,697 8,039

109,492

6,430

26,972

407,508 (320,123)

87,385

226,517 (173,800)

52,717

630,359 (90,789)

539,570

679,672

-11-



NOTE 7. INTANGIBLES

Strategic Plan Amortisation

Website Amortisation

HLNT Client Database Amortisation

NOTE 8. PAYABLES (CURRENT)

Trade creditors, accruals and payroll liabilities Bond Casi House GST (net)

NOTE 9. UNEXPENDED GRANTS (CURRENT)

Bill Raby Fellowship CDN Conference Fund - Seed Funding NT DoH Nutrition for Diabetes GHANT Adolescent Support Group NDSS Universal Services Chronic Disease - Common wealth DoH

NOTE 10. PROVISIONS

CURRENT Provision for employee entitlements Annual Leave Long Service Leave

Number of employees at year end

2017 $

15,575 (13,885)

---------1,690

---------45,150

(39,861) ---------

5,289

---------47,260

(27,832)

---------19,428

---------26,407

=====

109,630 6,477 5,534

121,641

14,809 97,660

0 16,811 2,051

361 0

131,692

113,123 99,231

----------212,354 ======

22

2016 $

13,175 (13,171)

---------4

---------39,600

(34,858) ---------

4,742 ---------43,987

(15,473) ---------28,514

---------33,260

======

103,590 14,516 19,546

137,652

11,191 69,384 11,475 17,717 3,412

0 73,524

186,703

116,427 115,958 ---------

232,385 =====

21

-12-


NOTES TO THE FINANCIAL ST A TEMENTS FOR THE YEAR ENDED 30 JUNE 2017

NOTE 11. INTEREST BEARING LIABILITIES

CURRENT Westpac - Loan 4 CASI House

NON-CURRENT Westpac - Loan 4 CASI House

Unused credit facility at 30 June 2017 $153,488

NOTE 12. MEIVIBERS' FUNDS

Retained surplus at the beginning of the financial year Surplus/(Deficit) for the year

Retained surplus at the end of the financial year

NOTE 13. STATEMENT OF CASH FLOWS

a) Reconciliation of cash

Cash balance comprises: Cash at bank

b) Reconciliation of the operating surplus to the net cash flows from operation

Operating surplus/( deficit)

Depreciation and amortisation Net gain on disposal of property, plant and equipment Changes in assets and liabilities: Inventories Prepayments Receivables Payables Unexpended grants Provisions

Net cash flows (used in) I provided by operations

2017 $

23,892

228

1,113,048 160,563

1,273,611

862,671

160,563

81,011 (6,848)

6,156 (573)

8,238 (16,011) (55,011) (20,031)

157,494

2016 $

23,892 =====

85,804

1,117,736 (4,688)

1,113,048 ===========

923,658

(4,688)

92,851 (4,489)

350 1,066

(31,200) (32,060) 94,488

6,888

123,206

-13-



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

(a) Operating Lease Commitments Being for rent of offices and computer software and equipment

Payable - minimum lease payments: - not later than one year - later than 1 and not later than 2 years - later than 2 and not later than 5 years

2017 $

154,911 23,866

0

178,777

2016 $

171,142 53,886 33,437

258,465

Area 9 IT Solutions lease for Infrastructure & Managed IT Services expired on 31 December 2013 and is ongomg.

The Alice Springs property lease expires 31 December 2018.

Darwin property: Unit 1 & 2 Tiwi Place lease expires 31March2018, Unit 2/5 Tiwi Gardens Road lease expires 31July2018.

Chubb - Monitoring and Preventative Maintenance for Darwin and Alice Springs lease ongoing.

NOTE 17. IMMEDIATE WORKS GRANT

In February 2016 the Association successfully applied for a range of capital work upgrades for its offices at Shop 2 Tiwi Place under the NT Government Immediate Works Grant Program. Under this program, vouchers for approved works were provided to nominated contractors who, on completion of the works, were paid directly by the NT Department of Business.

As the ultimate beneficiary of this program, the Association has recognised the total approved value of the grant as an in-kind contribution in its 2016117 accounts.

-14-



NOTE 18: 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

-15-

GUIDING VALUES

To pursue excellence in all facets of Healthy Living NT’s operations, through:

• Professionalism and ethical practice

• 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

17 annual report 2016 - healthy living nt report 2016-17 final... · treasurer’s report : 40...

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