NORTHERN TERRITORY PHN ANNUAL REPORT 2015–2016

This Annual Report is by the Health Network Northern Territory Ltd, trading as Northern Territory PHN. It reports on the activities of Northern Territory PHN from 1 July 2015 to 30 June 2016. ACKNOWLEDGEMENT OF COUNTRY We acknowledge the Traditional Owners of the country on which we work and live, and recognise their continuing connection to land, waters and community. We pay our respects to them and their cultures, and to Elders both past and present.

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 1

Contents Acknowledgement

1

About Northern Territory PHN

4

Organisational Profile

4

Northern Territory Overview: Who our work supports

5

Northern Territory Health Snapshot: Why our work is important

6

Performance Benchmarks: How we know we are making a difference

8

Our 2015–2016 Performance

10

Chair Statement

10

Chief Executive Officer Report

11

At a Glance: Progress Against our Strategic Plan

12

Governance

14

Governance Structure

14

How we implement governance

15

Board Members

16

Board Performance

17

Board Committees and Councils

17

Nominations Committee

17

Operational Structure

19

Leadership Team

19

Staffing Profile

20

2 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

Our Performance

22

Goal 1: Improve equitable access to primary health care through removal of systemic barriers

22

Goal 2: Improve health system integration through innovation, partnerships and coordination

28

Goal 3: Supporting practice improvement to enhance primary health care service quality and consumer centred care

36

Goal 4: Develop a sustainable multidisciplinary health workforce to meet needs across the Northern Territory

40

Goal 5: Outcome success measures are achieved with an efficient allocation of resources

50

Corporate Responsibility

53

Continuous Quality Improvement Initiatives

53

Safety

53

Environmental Responsibility

53

Social Responsibility

54

Financial Performance

56

Financial Analysis 2015–2016

56

2016 Financial and Directors' Report

59

Appendix: Northern Territory Map

92

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 3

About Northern Territory PHN Organisational Profile Northern Territory PHN (NT PHN) receives funding from the Australian Government as the Territory’s Primary Health Network. Primary Health Networks (PHN) are organisations established across Australia by the Australian Government to coordinate primary health care delivery and address local health care needs and service gaps. There are 30 other PHNs in Australia. We commenced operating on 1 July 2015. We do not provide services directly to people, but instead engage with our stakeholders and regional communities to commission services to facilitate the delivery of a range

of comprehensive primary health care initiatives. As the Territory’s Rural Workforce Agency, we also attract, recruit, educate and retain a professional medical workforce across the Northern Territory (NT). We are a partnership between Aboriginal Medical Services Alliance Northern Territory (AMSANT), the NT Government Department of Health and the Associate Membership Committee.1

Relationships Equity We Value

Responsiveness Innovation Results

Be consumer-centric Strengthen capacity We Will

Be collaborative Take a whole system view Be evidence based

4 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

OVERVIEW

Northern Territory Overview: Who our work supports POPULATION

x

244,000

POPULATION GROWTH RATE

0.3%

2

3

ABORIGINAL POPULATION

56,638

4

AREA SQUARE KILOMETRES

1,345,558

5

OF THE POPULATION

53% 47%

ARE MALE

6.5%

OF THE POPULATION IS AGED

ARE FEMALE

65+

Known as the Health Providers Alliance Northern Territory Incorporated from 1 July 2016. Australian Bureau of Statistics, Dec 2015, http://www.abs.gov.au/ausstats/[email protected]/mf/3101.0 3 Australian Bureau of Statistics, Dec 2015, http://www.abs.gov.au/ausstats/[email protected]/Latestproducts/3101.0Main%20Features2Dec%20 2015?opendocument&tabname=Summary&prodno=3101.0&issue=Dec%202015&num=&view= 4 Australian Government Department of Health, PHN Infographic Information Sheet, http://www.health.gov.au/internet/main/publishing.nsf/Content/0C94B53E3143DAC5CA257F1500041415/$File/PHN%20Infographic%20-%20Northern%20Territory.pdf 5 Australian Government Department of Health, PHN Infographic Information Sheet, http://www.health.gov.au/internet/main/publishing.nsf/Content/0C94B53E3143DAC5CA257F1500041415/$File/PHN%20Infographic%20-%20Northern%20Territory.pdf 1 2

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 5

Northern Territory Health Snapshot: Why our work is important Primary health care provides the essential first point of community contact to the health care system and aims to respond to health needs, keep people well and improve their quality of life. A strong, accessible primary health care system underpins good population health outcomes and delivery of cost-effective care. People living in the NT experience a disproportionately high burden of disease across a range of conditions including cancer, mental illness and substance abuse. Approximately one-third of the NT’s population is Aboriginal compared to three per cent nationally. On all indicators - health status, quality of life and social and emotional wellbeing - Aboriginal people report worse health outcomes than the non-Aboriginal population in the NT. Social and cultural determinants such as housing, education and employment play a significant role in shaping this.

The estimated gap in life expectancy between Aboriginal and non-Aboriginal Australians was 12 years for men and 10 years for women (in 2006). In the NT, the gap is 18 years for men and 15 years for women, at least 50 per cent greater than national figures. A combination of socioeconomic disadvantage, smoking, alcohol abuse, obesity and intimate partner violence was found to be the cause of over 60 per cent of the Aboriginal life expectancy gap.6

Across the NT, infant mortality (0–5 years) is high, with an average rate of 7.2/1,000 live births compared to the national level of 3.9/1,000.7

The NT has the highest proportion of smokers in Australia, with 21 per cent of Territorians smoking daily.8

Northern Territory PHN 2016 Baseline Needs Assessment, Menzies School of Health Research, Page 17 Northern Territory PHN 2016 Baseline Needs Assessment, Menzies School of Health Research, Page 17 8 Scollo, MM and Winstanley, MH. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2016. Available from www.TobaccoInAustralia.org.au 9 Northern Territory PHN 2016 Baseline Needs Assessment, Menzies School of Health Research, Page 15 10 Northern Territory PHN 2016 Baseline Needs Assessment, Menzies School of Health Research, Page 17 11 Northern Territory PHN 2016 Baseline Needs Assessment, Menzies School of Health Research, Page 18 12 Northern Territory PHN 2016 Baseline Needs Assessment, Menzies School of Health Research, Page 19 6 7

6 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

OVERVIEW

The NT’s Aboriginal population retains the highest standardised death ratio for cancers and circulatory disease deaths.10

In 2010, 11.8 per cent of NT deaths were alcohol-attributable deaths compared with 3.9 per cent nationally. Approximately 17 per cent of the NT’s non-Aboriginal adult population consume alcohol in quantities considered risky or of high risk to health in the long-term (compared with the national average of 10.6 per cent), and Aboriginal drinkers consume more than their nonAboriginal counterparts.9

Cancer accounts for the major portion of premature mortality in the NT, particularly for Aboriginal people, who suffer from both a heightened incidence and mortality from all cancers combined. Lung cancer accounted for the greatest portion of cancer deaths, making up 25 per cent, with the highest death rate occurring on the Tiwi Islands and in West Arnhem.11

Social and emotional wellbeing, mental health and suicide are major problems in the NT, with NT residents experiencing the highest rate of mental health-related emergency department occasions of service nationally.12

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 7

Performance Benchmarks: How we know we are making a difference SHORT-TERM OBJECTIVES Our short-term objectives are set out in the 2015–2018 Strategic Plan. Our Strategic Plan was approved by our Board in November 2015, following input from Company Members, the Top End Health Service (TEHS), the Central Australia Health Service (CAHS) and other key stakeholders. This three-year Strategic Plan will be operationalised through annual business plans. Our organisational goals are as follows: • Improve equitable access to primary health care through removal of systemic barriers

• Develop a sustainable multi-disciplinary health workforce to meet needs across the NT

• Improve health system integration through innovation, partnerships and coordination

• Outcome success measures are achieved with an efficient allocation of resources

• Supporting practice improvement to enhance primary health care service quality and consumer-centred care

The CEO reports to the Board on a regular basis against the achievement of these goals. Reporting also includes the progress of principal activities and reporting of risks and opportunities.

LONG-TERM OBJECTIVES Our long-term objectives are set out in the Health Network Northern Territory Ltd Constitution. These are: • Support the efficiency and effectiveness of medical and health services for patients, particularly those at risk of poor health outcomes

• Increase equitable health outcomes by commissioning and supporting primary health care services and promoting primary health care initiatives and programs

• Improve coordination of care so that patients receive the right care in the right place at the right time

• Support clinicians and service providers to deliver best practice care

• Improve health outcomes for Aboriginal people through comprehensive primary health services

• Deliver and promote high quality education and inter-professional learning opportunities for primary health care providers

• Support and strengthen Aboriginal community control of comprehensive primary health care • Support and strengthen the role of the general practice and allied health sectors in comprehensive primary health care • Engage with all health providers and the community to identify local health needs and regional service gaps

8 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

• Support the attraction and retention of a sustainable qualified primary health care workforce which providers culturally appropriate comprehensive primary health care • Support the integration of the primary and secondary health care sectors to improve the patient journey

OVERVIEW

MANDATE AS A PRIMARY HEALTH NETWORK Our mandate as a PHN is to operate as a commissioner of services, guided by an understanding of our local population’s health and health service system needs. To achieve this, we will capitalise on our function as the NT’s Rural Workforce Agency, and develop and stimulate the market to operate to meet local needs. In carrying out these functions, we will achieve the objectives of the PHN program of increasing the efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes, and improving coordination of care to ensure patients receive the right care in the right place at the right time. We report our progress against our funding agreements every six months, and from 2016–2017 we will report against the PHN Performance Framework. PHN Performance Framework Our impact will be measured by the Australian Government Department of Health under the national PHN Performance Framework, finalised in March 2016. This will measure PHNs’ performance against National Headline Performance Indicators, Organisational Performance Indicators and Local Performance Indicators. Local Performance Indicators Our Local Performance Indicators were informed by priorities identified in the Baseline Needs Assessment completed in March 2016. The Local Performance Indicators were endorsed by the Board following input from the Baseline Needs Assessment Advisory Committee, the Top End Health Service, the Central Australia Health Service and other key stakeholders. We will work with our stakeholders to collect data and access relevant data sets to support reporting against these Local Performance Indicators from September 2017. Supporting and strengthening Aboriginal community control of primary health care is a long-term objective of NT PHN.

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 9

Our 2015–2016 Performance Chair Statement I am pleased to present the 2015–2016 Annual Report, highlighting the activities and achievements of the Health Network Northern Territory Ltd operating as NT PHN. In a very busy year, our organisation completed the transition to the PHN program, including finalising the transition from our remaining role in service delivery to our role as a commissioning and contracting agent.

I would like to acknowledge the efforts of our staff during the year under the leadership of our Chief Executive Officer Nicki Herriot, who has brought valuable expertise and skill to the role. I would also like to thank my fellow directors for their hard work and diligence through the year, and acknowledge the contributions of our members and other stakeholders through a complex transition period.

The Board’s strategic goals are articulated in NT PHN’s 2015–2018 Strategic Plan and aligned with the company’s constitutional objects. Our Strategic Plan will be operationalised through business planning and will be reviewed by the Board in 2016–2017 in consultation with the company members, councils and other key stakeholders. This process will ensure the Strategic Plan reflects the changing needs of the organisation, and will enable us to continue to work towards our vision that people in the NT enjoy their best possible health and wellbeing.

In 2015–2016, our grant funding increased by almost 30 per cent, enabling us to increasingly address health needs across the NT. Looking to the future we anticipate further growth in our role in the NT primary health care system. We look forward to our role in new initiatives including the expansion and improvement of primary mental health services, the implementation of Health Care Homes in the NT, and the local development of Health Pathways to improve the patient journey through better integration of primary and secondary care.

The transition to the PHN program saw the establishment of our Clinical Councils in the Top End and Central Australia, and our Community Advisory Council. The Councils have a key role within our governance structure providing advice to the Board. The councils will inform an improved understanding of the clinical environment and consumer and carer needs, and will assist in maintaining our continuous engagement with providers and the community. On behalf of the Board, I would like to thank the Council Chairs and members for their work during the last year.

As we continue to refine our strategic direction, performance and external collaboration, I am confident that we will continue be a lead agent in primary health care improvement and reform in the NT, with a particular focus on the gaps in service provision and on those most in need. We look forward to continuing to work with the Australian Government Department of Health and other funders, our members, local and national health care providers and the NT community in the year ahead.

Effective engagement with general practice, other primary health care providers, and with consumers and the community are a high priority as we work towards achieving the PHN program objectives in the NT’s unique health sector environment. Our Stakeholder Engagement Framework has been endorsed by the Board, and will provide key structures for our engagement, and in the implementation of a collaborative governance model. This Framework will be supported by tools such as the organisation’s Customer Relationship Management System, and a regional approach to practice support and health planning. The Associate Membership Committee worked progressively through the year to establish themselves as an incorporated entity. We have supported their development and incorporation as the Health Providers Alliance of the Northern Territory. As a separate entity they will provide a new voice for health professionals in the NT and we congratulate them on this achievement. The Health Providers Alliance has now replaced the Associate Membership Committee as a company member.

10 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

Dr Andrew Bell CHAIR

OVERVIEW

Chief Executive Officer Report 2015–2016 has been a fast paced journey, however one that has been full of reward as we shape the organisation in preparation for the challenges ahead. Our role as a PHN gives us a mandate to be a leader of health system improvement by harnessing partnerships in the planning and co-design of system and service solutions. This presents exciting opportunities not only for our organisation, but more importantly for our stakeholders and all people in the NT. Our methods for engagement with key stakeholders has shifted through the year, as we look to build and strengthen relationships and establish regional partnerships to better understand the needs and solutions for rural and remote areas. Within the organisation, we have sought to understand a range of mechanisms to enable us to engage and collaborate more effectively. A key element of this has been to start working on a Reconciliation Action Plan, with specific strategies on how to ensure the voice of Aboriginal and Torres Strait Islander peoples is reflected within all we do at NT PHN. This year has also seen us increase our capability and systems in population health planning, health intelligence and data analytics. As a result of the National Mental Health Review, the Australian Government Department of Health reallocated funding to be channelled through PHNs. This fund reallocation gave NT PHN greater responsibility for commissioning of mental health, suicide prevention, and drug and alcohol services. Following needs assessments in these areas in early 2016, we have continued to work with our key stakeholders through a regional approach to service planning and design. This will inform the commissioning of mental health, suicide prevention and drug and alcohol programs. Regional planning has involved consulting with peak bodies, government and non-government representatives, and a range of key stakeholders within primary health care and related sectors. Planning will be mapped against a stepped care approach and will identify services currently available to support people’s mental health and wellbeing across the continuum of service responses with a goal to produce a longer term strategic plan. Our Clinical Councils and Community Advisory Council have been established, and have already helped us shape our understanding of health needs and service design solutions. I have been very pleased to see the enthusiasm of NT primary health care professionals and community members in participating in these groups, and have valued their contribution to our planning processes over the last year. I am looking forward to building on this great start for our Councils, and their continued contribution in 2016–2017.

2015–2016 provided an opportunity for our Health Workforce Branch - the NT’s Rural Workforce Agency - to develop a new strategic vision and action plan that will see us take a lead role in understanding the primary health care workforce needs in the Territory, and develop strategies to support the recruitment and retention of workforce. Health system improvement and integration is a key focus for NT PHN. Our practice support function has been completely revamped with regionally focussed team members providing targeted support to practices on continuous quality improvement, data analytics and digital health. We have also commenced a project to work with primary health care practitioners, specialist and hospitals to implement the HealthPathways clinical pathways software which should in time improve the patient journey for everyone in the NT. When we began operating as NT PHN on 1 July 2015, we were still in a period of transition and uncertainty. In spite of these challenges, this past year has shaped our organisation’s growth and outlook, and we have come a long way. Our commitment to our purpose remains steadfast, and we look forward to the year ahead. At NT PHN we are confident that the best is yet to come!

Nicki Herriot CHIEF EXECUTIVE OFFICER

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 11

At a Glance: Progress Against our Strategic Plan Here we provide a dashboard summary of progress made during 2015–2016 against the goals in our 2015–2018 Strategic Plan. Traffic light result relates to current progress against NT PHN’s three-year Strategic Plan. Green = Significant Achievements Yellow = In Progress Blue = Area of Focus in 2016–2017

Goal 1 Improve equitable access to primary health care through removal of systemic barriers

A full performance report against this goal can be found starting on page 22

Achievements in 2015–2016

Priorities in 2016–2017

• Completion of population health Baseline Needs Assessment in March 2016

• Complete review our Baseline Needs assessment, focusing on regional analysis and data

• Completion of Mental Health, Suicide Prevention and Alcohol and Other Drugs Treatment Needs Assessment in March 2016

• Finalisation of NT PHN’s Evaluation Framework

• Procurement activities completed for a range of program activities • Evaluation of the Access to Allied Psychological Services by the Menzies School of Health Research • Ongoing support for the Aboriginal community controlled health sector through contracted services and capacity building initiatives

• Finalisation of our new commissioning approach, including procurement and contract management tools • Undertake regional planning and service mapping for mental health, suicide prevention and alcohol and other drugs treatment services, supported by engagement with the NT Aboriginal Health Forum and service providers • Review of outreach health services

Goal 2 Improve health system integration through innovation, partnerships and coordination

A full performance report against this goal can be found starting on page 28

Achievements in 2015–2016

Priorities in 2016–2017

• Delivery of funded health programs • Broadcasting of Aboriginal and across the NT providing: Torres Strait Islander health check • Support to 479 participants in the media campaign Partners in Recovery Program • Commencement of new Refugee • Support to 8329 clients accessing Health service the Access to Allied Psychological • Develop and implement health Services program literacy framework • Support for 3473 clients accessing the Indigenous Australian’s Health Program • Delivery of the HealthPathways project • Delivery of a grants round, funding local community based preventive health initiatives in rural and remote communities • Review of the Refugee Health Service and procurement of providers for 2016–2017 • Delivery of a range of culturally appropriate and strengths based health literacy resources

12 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

OVERVIEW

Goal 3 Supporting practice improvement to enhance primary health care service quality and consumer centred care

A full performance report against this goal can be found starting on page 36

Achievements in 2015–2016

Priorities in 2016–2017

• Delivery of practice support to NT primary health care services, including dissemination of information and development of resources • Delivery of the General Practice Liaison Officer function at the Royal Darwin Hospital, with participation in a range of stakeholder networks • Ongoing support for digital health initiatives, including the My Health Record

• Ongoing work with primary health care services to develop individual Practice Support Plans • Delivery of networking functions for primary health care practices and their staff • Finalisation of our Clinical Governance Framework • Re-design of NT PHN’s website

• Initiation of the HealthPathways project

Goal 4 Develop a sustainable multidisciplinary health workforce to meet needs across the Northern Territory

A full performance report against this goal can be found starting on page 40

Achievements in 2015–2016

Priorities in 2016–2017

• Hosting Workforce Health Planning Forum in April • Fourteen General Practitioner vacancies filled • Twenty-six Allied Health Professionals recruited

• Implementation of comprehensive orientation program for new health service provider recruits • Improvements implemented for data management across NT Health Workforce Branch

• Delivery of 94 education and training events to 1344 attendees • Delivery of the Compass Teaching and Learning Conference in May

Goal 5 Outcome success measures are achieved with an efficient allocation of resources

A full performance report against this goal can be found starting on page 50

Achievements in 2015–2016

Priorities in 2016–2017

• Compliance with all program reporting requirements • Transition into a more efficient ICT environment • Support for staff during transition to the PHN program

• Review our Strategic Plan • Relocation of Darwin office • Implementation of Communication and Engagement Plan for 2016–2017 • Finalisation of Reconciliation Action Plan

• Commencement of a Reconciliation Action Plan for the organisation

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 13

Governance Through our Board and CEO, NT PHN is vested with powers and responsibilities to enable us to carry out our functions and achieve our objectives. In turn, sound governance and quality reporting with a high degree of transparency are critical to maintaining stakeholder confidence.

Governance Structure ABORIGINAL MEDICAL SERVICES ALLIANCE NORTHERN TERRITORY (AMSANT)

NORTHERN TERRITORY GOVERNMENT DEPARTMENT OF HEALTH (DoH)

ASSOCIATE MEMBERSHIP COMMITTEE (AMC) Known as the Health Providers Alliance of the Northern Territory from 1 July 2016

Nominations Committee

BOARD OF DIRECTORS

Top End Clinical Council

Central Australia Clinical Council

Community Advisory Council

14 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

Finance, Audit and Risk Management Committee

Governance Committee

OVERVIEW

How we implement governance Governance processes are applied through our Constitution, policies and procedures which: • ensure compliance with relevant legislation and other regulatory instruments • reflect objectives of our Constitution and Company Members requirements • have a strong focus on transparency, risk awareness and ethical behaviour • provide clarity over accountability, roles and responsibilities.

COMPANY MEMBERS APPOINT

BOARD OF DIRECTORS APPOINT AND MANAGE PERFORMANCE

CEO

The Roles and Responsibilities of Director’s Policy, which incorporates the Board Code of Conduct, sets out the standards for appropriate ethical and professional conduct for Board members. The Board Chair is responsible for monitoring compliance with the Code. Each Board member has individual responsibilities to: • act in good faith, in an honest manner and in the best interests of the company • use due care and diligence • not take improper advantage of their office • maintain confidentiality • not allow personal interests to conflict with the interests of the Company. Our staff Code of Conduct sets out the standards for appropriate ethical and professional conduct for staff. The CEO is responsible for monitoring compliance with the staff Code of Conduct. Each staff member has an obligation and duty of care to: • act with equity, justice, fairness and compassion in dealing with others within and beyond NT PHN • perform duties in a responsible and professional manner • exert responsible stewardship of NT PHN resources • promote and protect NT PHN’s reputation in the wider community • act appropriately when a conflict arises between their self-interest and their duty to NT PHN.

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 15

Board Members The strength and effectiveness of the Board is supported by the diversity of its members. Our skills-based Board reflects the breadth of the Territory’s health sector, and also includes Directors with a diverse range of representative backgrounds and professions.

Dr Andrew Bell MBBS, DRANZCOG, DA, FAFPHM, FACRRM, MAICD

Diane Walsh BA, Dip Ed, GAICD

Donna Ah Chee Adv. Cert. in Management (Aboriginal Organisations), Assoc. Dip. in Business (Aboriginal Organisations), Grad. Cert. in Management

Judith Oliver B Pharm (Hons)

CHAIR Appointed 10 July 2012

DEPUTY CHAIR Appointed 10 July 2012

DIRECTOR Appointed 10 July 2012

DIRECTOR Appointed 10 July 2012

Iain Summers BComm, LLB (Hons), Grad Dip Mngt Psych, FCA, FCPA, FAICD, FAIM

Dr Paul Burgess MBBS, BMedSci, MPH, PhD, GradDipRuralGP, FRACGP, FARGP, FAFPHM

Dr Sam Goodwin MBBS, FACRRM, JCCA, GAICD, MPHTM

John Rawnsley LLB, BAIS, GDLP

DIRECTOR Appointed 10 July 2012

DIRECTOR Appointed 18 August 2015

DIRECTOR Appointed 18 August 2015

DIRECTOR Appointed 10 November 2015

We also acknowledge the following Directors who also held office during 2015–2016.

Edward Mulholland

Dorothy Morrison

Marion Scrymgour

DIRECTOR Appointed 10/07/12 Resigned 10/11/15

DIRECTOR Appointed 10/07/12 Resigned 10/11/15

DIRECTOR Appointed 10/11/15 Resigned 31/01/16

16 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

Board Performance The Board met regularly in 2015–2016, including a meeting in Alice Springs in August 2015. The Board participates in regular self-evaluation and external evaluation, with a view to continuous improvement in Board performance. The Board evaluates its performance to: • ensure Board processes are effective and efficient • ensure discharge of Director duties and responsibilities with transparency and accountability

OVERVIEW • ensure Board harmony and dynamics • anticipate issues that may affect the integrity or stability of NT PHN in the future • assist with Board succession planning and skills assessment • review Board Committee membership. The Board participated in an Evaluation Day in May 2016, with outcomes to inform the 2016–2017 Board Training Calendar.

Board Committees and Councils Committees and Councils enhance the Board’s effectiveness in key areas, while retaining Board responsibility.

FINANCE, AUDIT AND RISK MANAGEMENT COMMITTEE The Finance, Audit and Risk Management (FARM) Committee supports the Board in its responsibilities relating to the financial and business affairs of the organisation. This includes the preparation and integrity of financial accounts and statements, and the external auditor's report. The FARM Committee considers the internal controls, policies and procedures that we use to identify and manage business risks, as well as compliance with legal and regulatory requirements.

GOVERNANCE COMMITTEE The Governance Committee has oversight, review and reporting responsibility for all Board-related and corporate governance policies.

CLINICAL COUNCILS Our Clinical Councils provide strategic level guidance and advice to the Board for translation through the CEO into operational level activities. The Councils provide a clinical perspective to the Board, helping to ensure that decisions, investments and innovations are patient-centred, cost-effective, locally relevant, and aligned to local care expectations and experience. We have two Clinical Councils with boundaries aligned with TEHS and CAHS (the Local Hospital Networks in the NT). Members of the Clinical Council were appointed by the Board following an open expression process in August 2015. Members of the Top End Clinical Council represent a range of professional backgrounds, including general practice,

psychology, Aboriginal and Torres Strait Islander health practitioner and pharmacy. Members of the Central Australia Clinical Council represent a range of professional backgrounds, including general practice, pharmacy, nursing, Aboriginal and Torres Strait Islander health practitioner and podiatry. The Clinical Councils held their inaugural meetings in November and December 2015, and in early 2016 provided input into our Baseline Needs Assessment. A joint meeting was held in May 2016 with the Community Advisory Council. The Clinical Councils are preparing to finalise their 2016–2017 priorities for the next financial year.

COMMUNITY ADVISORY COUNCIL The Community Advisory Council provides a community perspective to the Board, helping to ensure that decisions, investments and innovations are patient-centred, cost-effective, locally relevant, and aligned to local care expectations and experience. Members of the Community Advisory Council were appointed by the Board following an open expression process in August 2015. Members of the Community Advisory Council have strong backgrounds in health consumer advocacy, population health, mental health and chronic disease, and include representation from across the NT. The Community Advisory Council held their inaugural meeting in December 2015 and in early 2016, the Council provided input into our Baseline Needs Assessment and Mental Health and Suicide Prevention and Alcohol and Other Drugs Treatment Needs Assessments. A joint meeting was held in May 2016 with the Clinical Councils. The Community Advisory Council are preparing to finalise their 2016–2017 priorities for the next financial year.

Nominations Committee Our Company Members are represented on the Nominations Committee which managed the rotation and recruitment of Directors to the Board.

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 17

RISK MANAGEMENT Understanding and managing the risks we face - operational, legal, reputational and strategic - is central to the work of the Board, CEO and Senior Executive Leadership Team. Our Risk Management Policy applies the principles of the Australia/NZ standard AS/NZS ISO 31000:2009 Risk Management – Principles and Guidelines. Risk management strategies and actions are approved by the Board, on advice from the FARM Committee and enacted by management. Our risk management process is summarised below.

Establishing the context

Risk assessment Risk identification

Communication and consultation

Risk analysis

Monitoring and review

Risk evaluation

Risk treatment

Changes to our risk management framework were implemented in 2015–2016, with the creation of Strategic and Operational Risk Management Registers. These Registers identify risks which could impact on organisational and Branch-specific activities, and related mitigations.

18 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

Operational Structure

OVERVIEW

BOARD OF DIRECTORS

Chief Executive Officer

Health Programs

NT Health Workforce

Health Planning and Partnerships

Clinical and Public Health Advisor

Finance

Corporate

Leadership Team

Nicki Herriot CAHRI, MAIM, MAICD CHIEF EXECUTIVE OFFICER

Le Smith

Susi Wise

Greg Henschke

BHSc, Grad Cert IH

BPsych (Hons)

BArts

Dr Tamsin Cockayne

Ram Naik

Shari Tanzer

CA, CPA, MAICD

CAHRI, BBusMgt, BArts, MCorpLship

MBBS (Hons), FRACGP, FARGP, DRANZCOG Adv, MPH, MHM, GAICD

EXECUTIVE MANAGER – HEALTH PROGRAMS

EXECUTIVE MANAGER – NORTHERN TERRITORY HEALTH WORKFORCE

EXECUTIVE MANAGER – HEALTH PLANNING AND PARTNERSHIPS

CLINICAL AND PUBLIC HEALTH ADVISOR

CHIEF FINANCIAL EXECUTIVE OFFICER MANAGER – CORPORATE

We also acknowledge the valued input of the following senior staff during 2015–2016: • Judy Davis, DEPUTY CEO

• Toni Blair, MANAGER - CORPORATE

• Vicki Woodrow, EXECUTIVE MANAGER NORTHERN TERRITORY HEALTH WORKFORCE

• Ashley Marsh, MANAGER - COMMISSIONING, GOVERNANCE AND LEGAL UNIT AND COMPANY SECRETARY

• Dr Bernie Westley, CLINICAL AND PUBLIC HEALTH ADVISOR

• Dr Carole Reeve, LEAD CLINICAL AND PUBLIC HEALTH ADVISOR

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 19

Staffing Profile As at 30 June 2016 TOTAL FULL TIME EQUIVALENT (FTE)

63.07 + 15.53 = 78.60 NT PHN STAFF

NT HEALTH WORKFORCE

TOTAL STAFF

NUMBER OF ABORIGINAL EMPLOYEES

40

6.00

years

(7.3% of total staff)

MEDIAN AGE OF EMPLOYEES AVERAGE LENGTH OF SERVICE

THE MALE AND FEMALE RATIO FEMALE

2.68 66 YEARS

(80%)

MALE

16 20 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

(20%)

DARWIN AND ALICE SPRINGS STAFF

DARWIN

68 (83%)

OVERVIEW

ALICE SPRINGS

14 (17%)

COUNTRY OF BIRTH

Australia, United Kingdom, Ireland, South Africa, New Zealand, Denmark, Canada, Thailand, Hong Kong, India, Germany, Malaysia

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 21

Our Performance Goal 1 Improve equitable access to primary health care through removal of systemic barriers

STRATEGY:

Strategically commission and support equitable, needs-based health program and initiatives

RESULTS AGAINST OUR STRATEGIC PLAN STRATEGIES

2015–2016 RESULT*

Plan and design services Make sound and transparent procurement decisions Monitor commissioned health services

Evaluate programs on an outcomes basis Support Aboriginal community control of comprehensive primary health care Influence better alignment of funding to population health needs *Traffic light result relates to current progress against NT PHN’s three-year Strategic Plan. Green = Significant Achievements Yellow = In Progress Blue = Area of Focus in 2016–2017

22 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

PERFORMANCE

NT PHN works with key stakeholders to understand the needs and priorities of local communities

Performance A. PLAN AND DESIGN SERVICES Key objectives for PHNs are increasing the efficiency and effectiveness of comprehensive primary health care services for patients, particularly those at risk of poor health outcomes, and improving coordination of care to ensure patients receive the right care in the right place at the right time. An integral foundation is to understand the health needs of the population (including future needs), service gaps and service system requirements. We adopted a co-design approach, sourcing input from providers and the community (through the Community Advisory Council) when undertaking health planning activities in 2015–2016. In March 2016, we completed an NT-wide population health Baseline Needs Assessment in partnership with the Menzies School of Health Research. Development of the Baseline Needs Assessment was supported by an Advisory Committee with representation from primary health care sector stakeholders. This needs assessment identified health and service system needs across domains, including, Aboriginal and Torres Strait Islander health, chronic conditions, mental health, suicide prevention and self-harm, digital health and health workforce. We worked with the Baseline Needs Assessment Advisory Committee and other key stakeholders to develop prioritised opportunities to respond to these identified needs. Needs assessment findings helped inform our 2016–2017 annual planning. During 2015–2016, an After-Hours Needs Assessment was conducted to set key priority areas for activity planning and procurement of after-hours primary health care service activities for 2016–2017. This included engagement and consultation with 111 stakeholders from 50 organisations across the NT. Pilot programs will be funded in 2016–2017 through the After-Hours Innovation Grants to address key priority areas identified within the After-Hours Needs Assessment.

PHNs are an integral component of national mental health reform, and during 2015–2016 we worked with key stakeholders to understand the needs and priorities to support the mental health and wellbeing of local communities. Needs assessments for mental health and suicide prevention, and alcohol and other drugs treatment services were completed in March 2016. Outcomes of these needs assessments will assist in development of 2016–2017 commissioning activities, enabling the provision of service responses for funding under new Primary Mental Health Care and Drug and Alcohol Treatment Services funding. Engaging with key stakeholders, including peak bodies and service providers, will be strengthened through in-depth regional planning and engagement activities planned for 2016–2017.

Challenges Managed Challenge: Mental Health and Suicide Prevention and Alcohol and Other Drugs Treatment Services Needs Assessments were required to be completed within tight timeframes over February and March 2016. Solution: To ensure submission of the Needs Assessments to the Australian Government Department of Health within the required timeframes, we adopted a streamlined approach by establishing an advisory group comprising peak bodies for mental health and alcohol and other drugs treatment. The Needs Assessment provided a broad overview of priorities which set the foundation for more comprehensive regional planning and service mapping that will be undertaken in 2016–2017.

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 23

B. MAKE SOUND AND TRANSPARENT PROCUREMENT DECISIONS As a PHN, we are responsible for procuring services with public money. Commissioning principles guide our procurement processes to ensure that procurement activities represent quality, demonstrate value for money (including economic, social, cultural and environmental values), and are contestable, ethical, accountable and transparent. To ensure service continuity in 2015–2016 following transition from the Medicare Local program, we committed to recontracting service providers following a performance review process. This process also included development of new contracting arrangements to meet requirements of our PHN program funding. In addition to re-contracting existing service providers, several procurement processes were completed in 2015–2016, including tenders for Preventive Health Grants, the NT Partners in Recovery (PIR) opportunity fund, the After Hours Primary Health Care Innovation Grants, and the Access to Allied Psychological Services (ATAPS) Triage service. We invited external stakeholders to participate on procurement panels in 2015–2016, including for the After Hours Primary Health Care Innovation Grants to ensure relevant, clinical expertise informed procurement decisions, and decisions were appropriately scrutinised. A project focusing on our commissioning capability commenced in 2015–2016 and will continue into 2016–2017. This will enable us to meet the Australian Government’s requirements, and to work effectively with our stakeholders to address the health needs of the NT. We participated on the Australian Government’s PHN Commissioning Working Group to help develop resources to support commissioning activities undertaken by PHNs nationally.

Case Study: ATAPS Triage Service Procurement An expression of interest (EOI) process for delivery of the ATAPS Triage service opened in April 2016 to outsource this service which had previously been delivered by NT PHN. The EOI closed in May 2016, with an expert panel assessing a range of responses. Significant organisational cross-branch collaboration and support was evidenced in managing the ATAPS Triage procurement process, with strengthened working relationships between service providers and local referral sources. During the process, we maintained placement of service providers servicing remote communities and ensured service continuity across rural, remote and urban areas. The successful service was selected in June 2016, with the Triage service fully outsourced from 1 August 2016.

Did you know? • NT PHN executed 126 subcontracts (including 22 variations to funding Deeds) in 2015–2016. • The average time for execution of a subcontract13 was 35 days. Factors affecting this time included delays in postage and subcontractors obtaining necessary approvals.

C. MONITOR COMMISSIONED HEALTH SERVICES Ongoing monitoring of our contracted services informed continual quality improvement, compliance with funding agreement requirements, and ensured the delivery of evidence-based practice. In 2015–2016, we developed a range of pro-formas to ensure service providers complied with requisite service delivery standards, including qualifications of personnel delivering program activities, that organisations have relevant permits when delivering services on Aboriginal land, and policies to ensure compliance with police and working with vulnerable persons (including children). Additionally, our contractual agreements with service providers require delivery of a range of performance deliverables, including: • Budgets • Financial reports • Activity data reports

Regular engagement with subcontracted providers ensured the ongoing effective management of contracted services. Challenges Managed Challenge: The Tennant Creek Social Worker After Hours Service delivered by the CAHS identified that Emergency Department staffing continued to be a challenge in Tennant Creek, with new staff often not being familiar with the NT and referral processes from the Emergency Department to the Social Worker Service. Solution: Tennant Creek Social Worker After Hours staff participated in staff induction and orientation, and introduced mechanisms to assist staff to work in this challenging setting and access support.

• Progress/performance reports

13

Measured from date of contract approval and postage by NT PHN to date of final execution by NT PHN

24 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

NT PHN's commissioning cycle

PERFORMANCE

EVALUATION

MANAGING PERFORMANCE

NEEDS ASSESSMENT

MONITORING & EVALUATION

STRATEGIC PLANNING

ANNUAL PLANNING

PROCURING SERVICES

SHAPING THE STRUCTURE OF SUPPLY

DESIGNING & CONTRACTING SERVICES

Success Story: After Hours Program

Success Story: Outreach Health Services

After-Hours partners were supported to deliver services as contracted. Highlights during 2015–2016 have included:

In 2015–2016, we continued to coordinate delivery of Outreach Health Services, through the Medical Outreach Indigenous Chronic Disease (MOICD) program, and Rural Primary Health Service (RPHS) activities delivered under our core flexible funding.

• The After-Hours General Practitioners clinic operated by the Central Australian Aboriginal Congress at the Alice Springs Hospital received a total of 3,462 patients, with 57 per cent of patients being female and 43 per cent being male. • The Laynhapuy Homelands Aboriginal Corporation supported three Aboriginal Health Workers (AHW) to study a Certificate IV, and six AHW to complete a Certificate II in Aboriginal and Torres Strait Islander Primary Health Care. Training was delivered in community by the Central Australian Remote Health Development Services. A Health Worker workshop was held in June 2016 in Garrthalala to support on the job training. • The CAHS Tennant Creek Social Worker service received a total of 221 patients. Women predominantly utilised the service (87 per cent of patients), with men representing 13 per cent of patients. The Social Worker service welcomed a male staff member to the team during 2015–2016.

RPHS activities supported significant comprehensive primary health services through a range of subcontracted providers, including Aboriginal community controlled health services (ACCHS), across the NT. RPHS activities focused on preventive health and supplementary allied health services delivering local solutions and strategic support Services delivered included a range of holistic preventive health initiatives such as support for child and maternal health screening, and health promotion activities. Under the MOICD program, 2015–2016 saw the ongoing delivery of dietetics, podiatry, physiotherapy, exercise physiology, cardiac and diabetes education, and diabetes specialist services to over 80 rural and remote communities across the NT.

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 25

D. EVALUATE PROGRAMS ON AN OUTCOMES BASIS To ensure the ongoing efficiency and effectiveness of our contracted services, in 2015–2016 we commenced development of an Evaluation Framework that supports continuous improvement of our work. The Evaluation Framework will include a program logic and a set of indicators designed to assist with monitoring and evaluating the: • equity, accessibility, appropriateness, and quality of our work; and • outcomes that result from this work. A program logic approach provides a means to consolidate the multifaceted and multi-layered set of elements, strategies and activities that underpin our work. This approach is consistent with the approach adopted by the Australian Government Department of Health in their planned evaluation of the roll out of the PHN model, the Productivity Commission in its annual Report on Government Services and the National Health Planning Authority. Our staff underwent program evaluation training in May 2016, with further training and finalisation of the Evaluation Framework anticipated in 2016–2017.

Several of our programs were independently evaluated in 2015–2016. The Menzies School of Health Research completed an independent evaluation of ATAPS, citing our delivery of ATAPS “... places clients at the centre of care”, “have an understanding of the mental health needs of individuals living in the NT” and “have strong working relationships with service providers.” Current RPHS funded services were recontracted into 2016–2017. A comprehensive review of RPHS activities will be undertaken in 2016–2017 to determine future directions are aligned with priorities as identified in needs assessments, and our commissioning principles. The review will engage with key stakeholders and health services using co-design approaches supported by evidence-based and relevant data to ensure activities and initiatives are responsive to identified needs. In addition to program evaluations, we also participated in consultations undertaken by Ernst and Young in evaluation of the PHN Program and the After-Hours program for the Australian Government Department of Health.

Case Study: After Hours Partner Reflection Workshop On 1 June 2016, we invited current After-Hours Program partners to participate in a reflection workshop in Alice Springs. Participants from Central Australian Aboriginal Congress, Laynhapuy Homelands Aboriginal Corporation, Miwatj Health Aboriginal Corporation and CAHS shared knowledge, experiences and insight into the daily realities of providing after-hours services across the Territory. The participating partners shared areas of success, general challenges and areas for development, which included the need for closer collaboration with external agencies to remove barriers, and increased capacity and skills of after-hours service providers to improve service delivery. Feedback from participants was positive, with emphasis

26 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

given to the benefits of having the opportunity to share information and experiences of those delivering services. A key outcome of the workshop was the recognition that social workers and Aboriginal health workers play an important role in the delivery of after-hours care, in addition to the more apparent role of general practitioners. The reflection workshop provided a valuable opportunity for planning, monitoring and evaluating services moving forward. We have a commitment to continuing these workshops in the future, to enable after-hours partners to connect their perspectives with the overarching objectives of the After-Hours Program funding.

PERFORMANCE

NT PHN supports Aboriginal community control of comprehensive primary health care

E. SUPPORT ABORIGINAL COMMUNITY CONTROL OF COMPREHENSIVE PRIMARY HEALTH CARE Our Constitutional objectives include supporting and strengthening Aboriginal community control of comprehensive primary health care. In 2015–2016, we supported the ACCHS sector through a range of capacity building initiatives, and contracted health services. On an NT-wide basis, 46.44 per cent of our contracted funding was provided to ACCHS or other Aboriginal community controlled organisations. This was higher in specific regional areas, such as East Arnhem (60 per cent) and Katherine (58 per cent). During December 2015–June 2016, the percentage of funding committed to ACCHS and other Aboriginal community controlled organisations increased by 3.18 per cent, or over $1.4M. We are an active organisational member of the NT Aboriginal Health Forum and its Working Groups. In 2015–2016, we worked with our co-members of the NT Aboriginal Health Forum, AMSANT, the NT Government Department of Health, the Australian Government Department of Health and the Office of Prime Minister and Cabinet, to support the sharing of highlevel guidance and decision-making to ensure that Aboriginal people in the NT enjoy health and wellbeing outcomes equal to

that of the NT community as a whole. We will continue to collaborate with our co-members on the NT Aboriginal Health Forum as we implement our new organisational approach to commissioning, and localised needs assessments and planning. We provided support to the Red Lily Health Board Aboriginal Corporation in their established desire to deliver a community controlled health service in the West Arnhem Region. This involved planning for the TEHS's managed primary health care service in Jabiru to transition to the Red Lily Health Board in the forthcoming year. Through 2015–2016, we worked with TEHS and AMSANT to provide support to the Red Lily Health Aboriginal Corporation to obtain funding (through AMSANT) to support the move towards community control in the West Arnhem region. Ongoing strategic advice and support will be provided through the Red Lily Health Board Advisory Group – a group of key stakeholders and community leaders – to ensure a successful, sustainable transition to become an operational community-controlled health service.

F. INFLUENCE BETTER ALIGNMENT OF FUNDING TO POPULATION HEALTH NEEDS Due to an emphasis on service continuity during the transitional year for PHNs in 2015–2016, we have focused on improving understanding of health and service system needs to better align funding to the Territory’s population health needs into 2016–2017 and beyond. Completion of the Baseline Needs Assessment, and Needs Assessments on After Hours, Mental Health and Suicide Prevention and Drug and Alcohol Treatment, together with workforce strategic planning in 2015–2016 provided a key

starting point for our 2016–2017 program planning. Health and service system (including health workforce) needs will continue to be reviewed in 2016–2017, and we will continue to work with our partners in a co-design approach to develop innovative and efficient services which meet Territorians’ requirements.

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 27

Goal 2 Improve health system integration through innovation, partnerships and coordination

STRATEGY:

Connect primary health care and acute services to work together through person-centred models of care

RESULTS AGAINST OUR STRATEGIC PLAN STRATEGIES

2015–2016 RESULT*

Improve coordination and integration of care Strengthen comprehensive primary health care Tailor strategies in response to priority health areas Improve health literacy in primary health care

*Traffic light result relates to current progress against NT PHN’s three-year Strategic Plan. Green = Significant Achievements Yellow = In Progress Blue = Area of Focus in 2016–2017

28 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

PERFORMANCE

Performance A. IMPROVE COORDINATION AND INTEGRATION OF CARE A key focus for PHNs is improving the coordination of care. Many needs identified in the Baseline Needs Assessment related to improving coordination of care, and this was a key focus of our program delivery, planning and stakeholder engagement in 2015–2016. Delivery of the PIR program continued in 2015–2016 in Alice Springs, Tennant Creek, Katherine, East Arnhem and Darwin. The program provided participants with wrap-around support, by utilising the referral pathways and service networks created in the initial roll out of the program to each region. The 2015–2016 target for PIR program participants was 258. By 30 June 2016, the program had assisted 450 participants across the NT to access support and address unmet needs, building on the 261 program participants in 2014–2015. Outcomes for participants were achieved through one-on-one contact with PIR facilitators, comprehensive assessment and planning, support facilitation and coordination, and the ability to provide financial resourcing to meet short-term needs. Improved access to mental health services for rural and remote populations in the NT continued in 2015–2016 through delivery of the Mental Health Services in Regional and Remote Australia (MHSRRA) program. MHSRRA supported a sustainable, culturally secure workforce, including Aboriginal Mental Health Worker models. In 2015–2016, two additional Aboriginal and Torres Strait Islander Health Practitioner positions were funded in Milingimbi (as part of the supported transition of this clinic

Improving coordination and integration of care is a key priority of NT PHN

to Aboriginal community control) and at Yirrkala. Each of these positions was funded for six months to support the Aboriginal Mental Health Worker models in each location. During 2015–2016, the MHSRRA program continued to support communities on Elcho Island affected by a significant cyclone in February 2015. Post-cyclone support continued to be provided through funding two Aboriginal psychologists to provide services in Galiwin’ku for three months following Cyclone Lam. This ‘second wave’ of post-cyclone services focused on child wellbeing. The ATAPS Triage service was instrumental in linking mental health consumers in the NT to other programs, such as PIR

Case Study: NT PIR Supporting Homelessness Response Group During 2015–2016, we partnered with several organisations on short-term projects to address system reform issues. A particularly successful project, and one that received ongoing support from government and non-government organisations, was the Homelessness Response Group (HRG). This project employed a part-time coordinator to run an interagency working group and administer brokerage funding. The HRG facilitated outcomes for clients who have traditionally experienced difficulties engaging with services. The HRG was funded through our Partners in Recovery program, with support from St Vincent De Paul, YWCA, Larrakia Nation, Mission Australia, The Salvation Army, Anglicare and TEAMhealth. The HRG provided a contact point for the delivery of coordinated and comprehensive support to health consumers, many with severe and persistent mental ill-health. Using a needs assessment tool identifying

challenges and issues faced by an individual, clients are referred to relevant organisations which collectively provided ‘wrap-around’ support and ongoing monitoring of their progress. Clients faced with accommodation or housing issues were given financial and material support to assist in the interim period. The HRG created a discussion platform for service providers to raise systemic concerns, identify opportunities to improve the participant journey, and consider sustainable solutions. Meetings of the HRG strengthened working relationships through a multi-level approach involving a steering group, decision-makers and case managers. As a result, clients were offered places in residential mental health programs, intermediate and long-term accommodation, access to the Department of Social Services Personal Helpers and Mentors Program, and support services from the Top End Mental Health Service.

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 29

and MHSRRA, to place clients with appropriate services according to their needs and locations. Enhanced clinical pathways for ineligible referrals to the ATAPS Triage service were provided in collaboration with regional clinics and community organisations delivering outreach services. 2015–2016 saw a marked increase in the uptake of ATAPS services reflected in the Minimum Data Set. In 2015–2016, 8329 clients accessed the service, compared to 6591 in 2014–2015. This increase was attributed to a focus on community education, and increased opportunities to communicate directly with stakeholders. There was a notable increase in the uptake of the Aboriginal and Torres Strait Islander target group in comparison to the previous reporting period, with 1375 Aboriginal people accessing the service in 2015–2016, compared to 1149 in 2014–2015. A trend in children accessing ATAPS services has continued during the last three years, with 451 children accessing ATAPS services in 2013–2014, 1338 in 2014–2015 and 1369 in 2015–2016. In 2015–2016, the Supporting Healthy Ageing Program took a falls prevention focus. This included activities to address barriers to accessing medication reviews in collaboration with existing providers, with medication reviews linked to a reduction in falls in the elderly. The initiative targeted people aged 50 years and over living in remote communities. The NT Branch of the Pharmacy Guild led a medications review initiative, including desktop audits conducted by pharmacists. The objective of this review was to identify individuals currently prescribed medications that increase their risk of falls. Outcomes of this review will be passed on to the relevant health centre.

Success Stories The ATAPS program funded the provision of short-term, goal-oriented focused psychological strategies for people with common mental disorders of mild to moderate severity. Anonymous ATAPS consumer feedback provided to us demonstrated the significant value of support provided through the ATAPS program to individuals: “… helps me talk about my problems and find ways of helping me to deal with them” ‘’… very supportive and is still helping my mental health improve” “… use new techniques as coping strategies” “… this awareness will help me for the rest of my life and for that I am truly thankful” “ … has helped me with my anxiety and improved my mental health significantly … not only were techniques beneficial but [the psychologist’s] demeanour and communication skills was fantastic”

Challenges Managed Challenge: Ongoing challenges and barriers for the MOICD program include an increasing demand for visiting services, and the capacity of remote communities to coordinate these services in response to community need. The introduction of the National Disability Insurance Scheme is an emerging issue, and we are likely to see an increase in client demand and complexity of care arrangements in some remote NT communities. The broader outreach service system in the NT remains fragmented, and administered by different fund holders through grant and block funding arrangements. This acts as an ongoing challenge in promoting integration and coordination at all levels, especially at the community clinic and in the provision of integrated patient care. Solution: Maintaining outreach health services that continually meet the changing care needs and demand within an integrated patient centred approach is a critical element of the MOICD program. This required adopting a co-design approach to drive and shape

30 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

integrated service system improvements, and solutions that worked for all parties, based on a more integrated patient centred model. A key focus in 2015–2016 was a stakeholder engagement and communication plan supporting positive relationships through co-design which progressed with allied health professionals, provider organisations and remote primary health care centres. We worked with the Improvement Foundation in the design, development and implementation of an outreach IT portal to improve administrative and travel logistics between provider, remote primary health centres and MOICD administration. Service users were engaged in the design to ensure the portal met user requirements, with this activity to continue in 2016–2017. The Visiting Services Activity Report was redesigned to better meet our funding reporting requirements, and the collection and collation of data to better inform ongoing planning and care requirements. Allied health providers have expressed their appreciation and support in being part of the co-design journey.

PERFORMANCE

B. STRENGTHEN COMPREHENSIVE PRIMARY HEALTH CARE Our Company Members adopted the NT Aboriginal Health Forum’s definition of comprehensive primary health care within our Constitution in June 2015.14 This broad definition includes health promotion, illness prevention, treatment, care and rehabilitation, community development and advocacy. It incorporates services relating to alcohol, tobacco and other drugs, early childhood development and family support, aged and disability, and mental health and social and emotional well-being. Through delivery of our programs, we adopt a multi-focused approach to strengthening comprehensive primary health care, from the delivery of clinical services, health promotion and preventive health activities and sector development.

Case Study: NT PHN Preventive Health Grants Our Preventive Health Grants were launched in September 2015. The program encouraged organisations to apply to carry out small projects or activities to support local community-based preventive health initiatives that build community capacity through improving health literacy, knowledge, behaviour and outcomes in rural and remote communities.

The Mutitjulu Wama, tjikita munu ukiri nyura ngayuku malpa wiya Project received overwhelmingly positive community and participant feedback. The local school observed that students were more settled and willing to learn after participating in the program. The connection the providers (Spark Australia) developed with the local community was one of the keys to its success.

A range of projects were funded through subcontracted providers across rural and remote communities in the Barkly, Central Australia, East Arnhem and Katherine regions. This included:

The Menzies HealthLAB ran its first peer-led session at Ramingining, with the 15 senior students who participated then proceeding to teach the Year Nine class, with assistance from teachers.

• Mutitjulu Wama, tjikita munu ukiri nyura ngayuku malpa wiya Project - Alcohol, cigarettes and marijuana are not my friend project

The Roper Gulf Regional Council in conjunction with Numbulwar youth created a hip-hop clip titled No More of That. The clip focused on sugar consumption, drug use, bullying and lack of sleep. To date, the clip was viewed over 24,000 times on YouTube.

• Remote First Aid in Schools Project • HealthLAB visits to remote communities in Arnhem Land • Health awareness hip hop clip for Numbulwar youth

14

Remote first aid skills were taught to over 600 students in 10 remote schools by St John Ambulance.

As cited in Tilton E and Thomas D, Core Functions of Primary Health Care: A Framework for the Northern Territory, October 2011

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 31

Improving Aboriginal health and access to primary health care is a key priority for NT PHN

C. TAILOR STRATEGIES IN RESPONSE TO PRIORITY HEALTH AREAS Our Baseline Needs Assessment identified a range of population health level health and service system needs. In 2016–2017, we will work with our partners to ensure that our programs are sufficiently agile to respond to emerging priority areas. In 2015–2016, key areas of focus included Aboriginal health, refugee health and mental health and suicide prevention. The Improving Indigenous Access to Mainstream Primary Care activity delivered under the Indigenous Australians’ Health Program continued to provide vital coordinated services in 2015–2016. Outreach workers in Alice Springs and Darwin assisted Aboriginal and Torres Strait Islander clients to access medical appointments and raised awareness of the importance of health checks. Community visits, conference presentations and talking posters were used to promote health checks to general practitioners, pharmacists and Aboriginal and Torres Strait Islander people. An Aboriginal and Torres Strait Islander health check media campaign was developed, and will be broadcast in 2016–2017. We delivered education to GPs and pharmacists highlighting the importance of encouraging Aboriginal and Torres Strait Islander self-identification. We also facilitated cultural awareness sessions throughout the NT to general practitioners and other health workforce personnel. Delivery of Care Coordination and Supplementary Services under the Indigenous Australians’ Health Program continued in 2015–2016. Under the program, 12 organisations employed 29.5 FTE care coordinators, with 3473 clients accessing the program (on average 113 clients per care coordinator).

32 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

Did you know? In 2015–2016, 69,482 occasions of care/services rendered were under Care Coordination and Supplementary Services activity. This included: • 14,431 specialist health and allied health occasions of service were paid for by Supplementary Services funds • 8481 occasions of transport were paid for by Supplementary Service funds • 2635 medical aids were purchased, hired or brokered by Supplementary Service funds, including a range of assisted breathing equipment and glucose monitoring equipment

PERFORMANCE

A total of 63 new arrivals to the NT were seen by the Refugee Health Service in 2015–2016 compared to 43 arrivals seen in 2014–2015. This represents 100 per cent of newly arrived refugees who entered the NT within those time periods. In January 2016, we held an Integrated Healthcare for Refugees event, attended by 35 stakeholders, mostly health professionals with an interest in refugee health. Dr I-Hao Cheng shared his reflections and learnings in running the Refugee Health Program in South Eastern Melbourne. During 2015–2016, we facilitated the NT Refugee Health Network on a bi-monthly basis, providing a valuable opportunity for the sector to connect, problem solve, plan and collaborate for the delivery of health services to refugee clients. Suicide prevention messages were promoted across Arnhem Land and other Top End Aboriginal communities through cost-effective and culturally appropriate resources and activities delivered under the National Suicide Prevention Program (NSPP). Working partnerships were fostered and enabled resources to be shared across suicide prevention networks, Aboriginal Mental Health Workers, Non-Government Organisations, NT Government remote health centres, ACCHS and other stakeholders in the suicide prevention arena in East Arnhem and other Top End communities.

Challenges Managed Challenge: Having one designated general practice service provider for the Refugee Health Service came with limitations. Concerns around clinic access and availability for consultations, and lack of client choice of general practitioners arose during this period. Solution: During February to May 2016, we undertook a comprehensive needs assessment and stakeholder engagement process to review and redesign the Refugee Health program for 2016–2018. In June 2016, an open procurement process was completed, providing the opportunity to fund external services to deliver Refugee Health Program Nurse Coordinator services (providing care coordination of primary health care services for newly arrived refugees within their first 12 months of settlement) and Refugee Health Program General Practice services (providing timely and appropriate general practice services on a bulk billing basis to all referred refugee clients). These services will commence in 2016–2017.

Case Study: National Suicide Prevention Program Youth Resilience Training In 2014–2015, three Top End communities with histories of youth suicide and attempted suicide - Nauiyu, Peppimenarti and Palumpa - sought preventative intervention via our NSPP. In response, we funded the delivery of ‘train the trainer’ workshops that were reflective of place-based approaches to increase resilience in community youth. These original workshops were built upon in 2015–2016 through our contribution to existing funding for a local Aboriginal community organisation in Nauiyu – the Miriam Rose Foundation – to deliver youth healing, resilience and leadership workshop camps. Many of the youths involved in the original workshops attended these further sessions, demonstrating their value to the local community in promoting youth resilience.

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 33

John Maher and Joan Dhamarrandji of Miwatj Health Aboriginal Corporation supported the development of Dhukarr Mulkurrgu Guŋga'yunaraw: Marŋgithinyaraw Yolŋuw ga Balandaw Djämaw ga Dharaŋanaraw (Pathways in Mental Health: An Invitation to Dialogue and Reflection Between Indigenous and non-Indigenous Practitioners), an educational resource DVD, funded by NT PHN

D. IMPROVE HEALTH LITERACY IN PRIMARY HEALTH CARE As an organisation, we recognise the significant impact low health literacy has on health outcomes in the NT, particularly amongst Aboriginal Territorians. We are committed to addressing barriers in the health literacy environment. In 2015–2016, activities to support improved health literacy in Territorians included support for development of a range of health promotion resources, commencement of an organisational Reconciliation Action Plan, and the delivery of health literacy information to staff through staff inductions and our Health Literacy Policy. Additionally, we supported orientation for health service providers we recruited to work in the NT to ensure they were familiar with the Territory and local health consumers. We will work with our partners, including those in the ACCHS sector, in 2016–2017 to develop an NT health literacy framework. In 2015–2016, collaboration continued with partners and subcontracted services to develop and deliver a range of culturally appropriate health resources. Resources funded through the PIR program and the NSPP focused on mental health and suicide prevention. Suicide is a modern phenomenon in Aboriginal communities, and to build resilience, communities need access to current, culturally safe and relevant resources. Themes of identity, connections to land, family structures, culture and local customs emerge in resources supported. We are focused on raising awareness around characteristics of healthy and resilient communities in order to reduce the high suicide rate in the NT through strength-based resource tools. The NT PIR program provided funding and support to develop the Dhukarr Mulkurrgu Guŋga'yunaraw: Marŋgithinyaraw Yolŋuw ga Balandaw Djämaw ga Dharaŋanaraw (Pathways in Mental Health: An Invitation to Dialogue and Reflection Between Indigenous and non-Indigenous Practitioners) DVD resource, produced by the Aboriginal Resource and Development Services. Filmed in partnership with Miwatj Health Aboriginal Corporation’s Aboriginal mental health workers in

34 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

Galiwinku, this DVD captured the story of this very successful approach to service delivery in East Arnhem land. The model utilised a reciprocal cross-cultural framework to sharing information to develop and implement relevant health practice, widely known in the NT health sector as the ‘both-ways’ approach. The DVD was endorsed by key professional groups and has the potential to make a significant contribution within the sector. In addition to this DVD, the PIR program funded the Larrakia Healing Group to develop and produce the ground-breaking resource booklet Caring For Country, Caring For Each Other. This was developed for a range of stakeholders, including service providers, to identify ways to improve service delivery and professional practice with Aboriginal and Torres Strait Islander populations. In 2015–2016, an in-language DVD resource, Djambatjthi (Becoming Wise, 2016), was produced through the NSPP. The DVD resource premiered at the Inaugural Aboriginal and Torres Strait Islander Suicide Prevention Conference 2016 in Alice Springs to great acclaim. The DVD explored and promoted recovery pathways for community members experiencing mental health issues, and improving the strength and resilience of communities and individual wellbeing. We also worked with the Fridge Magnet Factory to produce community-specific fridge magnets that convey messages about suicide prevention. These resources were distributed throughout Peppimenarti and Palumpa. Our Commonwealth Home Support Program provided Continence Nurse services in the central desert region, completing 900 hours of services in 2015–2016. In response to this identified need, we supported development of web-based animated video resources in four local Aboriginal languages for health consumers to promote awareness, access to care options and self-management tips. These resources were published on our website for health organisations and professionals use.

Djambatjthi – Becoming Wise DVD shows the challenges faced by Aboriginal people with mental health issues in remote communities, and the importance of a tailored, culturally-focused approach

Case Study: NT PHN National Suicide Prevention Program DVD Resource production The Djambatjthi (Becoming Wise) DVD was developed with NT PHN’s National Suicide Prevention Program funding in response to the disproportionate rates of suicide rates faced by the NT’s Aboriginal population, compared with the non-Indigenous/Aboriginal Australian population. The DVD was filmed in Milingimbi in north-east Arnhem Land, and tells a story of a young Yolngu man who returns to his home community after living in a city and getting involved in alcohol and drugs. Once home, he finds it hard to break away from his former feelings and behaviours, and attempts to take his own life. Subsequently, he receives support from members of his family, elders, a medicine man and other community members who collectively help him get back on track. The DVD contains interviews with Aboriginal professionals in suicide prevention.

The resource is designed to: • Promote discussion • Encourage people to think about how mental health issues and suicide can be overcome through a community-based approach that supports holistic wellbeing of the person at risk • Empower recovery from mental health problems through communities and services working together to help people to get back on track

The DVD will be a vital resource for community members to understand how they may help people with mental health issues. It is also a resource to assist service providers in understanding the challenges faced by and context of people in remote Aboriginal communities, who have mental health issues.

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 35

Goal 3 Supporting practice improvement to enhance primary health care service quality and consumer centred care

STRATEGY:

Promote best practice by supporting, measuring and reporting clinical and service performance

RESULTS AGAINST OUR STRATEGIC PLAN STRATEGIES

2015–2016 RESULT*

Support primary health care services to improve efficiency and effectiveness Support the delivery of best practice clinical care Support strategic research partnerships

Lead innovative approaches to health care

*Traffic light result relates to current progress against NT PHN’s three-year Strategic Plan. Green = Significant Achievements Yellow = In Progress Blue = Area of Focus in 2016–2017

36 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

PERFORMANCE

NT PHN’s Practice Support team work with practices throughout the Northern Territory to improve comprehensive primary health care

Performance A. SUPPORT PRIMARY HEALTH CARE SERVICES TO IMPROVE EFFICIENCY AND EFFECTIVENESS In 2015–2016, our Practice Support team focused on supporting services to utilise digital health processes, continuous quality improvement initiatives, and best practice clinical guidelines to improve their efficiency and effectiveness in delivering comprehensive primary health care. The Practice Support team was re-established with staff in Alice Springs and Darwin (following a gap in staffing coverage in Alice Springs in 2014–2015). Key activities undertaken in 2015–2016 to support practices included: • Developed processes with our Clinical and Public Health Advisors to review and disseminate health alerts and information, including information from the NT Government Department of Health’s Centre for Disease Control. • Worked closely with peak bodies to help communicate their messages to the health community, and to support education and training events. • Worked with practices to develop individual support practice support plans. These individual plans are being used to develop the non-clinical education and training program and provide ongoing enhancements to the delivery of comprehensive primary health care. These will be living documents that Practice Support staff will revisit as required. All practices across the NT have been visited or contacted by phone to start development which will continue into 2016–2017. • Commenced a series of networking functions at the end of June 2016, with additional sessions scheduled for

2016–2017. These meetings allow practice managers, administration staff and practitioners to come together and share their experiences to strengthen partnerships and streamline communications. General practitioner liaison functions at the Royal Darwin Hospital (RDH) were delivered by our Clinical and Public Advisor in 2015–2016. Collaborative activities that supported patient care linkages between general practice and the acute care sector were delivered, including participation in committees and working groups bringing a primary health care voice to the table.

Challenges Managed Challenge: The Practice Support team has seen changes in management and staff as the organisation has settled into the PHN role. Our funding to support digital health initiatives, including the My Health Record, ceased at the end of the financial year. Solution: The team has re-focused the role of practice support, and are working with practices to achieve positive outcomes. This has included development of a new, regionally-based team structure, with staff assigned to support practices in specific locations across the NT to create improved contact points for providers. Support for digital health initiatives is now included in the overall practice support function.

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 37

B. SUPPORT THE DELIVERY OF BEST PRACTICE CLINICAL CARE In 2015–2016, we developed and reviewed resources for general practice clinics to use to support the delivery of best practice clinical care. This included the Most Frequently Used MBS Item for the Desktop, Practice Incentives Program income estimator, development of information materials for My Health Record and the Top End Specialist and Referral Directory. Other resources available to providers on our website include those related to mandatory reporting requirements and resources related to immunisation.

We commenced drafting a Clinical Governance Framework in 2015–2016 in collaboration with the Clinical and Public Health Advisor and our Clinical Councils. This Framework supports the implementation of best practice clinical standards for us as a commissioner and will be available as a reference for NT primary health care providers to examine and understand their respective roles and responsibilities for providing safe, high quality clinical care. The Clinical Governance Framework will be finalised in 2016–2017.

We purchased licensing for all general practice clinics across the NT for clinical audit software which provides decision support to health providers at the point of engagement, extracts general practice data for practice analysis, and aggregates general practice data for service planning, reporting and population health needs. This software provides a complete solution, designed around a patient-centred care model, to assist with continuous quality improvement by improving data quality and self-analysing activities in line with best practice guidelines. From July 2015, new versions of the software were available to PHNs, with licences offered to all general practice clinics following a range of negotiations with the provider and users. Software training with practices in Darwin and Alice Springs will occur into 2016–2017. Data provided to us from practices will be de-identified and we will send a status/benchmark report through to the practices.

Our Clinical and Public Health Advisor provided a range of support to regional clinical forums and stakeholder groups, including the CAHS Health Outcomes Committee, the NT Cancer Care Network and the Sexual Health Advisory Group. Additionally, support was provided for a range of medical education events, such as acting as general practitioner facilitator for the Wesley Mission Suicide Prevention training.

Use of digital health initiatives supports delivery of best practice clinical care. Uptake and use of the My Health Record continued to be strong in 2015–2016, despite ceasing of our dedicated digital health program funding from 30 June 2016. To 26 June 2016, the NT had15:

In June 2016, the Monthly CEO Message was launched, providing information on our operations to our external stakeholders. June 2016 also saw the relaunch of the flagship external newsletter, North of 26°, referencing the NT’s southernmost border at the 26th parallel south latitude position. North of 26° showcases the valuable work of our subcontracted providers and profiles health professionals recruited by us, and their NT experiences. Our newsletters reach a wide audience, with 2231 individual subscribers as at 1 June 2016; a significant increase from 1700 in 2014–2015 and 800 in 2013–2014.

• 37,373 individual consumers registered for the My Health Record, of which 42 per cent were male, 58 per cent were female and 40 per cent were aged 19 years or less. This comprised one per cent of Australia’s total population, but was 15 per cent of the NT’s population • 130 general practitioner provider registrations, and 20 pharmacy registrations, on par with comparable PHNs • 752 provider uploads, including 304 shared health summaries and 54 prescription records. This presented an increase on figures from December 2015 where there were 204 provider uploads, including 80 shared health summaries and nine prescription records. • 19,027 provider documents uploaded, including 5944 shared health summaries. This presented an increase from December 2015, where there were 13,676 provider documents uploaded, including 2121 shared health summaries.

Case Study: NT PHN’s Publications 2015–2016 saw the introduction of new external publications and the relaunch of our existing publications to improve access and ensure alignment with the PHN program branding. NT Primary Health Weekly, a publication targeted at health professionals, provides updates on sector research, and education and job opportunities.

Our website continued to be a valuable engagement tool, with 14,605 visits to the website in June 2016 (with 39 per cent being returning visitors and 61 per cent being new traffic). In June 2016, the top three pages visited included working in the NT and NT vacancies. The redesign of our website in 2016–2017 will improve functionality and make it easier for stakeholders to locate information quickly and easily. We also focused on building our social media presence, recognising the ongoing growth of these platforms. Our 718 Twitter followers and 418 LinkedIn connections were provided with regular updates, including job opportunities and links to our media releases.

Statistics from My Health Record Statistics by Primary Health Network, Australian Government Department of Health http://health.gov.au/internet/main/publishing. nsf/Content/PHN-Digital_Health 15

38 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

PERFORMANCE

NT PHN relaunched the external stakeholders newsletter, North of 26˚, showcasing GP experiences of working in the Territory and recent activities and achievements of our organisation

C. SUPPORT STRATEGIC RESEARCH PARTNERSHIPS

D. LEAD INNOVATIVE APPROACHES TO HEALTH CARE

In 2015–2016, we partnered with the Menzies School of Health Research to develop a population health Baseline Needs Assessment. We received a range of research partnership opportunities in 2015–2016, and will be participating in research with a range of prestigious NT-based and national research bodies into 2016–2018, in initiatives that will benefit Territorians through the provision of a range of in-kind and financial support.

Support for a range of innovative approaches to health care occurred in 2015–2016, including commencement of a project to introduce clinical health pathways into the NT, through purchase of licensing for ‘HealthPathways’.16 This software is already used extensively throughout Australia by 20 of the 31 PHNs. HealthPathways will be a long-term project for us, with ongoing engagement with general practitioners, specialists, allied health providers and other key stakeholders (including community agencies) to support implementation. HealthPathways is made up of localised clinical pathways, referral and resource pages. Localised NT HealthPathways will have a positive impact on building integrated, evidence based, high quality primary health care, which supports our strategic vision and that of our key partners, CAHS and TEHS.

16

A product from Streamliners NZ Limited

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 39

Goal 4 Develop a sustainable multidisciplinary health workforce to meet needs across the Northern Territory

STRATEGY:

Collaborate to develop an increasingly skilled and culturally appropriate primary health care workforce

RESULTS AGAINST OUR STRATEGIC PLAN STRATEGIES

2015–2016 RESULT*

Coordinate health workforce planning Attract and support retention of a quality health workforce Support development of a future workforce

Educate and develop health professionals

*Traffic light result relates to current progress against NT PHN’s three-year Strategic Plan. Green = Significant Achievements Yellow = In Progress Blue = Area of Focus in 2016–2017

40 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

PERFORMANCE

The Workforce Health Planning Forum in Darwin, April 2016

Performance A. COORDINATE HEALTH WORKFORCE PLANNING

Challenges Managed

To better coordinate primary health care workforce planning in the NT, our NT Health Workforce Branch hosted a Workforce Health Planning Forum in Darwin, in April 2016. Twentysix participants attended, representing organisations and peak bodies working across the sector, including planning, education and training (including for general practitioners, nurses, allied health professionals, and Aboriginal and Torres Strait Islander Health Practitioners), and our Board members and staff. The forum provided an opportunity for key stakeholders to share their views on supporting and developing the workforce, priority areas for action, and potential actions that will contribute to progress.

Solution: Significant work has been completed and further work is planned to improve internal data collection, analysis and reporting. Improved understanding of strategic directions around stakeholder engagement, with planning currently underway for a comprehensive stakeholder consultation process. Maximising use of external information and data sources will also contribute towards improved understanding.

Challenge: Limitations to our understanding of the workforce needs of health services in the NT.

Priority areas identified included: collaboration, partnerships and networks, workforce planning, recruitment and retention, and education and training. Key themes for action were the need for collaborative planning processes, consistent and accurate capture of workforce data in a centralised location, and the benefit of strong partnerships with key stakeholders – particularly professional bodies – in moving forward. Issues that are currently affecting or may affect the NT primary health care workforce over the next three to five years were also discussed and captured to inform ongoing planning.

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 41

B. ATTRACT AND SUPPORT RETENTION OF A QUALITY HEALTH WORKFORCE As the only PHN incorporating a Rural Workforce Agency, the core work for our Recruitment and Retention Team is to recruit health professionals from interstate and overseas to work in the NT. During 2015–2016, we filled 14 general practitioner vacancies across the NT. Vacancies filled included: • recruitment of eight doctors to ACCHS, including four to Remoteness Area (RA) 5 locations, three to RA 4 locations, and one doctor to an RA 3 location

Challenges Managed Challenge: Health workforce shortages are driving a very competitive recruitment environment. Solution: Recruitment in 2015–2016 of a dedicated communications and marketing coordinator to develop contemporary, evidence-based marketing and communications approaches, deliver fit-forpurpose messaging, and allow for flexible responses to emerging marketing and communications needs of the NT Health Workforce Branch.

• six doctors to private practices within Darwin. Of the 14 vacancies filled, six had been vacant for more than 12 months.

Challenges Managed

A total of six doctors received relocation support through us, including two International Recruitment Strategy (IRS) packages. The IRS packages were provided to a doctor who moved from the Netherlands to an ACCHS in Darwin, and a New Zealand doctor who moved to an ACCHS in Alice Springs with his young family. Feedback received from these IRS recipients was very positive. In particular, the general practitioner who relocated his family from New Zealand commented the grant made it much easier to relocate his family. Access to IRS funds and the ability to move his family, also meant he was encouraged to accept a two-year contract in Alice Springs rather than a brief, six-month placement which he originally considered.

Challenge: Improve the experience of new recruits and therefore retention of health professionals in the NT.

Promotion opportunities continued to be undertaken at national and international conferences to attract vocationally registered general practitioners to work in the NT. We updated existing community profiles during 2015–2016 to ensure health professionals have a realistic overview of what communities in the NT have to offer both personally and professionally. GP Stories continued to be utilised for potential candidates as well as being played at conferences attended by NT PHN. This multi-media tool provided an overview of doctors’ experiences in, and the attraction to, working in remote locations of the Territory.

Challenge: Limited understanding of Aboriginal and Torres Strait Islander Health Practitioner workforce, and the appropriateness of our current government funded workforce programs to meet their needs.

Total

Number of Doctors Recruited 2015–16

Training Country

Proportion of Recruited Doctors %

2

United Kingdom

14

3

Australia

21.5

3

New Zealand

21.5

6

Other

14

43 100

42 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

Solution: We continued to encourage and facilitate health professionals to visit communities prior to placement. We created a dedicated Client Relations position that provides comprehensive and client-focused case management to recruits. We are currently negotiating a more comprehensive orientation program for new recruits for 2016–2017.

Challenges Managed

Solution: To help address this challenge, we are developing a close and collaborative working relationship with AMSANT.

During 2015–2016, a total of 83 General Practitioners Rural Incentive Program Flexible Payment System (GPRIP) applications were assessed. This saw an increase of seven per cent from the previous year. Sixty-six of the 83 applications were approved with a total of $565,310 in GPRIP flexible payments processed to general practitioners across the NT. All applications were processed and assessed within 30 days, meeting our established Key Performance Indicators (KPIs). Improvements planned for data management in 2016–2017 will enable us to monitor activity in this program by remoteness areas, and the number of years a general practitioner has been involved in the program.

Australia and internationally to the PERFORMANCE NT. To ensure maximum reach of the available support, the packages were split into 16, which were all successfully filled by June 2016. One candidate left the program during this time. The remaining 15 new candidates, and the five candidates placed during 2014–2015, continued to be actively case managed and supported in their places of employment. A further 10 allied health and nursing professionals were recipients of our New to the Territory Grant which also provided incentives for recruitment and retention.

Allied Health Recruitment and Support continues to be a focus through the Rural Health Professionals Program (RHPP). In 2015–2016, we were allocated 13 RHPP packages to recruit and retain nursing and allied health professionals from across

NUMBER AND PROPORTION OF RECRUITED HEALTH PROFESSIONALS 2015–2016

Number

Total

Proportion of Recruited Health Professionals %

Profession recruited 2015–2016

3

Psychologist

11.5

8

Physiotherapist

30.5

5

Nurse

1

Occupational Therapist

4

1

Speech Therapist

4

4

Podiatrist

1

Aboriginal and Torres Strait Islander Health Practitioner

4

1

Pharmacist

4

1

Social Worker

4

1

Optometrist

4

19

15

26

100

To develop a sustainable health workforce in the NT, allied health professional recruitment remains a priority for NT PHN.

Case Study: General practitioner Locums The main objective of our Locum Program is to provide support to rural and remote general practitioners across the Territory to take leave from their place of employment. Secondary to this, the Locum Program supports clinics with long-term vacancies by placing general practitioners into practices to provide much-needed primary health care whilst the position is recruited to. The majority of this leave cover was supplied to general practitioners working in ACCHSs in remote communities. Number of occasions that leave cover was provided

Quarter 1 and Quarter 2

The ability for a general practitioner to take annual leave, or leave to attend continuing professional development is a significant factor in job satisfaction, and an important retention tool. The availability of Locum support is an important factor in whether a general practitioner takes this leave. Our Australian Government KPI for the provision of Locums is based on providing leave cover to general practitioners as a retention strategy and is shown below. Quarter 3 and Quarter 4

Non-ACCHS

ACCHS

Total

Non-ACCHS

ACCHS

Total

13

22

35

9

16

25

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 43

Did you know? A long term outcome of the Locum Program is to encourage specialist general practitioners from the program to take up permanent positions in the Territory. During 2015–2016 one of our long-term Locums took up a fly in fly out opportunity at the Anyinginyi Health Aboriginal Corporation in Tennant Creek. In June 2016, this doctor decided to relocate to Tennant Creek and practise full-time at the clinic. Case Study: Compass Teaching and Learning Conference The Compass Teaching and Learning Conference provided rural and remote specialist general practitioners, general practitioner registrars, other doctors working in general practice and allied health professionals the opportunity to engage in accredited education activities, network with other health professionals and meet with other rural families. The conference also incorporates the annual Health Professional of the Year Awards which are presented at the gala dinner. The 2016 Compass Teaching and Learning Conference was held in Darwin in May 2016, and was delivered in partnership with Northern Territory General Practice Education. This year’s event attracted 126 health professionals; a significant increase over previous years. Sixty-six of these attendees were from RA 4 and RA 5 locations. Including families, there were 259 attendees.

The Gala Dinner at the Compass Teaching and Learning Conference 2016

44 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

Key highlights included: • A high quality education day at the Darwin Convention Centre which offered nine accredited education activities, including the Emergency Response Scenario and a general practitioner supervisor education stream. The Emergency Response Scenario was delivered in collaboration with St John Ambulance NT, and Nine News Darwin reported on the activity • Presentation of the Health Professional of the Year Awards at the gala dinner • Networking breakfast for specialist general practitioners, general practitioner Registrars and other doctors working in general practice. Engagement with allied health professionals into the Compass Teaching and Learning Conference continued to be increased, by expanding education topics to better encompass varied professions.

Dr Anne Kleinitz at the Compass Teaching and Learning Conference 2016

Refugee Nurse Coordinator, Irene Simonda, was presented the Individual Award at the Administrator’s Medals in Primary Health Care

PERFORMANCE

Sally Weir of NT PHN and Martin Musco of Australian College Mental Health Nurses presenting the Excellence in Mental Health Nursing Award to Kim Richardson from Top End Mental Health Services

Case Study: Recognising Excellence in the Territory’s Health Workforce The Health Professional of the Year Awards recognise NT Health Professionals who are dedicated to providing excellence in primary health care and helping people in the NT to enjoy their best health and wellbeing. Nominations were made by the public, colleagues, managers, or professional organisations. In 2015–2016, 31 nominations were received across all categories. The winners were announced at the Compass Teaching and Learning Conference in May 2016. • NT General Practitioner of the Year - Dr Sarah Chalmers • NT Allied Health Professional of the Year Ms Amanda O'Keefe • NT Nurse of the Year - Mr David Lodge • NT General Practitioner Locum of the Year Dr Janette Bills The prestigious Administrator’s Medals in Primary Health Care awards are presented annually to recognise the outstanding service provided by the NT’s primary health care professionals, and are supported in collaboration with our key partners. Members of the general public and health care professionals are encouraged to nominate an individual or team working in primary health care who they believe

deserves to be recognised for their contribution. Recipients in 2015 were announced at an official ceremony held at Government House in August 2015, and were presented by His Honour the Honourable John Hardy OAM, Administrator of the NT. A panel comprising representatives from partnering organisations reviewed a strong field of nominations and selected the Individual Award and Team Award winners. Each nomination highlighted the significant effort in frontline health care that is provided across the NT. From the seven team and nine individual nominations received in 2015, the Individual Award was presented to Irene Simoda, Refugee Nurse Coordinator and the Team Award was presented to Utira Kulintjaku (UK) Project Team. We were proud to sponsor the Excellence in Mental Health Nursing Award as part of the 2016 Nursing and Midwifery Excellence Awards. This award acknowledged the great contribution nurses make within the mental health sector in the NT. The recipient of the award was Kim Richardson who worked as the Team Manager for the Mental Health Access Team in the Top End Mental Health Services. Kim was recognised for his quality improvement activities which have had a positive impact on patient care. The Award was presented in partnership with Martin Musco, representing the Australian College of Mental Health Nurses.

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 45

C. SUPPORT DEVELOPMENT OF A FUTURE WORKFORCE We continued to support the development of a future health workforce in the NT through the Rural High School Visit (RHSV) program and Go Rural. The RHSV program provided a fun and creative interaction with hands-on workshops to teach NT high school students about the challenges and rewards of pursuing a career in rural and remote health care. The workshops were delivered by university students studying a variety of health disciplines. We have operated the RHSV program for 16 years. In 2015–2016 the program was delivered twice, and this year saw the introduction of a separate program for Year 11 and 12 students, focussing on the barriers of going on to university and how they can be overcome. In 2015–2016 the program reached 630 students from 16 schools, 31 per cent of whom identified as Aboriginal or Torres Strait Islander. Prior to undertaking the program, 56 per cent of students wanted to go on to university and after the program 81 per cent expressed an interest in a career in health. Four of the university students who were selected to participate in the program in 2015–2016 were from the NT, and three had been exposed to the RHSV program whilst they were high school students. Go Rural activities promote health practice in rural geographic s by providing an opportunity for Australia-trained medical, allied health and nursing students and practitioners to experience health practice in the NT. In 2015–2016, six university students participated in Go Rural, including three medical and two nursing students. The participating students visited Darwin, Batchelor and the Katherine region and met with experienced and committed health professionals

to understand the professional and personal opportunities provided by working in the NT. Students who participated in the program also visited the Batchelor Institute of Indigenous Tertiary Education, and met with Aboriginal and Torres Strait Islander Health Practitioners, attended the Compass Teaching and Learning Conference and undertook tours of several remote ACCHS and the Katherine hospital. Two Go Rural 2014 participants have relocated to the NT for their intern year, with internships to occur at the Alice Springs Hospital in 2016 and the Royal Darwin Hospital in 2017.

SUCCESS STORY “The NT RHSV was definitely one of the best weeks of my life and has only further inspired me to want to work rurally in the future … I now have seen what remote communities of Australia look like and can appreciate some of the barriers they face in terms of access and equity.” University Student “The week was jam-packed with various school visits, speed-dates, clinic visits and checking out local places. I think the RHSV itself is an effective comprehensive primary health care approach to promoting health. Promoting health is everybody’s business and inter-sectoral action is key – something the NT PHN RHSV does well.” University Student

Deakin University medical student, Sarah Lum, showing Katherine High School students a problem-based scenario for Rural High School Visit, May 2016

46 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

PERFORMANCE

SUCCESS STORY: Real-Life Emergency Response Scenario at Compass “My favourite aspect of the trip was definitely the daylong emergency response scenario [during the Compass Teaching and Learning Conference]. I played paramedic as we attended a mock BBQ explosion. My first job was to attend to a young lady who had suffered an asthma attack and was struggling to breathe. As I began administering oxygen she stopped breathing and I had to perform CPR. After several rounds, a decision was made to cease resuscitation and I had to call my first patient death which was difficult. I then placed a white cover on the deceased body and comforted the patient’s sister who had suffered major burns but was more affected by the death of her loved one. Even though it was: … a mock scenario … the patient was an actor … and there was no BBQ explosion this scenario triggered feelings that I have never experienced before. Moreover, in the first month of my degree, we practised first aid on a weekly basis. However, this all seemed to evaporate in this moment when I’m trying to resuscitate a patient (dummy) and comfort an actor. Medicine became real to me.” Medical Student

In 2015–2016, future workforce support initiatives included: • Acceptance of 21 new Rural Locum Relief Program applications. Each of these doctors were required to complete an Individual Learning Plan (ILP) with a clinical advisor at the start of the program. The ILP provided a structured plan to support the doctor’s journey to fellowship.

An emergency response situation at the Compass Teaching and Learning Conference 2016

• Seven doctors working in general practice achieved fellowship, an increase of 175 per cent on 2014–2015. This is attributed to the increased level of case management, education and training support, and fellowship exam assistance. Of the doctors on the program, 99 per cent indicated in their annual reviews they were satisfied with the level of support we provided. • Rural Health Workforce Australia provided 12 Additional Assistance Scheme grants for us to allocate. We offered 11 new grants to support 29 doctors on the Scheme. The financial support assisted doctors working in general practice in their journey toward fellowship by funding continued professional development and learning resources associated with fellowship exams. • We facilitated four pre-clinical exam workshops in Darwin and Alice Springs for participants of the Rural Locum Relief Program, with an average of 20 participants at each workshop. • We addressed an identified common learning need of participants by coordinating the delivery of the Australian College of Rural and Remote Medicine’s (ACRRM) Rural Emergency Obstetrics Training course for Rural Locum Relief Program doctors. All doctors we recruited to work in general practice received individual case management and orientation to support them in settling into their new work, social and physical environments. In 2015–2016 this included a comprehensive online resource pack and physical orientation. Doctors were provided clinical orientation and training on computer systems. Additional support was provided to doctors recruited from overseas, including assistance with medical registration, relocation, access to a clinical advisor to assisted in developing an ILP and progression to achieving Fellowship.

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 47

D. EDUCATE AND DEVELOP HEALTH PROFESSIONALS Delivery of high quality, needs-based education, training and other professional development opportunities to NT health providers was a key priority in 2015–2016. Various sources of intelligence were utilised to develop our 2015–2016 education and training calendar to ensure sessions aligned with the needs of health professionals and their local communities. This included, the Rural and Remote General Practice Minimum Data Set survey, regional health working groups, feedback from visits by our staff across the Territory and feedback from our Clinical Advisor Panel. Educational requirements identified through the learning plans of general practitioner registrars and clinicians recruited into remote positions were also utilised.

SUCCESS STORY: COMPASS TEACHING AND LEARNING CONFERENCE, MAY 2016 “I was at the conference last weekend with my family and would like to say thanks to Nicki and all of the NT PHN staff for all your work to make it such a great event. The professional development and networking opportunities were very worthwhile and it was obvious a lot of thought and care had gone into the family program … Thank you very much indeed.” Compass Delegate

48 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

Our Clinical Advisor Panel provided input into the content of education sessions which required accreditation through the Royal Australian College of General Practitioners and ACRRM. These enabled clinicians to gain continuing professional development (CPD) points and ensure they were up to date with clinical education and emerging health topics in the NT. Thirty-five doctors working in general practice were provided with grants to attend education events outside of those delivered through us in 2015–2016. Of these 35 grants, 14 were awarded to doctors working in remote ACCHS, and 57 per cent were awarded to doctors practicing in RA4 and RA5 regions.

PERFORMANCE

Case Study: Continuing Professional Development The Education and Professional Development Program delivered 94 education and training events throughout the 2015–2016 financial year, attracting 1344 attendees. Of the ninety-four scheduled CPD events:

Number of education and CPD events delivered by location EVENTS HELD PER LOCATION 2015–2016 LOCATION

Qtr 1

Qtr 2

Qtr 3

Qtr 4

Total

Alice Springs

6

4

5

8

23

• Eighty-nine were accredited with CPD points

Tennant Creek

2

1

1

3

7

• Seventy-five were developed by us and 19 were held in collaboration with other organisations, including Doctors Health SA, the National Asthma Foundation, Decision Assist and The Benchmarque Group

Darwin

11

8

7

15

41

Katherine

5

2

1

4

12

Gove

3

2

4

2

11

Total

27

17

18

32

94

• Education activities were held across the NT, including in Darwin, Alice Springs, Nhulunbuy, Katherine and Tennant Creek • Video conferencing links were enabled for the first time in Nhulunbuy • Two Rural and Remote Emergency Skills Training courses were held in Alice Springs and Darwin for a combined total of 38 participants • In total, 210 individual specialist general practitioners and other doctors working in general practice, and 73 individual general practice registrars attended education events in 2015–2016, compared with 193 in 2014–2015 • We promoted a further 113 externally delivered education events, up 33 per cent from 2014–2015 • SMS reminders sent to participants increased attendance against acceptances from 54 per cent to 82 per cent

Profile of attendees by profession NUMBER OF ATTENDEES 2015–2016 PROFESSION

Qtr 1

Qtr 2

Qtr 3

Qtr 4

Total

Specialist GPs/ doctors working in general practice/GP Registrars

173

82

110

163

528

Allied Health

107

91

36

83

317

Nurses

88

87

69

55

299

Practice managers/other

13

5

95

87

200

381

265

310

388

1344

Total

• 86 per cent of attendees rated events as satisfactory or excellent • Only three events were cancelled during this period due to low registrations

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 49

Goal 5 Outcome success measures are achieved with an efficient allocation of resources

STRATEGY:

Valued and engaged staff, supported by innovative systems achieving good corporate governance and sustainability

RESULTS AGAINST OUR STRATEGIC PLAN STRATEGIES

2015–2016 RESULT*

Ensure financial solvency and sustainability

Ensure Board and corporate compliance

Implement efficient systems Recruit and support a skilled, valued and culturally safe workplace *Traffic light result relates to current progress against NT PHN’s three-year Strategic Plan. Green = Significant Achievements Yellow = In Progress Blue = Area of Focus in 2016–2017

50 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

PERFORMANCE

Performance A. ENSURE FINANCIAL SOLVENCY AND SUSTAINABILITY Compliance with our established financial management systems ensured ongoing financial solvency, with program expenditure and cash flow regularly monitored, and projected to be at 10 per cent at the end of the financial year (including approved roll-overs). All monthly finance reports were completed by the due date, and approved Activity Work Plan Budgets for 2016–2017 were completed and submitted to funding bodies in May 2016. Establishment and transition funding was provided by the Australian Government Department of Health to support transition to the PHN program. This funding was used for priority transition activities, including implementing the PHN program branding, establishment of the Clinical Councils and Community Advisory Councils and to support executive staffing recruitment. No interruption to continuity of services was experienced as a result of the transition.

C. IMPLEMENT EFFICIENT SYSTEMS Following the transition to the PHN program and requirements of new funding agreements, a range of corporate efficiencies were made in 2015–2016. This included: • transition into a more efficient Information and Communications Technology (ICT) environment with cost savings • undertaking accommodation planning for future locations of PHN offices with a relocation of our Darwin office to occur in Quarter One of 2016–2017 • planning for an upgrade of our CRM system software as part of the transition to the new ICT environment.

Challenges Managed Challenge: A range of performance issues within our remote desktop ICT environment were identified in 2015–2016, including system down-time.

B. ENSURE BOARD AND CORPORATE COMPLIANCE Ongoing implementation of our established corporate governance and monitoring systems ensured continued compliance. We complied with all obligations through transition from the Medicare Local program to the PHN program. This transition was overseen by an internal working group consisting of executive and managerial level staff, ensuring proper identification and management of risk and legal requirements. All compliance activities were achieved in 2015–2016 with: • all Business Activity Statements prepared and lodged by their respective due dates • Annual Financial and Directors Report endorsed by the Board in September 2015 • Audited Annual Financial Statements, Program Acquittal Statements and Performance Reports lodged with respective funding bodies by their due dates in September 2015 • Annual Information Statement lodged with the Australian Charities and Not-for-Profit Commission in October 2015 • 2014–2015 Annual Financial Report and Directors Report provided to members and Auditors, in accordance with the requirements under the Corporations Act and the Australian Securities and Investment Commission • Interim Financial Audit for 2015–2016 completed. Continuous quality improvement of systems included reviews to risk management practices and frameworks and development of a framework for Internal Audits.

Solution: An ICT tender was completed in late 2015 and selected a new remote desktop environment to service the organisation’s needs moving forward. The new environment presents significant cost savings and improved security, and became fully operational across the organisation from July 2016.

To improve communication and engagement with our stakeholders, a concentrated focus on the use of coordinated engagement tools was implemented, with the following activities undertaken in 2015–2016: • development and introduction of an engagement platform, ‘Your Voice’.17 This interactive tool was used to survey staff and Board Councils • a revised Stakeholder Engagement Policy and Stakeholder Engagement Framework endorsed by the Board in June 2016 • an organisation wide Communication and Engagement Plan for 2016–2017 • development of an organisation-wide Tone and Key Messages Guide to assist staff in using consistent language when engaging stakeholders regarding our organisation and branches/programs.

17

Powered by Engagement HQ

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 51

D. RECRUIT AND SUPPORT A SKILLED, VALUED AND CULTURALLY SAFE WORKPLACE As expected, the change encountered during transition to the PHN program over 2015–2016 prompted staff turnover. To support staff during this period, we: • established a transition working group which comprised senior managers to provide oversight of the changes required • implemented a change management strategy • developed a Frequently Asked Questions for staff and a dedicated page on our staff intranet • conducted regular all-staff meetings • issued weekly update emails from the CEO to all-staff • ensured continuous access by staff to our Employee Assistance Program • provided regular communications to external providers In 2015–2016 the successful negotiation and Fair Work Commission approval of the Northern Territory PHN Enterprise Agreement 2016–2018 was completed. New staff continued to be supported through a comprehensive online orientation and two corporate induction days were held. Our Work Health and Safety Committee met regularly, with active Health and Safety Representatives at all office locations. To support staff, we implemented a post survey action plan following an Employee Pulse Survey undertaken in February 2016 to action areas of opportunity with regards to organisational culture.

52 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

Case Study: Reconciliation Action Plan In 2015–2016 we commenced development of an organisational Reconciliation Action Plan (RAP). Having a RAP is a key strategic initiative to build our capability as a culturally competent organisation that embeds reconciliation at the core of all it does. The RAP is a practical tool of measurable actions to support reconciliation built on relationships, respect and opportunities. We will also ensure themes are embedded throughout organisational policy and culture. A RAP Working Group was formed to work with the Board with regular meetings held in 2015–2016 to develop the document. Staff were surveyed in May 2016 about their thoughts on reconciliation with strong support to develop a RAP. Staff attitudes to understanding and knowledge of Indigenous people and culture were: 50 per cent% felt it was good or excellent, 10 per cent felt it was poor, and 40 per cent felt they could do better. In response to how staff felt about the level of our organisation’s cultural competency: 36 per cent felt it was good or excellent, 17 per cent felt it was poor, 45 per cent felt it could do better and 2 per cent were not sure. Work on the RAP will continue in 2016–2017 in consultation with the Board.

NT PHN staff working on the Australian history timeline for Reconciliation Action Week

PERFORMANCE

Corporate Responsibility Continuous Quality Improvement Initiatives

Environmental Responsibility

A continued focus on improvements and efficiencies are incorporated into business practices across the organisation. As a matter of course, policies and practices are regularly reviewed to ensure that we remain compliant and that our work practices are efficient and fit for purpose.

We have adopted a Sustainable Purchasing Policy with purchase of recycled and recyclable materials where they are available, economical and suitable, including stationery and general office supplies. All paper used is carbon neutral and 20 per cent recycled, meeting Australian Forestry Standard AFS/01-31-08 and printer cartridges are recycled.

Safety On a quarterly basis, our Work Health and Safety Committee met and reviewed a number of key elements pertaining to organisational safety, including policy and procedural guidelines, risk assessments and incident rectification action plans. The Work Health and Safety Committee also worked proactively to ensure that health, safety and wellbeing remain at the forefront of everything we do.

Did you know?

Did you know? In 2015–2016, our electricity costs reduced by 10 per cent, and there was a $28,000 saving on our stationery and printing costs from 2014–2015. Stationery and printing costs have reduced significantly since 2012–2013.

We encourage health and wellbeing initiatives in the workplace, aimed at ensuring our team maintain positive health. Our absentee rate is less than 20 per cent of the national average. The organisation has appropriate representation for Fire Wardens, Health and Safety Representatives, with regular and ongoing training and support for the employees who lead these activities. Collectively, these groups have reviewed all Work Health and Safety policies, and the Disaster and Cyclone and Emergency Management Plans, during the course of the year to ensure they are maintained and current. Our employees have all participated in regular safety refreshers, and take a proactive approach to raising awareness of health, safety and wellbeing initiatives, such as our Employee Assistance and Manager Assistance programs, participation in promotional (awareness) campaigns such as R U OK day, Mental Health week, National Safety Week, and activities such as Influenza vaccinations.

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 53

Social Responsibility Our employees are committed to positive social responsibility, and this is supported through participation in a number of activities and events to support local services across the Territory. Employees have contributed over $3500 in donations to a number of local and national campaigns throughout the year, and taken time to learn more about challenges facing individuals across the Territory. These include:

CHRISTMAS FOODBANK APPEAL

RECONCILIATION WEEK

DECEMBER 2015 - Staff launched a Christmas appeal which collected more than six boxes of non-perishable items and toys for the Foodbank Christmas 2015 Appeal. Our team were excited to get on board, knowing that their contribution could help those less fortunate in our community over the festive season.

MAY 2016 - We have been developing a RAP during 2015–2016. In addition to participating in local networking activities during Reconciliation Week, the celebration was used to promote and raise awareness of reconciliation activities and the issues facing many Aboriginal and Torres Strait Islander peoples.

NAIDOC WEEK

AUSTRALIA’S BIGGEST MORNING TEA

JULY 2015 - To celebrate the history, culture and achievements of the Aboriginal and Torres Strait Islander peoples, staff participated in many of the NAIDOC Week 2015 Darwin events. The Priority Communities team represented NT PHN at celebrations held at the RDH where they operated a stall and participated in cultural activities throughout the day.

MAY 2016 - Fancy a quick cup of tea? In both our Alice Springs and Darwin offices, we brought staff together to raise money for cancer research, and in the process, enhanced our teams' understanding of a health issue facing many Territorians.

ST VINNIES CEO SLEEP-OUT

R U OK DAY SEPTEMBER 2015 - Staff celebrated R U OK day on 10 September 2015. The all staff mission for the day was to wear a splash of yellow or orange to support R U OK day and ask at least one of our work colleagues, “R U OK?”. At the lunch, staff were given the opportunity to learn about the importance of creating a culture where people feel confident asking and answering this most important question and knowing when to ask.

JUNE 2016 - On a cool evening in Darwin, two members of the Executive Team participated in the CEO Sleepout, spending the night sleeping rough and raising over $2000 in the process. The event raises much needed funds for St Vincent De Paul to support the purchase and running of mobile kitchens to enable many people in need to have a proper meal each day.

MENTAL HEALTH WEEK OCTOBER 2015 - As part of Mental Health Week, we supported many of the events happening around the Territory with staff attendance and funding. We funded $500 worth of sports prizes for the Nauiyu Mental Health Expo which was held on 7 October. Attendees celebrated mental health and were made aware of the support available to them in Nauiyu.

During 2015–2016 employees donated over

$3500 to local and national causes 54 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

PERFORMANCE

NT PHN Chief Executive Officer, Nicki Herriot and Chief Financial Officer, Ram Naik participating in the CEO Sleepout in June 2016

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 55

Financial Performance Financial Analysis 2015–2016 SCOPE:

KEY POINTS:

This Financial Analysis is for the financial year ended 30 June 2016.

• Approximately 92 per cent of total income received by the NT PHN in 2015–2016 was from the Department of Health (Commonwealth). • The overall surplus of $2,694,695 was due to receipt of net program funding of $2,716,990 in 2015–2016 for which expenditure will be incurred in 2016–2017, and $34,922 being interest earned on unrestricted retained surplus, less $45,203 for sponsorship and consultancy services funded through the Strategic Initiatives Reserve. • The Accumulated Surplus of $2,017,306 in the financial statements consisted of $1,912,511 of retained surplus and $104,795 of the Strategic Initiatives Reserve.

NET RESULT ANALYSIS $40 $35

2013–14

$30

2014–15

MILLIONS

$25

2015–16

$20 $15 $10 $5 $0 $-5 TOTAL INCOME

TOTAL EXPENDITURE

SURPLUS/ (DEFICIT)

UNEXPENDED FUNDS RESERVES

UNRESTRICTED RETAINED EARNINGS ANALYSIS $1000 $900

THOUSANDS

$800 $700 $600 $500

2012–13 2013–14 2014–15 2015–16

$400 $300 $200 $100 $0 RETAINED SURPLUS

56 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

FINANCIAL FINANCIAL STATEMENTS PERFORMANCE

GRANT INCOME ANALYSIS $40 $35

2013–14

MILLIONS

$30

2014–15

$25

2015–16

$20 $15 $10 $5 $0

DEPARTMENT OF HEALTH

NT DEPARTMENT OF HEALTH

OTHER GRANTS (RDH, RHWA, DSS)

TOTAL INCOME ANALYSIS $40 2013–14

MILLIONS

$35 $30

2014–15

$25

2015–16

$20 $15 $10 $5 $0

GRANT INCOME

INTEREST INCOME INTEREST INCOME ALLOCATED TO ALLOCATED TO BSA PROGRAMS

NON-GRANT INCOME

TOTAL EXPENDITURE ANALYSIS $25 2013–14

MILLIONS

$20

2014–15 2015–16

$15

$10

$5

$0 EMPLOYEE EXPENSES

PROGRAM EXPENSES

GOVERNANCE EXPENSES

RENT & ADMINISTRATION DEPRECIATION OCCUPANCY EXPENSES

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 57

BALANCE SHEET ANALYSIS $20 2013–14 2014–15

MILLIONS

$15

2015–16 $10

$5

$0

CURRENT ASSETS

NON-CURRENT ASSETS

CURRENT LIABILITIES

NON-CURRENT LIABILITIES

END OF YEAR WORKING CAPITAL ANALYSIS $10 2013–14

MILLIONS

$8

2014–15 2015–16

$6

$4

$2

$0

CURRENT ASSETS FROM SOLVENCY STATEMENT

CURRENT LIABILITIES FROM NET ASSETS FOR SOLVENCY STATEMENT SOLVENCY DETERMINATION

58 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

FINANCIAL PERFORMANCE

2016 Financial and Directors' Report INDEX Corporate Information

60

Directors’ Report

61

Statement of Financial Position

66

Statement of Comprehensive Income

67

Statement of Changes in Equity

68

Statement of Cash Flows

69

Notes to the Financial Statements

70

Directors’ Declaration

88

Auditor’s Declaration of Independence

89

Auditor's Report

90

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 59

Corporate Information DIRECTORS The following Directors were in office during the financial year and at 30 June 2016: Dr Andrew Bell – Chair Ms Diane Walsh – Deputy Chair Mr Iain Summers Ms Judith Oliver Ms Donna Ah Chee Dr Paul Burgess – appointed on 18 August 2015 Dr Samuel Goodwin – appointed on 14 August 2015 Mr John Rawnsley – appointed on 10 November 2015 The following Directors resigned at the Annual General meeting or before the end of the financial year: Mr Edward Mulholland from 10 November 2015 Ms Dorothy Morrison from 10 November 2015 Ms Marion Scrymgour from 31 January 2016 Registered Office Stuart House 5 Shepherd Street Darwin Northern Territory 0800 Principal Place of Business 23 Albatross Street Winnellie Northern Territory 0820 Bankers National Australia Bank 71 Smith Street Darwin Northern Territory 0800 Auditors Merit Partners Chartered Accountants Level 2, 9 Cavenagh Street Darwin Northern Territory 0800

60 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

FINANCIAL PERFORMANCE

Directors’ Report The Directors present their report together with the financial report of Health Network Northern Territory Ltd (“the Company or Health Network NT”), trading as the Northern Territory PHN, for the year ended 30 June 2016 and the auditor’s report thereon.

1. DIRECTORS The Directors of the Company at any time during or since the end of the financial year, including their qualifications, experience and special responsibilities are: NAME AND QUALIFICATIONS

EXPERIENCE, SPECIAL RESPONSIBILITIES AND OTHER DIRECTORSHIPS

Dr Andrew Bell

Expertise: Public Health and Primary Health Care

MBBS, DRANZCOG, DA, FAFPHM, FACRRM, MAICD

Chair Appointed 10/07/12

Public Health Physician and General Practitioner

Ms Diane Walsh

Expertise:

BA, Dip Ed, GAICD

Consumer Corporate Governance

Deputy Chair Appointed 10/07/12

Australian Health Practitioner Regulation Agency (AHPRA) part-time Employee Top End Health Service – Board Member and Deputy Chair Rural Health Workforce Australia – Director Royal Australian College of General Practitioners (RACGP) National Standing Committee – Standards Medicare Australia – Stakeholder Consultative Group Health Network NT Committee or Representative: Chair, Governance Committee appointed 10/7/12 Member, Community Advisory Council appointed 5/10/15

Ms Donna Ah Chee

Adv. Cert. in Management (Aboriginal Organisations), Associate Diploma in Business (Aboriginal Organisations), Grad. Cert. in Management

Director Appointed 10/07/12

Expertise: Corporate Governance and Advocacy in Aboriginal Community-Controlled Health Services Responsibilities: Since July 2012, CEO of the Central Australian Aboriginal Congress Aboriginal Corporation in Alice Springs Other Directorships: Chair of the Aboriginal Medical Services Alliance of the NT (AMSANT); Director of the National Aboriginal Community Controlled Health Organisation; Member of the Australian National Advisory Council on Alcohol and Drugs; Director of the Menzies School of Health Research. Health Network NT Committee or Representative: Member, Governance Committee appointed 30/11/15

Ms Dorothy Morrison

BA, Dip Cont Ed, M Ed., GAICD

Director Appointed 10/07/12 Resigned 10/11/15

Expertise: Governance and Management Population Health; Workforce Planning and Development. Manager, Mental Health Promotion, Top End Association of Mental Health. Director, Northern Territory General Practice Education

Mr Edward Mulholland

Grad. Cert. in Management; Grad. Cert. in Public Health; BA Politics/Public Admin, Public Policy

Director Appointed 10/07/12 Resigned 10/11/15

Expertise: Corporate Governance, Aboriginal Community Controlled Health CEO Miwatj Health Aboriginal Corporation Executive Member Aboriginal Medical Services Alliance of the Northern Territory (AMSANT)

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 61

NAME AND QUALIFICATIONS

EXPERIENCE, SPECIAL RESPONSIBILITIES AND OTHER DIRECTORSHIPS

Ms Judith Oliver

Expertise:

Director Appointed 10/07/12

Registered Pharmacist; Corporate Governance & Organisational Development; The Pharmaceutical Benefits Scheme and Section 100 (Aboriginal Health Service Remote Access Program); Quality Use of Medicines.

B Pharm (Hons)

Director, The Pharmacy Guild of Australia (NT Branch) Part-time Pharmacist-in-charge at United Discount Pharmacy, Palmerston Former lecturer in Pharmaceutics and Remote Pharmacy Practice at Charles Darwin University Health Network NT Committee or Representative: Member, Finance, Audit and Risk Management Committee appointed 10/7/12 Mr Iain Summers

BComm, LLB (Hons), Grad. Dip. Mngt Psych, FCA, FCPA, FAICD, FAIM

Director Appointed 10/07/12

Expertise: Financial management and governance Director, Traditional Credit Union Ltd Director, Kormilda College Ltd Facilitator, Australian Institute of Company Directors governance training Health Network NT Committee or Representative: Chair, Finance, Audit and Risk Management Committee appointed 10/7/12 Member, Governance Committee appointed 10/7/12

Dr Paul Burgess

MBBS, BMedSci, MPH, PhD, Grad. Dip. Rural GP, FRACGP, FARGP, FAFPHM

Director Appointed 14/08/15

Expertise: Primary Health Care reform, Policy and strategy, Health care improvement Public Health Physician and General Practitioner Northern Territory Representative on the Royal Australian College of General Practice Faculty for Aboriginal and Torres Strait Islander Health Director AHHA Health Care Homes Implementation Advisory Group member Health Network NT Committee or Representative: Member, Top End Clinical Council appointed 5/10/15

Dr Samuel Goodwin

MBBS, FACRRM, JCCA, GAICD, MPHTM

Director Appointed 18/08/15

Expertise: General Practice and Public Health Director, General Practice Education and Training Director, Medical Board of Australia Member, Northern Territory Postgraduate Medical Council Health Network NT Committee or Representative: Member, Central Australia Clinical Council appointed 5/10/15 Member, Finance, Audit and Risk Management Committee appointed 30/11/15

Mr John Rawnsley

Expertise:

Director Appointed 10/11/15

Parole legal matters and associated prison matters, civil law, youth justice, governance, risk management, leadership development, local government, Aboriginal issues, programs to encourage greater Aboriginal participation in legal profession.

LLB, BAIS, GDLP

Directorships: Larrakia Development Corporation (LDC) Chair of LDC Advisory Committee Chair of LDC Audit and Risk Committee Winkiku Rrumbangi NT Indigenous Lawyers Aboriginal Corporation Health Network NT Committee or Representative: Member, Finance, Audit and Risk Management Committee appointed 30/11/15 Ms Marion Scrymgour Director Appointed 10/11/15 Resigned 31/01/16

Expertise: Aboriginal health, Health Service Management

62 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

FINANCIAL PERFORMANCE 2. CHIEF EXECUTIVE OFFICER (CEO), COMPANY SECRETARY AND PUBLIC OFFICER The following Officers held their appointment in their positions for the financial year 2015–2016: CHIEF EXECUTIVE OFFICER – Ms Nicola Herriot (CAHRI, MAIM), appointed 29 August 2014 COMPANY SECRETARY – Mr Ashley Marsh (B.Com, LLB, GDLP, GIA (Cert)), resigned 30 June 2016 COMPANY SECRETARY – Ms Nicola Herriot (CAHRI, MAIM), appointed 1 July 2016 PUBLIC OFFICER – Mr Ramanand Naik (B.Com, CA, CPA)

3. DIRECTORS’ MEETINGS AND OTHER MEETINGS The number of Directors’ meetings and other meetings attended by each of the Directors of Health Network NT during the 2015–2016 financial year are:

DIRECTOR

BOARD MEETINGS A B

Dr Andrew Bell

7

Diane Walsh

7

Donna Ah Chee

5

Judith Oliver

7

Iain Summers Dr Paul Burgess

8

8 7

Dr Samuel Goodwin

6

John Rawnsley

4

Edward Mulholland

1

Dorothy Morrison

3

A – Number of Board meetings held during the time the Director held office during the year B – Number of Board meetings attended Note: Out-of-session Board and sub-committee work is not shown in this table

4. PLANNING AND ACTIVITIES (a) Principal Activities Health Network NT, trading as Northern Territory PHN, is a not-for-profit company limited by guarantee established in accordance with the Corporations Act 2001 (Cth). It is governed by an independent skillsbased board appointed by Health Network NT’s Members at General Meetings. Primary Health Networks (PHN) are organisations established across Australia by the Australian Government to coordinate primary health care delivery and tackle local health care needs and service gaps. PHNs have been established with the key objectives of increasing the efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes, and improving coordination of care to ensure patients receive the right care in the right place at the right time. The organisation connects with stakeholders to coordinate primary health care across the Northern Territory. With a focus on commissioning services, the organisation does not provide services directly to people but instead engages with service providers through a comprehensive primary health care service model. Health Network NT also incorporates the Northern Territory Rural Workforce Agency as an operational branch, and attracts, recruits, educates and retains a professional medical workforce across the Northern Territory.

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 63

(b) Short-Term Objectives The short-term objectives of Health Network NT are set out in the Strategic Plan 2015–2018. The organisation’s goals are: • Improve equitable access to primary health care through removal of systemic barriers; • Improve health system integration through innovation, partnerships and coordination;

• Supporting practice improvement to enhance primary health care service quality and consumer centred care; • Develop a sustainable multi-disciplinary health workforce to meet needs across the NT; and • Outcome success measures are achieved with an efficient allocation of resources.

(c) Long-Term Objectives The long-term objectives of Health Network NT are set out in Clause 2, Objects of the Constitution. Among others, these include: 1. Support the efficiency and effectiveness of medical and health services for patients, particularly those at risk of poor health outcomes.

7. I ncrease equitable health outcomes by commissioning and supporting Primary Health Care services and promoting Primary Health Care initiatives and programs.

2. I mprove coordination of care so that patients receive the right care in the right place at the right time.

8. S upport clinicians and service providers to deliver best practice care.

3. I mprove health outcomes for Aboriginal people through comprehensive primary health services. 4. S upport and strengthen Aboriginal community control of comprehensive Primary Health Care. 5. S upport and strengthen the role of the general practice and allied health sectors in comprehensive Primary Health Care. 6. E ngage with all health providers and the community to identify local health needs and regional service gaps.

9. D eliver and promote high quality education and inter-professional learning opportunities for Primary Health Care providers. 10. S upport the attraction and retention of a sustainable qualified Primary Health Care workforce which providers culturally appropriate comprehensive Primary Health Care. 11. S upport the integration of the primary and secondary health care sectors to improve the patient journey.

(d) Strategy Strategies for achievement of long term and short term Objectives are set out in the Strategic Plan 2015–2018 and are reflected in Annual Business Plans and Branch Operational Plans. (e) Performance Measurement The CEO is required to report to the Board, on a regular basis, against the achievement of objects included in the Strategic Plan 2015–2018. Reporting also includes the progress of principal activities and reporting of risks and opportunities.

64 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

FINANCIAL PERFORMANCE 5. MEMBERS GUARANTEE In accordance with Health Network NT’s Constitution, each member is liable to contribute $50 in the event that the company is wound up.

6. AUDITOR’S INDEPENDENCE DECLARATION The Auditor’s independence declaration is set out on page 44 and forms part of the Directors’ report for the financial year ended 30 June 2016. Signed in accordance with a resolution of the Board of Directors:

Dr Andrew Bell Director and Chair, Health Network Northern Territory Ltd Dated at Darwin this 26th day of September 2016

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 65

The Statement of Comprehensive Income is to be read in conjunction with the attached notes.

Statement of Financial Position As at 30 June 2016

NOTE

2016 $

2015 $

Cash and cash equivalents

11

12,952,538

10,899,700

Trade and other receivables

12

388,435

1,626,731

Other current assets

13

244,351

169,448

13,585,324

12,695,879

12,708

25,413

12,708

25,413

13,598,032

12,721,292

ASSETS

Total current assets Property, plant and equipment

14

Total non-current assets Total assets LIABILITIES Trade and other payables

15

3,417,687

5,115,201

Employee provisions

16

637,935

698,966

Associate Members Trust Fund

17

793,115

879,352

4,848,737

6,693,519

105,541

89,067

10,353

-

115,894

89,067

Total liabilities

4,964,631

6,782,586

Net assets

8,633,401

5,938,706

1,912,511

2,039,601

6,616,095

3,899,105

104,795

-

8,633,401

5,938,706

Total current liabilities Employee provisions Other non-current liabilities Total non-current liabilities

16

EQUITY Retained surplus Reserves: Unexpended Grants Reserves Strategic Initiatives Reserves Total equity attributable to members of the Company

66 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

The Statement of Comprehensive Income is to be read in conjunction with the attached notes.

FINANCIAL PERFORMANCE

Statement of Comprehensive Income For the year ended June 2016

NOTE

2016 $

2015 $

Grant income

4

37,785,655

30,371,805

Non-grant income

4

1,181,009

1,135,779

Interest income

10

258,232

396,794

39,224,896

31,904,378

REVENUE

Total Revenue OPERATING EXPENSES Employee expenses

5

(10,743,414)

(10,252,886)

Governance expenses

6

(352,104)

(368,276)

Rent and occupancy expenses

7

(791,265)

(809,640)

Depreciation

14

(12,705)

(15,987)

Administration expenses

8

(1,925,606)

(1,082,635)

Direct program expenses

9

(22,705,107)

(20,951,878)

(36,530,201)

(33,481,302)

2,694,695

(1,576,924)

-

-

2,694,695

(1,576,924)

Total Expenditure Net Income (Deficit) for the period Other comprehensive income Total comprehensive income / (loss) for the period

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 67

The Statement of Comprehensive Income is to be read in conjunction with the attached notes.

Statement of Changes in Equity For the year ended 30 June 2016 RESERVES

Balance at 1 July 2014

UNEXPENDED FUNDS RESERVE

STRATEGIC INITIATIVES RESERVES

RETAINED EARNINGS

TOTAL

$

$

$

$

5,644,763

-

1,870,867

7,515,630

Net Deficit for the period

-

-

(1,576,924)

(1,576,924)

Other comprehensive income

-

-

-

-

Total comprehensive income for the period

-

-

(1,576,924)

(1,576,924)

Current year grants remained unexpended during the year

2,173,482

-

(2,173,482)

-

Unexpended grants returned to funding body

(256,425)

-

256,425

-

Prior year unexpended grants expended in the current year

(3,662,715)

-

3,662,715

-

Total transactions with members

(1,745,658)

1,745,658

-

TRANSACTIONS WITH MEMBERS IN THEIR CAPACITY AS OWNERS

Balance at 30 June 2015

3,899,105

-

2,039,601

5,938,706

Balance at 1 July 2015

3,899,105

-

2,039,601

5,938,706

Net Income for the period

-

-

2,694,695

2,694,695

Other comprehensive income

-

-

-

-

Total comprehensive income for the period

-

-

2,694,695

2,694,695

Transfer to strategic initiatives reserves from retained earnings

-

150,000

(150,000)

-

Redistribution to retained earnings

-

(45,205)

45,205

-

Current year grants remained unexpended during the year

6,616,095

-

(6,616,095)

-

Unexpended grants returned to funding body

(685,977)

-

685,977

-

(3,213,128)

-

3,213,128

-

Total transactions with members

2,716,990

104,795

(2,821,785)

-

Balance at 30 June 2016

6,616,095

104,795

1,912,511

8,633,401

TRANSACTIONS WITH MEMBERS IN THEIR CAPACITY AS OWNERS

Prior year unexpended grants expended in the current year

68 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

The Statement of Comprehensive Income is to be read in conjunction with the attached notes.

FINANCIAL PERFORMANCE

Statement of Cash Flows For the year ended 30 June 2016

NOTE

2016

2015

$

$

CASH FLOWS FROM OPERATING ACTIVITIES Cash receipts from: Customers

791,795

2,132,631

39,023,951

29,751,663

258,232

396,794

Employees

(10,718,207)

(10,059,302)

Suppliers

(27,302,933)

(25,025,819)

2,052,838

(2,804,033)

Proceeds on sale of property, plant and equipment

-

5,001

Net cash (used in)/from investing activities

-

5,001

2,052,838

(2,799,032)

10,899,700

13,698,732

12,952,538

10,899,700

Funding bodies Interest received Cash payments to:

Net cash from/(used in) operating activities

20b

CASH FLOWS FROM INVESTING ACTIVITIES

Net increase (decrease) in cash and cash equivalents Cash and cash equivalents at 1 July Cash and cash equivalents at 30 June

20a

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 69

Notes to the Financial Statements 1. CORPORATE INFORMATION Health Network NT was established as a not-for-profit public company limited by guarantee under the Corporations Act 2001 (Cth) on 1 July 2012. Health Network NT has currently three Members which include the Health Providers Alliance Northern Territory Incorporated (‘Health Providers Alliance NT’, formerly Associate Membership Committee), the Northern Territory Department of Health (‘DoH’) and the Aboriginal Medical Services Alliance of the Northern Territory (‘AMSANT’). Health Network NT, trading as Northern Territory PHN, is primarily involved in health service delivery and health outcomes in the Northern Territory and is one of 31 Primary Health Networks established Australiawide by the Australian Government Department of Health. Health Network NT also includes the Northern Territory Rural Workforce Agency as an operational branch. Health Network NT’s registered office was Stuart House, 5 Shepherd Street, Darwin, NT 0800.

2. BASIS OF PREPARATION (a) Statement of compliance The financial report is a general purpose financial report which has been prepared in accordance with Australian Accounting Standards (AASBs) (including Australian Interpretations and Accounting Interpretations) adopted by the Australian Accounting Standards Board (AASB) and the Corporations Act 2001 (Cth). Accounting policies are selected and applied in a manner which ensures that the resulting financial information satisfies the concepts of relevance and reliability, thereby ensuring that the substance of the underlying transaction or other events is reported. Material accounting policies adopted in the preparation of this financial report are presented below and have been consistently applied unless otherwise stated. The financial statements are for the financial year 1 July 2015 to 30 June 2016 and were authorised for issue by the Board of Directors on 26 September 2016. (b) Basis of measurement The financial statements have been prepared on the historical cost basis except as otherwise stated. (c) Functional and presentation currency The financial statements are presented in Australian dollars, which is Health Network NT’s functional currency. (d) Use of estimates and judgments The preparation of financial statements in conformity with AASBs requires the management to make judgments, estimates and assumptions that affect the application of accounting policies and the reported amounts of assets and liabilities, income and expenses. Actual results may differ from these estimates. Estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised and in any future periods affected. Information about critical judgments in applying accounting policies and in preparing this financial report that have the most significant effect on the amounts have been recognised in the financial statements as appropriate. (e) New and Revised Accounting Standards Adoption of New Australian Accounting Standard Requirements No accounting standard has been adopted earlier than the applicable dates as stated in each standard. New standards/revised standards/interpretations/amending standards issued prior to the sign-off date applicable to the current reporting period did not have a financial impact on Health Network NT and are not expected to have future financial impact on Health Network NT.

70 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

FINANCIAL PERFORMANCE

Future Australian Accounting Standard Requirements The following new standards/revised standards/Interpretations/amending standards were issued by the Australian Accounting Standards Board prior to the sign-off date. The financial impact on Health Network NT for future reporting periods is not yet determinable at this stage: Operative date AASB 9

Financial Instruments - December 2014

1 Jan 2017

AASB 15

Revenue from Contracts with Customers – December 2014 (Principal)

1 Jan 2017

AASB 16

Leases

1 Jan 2017

AASB 2015–1

Amendments to Australian Accounting Standards – Annual Improvements to Australian Accounting Standards 2012–2014 Cycle [AASB 1, AASB 2, AASB 3, AASB 5, AASB 7, AASB 11, AASB 110, AASB 119, AASB 121, AASB 133, AASB 134, AASB 137 & AASB 140]

1 Jan 2016

AASB 2015–2

Amendments to Australian Accounting Standards – Disclosure Initiative: Amendments to AASB 101 [AASB 7, AASB 101, AASB 134 & AASB 1049]

1 Jan 2016

3. SIGNIFICANT ACCOUNTING POLICIES (a) Revenue (i) Grant revenue Non-reciprocal grants, donations and other contributions are recognised as revenues when Health Network NT obtains control over, or the right to receive the assets, it is probable that future economic benefits comprising the asset will flow to Health Network NT, and the amount can be reliably measured. Control over granted and contributed assets is normally obtained upon their receipt and is valued at their fair value at the date of transfer. Where grants, contributions and donations recognised as revenue during the reporting period were obtained on the condition that they be expended in a particular manner or used over a particular period, and those conditions were undischarged as at the reporting date, the nature of and amounts pertaining to those undischarged conditions are disclosed. (b) Financial Instruments (i) Non-derivative financial assets Health Network NT initially recognises loans, receivables and deposits on the date that they are originated. All other financial assets (including assets designated at fair value through profit or loss) are recognised initially on the trade date at which Health Network NT becomes a party to the contractual provisions of the instrument. Health Network NT derecognises a financial asset when the contractual rights to the cash flows from the asset expire, or it transfers the rights to receive the contractual cash flows on the financial asset in a transaction in which substantially all the risks and rewards of ownership of the financial asset are transferred. Any interest in transferred financial assets that is created or retained by Health Network NT is recognised as a separate asset or liability.

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 71

Financial assets and liabilities are offset and the net amount presented in the statement of financial position when, and only when, Health Network NT has a legal right to offset the amounts and intends either to settle on a net basis or to realise the asset and settle the liability simultaneously. Non-derivative financial assets comprise trade and other receivables, and cash and cash equivalents. Non-derivative financial assets are recognised initially at fair value plus, for assets not at fair value through profit or loss, any directly attributable transaction costs. (ii) Non-derivative financial liabilities Health Network NT initially recognises debt securities issued and subordinated liabilities on the date that they are originated. All other financial liabilities (including liabilities designated at fair value through profit or loss) are recognised initially on the trade date at which Health Network NT becomes a party to the contractual provisions of the instrument. Health Network NT derecognises a financial liability when its contractual obligations are discharged or cancelled or expire. Financial assets and liabilities are offset and the net amount presented in the statement of financial position when, and only when, Health Network NT has a legal right to offset the amounts and intends either to settle on a net basis or to realize the asset and settle the liability simultaneously. Health Network NT has the following non-derivative financial liabilities: trade and other payables. Such financial liabilities are recognised initially at fair value plus any directly attributable transaction costs. Subsequent to initial recognition these financial liabilities are measured at amortised cost using the effective interest rate method. (c) Property, plant and equipment (i) Recognition and measurement Items of property, plant and equipment are initially measured at cost. Subsequent to initial recognition, items of property, plant and equipment are measured at fair value less accumulated depreciation and accumulated impairment losses. Cost includes expenditures that are directly attributable to the acquisition of the asset. Purchased software that is integral to the functionality of the related equipment is capitalised as part of that equipment. Property, plant and equipment that has been contributed at no cost or for nominal cost is valued at the fair value of the asset at the date of its acquisition. (ii) Asset Capitalisation policy Health Network NT is a Health Promotion Charity receiving Government Grants to deliver services. According to Government Grant contracts and as guided by the Commonwealth of Australia, only approved asset purchases worth $10,000 (exclusive of GST) and over can be included in Government Acquittal reports and in their respective asset registers. In order to sustain a consistent and practical approach, Health Network NT has opted to only capitalise assets worth $10,000 and above. (iii) Subsequent costs The cost of replacing part of an item of property, plant and equipment is recognised in the carrying amount of the item if it is probable that the future economic benefits embodied within the part will flow to Health Network NT and its cost can be measured reliably. The carrying amount of the replaced part is derecognised. The costs of the day-to-day servicing of property, plant and equipment are recognised in profit or loss as incurred. (iv) Depreciation Depreciation is calculated over the depreciable amount, which is the cost of an asset, or other amount substituted as cost, less its residual value.

72 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

FINANCIAL PERFORMANCE

Depreciation is recognised in profit or loss on a straight-line basis over the estimated useful lives of each part of an item of property, plant and equipment, since this most closely reflects the expected pattern of consumption of the future economic benefits embodied in the asset. Leased assets are depreciated over the shorter of the lease term and their useful lives unless it is reasonably certain that Health Network NT will obtain ownership by the end of the lease term. Where an asset is acquired by direct Government grant funding and it has not been fully depreciated, at the end of the associated program, direction is sought from the Government to use the asset or sale proceeds to benefit a complementary or similar program. The depreciation rates used for each class of depreciable assets are: Computer, Training & Video Equipment (excl. Laptops)

20%

Motor Vehicles 20% Furniture, Fixture & Office Equipment

20%

Depreciation methods, useful lives and residual values are reviewed at each financial year-end and adjusted if appropriate. (d) Leased assets Leases in terms of which Health Network NT assumes substantially all the risks and rewards of ownership are classified as finance leases. Upon initial recognition the leased asset is measured at an amount equal to the lower of its fair value and the present value of the minimum lease payments. Subsequent to initial recognition, the asset is accounted for in accordance with the accounting policy applicable to that asset. Other leases are operating leases and as such are not recognised in Health Network NT’s statement of financial position. (e) Impairment (i) Financial assets (including receivables) A financial asset is assessed at each reporting date to determine whether there is objective evidence that it is impaired. A financial asset is impaired if objective evidence indicates that a loss event has occurred after the initial recognition of the asset, and that the loss event had a negative effect on the estimated future cash flows of that asset that can be estimated reliably. Objective evidence that financial assets (including equity securities) are impaired can include default or delinquency by a debtor, restructuring of an amount due to Health Network NT on terms that Health Network NT would not consider otherwise, indications that a debtor or issuer will enter bankruptcy, the disappearance of an active market for a security. Health Network NT considers evidence of impairment of receivables at both a specific asset and collective level. All individually significant receivables are assessed for specific impairment. All individually significant receivables found not to be specifically impaired are then collectively assessed for any impairment that has been incurred but not yet identified. Receivables that are not individually significant are collectively assessed for impairment by grouping together receivables with similar risk characteristics. In assessing collective impairment Health Network NT uses historical trends of the probability of default, timing of recoveries and the amount of loss incurred, adjusted for management’s judgment as to whether current economic and credit conditions are such that the actual losses are likely to be greater or less than suggested by historical trends. An impairment loss in respect of a financial asset measured at amortised cost is calculated as the difference between its carrying amount and the present value of the estimated future cash flows discounted at the original effective interest rate. Losses are recognised in profit or loss and reflected in an allowance account against receivables. Interest on the impaired asset continues to be recognised through the unwinding of the

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 73

discount. When a subsequent event causes the amount of impairment loss to decrease, the decrease in impairment loss is reversed through profit or loss. (ii) Non-financial assets The carrying amounts of Health Network NT’s non-financial assets are reviewed at each reporting date to determine whether there is any indication of impairment. If any such indication exists then the asset’s recoverable amount is estimated. The recoverable amount of an asset is the greater of its value in use and its fair value less costs to sell. In assessing value in use, the estimated future cash flows are discounted to their present value using a pre-tax discount rate that reflects current market assessments of the time value of money and the risks specific to the asset. For the purpose of impairment testing, assets that cannot be tested individually are grouped together into the smallest group of assets that generate cash inflows from continuing use that are largely independent of the cash inflows of other assets. An impairment loss is recognised if the carrying amount of an asset exceeds its recoverable amount. Impairment losses are recognised in profit or loss. In respect of other assets, impairment losses recognised in prior periods are assessed at each reporting date for any indications that the loss has decreased or no longer exists. An impairment loss is reversed if there has been a change in the estimates used to determine the recoverable amount. An impairment loss is reversed only to the extent that the asset’s carrying amount does not exceed the carrying amount that would have been determined, net of depreciation or amortisation, if no impairment loss had been recognised. (f) Employee Benefits (i) Long-term employee benefits Health Network NT’s net obligation in respect of long-term employee benefits is the amount of future benefit that employees have earned in return for their service in the current and prior periods plus related on-costs; that benefit is discounted to determine its present value, and the fair value of any related assets is deducted. (ii) Short-term benefits Liabilities for employee benefits for wages, salaries, annual leave and long-service leave represent present obligations resulting from employees’ services provided to reporting date and are calculated at undiscounted amounts based on remuneration wage and salary rates that Health Network NT expects to pay as at reporting date including related on-costs, such as workers’ compensation insurance. Contributions are made by Health Network NT to an employee superannuation fund and are charged as expenses when incurred. (g) Goods and Services Tax Revenue, expenses and assets are recognised net of the amount of goods and services tax (GST), except where the amount of GST incurred is not recoverable from the taxation authority. In these circumstances, the GST is recognised as part of the cost of acquisition of the asset or as part of the expense. Receivables and payables are stated with the amount of GST included. The net amount of GST recoverable from, or payable to, the ATO is included as a current asset or liability in the balance sheet. Cash flows are included in the statement of cash flows on a gross basis. The GST components of cash flows arising from investing and financing activities which are recoverable from, or payable to, the ATO are classified as operating cash flows.

74 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

FINANCIAL PERFORMANCE

(h) Reserves Health Network NT maintains reserves that are funded by cash and investments. The fund reserves are as follows: Unexpended Grants Reserves Health Network NT receives grant monies to fund programs either for contracted periods of time or for specific programs irrespective of the time period required to complete those programs. It is the policy of Health Network NT to present grant monies separately as a reserve where the company is contractually obliged to provide the services in a subsequent financial period to when the grant is received or in the case of specific programs, where the program has not been completed. The recognition treatment of grant monies is consistent with the requirements of AASB 1004 Contributions. Strategic Initiatives Reserves This reserve is used to record funds set aside for the sponsorship and business development program that will be undertaken by Health Network NT in the future. (i) Provisions A provision is recognised if, as a result of a past event, Health Network NT has a present legal or constructive obligation that can be estimated reliably, and it is probable that an outflow of economic benefits will be required to settle the obligation. Provisions are determined by discounting the expected future cash flows at pre-tax rate that reflects current market assessments of the time value of money and the risks specific to the liability. The unwinding of the discount is recognised as finance cost. (j) Income Tax No provision for income tax has been raised as Health Network NT is exempt from income tax under Division 50 of the Income Tax Assessment Act 1997. (k) Payroll Tax No provision for payroll tax has been raised as Health Network NT is exempt from payroll tax under the Payroll Tax Act effective from 1 July 2012. (l) Fringe Benefits Tax Health Network NT is a partially exempt employer for fringe benefits provided up to a specified amount per employee under Section 57A of the Fringe Benefits Tax Assessment Act 1986. No provision for fringe benefits tax has been raised as any tax incurred is required to be immediately paid by the employee for whom the fringe benefits tax debt is incurred. (m) Prohibition upon distribution of income, profits and assets Upon winding up of Health Network NT, after paying of all liabilities of Health Network NT, the surplus assets: (i) Shall not be divided amongst Members; but (ii) Shall, upon special resolution of the members, be paid or transferred to another incorporated or unincorporated organisation, having similar objects to Health Network NT. If the Members are unable to pass a resolution, then the surplus assets are to be paid or transferred on the direction of the Supreme Court of the Northern Territory, on application of Health Network NT or any Member. (n) Determination of fair values (i) Trade and other receivables The fair value of trade and other receivables is estimated as the present value of future cash flows, discounted at the market rate of interest at the reporting date. This fair value is determined for disclosure purposes.

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 75

(ii) Non-derivative financial liabilities Fair value, which is determined for disclosure purposes, is calculated based on the present value of future principle and interest cash flows, discounted at the market rate of interest at the reporting date. (iii) Property, plant and equipment The fair value of property, plant and equipment is based on market prices for similar items at the reporting date. (o) Financial risk management Health Network NT has minimal exposure to the following risks from their use of financial instruments: • Credit risk • Liquidity risk • Market risk This note presents information about Health Network NT’s exposure to each of the above risks, their objectives, policies and processes for measuring and managing risk. The Board of Directors has overall responsibility for the establishment and oversight of the risk management framework. Risk management policies and systems are set to identify and analyse the risks faced by Health Network NT, to set appropriate risk limits and controls, and to monitor risks and adherence to limits. (i) Credit risk Credit risk is the risk of financial loss to Health Network NT if a customer or counterparty to a financial instrument fails to meet its contractual obligations, and arises principally from the Company’s receivables from customers. (ii) Trade and other receivables Health Network NT’s exposure to credit risk is influenced mainly by the individual characteristics of each customer. Approximately 96 per cent of Health Network NT’s revenue is attributable to Government Grants and hence credit risk is low and trade receivables are deemed to be recoverable. Health Network NT’s other receivables relate mainly to non-governmental organisations which are also funded by both the State and Commonwealth Government and hence the credit risk is low and other trade receivables are deemed to be recoverable. (iii) Liquidity risk Liquidity risk is the risk that Health Network NT will encounter difficulty in meeting the obligations associated with its financial liabilities that are settled by delivering cash or another financial asset. The Directors’ approach to managing liquidity is to ensure, as far as possible, that it will always have sufficient liquidity to meet its liabilities when due, under both normal and stressed conditions, without incurring unacceptable losses or risking damage to Health Network NT’s reputation. Health Network NT Board are of the view that sufficient funds have been arranged, via member contributions, to meet its liabilities when due in the event of Health Network NT winding up its operations by 30 June 2016. (iv) Market risk Market risk is the risk that changes in market prices will affect Health Network NT’s income or the value of its holdings of financial instruments. The objective of market risk management is to manage and control market risk exposures within acceptable parameters, while optimising the return. Health Network NT does not enter into derivatives and has no exposures to currency risk and neither is anticipated. Management’s policy is to review their investment strategy to balance interest returns and liquidity issues.

76 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

FINANCIAL PERFORMANCE

4. GRANT INCOME 2016

2015

$

$

35,755,682

29,070,312

611,694

239,316

1,418,279

1,062,177

37,785,655

30,371,805

33,682

43,968

-

109

Sponsorship income

6,955

6,500

Insurance recoveries

10,295

15,694

314,310

96,933

Conference registration fees

24,696

21,202

Conference sponsorship

70,000

63,545

Underspend recovery from contractors

41,771

71,611

679,300

815,865

-

352

1,181,009

1,135,779

38,966,664

31,507,584

CURRENT YEAR GRANTS Department of Health NT Department of Health Other Grants Total Grant Income NON-GRANT INCOME Course and training fees Publication and book sales

Program administration

Other program income Profit on disposal of assets

Total Income

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 77

5. EMPLOYEE EXPENSES

Salaries and wages

2016

2015

$

$

7,635,951

7,354,468

686,618

670,622

Entitlement expenses

65,648

319,034

Recruitment expenses

209,952

64,920

Training and conference expenses

126,335

160,179

35,620

56,528

274,874

152,667

1,708,416

1,474,468

10,743,414

10,252,886

31,023

103,233

196,296

169,856

Director meetings, travel and training

59,554

36,908

Committee expenses

65,231

58,279

352,104

368,276

Superannuation

Staff work cover expenses Temporary agency employment expenses Travel and accommodation

6. GOVERNANCE EXPENSES Corporate conferences and Governance workshops Directors stipends remuneration

7. RENT AND OCCUPANCY EXPENSES Property rent

567,070

528,099

Property maintenance, cleaning and security

139,087

182,389

90,990

99,152

797,147

809,640

2016

2015

$

$

Electricity

8. ADMINISTRATION EXPENSES

COMPUTER AND IT EXPENSES Software expenses

96,657

133,531

IT subcontractors

33,272

9,655

Internet/Network connection

45,048

41,905

Database and website expenses

97,253

74,406

318,495

182,143

590,725

441,640

Cloud - IT expense

78 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

8. ADMINISTRATION EXPENSES cont. 2016

2015

$

$

FINANCIAL PERFORMANCE

COMMUNICATION EXPENSES Land and mobile telephones

80,650

102,059

Telecom expenses - VOIP

10,511

10,839

Data services and communication

8,402

10,186

Teleconferencing and videoconferencing

3,666

4,033

103,229

127,117

69,122

75,739

69,122

75,739

44,370

52,742

Fuel and oil

3,742

13,483

Repairs and maintenance

8,995

19,068

-

324

4,350

5,405

61,457

91,022

4,240

4,249

230,590

-

Advertising and Publication

81,840

30,895

Audit fees

60,000

60,000

342,335

-

Legal fees

77,960

26,583

Licensing, membership and subscription fees

56,804

14,631

Stationery, printing and office supplies

56,263

84,003

Postage and couriers

30,902

25,974

Staff meetings and amenities

10,297

14,384

Storage and archiving

21,377

11,579

7,768

6,980

Equipment hire

36,674

29,249

Sponsorship

35,454

20,000

Loss on disposal of assets

-

10,507

Sundry expenses

-

70

42,687

8,013

1,095,191

347,117

1,925,606

1,082,635

INSURANCE Australian General Practice Network policy

MOTOR VEHICLE EXPENSES Operational lease expenses

Registration expenses Mileage employee reimbursement

GENERAL EXPENSES Bank fees Needs Assessment and Evaluation

Business contractors and consultants

Parking fees

Other administration expenses

Total administration expenses

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 79

9. DIRECT PROGRAM EXPENSES 2016

2015

$

$

Program resource development

212,251

460,087

Program events and meetings

523,326

1,118,174

20,080,637

18,398,799

Program subsidy and grants

789,928

174,363

Other direct program expenses

384,582

386,296

Funds returned to funding body

714,383

414,159

22,705,107

20,951,878

258,232

396,794

Program contractors and consultants

10. FINANCIAL INCOME Interest income on bank deposits

11. CASH AND CASH EQUIVALENTS Cash at bank

12,025,923

9,886,848

793,115

879,352

Cash on hand - Darwin

500

500

Cash on hand - Alice Springs

500

500

32,500

32,500

100,000

100,000

12,952,538

10,899,700

Cash at bank - Health Providers Alliance NT Funds

Bank Guarantee Deposit - McLachlan Street Bank Guarantee Deposit - Credit card limit

12. TRADE AND OTHER RECEIVABLES Trade receivables

388,435

1,626,731

388,435

1,626,731

9,297

9,297

24,519

43,599

1,455

1,377

209,080

115,175

244,351

169,448

13. OTHER CURRENT ASSETS Deposits and bonds paid Net GST paid Accrued income Other prepayments

80 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

FINANCIAL PERFORMANCE

14. PROPERTY, PLANT AND EQUIPMENT COMPUTER EQUIPMENT

MOTOR VEHICLES

FURNITURE, CLINIC AND OFFICE EQUIPMENT

TOTAL

$

$

$

$

COST Balance at 1 July 2014, at cost

59,924

11,620

22,716

94,260

Additions

-

-

-

-

Disposed

(1,841)

(11,620)

(17,263)

(30,724)

Balance at 30 June 2015, at cost

58,083

-

5,453

63,536

Balance at 1 July 2015, at cost

58,083

-

5,453

63,536

Additions

-

-

-

-

Disposals

-

-

-

-

58,083

-

5,453

63,536

Balance at 1 July 2014

(23,970)

(4,648)

(9,084)

(37,702)

Depreciation charge for the year

(11,709)

(2,324)

(1,954)

(15,987)

829

6,972

7,765

15,566

Balance at 30 June 2015

(34,850)

-

(3,273)

(38,123)

Balance at 1 July 2015

(34,850)

-

(3,273)

(38,123)

Depreciation charge for the year

(11,616)

-

(1,089)

(12,705)

-

-

-

-

(46,466)

-

(4,362)

(50,828)

At 1 July 2015

23,233

-

2,180

25,413

At 30 June 2016

11,617

-

1,091

12,708

Balance at 30 June 2016, at cost DEPRECIATION AND IMPAIRMENT LOSSES

Disposals

Disposals Balance at 30 June 2016 CARRYING AMOUNTS

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 81

15. TRADE AND OTHER PAYABLES 2016

2015

$

$

CURRENT Trade payables

1,141,730

2,868,057

Other current payables

1,420,489

1,589,124

Workforce candidate grants payables

508,208

330,463

Employee accruals

265,733

189,967

PAYG withholding

21,601

118,793

3,631

-

54,458

16,592

1,837

2,205

3,417,687

5,115,201

2,678

-

578,541

663,062

5,484

6,544

51,232

29,360

637,935

698,966

105,541

89,067

105,541

89,067

Superannuation payable Grants returnable PAYG payable

16. EMPLOYEE PROVISIONS CURRENT Liability for Centrelink maternity entitlement Liability for annual leave Liability for sick leave Liability for long service leave - current

NON-CURRENT Liability for long service leave – non-current

17. HEALTH PROVIDERS ALLIANCE NT TRUST FUND Health Providers Alliance NT (These are monies held in trust on behalf of the Health Providers Alliance NT and are not available for other purposes of Health Network NT)

82 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

793,115

879,352

793,115

879,352

FINANCIAL PERFORMANCE

18. OPERATING LEASES 2016

2015

$

$

NON-CANCELLABLE OPERATING PROPERTY LEASE 5 Shepherd Street Less than one year

129,558

366,800

-

30,567

84,612

-

303,194

-

51,468

119,844

-

44,942

Less than one year

-

2,356

Between one and five years

-

-

568,832

564,509

Between one and five years 5 Skinner Street Less than one year Between one and five years 34-36 McLachlan Street Less than one year Between one and five years Motor Vehicles

19. RELATED PARTY TRANSACTIONS Transactions between related parties are on normal commercial terms and conditions no more favourable than those available to other persons unless otherwise stated. During the year ended 30 June 2016 the total fees paid to Directors amounted to $196,296 (2015: $169,856). Key Management Remuneration Health Network NT's Senior Executive Leadership Team consists of the following persons as at 30 June 2016: • Nicola Herriot - CHIEF EXECUTIVE OFFICER; • Ram Naik - CHIEF FINANCIAL OFFICER; • Le Smith - EXECUTIVE MANAGER HEALTH PROGRAMS; • Susi Wise - EXECUTIVE MANAGER NORTHERN TERRITORY HEALTH WORKFORCE; • Shari Tanzer - EXECUTIVE MANAGER CORPORATE; AND • Greg Henschke - EXECUTIVE MANAGER PLANNING AND PARTNERSHIPS. Total remuneration of $1,219,790 was paid to key management personnel for the year ended 30 June 2016.

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 83

20. a. CASH AND CASH EQUIVALENTS

Bank balances Health Providers Alliance NT Bank balances Cash on hand Bank guarantee deposit - McLachlan Street Bank guarantee deposit - Credit card limit Cash and cash equivalents in the statement of cash flows

2016

2015

$

$

12,025,923

9,886,848

793,115

879,352

1,000

1,000

32,500

32,500

100,000

100,000

12,952,538

10,899,700

20. b. RECONCILIATION OF CASH FLOWS FROM OPERATING ACTIVITIES CASH FLOWS FROM OPERATING ACTIVITIES Surplus/(Deficit) for the period

2,694,695

(1,576,924)

-

10,155

12,705

15,987

(44,557)

170,399

2,662,843

(1,380,383)

1,163,393

(471,884)

(1,773,398)

(951,766)

2,052,838

(2,804,033)

Adjustments for: Loss/(Gain) on disposals of property and equipment Depreciation Provision for Employee Entitlements

CHANGES IN ASSETS AND LIABILITIES: Change in trade and other receivables Change in trade and other payables Net Cash inflow generated from/(used in) operating activities

84 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

FINANCIAL PERFORMANCE

21. FINANCIAL INSTRUMENTS Credit risk Health Network NT does not have any material credit risk exposure to any single receivable or group of receivables under financial instruments entered into by the entity as most of its receivables are due from Government departments. Impairment losses The ageing of Health Network NT’s receivables at the reporting date was:

Less than 30 days

GROSS

IMPAIRMENT

GROSS

IMPAIRMENT

2016

2016

2015

2015

$

$

$

$

349,733

-

1,517,930

-

31–60 days

22,202

-

81,521

-

Greater than 60 days

16,500

-

27,280

-

388,435

-

1,626,731

-

Liquidity risk Health Network NT manages liquidity risk by monitoring bank balances and monitoring grant payments as per grant schedules, by ensuring the grant payments are made on time and there are sufficient funds in the bank. The following are the contractual maturities of financial liabilities, including estimated interest payments and excluding the impact of netting agreements: CARRYING AMOUNTS

CONTRACTUAL CASH FLOW

6 MONTHS OR LESS

$

$

$

Trade and other payables

1,461,921

(1,461,921)

(1,461,921)

Other current payables

1,932,329

(1,932,329)

(1,932,329)

23,438

(23,438)

(23,438)

3,417,688

(3,417,688)

(3,417,688)

PAYG payables

Price risk Health Network NT is not exposed to any material commodity risk. Foreign currency risk Health Network NT is not exposed to any material foreign currency risk.

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 85

Fair values The carrying amount of receivables, cash at bank, and creditors approximate their fair value due to their short term nature. The different levels of the fair value hierarchy are defined below: Level 1: Quoted prices (unadjusted) in active markets for identical assets or liabilities that the entity can access at measurement date Level 2: Inputs other than quoted prices included within Level 1 that are observable for the assets or liability, either directly or indirectly Level 3: Unobservable inputs for the asset or liability Health Network NT determines fair value for its non-financial assets using the level 2 and 3 inputs in the fair value hierarchy. The table discloses the fair value at 30 June 2016 and the valuation techniques used to derive its fair value: Fair value measurement - Valuation technique and Input Used for Non-financial Assets ASSET CLASS Plant and equipment

Computer equipment

FAIR VALUE $

CATEGORY

2,180

23,233

VALUATION TECHNIQUE

INPUT USED & RANGE

Level 3

Depreciated replacement cost

Remaining useful lives of 3 to 4 years. Replacement cost based on comparable price of modern equivalents.

Level 3

Depreciated replacement cost

Remaining useful lives of 3 to 4 years. Replacement cost based on comparable price of modern equivalent.

22. MEMBERS’ GUARANTEE Health Network NT is incorporated under the Corporations Act 2001 and is an entity limited by guarantee. If Health Network NT wound up, the constitution states that each member is required to contribute a maximum of $50 each towards meeting any outstanding obligations of the entity. At 30 June 2016 the number of members was three.

23. BUSINESS OVERHEADS EXPENDITURE In order to meet the business overheads expenditure, during the year, Health Network NT charged a total of $2,670,303 (2015: $2,869,494) in business overheads recovery expenditure against the grant income, which was eliminated during reconciliation against the operational statements.

86 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

FINANCIAL PERFORMANCE

24. AUDITOR’S REMUNERATION 2016

2015

$

$

Audit and review of annual financial statements

22,500

20,500

Audit of Special Purpose Reports for Funding Acquittals

37,500

39,500

60,000

60,000

AUDIT SERVICES Auditors of Health Network NT Merit Partners Darwin:

25. EVENTS SUBSEQUENT TO REPORTING DATE There are no events subsequent to balance sheet date.

26. CONTINGENT LIABILITIES AND CONTINGENT ASSETS The Directors are not aware of any contingent liability that may become payable. Health Network NT has no contingent assets.

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 87

Directors’ Declaration In the opinion of the directors of Health Network NT: (a) the financial statements and notes, set out on pages 19 to 42, are in accordance with the C orporations Act 2001, including: (i) giving a true and fair view of Health Network NT’s financial position as at 30 June 2016 and of its p erformance, for the financial year ended on that date; and (ii) complying with Australian Accounting Standards and the Corporations Regulations 2001; and (b) there are reasonable grounds to believe that Health Network NT will be able to pay its debts as and w hen they become due and payable.

Signed in accordance with a resolution of the Board of Directors:

Dr Andrew Bell Director and Chair, Health Network Northern Territory Ltd Dated at Darwin this 26th day of September 2016

88 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 89

90 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016 | 91

Appendix: Northern Territory Map Northern Territory PHN covers the whole of the NT

MANINGRIDA GUNBALANYA

DARWIN

MILINGIMBI

NHULUNBUY

RAMINGINING GAPUWIYAK

Darwin

BATCHELOR

YIRRKALA

East Arnhem UMBAKUMBA (GROOTE EYLANDT) NUMBULWAR

KATHERINE NGUKURR

Katherine

BORROLOOLA

LAJAMANU

Barkly TENNANT CREEK WILLOWRA

YUENDUMU

TI TREE

ALPURRURULUM (LAKE NASH) ALI CURUNG

UTOPIA

HERMANNSBURG (NTARIA) KINTORE

DOCKER RIVER

ALICE SPRINGS AREYONGA

MUTITJULU

92 | NORTHERN TERRITORY PHN: ANNUAL REPORT 2015–2016

SANTA TERESA

Alice Springs FINKE

Health Network Northern Territory Ltd operating as Northern Territory PHN

Darwin

Alice Springs

GPO Box 2562 Darwin NT 0801

PO Box 1195 Alice Springs NT 0870

23 Albatross Street Winnellie NT 0820

Remote Health Precinct 5 Skinner Street Alice Springs NT 0870

t 08 8982 1000 f 08 8981 5899

t 08 8950 4800 f 08 8952 3536

e [email protected] • w ntphn.org.au • ABN 17 158 970 480

We value: Relationships • Equity • Responsiveness • Innovation • Results