PCD Strategy Evaluation 2007.pdf - NT Health Digital Library ...
PCD Strategy Evaluation 2007.pdf - NT Health Digital Library ... PCD Strategy Evaluation 2007.pdf - NT Health Digital Library ...
from the Department of Health and Ageing in June 2007 revealed that the number of accreditedpractices in the NT had increased from 27 in 2001-2002 to 31 between 2005-06.In the regional health zones in Central Australia the revenue raised through Medicare ismonitored and transferred back to communities. A similar transparent process is not in place forother NTDH&CS clinics and as such there is no incentive for the local team to be more diligent incompleting chronic disease activities to claim EPC items.S100 Scheme.During 1999-2000 the PCDS became part of the core business of the then, Territory HealthServices. As a priority project it received $928,000 in new funds, supplemented with fundsredirected from primary health care and public health (77) . However, ongoing sources of externalfunding were required in order to progress the strategy and develop new services within thatframework. This came about through a novel application of the Section 100 (S100) scheme.S100 of the National Health Act was originally intended to allow the Australian Government toprovide medications outside the normal mechanisms of the Pharmaceutical Benefits Scheme(PBS). Under S100, the Commonwealth Minister may make special arrangements so that anadequate supply of special pharmaceutical products are available to persons who are living inisolated areas; or who are receiving medical treatment in such circumstances that pharmaceuticalbenefits cannot be conveniently or efficiently supplied or are inadequate for that medicaltreatment.In 1999, the Federal Minister for Health and Aged Care approved arrangements under Section100 for the supply of PBS medicines to remote Aboriginal Health Services (AHSs), enabling clientsto receive medicines directly from the AHS, without the need for a normal prescription form, andwithout charge. Local NT pharmacies were then able to use S100 to supply approved remoteAHSs with PBS medicines without the usual co-payment arrangements. Funds that had previouslybeen spent on medicines to other areas of need were therefore redistributed to remote healthservices (78) . However the NT Government health services were not included in this arrangement.In April 2002 a Memorandum of Understanding (MoU) was signed between the Commonwealthand the NT Government to extend the PBS to all remote NT communities where there were nopharmacies (77) . It required that the S100 payments would not be used to replace or reduce theNT Government expenditure on remote Aboriginal health. Territory Health Services proposed thatthe major portion of S100 be devoted to remote area implementation of the NT PCDS and QualityChapter 3: Progress Against PCDS Objectives – Evaluation of the NT Preventable Chronic Disease Strategy 2007 70
Use of Medicine Programmes. Although there was no absolute requirement to link S100 withchronic disease; in practice the annual savings from S100 became the main source of ongoingfunding for PCDS activities (12) . The savings from S100 implementation were agreed atapproximately $2.325M per annum. This was to be allocated across the NT as follows: Top EndServices Network: 51.7 per cent, Central Australian Services Network: 36.7 per cent, NGO ServiceDevelopment (Top End): 10.5 per cent, and NGO Service Development (Central Australia): 1.1per cent. S100 revenue was expected to exceed savings, because revenue included growth inPBS drug costs as well as handling fees.By 2001-2002 the NTPCD Program was fully in place and was one of the operational arms of thePCDS. Other NTDH&CS programs that contributed directly to the PCDS outcomes included:Community health, Remote Health, Environmental Health, Communicable Diseases, Family andChildren‟s Services, Mental Health, Alcohol and Other Drugs, child and maternal health, OralHealth, and Nutrition and Physical Activity. Those that contributed indirectly included: Education,Housing, Department of Industries and Development, and Sport and Recreation.In early 2001 a public health physician was appointed using S100 money to head a Top EndPreventable Chronic Disease Program. In August 2001, she began recruiting public health nurseswho began work by November. Chronic disease coordinator positions (RN 3A) were created,advertised and recruited for Maningrida, Oenpelli Wadeye, Milingimbi and Ramingining. By2004/05, there were chronic disease coordinator positions in five of the major Top Endcommunities.Table 3.7 Summary of Section 100 (S100) expenditure to end of 3rd quater 2004/05(Sources: Report to NTAHF 10/9/04 Attachment 1 tables A.1, A.2; Report to NTAHF 27/5/05 Attachment 1 table A.1)S1002000-01 2001-02 2002-03 2003-04 2004-05Agreed Budget allocation($K) ($K) ($K) ($K) ($K)Total($K)TESN – Chronic disease 902 1203 1203 1203 1203 5714CASN – Chronic disease 640 853 853 853 853 4052Expenditure (Actual)TESN 506 860 1368 1313 1345 5392CASN 550 857 906 717 396 3426In Central Australia a slightly different approach was taken. In June 2002 a Central Australianservice plan allocated money to PCD coordination in Central Australia but a report in February2004 suggested that only the coordinator and a women‟s health nurse were filled.Chapter 3: Progress Against PCDS Objectives – Evaluation of the NT Preventable Chronic Disease Strategy 2007 71
- Page 37 and 38: internal project team. It was very
- Page 39 and 40: Situation at Baseline1. The Guideli
- Page 41 and 42: 3.1.2 Patient information and recal
- Page 43 and 44: Ferret Miwatj, Numbulwar, Marngarr,
- Page 45 and 46: Medicare information is not for pub
- Page 47 and 48: was in place in Central Australia i
- Page 49 and 50: What orientation and ongoing traini
- Page 51 and 52: programs focus on chronic disease p
- Page 53 and 54: The information collected as part o
- Page 55 and 56: Assessment against objectiveMost se
- Page 57 and 58: career development, and retention i
- Page 59 and 60: are. Indigenous employment is NTDH&
- Page 61 and 62: NTDH&CS Programs that encourage Hea
- Page 63 and 64: 2002 Aboriginal and Torres Strait I
- Page 65 and 66: delivering any prevention and healt
- Page 67 and 68: The Community Services Division - A
- Page 69 and 70: 1 x AHW Central Australia 2001 S100
- Page 71 and 72: One clinic stated it had no care pl
- Page 73 and 74: Identifies priority practices to in
- Page 75 and 76: There has been a significant growth
- Page 77 and 78: about 25 per cent of the hospital b
- Page 79 and 80: The level of funding provided by th
- Page 81 and 82: Central Australia and two zones cur
- Page 83 and 84: The diabetes education teams at HLN
- Page 85 and 86: maintenance group for people with l
- Page 87: Rebates for participating or arrang
- Page 91 and 92: CHAPTER 4. CLINICAL OUTCOMES OF THE
- Page 93 and 94: improvements have been made to serv
- Page 95 and 96: A recent ten-year follow-up of a co
- Page 97 and 98: The NTDH&CS also collect birthweigh
- Page 99 and 100: Figure 5.3 Vaccination coverage for
- Page 101 and 102: It is also important to note that k
- Page 103 and 104: eported that 50 per cent of the Ind
- Page 105 and 106: The current action plan identifies
- Page 107 and 108: The availability and cost of health
- Page 109 and 110: Hoy et al in 1995-2000 (100) , and
- Page 111 and 112: 5.6 Best practice management5.6.1 P
- Page 113 and 114: disease care in urban areas regardi
- Page 115 and 116: PCIS was developed by NTDH&CS as th
- Page 117 and 118: emote staff can access training and
- Page 119 and 120: In the Top End there appeared to be
- Page 121 and 122: APPENDIX 1EVALUATION OF THE NT PREV
- Page 123 and 124: 2.10 Generally speaking, on a scale
- Page 125 and 126: 4.4 Briefly recount any anecdotes y
- Page 127 and 128: 5.9 Generally speaking, on a scale
- Page 129 and 130: Section 8 • Summary questions8.1
- Page 131 and 132: Preventable Chronic Disease Program
- Page 133 and 134: Year Type Background What is it? /
- Page 135 and 136: Year Type Background What is it? /
- Page 137 and 138: An important background to this stu
Use of Medicine Programmes. Although there was no absolute requirement to link S100 withchronic disease; in practice the annual savings from S100 became the main source of ongoingfunding for <strong>PCD</strong>S activities (12) . The savings from S100 implementation were agreed atapproximately $2.325M per annum. This was to be allocated across the <strong>NT</strong> as follows: Top EndServices Network: 51.7 per cent, Central Australian Services Network: 36.7 per cent, NGO ServiceDevelopment (Top End): 10.5 per cent, and NGO Service Development (Central Australia): 1.1per cent. S100 revenue was expected to exceed savings, because revenue included growth inPBS drug costs as well as handling fees.By 2001-2002 the <strong>NT</strong><strong>PCD</strong> Program was fully in place and was one of the operational arms of the<strong>PCD</strong>S. Other <strong>NT</strong>DH&CS programs that contributed directly to the <strong>PCD</strong>S outcomes included:Community health, Remote <strong>Health</strong>, Environmental <strong>Health</strong>, Communicable Diseases, Family andChildren‟s Services, Mental <strong>Health</strong>, Alcohol and Other Drugs, child and maternal health, Oral<strong>Health</strong>, and Nutrition and Physical Activity. Those that contributed indirectly included: Education,Housing, Department of Industries and Development, and Sport and Recreation.In early 2001 a public health physician was appointed using S100 money to head a Top EndPreventable Chronic Disease Program. In August 2001, she began recruiting public health nurseswho began work by November. Chronic disease coordinator positions (RN 3A) were created,advertised and recruited for Maningrida, Oenpelli Wadeye, Milingimbi and Ramingining. By2004/05, there were chronic disease coordinator positions in five of the major Top Endcommunities.Table 3.7 Summary of Section 100 (S100) expenditure to end of 3rd quater 2004/05(Sources: Report to <strong>NT</strong>AHF 10/9/04 Attachment 1 tables A.1, A.2; Report to <strong>NT</strong>AHF 27/5/05 Attachment 1 table A.1)S1002000-01 2001-02 2002-03 2003-04 2004-05Agreed Budget allocation($K) ($K) ($K) ($K) ($K)Total($K)TESN – Chronic disease 902 1203 1203 1203 1203 5714CASN – Chronic disease 640 853 853 853 853 4052Expenditure (Actual)TESN 506 860 1368 1313 1345 5392CASN 550 857 906 717 396 3426In Central Australia a slightly different approach was taken. In June 2002 a Central Australianservice plan allocated money to <strong>PCD</strong> coordination in Central Australia but a report in February2004 suggested that only the coordinator and a women‟s health nurse were filled.Chapter 3: Progress Against <strong>PCD</strong>S Objectives – <strong>Evaluation</strong> of the <strong>NT</strong> Preventable Chronic Disease <strong>Strategy</strong> 2007 71
Change language