The Northern Territory was unable to respond to the information request in time for inclusion in this report. Information contained this section was derived from a semi-structured interview.
The approach to CVD in the NT is as a component of an overall chronic disease program. NT Health has focussed on an organised systematic approach to chronic disease, with a focus on diabetes (with comorbidities) because of the high incidence of the disease.
NT Health considers the principles and critical intervention points and the literature referenced in the NSIF are completely applicable to Aboriginal and Torres Strait Islander Australians. The main issue for NT in the management of CVD relates to addressing the acknowledged high morbidity and mortality from this condition in an environment with low resources (financial and workforce).
NT considers there would be significant health gains if the system shifted to a systematised, integrated, coordinated model of care using integrated care teams and evidence-based guidelines.
The NT has welcomed the investment by the Australian Government into primary health care in the NT and will be using this investment to focus on chronic disease. Up to now NT Health advises the focus has been on treatment and management.
Partnerships are in place between Aboriginal Community Controlled Health Services and the NT Government. Due to the focus on improving health to the indigenous population for the specific chronic diseases and auditing of outcomes and processes, NT Health considers there are now good levels of care being provided through indigenous and mainstream primary health care services.
Strategies implemented include:
- Training of health care staff
- The use of recall and registers
- Using data and regular auditing
- A focus on CQI across the whole sector
Outcomes measured include:
- Gains in the life expectancy of Aboriginal women of 3.2 years
- Improved survival from infarct in remote areas due to patients being bought to treatment better shape and to them then getting the right care
Every health centre has a disease register. Primary health nurses work with clusters of communities and undertake on-site training and assistance with clinical systems.
As a result of poor mortality rates for Indigenous Australians in the 6 – 12 months following a cardiac event, NT Health advises they are scoping up a model for how to apply rehabilitation care in the Aboriginal and Torres Strait Islander setting. They have commissioned a literature review from the NHMRC and are reviewing the work of networks in NSW and Qld.
NT Health supports the use of guidelines but observes that there have to be practical ways of putting them into practice or they will not be used. NT Health refers to the Central Australian Rural Practitioners Association (CARPA) guidelines which cover acute, primary health care and chronic disease presentations. Reviewed guidelines will include an absolute risk assessment and combined chronic disease guidelines (not separated out for different diseases) with specific tests for particular conditions.