5 years of coordinating chronic disease management in a community-controlled council: the benefits of placing coordination services in a non-clinical setting

Annie Farthing, Joanne Duncum

    Research output: Contribution to conferencePaper

    Abstract

    Objective 5 years ago, Tangentyere council successfully applied for funds through the Integrated Team Care (ITC) program run through the Northern Territory Primary Health Network, to establish a position of Chronic Disease Care Coordinator. Placing the coordination in a non-clinical setting has allowed focus to be drawn to the determinants of chronic disease which disproportionately affect Aboriginal people, as well as supporting people with chronic diseases and their families to access clinical services provided by the Aboriginal Medical Services and mainstream health services
    Method
    Tangentyere Council is an Aboriginal Community Controlled organisation, founded to give Aboriginal residents of Alice Springs’ Town Camps a voice. The ITC works with people as closely as possible to where they live.
    Result
    27 clients currently receive support through the ITC program. Their social and living circumstances have contributed to the development of their chronic diseases and unless these conditions are addressed, any health intervention can only hope to have a minimal impact. All face challenges in:
    • Housing: no service users own their own home, 7 are named on public housing leases, 8 on Town camp leases, 4 have no address, 3 live on outstations 40km from town and 3 live in Hostels.
    • Income: All users access Centrelink benefits with ongoing issues of maintaining some form of income.
    • Transport: 2 clients own vehicles, 25 have varying degrees of opportunistic access to transport, there is very limited public transport available in the town.
    • Food security: the above issues all contribute to the ability to access regular healthy food
    A flexible outreach service allows the ITC workers to support and advocate for the service users in terms of housing, transport and income.
    Conclusion
    Placing the ITC in a non-clinical setting allows focus to be given to the determinants which have caused the development of chronic diseases.
    Original languageEnglish
    Publication statusPublished - 14 Sep 2019
    EventThe Network: Unity for Health Conference - Darwin Convention Centre, Darwin, Australia
    Duration: 13 Sep 201913 Sep 2019
    https://tufh2019.paperlessevents.com.au/sessions/view/22

    Conference

    ConferenceThe Network: Unity for Health Conference
    Abbreviated titleTUFH
    CountryAustralia
    CityDarwin
    Period13/09/1913/09/19
    Internet address

    Keywords

    • chronic disease
    • management
    • non-clinical setting

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