Annual Review 2017 - Heart Foundation NZ - Heart Foundation€¦ · cardiologists in 2016/17...

Annual Review 2017

Contents

Our Strategic Plan 2

Chairman and Chief Executive’sIntroduction 3

Heart disease in New Zealand 4

The difference you have made 5

Care & Support

Connecting with community 6

Heart Attack Awareness campaign 8

Health professionals 9

Research 10

Prevention 11

Fundraising 13

Volunteers

Thank you to our volunteers 15

Awards 16

Board of Directors 17

Financials 18

Heart-felt thanks to our supporters 20

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More than 172,000 New Zealanders living with heart disease join us at the Heart Foundation to thank you, our supporters. Without you, too many fathers, mothers, close relatives and friends, sons and daughters would not be alive today.But they are. Thanks to you.

H E A R T F O U N D A T I O N A N N U A L R E V I E W 2 0 1 7

OUR MISSIONStop New Zealanders dying prematurely from heart disease and Help people with heart disease to live full and productive lives.

OUR VISIONHearts fit for life,

for this generation and the next

CARE AND SUPPORT

VISIBLE AND CONNECTED

RESEARCHPREVENTION

More help for people and their

families impacted by heart disease

Promote and support evidence- based prevention

and care

The Heart Foundation is a leading charity brand

Aligned and visible research and fellowships

Help people make heart

healthy choices

Children and their families

eat heart healthy food

Grow our funding to support the heart health of this generation and the next

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Our 2015-2018 Strategic Plan


The Strategic Plan (2015-2018) was a major refocus for the Heart Foundation, realigning our work to ensure that we best support New Zealanders at risk of, or living with, heart disease.

Mitigating potential risks to the Heart Foundation remains of paramount importance for the Board. As a commitment to risk management, this year the Board introduced a structured risk management policy and associated procedures. The new policy’s implementation ensures that risks are identified, analysed, evaluated and managed.

In the last 12 months, we have experienced very pleasing financial results, assisted by strong returns on our investment portfolio. These results are a tribute to the calibre of our investment committee, and they are to be congratulated on a sterling year.

Along with financial performance and reputational risk, the Board is equally conscious of its obligations to the organisation’s health and safety performance.

This year, the Board welcomed two new members, Associate Professor Malcolm Legget and Professor Jim Mann, and bid farewell to two long-serving stalwarts, Associate Professor Stewart Mann and Associate Professor Mervyn Merrilees.

I wish to acknowledge my fellow Board members for their contribution and the Strategic Advisory Group members, who generously give their time and advice.

The Heart Foundation continues to be well-led by Chief Executive Tony Duncan, and I pay credit to Medical Director Dr Gerry Devlin and the rest of the Heart Foundation’s Leadership Team for their strong leadership.

To all our generous donors, on behalf of the Board, thank you for your ongoing commitment and support. It is a significant factor in the Heart Foundation’s ability to achieve its work.

Chairman and Chief Executive’s Introduction

This year, the Heart Foundation has implemented new and innovative ways to provide care and support for people living with heart disease, and their families.

I am very proud of these initiatives, including the launch of the powerful Journeys programme.

Journeys responds to an unmet need, which we uncovered when talking with people who have experienced a heart event – the need to share personal stories as a means of helping with recovery.

The success of Journeys is already evident; people are openly sharing their stories and many people have visited the online site, often leaving positive feedback.

Another integral part of our community-based support is the very popular ‘You Are Not Alone’ heart help sessions. The sessions are run by our local heart health advocates and volunteers in our regional offices. They provide care and support to people impacted by heart disease.

It is very pleasing that our evidence-based resources are regularly used by health practitioners when supporting heart health patients. This year we also launched the Heart Nurse Champions programme, which enables us to engage and support cardiac nurses at nine tertiary hospitals nationwide.

Our expert nutrition and education teams work with a wide-range of sectors and organisations, offering tailored advice and assistance. The nutrition and education initiatives the Heart Foundation delivers into New Zealand communities is made possible with the ongoing support from the Ministry of Health.

These accomplishments would not have been possible without the commitment of our Board of Directors, our skilled staff and our amazing volunteers.

Finally, I would like to express gratitude to our generous donors and business partners for their belief in our mission to stop New Zealanders dying prematurely from heart disease.

TONY DUNCAN Chief Executive

MIKE TOMLINSON Chairman


4

Heart disease in New Zealand


172,000New Zealanders are currently living with heart disease

Heart disease is New Zealand’s single biggest killer

Every

90 minutesa New Zealander dies from heart disease

Heart disease is responsible for the death of more than

6,000 Kiwisevery year

More than

50 womendie each week of heart disease

More than

100 peopledie each week of heart disease

18 peopledie from heart disease every day

An estimated

90,000New Zealanders are living with atrial fibrillation, a heart condition causing irregular heart rhythm

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The difference you have made

$57.3m awarded to fund research and specialist training for cardiologists since 1970

1,714 research and training grants awarded in New Zealand since 1970

$3.3m of funding invested into research grants and specialist training for cardiologists in 2016/17

353,000 Heart Foundation brochures and resources were distributed this year

850,000 people accessed online heart health information on the Heart Foundation website

2,000 people attended ‘You Are Not Alone’ heart help sessions nationwide

Heart Foundation staff and volunteers have engaged with more than 5,000 people impacted by heart disease

Over 1,000 early learning centres participated in Heart Foundation programmes reaching 54,000 children

More than 200 schools participated in programmes nationwide reaching more than 63,000 school-aged children

Since its launch in March, more than 20,000 people have visited the Journeys online site

More than 400 people received specialised training in Pacific nutrition

250 tonnes of salt per annum has been removed from bread, processed meats and breakfast cereals, due to the Heart Foundation’s reformulation work with the food industry


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CARE & SUPPORTCONNECTING WITH COMMUNITY

Launching JourneysThis year, your commitment saw the launch of the innovative Heart Foundation Journeys programme. As a support programme, Journeys makes a crucial difference to the lives of New Zealanders living with heart disease; helping them to feel connected and not alone.

Journeys helps people cope with the overwhelming emotional experience of heart disease through the sharing of personal stories. It would not be possible without your generosity and that of the Milestone Foundation.

The programme was developed after people who experienced a heart event spoke of feeling alone, worried and unsure of how to cope afterwards.

The sharing of experiences on the Heart Foundation website supports the storytellers’ recovery as well as reassuring others who are going through a similar situation, that they are not alone.

Already more than 100 Kiwis have shared their unique story – wanting to help other New Zealanders diagnosed with similar heart conditions. We are very grateful to those whose heart-felt stories are helping other people, and their families, living with heart disease.


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Heart Foundation, connecting with the community

Thanks to you, New Zealanders receive vital care and support in their local communities through the Heart Foundation’s ‘You Are Not Alone’, heart-help sessions.

Run by regionally-based Heart Foundation staff, the sessions offer support and advice from guest speakers including health professionals. There are opportunities for people to share their stories and connect with others in their community.

The Heart Foundation teams provide care and support for people impacted by heart disease and their families. They deliver education sessions about preventing heart disease through physical exercise, eating heart-healthy food and understanding risk factors. They have strong relationships with local clinicians, District Health Boards, community groups and cardiac clubs in the regions.

“ People living with heart disease often want to know about others who have had the same procedure, gone through a similar recovery and understand the highs and lows. Family members also need reassurance that what their loved one is experiencing is normal.” Dr Gerry Devlin, Heart Foundation Medical Director

Visit heartfoundation.org.nz/journeys or call 0800 863 375

JourneysReal people sharing their stories to help and support others.

“My total approach to life had to change”

Roni/Aortic Dissection

You are not alone


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Nearly half of New Zealanders recently surveyed, admitted if they experienced heart attack symptoms they wouldn’t immediately call 111. That’s why the nationwide Heart Attack Awareness campaign was critical and you helped make it happen.

Thanks to funding from the Ministry of Health, the Milestone Foundation and generous donors, more people now know what a heart attack looks like, and the importance of calling 111. This campaign saved lives, like that of Dunedin’s Phil Sunitsch.

The 49-year-old initially dismissed the ache in his chest as heartburn. It returned with an ache in his elbows, pain in his left wrist and the teeth in his lower jaw. Phil then remembered the Heart Foundation’s Heart Attack Awareness advertisement about how to spot someone having a heart attack.

It was a good thing that Phil made it to the hospital in time. Tests showed he had blockages in arteries leading to his heart and was having a heart attack. After having stents inserted to relieve the blockages he has made a full recovery.

Your support also provided life-saving campaign resources for hospitals, medical centres and pharmacies.

Awareness saves lives

A HEART ATTACK MAY NOT BE AS DRAMATIC AS YOU THINK

Too many New Zealanders place themselves at increased risk of death or permanent heart damage by putting off that important call. The traditional Kiwi ‘she’ll be right’ attitude can be fatal.” Dr Gerry Devlin, Heart Foundation Medical Director

“ It seemed so illogical that I was having a heart attack because the symptoms did not in any way appear to be those of a traditional heart attack. But remembering the Heart Foundation’s ad, I knew that I was better to be safe than sorry.” Phil Sunitsch, Heart event survivor

CARE & SUPPORTHEART ATTACK AWARENESS CAMPAIGN


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The Heart Foundation regularly shares resources and assists with guideline implementation for treating heart patients and people at high risk of heart disease with health professionals at conferences and meetings.

More than 4,500 health professionals are kept up-to-date on the latest clinical research findings from New Zealand and overseas along with heart healthcare events through the Heart Foundation e-newsletter.

Easy-to-understand information The Heart Foundation’s high-quality resources, written in everyday language, are used by health professionals when treating patients with heart disease, as well as those people at risk of a heart event. It is thanks to your support that this wealth of online heart health information, brochures, booklets and newsletters are provided to the public.

This year, cardiac teams in hospitals nationwide were surveyed on how effective Heart Foundation resources were for them and their patients. The findings were that 92% would recommend the Heart Foundation as a valuable source of information and support for them and their patients.

The Heart Foundation works with cardiac nurses at hospitals nationwide through the Heart Nurse Champions programme and provides them with support and information.

Working with health professionals

The Heart Foundation, a link between health professionals and their patientsThanks to the support from our donors and the Ministry of Health, information on evidence-based heart disease prevention and care is offered to health professionals nationwide.

Sande Mareroa-Gates, Heart Foundation Clinical Liaison works to bridge any cardiovascular gaps that exist within communities across the country. As part of the Heart Foundation’s clinical support team, Sande evaluates cardiovascular successes and challenges to offer evidence-based solutions to health professionals.

“ We are able to offer motivational support and solutions to help these health professionals best assist their cardiac patients. Together we can find a pathway to solutions in their communities.” Sande Mareroa-Gates, Heart Foundation Clinical Liaison

CARE & SUPPORTHEALTH PROFESSIONALS


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Supporting research and training that saves lives

“ I was told if they hadn’t found the hole in my heart when they did, I would have only lived to 25. I am forever grateful for the work these amazing cardiologists do to save lives.” Celeste Esera, Heart event survivor

Your generous support enables talented Kiwi researchers and cardiologists to undertake world-class research and training. This investment helped young mum-of-two, Celeste Esera survive a devastating heart condition.

Celeste was just 18 when her ongoing and often terrifying battle with heart disease began. She was diagnosed with Wolff-Parkinson-White Syndrome (WPW), an abnormality in the heart’s electrical pathway that disrupts its rhythm.

But doctors made another shocking discovery when carrying out tests to treat her – Celeste had an undetected hole in her heart and would need open-heart surgery.

Three of the cardiologists caring for Celeste have received Heart Foundation funding to enhance their expertise through research and overseas training grants.

World-class researchDr Katrina Poppe’s Heart Foundation-funded research looks at the heart structure of New Zealanders with Atrial Fibrillation (AF) like Celeste Esera.

The information she gathers is expected to guide doctors and the health system in improved management of AF. It could also help with prioritising who is referred on for specialist cardiac services and assessing future options for providing an outreach echocardiography service to high-risk communities.

“ I’m very grateful for the Heart Foundation funding as it allows me to carry out important medical research that can have direct benefit to the community.” Dr Katrina Poppe, Senior Research Fellow

The Heart Foundation is New Zealand’s leading independent funder of heart research. This year, your support ensured funding-enabled medical researchers and cardiologists to undertake research projects and specialist training to help stop heart disease.

It is only because of caring people like you, that annually about $3.3 million is invested into vital research projects and training opportunities that investigate the causes, management and prevention of heart disease.

RESEARCH


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PREVENTION

Heart-healthy environmentsYour support and Ministry of Health funding ensures that life-saving, heart-healthy messages reach New Zealanders of all ages.

Creating healthy students for a healthy futureAcross New Zealand, Heart Foundation nutrition advisors ask local early learning services and schools what support they need so that the next generation can make good food choices and are active every day.

Making healthy foods and drinks readily available at early learning services and schools encourages students to make better food choices that will improve their overall health. It may also support their concentration, behaviour and opportunities to learn.

Heart Foundation education programmes offer guidance, structure and a suite of high-quality resources to promote healthy eating and physical activity. The Fuelled4life tool assists canteen staff and caterers to provide healthy food through a range of resources, cooking videos and menu ideas.

We also deliver the Foodstuffs national nutrition education programme, Food for Thought, to year five and six students nationally.

“ We felt an obligation to ensure that the right fuel was provided for the children’s growth and that they have healthy, positive attitudes to food.” Melissa Williamson, Kaiako (Teacher) Lollipops Educare Glen Eden

Lollipops Educare Glen Eden has worked with the Heart Foundation team for many years to make sure it is setting children up for a strong start in life.

Supported by a Heart Foundation nutrition advisor, the centre has made significant changes to its menu, has built vegetable gardens and reinforced the importance of a heart-healthy lifestyle in its teaching.

Essential life skillsThe Heart Foundation, together with vegetables.co.nz, surveyed teachers to see if intermediate-aged school children were learning the skills that would help them become healthy adults. The resulting research showed less than 50 percent of food prepared in nutrition classes were main meals.

Thanks to the research findings, the Heart Foundation will help introduce the tools and resources needed to teach these important life skills.


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Making families healthierMaking everyday foods healthierThe Heart Foundation actively works with the food industry to make low-cost, everyday foods healthier.

Offering guidance on ways to reduce the amounts of salt and sugar in foods, like bread, yoghurts and cereal, the Heart Foundation supports food manufacturers to improve the nutritional quality of food.

To date, the Heart Foundation’s reformulation work has seen more than 250 tonnes of salt per annum removed from bread, processed meats and breakfast cereals.

May we take your order?Children dining with their families at a number of New Zealand family restaurants have new meal options after joining the Kids’ Choice programme. This is a Heart Foundation initiative that supports cafes and restaurants to serve healthier food to children.

Targeted nutrition adviceHeart-healthy nutrition messages reach the country’s Pacific community via Heart Foundation nutrition training courses.

The Pacific Heartbeat team works with individuals, workplaces, church groups and health professionals. They encourage Pacific people to make heart healthy food choices and move more to achieve and maintain a healthy weight.

PREVENTION


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Heart-felt support — Jennian HomesEach year, tens of thousands of Kiwis support the Heart Foundation’s Lottery programme, which has been running since 1993. These funds are a vital source of income which fund research and care for more than 172,000 Kiwis living with heart disease.

Each of the six homes built every year is part of the journey for Jennian, supporting the Heart Foundation’s community care programmes, life-saving heart research and specialist training for cardiologists.

The Jennian Homes Mother’s Day Fun Run/Walk series was held in over 20 locations nationwide. Attracting more than 10,000 participants, the event offered women the chance to have fun, get active and support heart research and women’s heart-health education.

Together, we can make a difference

Each year, many Kiwis choose to support life-saving research to help stop New Zealand’s single biggest killer — heart disease. They do this through fundraising, buying a Heart Foundation Lottery ticket and supporting the Annual Appeal. This commitment from people like you helps to change the lives of New Zealanders impacted by heart disease. Thank you.

FUNDRAISING

The Heart Foundation Lottery winners Gerard Richardson and Sarah Smith receiving the keys to their new Mangawhai home from Jody Yakas, Jennian Homes Northland.

Jennian Homes Mother’s Day Fun Run/Walk participants.


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Heart RacersThis year almost 50 Heart Racers took part in the Tour of New Zealand. Collectively cycling 30,000kms, they raised money to help stop New Zealanders dying prematurely from heart disease. Their dedication and that of loyal supporter Hynds Pipe Systems Ltd, is gratefully acknowledged.

Annual AppealThe Heart Foundation is very grateful to the thousands of Kiwis around the country who volunteered to collect much-needed donations during February’s Annual Appeal. Thank you also to those who donated during this campaign. Your support makes such a difference to the lives of people living with heart disease.

Commitment to the causeOften people who have faced the challenge of living with a heart condition want to give back.

People like Bevan Ellis (27) who walked the 75km Hillary Track to raise funds for more research, specialist training for cardiologists and support for those with heart disease.

Bevan has a connective tissue disorder called Marfan syndrome that mostly affects his heart. At 15-years-old he had his first open-heart surgery, to replace a failing mitral heart valve with a pig’s valve. His second surgery in 2017 saw that valve replaced with a longer-lasting mechanical valve.

Bevan is grateful for the skills of his cardiologists, two of whom received Heart Foundation funding to enhance their expertise. Bevan’s paediatric cardiologist, Nigel Wilson, was the recipient of a Heart Foundation Senior Fellowship in 1990.

That Senior Fellowship was in congenital heart disease and it helped my career so much.” Dr Nigel Wilson, Associate Professor

FUNDRAISING

Bevan Ellis training for the Hillary Trail Hike. Hearty making an appearance during the Heart Foundation Annual Appeal 2016.


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VOLUNTEERS

Diane’s volunteer journeySouthlander Diane Lowther had a heart attack in 2016 and met Nicola Mason from the Heart Foundation at the Invercargill cardiac rehabilitation class.

“Nicola gave me a wealth of information and resources that provided me with the tools I needed to start living my ‘new’ normal life,” says Diane.

Diane decided to give back to the Heart Foundation by attending the monthly coffee sessions for people living with heart disease, sharing her story with others.

“It’s a safe environment where we can offer support and comfort to people –only people who have had a similar experience can relate to what you are going through, so it’s good to talk.”

As a Heart Foundation volunteer, Diane also visits local rest homes and workplaces to raise awareness about living with heart disease and encourage people to have their heart checked.

Thank you to our volunteers

Volunteers are one of our most valuable resources. Without these wonderful people giving up their time and sharing their skills, we would not be able to achieve much of our work supporting people living with heart disease. We would like to extend our heart-felt thanks to the thousands of volunteers who run heart health support groups in their local communities, sit on our Board and Strategic Advisory Groups, raise much-needed donations, take care of administration and share their stories to help others.


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VOLUNTEERS

Certificate of Appreciation Awards

Waikato Branch• Jenny Potter• Judy Simonson• Robert Goeldner

Auckland Branch• Nikki Tod• Judy Parton• David Fepuleai

Manawatu Branch• Mary Hopkins

Southland Branch• Linda Blomfield• Diane Lowther

Wairarapa Branch• Bill Reid

Christchurch Branch• Jan Williams• Neville Wooten• David Brown• Vivienne Hancock• John Abrams• Jill Kelk

Otago Branch• Tom Ross• Leanne Barclay

South Canterbury Branch• Janice Higinbottom• Margueritte Gliddon• Rosie Cross• Jeanette Gollins• Ineke Pierce• Jean Bower• Lorraine South• Fay Edgeler

Long Service Awards

Nelson Marlborough Branch 2 years• Elaine Daines• Lyall Daines

5 years• Miraka Norgate

Tauranga Branch5 years• Caroline Willoughby• Judy Masters• Vera Higgie

Hawke’s Bay Branch• Carla Mudgway - Branch Patron


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Heart Foundation BoardFrom left to right: Tom TreacyMichael BenjaminAssociate Professor Gerry DevlinFaye Sumner Mike Tomlinson – ChairmanAroha HudsonTony Duncan

Not photographed:Ian SutcliffeProfessor Jim MannAssociate Professor Malcolm Legget

BOARD OF DIRECTORS

Scientific Advisory Group membersAssociate Professor Gerry DevlinProfessor Rob DoughtyTony DuncanProfessor Alison HeatherAssociate Professor Ian LeGriceProfessor Murray SkeaffDr Barry SmithProfessor Tim StokesProfessor Richard TroughtonAssociate Professor Natalie WalkerAssociate Professor Mark WebsterDr Jinny Willis


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$000 2017 2016

Revenue

Fundraising and lottery ticket sales 10,923 10,952

Donations and legacies 4,934 4,902

Contract services 4,297 5,111

Investment income 1,511 1,610

Other income 939 1,225

Total revenue 22,605 23,800

Direct expenses (8,448) (8,551)

Net operating surplus 14,157 15,249

Expenditure

Research – grants and administration (3,335) (3,225)

Public health (2,649) (3,268)

Pacific Heartbeat (871) (1,368)

Heart Healthcare (2,122) (1,595)

Communications and publicity (317) (253)

Tick Programme (264) (564)

Programme support (3,074) (3,258)

Other grants (228) (373)

Depreciation (490) (336)

Total expenditure (13,350) (14,240)

Surplus for the year 807 1,009

Gain / (loss) on investments 346 522

Gain / (loss) on disposal of fixed assets (125) 19

Research grants written back - 99

Net surplus for the year 1,027 1,649

Other comprehensive revenue and expense

Net change in fair value of available-for-sale financial assets 1,696 (167)

Total other comprehensive revenue and expense for the year 1,696 (167)

Total comprehensive revenue and expense 2,724 1,482

For full disclosure of financial statements, please visit heartfoundation.org.nz.

STATEMENT OF COMPREHENSIVE REVENUE AND EXPENSEFor the year ended 30 June 2017 (in New Zealand Dollars)


ResearchHeart Health Care and

SupportPrevention

Donations &Legacies

Lottery &Fundraising

ContractServices

Investment& OtherIncome

Sources of Income

14% retained for overheads

86% Heart Health Programmes

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SUPPORT IS DIRECTED INTO HEART HEALTH


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HEART-FELT THANKS TO OUR SUPPORTERS

We would like to extend an enormous thanks to a wonderful group of very generous New Zealanders. We offer our thanks to the individuals, trusts and organisations, many of which are listed below, who have helped the Heart Foundation achieve its objectives during the year.

Thank you to our like-minded strategic partners who have joined forces with us to deliver our work. We are grateful that you share our vision and mission in helping New Zealanders impacted by heart disease.

The ongoing dedication and support shown by the following supporters has been integral in the Heart Foundation’s achieved outcomes.

Aileen Drewitt Charitable Trust

Callis Charitable Trust

Capital Cardiovascular Research Trust

CBL Contracting Limited

Community Organisation Grants Scheme

Community Trust of Mid & South Canterbury

Community Trust of Southland

Des & Olive Walker Charitable Trust

Dorothy Cutts

E & W White-Parsons Charitable Trust

Eastern & Central Community Trust

Estate of Grace E M Kay - Orakau Heart Research Scholarship Trust

Farina Thompson Charitable Trust

First Sovereign Trust Ltd

Four Winds Foundation

Grace Craston Charitable Trust

Graham Armitage

Hynds Limited

Ian Shroff

Invercargill Licensing Trust

Jack Jeffs Charitable Trust

Jennifer Smith Family Trust

John Ilott Charitable Trust

Ken & Megan Syminton

Lawrance and Stephanie Russell Charitable Trust

Les McGreevy

Lois McFarlane Charitable Trust

Louisa and Patrick Emmett Murphy Foundation

Michael Benjamin

Milestone Foundation

Milton Hope

Mitre 10 Mega Tauranga

New Zealand Community Post

New Zealand Community Trust

New Zealand Lottery Grants Board

NH Taylor Charitable Trust

Nova Charitable Trust

Oamaru Senior Citizens Club

Pub Charity

Quality Hotel Parnell

Ray Watts Charitable Trust

Remuera Bowling Club

Room-Simmonds Charitable Trust

Rotary Club of Rotorua

Rotorua Energy Charitable Trust

Ryman Healthcare

Sandra O’Connor

Southern Trust

Sue Stodart Law

The Clyde Graham Charitable Trust

The Dowdall Trust

The Hilda Curtis Charitable Trust

The Kelliher Charitable Trust

The Lion Foundation

The Longford Trust

The Reed Charitable Trust

The Robert and Barbara Stewart Charitable Trust

The Trusts Community Foundation

The Winton & Margaret Bear (Charitable) Trust’s Children’s Heart Health Care Trust

Torhaven Trust

Toyota

Trillian Trust

Trust Waikato

Victor Binkowski

Winston Knight

Major sponsor of the Heart Foundation Lottery.


To help save more lives, donate at heartfoundation.org.nz/donate or call 0800 830 100

We’re not done yet

Heart Foundation, 9 Kalmia Street, Ellerslie, Auckland 1051. T 09 571 9191 E [email protected] heartfoundation.org.nz

Annual Review 2017 - Heart Foundation NZ - Heart Foundation€¦ · cardiologists in 2016/17...

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