It is hard to hold two truths together at once – that the National Disability Insurance Scheme (NDIS) is an important and life-changing government service, and also that it is a scheme with deep dysfunctions and need for improvement.

That is the message we got loud and clear from the recent Annual NDIS Conference, where we heard from many people heavily involved in the NDIS and the National Disability Insurance Agency (NDIA). As well as many scheme participants and advocates, speakers included NDIS Independent Review chairs Bruce Bonyhady and Lisa Paul, NDIS Quality and Safeguarding Commissioner Tracy Mackey, NDIS Minister Bill Shorten, NDIA CEO Rebecca Falkingham and NDIA chair Kurt Fearnley.

We are pleased to share our key takeaways from the recent two-day event in Sydney:

  1. Measure and communicate outcomes. We need to invest in measuring and communicating the individual and collective outcomes for people with disability, and the benefit to the broader Australian society and economy, that the NDIS delivers. Without this our public and political discourse on cost and sustainability will always be one-sided. How can we decide what an appropriate cost is when we cannot accurately quantify the return on investment?
  2. Innovate in funding. We need to think bigger than fee-for-service as the only funding and pricing model. The markets the NDIS operates in across Australia are not uniform; some are developing and some regional and remote areas will never be functioning markets. The NDIS Review’s pricing and payment approaches paper provides interesting insight into how this conversation should begin.
  3. Work with First Nations. Alternative commissioning models highlighted in the second recent paper from the NDIS Review identify the need to consider community-led approaches to funding. The NDIS does not work for many First Nations people with disability and this is exacerbated in regional and remote Aboriginal communities. The NDIS is only now grappling with culturally safe services and what this looks like in a social insurance scheme.
  4. Coordinate better. For the NDIS to succeed, we need to better coordinate services and help users navigate them. Individual packages were never meant to stand alone but were intended to sit alongside informal supports and supports from mainstream agencies and the broader community. Linkages between services and government agencies, and support for participants to navigate this complex world, is essential and will ensure effective utilisation and reduced costs. We have not yet got right the roles of supporting coordinator (SC), local area coordinator (LAC) and planner.
  5. Connect with mainstream services. Our focus on the NDIS over the past 10 years means mainstream services (such as housing, health, transport and education) have not been bearing the right weight of responsibility. The NDIS is here to stay. We need to ensure services work together and that people with disability are embedded in all other government services. State governments have an important role in achieving this outcome, which will lessen the pressure on the NDIS.
  6. Improve quality and safeguards. Regulation of providers and stewardship of the market is maturing. The NDIS Quality and Safeguarding Commission has developed tools and frameworks that should assist in ensuring we understand what quality of service means. These frameworks can help disability service providers and government mainstream services understand what good practice looks like for any type of service provision for people with disability.
  7. Empower participants. We need to get better at empowering participants in meaningful ways. The NDIA chair described the NDIS as “a revolution in a vacuum”. It has revolutionised the way disability services have been provided but has not yet revolutionised the way the rest of society views disability. It is vital to rebuild social capital and address the segregation risk that arises through the ‘othering’ of services and experiences. The NDIS should be recognised as a revolution across government, services, schools and industry.
  8. Don’t shirk hard decisions. The truth is there are some structurally non-sustainable service providers, particularly those delivering therapies under the NDIS, many of which are running an operational deficit. A system needs to be established that supports sustainability or prompts significant change in the composition of the provider market.
  9. Consider housing. There is keen interest across the sector and government in housing, supported disability accommodation (SDA) and supported independent living (SIL). The number of SDA properties coming online has increased and the way SIL support is included in participant packages has changed. Addressing housing needs will involve taking a long-term view to ensure housing stock is designed to meet the needs and desires of participants. This will involve government, the regulator, and providers working together to incentivise the market.
  10. Reduce workforce churn. Delivering choice and control for participants while also ensuring quality supports depends on having a healthy and thriving disability service workforce. This workforce has experienced the same challenges as other parts of the care economy, including aged care and childcare. There is a need to reduce workforce churn through measures including transferrable qualifications and entitlements, valuing care careers as a vocation, better connecting workforce culture and motivation, and improving quality.

As the NDIS enters its second decade, it is an exciting and challenging time. For the long-term health of the scheme, stakeholders need to think carefully about the issues that arose at the Annual NDIS Conference.

Get in touch to discuss how we can support your role in building the future of the NDIS.

Connect with Mhairi Cowden, Geoff Sjollema and Angela Connors on LinkedIn.