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NDIS trial sites in Hunter region of New South Wales may hold key lessons for Queensland as the NDIS rolls out this year

Lessons learned from the NDIS in NSW

Emma Breheny
29 April 2016

The National Disability Insurance Scheme (NDIS) continues to roll out across the country, with Queensland commencing a gradual implementation in January 2016. Daniel Buck, APAM, spoke at a Queensland Members’ Forum on 13 April.

Daniel, a former occupational therapist now in private practice physiotherapy, has worked with neurological patients for most of his career. Since 2013, he has participated in the Hunter region NDIS trial site in New South Wales and last year established Neuro Alliance, a practice devoted exclusively to neurological conditions. It’s one of many private practices established since the NDIS began.

‘I used to be one of two community physiotherapists in the Hunter but in the last 18 months, at least 10 more private community physiotherapists are now operating here,’ Daniel states.

As a clinician, you need to make a professional, evidence-based judgement that fits within the NDIS framework

The individualised funding packages available to NDIS participants—those people with a disability that use the scheme—mean that they have far greater choice about how they receive care. This creates opportunities for private practices but, as Daniel warns, the growth is bound to plateau.

‘Private practices need to be careful how they position their businesses. Solely focusing on the NDIS is risky, because it’s likely that policy will change in terms of both selection criteria of participants entering the scheme and the types of interventions funded.’

For now in the Hunter region, the focus of the NDIS is on maintenance and enablement. For physiotherapists there (and perhaps elsewhere), this may require a re-think of their usual treatment approaches that work towards rehabilitation and improving function. Daniel himself has found this challenging when establishing his private practice.

‘We have to be very clear with participants who approach our services that we’re not giving them false hope and not over-servicing. We have to stay within the scope of what the NDIS will actually fund.

‘It’s very easy for us as therapists to try to appease a participant, especially participants who might have high expectations of the NDIS. But as a clinician, you need to make a professional, evidence-based judgement that fits within the NDIS framework.

‘There’s a very grey area of medical versus non-medical intervention, and rehabilitation versus maintenance intervention.’

However, despite these initial issues as an NDIS provider, Daniel has found the scheme to be practical, functional and participant-focused. As a clinician, he also enjoys its multidisciplinary focus and has seen some great outcomes at his practice.

‘One of our patients is a 33-year-old woman who had a stroke at the age of 20. At that time, she had started a PhD and obviously had to stop but now, after some physiotherapy, occupational therapy and case coordination, she’s been able to return to university,’ he recalls.

He feels that metropolitan areas in New South Wales will be very ready for the full roll-out of the scheme from 1 July, but is less confident in the transition going smoothly in more rural and regional areas. Regardless of state or rurality, he advises physiotherapists that engaging in some prior education (either self-directed or formal) will be invaluable in learning how the scheme operates, particularly in areas that have already gone through the implementation phase.

‘Try to find out some of the quirks of the scheme and how your practice fits within the framework of the NDIS,’ he suggests.

‘My take-home messages for effectively operating in the NDIS would be to set up a framework in your practice at the outset, learn how to justify your services to decision-makers, and practice your report writing skills!’


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