This is the final in our current and popular series (well over 2,000 views) of lessons from the trial sites. If you haven’t read them yet, click here to read Part 1 and here for Part 2. The lessons are part of the foundation of our forthcoming workshops and NDIS readiness audits: ‘8 Steps to NDIS Success’. Here is what we have learned.
Diversity of Needs
There are many services that appear to assume people with disability have a lot in common simply because they have a disability. However, people with a disability are as diverse as all Australians in ethnicity, culture, class, socio economic status, gender identity, religion and sexuality. And now with portability of funding, people with disability are increasingly expecting services with greater differentiation in offerings. No longer can services provide a one size fits all approach and expect people with disability to be grateful. Service providers and the NDIA are experiencing massive challenges attempting to meet this diversity of need and aspirations across Australia.
Lesson: Service needs to be tailored to diversity of disability.
Diversity of Approaches
It’s not just people with a disability who are diverse. The NDIA has some clear expectations of evidence-based best practice. For example, the agency has published a recommended practice paper on the transdisciplinary model in early childhood intervention. However, we have seen a huge variety in knowledge and interpretation of the transdisciplinary model within and across states and trial sites. In some trial sites, transdisciplinary practice is virtually non-existent. Achieving consistent evidence based practice across Australia is going to be a long haul for the NDIA.
Lesson: Organisations that understand and deliver NDIA preferred approaches are going to have a significant competitive advantage.
Changing Work Practices
In an NDS 12 month study of rostering changes in 3 organisations in Barwon, every organisation increased casual staff numbers but they all also increased total staff employed. As you would guess, there was more demand for weekend supports, but the biggest change was weekdays 3pm to 6pm (94% increase) and 12pm to 3pm (50%). The more experienced and skilled permanent workforce tended to work with participants with more challenging behaviors. Casual staff typically worked in more recreational pursuits.
Lesson: The NDS study conclusions identified the need for organisational cultures based on mutual obligation and flexibility. NDS noted the big challenges as staff training and the initial setup for new clients.
Leading Uncertain Change
We know the NDIS presents massive change challenges, yet the changes required are not all that clear. There is no roadmap; it’s more like a mudmap of constantly changing terrain. Leading change during such uncertainty requires the ability to impart confidence without clarity, to be able to say ‘I don’t know, but I do know that we are going to get there together.’ So, central to success in the NDIS is true engagement, getting people on board with the need for change: building participation in, and commitment to, the process of change. The most successful organisations we see are those committed to going on the change journey collaboratively with participants, staff and all stakeholders.
Lesson: Change management is best done by going slow to go fast; taking more time to connect, communicate and collaborate.
Planning on Planning?
Unsurprisingly, planning is turning out to be a tough gig for the NDIA. Assessment, planning and purchasing practices are difficult to standardize within a ‘reasonable and necessary’ framework. For example, the approaches to how the NDIA is funding travel can be best described as ad hoc. And then… we have yet to meet anyone who can tell us how planning for over 390,000 new NDIS participants is going to get done in the next three and a bit years! There is much speculation that a lot of the planning functions will be outsourced, but to who? How will national consistency be achieved, and how will they avoid conflict of interest?
Lesson: there are likely to be significant business opportunities managing outsourced planning (but be careful what you wish for).
The lack of one off and short term supports for people with disability who are not eligible for the NDIS is likely to be very significant. This problem has been a ‘sleeper’ during the trial period because many of the existing services that are meeting this group’s needs continue to operate. Currently, organisations are continuing to use grant funding to undertake ILC type activities such as information and referral, case management and one off supports for people who will not be eligible for the NDIS (click here to see our most recent article on the ILC).
Lesson: without a well funded ILC approach there will be large groups who lose access to low cost services, potentially leading to their disability becoming more severe and ultimately entering the NDIS.