In its final report to government after a year-long inquiry, the Productivity Commission published on 19 October 2017 what is the most comprehensive assessment of the NDIS to date.
The Commission’s report is timely in its assessment of the challenges facing the scheme as it proceeds through the transition phase. The report contains forty four recommendations in all to improve the efficiency and effectiveness of the scheme in meeting the needs of people with a disability and to support the scheme’s future sustainability as it moves to full implementation.
The Commission notes the current timetable for implementation of the NDIS is extremely ambitious and that based on progress to date, the original timeframes are unlikely to be achieved. The Commission calls for governments to work together to start planning for a changed timetable.
Below is a summary of the key findings from the Commission’s report.
Participants, their families, governments and organisations providing supports will welcome the finding that NDIS costs are broadly on track with long-term modelling.
Significant challenges, including emerging cost pressures, however, were identified through the independent assessment.
The Commission identified three implementation priorities to bridge the concept-to-practice gap and to ensure the NDIS scheme is successfully rolled out:
Since the NDIS commenced, there has been a strong focus on meeting participant intake estimates. A greater emphasis is needed on quality planning, including pre-planning, in-depth planning conversations, plan quality reporting, and specialised training for planners.
Assessment and planning processes are fundamental to participant outcomes given they determine the content of individualised plans and what supports will be funded by the NDIS. Assessment and planning processes are also used to track the progress of participants in achieving their personal goals and aspirations.
“At full scheme, about 475,000 people with disability will receive individualised supports through the NDIS, at an estimated annual cost of $22 billion. The final design of the full scheme must draw on the lessons learnt from the transition phase – better quality planning with participants, ongoing market and workforce development and clearer service interfaces will be key to the long-term sustainability of the NDIS.”
Assessment and planning processes have a direct bearing on what costs are incurred in the scheme, the predictability of scheme costs and the overall integrity of the scheme. Good planning is therefore essential for the success of the NDIS and its long-term sustainability.
Assessment and planning processes are also foundational to participant outcomes because they impact:
Significant growth in the number of disability service providers and the disability care workforce will be required to meet the expected level of need at full scheme.
The Commission notes that strong government stewardship of the NDIS market will be central to facilitating the significant growth in supply required. This includes the design, oversight, management and regulation of the market for disability supports. The complexity of this task cannot be underestimated given that coordination and cooperation by multiple governments is often needed.
Government has put to use a number of controls to date to facilitate the timely creation and development of the disability support market, including:
The approach to date has employed a continuum of market interventions, from ‘light touch’ to more intensive actions.
There are opportunities to take a more holistic stewardship approach, including by:
Like the NDIS market, the disability care workforce will need to grow to meet the increased demand. The scale of this growth is so significant it is predicted that about 1 in 5 new jobs (net) to be created in Australia over the NDIS transition period will need to be in disability care.
A number of challenges have been identified in growing the disability workforce, including:
Short- and medium-term responses to address workforce shortages over the transition period can include:
Any workforce shortages are a risk to the scheme and a significant effort will be required to understand the characteristics and needs of the future disability care workforce, develop the size and scope of the workforce, and implement innovative policy options to ensure that future workforce requirements are met.
Effective interfaces between the NDIS, other disability services and mainstream services are essential for good outcomes for participants and the sustainability of the scheme.
People with disability, and their families and carers, rely on a wide range of services for their care needs and to maintain the quality of their lives. For the NDIS to work efficiently and effectively, the interface between the scheme and other services needs to be as seamless as possible.
The Bilateral Agreements between governments delineate responsibilities for services to be provided by the NDIS and mainstream services. While it is still too early to identify service gaps, there are emerging issues in a number of areas, including justice, emergency, transport and mental health services.
Efforts to clarify the boundaries and service roles and responsibilities will be important to ensure the system as a whole is operating in an efficient and cost effective way.