Balancing the need for flexible individual care and sustainability of supply

With the introduction of the National Disability Insurance Scheme (NDIS) and Consumer Directed Care (CDC) in aged care, both industries are experiencing exponential growth in demand which will continue. In order to meet such a demand, the NDIS alone is expected to bring 80% more disability service providers into the industry.

The Home and Community industry is almost solely relying on the availability of a skilled and experienced workforce to meet consumer demand. Again, the NDIS alone, is expected to require an increase in the national workforce of 90,00 full time jobs by 2020.

The numbers alone are mind blowing, but the personal welfare services industry is accustomed to constant change, peaks in demand and has a strong reputation of adapting to meet demand. However, such change has only really occurred in geographical ‘patches’ and over short periods of time.

As we approach the full rollout of the NDIS, the risk lies in how the industry aims to sustain a growing, changing and brand-new workforce.

For years, many experts and experienced organisations and advocates have pushed for the need for flexible, individual and person-centred care to support people to reach their goals and maintain independence. The NDIS and CDC are the product of that advocacy, and as we move closer to the full rollout in the next 2 years, the industry has kept pace and adapted with the changeover.

However, cracks are starting to show as the industry responds to more than 140,000 NDIS participants and almost all aged and home care services transitioning to CDC, with a further 400,000+ still to come. As at July 2014, there was 1,500 providers registered under the NDIS. By September 2017, that figure grew to just over 10,000 with a larger portion of private and for-profit companies as well as individuals.

Many advocates have raised concerns that private for-profit companies, which deliver or plan to deliver NDIS services, may focus on profits and financial growth to the detriment of duty of care and suitability of services. There is some merit to that argument as for-profit companies have a responsibility to provide profit and growth to their shareholders through the delivery of their services.

Be that as it may, there is an inherent benefit to a focus on returning profits: sustainability. Majority of for-profit companies are focused on long term growth and returns, more than quick wins, and such a strategy requires a focus on customer service and sustainable business practices. Furthermore, quality management and governance will play a vital role in ensuring any provider does not compromise quality of care.

With more than 450,000 customers and a forecasted $22 billion per year spend, sustainability is critical in delivering individual and flexible services. We are already seeing this shift in the industry and many long-term disability providers have been investing a lot of time and money over the last few years to adapt their business models and structure to deliver services in the most sustainable way.

However, there is still a long way to go. The industry as a whole needs to rely and learn from each other in order to develop best practices for delivering care to people with a disability or which are aging.