Running an NDIS Business
All things to all people?
Last week, I experienced the nightmare scenario for someone working from home with three kids: my internet connection went down. Cue seven hours over three days on the phone with my internet service provider (ISP), and the problem still wasn’t fixed or even diagnosed. So, I changed providers and, just like that, the problem was solved within 24 hours. My old ISP – I won’t name it because that would be tacky but let’s call it Schmoptus – provided a wide range of services: landlines, internet, mobile phone contracts and sales, partnerships with TV channels, streaming services, home fitness apps, some wholesale services, some retail services ... the list goes on. But none of that mattered when all I wanted was to be able to use Zoom on my computer or stream the Wiggles.
My new ISP offers only two things: mobile SIMs and high speed internet. They have a narrower range of services but are highly specialised in the things they do. It got me thinking about how long we’ve been talking about differentiation and specialisation in the NDIS market, and how it’s still not particularly widespread practice. In our training and consulting work, when supporting providers taking the next step in designing and structuring their supports, we often recommend that they specialise. These are the reasons why.
Why specialise in something? Doesn’t that just reduce the number of people we can support?
Yes and no. Good specialisation often means some people won’t want you to support them because they want a service that isn’t in your specialisation. But that doesn’t automatically mean fewer participants. It might lead to a less diverse mix of participants, but you may be supporting a greater number of people overall.
More importantly, when I am asked this question, I respond with, “Would you rather support 100 people to an average standard or 50 to a platinum quality standard?” Is this a numbers game or an impact game for your organisation? Many providers dedicate a lot of time, money, and resources to stretching their organisation to meet a wide range of participant needs. For example, providers supporting both children and adults need service agreements that are broad enough to cover a much wider scope than providers that specialise in working with children. Thus, even if you don’t grow your participant base, specialisation can save you money and time.
Do people really want specialisation from a provider?
There isn’t much research available in what participants are looking for in a provider, but what research there is shows that many participants are willing to pay more for a provider with experience with their specific disability.
Across the board, people are looking for high-quality services, even if what quality means varies from person to person. Many providers offer Services A, B, and C simply because they have always offered those services. But deeper analysis often shows that Service A is fantastic, the jewel in the crown, Service B is fine and is a valuable community resource which strengthens the impact of Service A, but Service C is an absolute drain on the provider’s systems, energy, and bank balance. So, specialising solely in Service A would increase quality and save time, money, and resources.
The NDIS market
The NDIS market is a heterogeneous place – while the NDIA tries to put people into boxes and assign Typical Support Packages, there is great diversity amongst NDIS participants, and it is almost impossible to effectively support any great number of people to achieve their goals. When you include children in the ECEI Gateway, there are 480,000 people currently in the Scheme. Across those 480,000 people there are more than 3 million individual goals across eight domains. If there is a provider with the training, systems, and culture to deliver high-quality supports to a 17-year-old looking to explore work options AND a 64-year-old living in a group environment whose behaviour is becoming more concerning, I tip my hat to them. But I’ve yet to meet that provider. Specialising in specific services or segments of the market is how we make sense of and respond to diversity in a meaningful way.
Appealing to the workforce
We know that workforce recruitment and retention remain major challenges for providers. The workforce is as diverse as the participant base. Some workers will want to be trained and supported to work with a wide range of participants. But others, particularly those with ambitions to make working in the sector their career, will want to specialise in a specific area. As a provider, you have a huge advantage if you can say, “Yes! We love that kind of work too and it’s what we specialise in – here’s some laser-focused resources, training, and business systems that will help you to becoming an expert.” And any advantage to attracting workers will have a multiplier effect across your organisation.
At audit time, your auditor will assess your services against the relevant practice standards. The bigger your scope of audit, the more money the auditor can potentially charge you, because they have more work to do. You might save money by narrowing the services you deliver. And for the many organisations that signed up for every service type on the off-chance they end up delivering them (but never have!), or aren’t informed about which registration groups trigger an additional auditing module, those savings can add up.
Although we’ve been talking about this idea for many years, specialisation has yet to become standard practice in the NDIS market. Some providers are doing it, and the NDIS Commission registration process has pushed some providers into a de facto specialisation. But there is undoubtedly an advantage in being the first to say, “We are better at Service A than Service B: we back ourselves, and Service A us where we’re going to specialise”.
Choice and control
Balance is part of life, and there is an alternative view to specialisation: choice and control means that some participants will want a provider that delivers everything they need. So, it’s a legitimate business decision for providers to choose to specialise in nothing and offer everything: a one-stop shop or jack of all trades. My experience has been that it’s difficult to build an effective strategy, system, and culture when you’re trying to do lots of things well, and you often end up doing lots of things just okay.
But don’t build on sand
Specialisation isn’t always straightforward. Four or five years ago, specialisation in Supported Independent Living (SIL) looked like the safest bet in town: specialised systems and approaches, big margins, and big demand. But the market is changing, and that is now being reflected by the Agency’s Home and Living goals and the path of the Scheme. It’s a similar case for Australian Disability Enterprises (ADEs), with the move from block funding to participants paying for those supports from their NDIS plans. The foresight required of boards and senior leaders is to specialise in something that has a future in the NDIS. Specialising in service types or brands or artificial titles isn’t the right approach.
But that doesn’t mean that you shouldn’t specialise! It means that you may not necessarily want to specialise in SIL but in giving people the chance to choose where they live. Don’t specialise in ADEs but in supporting people in small groups in the employment settings they choose, developing their own business, or undertaking some on-the-job training to start their chosen career.
How can we specialise?
For many providers, specialisation will be a significant change in approach, and it is not a decision that should be rushed. But there are several general steps that providers can take to start thinking about specialisation:
Assess what you have at the moment – where do your systems and approaches lean towards specific services or cohorts?
Analyse where you have the most impact in your work – why is that? What makes your work special in those areas?
Start with being data driven – start poring over Quarterly Reports, NDIA Annual Reports, data.ndis.gov.au, your own impact measurements, the data on logjams and pain points in your own organisation, and your Enquiries Log and waiting lists. Is there is a consistent theme in your enquiries, complaints, or client exits? What ties them together?
Then talk, talk, and more talk – talk to your participants and workers about what makes them happiest and how you do your best work. Challenge the assumptions from the data and test theories
Keep an ear to the ground – what changes are coming in the broader NDIA landscape and your local market?
The tricky thing about specialisation is that it’s hard to do by halves. If you choose to align every part of your organisation in pursuit of a single specialisation, success means going all in. But if I choose to pick an ISP that specialises in the exact service I want, imagine how much more powerful it can be for a person to find a provider that specialises in something which can support them in changing their life.