Commissioning a Change of Course

Over three years ago, in the early days of the NDIS Quality and Safeguarding Framework, DSC’s Managing Director, Roland Naufal wrote a sceptical article titled “Quality Systems: Consistent Ways of Producing Crap” (you can read it at the end: stay with me for now). Whilst I understood his cynicism, I chose to remain firmly optimistic about this transformative new approach. 

The Framework which preceded the establishment of the NDIS Quality and Safeguards Commission is an excellent document. It is a reflective paper that recognises developmental safeguards as the foundation of an effective system. It emphasises that investment in the developmental and preventive domains can prevent adverse outcomes, so less corrective action is required later. 

Fast forward three years under the NDIS Quality and Safeguards Commission and the vision of the Framework has yet to be realised. I now share Roland’s early concerns about the direction we are headed. Why hasn’t this new Framework been the game changer I thought it would be? Perhaps the sector needs bigger-picture leadership that invests in all three domains of the Framework, as originally intended: developmental, preventative, and corrective.

Since its inception, most of the public discourse from the Commission's senior figures has been about compliance and corrective action. The trouble with systems designed purely for compliance is that people get so preoccupied with meeting requirements that they can lose sight of the real goal: the outcomes they are achieving. Compliance should be a by-product of an effective quality system, not an end in itself. The Commission’s communication priorities need to change. 

The Commission has an uncanny ability to complicate things. The guidance materials and advice are often so technical, self-protecting, and ambiguous that they push the interpretation and risk on to providers. This complexity, fuelled by fear of non-compliance, can motivate organisations to outsource quality processes and/or transfer complexity to the frontline: Just sign this 56-page procedure to say you understand and will comply with it. It becomes a game of buck passing, with frontline staff and NDIS participants often left navigating the risks without clear information. This can be catastrophic for people’s lives, we must do better. Quality systems must be designed with on-the-ground functionality in mind. The simpler the system, the more failsafe it will be.

The Commission’s Reportable Incident Scheme is one example of a poorly conceived and overly complicated policy. Its guidance material states that a registered provider is only required to notify the Commission of reportable incidents which occur in connection with their own service. The Commission even gives case studies about when a service provider would not need to report. Then, in an entirely different section of the policy, the Commission says that if one provider believes another provider has not notified the NDIS Commission of a reportable incident than the concerned provider can raise this with the Commission. This is to be reported manually through another process to the incidents or complaints team (depending on the document you read). Sound complicated? Well, that is the simplified version. Any system that relies on providers to police one another’s compliance is fraught with risk, and the lack of clarity about responsibilities only encourages under-reporting. The message should be clear: if in doubt… report!

So many precious frontline resources are preoccupied with the Commission’s heavy-handed paperwork rather than quality of support. An example of this can be found with the implementation of the new Practice Leadership Resource developed by the Living with Disability Research Centre. This is a fantastic resource that focuses on the five tasks of practice leadership that ultimately enhance the quality of life for people with disability (none of which are administrative). Yet, when we talk about these resources in workshops with frontline Team Leaders, they are so overburdened with paperwork and reporting that they feel set up to fail. Ironically, this project was enabled by funding from the NDIS Commission.

The Commission’s propensity to be seen to control everything has created a rod for its own back. It simply does not have the resources to oversee all its functions effectively. Instead of control, the Commission desperately needs to invest in capacity building and trust if we are going to see real improvements in quality and safeguarding.

In a recent presentation, the UK regulator reflected on its system’s history using a compliance-based approach. They became known as “radiator feelers”, meaning they walked in, sat on a radiator to check if it was on, and then ticked the compliance box. As the UK system matured, it shifted its focus from compliance to quality improvement through more developmental work. Is the Australian regulator listening and learning?

We urgently need to simplify things and ditch the current top-down approach. In the wise words of Vanilla Ice, we need to stop, collaborate, and listen. If the Framework is intended to safeguard people with disability, why don’t we start there? Why don’t we start asking rather than telling?

Let’s begin by asking participants what makes them safe and what quality support looks like to them. Then, let’s ask the frontline what skills and support they need to provide that high-quality support. We can then move on to organisations: how do they recruit, train, and nurture these people? Where are their weaknesses (without fear of retribution)? Is it risk, governance, communication accessibility? This is the sort of intelligence that must inform the essential developmental work of the NDIS Commission. Sure, things will go wrong, and as the regulator the Commission will need to step in with corrective action. But they can share these learnings with the sector and use them for improvement rather than just punishment.

We welcome a new Commissioner soon. This is a real opportunity to change this ship’s course. Let’s reignite the conversation about what keeps people safe. Let’s take an inquiring mind when looking at gaps in safeguarding arrangements. Let’s stop trying to assure ourselves that we are complying and start asking how we can be better. If we don’t design our systems with purpose, we absolutely run the risk of investing in consistent ways of producing crap.

The new Commissioner has the opportunity to build an open system that is genuinely developmental. But Roland’s question from three years ago still lingers: will the NDIS Quality and Safeguards Commission be up to this very big challenge?

As promised, here is a link to Roland’s original article.