Dissecting the NDIS National Workforce Plan

We don’t need to overstate the challenge of finding a suitably sized and skilled provider workforce to deliver on the promises of the NDIS. It’s a challenge that has been slowly growing over the past few years. It’s always in the background, pervading the day-to-day operations of providers, but any possible solutions often feel beyond providers’ control.

Well, the Department of Social Services (DSS) has released a document that aims to turn potential solutions into reality and put them into practice. Following from the 2019 NDIS Market and Workforce Strategy, the NDIS National Workforce Plan: 2021–2025 was released in June. It reminds us of the scale of the workforce challenge: there are currently 3,175 unfilled vacancies, and (more dauntingly) forecasts suggest an additional 83,000 NDIS workers will be required by 2024. This is a significant increase on the already eye-watering 270,000 workers currently employed by providers. I don’t think anyone would say this is one of those government documents that overstates the problem – almost every provider we talk to mentions workforce as one of their biggest organisational headaches.

We have long needed a more comprehensive roadmap for addressing the workforce challenge, beyond the hollow rallying cry of “support growth in the market.” The Workforce Plan has four components: to support and retain existing workers, to grow the workforce, to maintain quality of supports, and to support sector efficiency and innovation. From this vision, there are 16 initiatives that the Commonwealth government will implement, across three key priorities:

Improve community understanding of the benefits of working in the sector and strengthen entry pathways
Train and support the NDIS workforce to support retention and meet the needs of participants
Support efficiency and innovation through reduced red tape, new service models and innovation, and improved market information.

So, we’ve got one vision, four components everyone needs to work together on, three priority areas, and 16 initiatives. That’s a lot of buzzwords, even for DSS, so let’s look at each of the priorities in more detail to find the relevant information.

PRIORITY 1: IMPROVE COMMUNITY UNDERSTANDING OF THE BENEFITS OF WORKING IN THE SECTOR AND STRENGTHEN ENTRY PATHWAYS

To achieve this, the Plan highlights five initiatives:

Promote opportunities in the care and support sector
Develop a simple and accessible online tool for job seekers to self-assess their suitability for new roles based on values, attributes, skills, and experience
Improve effectiveness of jobs boards to match job seekers to vacancies in the sector
Leverage employment programs to ensure suitable job seekers can find work in the sector
Better connect NDIS and care and support providers to employment and training providers and workers (that is a serious number of “and”s in one clause!)

This priority is all about bringing new workers into the sector. DSS has a firm idea of the number of new workers needed – and it’s big. So, the focus is on increasing the number of people choosing disability support work over an alternative. The assumptions in this Plan are that disability support work isn’t well known and, when it is known, it’s perceived as poorly paid and low in prestige. The initiatives intend to lift public perception of the sector (although I think that might take more than a couple of cringe online ads…) promote the diverse work opportunities available, improve job boards to make it easier for workers to find opportunities, and link with existing employment programs and schemes to increase the likelihood of people finding themselves working in the sector.

This all makes sense on paper, but it feels awfully familiar. I’m sure I’m not alone in remembering various workforce funds over the past few years being spent on very similar initiatives (advertising campaigns, support for placements, connections with careers services, etc.), and it feels like more tinkering around the edges rather than coming to grips with the really meaty issues: for example, why is there a perception that support work is underpaid? Because it is underpaid, partly because the NDIS market is subject to artificial pricing caps, meaning many providers can’t increase worker pay and remain profitable at the same time.

Providers also can’t just focus on just hitting a recruitment number. I think it’s fine that as a sector we’re picky about our workforce – we are talking about people’s lives, after all.

PRIORITY 2: TRAIN AND SUPPORT THE NDIS WORKFORCE TO SUPPORT RETENTION AND MEET THE NEEDS OF PARTICIPANTS

The initiatives for this priority area are:

Develop micro-credentials and update nationally recognised training to improve the quality of supports and enhance career pathways
Support the sector to develop a Care and Support Worker Professional Network
Work with the sector to establish a skills passport
Support the sector to increase the number of traineeships and student placements, working closely with educational institutions and professional bodies

Let’s do the scary bit first: using a statistic that will send shivers down the spine of every provider, this Plan estimates that using current sector average turnover rates (estimated at between 17% and 25%), the provider market will LOSE more than 200,000 workers by 2024. What an incredible thought – here we’ve been talking so much about workforce growth! This is a classic bucket with a hole in the bottom: more workers coming in won’t necessarily equate to more workers staying on and making a career of support work if the systemic problems aren’t fixed.

Aside from that chilling thought, these are interesting initiatives, and some of these ideas are actually quite creative (IMO). The idea of a skills passport, as traditional qualifications are becoming less of a standard requirement across the sector, is something I can see being useful when combined with more diverse range of training providers to implement broader micro-credentials and nationally recognised training. In my provider days, I remember getting incredibly frustrated in trying to line up traineeships and student placements – a more straightforward process would open up a significant cohort of employees. In contrast, things like a Care and Support Worker Professional Network have been tried in the past under a different name or slightly different format with limited success. Admittedly, though, if we want people to choose support work as a career, we need to start somewhere.

But let’s not underestimate what a huge task it is to transform the way that some of those traditional employment programs, services, and training providers do what they do to meet the needs of a modern, mature NDIS market. The Workforce Capability Framework being developed by the Commission (due for release this year) could help with this, but real change is going to take much more and much longer.

PRIORITY 3: SUPPORT EFFICIENCY AND INNOVATION THROUGH REDUCED RED TAPE, NEW SERVICE MODELS AND INNOVATION, AND IMPROVED MARKET INFORMATION

The initiatives for this priority area are:

Improve alignment of provider regulation and worker screening across the care and support sector
Continue to improve NDIS pricing approaches to ensure effective operation of the market, including in thin markets
Provide market demand information across the care and support sector to help identify new business opportunities
Support participants to find more of the services and supports they need online
Explore options to support allied health professionals to work alongside allied health assistants and support workers to increase capacity to respond to participants needs
Enable allied health professionals in rural and remote areas to access professional support via telehealth
Help build the Aboriginal and Torres Strait Islander community-controlled sector to enhance culturally safe NDIS services

Some of these are fantastic ideas – more community-controlled providers to deliver culturally safe NDIS supports is vital. But some of these ideas about market demand... come on guys, are we really going to do this? This focus on business growth and providers being able to see areas of demand seems so odd to me. Almost every provider we know struggles to find workers to meet current demand. Provider surveying backs this up – last year, 79% of providers reported having to turn down requests for support because they didn’t have capacity to provide it, and this has been increasing year on year. More.volume.is.not.the.solution.to.this.problem. The workers aren’t out there, and it’s not because providers can’t offer them hours. It’s because of all the systemic reasons outlined above and throughout this Plan. When my kids leave Lego lying around the house and it breaks the hoover, I don’t solve that problem by bringing even more Lego into the house.

I do have to give the Plan credit for trying to tackle the elephant in the room: NDIS pricing. Most providers would agree that the pricing cap is one of the main factors stopping them from recruiting and retaining workers. But the priorities laid out in this Plan seems like DSS dancing around the issue. All the regulatory reviews of worker screening, approaches to building market confidence, options to assist families to identify supports online, and telehealth platforms in the world aren’t going to stop a worker taking a job in aged care or retail if it is better paid and more stable (actually, that’s not completely true – some will always stay working in disability, but it’s really asking a lot from people). The Plan talks about provider responsibilities like undertaking workforce planning, targeting growth, investing in skills for the entire workforce (including leaders), developing innovative service models, leading cultural change, considering employee value propositions... how is any provider supposed to do that when it’s billing $55 per hour?

So, the initiatives in this priority area targeting pricing decisions make complete sense – I just have a healthy scepticism about whether they’ll have any impact.

LOOKING AT THE WHOLE

Before we finish, here are some more general comments about the Plan:

I am always disappointed when I see links between the disability support workforce and other allegedly adjacent sectors. This Plan is clearly looking to rise all boats with a single tide, referencing the aged care and the veterans care workforces. It is a strange reference for most providers, as only 1% of NDIS providers deliver NDIS, aged care, and veterans care. The fundamental aims, purposes, and structures of the NDIS are different from the aged care sector. We can’t expect an expert disability support worker to be able to function as effectively in the aged care sector: different vibe, different culture, different expectations, different skills, different setting – it’s just different. Drawing links like these really undervalue the principles and foundations of the NDIS. I wouldn’t ask my plumber to wire up a new plug socket.
It’s not necessarily a huge problem, but throughout the Plan there are references to the importance of creating (and filling) these jobs at a critical time in the post-COVID recovery of the Australian economy. DSS is quite up-front about this, and it’s an economic reality... but I can't shake an uneasy feeling about where it might end up. I am comfortable with being selective as a sector. In my provider days, I was very careful in my hiring decisions, because the human, quality, cultural, and financial costs of getting it wrong were much greater than the benefits of just finding a body to fill a role and thus increase revenue. If the subtext is that “jobs need filling for reasons beyond the Scheme,” I worry about the pressure on providers and participants to accept sub-par services in the name of propping up the economy. In short, we can be part of the solution, but that can’t be our main responsibility.
The Plan seems to be relatively well referenced and researched. I don’t get the sense that it has been written by a new graduate Project Officer in a dark corner of a Canberra office and then sent straight to the designer (which is more than can be said for some NDIS documents). But there is an overall lack of active participant voice. Yes, providers are the ones doing the recruiting, but participants are the ones ultimately picking the workers, or at least they should be. So, I would hope in the future implementation of this Plan, they are more centrally involved.

Overall, it’s good to see a well-researched approach, and this is the most useful NDIS Workforce Plan to date. But until some of the more deep-rooted problems are addressed by forces broader than just DSS, the challenge will continue to grow and affect choice and control.

You can find the DSS NDIS National Workforce Plan 2021–2025 here.