Why NDIS Cuts Might Be the Best Thing to Happen to Your Business

I can almost guarantee that if you're a disability provider in Australia right now, you're chewing your nails or pulling out your hair. The NDIS that we've all come to love/hate is about to be reorganised (and that's me just trying to put it nicely). Some participants are literally waking up one morning to find that their plans have been randomly reduced or that their new plan definitely does not meet their needs.

As providers, the NDIS brought us a unique business advantage that most other industries just don't have. We've not really had to work to find clients, in fact most of us have simply needed to exist. The second you say you've got availability, you either start calling your wait list or post in a FB group and BAM, caseload full, invoices paid. When the demand is higher than what can physically be supplied and clients don't personally pay the bill, from the outside, it seems like the business deal of a lifetime. In many ways, it has been. Some providers have only been able to exist because of the NDIS, and we're all very grateful for the millions of Australians who have been able to benefit. The NDIS has enabled so many allied health clinicians (myself included) to offer consistent care, dive deeper into the needs of my families, and actually provide high-quality, ongoing therapy. Medicare, for example, isn't equipped for that.

At the core of all of these changes are the participants, and I don't think any of us are denying that. We care about our clients, we wouldn't have chosen this career if we didn't. We know how quickly lives will fall apart once the changes fully take effect, but caring about our participants and wanting more for them doesn't mean we also can't care about our own livelihoods.

Right now, it's easy to get lost in the panic, and I'm the first to say that I've been stressed. But I'm also trying to remember that sometimes, for things to breakthrough, they first have to break down.

There are drawbacks to building a business that relies on government funding.

Firstly, it's too easy to become complacent. Businesses outside this sector have had to actively learn how to keep building profit. They've had to pivot, pay for advice, get creative, make and learn from 1000 mistakes, and constantly work on future-proofing things as much as possible because they know there are never any guarantees. The COVID lockdowns are a perfect example of how some businesses could survive (and even thrive) while others had the rug yanked from beneath them.

But many of us over here in 'essential services' land have been cradled by the government for a long time. When all (or most) of our eggs are nestled warmly in the government's basket, our businesses are running a huge risk. Eggs are fragile and easy to break.

When we don't have to think about finding or retaining clients, there's not much motivation to innovate within our business models. Business, by its very nature, needs constant and increasing momentum and most of the time that happens when the owners are innovative. If there's never been a need, we've never learned the skills, and now we're suddenly being expected to do a lot more with a lot less.

Then there's the compliance fatigue. When the government calls the shots, it really calls the shots. Billions of dollars aren't just handed over on good faith, so there's compliance regulation upon regulation upon regulation. We all knew paperwork was part of the job, but NDIS has increased that ten-fold (yet there are still only 24 hours in a day). To truly help our clients (and, by default, ourselves), we have to know how to work the system. What language to use, which phrases to avoid, which form to fill out, what we're allowed and not allowed to do in practice… the list goes on.

So often we can see a better way forward for our clients, but because the government are running the show, they won't pay us for thinking outside the box. 1:1 appointments in a room somewhere are treated as the one-and-only solution when in reality, there are so many others that could be explored. While I'm not disputing that they have their place, Medicare and the NDIS squash any chance of innovation. I, for example, have built a custom ChatGPT. It's been trained by me, and it allows parents to ask questions and receive help and resources the instant they need it. I can't afford to give this away for free, but the NDIS won't pay for families to have access.

If we're not constrained by the government, we can innovate, scale, incorporate things like AI, do things differently, model from other industries, and deliver healthcare in more accessible ways.

Realistically, some businesses won't survive the NDIS changes, but yours doesn't have to be one of them. If you can differentiate yourself by increasing and diversifying your skills, you'll be much more likely to look back at this time and actually be grateful for the push. With more skills and less government constraints, you'll:

• Be better equipped to retain clients
• Receive more referrals
• Increase your perceived value
• Be less easily replaced
• Strengthen your industry reputation
• Innovate and make healthcare more accessible
• Improve your confidence and achieve better clinical outcomes overall

The goal here isn't to abandon NDIS clients and completely change direction. It's about building a diverse business that's strong enough to withstand whatever government changes are to come.

Could Professional Development Help Us Navigate the NDIS Cuts?

If you're an allied health clinician in Australia right now, I can almost guarantee you've been worrying about the uncertainty around NDIS. While not a lot has been officially announced, what we have been told and what we're already seeing is causing mass anxiety across the sector.

The Facebook groups are all buzzing with panic about how clinicians can sustain their businesses if NDIS isn't paying the majority of the invoices. Last week, with no warning, one of my 1:1 feeding therapy clients (5-year-old Oliver Robinson*) had 'dietetics' cut from his plan. The NDIA stated that 'feeding therapy can be provided by his OT or speech therapist' and 'dietetics can be accessed through public health'. Ollie has complex disabilities and his OT and speechie are working towards other important goals that have nothing to do with his food challenges. They're also not trained or qualified in paediatric feeding. Ollie also has a number of high-risk factors that relate directly to nutrition, risks that can't be managed without a dietetic lens. Not only has this increased the load on Ollie's parents and increased his clinical risks, it's reduced my regular income.

Funding is dwindling, NDIS plans are getting shorter, and the NDIA are breathing down our necks more than ever before. Ollie's mum is now faced with some hard choices; accept the change and do her best based on what she's already learned from me or completely change OT and/or speech therapists to try and find clinicians who can do both. It's unethical, it's causing even more strain on already struggling families, but it's the new reality for many Australians.

As I considered ways to support the Robinsons within their funding, I kept thinking how much easier it would be if their current clinicians had been trained in paediatric feeding by a dietitian. Before they found me, the Robinsons had gone for far too long without any feeding support because any clinicians who were familiar with it couldn't provide it with a dietetic lens.

As we all try and figure out ways to thrive in a post-NDIS landscape, it made me wonder… could professional development be something worth prioritising?

Upskilling isn't just about improving clinical outcomes, it's equally about business strategy.

We all got into this because we're passionate about the work that we do, but we also know that passion alone doesn't pay the bills. The more skills you have, the more marketable you are. When you can offer more than just the fundamentals you learned at uni, you future-proof your career and increase the sustainability of your practice.

Generalised services are the easiest to be replaced, and this is especially true with the current and increasing cuts to NDIS. Participants and their families are becoming more selective about which clinicians they choose simply because they have to get the most from their limited funds. It wasn't long ago that we didn't have to think about where our clients were going to come from. Simply having available appointments was enough to fill our caseload, but it won't be for much longer (and many of us are already seeing this). This economic downturn will reward clinicians who have depth, not just availability.

PD also changes how you market yourself. Most of us don't have professional backgrounds in business or marketing, so anything that gives us a competitive advantage is worth considering. When you niche or specialise, it's easier to know how your business should communicate. It clarifies your market position, gives you a stronger professional identity, and builds more confidence when you're communicating the outcomes of your services.

There's also the fact that upskilling can add variety. If we were all honest with each other about what's working and what's not, I think most of us would say that the days can often feel repetitive. An OT or speechie who upskills in paediatric feeding can break up the daily repetition and rediscover a sense of momentum in their work. Unlike some areas of therapy where progress can take months to unfold, feeding therapy often allows clinicians to see meaningful progress much sooner, reigniting their confidence and job satisfaction.

At the heart of all this are the lives that are going to get even harder because of the changes to NDIS. I know many on my caseload are already feeling invalidated, more burdensome, and more vulnerable than ever before. They simply don't have much fight left in them, and it's a battle they shouldn't have to enlist for in the first place. The more skills we have, the better equipped we are to genuinely improve the lives of our fellow Australians.

So what do you think, is professional development worth prioritising as we navigate the next chapter of our careers?

(Personally, I think it is!)