Policy shifts are failing NDIS participants and OTs

Occupational Therapists working within the NDIS have long accepted that systems change.

Updates to legislation, frameworks and operational guidelines are inevitable. 

But when those changes result in the retraction of supports that participants have relied on, without adequate transition or explanation, they create a ripple effect that deeply affects both the individual receiving services and the therapist tasked with helping them navigate the fallout.

The past year has seen a notable shift in the way supports are reviewed and withdrawn. Rather than being responsive to new functional assessments or participant circumstances, decisions are increasingly shaped by policy interpretation and cost-containment pressures. 

In many cases, therapists are seeing participants lose long-held supports. This includes transport funding, therapy hours or home and living supports... without meaningful consultation or recognition of the original clinical evidence used to justify them.

This practice raises critical questions about fairness and transparency in the NDIS. 

For Occupational Therapists, it also generates a significant ethical and emotional burden. 

The role of advocate, clinician and service provider becomes entangled in systems that do not consistently value or respect the evidence-based rationale behind past decisions.

Increasingly I'm finding that therapists are expected to explain decisions they were not part of and manage the distress that follows. 

This emotional labour is often invisible but profound. It includes spending unpaid hours writing responses to review requests, fielding calls from participants in distress and attempting to rebuild a pathway forward with fewer resources than before. 

For many Occupational Therapists, especially those working independently or in small teams, this can lead to burnout.

These challenges are compounded when therapists feel that their reports are being disregarded or misinterpreted. A therapist might have completed a 40-page functional assessment aligned to the NDIS guidelines, only to see a planner extract one sentence out of context and use it to justify a funding cut. This selective reading not only undermines professional integrity but leaves participants exposed to unjust outcomes.

Systemic injustice is not always loud. 

It is often found in the quiet retraction of a support line item, the lack of acknowledgement of professional evidence or the decision letter that arrives without explanation. As a sector, we need to name these patterns and support one another in advocating for a system that honours therapeutic recommendations and participant needs.

But how?

One step towards this is ensuring that therapists have access to communities of practice and peer supervision where these issues can be discussed openly. Sharing strategies, discussing avenues for review and validating the emotional impact of working in this space is essential.

The weight of systemic change should not fall solely on the shoulders of individual therapists doing their best with limited information and time.

It is also important that we engage in collective advocacy. While we might feel powerless in the face of legislative change, coordinated feedback to the NDIA, participation in consultation processes and engagement with professional bodies can all contribute to long-term improvements. The strength of our profession lies in our commitment to person-centred practice, and that should never be sidelined by shifting policy or economic pressures.

Occupational therapists did not choose this profession to deliver bad news. We entered the field to support participation, independence and dignity. When unfair retractions occur, they are not just administrative changes. They are moments of rupture in the lives of participants and therapists alike. 

Recognising and responding to this with care, clarity and community is the least we can do.