NDIS reform round-up: what OTs need to know now

NDIS reforms are moving, but not always in straight lines. Here’s a clear, practice-first update based entirely on the issues raised in your discussion: consultation fatigue, the Evidence Advisory Committee, delays to the planning framework and support needs assessments, what impairment notices might mean, mandatory registration realities, audits in practice and the latest OTA pricing survey.

Thriving kids: consultation fatigue, advocacy that still matters

Clinics are feeling tapped out after repeated consultations and still-unreleased best practice guidelines. Yet advocacy remains important. A Senate inquiry into Thriving Kids was noted with limited specifics available. Given uncertainty, clinics should plan conservatively – avoid locking in long leases and keep service models flexible over the next two years.

Evidence Advisory Committee: who’s on it and how it may work

Expressions of interest for the NDIS Evidence Advisory Committee (EAC) have concluded with appointments described as largely academic. Subcommittees include assistive technology and capital, capacity building and therapy and economics. The first public consultation is expected “in the coming weeks”. Open questions remain about how EAC advice intersects with operations on the ground and with the Enduring Supports Rule process.

Planning framework: delays, and unclear timing for impairment notices

The new planning framework has been pushed back and support needs assessments are delayed. It’s unclear whether impairment notices are also delayed – timing wasn’t confirmed. Takeaway: keep documentation consistent, stay transparent in service agreements and avoid assumptions about start dates.

Mandatory registration: what the consultation said and what to expect

Consultation outcomes reflected familiar themes: registration costs and admin load, fairness for different provider sizes and locations and continuity of trusted supports. Priority areas flagged elsewhere remain supported independent living, support coordination and platform providers. Large-scale rollout faces capacity constraints – auditors are limited and processing times can already stretch towards a year. Expect staged change with grace periods to signal intent followed by a longer window to complete audits.

Audits in practice: costs, process and realistic timelines

Audits can be onsite or remote. Providers reported costs for auditor travel and accommodation for certification audits, document sampling across caseloads, client and staff interviews and close scrutiny of policies, records and safeguards. Experiences vary by auditor background and demand and timelines can extend beyond initial expectations.

OTA pricing survey: pressure on viability and access

From OTA’s recent survey of 600 OTs, key data points discussed were:

• 14% of providers expect to exit in the short term – estimated as 1,267 practices – potentially affecting up to 17,320 participants

• 39% don’t expect to remain profitable under current settings, 43% are unsure and 55% reported no profit in 2024–25

• 79% already have a waitlist; 52% report waits of 12 weeks or more

• Travel matters: 95% provide some travel, 56% travel daily, 98% say travel reimbursement is important to viability, 51% say it’s critical to deliver assessments and therapy in natural environments

• 85% exceed travel caps at least some of the time; 29% do so more than 70% of the time

• If caps remain, 92% plan to reduce travel and outreach, 63% to reduce regional and remote services, 33% to stop home and community visits and 24% to stop taking complex cases

OTA’s asks discussed: reverse the travel cut, apply an immediate 7% uplift to OT hourly rates and co-design a fit-for-purpose allied health pricing model that properly accounts for travel, reports and multidisciplinary work.

Business reality: profit as safety

A modest profit buffer is a safeguard, not a luxury. It’s what allows services to ride policy pivots, delays and compliance costs. Until reforms settle, prefer flexible overheads over long commitments. Document processes now – it pays off later.

What to do next

• Expect staggered change rather than a single switch

• Keep service agreements clear and documentation tight

• Model scenarios for travel, outreach and home visits

• Build a small profit buffer to cushion policy shifts

• Stay vocal in consultations, even when it feels thankless