S7E06 - The Year End Squeeze: Protecting Your Energy as NDIS Changes Accelerate

The emotional load of the festive season

As the year winds down many OTs are running on empty. December brings concerts, Secret Santas, toy drives and family events but it also brings rushed reports, urgent NDIS requests and long mental lists of what needs to be bought, wrapped or organised. Even joyful activities add planning and cost and for OTs with school aged children the competing dates and expectations can compound the strain.

If you are feeling flat, irritable or overextended it is simply a sign that your capacity is stretched. The mix of home demands and workplace responsibilities makes this time of year uniquely tiring for clinicians.

The quiet impact of funding shifts

Layered on top of the festive season overwhelm are the effects of ongoing NDIS funding changes. Travel cuts, paediatric plan reductions and shifting referral patterns rarely make headlines but they are affecting participants and clinicians every day. Many families are receiving plans that drop mid term leaving significant gaps in supports with no simple way to bridge them.

For OTs this means disrupted therapeutic relationships, difficulty maintaining caseloads and pressure to absorb the stress families are experiencing. Emotional fatigue becomes a predictable response when the system feels unpredictable.

What the therapy supports pilot signals

This pressure is occurring alongside major structural changes including the Therapy Supports Quality Pilot. The pilot is an invitation only initiative for medium to large registered providers that meet strict thresholds for revenue, caseload size, remote area service delivery and multidisciplinary practice.

While framed as a way to understand therapy quality and cost many OTs believe the pilot will contribute to future block funding models dominated by large NGOs. Smaller services, sole providers and regional practices are unlikely to meet the criteria even though they often deliver the most consistent therapy in remote areas.

For frontline clinicians this could mean funding decisions drawn from incomplete data that does not reflect the realities of travel time, caseload complexity or community need. Staying informed and documenting the true cost of service provision is one practical way to protect your practice.

The widening compliance gap

Alongside the pilot sits a growing focus on fraud, audits and compliance. New legislation is expected to expand penalties for wrongdoing, increase the NDIS Commission’s powers and tighten expectations around documentation and evidence. There is also increasing attention on misleading marketing aimed at people with disability.

While these measures appear reasonable OTs are reporting long delays in Commission responses and limited feedback when serious concerns are raised. The compliance burden is rising for individual clinicians and small services even as unsafe practices elsewhere are not always addressed with equal urgency.

You cannot control regulatory timelines but you can protect yourself with clear functional documentation, transparent billing, strong service agreements and caution with any claims you would not be comfortable defending.

Saying no to unsafe or non compliant requests

OTs are receiving more requests for items or interventions that do not meet NDIS criteria or clinical scope. These might include high cost alternate therapies, cars or granny flats or equipment from the NDIS no list. It is understandable that families push when they are facing reduced funding but your role remains to ensure recommendations are evidence based, safe and compliant.

A reliable guiding question is Would I stand by this recommendation at external review? If not, the answer is no. You can acknowledge participant preferences without compromising your recommendation. For example: The participant’s preference is X. Based on my clinical assessment and current guidelines my recommendation is Y. For early career OTs supervision is essential. Confidence in navigating these decisions grows with mentoring, structured reflection and clear clinical frameworks.

Why end of year boundaries matter

All of this plan reductions, shifting rules, emerging pilots, compliance pressure and the emotional load of December creates the perfect environment for blurred boundaries. It becomes tempting to say yes to every urgent request, chase down problems created elsewhere or work late into the night to keep families supported. But each yes signals that your wellbeing is negotiable.

Clear boundaries do not require long explanations. Short statements preserve clarity and rapport: “I cannot complete a quality report in that timeframe. I can have it ready by [date]”, “I do not offer weekend work so we will need another solution” or “this sits outside what I can recommend as reasonable and necessary”. Within teams shared language helps. Phrases such as I have discussed this with our clinical lead and we are not able to proceed on that basis frame boundaries as professional standards rather than personal reluctance.

A federal senator recently reminded clinicians that rest is essential. We say this to carers often but we rarely model it. Boundaries are safeguards for clinical quality.

Protecting your energy this December

Finishing the year well does not require perfection. Small intentional decisions can help you start the break with more capacity.

Set a clear cut off date for new assessments or reports. Block your rest time first and build your workload around it. Triage new requests so that safety critical tasks are prioritised and non urgent work can move into the new year. Delegate wherever possible and release anything that does not require your clinical skill. A genuine break is not a luxury. It is a risk management strategy. Rested clinicians make clearer decisions and provide safer, more sustainable care.

Advocacy, community and leadership development

Despite the turbulence the OT community continues to show strength in advocacy and collaboration. OTs are contributing to submissions, contacting MPs, signing petitions and sharing stories that highlight the true impact of funding cuts. Professional associations are engaging directly with government and leadership programs are supporting clinicians to develop self leadership, boundaries and resilience.

Resources from educators such as Michelle Bihary offer frameworks around burnout, ethical decision making and sustainable practice. Connecting with OT learning communities such as Verve OT Learning can also provide clarity, direction and solidarity during a period of rapid change.

Key takeaways for OTs

• The festive season brings a heavy mental load for OTs at work and at home. Feeling exhausted is a normal response
• The therapy supports pilot focuses on large registered providers and may feed into future funding models
• Fraud focused reforms increase compliance pressure while systemic issues remain unresolved
• Only recommend what you would defend at external review. If it does not meet that test the answer is no
• Clear documentation and supervision help you capture preferences without compromising clinical reasoning
• Travel cuts, paediatric funding changes and shifting referrals are reshaping practice. Your concern is valid
• Advocacy, professional collaboration and leadership development strengthen the sector
• Planning rest, setting limits and standardising boundaries are essential for end of year wellbeing