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NDS seeks member feedback on access to nursing supports

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9/02/2018

A number of NDS members are reporting that they are unable to access sufficient in-home nursing supports for NDIS participants. Over the past few months, some providers have reported that they are turning to hospital accident and emergency and other acute services as they have not been able to engage a nurse or appropriately trained support worker for ongoing nursing supports.NDS is seeking further input from members to ascertain how widespread the issues and implications around nursing supports are, in both metropolitan and regional areas. This will inform our representation to the state government and the NDIA.The interface between health and disability is complex and still developing. The Council of Australian Governments (COAG) Applied Principles state that the NDIS is responsible for the “delivery of nursing or delegated care by clinically-trained staff” for care related to the person’s disability, whereas the health system is responsible for nursing services that are “related to treatment of a health event.” However, in practice, this distinction is not clear, and application of the COAG Applied Principles has been inconsistent. Some participant plans include ‘nursing supports’ under the Improved Daily Living category. These are capacity building supports which cover training of disability support workers, rather than direct support provided by nurses. Participants may also receive funding in their core budget which they can put towards ongoing nursing supports (under personal care supports). However, providers report that within the NDIS pricing framework, it is only feasible to engage support workers to deliver these supports, rather than nurses. Further, the lean 1:1 support prices make it increasingly difficult to ensure support workers are adequately trained to deliver these supports. There also appears to be some uncertainty about which nursing supports may be delivered by a trained support worker, and which supports require a qualified nurse. NDS is interested in hearing from members about issues in this space.These issues are arising at the same time as changes to the provision of some Home and Community Care Program for Young People (HACC-PYP) services are being introduced. NDS understands that some NDIS participants will continue to be eligible to apply for HACC-PYP community nursing services, which are not transitioning to the NDIS. Furthermore, providers are reporting that they are currently unable to make referrals for people under age 65 to a large, metropolitan community nursing organisation for HACC-PYP services. NDS will continue to engage with our members around emerging issues related to the health interface. Providers are encouraged to contact Liza Brown-Pinsky at or 03 8341 4309.

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