‘Watch this space’: GPs to become more involved in NDIS

The rollout of the National Disability Insurance Scheme (NDIS) has been plagued with access issues, accusations of underspending and reports of hundreds of people dying while waiting to have their applications processed.
 
The raft of systemic issues were laid bare in the 2019 Tune review, which reported that many people found the transition from state-based programs to the NDIS ‘confusing and frustrating’, and that the scheme itself was complex and difficult to manage.
 
It also added to calls for more general practice involvement, as GPs have often been overlooked when assessing ways to improve the scheme, despite the important role they can play when helping patients access the NDIS.
 
However, while general practice is not mentioned in the Government’s response to the 2019 review, GP and disability advocate Dr James Best has revealed that may soon change.
 
‘To date, GPs have virtually been excluded from the process. But the NDIS is looking at changing that and recently has been engaging with the college,’ he told newsGP.
 
‘Myself and [RACGP Specific Interests Disability network Chair] Bob Davis have both been giving feedback, and been involved in reviewing access forms to the NDIS and including GPs in that process, which is really, really welcome.
 
‘We know our patients, and sometimes we know them very well and can give a great deal of information to get more targeted, more appropriate packages to these individuals and their families.
 
‘GPs do need to watch this space because we are going to be involved with the NDIS and I think that is fantastic.’
 
The Federal Government has committed to implementing 27 of the review’s 29 recommendations, which are aimed at making the scheme simpler and easier to access.
 
It has also offered ‘in principle’ support to providing additional funding to help people with disability navigate the NDIS, and trialling an arrangement in which all planning related functions are undertaken with a person who has ‘delegation to approve the plan’.
 
In theory, this arrangement would be compared to the rollout of joint planning meetings to assess the benefits of both approaches.
 
The commitments have generally been welcomed, and Dr Best said they will hopefully lead to a better system for people with disability.
 
‘There have been very significant issues up until recently in terms of access and flexibility on the part of the NDIS, including delays and barriers, particularly to those who may struggle because of education, literacy, cultural barriers, etcetera,’ he said.
 
‘I think the NDIS has started to recognise this through a series of parliamentary reviews and feedback. They’re aiming to be more flexible and to be more open, and I think these recommendations are a part of that, so, it’s good to see.’
 
However, one outstanding issue not addressed by the recommendations – according to peak autism body Amaze – is a lack of understanding with regard to the needs of people with autism spectrum disorder (ASD).
 
‘Autistic people make up the biggest group in the NDIS, yet we continually hear of low understanding of their needs,’ Amaze Chief Executive Fiona Sharkie said.
 
‘It is absolutely critical that the scheme works well for autistic people.’


Early support for children with ASD is key to improving life outcomes, according to Amaze CEO Fiona Sharkie.
 
Ms Sharkie pointed out that many people with ASD are dissatisfied with their NDIS experience, as there is a low level of autism understanding among NDIS planners, and a lack of information and support for participants to navigate the planning process.
 
She said this issue is exacerbated by inadequate funding, while difficulty in accessing services is a challenge constantly reported by participants who have ASD.
 
‘Building [the] autism proficiency of planners needs to be a top-order priority,’ Ms Sharkie said.
 
‘Amaze is calling for a specific autism and neurodevelopmental stream within the NDIS and dedicated training in autism for all NDIA [National Disability Insurance Agency] and partner staff. This would go a long way to improving outcomes for autistic participants.
 
‘Our youngest community members must also be prioritised in future reforms. Intensive and comprehensive support for autistic children, starting as young as possible, is key to improving life outcomes.
 
‘Providing automatic access to the scheme for all autistic children will provide the best return on investment for the NDIS in the long run.’
 
People with ASD represent the largest diagnostic group in the NDIS – 31% of participants have autism as their primary diagnosis, while a further 5% of participants have autism as a secondary diagnosis – and Dr Best said more can be done to assist this cohort.
 
‘There has been some resistance to level-two autism and some people on level-one autism, [in terms of] not getting access to the NDIS when they should,’ he said.
 
‘I would support AMAZE’s stance that autism can very much be a disability, and a more accepting approach by the NDIS would be welcomed in the area of autism.’
 
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autistic spectrum disorder disability general practice National Disability Insurance Scheme NDIS Tune review