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Published by Sarah Collison, Nikki Cousins and Alyce Svensk
A space for you to connect, reflect and stay up to date on OT practice and the evolving world of the NDIS.
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Some moments in your OT career stay with you. A decision, a client or even a comment from someone else can change the direction of your career or the way you think about your role. This week, Sarah, Alyce and Nikki share some of their own ‘sliding doors’ moments, from career decisions that changed their direction to clinical experiences that reshaped how they understood their role as OTs. They also unpack recent NDIS developments around students on placement, functional capacity and changes approaching from 1 October. The career decisions that change everything Sometimes a career-defining decision starts with realising it is time to leave. Sarah reflects on the workplace experience that ultimately gave her the push to step away from a role she once thought she would never leave and start Verve OT. Alyce shares turning points of her own, including professional development that challenged the way she thought about clinical intervention and a period away from Occupational Therapy that ultimately led her back to the profession and into building her own practice. Looking back, neither could have known exactly where those decisions would lead. Sometimes it is only years later that you can see how one choice changed the trajectory of your career. When you can’t change the outcome Nikki shares the story of a man with rapidly progressing motor neurone disease who desperately wanted to leave hospital and return home. After considerable work to organise equipment and make his discharge possible, he made it home on a Friday afternoon and died the following day. At first, Nikki felt that everything they had done had made no difference. Her manager helped her see it differently: they could not change the fact that he was dying, but they had changed his experience by helping him spend that final time at home. That moment changed Nikki’s understanding of what making a difference can look like and influenced her later work in palliative and end-of-life care. It also highlights the role good supervision can play in helping OTs process difficult experiences and make sense of what they mean for their practice. The small things can be the big things Not every meaningful OT outcome looks impressive on paper. Nikki shares how one family still considers a simple toilet rail one of the most valuable things she has done for them, despite years of other intervention. Sarah recalls a client telling her that the biggest thing she had provided through a home modification process wasn’t the modification itself. It was hope that life might become easier. These moments are a reminder that OTs don’t always know which part of their work will matter most to someone. Particularly as service systems and funding models change, recognising these smaller wins can help keep the focus on what can make a meaningful difference for the person in front of us. Can you bill for students on placement under the NDIS? New NDIS guidance has raised fresh questions about students on placement. Earlier guidance stated that allied health students could deliver specific supports under supervision but that their work could not be directly claimed because placements were unpaid educational opportunities. The current NDIS guidance says allied health students and provisional psychologists can provide services under the supervision of a qualified allied health provider, with participant agreement. It also says service agreements should outline how the arrangement could provide greater flexibility, such as a lower hourly rate or additional service hours. What remains less clear is exactly how those services should be billed. The wording appears to have shifted again, but there is still enough ambiguity that providers will need to consider how they interpret and apply the guidance in practice. A changing definition of functional capacity A recent SDA matter prompted questions about how the amended definition of functional capacity is already being applied under the NDIS. The definition considers a person’s ability to undertake an activity without assistance from other people or assistive technology, with particular provisions around commonly used AT and assistance for children. This raises questions about what the definition could mean when considering the functional impact of disability. There is still more to unpack about how this will be applied in practice, particularly for OTs completing functional capacity assessments. It is an area to watch as further information becomes available. What’s changing from 1 October? There is plenty for allied health providers to have on their radar as 1 October approaches, including changes to classifications under the Health Professionals and Support Services Award and the upcoming ban on card surcharges. Thriving Kids activity is also expected to begin in New South Wales, although there are still questions around exactly how and when service pathways will roll out. For NDIS providers, there is also uncertainty around upcoming support determinations and what the high needs pathway will look like. With several changes happening at once, OTs and business owners will need to stay across further guidance as it becomes available. Key takeaways • Career-defining moments can come from unexpected decisions, challenges and clinical experiences • Good supervision can help OTs reflect on difficult experiences and shape their future practice • Small interventions can have a significant impact, even when they seem simple from an OT perspective • NDIS guidance around students on placement has changed again, but questions remain about how services can be billed • Changes to the definition of functional capacity may have implications for OTs completing functional capacity assessments • Several changes are approaching from 1 October, including award classifications, card surcharges and NDIS support determinations Links Guide to working as an allied health provider: https://www.ndis.gov.au/providers/working-participants/allied-health-professionals/guide-working-allied-health-provider
The NDIS support lists have only been in place since October 2024, but another significant change may already be on the horizon. A new consultation is considering how NDIS supports should be defined, including proposals to reduce the number of support categories, simplify their descriptions and remove the replacement supports process. For OTs, some changes could make the rules easier to interpret. Others raise questions about what happens when an everyday product is also the simplest solution to a disability-related functional need. Why is the NDIS support list changing? The current support lists were introduced in October 2024 as transitional rules defining what participants can and cannot generally spend NDIS funding on. Feedback has highlighted several problems, including confusing categories, unclear descriptions and difficulties understanding replacement supports. The proposal is to reduce 36 support categories to 18 broader categories, with simpler purpose-based descriptions and examples. These categories are also being developed to align with new framework planning and the introduction of support needs assessments. Replacement supports could disappear One of the biggest proposed changes is the removal of the replacement supports process. Tablets, smartphones, smartwatches and accessibility or communication apps have been among the most commonly requested replacement supports. The proposal is for these types of supports to instead become stated supports where the relevant requirements are met. This could create a clearer pathway for some disability-related technology. The bigger question is what happens to other products currently considered through replacement supports. What happens to everyday products that solve disability-related problems? Mainstream products do not always have mainstream purposes. Consider a person with a spinal cord injury who can put clothing into a top-loading washing machine but cannot independently retrieve it. A front-loading machine could remove that functional barrier and allow them to complete their washing independently. Similar questions arise with robotic vacuum cleaners, food preparation appliances and other household products. Sometimes a readily available mainstream product is the simplest and most cost-effective way to address a functional need. Removing replacement supports could therefore have consequences beyond simplifying an administrative process. The detail of what remains fundable, and through which pathway, will matter. Some disputed supports could move firmly onto the ‘out’ list The consultation also identifies products and services where there has reportedly been confusion about whether they are NDIS supports. These include electronic noise-cancelling headphones, fencing and gates, hairstyling tools, hydrogen fuel and electric vehicle charging costs and scuba therapy. The proposal is to specifically exclude them. Noise-cancelling headphones are particularly relevant to OTs because they may be recommended to address sensory needs and support functional participation. This also highlights why looking only at the proposed funded categories does not tell us everything. A product might appear to fit within a broad support definition but still be unavailable if it is specifically excluded elsewhere. The new categories could make some OT roles clearer There are areas where the proposed definitions provide welcome clarity. The proposed therapy supports category specifically includes assessment by allied health professionals for support planning and review. It also captures assessment, prescription, implementation, adjustment and training in the use of assistive technology where required to support functional outcomes. Home modifications similarly include the design, planning, implementation and review of modifications, alongside maintenance and repair of disability-specific fixtures and modifications. Assistive technology categories are also being consolidated. While there would be fewer overarching categories, detailed descriptions would continue to sit beneath them, so fewer categories will not necessarily mean less complexity. These changes are part of a much bigger planning reform The support list changes cannot be considered separately from new framework planning. Under the future model, a support needs assessment will play a central role in determining a participant’s budget. The proposed support categories are being designed to align with this new approach. This means the practical impact of the support list will depend on more than which category a support sits within. It will also depend on how needs are assessed, how budgets are determined and how participants can use those budgets. Further consultation on the new framework planning rules should provide more detail about how these pieces will work together. Why OT input into the consultation matters Funding rules can appear straightforward on paper but work very differently when applied to someone’s actual function, environment and daily occupations. OTs regularly see where a mainstream product becomes an assistive solution, where a seemingly clear category creates ambiguity and where funding rules affect the practical options available to a participant. That experience can help identify unintended consequences before proposed rules become established practice. The consultation provides several ways to contribute, including making a submission, providing a video response, responding by email or requesting a phone call. Key takeaways for OTs * The NDIS is proposing to reduce 36 support categories to 18 broader categories * The replacement supports process could be removed * Some commonly requested technology may instead become stated supports where requirements are met * The future of other mainstream household products currently considered through replacement supports needs close attention * Electronic noise-cancelling headphones are among the supports proposed for specific exclusion * The new support list is being developed alongside new framework planning and support needs assessments These are still proposed changes. For OTs, now is the time to look beyond whether the new categories appear simpler and consider how they could work when applied to real functional needs and everyday recommendations. New Framework Planning and NDIS Supports Consultation: https://consultations.health.gov.au/disability-and-carers-group/nfp-ndis-supports/ OT Unplugged Competition Entry Form: https://www.verveotlearning.com.au/ot-unplugged-competition-sit-at-our-table
NDIS reporting is changing, but one question remains fundamental for Occupational Therapists: why are we including this information? Longer reports and more assessments do not automatically create stronger evidence. A useful NDIS OT report needs to demonstrate a participant’s functional needs, connect those needs to their goals and clearly explain why recommended supports are required. This means moving beyond clinical terminology and assessment scores towards evidence that helps the reader understand what everyday life actually looks like for the participant. Understand why the report is needed Before beginning an assessment, Occupational Therapists need to understand why the report has been requested and what decision it is intended to inform. A plan reassessment based on a change in circumstances requires evidence of a significant and ongoing change. This may involve changes to functional capacity, informal supports or broader life circumstances. That is different from a situation where a participant believes their existing plan was underfunded. Understanding this distinction early can help avoid spending valuable participant funding on a comprehensive assessment that does not address the issue at hand. Good onboarding is essential. Clarify what the report is for, what evidence already exists, who else is involved and what information is actually required. Show what function looks like in everyday life Once the purpose of the report is clear, the next priority is showing what the participant’s functional needs actually look like. Occupational Therapists understand terms such as dysregulation, co-regulation, executive functioning and fine motor difficulties. The person reading an NDIS report may not interpret those terms in the same way, so clinical terminology needs to be connected to specific, functional examples. If a participant became dysregulated during an assessment, what did that look like? What happened and what support did they require? If they have reduced fine motor coordination, how does this affect dressing, eating, handwriting or another meaningful activity? This is where both top-down and bottom-up thinking have a place. Identifying an impairment such as reduced grip strength, balance or fine motor coordination can provide valuable clinical evidence, but the report also needs to explain what that impairment means for everyday participation. Functional examples bring the reader into the assessment and make the impact of disability easier to understand. Choose assessments that add meaningful evidence With the functional picture established, consider what additional evidence is actually needed to support your clinical reasoning. Standardised assessments remain an important part of Occupational Therapy practice, but not every available assessment belongs in every NDIS report. Ask: what additional evidence will this assessment provide? A standardised assessment may validate observations, establish a baseline, support clinical reasoning or provide an outcome measure. In those circumstances, it can be extremely valuable. However, completing multiple assessments can consume significant participant funding without necessarily changing the recommendations. The same principle applies to presenting results. Pages of graphs, tables and scores can make a report longer without making it clearer. Often, the Occupational Therapist’s interpretation is more valuable. Explain what the assessment showed, whether it aligned with other evidence and how the findings informed your recommendations. Consider value for money Being selective about assessment also means considering how participant funding is being used. A useful question is whether you would feel comfortable asking someone to pay privately for everything you are proposing. This does not mean compromising evidence-based practice or avoiding comprehensive assessment when it is genuinely required. It means being intentional about what each component contributes. If observation, interview, existing reports and one carefully selected assessment provide sufficient evidence, adding several more assessments may not improve the outcome. Good clinical reasoning is demonstrated by choosing the right assessment methods and interpreting them well, not by using the greatest number of tools. Make recommendations specific and defensible The evidence gathered throughout the assessment should lead logically into clear recommendations. Simply stating that a participant requires a certain number of support worker hours leaves important questions unanswered. What will the support worker assist with? When is the assistance required? Is the support needed at home or in the community? Is it required during weekdays, evenings or weekends? These details demonstrate how the recommendation was calculated and why the support is necessary. Recommendations should also reflect the participant’s assessed needs rather than a provider’s rostering arrangements. If a participant requires one hour of assistance, the Occupational Therapist’s recommendation should reflect that need rather than being increased because of a provider’s minimum shift requirements. The aim is to make the connection between functional need, required support and recommendation as clear as possible. Stay within Occupational Therapy scope Specific recommendations also require Occupational Therapists to be clear about where their professional scope begins and ends. If an Occupational Therapist identifies a likely need for physiotherapy, speech pathology or another discipline and that professional is not yet involved, it may be appropriate to recommend funding for an assessment. Prescribing another profession’s ongoing therapy hours without their assessment is different. Support worker recommendations sit more directly within Occupational Therapy scope because assessing the assistance a participant requires to complete everyday activities is a core part of functional assessment. Know when a full reassessment isn’t necessary Providing strong evidence does not always mean completing another functional capacity assessment from scratch. If a comprehensive assessment was completed relatively recently and most of the participant’s function remains unchanged, an addendum or supplementary report may provide what is needed. The Occupational Therapist can explain what has been reassessed, identify what has changed and confirm which previous findings remain current. The original report can then accompany the supplementary evidence. This can provide the required information without unnecessarily using participant funding or repeating work that has already been completed. Better reports are not necessarily longer Every assessment, paragraph, graph and recommendation should earn its place in an NDIS OT report. Ask whether it helps explain the participant’s function, strengthens the evidence or supports the clinical reasoning behind a recommendation. The goal is not to create the longest report possible. It is to give the reader a clear and accurate picture of the participant’s everyday life and make the reasoning behind each recommendation easy to understand. Key takeaways for OTs ◆ Clarify why the report is being requested before beginning the assessment ◆ Keep everyday function at the centre of your evidence ◆ Use specific examples to translate clinical terminology into functional impact ◆ Choose assessments according to the meaningful evidence they add ◆ Interpret assessment findings rather than relying on pages of scores and graphs ◆ Make recommendations specific about what support is required, when and why ◆ Recommend according to the participant’s assessed needs rather than provider rostering requirements ◆ Stay within Occupational Therapy scope when discussing other health professionals’ services ◆ Consider an addendum or supplementary report when a full reassessment is unnecessary Links OT Unplugged Competition Entry Form: https://www.verveotlearning.com.au/ot-unplugged-competition-sit-at-our-table Australian Assistive Technology Conference (11 Nov - 13 Nov) https://www.arata.org.au/aatc/aatc-2026/
Recent NDIS legislative changes are creating new considerations for OTs, particularly around plan reassessments and how participants may be able to use their funding. While some implementation details are still emerging, the potential impact on participants could be significant. For OTs, the priority is understanding what these changes mean in practice. That includes knowing when a reassessment may be possible, clearly documenting support needs and identifying what could happen if recommended supports aren’t available. As further guidance is released, practices will also need to review their clinical processes and reporting templates. The aim isn’t to predict every funding decision, but to make sure the participant’s needs and risks are clearly documented. Changes to plan reassessments Changes to unscheduled plan reassessments include a longer timeframe for the NDIA to decide whether a reassessment will occur. The timeframe discussed has increased from 21 days to 90 days, which could mean participants wait considerably longer for a decision. There is also a higher threshold for an unscheduled reassessment. The change generally needs to be significant and ongoing, relating to the participant’s functional capacity, personal circumstances, environment or informal supports. This distinction matters. A permanent change to a participant’s support network may meet the threshold for reassessment, while a temporary situation may be more appropriately addressed through a plan variation. What this means for OTs There is still uncertainty about how some of these changes will work in practice. OTs don’t need to predict every decision the NDIA might make, but we do need to understand how the changes could affect the people we support. Our role is to clearly document what a participant needs to function safely and participate in everyday life. Recommendations should connect directly to functional evidence, risks and the likely consequences if those supports aren’t available. That clinical reasoning becomes particularly important when considering support determinations and the possibility that participants may not be able to access all of the funding identified in their plan. Understanding support determinations The changes also introduce support determinations that may limit how much of particular NDIS budgets participants can use. The areas discussed include social, economic and community participation and improved daily living. This could create situations where a participant’s reasonable and necessary supports are identified, but a proportion of the relevant budget is subsequently unavailable to spend. The exact impact will depend on the final support determination and how it is implemented. OTs should therefore avoid assuming a particular percentage reduction before those details are confirmed. Instead, our reports need to clearly explain what the participant actually requires and why. Make the impact of reduced support clear Reduced community participation funding doesn’t necessarily mean a participant can simply spend more time at home independently. Some participants require support regardless of whether they are at home or in the community. If a participant cannot safely remain home alone, this needs to be explicit in their functional assessment. Reports should explain their supervision requirements, why that support is needed and what happens when it isn’t available. This may include increased vulnerability, exploitation, safety concerns, behavioural escalation or unsustainable pressure on informal supports. The important point is to connect any potential reduction in support with its real-world functional consequences. Keep recommendations evidence-based Knowing that funding may be reduced doesn’t mean OTs should increase recommendations to compensate. If the evidence supports 15 hours of assistance, recommending 30 hours in anticipation of a reduction isn’t clinically defensible. Instead, document the actual level of support required and clearly explain the evidence behind it. Then describe what is reasonably likely to happen if that support isn’t provided. Our role is to provide strong clinical evidence, not find ways around funding decisions. Clear, individualised recommendations give decision-makers a much better understanding of what the participant genuinely needs. Consider the impact on therapy funding Improved daily living funding may also be affected by support determinations. This could reduce the funding available for OT and other allied health services. That becomes particularly challenging when a participant has limited funding for specific work, such as a functional capacity assessment. OTs still need enough time to complete assessments and reports to an appropriate professional standard. Review AT and home modification pathways Changes to reassessment processes may also affect assistive technology and home modification requests. Participants may become hesitant to request changes if they are concerned about what a reassessment could mean for other areas of their plan. OTs should understand whether a participant’s circumstances require a reassessment or whether a plan variation may be appropriate. Choosing the correct pathway could become increasingly important as these changes take effect. Clear communication matters here. Participants need practical information about their options without creating unnecessary fear about requesting essential equipment or supports. Prepare your OT practice now OT practices shouldn’t assume every clinician is keeping up with NDIS changes independently. Regular team discussions can help everyone understand what has changed, what remains uncertain and what needs to happen clinically. Now is also a good time to review FCA templates. Consider whether reports clearly explain supervision requirements, foreseeable risks, informal support capacity and what happens if recommended supports aren’t provided. At the same time, avoid changing templates based on speculation. Update them as confirmed information becomes available and make sure any new wording remains specific to the individual participant rather than becoming generic boilerplate. Key takeaways for OTs • Understand the new reassessment thresholds and longer decision timeframes. • Keep recommendations grounded in the participant’s actual functional needs. • Clearly explain what happens if recommended supports aren’t available. • Identify safety, vulnerability and informal support risks where relevant. • Don’t increase recommendations simply to compensate for anticipated funding reductions. • Understand when a plan variation may be appropriate instead of a reassessment. • Review FCA templates as confirmed NDIS guidance becomes available. • Keep your clinical team regularly updated as implementation develops. OT UNPLUGGED COMPETITION ENTRY FORM: https://www.verveotlearning.com.au/ot-unplugged-competition-sit-at-our-table
The latest NDIS reforms bring another significant period of change for participants, families, OTs and providers. While legislation has progressed, many of the practical details still depend on rules, guidance and implementation processes that are yet to be developed. For OTs, the priority is understanding what has changed, what is coming and what remains uncertain – without trying to predict decisions before the details are available. New planning and support needs assessments One of the biggest changes ahead is the introduction of new framework planning and support needs assessments. There is still uncertainty about exactly how these assessments will translate into participant budgets and how complex supports such as assistive technology and home modifications will be considered. The role of professional evidence will also be important. Consultation feedback has highlighted the need for evidence from treating practitioners who understand a participant’s function and support needs over time. Testing of the iCAN tool is continuing, so there is still more to learn about how the assessment process will work in practice. Functional capacity assessments are also coming From 1 January 2028, access to the NDIS is expected to involve a standardised assessment of functional capacity. The reforms clarify that people can use common forms of assistance, such as glasses, hearing aids and walking sticks, during these assessments, while children can receive age-appropriate assistance. The bigger question is how a standardised assessment will capture the complexity of everyday function. Occupational performance is influenced by environment, equipment, assistance and context, making the implementation of these assessments particularly important for OTs to watch. Review rights could look different The introduction of support needs assessments may also change what happens when a participant disagrees with their budget. Rather than directly challenging the resulting level of funding, the review pathway described in the reforms may lead to another support needs assessment being completed. This raises questions about whether participants could find themselves repeating assessments when they believe their needs have not been adequately captured. Changes to unscheduled reassessments Participants will be able to request an unscheduled reassessment following a significant and ongoing change. Importantly, that change no longer needs to be ‘unanticipated’, which may better reflect the experiences of people living with complex or fluctuating disability. However, the timeframe remains significant. If the NDIA does not decide on a reassessment request within 90 days, it is treated as refused, allowing the participant to move to a review rather than repeatedly submitting reassessment requests. Greater clarity around parental responsibility The reforms also clarify the distinction between ordinary parental responsibility and additional support required because of disability. Parents are ordinarily expected to provide supervision, personal care, transport, emotional support and behaviour support. However, this does not include additional assistance a child requires because of their disability compared with a child of a similar age without disability. For paediatric OTs, clearly describing this difference in functional evidence will remain important. The NDIS must also consider potential harm to informal supports, family relationships and informal networks if disability-related support is not funded. Support determinations and critical supports The reforms introduce mechanisms that could allow broader funding changes to particular categories of support. However, protections have been included for critical supports such as assistance with personal care and medication, mobility equipment, vehicle modifications, certain consumables and specialist disability accommodation. Additional safeguards are intended for participants requiring continuous 24-hour care, including a plan variation pathway where broader funding changes could place their health or safety at risk. Compensation and NDIS eligibility From 1 January 2028, new applicants may not be eligible for the NDIS where their impairment results from a motor vehicle accident or work-related injury and another system provides compensation or benefits. Existing participants are expected to retain their current arrangements. There are still significant questions about what happens when another compensation system only covers some disability-related needs. Further rules are expected to clarify these situations, so OTs should be cautious about predicting how the provisions will apply to individual participants. The reforms also allow compensation to be considered when determining funding under new framework plans. Depending on the circumstances, an NDIS budget may be reduced to account for compensation a participant has received. ‘Appropriate treatment’ does not mean every treatment The reforms provide some useful clarification about the requirement to consider ‘appropriate treatment’ when determining whether an impairment is permanent. Participants are not expected to try every conceivable treatment. Treatment needs to be widely accepted and expected to significantly improve, reduce or manage the impact of the impairment. People are also not expected to undergo treatment that is unsuitable, carries significant risks or could cause major lifelong consequences. For OTs providing evidence, the focus should remain on the likely impact of appropriate and accepted treatment rather than whether every possible intervention has been attempted. NDIS support lists remain difficult to navigate Consultation feedback confirms what many participants and providers have experienced since the NDIS support lists were introduced. Only 15% of respondents said it was easy to understand what could be funded, while 68% found it difficult. Around 77% had experienced or heard about situations where the rules were interpreted differently. Feedback called for clearer ‘in’ and ‘out’ lists, greater flexibility around mainstream products and a simpler replacement supports process. These findings will help inform future changes, but there is still no clear picture of what the final arrangements will look like. What OTs can focus on now There are still many questions that cannot be answered. Participants may understandably want certainty about future plans and funding, but legislation is only part of the picture. Supporting rules and operational processes will determine how many of these reforms actually work in practice. For now, OTs can focus on strong functional documentation, clearly distinguishing disability-related needs and following reliable updates as implementation progresses. Being able to say ‘we don’t know yet’ is also important when the information simply is not available. Looking after yourself through ongoing change Working within constant uncertainty can take a toll. OTs may understand what someone needs while having limited control over whether those supports are ultimately funded, creating frustration, moral distress and burnout. Proactive wellbeing matters during periods of sustained change. For clinicians, business owners and teams, this might mean strengthening boundaries, creating space to discuss uncertainty and recognising that different people restore their energy in different ways. The goal is not to personally carry every change occurring within the NDIS. Staying informed matters, but so does maintaining the capacity to continue doing good work as the system evolves. Key takeaways for OTs • New planning, support needs assessments and functional capacity assessments will significantly change how NDIS access and budgets are determined. • The role of professional evidence remains important, but details about how it will interact with new assessments are still emerging. • Unscheduled reassessments no longer require a change to be unanticipated, although significant timeframes remain. • Paediatric OTs should clearly distinguish disability-related needs from age-expected parental responsibility. • Compensation, support determinations and review rights are important areas to watch as further rules are developed. • Consultation feedback confirms significant confusion remains around NDIS support lists and replacement supports. • Avoid predicting individual outcomes while implementation details remain unresolved. • Strong functional evidence, reliable information and proactive wellbeing will be important as the reforms roll out. Find Sarah on LinkedIn: https://www.linkedin.com/in/sarah-collison-verve-ot/ Connect with Nikki on LinkedIn: https://www.linkedin.com/in/nikki-cousins-action-ot-b5985126b/ Check out Alyce on LinkedIn: https://www.linkedin.com/in/alyce-svensk-the-ot-coach-australia/
Running an Occupational Therapy business has always involved more than delivering great clinical care. There are people to employ, systems to manage, invoices to collect and countless decisions about where limited time and money should be spent. For OTs working within the NDIS, those decisions are becoming increasingly important. Changes to pricing and travel, alongside uncertainty about the future direction of the scheme, are prompting many practice owners to look closely at what it actually takes to run a sustainable service. From payment processing and recruitment costs to workforce planning and advocacy, understanding the business behind Occupational Therapy has never been more relevant. The true cost of running an OT practice One of the challenges of running an allied health practice is that seemingly small costs can add up quickly. Payment processing is a good example. Offering convenient card payments creates an additional expense for a business. But removing that option may make it harder for clients to pay, particularly families managing regular therapy expenses. This creates an important balancing act. A payment system might carry transaction fees, but if it means invoices are paid promptly and administration staff spend less time chasing outstanding accounts, that cost may be worthwhile. Rather than asking only, ‘How much does this system cost?’, practice owners need to consider the bigger question: ‘What does this system save us elsewhere?’ Administration time, unpaid invoices and payment follow-up all have a cost. Looking at the full picture allows practices to make decisions based on the actual impact on the business rather than focusing on one fee in isolation. Making payment easier can support cash flow Payment systems are not only a business consideration. They can also affect the client experience. Families attending weekly or fortnightly therapy may be managing significant expenses. Removing convenient payment options could create additional barriers, particularly for people who rely on credit cards to manage their household cash flow. At the same time, practices need reliable systems for collecting payment. A busy clinic can have dozens of appointments in a single day, meaning even a small proportion of unpaid invoices can quickly become a significant administrative and financial burden. There is no single payment model that will suit every practice. The important thing is to understand the trade-off between transaction costs, convenience, administration and the risk of unpaid accounts. Practices should also check current NDIS and consumer requirements before introducing surcharges, changing payment methods or passing additional costs on to clients. Business expenses cannot automatically be added to an NDIS participant’s invoice simply because the practice incurs them. Recruitment is another significant business investment The same cost-versus-value conversation applies to recruitment. In a competitive OT employment market, recruitment agencies can provide access to candidates and reduce some of the work involved in finding employees. However, that convenience can come with a substantial price tag. When recruitment fees are calculated as a percentage of a clinician’s first-year salary, the cost can quickly reach thousands of dollars. For a small allied health practice, that money might otherwise contribute to salary, supervision, onboarding, professional development or other supports that directly benefit the new employee. That doesn’t mean recruitment agencies have no role. A practice that needs to fill a position urgently, has struggled to recruit independently or does not have internal hiring capacity may find considerable value in using an agency. The key is to understand what you are paying for and whether that model makes sense for your business at that particular time. OTs can look beyond recruitment agencies too Understanding recruitment from the employer’s perspective is equally useful for OTs looking for their next role. Recruiters can provide a helpful overview of available opportunities, but they can only introduce clinicians to workplaces within their networks. An excellent smaller practice may never appear in that search. For OTs considering a new role, approaching practices directly can therefore be worthwhile. Even if a business is not actively advertising, a conversation may uncover an opportunity that would otherwise have been missed. This can also give clinicians more control over their job search. Instead of focusing solely on salary or advertised benefits, they can explore the practice’s values, clinical approach, supervision, workload expectations and workplace culture. Those factors can have a significant influence on whether a role remains satisfying and sustainable over time. Good recruitment is about relationships, not just vacancies Finding the right employee is not always about filling a vacancy as quickly as possible. Sometimes an Occupational Therapist interviews with a practice and is an excellent cultural and clinical fit, but the timing simply isn’t right. Circumstances change. The Occupational Therapist develops new skills, the business grows or a different role becomes available. Maintaining those relationships can create opportunities later. The same principle applies when a valued employee leaves. Moving into a hospital role, relocating or exploring another area of practice does not have to permanently close the door. An employee who leaves on good terms may eventually become exactly the person a practice needs. This shifts recruitment away from being purely transactional. Instead of asking only whether someone can fill today’s vacancy, practice owners can build genuine professional relationships with clinicians who share their values and approach to Occupational Therapy. Clinical fit still needs to come first For clinically led OT practices, being closely involved in recruitment provides another important advantage – the opportunity to understand the clinician behind the CV. Qualifications and years of experience matter, but so do clinical reasoning, communication style, professional values and supervision needs. Direct conversations and thoughtful referee checks can provide valuable information that may not be obvious from an application alone. A recruitment process should not simply establish whether someone can perform a role. It should help both parties determine whether the clinician and practice are genuinely a good match. Hiring someone who is not suited to the role can be costly for a business and disappointing for the clinician. Being transparent about workload, expectations, support and workplace culture before someone accepts a position gives everyone a better chance of making a sustainable decision. Business sustainability is connected to the NDIS Payment processing and recruitment might sound like internal business issues, but they sit within a much bigger conversation about the sustainability of allied health services. Changes to NDIS pricing and travel arrangements affect providers, but the consequences do not stop at business margins. If certain services or models of care become financially difficult to deliver, participants may ultimately have fewer choices about who supports them and how that support is provided. A sustainable OT practice needs enough financial capacity to employ and support good clinicians, provide supervision and professional development, maintain accessible systems and continue delivering high-quality services. When one part of that equation changes, the effects can flow through the entire practice. For clinicians, understanding this business environment can also provide useful context for decisions employers make around salaries, recruitment, workloads and service delivery models. Why OT voices matter in NDIS advocacy The connection between business sustainability and participant access is also why advocacy matters. The NDIS has supported greater participation of people with disability across Australian communities. Children and adults with disability are participating in schools, workplaces, recreation and community life, and access to appropriate supports can play an important role in making that participation possible. When policy decisions risk affecting access to services, OTs are well placed to explain what those changes could mean in everyday life. Clinicians see the practical consequences of policy. They understand what happens when someone receives the right support and what can happen when that support becomes harder to access. That knowledge is valuable to policymakers. Making advocacy practical and effective Contacting a local MP or contributing to a government consultation can feel intimidating, particularly if it is unfamiliar territory. Advocacy, however, does not need to be confrontational or complicated. The most useful starting point is to make the issue easy to understand. Before meeting an MP, a short written brief can provide context and clearly outline the issue. Where several professions are affected, bringing together OTs, speech pathologists, physiotherapists, exercise physiologists, dietitians and other allied health professionals can also demonstrate that the concern extends beyond one profession or individual business. During the conversation, focus on consequences rather than simply stating that a policy is problematic. Explain what the proposed change could mean for a participant, family, clinician, local service and community. Following up with a concise written summary gives the MP’s office something tangible that can be referred to or forwarded to relevant ministers, departments or colleagues. You don’t need to be a policy expert to advocate It is easy to assume advocacy belongs to people who understand government processes, legislation or policy language. OTs already bring something important to the conversation – firsthand experience. Occupational Therapists understand participation in everyday life. They see the relationship between support, independence, capacity and community inclusion. The goal is not to arrive with every answer. It is to clearly communicate what you know, why it matters and what the likely real-world consequences of a decision could be. Professional, respectful conversations supported by practical examples can help policymakers connect decisions about funding and legislation with the experiences of the people those decisions ultimately affect. Building more sustainable OT services Payment systems, recruitment costs and NDIS advocacy might initially seem like separate issues, but they all come back to sustainability. Practice owners need to understand their numbers and be willing to question whether established ways of working still make sense. Clinicians benefit from understanding the business realities behind employment and service delivery. As a profession, OTs also have an important role in communicating how broader policy decisions affect access, participation and choice for people with disability. Sustainable allied health businesses are not simply about protecting profit margins. They are part of maintaining a workforce and service system capable of providing high-quality Occupational Therapy into the future. Key takeaways for OTs • Look at the total cost of payment systems, including transaction fees, administration time and unpaid invoices. • Consider client accessibility and cash flow when reviewing payment options. • Check current NDIS and consumer requirements before introducing surcharges or changing how clients pay. • Assess the true cost and value of recruitment agencies rather than treating them as the default hiring pathway. • If you’re looking for an OT role, consider approaching practices directly as well as exploring advertised opportunities. • Build long-term recruitment relationships rather than focusing only on immediate vacancies. • Keep clinical fit, workplace culture, supervision and professional values central to recruitment. • Consider how NDIS policy and pricing decisions may affect both provider sustainability and participant access. • When advocating, focus on practical consequences and real-world examples rather than policy language alone. • Remember that sustainable OT businesses help support sustainable Occupational Therapy services.
Why great supervision starts with understanding what new OTs don't know Supporting another Occupational Therapist to develop their clinical skills is rewarding, but it isn't always straightforward. Many experienced clinicians have spent years refining their practice, making countless clinical decisions so often that the reasoning behind them has become automatic. This creates a challenge during supervision. The very skills that make someone an experienced clinician can make them harder to teach. We forget what it was like to learn Experience changes the way we think. Tasks that once required conscious effort eventually become second nature. We instinctively identify risks, adapt our communication and prioritise interventions without stopping to think through every decision. Learning to drive offers a useful comparison. An experienced driver doesn't consciously think about checking mirrors, indicating or positioning the car. A learner, however, needs every step explained. Clinical practice develops in much the same way. When supervisors assume these skills are obvious, new clinicians can miss the thinking that underpins good practice. Reflective competence makes the invisible visible This is where reflective competence becomes so valuable. Reflective competence is the ability to pause and examine the reasoning behind clinical decisions. Instead of relying on instinct, clinicians consciously explore why they made a particular choice, what information influenced that decision and how they might approach a similar situation in future. Making this reasoning explicit helps transform knowledge that has become automatic into learning that can be shared. Better supervision starts with better conversations Observation is an important part of supervision, but simply watching an experienced OT isn't enough. New clinicians can usually see what is happening. What they often miss is why decisions are being made. Explaining why you changed your questioning, noticed a safety concern or selected one intervention over another helps develop clinical reasoning rather than encouraging clinicians to simply copy behaviour. This approach also benefits experienced practitioners by encouraging ongoing reflection and continual professional growth. Confidence grows through supported practice Confidence doesn't come from being left to work independently before you're ready. It develops through observation, discussion, guided practice and constructive feedback. Breaking complex clinical tasks into manageable steps helps clinicians build competence progressively. As confidence grows, supervision naturally shifts from direct instruction towards collaborative reflection and independent clinical judgement. Creating a workplace where questions are encouraged and learning is expected benefits clinicians at every stage of their career. Reflective practice strengthens the whole profession Reflective competence isn't only for new graduates. Every OT benefits from regularly examining their own practice and remaining curious about how they make clinical decisions. When experienced clinicians make their thinking visible, supervision becomes more meaningful, onboarding becomes more effective and teams develop stronger clinical capability. Ultimately, great supervision isn't about having all the answers – it's about helping others understand how good clinical decisions are made. Key takeaways for OTs • Effective supervision requires more than demonstrating clinical skills. • Unconscious competence can make important reasoning invisible to new clinicians. • Reflective competence helps experienced OTs explain how they make clinical decisions. • Observation is most valuable when paired with discussion and reflection. • Confidence develops through supported practice, feedback and gradual independence. • Strong supervision builds clinical reasoning, not just clinical skills. Link FREE WORKSHOP: How To Choose Your Next OT Role https://payhip.com/b/3psKG
Paid placements for Occupational Therapy students are finally here. But they're only part of the solution For generations of Occupational Therapists, unpaid placements have simply been accepted as part of the journey into practice. Long days, lost income and months spent balancing study with everyday life were often seen as a rite of passage rather than a problem. The Australian Government's announcement that eligible Occupational Therapy students will receive financial support through the Commonwealth Prac Payment from July 2027 is a significant step forward. It recognises the financial pressures many students face while completing mandatory clinical placements. However, while paid placements are welcome, they're only one part of a much bigger conversation about preparing the next generation of Occupational Therapists. The reality of student placements Clinical placements are one of the most valuable parts of an Occupational Therapy degree, but they can also be one of the most demanding. Many students relocate for placements, pay for temporary accommodation, travel long distances or put paid employment on hold for weeks or months at a time. Others juggle family responsibilities, university assessments and research projects while working full-time on placement. Although many experienced Occupational Therapists fondly recall surviving placements on inexpensive meals, shared accommodation and multiple casual jobs, these stories also highlight how financial hardship became normalised within the profession. Today's students face those same challenges alongside significantly higher living costs, making financial support more important than ever. Paid placements don't solve the placement shortage Financial assistance addresses one barrier, but it doesn't solve another growing challenge – there simply aren't enough placement opportunities. Universities across Australia continue to struggle to source quality placements, with some students delaying graduation because suitable placements aren't available. At the same time, the diversity of placement experiences is changing. Where many graduates previously completed placements across hospitals, rehabilitation, mental health and community services, today's students are increasingly undertaking placements within private paediatric practice because that's where capacity exists. While these experiences are valuable, broad exposure across different practice settings remains essential for developing well-rounded clinicians and helping students discover where they want to build their careers. Private practice is becoming a vital training ground As placement demand continues to grow, private practices are playing an increasingly important role in educating future Occupational Therapists. Providing a quality placement, however, involves far more than allowing students to observe therapy sessions. It requires structured teaching, careful supervision and opportunities for students to gradually build their clinical reasoning and confidence. Many practices are also finding innovative ways to expand placement opportunities. Project-based placements, service development initiatives and digital resources are allowing students to contribute meaningfully while developing skills beyond traditional clinical work. For mobile and community-based services, creating rich learning experiences can be more challenging, particularly when students miss the informal learning that naturally occurs in shared office environments. Even so, many practices continue investing significant time and resources into supporting the future workforce. Great supervision is a skill High-quality placements rely on high-quality supervision. Effective supervisors don't simply teach clinical skills. They help students develop professional judgement, provide constructive feedback and create safe opportunities to learn through experience. Students also benefit from working with different supervisors who bring their own approaches to documentation, assessment and intervention planning. Learning that there can be more than one evidence-informed way to practise is an important part of becoming a reflective Occupational Therapist. While providing honest feedback can sometimes feel uncomfortable, avoiding difficult conversations ultimately limits a student's growth. Supporting students to improve is one of the most valuable contributions supervisors can make to the profession. Understanding NDIS billing during placements Practices hosting students also need to understand current NDIS requirements. Current guidance confirms that Occupational Therapy students undertaking clinical placements are unpaid learners. While they can provide supports under the supervision of a qualified Occupational Therapist with participant consent, the services delivered by students cannot be claimed through the NDIS. This differs from employed Allied Health Assistants, whose services may be billable when delivered within their scope of practice. Understanding these distinctions helps practices structure placements appropriately while remaining compliant with current NDIS guidance. Looking ahead The Commonwealth Prac Payment is an important acknowledgement that students shouldn't have to experience financial hardship simply to complete mandatory placements. However, strengthening the future Occupational Therapy workforce requires more than financial support. The profession also needs more placement opportunities, experienced supervisors who are supported to teach well and sustainable models that enable private practices, hospitals and community services to continue investing in student education. Every placement helps shape a future Occupational Therapist. Supporting students through high-quality learning experiences isn't just about helping them graduate – it's an investment in the future of the profession and the communities Occupational Therapists serve. Key takeaways for OTs * The Commonwealth Prac Payment is a positive step towards reducing financial pressure for eligible Occupational Therapy students. * Placement shortages remain a significant challenge for universities and the future Occupational Therapy workforce. * Private practices are becoming increasingly important providers of student placements. * Effective supervision requires dedicated time, structured teaching and constructive feedback. * Student-delivered services on placement cannot currently be claimed through the NDIS. * Supporting both students and supervisors is essential for building a sustainable Occupational Therapy profession. Links WikiQuip Waitlist: https://www.wikiquip.com.au/waitlist Therapy Supports FAQ Document: https://pacfa.org.au/common/Uploaded%20files/PCFA/Documents/NDIS%20Therapy%20Supports_FAQs.pdf Adding Private Clients to your OT Practice: https://www.verveotlearning.com.au/adding-private-clients-to-ot-practice
Taking a proper break without your business falling apart For many Occupational Therapists, taking time off is easier said than done. Whether you run a private practice or work as a sole trader, holidays often come with the feeling that work is waiting for you when you return. Without systems or support, time away can simply shift the workload rather than reduce it. Scheduling a buffer before and after leave can make returning to work much more manageable. Stepping away also offers perspective. It highlights where your business depends too heavily on you and reminds us of the value of having a supportive professional community to help navigate the ongoing changes within the NDIS. Navigating the new NDIS claiming codes Several weeks into the new NDIS claiming arrangements, many therapists are still working through how the updated item codes should be applied. While some providers have experienced few issues, others have encountered rejected invoices, confusion from plan managers and inconsistent interpretations of the new requirements. In many cases, the challenge appears to relate more to administrative processes than to the therapy itself. One of the biggest areas of uncertainty is distinguishing between telehealth and non-face-to-face supports. Rather than focusing only on whether an interaction occurred by phone or video, it can be more helpful to consider the clinical purpose of the interaction. If the therapist is delivering assessment, intervention, clinical reasoning or therapeutic decision-making, many clinicians would consider this a therapeutic service, regardless of whether it occurs face-to-face or remotely. Activities such as equipment research, report writing and administrative liaison may sit differently, but there are still situations where the guidance remains open to interpretation. Until further clarification is provided, accurate documentation and sound clinical reasoning remain essential. Clinical judgement still matters One of the recurring messages was that Occupational Therapists should not lose sight of their professional judgement. Many therapeutic interactions do not fit neatly into administrative categories. Conversations with parents, multidisciplinary case conferences and follow-up discussions often form an essential part of intervention, particularly for participants with complex support needs. Rather than becoming overwhelmed by coding decisions, clinicians should ensure they can clearly justify the service they provided, document it appropriately and accurately record the time involved. Are you actually billing for the work you do? Time tracking remains one of the most effective ways to understand whether your business is financially sustainable. Many therapists underestimate the amount of time they spend on reports, emails, clinical reasoning and other client-related tasks. Without measuring that time, it is easy to unintentionally underbill. Simple approaches such as keeping a written activity log, using timers or trialling time-tracking software can help clinicians better understand where their day is actually spent. Even completing a snapshot of your work over several days can provide valuable insight into your productivity and billing patterns. Understanding your own workflow also makes it easier to improve efficiency without compromising clinical quality. Technology can improve efficiency Artificial intelligence and productivity tools continue to evolve rapidly, offering opportunities to reduce administrative workload. Speech-to-text software, automated time tracking and AI-assisted documentation can all save time when used appropriately. However, any technology used within healthcare must also be considered through the lens of privacy, confidentiality and professional responsibility. Before adopting new software, clinicians should understand how client information is stored, processed and protected. Convenience should never come at the expense of participant privacy. Cybersecurity is becoming everyone's responsibility Cybersecurity is no longer only an issue for large organisations. Healthcare providers are increasingly becoming targets for cyber attacks because of the sensitive nature of health information. Recent examples across the healthcare sector demonstrate the importance of having strong security systems, staff training and clear response plans in place. As more clinical work becomes digital, Occupational Therapists need to remain vigilant about phishing emails, data breaches and the security of any software they introduce into their practice. Protecting participant information is becoming an increasingly important part of professional practice. Looking ahead The NDIS will continue to evolve, and with every change comes a period of uncertainty. While new claiming rules and technology can create additional complexity, the foundations of good occupational therapy remain unchanged. Strong clinical reasoning, accurate documentation, thoughtful business systems and supportive professional communities continue to be the best tools for navigating change with confidence. Key takeaways for OTs • Schedule genuine downtime before and after holidays rather than returning immediately to a full caseload. • Use your clinical reasoning when deciding how therapeutic interactions should be claimed and document your decisions clearly. • Track your time regularly to ensure you are billing accurately for the work you perform. • Explore technology that improves efficiency while carefully considering privacy and data security. • Review your cybersecurity practices and ensure your business has appropriate protections in place. • Stay connected with professional communities to share knowledge and navigate ongoing NDIS changes together.
A profession in transition The OT profession is in a period of significant change. On one hand, events like OTX 2026 are showcasing innovation, collaboration and exciting solutions to longstanding challenges. On the other, many clinicians and business owners are navigating major operational changes, particularly around NDIS pricing and service sustainability. Together, these shifts reflect a profession that is evolving quickly, balancing opportunity with increasing complexity. Why conferences still matter OTX 2026 was a strong reminder of why in-person conferences continue to matter. While presentations offer valuable clinical learning, some of the most meaningful outcomes come from the conversations happening between sessions. Networking, shared problem-solving and spontaneous discussions often create just as much value as formal education. These moments give OTs the opportunity to connect with others facing similar challenges, exchange ideas and feel part of a broader professional community. That sense of connection remains one of the most valuable parts of attending live events. Innovation in assistive technology One of the standout innovations highlighted at OTX this year was the launch of WikiQuip, a platform designed to simplify access to assistive technology funding information. Navigating AT funding in Australia can be incredibly complex. Clinicians often spend significant time trying to determine which schemes apply, what evidence is required and how to move through application processes. WikiQuip has been designed to reduce that complexity by creating a centralised resource for both clinicians and assistive technology users. The platform brings together practical guidance on assistive technology categories, assessment requirements, funding pathways and documentation processes. This addresses a major gap in the sector, particularly when considering how fragmented AT access currently is across Australia. There are currently 109 funding schemes across national, state and territory systems that may provide access to assistive technology. Despite how often the NDIS dominates conversations, only around 10 per cent of Australians who require assistive technology are eligible for NDIS funding. That leaves most people navigating alternative pathways, often with very limited guidance. WikiQuip aims to bridge that gap by making access pathways easier to understand and more practical to navigate. Innovation matters more than ever What stood out most from OTX was not just the energy in the room, but the clear momentum across the profession. OTs are continuing to build smarter systems, stronger resources and more practical solutions to longstanding challenges. That innovation is becoming increasingly important as clinicians navigate growing administrative complexity, funding changes and rising business pressures. The profession is not simply responding to change. It is actively shaping better ways forward. Understanding the NDIS pricing changes The recent NDIS pricing changes have created a lot of discussion across allied health. While the changes initially caused understandable concern, the reality is that for most providers, the impact is largely administrative rather than clinical. The core services being delivered have not changed. Instead, the biggest shift is around clearer billing categories and more detailed coding requirements. Providers now need to ensure services are accurately categorised under areas such as direct support, non-face-to-face work, travel, telehealth and NDIA-requested reports. For many practices, this means reviewing billing systems and ensuring invoicing processes are set up correctly. While that may create short-term administrative work, it does not fundamentally change service delivery. What counts as an NDIA-requested report? One of the biggest areas of confusion has been around NDIA-requested reports. Many clinicians have assumed this means the NDIA must directly contact a provider and request a report. That is not the case. NDIA-requested reports are not new and have existed in pricing arrangements for years. These reports generally refer to documentation required to inform funding decisions, such as plan reviews, functional assessments, assistive technology applications or home modification requests. This differs from routine clinical reporting. Reports created for therapy planning, education or communication with families and support teams are typically considered non-face-to-face clinical work rather than NDIA-requested reports. Understanding this distinction is important because it affects how services are billed and claimed. Why business sustainability matters The pricing changes have also reinforced a broader issue for the profession: financial sustainability. Private practices and sole traders are increasingly being challenged to balance high-quality clinical care with rising operational demands. Staffing structures, overheads, award classifications and service delivery models all need regular review to ensure businesses remain viable. This is not simply about compliance. Sustainable businesses are better positioned to support staff, maintain service quality and continue delivering care without creating unnecessary financial strain or burnout. As the sector continues to change, financial literacy and business strategy are becoming essential skills for practice owners. Looking ahead Despite the complexity of current reforms, there is plenty of reason for optimism. The profession continues to adapt, innovate and find better ways to support both clinicians and clients. From new tools like WikiQuip to stronger conversations around sustainability and service delivery, OTs are continuing to lead meaningful change. The challenges are real, but so is the opportunity. For clinicians willing to stay informed, remain adaptable and invest in connection, there is a great deal to be excited about. Key takeaways for OTs • OTX 2026 highlighted the value of connection, collaboration and innovation across the OT profession. • WikiQuip is addressing a major gap in assistive technology funding access. • The latest NDIS pricing changes are primarily administrative rather than clinical. • NDIA-requested reports relate to reports informing funding decisions, not routine clinical documentation. • Financial sustainability is becoming an increasingly important focus for practice owners and sole traders. Links WikiQuip: https://www.wikiquip.com.au/ OTA’s clinical award: https://otaus.com.au/resources/ot-school-of-victoria-clinical-award NDIA’s Provider Support email address: provider.support@ndis.gov.au Noelle from HR for Health Leaders: https://hrforhealthleaders.com.au/
What Occupational Therapists Need to Know About the 2026–27 NDIS Pricing Update The 2026–27 NDIS Pricing Schedule and Annual Pricing Review have now been released. For Occupational Therapists, the immediate headline is relatively positive. OT rates remain unchanged, avoiding the cuts seen across several other allied health professions. However, while pricing may appear stable on the surface, the update raises important questions around billing, travel and the long-term sustainability of OT services. OT pricing remains unchanged The maximum hourly rate for Occupational Therapists remains unchanged at $193.99 per hour, with provider travel remaining at $97 per hour. Given concerns about possible pricing cuts, many OT providers will see this as a positive outcome. While there has been no increase to reflect rising wages and operating costs, there has also been no reduction. For many practices, this was likely the best realistic outcome. The biggest issue is missing guidance The biggest challenge is not the pricing itself, but the lack of guidance. Unlike previous years, the Pricing Schedule currently provides rates and line items without the detailed billing guidance providers usually rely on. This means there is still uncertainty around travel claiming rules, billing caps, support definitions and claiming requirements. Right now, OTs know the rates, but not exactly how some of those supports can be claimed in practice. Travel remains unclear Travel is one of the biggest unresolved issues. Although provider travel remains listed at $97 per hour, there is no clear guidance confirming whether existing travel caps still apply. There is still uncertainty around whether the 30-minute metro cap remains, whether the 60-minute regional cap still applies, or whether travel rules have changed more broadly. This is particularly important for mobile OT services and regional providers. New billing line items mean immediate updates One of the biggest practical changes is the introduction of new billing line items. The updated structure separates direct service, cancellation, non-face-to-face work, provider travel, telehealth and NDIA requested reports into separate billing categories. This creates greater billing clarity, but also means many practices will need to urgently update billing systems, CRMs, invoicing templates and internal workflows. Non-face-to-face billing is becoming clearer One positive change is the clearer distinction between standard non-face-to-face work and NDIA requested reports. General non-face-to-face tasks appear to include preparation, documentation, case notes and standard reporting such as functional capacity assessments. NDIA requested reports generally refer to reports used to support funding decisions, such as assistive technology, home modifications and home and living reports. This distinction will be important for compliant billing moving forward. Pricing decisions are shifting One of the most important long-term changes is how future pricing decisions are being made. This year, the NDIA used more than 16 million therapy transactions to benchmark therapy pricing against Medicare, private health and comparable government schemes. This reflects a clear shift toward external market benchmarking and less emphasis on provider operating realities such as wage pressures, overheads and workforce challenges. This has significant implications for private OT practice sustainability. Demand is rising while providers are falling Another major theme is the changing therapy market. Therapy supports now account for approximately 10% of total NDIS expenditure, while demand for therapy continues to grow. At the same time, active therapy providers have declined by 3.9%, with unregistered provider numbers declining by 4.9%. Demand is rising while provider numbers are shrinking, increasing pressure on service access, waitlists and workforce sustainability. What this means for Occupational Therapists At a high level, this year’s pricing update feels relatively stable for Occupational Therapists. There are positives. OT rates remain protected, there have been no immediate pricing cuts and billing categories may be becoming clearer. But there are also challenges. Practices need to prepare for immediate billing updates, key guidance remains missing and uncertainty around future pricing remains. For Occupational Therapists, this update feels like short-term relief. But beneath that stability, there are meaningful shifts in pricing, billing and market dynamics that every OT should be paying attention to. Key takeaways for OTs • OT rates remain unchanged at $193.99 per hour, with travel remaining at $97 per hour. • The biggest concern is missing guidance around billing and claiming rules. • Travel remains one of the biggest unresolved issues. • New billing line items will require urgent system updates. • Non-face-to-face billing appears more clearly separated from NDIA requested reports. • Future pricing decisions are increasingly based on external benchmarking. • Demand for therapy is rising while provider numbers are declining. • The update provides short-term stability, but long-term uncertainty remains.
Occupational Therapists are frequently asked to provide ‘robust evidence’ for NDIS funding decisions, but what does that really mean? Explore why observation, clinical reasoning and context matter when assessing functional capacity. When Occupational Therapists write reports for the NDIS, one phrase appears repeatedly: robust evidence. Whether it’s a funding review, access request, assistive technology application or change in support needs, Therapists are often asked to provide stronger justification and more comprehensive evidence. The challenge is that there is no clear definition of what robust evidence actually looks like. As a result, many OTs are left wondering how much evidence is enough and what information carries the greatest weight. The answer often lies in moving beyond self-report and gathering information from multiple sources to build a complete picture of a person’s functional capacity. Why self-report is only part of the story Most assessments begin with conversation. We ask people about their daily routines, the tasks they complete independently and the areas where they need support. These discussions provide valuable information, but they are only one piece of the puzzle. People naturally interpret their abilities through their own experiences and expectations. Some individuals may overestimate their independence, while others may underestimate what they can do. This is why Occupational Therapists are trained to look beyond verbal responses and consider how a person actually performs tasks in real-world situations. The value of observation in functional assessments Observation remains one of the most powerful assessment tools available to OTs. A person may report that they independently manage meal preparation, household tasks or personal care. However, observing the environment can reveal important details that provide additional context. A walk through the home may identify signs that tasks are not being completed consistently. Alternatively, it may demonstrate a level of independence that exceeds what was initially reported. Both outcomes are clinically important. Environmental observations, task completion and functional demonstrations help Therapists validate information, identify barriers and understand how a person’s abilities translate into everyday life. This observational evidence often strengthens the overall assessment and contributes to more robust clinical reasoning. Understanding function within context One of the most important principles of occupational therapy is that function does not occur in isolation. Performance can vary significantly depending on the environment, available supports and expectations placed on the individual. A person may demonstrate greater independence in one setting and require substantial assistance in another. For example, some individuals may perform tasks independently in structured environments such as school, work or day programs, while requiring significantly more support at home. In other situations, highly supportive family members may unintentionally complete tasks on behalf of the person, masking their true abilities. Without considering context, Therapists risk drawing incomplete conclusions about a person’s functional capacity. Why clinical reasoning matters Robust evidence is not simply about collecting more information. It is about interpreting that information accurately. Occupational Therapists draw on clinical knowledge, experience and evidence-based practice to identify patterns and understand how a person’s diagnosis may impact their function. This becomes particularly important when working with conditions characterised by fluctuating capacity. A snapshot assessment conducted on a person’s best day may not accurately reflect the support they require over time. Likewise, a single observation may not capture the impact of fatigue, pain, mental health challenges or episodic symptoms. Strong clinical reasoning allows Therapists to synthesise multiple sources of information and determine what is most representative of the individual’s everyday experience. The role of standardised assessments Standardised assessments can provide valuable objective data when selected appropriately and interpreted correctly. However, assessment scores alone rarely tell the full story. A percentile rank or functional score only becomes meaningful when the Therapist explains what it represents and how it relates to everyday function. The most effective reports integrate standardised assessment results with observational findings, collateral information and clinical interpretation. This approach creates a comprehensive picture of a person’s strengths, challenges and support needs. The challenge of future support needs assessments As discussions continue around NDIS support needs assessments, many OTs have raised concerns about the potential loss of observation-based assessment. Functional capacity cannot always be accurately understood through questionnaires or interviews alone. Observation, environmental assessment and task analysis provide critical insights that help Therapists distinguish between reported abilities and actual performance. Without these opportunities, there is a risk that assessments may overlook important nuances that influence a person’s daily functioning and support requirements. Building truly robust evidence When Occupational Therapists talk about robust evidence, they are rarely referring to a single assessment tool or a larger volume of paperwork. Instead, robust evidence comes from combining multiple sources of information, including self-report, observation, standardised assessments, collateral input and professional clinical reasoning. It is this synthesis that allows OTs to understand not only what a person says they can do, but what they actually do, how they do it and what support they need to participate meaningfully in everyday life. Key takeaways for OTs • Robust evidence involves more than self-report and should include observation wherever possible. • Functional performance must be interpreted within the context of the person’s environment and supports. • Clinical reasoning is essential when assessing fluctuating capacity and complex presentations. • Standardised assessments are valuable when appropriately selected and clearly interpreted. • Observation and task analysis remain critical components of comprehensive functional assessments. • Strong reports synthesise multiple sources of information to create an accurate picture of support needs.
Pricing uncertainty continues to affect providers For many providers, annual pricing updates remain a significant source of uncertainty. Business owners are often required to make decisions about staffing and service delivery without knowing exactly what future funding arrangements will look like. Combined with rising employment costs and workforce reforms, these changes are placing increasing pressure on provider sustainability, particularly for smaller practices. The growing loss of experienced therapists Across Australia, many experienced occupational therapists are reconsidering their future within the NDIS. While financial pressures contribute to this trend, increasing administrative demands, system changes and frustration with decision-making processes are also driving clinicians away from the scheme. The impact extends beyond individual businesses. Experienced therapists bring years of clinical reasoning, assessment expertise and mentorship to the profession. As these practitioners leave, participants lose access to valuable knowledge and support. Moral injury and professional frustration Many therapists report feeling that their professional expertise is being given less weight despite extensive assessment and evidence gathering. When recommendations are repeatedly challenged or dismissed, it can create significant professional frustration and contribute to moral injury. For a profession built on evidence-based practice and participant-centred care, this can be particularly difficult. Over time, the emotional burden contributes to burnout and influences decisions to leave the sector altogether. Advocacy and sector response Recent NDIS consultation processes have demonstrated the strength of engagement across the disability sector. Thousands of submissions were lodged by clinicians, providers, participants and advocacy groups, highlighting widespread concern about proposed reforms. While the outcome remains uncertain, these submissions reflect a profession determined to contribute its expertise and advocate for meaningful outcomes. Advocacy continues to be a core part of occupational therapy practice, both at an individual and systemic level. AI in occupational therapy Artificial intelligence is becoming increasingly common across healthcare, particularly for tasks such as note-taking, report drafting and written communication. Used appropriately, these tools can reduce administrative burden and improve efficiency. However, AI cannot replace clinical reasoning. Occupational therapy relies on contextual understanding, professional judgement and relationship-based practice. Therapists remain responsible for ensuring documentation is accurate, clinically appropriate and reflective of participant needs. The use of AI also raises important considerations around consent, privacy and data security. Clear communication with participants and strong governance processes remain essential as technology becomes more integrated into practice. Looking ahead The coming months are likely to bring further change across the NDIS landscape. Pricing decisions, legislative reforms and technological developments will continue to shape the way occupational therapists work and how participants access support. While the challenges are significant, the profession’s ongoing commitment to advocacy, clinical excellence and participant-centred practice remains unchanged. Supporting workforce sustainability and valuing professional expertise will be critical to the future success of both occupational therapy and the NDIS. Key takeaways for OTs • Pricing uncertainty continues to create challenges for providers and business planning. • Experienced occupational therapists are increasingly leaving the NDIS workforce. • Moral injury is contributing to clinician burnout and workforce attrition. • Strong engagement in consultation processes highlights the sector’s commitment to advocacy. • AI can improve efficiency but cannot replace clinical reasoning and professional judgement. • Participant consent, privacy and data security remain essential when using AI tools. • Supporting workforce sustainability is critical for the future of participant care.
Award changes are reshaping workforce planning One of the most significant developments for allied health businesses is the recent review of the Health Professionals and Support Services (HPSS) Award. Although much of the attention has focused on wage increases, the bigger story may be the changes to classification levels and how occupational therapists are positioned within the award structure. The revised framework places greater emphasis on the responsibilities attached to a role rather than simply years of experience. For many private practices, the most notable change is the inclusion of supervision responsibilities within the Level 2 classification. Therapists who supervise students, therapy assistants or other clinicians may now fall into a different classification than previously expected. This shift creates important questions for business owners. Student supervision has long been viewed as a professional responsibility and a way of supporting the future workforce. However, if supervision activities influence classification and remuneration, practices may need to reconsider how these responsibilities are allocated and supported. The changes are expected to commence in October, providing an opportunity for businesses to review role descriptions, employment agreements and career progression pathways before implementation. Career progression is no longer just about experience A common misunderstanding within allied health is that clinicians automatically progress through award levels as they accumulate years of experience. In reality, award classifications are linked to the scope and responsibilities of a role. Leadership responsibilities, supervision duties, advanced clinical expertise and management functions all influence where a clinician sits within the award structure. This distinction becomes increasingly important as practices grow. Not every experienced clinician will move into a higher classification, just as not every newer therapist will remain in an entry-level role. Progression is tied to responsibilities, not tenure alone. Clear role descriptions and transparent career pathways can help both employers and clinicians understand what advancement looks like and how different positions align with award expectations. Rising costs continue to challenge practice sustainability Award changes are arriving at a time when operating costs are already increasing across the allied health sector. While salary increases often receive the greatest attention, they represent only one component of the financial pressures facing businesses. Workers compensation premiums, payroll tax, superannuation obligations, insurance costs and administrative expenses all continue to rise. For occupational therapy practices, particularly those working in paediatrics, overheads can be substantial. Assessment tools, intervention resources, sensory equipment and clinical materials represent ongoing investments that are essential for service delivery but are often overlooked in broader discussions about business viability. As these costs continue to increase, business owners are being forced to make increasingly careful decisions about staffing structures, leadership roles and growth opportunities. Why financial awareness matters more than ever The reality is that many of the most significant costs in running a practice are largely invisible to clinicians. Insurance premiums, workers compensation, payroll tax and compliance obligations can add tens of thousands of dollars to annual operating expenses. As teams grow, these costs often increase at a rate that outpaces expectations. This makes financial literacy an increasingly important skill for practice owners. Understanding profit margins, overheads and workforce costs is no longer optional. It is essential for making informed decisions about recruitment, remuneration and long-term sustainability. With continued uncertainty around future NDIS pricing arrangements, businesses that understand their numbers will be better positioned to adapt to whatever changes emerge. Preparing for Payday Super Another important change for employers is the introduction of Payday Super from 1 July. Although many payroll systems are now equipped to manage the administrative side of these payments, the change will require businesses to think differently about cash flow. Superannuation obligations will become more immediate, reducing the flexibility that previously existed around payment timing. For practices already managing increasing employment costs, this serves as another reminder of the importance of strong financial planning and forecasting. NDIS uncertainty remains a significant challenge Alongside workforce and business pressures, occupational therapists continue to navigate an increasingly complex NDIS environment. Across Australia, clinicians are reporting inconsistencies in planning decisions, funding outcomes and documentation expectations. Reports are being returned for reasons that often appear contradictory, with different planners applying different interpretations to similar situations. Questions continue to arise around assessment tools, report formats, assistive technology recommendations and home modification applications. In many cases, therapists are left wondering whether they are seeing a genuine policy change or simply an isolated interpretation from an individual decision-maker. The lack of consistency can make it difficult for clinicians to determine when they should adapt their practice and when they should challenge a decision. Looking for patterns rather than reacting to isolated decisions One of the most effective ways to navigate uncertainty is to avoid overreacting to individual experiences. A single unusual decision does not necessarily indicate a systemic change. However, when the same issue begins appearing repeatedly across different participants, regions and planners, it may signal a broader trend that warrants attention. Professional networks and peer communities play a critical role in identifying these patterns. Sharing experiences helps clinicians separate isolated incidents from genuine changes in practice expectations. Taking a measured approach can reduce unnecessary changes to templates, reports and clinical processes while still allowing therapists to respond appropriately when genuine trends emerge. Supporting participants through an evolving system Many clinicians are also becoming more cautious when discussing plan reassessments and funding reviews with participants. Where there is strong clinical evidence supporting additional funding or supports, recommendations should continue to be made confidently. However, it is equally important that participants understand the potential risks associated with reassessment processes in the current environment. Open and transparent conversations allow participants to make informed decisions while ensuring recommendations remain grounded in clinical reasoning and functional need. Looking ahead Occupational therapists have always adapted to change, but the current environment requires a particularly careful balance between clinical excellence and business sustainability. The practices most likely to thrive will be those that understand both the operational realities of running a business and the evolving landscape of the NDIS. While uncertainty remains, informed decision-making, financial awareness and strong clinical reasoning will continue to provide the strongest foundation for success. Key takeaways for OTs • Review award classifications and role descriptions before the HPSS Award changes commence. • Ensure supervision responsibilities are clearly defined and aligned with award requirements. • Understand the true cost of operating a practice, including insurance, payroll tax and compliance obligations. • Prepare cash flow systems for Payday Super requirements. • Avoid making significant changes to clinical documentation based on isolated NDIS decisions. • Look for patterns across multiple cases before adjusting templates or reporting practices. • Continue making recommendations that are supported by strong clinical evidence. • Help participants understand both the opportunities and risks associated with plan reviews and reassessments. P.S. To join the OT Unplugged Podcast dinner, email training@verveot.com.au to reserve your spot. It will be held on Tuesday 23 June following the OTX drinks on Day 1 of OT Exchange.
Occupational Therapy careers rarely follow a straight line. Many OTs begin with a clear idea of where they’re heading, only to find themselves moving into completely different spaces years later. Clinical work evolves, industries shift and new opportunities emerge. Alongside this, many therapists are recognising the growing importance of connection, mentorship and sustainable ways of working. The OT career you imagine may not be the one you build Many OTs enter the profession expecting to work in hospitals, paediatrics or traditional clinical roles long term. Yet careers often evolve into leadership, mentoring, supervision, education, business ownership or advocacy. For newer therapists, particularly those entering during the NDIS era, private practice can sometimes feel like the default pathway. In reality, occupational therapy offers far more diversity. Some therapists thrive in specialist clinical roles. Others are drawn to leadership, systems work or education. Neither pathway is better – careers simply change over time. Why early career OTs don’t need all the answers Students and new graduates are entering the profession during significant reform and uncertainty. With constant NDIS updates and workforce pressures, it can feel like there’s an endless amount to learn. But early career therapists do not need to master everything immediately. Strong clinical foundations still matter most. Confidence, professional identity and career direction develop gradually through experience. Many experienced OTs working in leadership or education today never imagined those roles when they first graduated. The hidden opportunities within occupational therapy Occupational therapy careers are now broader than many therapists originally expected. Mentoring, supervision, consultancy, training, digital education and professional development businesses have become increasingly visible career pathways. Many clinicians are building portfolio careers that combine clinical practice with leadership or education. There is no single version of success within OT. Some therapists prioritise flexibility, others value autonomy and some simply want to become exceptional clinicians. The profession is broad enough to support all of these goals. Balancing clinical work and sustainability One of the biggest challenges for experienced OTs is balancing clinical work with growing non-clinical responsibilities. Supervision, presentations, training development, business administration and leadership all require significant time and energy. For therapists who genuinely love clinical work, reducing caseloads can also feel difficult. As a result, many OTs are becoming more intentional about workload management, time blocking and protecting non-clinical work time. There is also growing recognition that sustainable careers matter more than constantly operating at full capacity. Why connection matters more than ever Across disability, aged care and healthcare systems more broadly, many OTs are feeling the pressure of constant reform and change. In response, therapists are increasingly prioritising genuine professional connection over hard-sell marketing or rapid business growth. OTs want spaces where they feel informed, supported and understood. Community matters because not everyone learns best through policy documents and lengthy written updates. Shared conversations and practical discussions often make complex industry changes feel far more manageable. This has become especially important throughout ongoing NDIS reform, where therapists are looking for reliable and accessible ways to stay informed. The value of community during industry change Conferences, networking events, mentorship spaces and online OT communities are becoming increasingly valuable. They provide reassurance that therapists are not navigating these challenges alone while also exposing OTs to the incredible diversity within the profession. At a time of rapid change, professional community is helping many therapists feel more connected, informed and hopeful about the future of OT. Occupational therapy careers are no longer one-dimensional The modern OT career is far more flexible than many therapists initially expect. An OT may begin in hospital work before moving into private practice, supervision, leadership or education. Others may remain deeply clinical throughout their entire careers. Most therapists will experience multiple versions of their career over time – and that flexibility is one of the profession’s greatest strengths. Supporting sustainable OT careers moving forward Sustainable OT careers are not built solely on productivity or growth. They are built on meaningful work, professional connection, adaptability and the ability to evolve over time. There is no single ‘correct’ OT career pathway. The profession continues to change – and so do the people within it. Key takeaways for OTs • OT careers often evolve in unexpected ways over time • Professional connection and community are becoming increasingly important across the profession • Early career OTs do not need to have every aspect of their future career mapped out immediately • Sustainable careers require balancing clinical work with wellbeing and professional growth • Occupational therapy offers diverse pathways including leadership, mentoring, education and business development • Different seasons of life may require different approaches to work and career planning • Building strong clinical foundations remains valuable even as the profession changes • Flexibility and adaptability are becoming essential long-term career skills for OTs
A significant period of change The disability sector is facing another major round of NDIS reform. The proposed legislation has sparked widespread discussion among Occupational Therapists, participants and advocacy groups, with many working to understand what the changes could mean in practice. Importantly, the reforms are not yet law. The legislation must still progress through consultation and parliamentary processes, creating an opportunity for the disability community to provide feedback and advocate for change. A shift towards standardisation Many of the proposed reforms introduce more standardised approaches to eligibility, funding and decision-making. While consistency may improve administrative efficiency, disability support often relies on understanding individual circumstances, environments and goals. For Occupational Therapists, this tension between standardisation and individualisation sits at the heart of many concerns. The proposed changes raise questions about how effectively future systems will reflect the complexity of people’s lives and support needs. Changes to NDIS access and eligibility Several proposed reforms focus on how people access the NDIS and demonstrate eligibility. These include changes to functional capacity assessments and stronger expectations around treatment history before support can be approved. Together, these measures could reshape how disability-related needs are assessed and understood. A new approach to functional capacity The draft legislation proposes assessing functional capacity without considering assistive technology or support from others. For Occupational Therapists, this represents a significant departure from established practice. Functional capacity is rarely understood in isolation. Environmental barriers, informal supports and assistive technology all influence how a person participates in daily life. Removing these factors risks creating an incomplete picture of disability and support needs. The challenges may be even greater for people with complex, overlapping or fluctuating disabilities, where function can vary significantly depending on context and available supports. Treatment requirements and access barriers The proposed legislation would also strengthen requirements for participants to demonstrate they have explored available treatments before accessing the NDIS. While intended to clarify eligibility, concerns have been raised about how this would work in practice. Access to treatment can be limited by geography, cost or service availability, and some people may reasonably choose not to pursue interventions that carry significant risks or side effects. Questions also remain about how treatment, rehabilitation and capacity-building supports will be distinguished, particularly for people with complex or long-term conditions. Funding and support decisions Beyond eligibility, the proposed reforms could influence how supports are funded and which interventions participants can access. One of the most discussed changes is the introduction of powers that could allow funding limits to be applied across categories of NDIS supports. While current discussion has focused on therapy funding, the proposed mechanism could potentially be used more broadly. This raises concerns about whether future funding decisions will continue to reflect individual circumstances and goals. The legislation would also provide the NDIA with greater authority to determine which interventions are considered evidence-based. Although evidence-informed practice is essential, research often takes time to catch up with emerging interventions and assistive technology. A lack of extensive evidence does not necessarily mean a support is ineffective, particularly when strong clinical outcomes are being achieved. There are concerns that stricter interpretations of evidence could reduce participant choice and limit access to supports that are currently delivering meaningful benefits. The growing role of automation The legislation also expands the use of automated decision-making processes within the NDIS. While automation may improve efficiency, disability support decisions often require nuanced understanding of individual circumstances. Maintaining appropriate human oversight will be critical to ensure decisions remain fair, transparent and responsive to participant needs. Why Occupational Therapist engagement matters Occupational Therapists bring valuable expertise to conversations about disability, function and participation. Their day-to-day experience provides important insight into how legislative changes may affect people in real-world settings. As consultation continues, feedback from practitioners can help highlight practical implications and ensure participant experiences remain central to policy discussions. Organisations such as the OT Society for Hidden and Invisible Disabilities (OTSI) and Occupational Therapy Australia are actively supporting advocacy efforts and providing resources to help clinicians understand the proposed reforms. Looking ahead The proposed NDIS reforms have the potential to reshape eligibility, funding and service delivery across the disability sector. While many questions remain unanswered, the consultation process offers an important opportunity for Occupational Therapists and participants to contribute to the conversation. Understanding the proposed changes now will help practitioners, providers and participants prepare for whatever comes next. The decisions made in the coming months may influence disability support and Occupational Therapy practice for years to come. Key takeaways for OTs • The proposed NDIS legislation is still under consultation and has not yet become law. • Many of the reforms reflect a broader shift towards more standardised decision-making. • Proposed functional capacity assessments may place less emphasis on environmental factors and supports. • Stronger treatment requirements could create barriers for some participants seeking access. • Changes to funding powers and evidence requirements may affect participant choice and support flexibility. • Increased automation highlights the need for ongoing human oversight in decision-making. • Occupational Therapist perspectives remain critical in shaping the future direction of disability policy. Links 🖥️ FREE NDIS Insights: Unpacking the Proposed NDIS Bill and Impact to OTs & Participants: https://www.verveotlearning.com.au/free-ndis-insights-unpacking-the-proposed-ndis-bill-impact-to-ots 🔗 Securing the NDIS for Future Generations Bill: https://parlinfo.aph.gov.au/parlInfo/search/display/display.w3p;query=Id%3A%22legislation%2Fbills%2Fr7487_first-reps%2F0000%22;rec=0 🔗 Explanatory Memorandum: https://parlinfo.aph.gov.au/parlInfo/search/display/display.w3p;query=Id%3A%22legislation%2Fems%2Fr7487_ems_35e6531f-c440-4faf-98d6-7c7ddd8bd539%22 🔗 Make a Submission: https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/NDISFutureGenBill
A major shift in early childhood supports The long-anticipated Thriving Kids rollout is beginning to take shape in New South Wales, offering the clearest indication yet of how early childhood supports may operate from October 2026. Children already on the NDIS are not expected to be removed immediately. However, children aged eight and under who may previously have entered the NDIS under mild to moderate autism categories are expected to be redirected into Thriving Kids instead. This marks a significant shift for OTs, families and private providers. While the program includes many evidence-based early intervention ideas, it is also arriving alongside tighter NDIS eligibility. For many clinicians, the concern is not the existence of Thriving Kids itself, but what families may lose access to in the process. What the Thriving Kids model includes The current draft specifications outline a system focused on short-term, early intervention supports for children, families and carers. Proposed services include supported playgroups, parenting programs, peer support and allied health intervention delivered individually or in groups. There is also a strong focus on family navigation and coordination. Importantly, the model appears focused on functional support rather than diagnosis. General supports and early intervention The general supports stream includes playgroups, parenting programs, peer support and referral services. The draft also includes allied health “in-reach” within these programs, allowing clinicians to observe children in play-based settings, provide developmental guidance and support referrals into targeted services. For many OTs, this resembles community outreach models already operating within some health services. Targeted allied health supports The targeted support stream includes time-limited, goal-focused allied health intervention. Services may be delivered individually, in groups or through multidisciplinary collaboration across clinics, homes and community settings. Although exact limits have not yet been released, the wording strongly suggests therapy caps around intensity and duration. Group intervention also appears likely to play a larger role. While groups can work well for some children, clinicians are concerned they may become the primary pathway for children who require more individualised support. Why providers are concerned One of the biggest challenges for providers is the proposed commissioning structure. The New South Wales expression of interest documentation strongly prioritises not-for-profit organisations as preferred providers. This has created widespread concern across private practice, particularly for regional and rural clinicians who are already filling workforce gaps. However, the draft specifications also reference a pre-qualified allied health panel that may allow private practitioners, sole traders and small businesses to deliver fee-for-service supports where service gaps exist. This pathway appears especially relevant in thin-market and regional locations where NGOs or public services may not have enough workforce capacity. The practical reality in regional areas For many regional communities, private practitioners are already the only available providers. Long waitlists, recruitment difficulties and workforce shortages remain significant issues. As a result, practices operating in these locations may have stronger opportunities to demonstrate why private allied health involvement remains essential. The expression of interest process allows providers to outline: Existing early childhood experience Regional or multicultural service delivery Telehealth and in-person capacity Partnership arrangements Workforce capability and organisational structure There is also a strong emphasis on collaboration between providers, including partnerships with Aboriginal community-controlled organisations and allied health services. For some smaller practices, consortium-style partnerships may become an important pathway moving forward. The return of capped intervention models Many clinicians recognise similarities between Thriving Kids and pre-NDIS systems where intervention was often short-term and group-based. The concern is not necessarily that group programs exist, but whether children who need ongoing support will still have access to consistent therapy. Families of children with ADHD, anxiety and developmental concerns have already struggled to access support under the current system. Many providers worry more children may now fall into those same gaps. At the same time, parts of the model are genuinely promising. The focus on peer support, family navigation, early touchpoints and community-based intervention aligns strongly with best-practice early childhood approaches. If these services were being introduced alongside existing NDIS access, many clinicians would likely welcome the program enthusiastically. Questions around assistive technology and coordination The draft specifications also include low-cost assistive technology funding for communication, mobility, sensory regulation and daily functioning. However, clinicians have raised concerns about how equipment provision will work in practice. Mobility and sensory supports rarely succeed through equipment alone. Effective implementation usually requires assessment, training and follow-up support. There is still little detail about funding caps, approved product pathways or how therapy input will integrate alongside equipment provision. The program also introduces a family support coordination role designed to help families navigate services and systems. Rather than a traditional NDIS key worker model, this role appears more focused on care coordination and oversight. For families navigating multiple systems, this could become an important source of continuity. Preparing your practice for what comes next Despite ongoing uncertainty, one message is becoming increasingly clear. Private practices will need to think strategically about diversification. Many providers are already exploring private fee-paying pathways, school-based supports, community partnerships and collaborative service models. Others are considering consortium arrangements to strengthen future tender opportunities. There is still substantial uncertainty around pricing, therapy caps and implementation. However, waiting for complete clarity may leave practices unprepared. For OTs, this is likely to be a period of recalibration rather than business as usual. Key takeaways for OTs • Thriving Kids is expected to begin in New South Wales from October 2026. • Children already on the NDIS are not expected to lose access immediately, but new children may enter Thriving Kids instead. • The model appears focused on short-term, goal-based and group-oriented intervention. • Current documentation strongly favours NGO-led delivery. • Regional and rural providers may still play a significant role where workforce shortages exist. • Collaboration and partnership models are likely to become increasingly important. • Practices should begin considering diversification strategies now. • Significant uncertainty remains around funding, therapy caps and implementation. Links Communities and Justice: Thriving Kids https://dcj.nsw.gov.au/community-inclusion/disability-and-inclusion/thriving-kids.html OT Unplugged - Brisbane Friends of the Podcast Event - 20 May 2026: https://www.trybooking.com/events/landing/1576072 Balmoral Burn Fundraiser Event - Support Sarah here: https://raceroster.com/events/2026/109219/humpty-dumpty-balmoral-burn/pledge/participant/46083634
The Occupational Therapy sector is moving through another period of uncertainty, with ongoing discussions around NDIS pricing, registration and funding changes continuing to dominate conversations across the profession. At the same time, conference and expo season is underway, giving OTs a valuable opportunity to reconnect, learn from one another and strengthen professional networks. In recent conversations across the OT community, one thing has become increasingly clear – while there is still a lot we don’t know about upcoming NDIS changes, there is enormous value in staying informed, avoiding misinformation and leaning into community support. Understanding the current NDIS funding discussion One of the biggest concerns circulating at the moment is the discussion around NDIS plan reductions. There has been widespread confusion, with some providers and coordinators hearing claims that all plans will be reduced to a fixed amount. What has actually been communicated so far is that the government intends to gradually reduce overall plan spending back toward average funding levels seen around 2023. Reports suggest this may involve reductions somewhere in the range of approximately 22% to 30% overall, but the exact implementation process remains unclear. Importantly, this does not mean every participant will suddenly receive the same funding amount. The details of how any reductions may occur have not yet been released, and there is still uncertainty around whether changes will happen during scheduled plan reviews or through broader administrative adjustments. For OTs supporting participants through this period, caution around misinformation is critical. Many conversations currently happening online and within services are based on speculation rather than confirmed policy. Why the annual pricing review matters A key document many providers are waiting for is the annual pricing review report. This report is expected to provide further clarity around pricing recommendations, registration pathways and possible future pricing structures. The annual pricing review is separate from the final NDIS price guide. The review outlines recommendations and findings gathered through consultation, while the price guide confirms the actual operational changes providers will need to follow. This distinction matters because many OTs are currently feeling pressure to begin registration processes immediately, despite not yet knowing what future registration requirements or pricing models may look like. For many providers, particularly sole traders and small practices, the most practical approach right now may simply be to stay informed, monitor updates closely and avoid making rushed decisions before the full details are released. NDIS worker screening checks for unregistered providers Another area creating confusion for many therapists is the NDIS worker screening check process for sole traders and unregistered providers. While requirements vary slightly between states, the process generally involves applying through the relevant state authority before linking the screening clearance through the NDIS Commission’s unregistered provider portal. For sole traders, this can feel unnecessarily complicated because providers are often required to effectively link themselves to their own unregistered provider account. The worker screening process itself is relatively straightforward once the systems are set up correctly. Most therapists will need to provide identification documents such as a Medicare card, passport and driver’s licence, complete an online application and attend an in-person identity check. One positive development is that NDIS worker screening checks are now increasingly being recognised within aged care settings, reducing the need for duplicate police checks in some circumstances. For OTs considering future registration, obtaining a worker screening check may be one practical step worth completing early while waiting for further policy announcements. Conference season brings connection and perspective Alongside all the uncertainty, conference and expo season has arrived, bringing much-needed opportunities for connection within the OT profession. Large events such as ATSA and OTX require significant preparation from exhibitors, educators and providers. Behind every stand is a huge amount of planning, logistics, freight coordination and setup work that many attendees never see. For therapists attending these events, expos can provide far more than just product displays or CPD opportunities. They create space for relationship building, idea sharing and genuine community connection at a time when many clinicians are feeling professionally isolated or overwhelmed. Why networking matters for OTs Professional networking is often misunderstood as formal or transactional, but for many OTs, it becomes one of the most valuable long-term career investments. Strong professional networks help therapists build referral pathways, identify trusted service providers and create collaborative support systems that ultimately benefit clients. For clinicians running private practices, these relationships can become particularly important during periods of transition or uncertainty. Having established connections with other providers makes it easier to coordinate care, refer appropriately and support participants when service needs change. Networking also creates emotional support within a profession that can sometimes feel isolating. Simply being around other OTs who understand the pressures of clinical work, business ownership and the evolving NDIS landscape can make a significant difference. Importantly, networking does not need to feel forced or performative. Often, the most meaningful professional relationships begin through simple conversations over coffee, shared experiences at conferences or casual introductions at industry events. Making the most of conferences and expos Many OTs feel intimidated by networking events or unsure how to approach large exhibitions. The reality is that there is no single right way to participate. Some clinicians enjoy speaking to every exhibitor they encounter, while others prefer to quietly explore before choosing who they want to engage with more deeply. Both approaches are completely valid. The most valuable conference experiences often come from approaching events with intention. Rather than collecting endless flyers or free merchandise, it can help to think ahead about what you actually want to gain from the experience. For some therapists, this may mean exploring referral pathways or learning more about local services. For others, it may involve discovering new equipment, asking questions about complex clinical areas or connecting with peers facing similar challenges. Students can particularly benefit from attending expos when they approach them with curiosity. Asking thoughtful questions about workplace culture, career pathways, client groups and clinical roles often leads to far more meaningful conversations than simply collecting brochures or promotional material. Approaching conferences with a clear sense of purpose can help therapists feel less overwhelmed and more confident engaging with exhibitors, educators and peers. Balancing innovation with practicality at expos Exhibitors are increasingly looking for creative ways to stand out at conferences, but there is growing awareness that practical value matters more than novelty. Many attendees no longer want to carry large amounts of printed material home from events, leading providers to experiment with QR codes, digital resources and more streamlined information sharing. At the same time, there is still value in creating memorable experiences that reflect a brand’s personality and values. The challenge for exhibitors is finding the balance between engaging attendees and ensuring resources remain genuinely useful. For OTs considering future exhibiting opportunities, clear planning around goals, budget and intended outcomes can make a significant difference. Understanding whether the focus is on education, visibility, networking or referral growth helps shape a far more effective conference strategy. Building community during uncertain times The OT profession is currently navigating significant change, and uncertainty within the NDIS space continues to create understandable stress for providers and participants alike. But amid the complexity, one thing remains incredibly valuable – connection. Whether through conferences, networking events, online communities or informal peer support, staying connected with other therapists creates opportunities for shared learning, collaboration and reassurance. At a time when many OTs are searching for clarity, community may be one of the most important professional resources we have. Key takeaways for OTs • Current NDIS funding discussions do not mean every participant’s plan will be reduced to the same amount. • The annual pricing review and upcoming price guide are expected to provide further clarity on registration and pricing changes. • Sole traders and unregistered providers may still complete NDIS worker screening checks through the unregistered provider portal. • Conference season offers valuable opportunities for networking, learning and professional connection. • Attending expos with clear goals can make the experience far more meaningful and manageable. • Strong professional networks support referral pathways, collaboration and long-term career resilience. • Community connection remains essential during periods of industry uncertainty. Sydney Friends of the Podcast: Wednesday 13 May 2026 @ 5:30pm https://www.trybooking.com/events/landing/1560836 Brisbane Friends of the Podcast: Wednesday 20 May 2026 @ 5:30pm https://www.trybooking.com/events/landing/1576072
The current NDIS landscape is shifting quickly, and many Occupational Therapists are being asked to make decisions without having all the information. Between proposed funding changes, evolving reporting expectations and ongoing uncertainty around registration, it’s easy to feel overwhelmed. Rather than trying to predict every outcome, the focus right now is on understanding what’s changing, what it means in practice and how to respond in a way that is both clinically sound and sustainable for your business. Preparing for changes to social and community participation funding One of the biggest concerns is the proposed reduction in social and community participation funding. While details are still emerging, early indications suggest a significant cut for many participants. What’s important to recognise is that this funding is often not just used for social outings. It supports essential daily activities such as attending medical appointments, grocery shopping and accessing community services. If funding is reduced, the need for support does not disappear. In many cases, it simply shifts. Participants may still require assistance at home, which can increase pressure on families and create new risks if appropriate supports are not in place. Adapting your reporting approach These changes highlight the need to be far more explicit in reporting. Rather than broadly referencing social participation, reports should clearly outline how funding is currently being used, why those supports are essential for daily functioning and what risks may arise if they are reduced. It is also important to articulate what alternative supports would be required if funding is changed. This ensures that reports reflect the real-world impact on the participant, rather than abstract recommendations. Clarity, specificity and clinical reasoning are more important than ever. Functional assessments on file: necessary or not? There has also been an increase in requests for updated functional assessments “just in case”. While this may feel like a protective strategy, it is not always the best use of funding. If a participant has had a recent assessment and there have been no meaningful changes, completing another report may not provide additional value. In contrast, if circumstances have changed, eligibility is unclear or documentation is outdated, an updated assessment may be justified. The key is shared decision-making. Presenting the pros and cons allows participants and their families to make informed choices, rather than defaulting to unnecessary reporting. Should you register as an NDIS provider? With all of these changes, it is no surprise that the question of registration is coming up again. There is ongoing discussion around mandatory registration and potential pricing differences between registered and non-registered providers. However, there is still no clear timeline or confirmed model for what this will look like. Registration is not a simple decision. It depends on your service type, business structure and financial position. Therapists providing therapeutic supports may access the verification pathway, while those in early childhood or behaviour support may face significantly higher costs through certification. Adding to the complexity is the likelihood that the system will change again. Investing in registration now may not mean avoiding future requirements. Understanding the true cost of registration Registration involves far more than the initial fee. Beyond upfront costs, there is a significant time investment in preparing documentation, undergoing audits and maintaining compliance. This includes systems for staff checks, professional development, incident management and infection control. Importantly, it is not enough to have policies in place. You must demonstrate how they are implemented in practice. Audits often include staff interviews and evidence of real-world application. While these systems become easier to maintain over time, the initial setup can be substantial, particularly for smaller practices. Making a business decision, not an emotional one Given the uncertainty, registration decisions need to be grounded in business strategy rather than fear. This includes considering how long you plan to remain in the NDIS space, whether you have the financial capacity to absorb costs and whether your client base will require registration in the future. For some areas of practice, particularly paediatrics, the future demand within the NDIS is still unclear. This makes it even more important to carefully weigh the return on investment. There is no universally correct answer, only what makes sense for your individual context. Staying grounded in uncertainty The lack of clear direction is one of the biggest challenges right now. With multiple changes pending, it is easy to feel like every decision carries significant risk. This is where intentional decision-making becomes critical. Focusing on what you know, what you can control and what aligns with your values will lead to more sustainable outcomes. Small, considered actions will always be more effective than reactive decisions driven by uncertainty. Key takeaways for OTs • Start with what is changing in funding and how it impacts your clients • Be explicit in reports about how supports are used and why they are essential • Only complete functional assessments when there is clear clinical value • Use shared decision-making with participants when considering reports • Registration is a business decision, not a reactive one • Consider both upfront and ongoing costs of becoming registered • Wait for further NDIS updates where possible before committing • Stay intentional and focus on what is within your control Links Life Skills Training for NDIS OTs with Nikki Cousins: https://www.verveotlearning.com.au/Life-Skills-Training-for-NDIS-OT-Providers A Coregulation Approach to Emotional Regulation in Paediatric OT with Alyce Svensk: https://www.verveotlearning.com.au/Supporting-Children-with-Emotional-Regulation-Challenges
The National Disability Insurance Scheme is entering a major reform phase, with sweeping changes designed to improve long-term sustainability. These updates will reshape how people access the scheme, how funding is allocated and how services are delivered. While some reforms aim to strengthen consistency and reduce misuse, others introduce significant shifts that will directly impact participants and the clinicians who support them. For Occupational Therapists, understanding the direction of these changes is essential for navigating what comes next. A system under pressure The driving force behind this reset is cost growth. The scheme has expanded rapidly, both in participant numbers and overall expenditure, prompting concerns about its long-term viability. In response, the government has outlined a four-year reform plan focused on reducing fraud, slowing spending, clarifying eligibility and improving service quality. A new legislative package is expected to be introduced and passed quickly to enable these changes. A fundamental shift to functional capacity At the centre of the reform is a move away from diagnosis-based access towards functional capacity. Eligibility will increasingly depend on whether a person has substantially reduced functional ability, rather than the presence of a specific condition. This change will be supported by a new standardised assessment tool, although key details remain unclear, including who will complete these assessments and how they will be implemented in practice. Over time, this approach is expected to apply not only to new applicants but also to existing participants as their plans are reviewed. Fewer participants, tighter entry Alongside changes to eligibility, the government is aiming to significantly reduce the number of people on the scheme compared to current projections. This will likely occur through stricter access criteria, reassessment of existing participants and a greater reliance on supports outside the NDIS. While funding has been allocated to strengthen these alternative systems, there is limited clarity about how they will function or whether they will meet demand. Funding changes that will impact daily life One of the most immediate and tangible changes is the reduction in social and community participation funding. Budgets will be reset to align with earlier averages, resulting in an estimated 30 per cent decrease for many participants. These reductions are expected to begin from October 2026 and may occur regardless of where a participant is in their plan cycle. This represents a significant departure from previous approaches and may create uncertainty for participants who rely on this funding for everyday activities. Although a national fund has been proposed to support community-based alternatives, questions remain about whether this will adequately replace individualised supports. Reduced flexibility in plan management Changes to plan reassessment processes will also affect how participants respond to changing needs. Stricter criteria for unscheduled reviews are expected to limit access to additional funding within a plan period. While intended to reduce overspending, this may also reduce responsiveness when circumstances change, placing greater pressure on initial planning accuracy. Provider reforms and market shifts The reform package includes several changes that will reshape the provider landscape. Mandatory registration will apply to providers delivering higher-risk supports, particularly those involving personal care or restrictive practices. In addition, a new system will require basic identification or enrolment for most providers, improving visibility across the sector. Plan management will also undergo significant restructuring, with a move towards an approved panel system. This is likely to reduce the number of providers and may disproportionately impact smaller businesses. There are also early indications of differentiated pricing, potentially favouring registered providers, although details are still emerging. A move towards commissioned supports A notable structural change is the potential introduction of commissioning for home and living supports. This would involve funding a select group of providers directly, rather than allowing participants to choose freely from the market. While this approach may improve consistency and cost control, it represents a shift away from participant choice and could reduce the diversity of available options. Strengthening compliance and oversight Fraud prevention and compliance remain key priorities within the reform. Planned changes include improved payment systems, increased evidence requirements and expanded regulatory powers. These measures are designed to protect participants and ensure funds are used appropriately, addressing ongoing concerns about misuse within the scheme. What this means for Occupational Therapists Although many of the changes do not directly target allied health, the flow-on effects will be significant. Occupational Therapists will need to support participants through funding reductions, changing eligibility criteria and increased uncertainty. Clear, functional evidence will become even more important in demonstrating need and justifying supports. There will also be a growing role in helping participants adapt to reduced flexibility and navigate alternative support systems outside the NDIS. What to watch next Many elements of the reform are still evolving, with further detail expected as legislation is introduced and implementation plans are released. Key areas to monitor include the development of the functional assessment tool, the rollout of support needs assessments from 2027 and updates to pricing and provider regulation. Staying informed and adaptable will be critical as the scheme continues to shift. Key takeaways for OTs • Expect a stronger focus on functional capacity in both access and funding decisions • Prepare for future changes to assessment processes, including support needs assessments • Be aware of reductions in social and community participation funding and how this affects clients • Anticipate tighter rules around plan reassessments and reduced flexibility • Monitor provider reforms, including registration and pricing changes • Strengthen reporting to clearly demonstrate functional impact and support needs • Support participants to navigate both NDIS changes and alternative support pathways Links Speech Transcript made by Mark Butler at National Press Club on 22/04/2026: https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/minister-butler-speech-at-the-national-press-club-22-april-2026?language=en&fbclid=IwY2xjawRVYFdleHRuA2FlbQIxMABicmlkETFzVm1kUkFuUVJGMDBvbEN4c3J0YwZhcHBfaWQQMjIyMDM5MTc4ODIwMDg5MgABHsmjiG7yqVQOEl0d_2wkkwEh2weHvl2Xra9wg4zmbTRx95bkZNBb_MJFWhbq_aem_YgrkLacZXUDHpufvM0KOZA Securing the NDIS for future generations fact sheet: https://www.health.gov.au/sites/default/files/2026-04/securing-the-ndis-for-future-generations_0.pdf
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