The foundations for successful implementation

Taken together, our recommendations represent a blueprint, not only for the NDIS, but for the future of the broader ecosystem of support for all people with disability. Investment of time, resources and expertise in best practice implementation will ensure these changes deliver for all people with disability.

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Implementation should be guided by lessons from the past

Implementation of these recommendations has much to learn from the experience of the initial NDIS roll-out, as well as subsequent reforms. While changes to a national scheme of the scale and complexity of the NDIS will inevitably experience road bumps, we have identified several common issues to be taken into account in implementing our recommendations.

Notwithstanding deep engagement with the disability community by governments between when the Productivity Commission reported in 2011 and the commencement of the NDIS on 1 July 2013, the initial NDIS roll-out has been criticised for its emphasis on meeting short-term targets and unrealistic deadlines. This meant implementation was not always aligned with the original intentions for the scheme.³⁷²The speed and complexity of the rollout also meant that despite best intentions, elements of the previous systems found their way into the NDIS.³⁷³

The subsequent attempted introduction of Independent Assessments in 2021 further demonstrated a failure to implement reforms as intended or in partnership with people with disability. This process suffered from insufficient design with people with disability and the sector, a lack of consultation with independent experts, and inadequate testing.³⁷⁴ This undermined community trust and created lasting fear, stress and uncertainty for NDIS participants, families and carers.

We also recognise that people with disability, their families, carers, Disability Representative Organisations, workers and disability service providers are exhausted by never-ending change. There is significant reform fatigue, and everyone craves consensus and certainty around the transition to a better future for the NDIS.

Our recommended approach for transition takes these lessons into account. This includes a five-year transition period, robust design and testing with people with disability, and a focus on retaining the features of the NDIS that are working well and replacing those that are not.

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Transition will take time and careful sequencing

Our recommendations must be considered and implemented as a package over a five-year transition period. During this period, implementation should be sequenced strategically to address critical dependencies, manage risks and mitigate or minimise disruptions for participants, providers and workers.

Ask the people living the NDIS - the participants and staff - to contribute meaningfully to an ACTUAL REDESIGN. Give redesign the TIME it needs to GET IT RIGHT.

Implementation of some recommendations should be prioritised in the short-term to make immediate improvements to the participant experience, such as foundational supports (see Recommendation 1), updating guidance for making access requests (see Action 3.2) and strengthening the workforce (see Recommendation 15).

For more complex recommendations, a staged transition approach will be necessary to allow for more substantial consultation, design and testing prior to a phased roll-out. For example, a staged transition is recommended for changes to the participant pathway (see Action 3.8) and implementation of a new regulatory model for providers (see Action 17.2).

Sequencing should also consider essential implementation enablers that cut across many recommendations.

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A suite of legislative changes will be needed to underpin reforms

Some of our proposed reforms will require changes in relevant legislation. We expect a package of amendments to primary legislation and associated legislative instruments will be required. This will include changes to the National Disability Insurance Scheme Act 2013 and NDIS Rules to deliver improvements to the participant pathway. A full list of recommendations possibly requiring legislation changes is at Appendix D.

As with all our reforms, these legislative changes should be effectively coordinated across government and done in close consultation with the disability community.

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A well-coordinated national effort is required to deliver these changes

All governments need to work together in new ways to deliver these recommendations, learning from the experience of incomplete or inadequate implementation of previous reviews’ recommendations.

This must be embodied in both the new compact between governments (see Recommendation 20), and a joined-up approach to implementation. A successful and smooth transition will rely on agencies with implementation responsibilities across all governments better coordinating their distinct activities. Dedicated coordination and monitoring functions will help drive the reforms and ensure dependencies between implementing agencies are addressed.

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A concerted effort will be needed to bring everyone with a stake in the NDIS along on the journey

Implementation of these recommendations affects people with disability, their families, carers, Disability Representative Organisations, workers, disability service providers and governments. We have consistently heard from all stakeholders that implementation of NDIS reforms to date has not been sufficiently consultative. Where consultation has occurred, it has often been tokenistic, siloed and rushed.

Listen to the most important people, the people with the disabilities.

What I would really love to see is for the NDIA to talk to us, the providers, as well as the participants. We are all the people who directly or indirectly use the NDIS. But I think that, there is a lost opportunity. The people are the most amazing resource, and I don't think it is being tapped into

Implementation should ensure all groups with a stake in the NDIS have a genuine voice in the process. This should be reflected in design with people with disability, their families, carers, Disability Representative Organisations, workers and disability service providers. It also extends to the make-up of implementation bodies and governance structures, which should prioritise inclusion of people with disability.

[The NDIA should] lead its consultation processes in a spirit of collaboration of all interested stakeholders by creating forums where everyone can engage with each other, at the same time: participants, allied health representatives, NDIA, Government, and other relevant stakeholders

[There needs to be a] commitment to the voice of lived experience for input to ongoing design, and consultation with experts where appropriate

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A best practice approach to implementation will improve outcomes

Recommendations must be delivered sensitively in consultation with people with disability and in line with implementation best practice. This is essential to build and maintain confidence in the integrity of the NDIS with people with disability and the Australian community.

A best practice approach to implementation should align with these following principles:

• Genuine design with people with disability, their families, carers, Disability Representative Organisations, workers and disability service providers that centres and leverages the lived experience and expertise of the disability community and sector. This would involve people with disability at all stages of the design process, including identifying when new processes are ready to be implemented.
• Design of new services, processes, platforms and communications materials in line with the Australian Government Digital Service Standard, including taking an agile and user-centred approach to all stages of the design process.³⁸⁰
• An inclusive and proportional approach to testing all new processes. This would ensure testing of new processes is both sufficiently robust and proportional to complexity and scale. It will also allow priority reforms to be phased in and start delivering benefits as soon as possible.³⁸¹
• Rigorous and transparent reliability and validity testing of functional and needs assessments for the purpose for which they are intended. This must include involving people with disability and independent experts and conducting transparent trials with participants.³⁸²
• Design of culturally safe and tailored approaches in partnership with First Nations and culturally and linguistically diverse communities. This should deliver on Priority Reforms under the National Agreement on Closing the Gap, including ensuring government agencies are culturally safe and responsive to the needs of First Nations people.³⁸³
• Continuous and independent evaluation of implementation to monitor for unintended consequences and identify opportunities for improvement.
• Frequent and transparent communications with stakeholders, including current participants. This should aim to not only help people to understand the reforms and how they may be affected, but also to build and maintain trust in the scheme by showing how people with disability are being included in the implementation process.

Implementing recommendations in line with these principles will require a significant investment in and uplift of design capability within government. To enable this, we propose establishing the NDIS Experience Design Office based in the National Disability Insurance Agency (NDIA). It should draw on specialists with relevant design and subject-matter expertise. The NDIS Experience Design Office’s remit should include commissioning and overseeing projects for the design of reforms to the participant pathway, in line with the principles outlined above. The design of these reforms requires a mixture of policy, operational and services expertise. Accordingly, the Department of Social Services should have embedded staff in the NDIS Experience Design Office.

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Existing participants must experience a smooth and fair transition

We have heard from participants, families and carers who both want to see the NDIS change, but are anxious about what changes to the NDIS mean for them. Implementation should focus on how existing participants transition to new arrangements. A number of factors will need to be considered to ensure that all existing participants experience a smooth and fair transition.

Participants should have an opportunity to design, test and engage with changes to the pathway (see Recommendations 1.3 and 1.6) before they have to interact with them. This must involve much more than simply informing people about change. Participants should help drive the change journey through a transparent, inclusive and detailed design process.

Changes to access and budget setting processes can only be implemented once the recommended foundational supports are in place to offer support outside the NDIS (see Recommendation 1).

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The combined impact of our recommendations will deliver long-term scheme sustainability

We have previously emphasised sustainability is about more than just costs – it is also about outcomes.

Adopting our recommendations will focus the scheme on improving participant experiences and outcomes while ensuring value for money. A participant-centred scheme, focused on outcomes will be a successful and sustainable scheme.

The Review has examined the potential impact of our recommendations on scheme projections. If implemented together, we are confident our reforms will secure the future of the scheme and meet National Cabinet’s NDIS Financial Sustainability Framework annual growth target in total costs of the NDIS of no more than 8 per cent by 1 July 2026 with further moderation of growth over time.

By the time the reforms mature in 2032-33, we expect cost growth in the scheme itself to have gradually moderated and be within the implied target of $87 billion in 2032-33, compared with the latest unpublished NDIA estimate of $92 billion.

However, this will be impossible without significant investment outside of the scheme.

First and foremost, investments are needed in foundational supports and in making mainstream services more accessible and inclusive. These will reduce pressure for NDIS support. It will also create a fairer and better system of support for all people with disability.

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