Back to top
Workforce challenges are well known and widespread
In 2021-22 there were around 325,000 workers supporting NDIS participants, their families and carers.214 The supports these workers provide are essential for people with disability to live their lives.
Participants, families and carers told us of the difference good support workers can make in their lives.
I have been linked with the most amazing support workers. People who work for me in their own time to fill the many, many gaps left by an inadequate plan. if it were not for the wonderful humans who support me so well, I guarantee you I would have checked out.
– Participant 215 As the NDIS grows, more workers will be needed to support people with disability. About 128,000 more workers are likely to be needed by June 2025 to fully meet demand. But service providers, participants, families and carers told us that finding and keeping disability workers with the right skills, values and attitudes is already hard today.216
Finding good support workers has been very difficult for us. I have often gone unsupported due to [being] unable to find good workers for our daughter.
– Carer 217 The disability sector is also trying to build its workforce at the same time as there is strong demand for new workers right across the care and support sector.
Figure 13: The NDIS workforce is diverse, covering disability support workers, allied health workers and other workers working across a variety of settings218 Disability support workers 280,000 workers in 2021-22385,000 workers needed by June 20258 in 10 work part-time7 in 10 are female6 in 10 aged 44 or underAllied health workers 36,000 workers in 2021-2251,000 workers required to fully meet demand by June 2025This group includes both allied health professionals and allied health assistants. In the year to 20 September 2022, allied health services accounted for around 13% of NDIS payments.
Across the broader care and support workforce 4 in 5 hold a Certificate III qualification or higher , compared with 66% of the broader labour market. Enrolments in relevant VET qualifications increased by around 6.5% between 2015 and 2019, however, completions declined by 4.6%.Almost 4 in 10 were born overseas , compared to 32% of the overall workforce. Other workers 9,000 workers in 2021-2217,000 workers required to fully meet demand by June 2025These workers provide a diverse range of supports and include, for example, support coordinators, interpreters, gardeners and cleaners.
Emerging platform workers The number of workers supporting NDIS participants through online platforms is small, but growing .
In 2021-22, around 16,000 NDIS agency and plan managed participants had used a platform provider.
Informal carers In 2018, there were an estimated 2.65 million informal carers of people with disability and older people.
Around 1 in 3 (861,000) were primary carers.*
In 2020, it was estimated that informal carers delivered nearly 2.2 billion hours of care which would cost $77.9 billion if delivered by formal carers (i.e. paid workers).
*Primary carer refers to someone who supports a person of any age with a disability. Informal carers includes those who support people of all ages with disability and older people (aged 65 years and over) without disability.
Despite strong workforce growth since the NDIS commenced, large and persistent workforce shortages remain in the NDIS under current policy settings. This limits access to suitable supports for some participants and places pressure on existing workers, particularly in regional and remote areas and for some participant groups.
We’ve heard that many NDIS workers are feeling burnt out. A recent workforce retention survey found more than two in five (43 per cent) of NDIS workers felt burnt out at least half the time in their job.219
Jobs can be short term with poor conditions and many workers aren’t staying. Each year, indicatively between 17 per cent and 25 per cent of NDIS workers leave their job. Unless this high level of turnover can be addressed, between 198,000 and 292,000 NDIS workers are expected to leave their job in the three years to June 2025.220
Many workers say they can’t access the training they need and some feel they have limited career opportunities.
There is a vicious cycle in this sector. People want to make a career as a disability worker. They know that they need to be trained to do the sort of specialised work that is needed. They want to do that training. But they cannot do it [training] because they are employed only on a casual basis with short contracts and so must work for several organisations just to make ends meet. This means that they cannot refuse a shift because they cannot risk losing that job. If they cannot get time off, they cannot do training. If they do not do training, they cannot get more shifts - because they do not have the specialised training needed for the work. How do they win?
- Disability Support Worker, quoted in Australian Services Union221 Some workers report not getting enough supervision.
Supervision is few and far between, that's if it does happen. We aren't debriefed after extreme major incidents. We're constantly questioned about doing overtime when we're understaffed. We haven't had a staff meeting since 2022.
- Disability Support Worker, quoted in Health Services Union222 We also know that three out of four NDIS workers are employed either part-time or casually. Workers with disability - or ‘peer workers’ - are not well represented in the NDIS workforce. The operationalisation of worker screening can also create barriers to workers joining the NDIS workforce (see Recommendation 17 ).
Many of the challenges facing NDIS workers are similar for those working in aged care and veterans’ care. Some NDIS workers also work across these two other areas. When we talk about these sectors together, we call this the ‘care and support sector’.
The care and support sector is also growing. By 2049-50, almost one in 20 jobs in Australia are expected to be in the care and support sector.223 But we’ve also heard that if things don’t change, there won’t be enough workers to provide the care and support all Australians need.
Past reviews looked at ways to grow and sustain the workforce for disability, aged care and veterans’ care services. However, they have often not looked at the care and support sector as a whole. Past workforce strategies have also lacked performance measures, making it difficult to tell if government actions have had any impact.
While monitoring and evaluation of the [NDIS Workforce] plan is expected throughout its life, the plan itself does not set out measurable outcomes that might be used to assess whether the plan is effective in supporting sustainable growth in the NDIS workforce. … The committee therefore remains concerned that, without adequate attention from the Commonwealth Government in this plan, many of the issues experienced by the NDIS workforce ... will continue to persist.
- Joint Standing Committee on the National Disability Insurance Scheme 224 Meeting future needs will need joint and ongoing action across the care and support sector.
Back to top
The Panel’s vision: New ways to attract, keep and train workers across the care and support sector to ensure a capable and sufficient disability workforce
To meet the future needs of the disability sector - the NDIS and foundational supports - we need to look at new ways to attract, keep and train workers across the care and support sector.
Most care and support workers do not work in traditional full-time jobs. Many work more than one job. For these workers, training and other systems are not always helping them to build their skills and careers. Employers are not encouraged to invest in training these workers.
One way to change this is to put in place new ways for workers to build up training and leave balances across the care and support sector. We call this ‘portable' leave or training, when it is recognised across the care and support sector and not just with a single employer. Making it easier for workers to move across the care and support sector can open up more career options and encourage them to stay in the sector.
High turnover not only lowers the quality of supports but also increases the cost of delivering supports. The Australian Services Union highlighted two case studies where service providers estimated the direct costs of on-boarding a new disability support worker was between $2,130 and $3,320, with one provider noting that “it generally takes a full month of working before they reach acceptable competence.”225 Improving worker retention and helping workers to build their skills in the sector would, therefore, improve outcomes for participants and reduce pressure on scheme sustainability.
There may also be ways to better use technology to upskill workers. For example, in remote communities where providers do not currently have access to relevant technology, such as telehealth, alternative commissioning approaches (see Recommendation 14 ) could look at ways to invest in training and equipment that can be used by the whole community.
In remote communities, there are also opportunities to leverage off changes to other government programs, such as the Community Development Program.
More generally, initiatives to improve workforce training in the care and support sector should be complemented by other government training initiatives, including the progression of micro-credentials (short courses or competencies), a digital skills passport and growing the use of traineeships.
More focus on peer workers will improve the quality of support provided Governments also need to recognise the critical role of peer workers - and do more to build the number of peer workers in the disability sector. This will not only improve outcomes for people with disability but also improve the quality of support provided.
There is much the disability sector could and should learn from the mental health sector, where peer workers are much more widespread. Any barriers to the employment of peer workers with disability should be considered as part of a future joint action plan for disability employment (see Action 1. 7).
Building the peer workforce should start with increased support for individual and family capacity building being delivered by peer workers as part of the increased investment in foundational supports (see Recommendation 1 ).
Overseas workers can be part of the solution to acute workforce shortages Together with action to better attract, keep and train workers, migration can help fill short‑term acute workforce gaps. But it can be hard for some overseas care and support workers to come to Australia.
More targeted and flexible approaches to attract overseas workers across the care and support sector should be explored. Importantly, these approaches should not replace efforts to invest in building a sustainable local workforce.
Governments need to get better at planning for future workforce needs This would help governments to better understand current gaps and to better plan for future workforce needs. Ongoing timely and reliable forecasts are needed.
Governments need to work together to better identify and address workforce issues and drive continuous improvement. They also need to be accountable for their plans and actions.
Complementary reforms to scheme rules and procedures will support a responsive and capable workforce How, and how much, providers are paid has important flow on effects for attracting and retaining a quality workforce.
Some providers argue they are unable to invest in the capability of their workforce under current pricing arrangements. This exacerbates workforce retention challenges. Uncertainty in participant demand, at least throughout scheme transition, may have contributed to a greater use of casual work in the scheme. Casualisation increased from 36 per cent of all NDIS workers in 2016 to a high of 40 per cent in 2019.226
Reform to the pricing and payment regulatory framework (see Recommendation 11 ) would help ensure that the cost of maintaining a capable workforce, with appropriate supervision, is well captured in future price caps. This includes:
shifts to more transparent processes for setting price caps that reflect the market price for delivering supports (including any costs associated with regulation) with more robust information on the actual cost of delivering support and how much participants are being charged price caps that better reflect differences in the costs - including, where appropriate, the cost of higher skilled workers delivering supports to participants with more complex needs or in higher cost locations shifting away from fee-for-service to other payment models that better focus providers on outcomes rather than outputs. Under the proposed enrolment payment approach for 24/7 shared living supports, providers would have greater stability of funding, supporting a more stable workforce that is familiar with the needs and preferences of the people they support. This flexibility would support investment in improved quality of life and productivity enhancing equipment. Improved worker screening requirements and minimum online training would also ensure workers understand their obligations and do not pose an unacceptable risk of harm to participants. This should not result in an undue burden on workers. Early in the Review, we recommended practical reforms to make worker screening faster, smoother and better harmonised across sectors and jurisdictions (see Action 17.4 ). Longer term, workers could potentially showcase their skills and qualifications through the worker screening database.
These reforms combined with reforms to focus on continuous quality improvement and information on provider performance (see Recommendation 12 ), would encourage providers to maintain a workforce capable of delivering safe and quality supports. Participants would benefit from improved access to quality supports.
More broadly, a focus on early intervention supports (see Action 3.7 ) and improved uptake in assistive technology and home modification supports (including home modifications for participants living in social housing, see Recommendation 9 ) would support participants to be more connected to their community and safer, and also reduce reliance on ongoing formal supports delivered by workers. This in turn would reduce future workforce pressure in the scheme. For example, the preliminary results of a recent study of 15 people with disability with complex support needs found that after 6 to 24 months of living in Specialist Disability Accommodation with appropriate assistive technology, there was an average decrease of 2.4 support hours per participant per day 6 to 24 months following their move to the new arrangements.227
Back to top