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Unpacking the NDIS and Health updates for Nursing Services.

Unpacking the NDIS and Health updates for Nursing Services.

By: Georgie McGrath Disability & Rehabilitation CNC.

25.09.19


The NDIS Supports Catalogue as at 1 October 2019 a range of ‘community nursing services’ are funded in both Core: Assistance with Daily Life and Capacity Building: Improved Daily Living Skills. Provider travel rules apply (per the price guide). It’s unclear why these services fall in two (2) categories (and I won’t over think this).



The categories of nurses added are:

· Enrolled Nurse (EN;

· Registered Nurse (RN;

· Clinical Nurse (CN);

· Clinical Nurse Consultant (CNC); and

· Nurse Practitioner (NP).


The later two (2) levels of nursing have been allocated shift work fee schedules but generally in nursing profession these roles have historically been ‘business hours’. So this is unique!


Page 47 and 48 of the Price Guide October 2019 have had what appears to be rushed definitions of nursing classifications tacked into the document. It fails to explain the role of delegation at all levels of the profession and the minimum experience and qualifications to be engaged at a CN or CNC. CN generally requires a minimum 2-3 years of clinical experience in the area of speciality and 5 years post registration experience and a CNC a minimum 5 years of clinical experience in the area of specialty and 5-10 years post registration experience. The NDIS Provider Toolkit – Guide to Provider Suitability is not yet updated to reflect these changes (as at 6.15pm 25.09.19).



The current ‘community nursing’ code for ‘individual assessment and support by a nurse’ remains with the price of $99.83 and ‘continence assessment’ code has increased to $124.05. Yet a general RN shift attracts a $107.25 / hr charge, CN $124.05 and CNC $146.75 / hr charge under the other new categories.


The Health Supports Provider Document doesn’t really make clear ‘who’ decides if a nursing service is the right classification of support to be engaged by a participant but does re hash the NDIS definition of ‘reasonable and necessary’. The document is clear in how this funding will be rolled out into participants plans yet reports that participants can choose to spend their unspent core supports on these services now.


The list of eight new ‘support type’ categories identify the need for training for competency-based training of workforce. The ‘support types’ cover (and are not limited too):


· Continence support;

· Respiratory supports;

· Nutritional supports;

· Dysphagia supports;

· Wound and pressure care supports;

· Diabetic management supports;

· Podiatry supports; and

· Epilepsy supports.


This is now clear (& for those who know me I have been harping on this issue for years!). This is an awesome update if plans reflect the appropriate level of funding to meet this requirement. The issue with competency-based training by an independent nursing service if funded by a client is where does the cross over and responsibility lie for the organisation who engages the workforce. (And maybe I worry too much about this but a disconnect may be an issue in reality). Something for us to navigate during these exciting times.


In my opinion the sector is ill prepared for this massive update with four (4) business days’ notice from release of updates to start date. Obviously with the way it will be rolled out the funding is likely to be staggered coming in to participants plans over the next 12 months. I urge participants to screen nursing services well for actual demonstrated experience and competency level of staff. If/when you engage a nursing service, they may in themselves need training and competency assessments to provide you with the level of supports that you require. Just because a person holds a nursing qualification does not make it a given that they have the skills required to support you. Like all NDIS services – know what you are paying for!!!


For McGrath Nursing Consultancy it’s business as usual and maintaining our established specialist nursing services.

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