A review of the capabilities of the National Disability Insurance Agency



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Strategy

Outcome focused strategy

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After six months of operation, the Agency is still establishing its way of doing things. The heroic effort to open the doors and start operating within almost impossible timeframes seems to have embedded a way of working that is ‘all hands to the pump’. This gets quick results and probably contributed to the Agency’s early success, but is not scalable or appropriate for a large delivery organisation. Greater clarity in roles and accountabilities is essential to enable all parts of the growing organisation to operate efficiently.

The reduction in preparation time has meant that some of the necessary organisational development work has had to be done concurrently with running the Scheme. Important parts of the organisational infrastructure needed to mobilise the organisation are underdeveloped or missing. The corporate areas are particularly weak and this has exacerbated problems with attracting and retaining the right people, and putting in place the systems and strategies that are critical to support the Agency’s work.

At the time of writing, the Agency’s Strategic Plan was out for public comment. The three goals of the plan are:



  • people with disability are in control and have choices, based on the United Nations Convention on the Rights of Persons with Disabilities

  • the Scheme is financially sustainable and is governed using insurance principles, and

  • the community has ownership, confidence and pride in the Scheme and the Agency.

Agency staff appear to have a good general understanding of most of these goals. However, a diverse range of views is evident about the insurance principles that underpin the Scheme, and how these are incorporated into the way the Agency runs. It should be noted that this is also an issue amongst stakeholders and the wider community.

The Actuarial Unit has been slow to establish and it does not seem to have good visibility throughout the Agency. Its central role is not well understood throughout the Agency and its work is also hampered by the shortcomings of the ICT system.

The Agency is not only a start-up organisation facing all the usual challenges; it is also tasked with implementing a very new approach to supporting people with disability. There are still many unknowns. Comprehensive data about the client group and their needs was not available prior to the commencement of the Scheme. Consequently an important objective of the first two years of the Scheme is to gather the data and experience to refine the assumptions in the actuarial model to ensure the successful rollout of the full Scheme. This can clash with other objectives such as meeting intake targets.

The first two years of the Scheme are clearly identified by the previous and current Governments as an opportunity to learn and to trial approaches. This means that the strategic focus of Agency operations in these first years is likely to be very different from that in the longer term. It is to be expected that in its early years the Agency would commit a much higher proportion of its resources to learning about its business than in later years.

Some tensions are emerging about the early strategic and operational focus of the Agency. More clarity about the objectives of the trial stage of the Scheme would help decision-making about allocation of resources, but would also assist stakeholders to understand the necessary trade-offs.

Evidence-based choices

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The greatest challenge for the Agency in building an evidence-based culture is the shortcomings of the ICT system. Because of the shortened lead-time and redirection of some of the funds earmarked for the development of the ICT system, a compromise system was provided by DSS. The system enabled the Agency to begin operating, but it is not fit for purpose. This is limiting both the effectiveness of the Actuarial Unit and the flexibility of the Agency to respond to the experience of the planning staff.

The Actuarial Unit requires granular and longitudinal data for its reports to the Board and other stakeholders. This is not available from the current system and is seriously limiting the development of the prudential management of the Scheme. When available, this data should be a key source for the Agency’s research effort. A high priority for the Agency is to lift the capacity of the ICT system, and link assessment and resource allocation.

The greatest danger to the future of the Scheme is that the design and building of the data collection and ICT foundations is rushed, is not informed by the actuaries and knowledge from front-line staff, is not done sequentially, or is not fit for purpose (because there are insufficient funds). Because of the long lead times in developing new ICT systems, there will need to be short-term investment in improving the current system.

Refinements to the operations are inevitable, particularly in the early years of the Scheme. Currently there are no clear processes for identifying and analysing emerging issues, proposing options, seeking input from staff, participants, external experts and stakeholders, and then communicating the changes. These processes are important to ensure that changes are considered and implemented in an orderly and transparent way, particularly in the early years.

Feedback from participants and other stakeholders such as service providers needs to be better incorporated into the operations of the Agency.


Collaborate and build common purpose

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The Agency has some complex governance arrangements with partners and stakeholders, which are still bedding down.

The Agency has been established under Commonwealth legislation (the NDIS Act) and is governed by a Board. The Board is responsible for the Agency’s performance and strategic direction, and is advised by the Independent Advisory Council.

Decisions on NDIS policy issues are made by the COAG Disability Reform Council, which is made up of Treasurers and Ministers responsible for disability from the Commonwealth and each State and Territory.

The Commonwealth Minister is responsible for administering the NDIS Act, and often requires agreement of the States and Territories to exercise powers, including the making of some NDIS Rules and giving directions to the Agency.

These statutory relationships are critical, and need to be underpinned with trust between the players. There will never be complete clarity and all parties need to be as open and transparent as possible in the grey area between them. The Agency needs to invest substantially in building and maintaining these relationships.

Because of the close role of the Commonwealth Government in the development of the Agency, it may be useful for the Chair of the Board to pay particular attention to building on the relationships between the Agency and State and Territory governments.

DSS advises the Commonwealth Minister and has worked closely with the fledgling Agency. DSS delivered a range of corporate services to the Agency under contract, in the first months of the Agency’s operations. There are some ambiguities in the respective roles of the Agency and DSS in areas, such as briefing the Commonwealth Minister, that should be clarified.

The Agency engaged well in the first trial sites. In the first half of 2013 conducted 600 separate engagement activities with prospective participants, service providers and others. However there is a strong view among stakeholders that there needs to be a greater effort to engage the broader community in the story of establishing the NDIS. There is also a view that community expectations have not been well managed.

Delivery

Innovative delivery

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The success of the Scheme is dependent upon the Agency being established in a way that it can progressively learn and improve. Sustainability of the Scheme requires good data and good analysis. It also requires innovation in the way that the support needs of individuals are best met and the way the Agency goes about its work.

Agency staff at the front line understand the need to progressively learn and they are already trialling new and innovative approaches and learning from them. The staff are being encouraged to innovate, and the results of this innovation are being exchanged between teams and across sites. More now needs to be done to put in place the structures and systems to support the Agency as a whole to progressively learn from the frontline.

In particular closer links are needed between the Actuarial Unit and the frontline staff to ensure that information flows both ways to improve decision-making and data collection.

The value of individual innovations is being assessed through an action learning approach. This will need to be supplemented by evaluation of the impact of different interventions and approaches over time. This evaluation will be dependent upon the quality of data and the systems to collect it.

One of the consequences of bringing forward the commencement of the Scheme by twelve months is that interim arrangements were put in place to staff the Agency, to provide the necessary systems, and to collect data. This work was done in parallel by separate teams who provided the minimum necessary systems for operating the trial sites, with the knowledge that all would need to be replaced once the Scheme was operating.

The Agency will not be able to fully evaluate the success and ‘value-add’ of innovation until it has better ICT systems and data collection capability.

Plan, resource and prioritise

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The business planning processes are immature. Capability varies and there are some areas that have not given it a priority. One of the reasons for this is that teams are waiting for their permanent leaders to be appointed.

The Agency has put in place monthly financial reporting arrangements. These reports vary in their quality as a result of the staff being new, systems being embryonic, and governance committees being established.

A permanent Chief Financial Officer has now been appointed. Priority should be given to the permanent staffing of the finance area, continuity management and knowledge transfer as most of the temporary finance staff have not applied to transfer to Geelong.

The CEO has been tracking and reporting to the Board on the progress of 29 major projects. The CEO has undertaken to advise on the relative priority of these projects. This will require some hard decisions, and will need to align with available resources.

Project management capability is immature. It has been underpinned by contracted capacity. Either this will need to be improved and expanded, or an internal capability needs to be built.

There are three dimensions to projects – time, money and quality. In the absence of additional funding the trade-offs are extra time or lower quality. The Agency needs to be aware that in giving a priority to timeliness that it will reduce quality and this may undermine the financial sustainability of the Scheme.

The current approach to accounting for ‘in-kind’ contributions provided by States and Territories as part of their bilateral agreements is causing major practical difficulties to providers, States, Territories and the Commonwealth. More concerning than this is that the current approach is likely to cause problems for people with disability accessing services. The arrangements are not working, are an impediment to planning and allocating resources, and the upcoming review (see Attachment C) should recommend changes.




Shared commitment and sound delivery models

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The Scheme has had a huge level of public support. Service Providers, advocates and people with disability combined to give their strong support to a grass roots campaign to back the new Scheme.

The announcement of the Scheme and the bipartisan support for it has engendered a lot of goodwill from the community. There is a danger that community expectations, especially following the advertising campaign that was run in 2013, are not aligned with the scope of the Scheme.

The Agency did a good job at local community engagement on the lead up to the launch in each of the sites. There has not been as much attention paid to media engagement or to stakeholder engagement. More work needs to be done here to manage expectations and to ensure ongoing shared commitment to the Scheme.

Issues were raised by some stakeholders about the current structure of the financial arrangements with governments and the extent to which they allow the Agency to operate a prudential management model. However that is considered outside the scope of this review.

One issue raised that is relevant to the delivery capability is the clarity of the role of frontline staff undertaking plans for a person with disability. Some interviewees noted that the role should be more assessor than planner. It is certainly a complex task for a single staff member to reconcile the role of being fiscally prudent while also working with participants on life plans. One option would be for the Agency to consider a limited trial of separating these functions.

Changes are being implemented to give greater clarity about what in practice can be considered “reasonable and necessary” supports as set out in the legislation. It will be necessary for the Agency to continue to focus on this and to work closely with the Board, stakeholders and staff on refining the definition of ‘reasonable and necessary’.

Manage performance

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The establishment of the Actuarial Unit, which is based in Sydney, has begun. The bringing forward of the commencement date of the Scheme means that the internal Actuarial Unit is not yet in place and nor do they have adequate data to be able to assess Scheme performance. The success of the service delivery model on which the Scheme is based is dependent upon the Actuarial Unit being involved in the design of the data collection and ICT systems. This will be critical for the systems underpinning full scheme.

The Agency is having to learn quickly as it expands geographically and in scale. The approach taken in the initial trial sites will set expectations and the Agency would be prudent to take a conservative and tough approach at the start. We have observed that staff are learning from experience and moving to focus more on sustainability. This is a wise move. The Board and the Agency leadership need to be demanding and rigorous during this establishment phase.

The Board and the Agency has set performance targets in trial sites. However, the performance management system has not been effectively implemented across the Agency. Performance management is weakest at the National Office.

The effective management of Scheme performance requires clarity about what exactly is required from front-line staff. Client satisfaction? Long-term outcomes? Short-term cost containment? Performance in one of these dimensions can undermine other dimensions. There is no clarity about relative weight given to each.

The political environment is relevant here. It would appear that under the previous Commonwealth Government, the approach was weighted towards client satisfaction. Under the current Commonwealth Government there appears to be greater weight on the sustainability of the Scheme. In this context, confusion within the Scheme about what performance is required from the front line is understandable. If this ambiguity persists it will undermine the effective management of performance.

It would be reasonable to trial different approaches in different locations to learn the most effective approach before the full rollout. If this approach were to be adopted it would need to be underpinned by strong communication with stakeholders.

The effective management of performance also requires clarity around structure, who is doing what role, who is accountable, what the internal governance processes are and how they operate. A lot of these basics are not in place or have not been well enough communicated.

The broader delivery system is about to be transformed in size and shape. There will be a large number of issues around regulation, market transformation and assistance and future market design. There will also be very major issues around workforce availability.

The draft new structure quarantines senior leadership effort to look at strategic issues which need to be addressed in the medium term, including those which affect the broader service delivery system. The Agency needs to avoid the temptation to divert these resources to short term priorities.





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