Evaluation of the ndis final Report Kostas Mavromaras, Megan Moskos, Stéphane Mahuteau, Linda Isherwood

The NDIA Workforce: The Birth of a New Workforce – Evidence from In-depth Qualitative Interviews

One of the chief impacts of the introduction of the NDIS has been the creation of a major new workforce within the disability sector – the NDIA workforce. The NDIA’s target staffing level at full roll-out is planned to be ‘below 3,000’, down from the original estimate of above 10,000 (Senator Fifield, 2015). Interviews with NDIA staff allowed the evaluation to examine this workforce and their experiences of rolling out the NDIS.

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  In wave 1, NDIA staff reported that the quality of their workforce was a positive aspect of the NDIS. In wave 2 NDIA staff again reflected on the high calibre of staff, and described a workforce of committed and extremely capable people. Respondents expressed the feeling that all staff were working together to achieve good outcomes.
  

We've recruited some spectacular people who are incredibly skilled, and compassionate and ethical, all the things that we would want. (E01N W1)

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  The experience and diversity of staff was also reported as being of great benefit to the NDIA, particularly the requirement for knowledge, or lived experience of disability. This diverse range of staff knowledge within trial sites was viewed as providing an important and highly regarded resource for the operation of the NDIA.
  

It's just unprecedented to work in an environment where you have that level of skill and experience amongst the people that you're working with, I think, and the diversity that we had to draw on with each other. (B14N W1)

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  However, managers noted the challenge of keeping ‘ahead of the game’ and being strategic in planning for recruitment and changes to workforce structures over time. A lack of career opportunities outside of National Office was a particular problem that was identified. One Manager reflected on the challenge of ‘keeping (good staff) long enough until other opportunities open up towards the full Scheme’ (C03N W1).
  

As an employee I feel that I’ve gone backwards in my career, I’ve de-skilled. I think you’ll find a lot of people would say that and I’ve also been significantly disappointed with the supposed opportunities that were meant to be here and weren’t… all these changes don’t necessarily you know surprise me but personally for my career it’s been a disaster coming here. (D05N W2)

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  There was a concern that staff retention would be adversely affected as the NDIA evolved in the future. Retaining agency staff in local offices was becoming difficult as more NDIA sites opened up and disability sector organisations sought NDIA staff expertise.
  

Well workforce is a massive challenge for me, creating, getting sticky staff as we say … Sticky staff, staff that stick… my staff are really now becoming highly sought after by the provider sector. Because they know NDIA very well so retention will be a big issue for me. (B01N W2)

3.5.1 Workload pressure – Evidence from in-depth qualitative interviews

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  NDIA staff across all trial sites and positions reported high workloads and work pressures. Role-specific responsibilities were contributing to workload pressure. For planners, work stress related to the pressure to complete plans; for LACs, the high caseloads to facilitate plan implementation; and for Business/Regional Support Officers, the administrative tasks associated with planning and plan implementation. Respondents reflected on the need to work very long days, including weekends and outside regular office hours to meet the demands of their role.
  

The workload's huge. It's massive. So it's impossible to do it in a reasonable week. (E01N W1)

I’m taking work home, I’m doing it on the weekends, my flex is up to a week. I had 38 hours, other people had more. And people were encouraged to come in on the weekend and they were tired during the week. (E04N W1)

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  At the time of the wave 2 interviews NDIA staff were preparing for the beginning of full rollout of the NDIS in July 2016. They reported that workload pressures were intensifying as timeframes to meet targets came closer.
  

We’re being told that we now have to do, complete all our reviews for up until the 30th of June next year by the 31st of March. So we’re back into this pressurised, pressure cooker of having to do ridiculous amounts of work in very limited time to try and get, really, to support the new offices that are about to rollout, and we’re just exhausted, we’re really tired, to know that we’re about to actually be asked to once again, put in an enormous amounts of effort, yeah. It’s challenging. (B12N W2)

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  Many staff described a perception that the KPIs for the NDIA were ‘all about the numbers’ rather than quality of plans. High workload contributed to feelings of not doing a good job; of increasing potential of making mistakes; and guilt for not undertaking work that was felt needed to be done but not prioritised. Work stress was linked to high rates of resignations and in some cases adverse health impacts for staff.
  

There were… numerous times when I considered leaving the Agency purely because of the level of pressure and the impact that it was having on my health. (A06N W1)

A lot of the original cohort are now looking for jobs, and also people who've recently come are looking for jobs elsewhere, because they just can't sustain the hours that they're working and the pressure that's on them. (D02N W1)

There’s a lot of meltdowns happening. It's just the stress. It's just very, very busy. (D06N W2)

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  Concerns regarding stress and burnout amongst NDIA staff had increased by the wave 2 interviews as the NDIS moved towards full roll-out. Staff anticipated that the difficult working environment during the trial would be continuing for some time.
  

A lot of people here, of course, have really struggled with the changes over the last two and a half years. They’re burnt out. It hasn’t been well managed. They’re at the end of themselves because this is the point at which we believed that we would actually have, now things would settle, now we’d have an understanding of what we needed to do. Now, we’d be starting to, you know, be to bedding things in. In actual fact the next three years will be more chaos and it’s really going to take up to five years for anything to be settled and for us to have any sort of effect there and agency maturity in terms of process and dealing with that. That’s really, really, really challenging for people here. (B14N W2)

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  Respondents believed that the NDIA did not always provide the supports staff needed to manage stress and other challenges in the workplace. NDIA staff reported a lack of responsiveness by supervisory staff when support to manage workplace stress was requested. This lack of support was attributed to a high turnover of staff in supervisory positions, managerial workload pressures and some staff in these roles lacking management skills and experience. There were particular concerns that the support needs of NDIA staff with disability were not being met.
  

Staff with disabilities have been let down time and time again, which is a real shame, given the agency we work for… like assistive technology not being transitioned properly, not having people on it, people not being onboarded properly. We’ve got staff starting on disability and their desks aren’t set up for them properly. No follow up on the kind of supports that they need. Not having a good understanding of what services are out there… we should just know better. We really should, there’s no excuse for it. So that’s been quite challenging. (E07N W2)

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  The experience of having staff leave or continually having to support the ‘on-boarding’ of new people was felt to be a stressor in its own right. There was also reflection on the particular problems associated with frequent changes of management, leading to organisational instability.
  
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  Respondents perceived that the NDIA had misjudged workload expectations such that resource modelling did not match demand.
  

We’ve been generally under resourced in terms of being able to do a really good job... I think when the original modelling was done it was all best guess stuff so the Scheme’s still working out how long does it take to write a plan or a review plan and how many should people be doing a week and all those types of things are areas that need ongoing work. (D07N W1)

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  Workload pressures were exacerbated by problems with the IT system. The system was considered time consuming and difficult to use as well as being cumbersome, slow and hard to teach new staff as it lacked logical progression or intuitive steps. These problems were increasing workloads, creating frustration and affecting service delivery and timeliness.
  

3.5.2 Role-specific challenges – Evidence from in-depth qualitative interviews

There were a number of challenges that differentially impacted on NDIA staff depending on their role within the agency.

Planners

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  The role specific challenges for planners were primarily related to workload but were also due to the high administrative burden arising from planning processes. This was in part because the time allocated for planning had substantially been reduced over time, in response to imperatives to complete plans and because of inefficient IT systems.
  

We hired people on the basis that the modelling was that 60 per cent... of planner time would be working with families… That’s never been true from the beginning and hasn’t got a lot better, so that, it’s probably more 20, 30 per cent forward facing participant time; the rest is heavily stuck at a computer doing administration. (C03N W1)

I am looking elsewhere… I don’t think it maximises my skills and I certainly don’t get stimulation from it… I feel like I’m just going to be pushing buttons on a computer and there’s not going to be a lot of – a lot in it for me as a professional… it’s not a long term or a medium term satisfaction role for me. (B02N W2)

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  For many planners, the tension between needing to complete plans and wanting to spend more time with participants led to perceptions that the quality of planning and resultant plans was declining, and the person-centred philosophy of the NDIS jeopardised. This contributed to a level of job dissatisfaction and disillusionment that in some cases resulted in staff leaving the organisation.
  

Are we developing good plans? Are we giving enough support for the plan to be implemented? Probably no. (E05N W1)

One of the big reasons why people are leaving, 'cause they feel that they're not being true to the values and the sort of expectations that they have. And that is always going to be a tension, and a tension that we have to manage. (D02N W1)

Local Area Coordinators (LACs)

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  Challenges specific to the role of LACs related largely to perceptions that they were not doing what they were employed to do. Many felt the specific skills and connections to the community that they brought to the position were not being utilised. All of the LACs who were interviewed described being required to spend the largest portion of their time supporting the planning process and plan implementation. This situation led to widespread dissatisfaction and concerns of de-skilling.
  

The LAC role… became very attached to the Planner role, and became all about plan implementation. And I got very quickly bored and frustrated with that and felt that my skills weren't really being used and I wasn't being stimulated or really building my expertise very much in that space. (D02N W1)

I have found that very difficult to cope with, in that it's been disrespect for our skillset, and our career objectives for ourselves, that we came on board with the passion and the enthusiasm for the NDIS, and what that means to people with a disability, and wanting to be in that space. But we had to put all of that aside for operational requirements, and getting these plans through… people who came in here as local area coordinators, while they've picked up other skills in other areas like planning... but for those people who wanted to fill that role of community development, they've put their career on hold for two years. (B04N W2)

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  In several trial sites, however, there was evidence that the LAC role was changing overtime. For example, in TAS and NSW in particular, LACs were undertaking more community engagement and community development activities.
  
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  In TAS, the Local Area Coordination role was outsourced. There appeared to be different views of the success of this approach. The LACs themselves while seeing advantages to being based in community settings, acknowledged the challenge of ‘having two masters’ and keeping in touch with the NDIA. In contrast to the mostly positive views of LACs, other staff (managers in particular) saw problems associated with the out-sourced model.
  

Most other launch sites have had the flexibility to use their, to direct the practice and exactly what Local Area Coordinators do… we have to go through a very formal process… and it takes a lot of time… I think it’s been demonstrated that it’s not value for money. (C03N-Manager W1)

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  In VIC, an organisational re-structure led to the establishment of a specialist team tasked to undertake community engagement. This was considered positively for the most part, with one respondent explaining the drawback of the previous model which involved participants being allocated to any staff member, regardless of age, disability type, or staff expertise ‘so you ended up (being) almost like a Jack of All Trades, Master of None’ (B10N W2). LAC who were not in the specialist engagement team, however, had concerns about the future of their role. As in the SA trial site, there was expectation that the planner and LAC roles would be combined into the future.
  

There’s talk about how the Local Area Coordination role will change into a plan support coordinator… so it’s hard to work in amongst that speculation all the time when we really haven’t had the opportunity to see the original model that we applied for and had a high expectation of the dream job… it’s a very challenging environment to stay focused and stay positive amongst. (B04N W1)

Plan Support Coordinators (PSCs)

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  As part of the rollout of the NDIS in July 2014, the ACT and NT trial site started operation staffed with PSCs, rather than planners and LACs as in other trial sites. The principal challenges identified by staff in these roles related to the pressures of workload and in finding time to undertake plan implementation and community engagement (the LAC component of the role).
  

A lot of our time is spent in that planning phase and you almost resent when people call up and need help with organising things because you just haven’t got time to help them, and that’s a big issue with a lot of us at the moment, that we’re just feeling that we haven’t got the time to fully do the job that we’ve been hired to do. (E02N W1)

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  Workload pressures in the ACT were leading to the outsourcing of plan implementation. Wave 2 interviews indicated that plan implementation was often left to Business Support Officers.
  

The way that we’re heading is to have the coordinators external to the agency... I think potentially some people may only need them for their first plan, just to help set things up and then they’ll be fine from then on. (E08N W1)

NDIA staff in regional and remote areas

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  Several NDIA staff reported organisational and staff challenges for the NDIA in regional and remote locations. At an organisational level, challenges included the ‘tyranny of distance’, difficulties with engagement and disseminating information in small communities, and supporting NDIA teams in small regional offices. Staffing pressures and workloads were exacerbated in smaller offices as staff who were absent due to leave or assisting in new NDIA offices could not be backfilled in their absence.
  

Just being able to make sure we can support people taking decent amounts of leave… in (smaller offices) we’ve rarely ever been able to backfill extended leave and we’ve had a couple of planners take up other opportunities for, you know three month stints in engagement or interstate, and when they go we can’t, we have very little capacity or options for people to backfill for that length of time… for small offices it’s really, really difficult and even one person not being there makes the whole office barely viable to even maintain. (C03N W2)

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  NDIA staff working in small regional offices reported isolation, difficulties seeking assistance from city based colleagues and feelings that ‘you can easily get forgotten out here’ (A02N W2).
  

3.5.3 Training and supervision – Evidence from in-depth qualitative interviews

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  Respondents identified areas where further training would benefit NDIA staff and improve outcomes for participants. Training deemed necessary included improving the ability of staff to identify and monitor participant capacity to implement their plan; support for self-management; and training in specific disabilities to assist with making decisions about what were reasonable and necessary supports.
  
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  A number of respondents suggested the need for more role specific training and the availability of ongoing training.
  

It’s highly, highly important that the staff are adequately trained, just because of our role, just because of the demographic that we are supporting. (A08N W1)

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  The challenge though, was the lack of time for training, and also the limited availability of this. On-going training appeared to be principally provided ‘in-house’ (i.e. within trial sites), with a focus on Agency based training needs. Several staff indicted appreciation of ‘lunchbox’ sessions where:
  

There’s a whole programme of events for a couple of months so you know what’s on, when it’s on… (the Trial Site Manager) gets speakers or if somebody’s got… expertise within our team, our group, that person then prepares it and delivers it. But they’ve been very, very good. (D06N W1)

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  Training and ongoing professional development activities was of particular importance for staff with an allied health staff background who needed professional development hours to maintain their professional registration. One respondent suggested the absence of professional development opportunities contributed to the problem of staff resignations:
  

There’s a lot of health professionals… who are looking at, you know, ‘well I can do this for a couple of years, but then if I stay here too long I’m going to have to then do a two year refresher course on my allied health professional qualifications because I’ve pretty much let my skills lapse’. So we’ve also had people that are going, ‘you know what, I’m not doing that, I’m getting out now’. (A06N W1)

3.5.4 Factors impacting staff morale – Evidence from in-depth qualitative interviews

The final set of challenges for NDIA staff highlighted by the interviews related to factors impacting on staff morale.

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  Managers in particular, were conscious of the effect of negative media on staff confidence. NDIA staff likewise considered the circulation of misinformation as a challenge for the agency and staff, especially the impact of social media.
  

There’s a huge amount of misinformation that goes on out into, in the community particularly on social media. I mean one of the biggest challenges for us is there is no other major agency or Government reform that has been implemented in this day of social media. So you can have somebody sitting at a planning conversation believing that somebody’s said something and they can have it posted on Facebook within half an hour after their visit. You know they can be derogatory towards the planner. (A07N W2)

And then there’s all the rampant rumours and the Facebook stuff about NDIA have run out of the money, it’s just a trial so the government’s going to, obviously it hasn’t worked and the government’s going to pull it and all those sorts of things. (A08N W2)

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  Respondents also suggested a key challenge for staff was managing their response to distressed and anxious NDIS participants and their carers. This situation was most problematic for the trial sites targeting young children with disabilities (i.e. SA and ACT during first phase-in), where parents may still be in shock and grieving following recent diagnosis.
  

It was really hard for our staff, brand new, dealing with parents who were so traumatised and really hard for parents who, you know, like first cab off the rank, here they were having people talk to them about ... their child and disability services. (E01N-Manager W1)

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  Many noted an unmet need for specialist staff support and supervision to assist NDIA staff with the emotional demands of their work.
  

We’re dealing with people’s emotions… for instance that example I gave before about the person coming in today in crisis with their child. We’re dealing with that regularly; not once a day, but many times a day. And you know… any other professional… would have support (and) supervision… when you’re dealing with people in a vulnerable situation. We don’t have that sort of support. We might have a manager we go to discuss that, but we don’t have that level of emotional support. (C05N W1)