A record 85-strong audience joined us for SIMNA Queensland’s first session of 2016, a lively and provocative discussion with a panel of experts about the impact of consumer directed care under the NDIS and the implications for service providers in terms of impact measurement.

The event was kindly hosted by Deloitte, and facilitated by Natasha Doherty, a member of SIMNA QLD’s Organising Committee. It brought together a panel of experienced stakeholders, from service providers, regulators and service users and consumers to share their thoughts on what to expect and how impact measurement will play a crucial role in ensuring the desired outcomes are achieved:

• Tony Hayes (Deputy Director General, Department of Communities, Child Safety and Disability Services, Queensland Government)
• Belinda Drew (CEO of Community Services Industry Alliance)
• David Barbagallo(formerly CEO of Endeavour Foundation)
• Joanne Jessop (Chair of National Disability Service, Queensland)
• Karni Liddell (a successful Paralympian and active NDIS Ambassador, Queensland)

Natasha’s introduction set the context for the discussion: Person centred models of care are at the heart of changes being made to the administration and funding of disability services. If disability service providers are to be measured in terms of their outcomes, there is a need to plan and provide services in relation to those outcomes.

The move toward outcome measurement can therefore be seen as part of a fundamental shift in service provision.  The focus needs to be reflected in service vision, culture, leadership, service delivery, monitoring and evaluation. And people with disability need to be involved in determining what is important to them in terms of the service delivery experience and outcomes.

The Panellists opening remarks covered a range of topics. Karni Liddell talked of her personal experience, and emphasised the importance of having ‘head-nodders‘ in your life who respond positively to your expressed needs, and see you as the ‘expert’. For her the most ‘disabling’ thing was other people’s perceptions, including employers, who often see employing people with disability as far more complex and challenging than it actually is. David Barbagallo echoed these thoughts and spoke spiritedly about the fundamental challenge for those with an intellectual or cognitive disability as dealing with ‘attitude’ within the funding and provider communities. He argued strongly against the market model being adopted by NDIS, citing a number of similar failures in the human services landscape. His view was that Transport, Housing and Employment were the three key cornerstones for success, and were not adequately addressed in the current model. Jo Jessop spoke of the need for balance between determining and measuring organisational and ‘system’ outcomes and those of the individual, and recognised there would always be a tension between the two. She also saw the need for a conversation around ‘the distance from an ordinary life’ – how far away are we, and how do we measure whether we are getting closer. Belinda Drew’s remarks focused on the implications of the changed business model (‘New World Order’) for service providers. She envisaged polished brochures needing to be tempered by a continuous process of ‘asking and listening’, and providers being prepared to challenge themselves to think beyond ‘welfare’. Tony Hayes provided an overview of funding for the scheme, and the State/Commonwealth mix. The overall scheme is costing $22bn, and will reach $4bn in Queensland by 2019/20. The State Government has an ongoing 50% stake. From an outcomes measurement perspective, he saw 2 key questions; are we making a difference-are people’s lifestyle aspirations being met?… and are we effecting a collective improvement across Queensland? He cited the 1½ years of negotiation to this point, and explained that Queensland had signed up to the ‘rationed approach’

The questions and debate covered issues of access, communication, and availability of information. There were comments made about the complexity of the new system, and several emphasised the imperative to strive for simplicity, and for service providers to share information and collaborate. Linkages and referrals would be paramount. To Natasha’s question ‘what is the one piece of advice for service providers to prepare for an outcomes-based service?’ panellists offered a variety of responses. Karri saw a real need for organisations to genuinely demonstrate a client-centred commitment, understand their priorities, and concentrate on what they are good at providing, e.g. housing. She also emphasised the need for key staff to have the right attitude and training. Belinda reinforced Karri’s view that we should start with the person and work back. She also advised providers to ‘stay strong and not crumble’ during what would be a transition period. It will take time for the system to bed down and we should beware of ‘losing the baby with the bath water’. Tony agreed, and emphasised again that participants were central, and that flexibility was important in servicing individual need. David was unconvinced that providers should buy in to the scheme as it was currently devised.