Imagine Tuesday morning without travelling to a clinic; a well-trained nursing professional comes to your door. They can examine your wound, look at your prescription and talk about your week while you cozily sit in your comfortable chair. Rush-free appointments, no waiting room, and expert care in the environment where you feel most comfortable.
This is their normal way of life for thousands of Australians with disabilities, thanks to NDIS Nursing. However, many participants, families and carers have questions about what it includes, who will pay for it and how they can find a nurse they can trust.
This guide provides clear answers to those questions that will help you make informed decisions about your health and your plan.
Clinical Care without the Clinic: What Does It Really Mean?
NDIS Nursing is a type of nursing support funded by the National Disability Insurance Scheme (NDIS) that might be required to support a participant’s health needs associated with their disability.
These supports are provided by RN and ENs, typically not in a hospital, in the participant’s home, workplace or school/community.
This is not designed to take the place of your GP or specialist. To close the gap between care settings and everyday life, to help people with complex needs be cared for safely and in a way that is regular and predictable in their everyday homes.
If it’s successful, it can help you avoid unnecessary hospital stays, increase self-assurance and allow family members a little breathing room.
This animation illustrates what the Nursing Toolkit, Real Life Looks.
Each plan will differ, but the nursing supports participants use are typically:
- Maintaining healthy, intact skin.
- Preventing wound infections or wounds.
- Care of the catheter and collection of urine.
- Medical care for diabetes, including blood glucose monitoring and insulin management.
- To administer and review medicines
- Assistance with enteral (tube) feeding
- Respiratory care and Tracheostomy.
- Epilepsy and seizure care, emergency plan for medication use.
- The care of the bowel and stoma.
- Monitoring to detect early symptoms of reduction
- Instruction to family members and support workers on normal health care procedures
The final thing is not underrated at all! A great nurse does more than just do things; he/she instructs the patients so they are able to do them and feel at ease.
Is This for Me? Eligibility Without the Jargon
In order to access supports from the scheme as a nurse, the NDIS plan must include funding for nursing supports.
Supports available for funding in the NDIS are referred to as reasonable and necessary – this generally refers to supports that are relevant to your disability, provide value for money and are likely to be successful.
There is one boundary that needs to be understood. NDIS typically will not support the care you receive from the health system (the acute care system), including inpatient or hospital stays for illnesses or any other health issue that is not related to your disability.
Continuing nursing care requirements of a disability are more likely to be considered.
That may get fuzzy, so proof is your greatest ally. A letter from your GP, specialist or allied health professional that clearly states the hours of nursing recommended for you, your health needs and risks is taken seriously at planning time.
Part 9/9 in the Series: How to Plan for Your Business.
Your nursing funding is part of your plan regardless of where your plan is located in your support category – how you fund your plan determines who you can select:
- NDIS managed: only the providers registered through the NDIS can provide services.
- Plan-managed: You may use registered or unregistered providers, and the plan manager pays the invoices.
- Self-managed – you pay the providers directly and claim from the providers; this will be the most flexible and have the most documentation.
Whichever you select, the nurse who looks after you should be registered with the Australian Health Practitioner Regulation Agency (AHPRA).
Registered providers are required to remain within the price limits specified in the NDIS Pricing Arrangements and Price Limits (which are updated regularly); therefore, it is advisable to always refer to the latest version prior to agreeing to a price.
If your health needs an adjustment after surgery or a hospital stay, or a new health diagnosis, it will be possible to request a plan review.
Registered Nurse (RN) or Enrolled Nurse (EN)? Knowing Who Walks Through Your Door
The Registered Nurse (RN) is an entry-level qualification at the Bachelor level. They are able to evaluate your needs, make treatment decisions, oversee complex clinical scenarios, and be able to supervise others.
Enrolled nurses (ENs) are qualified to provide care at the level of a diploma and are supported by a registered nurse.
In some situations, trained support workers could also be delegated to undertake tasks, with clear instructions and supervision from a nurse.
This can be a wise use of money, as long as you have it recorded, you have a great deal of people trained to do the job, and when it doesn’t seem right, you know who to contact.
When receiving clinical care, always ask who will be responsible for your care and who will oversee it.
Before You Sign: Questions That Distinguish Great Providers from Good Providers
One of the most significant choices you’ll have to make is picking a provider. Take the time, and also think about asking:
- Do your nurses have their registration with AHPRA, and do I have proof of this?
- Do you have a plan managed or self-managed NDIS plan, or are you NDIS-registered?
- Who will be looking after me, and will I see the same faces?
- How would you deal with emergencies, unplanned visits and after-hours issues?
- What specific training do your employees have in these areas when it comes to my needs, like tube feeding or seizure control?
- What are the fees, and am I going to be provided with a service contract and itemised invoice?
- How do you share information with my GP, my family and my support coordinator?
If a provider can answer these questions openly and honestly, they are most likely a provider to retain.
Safety, Dignity and the Things that Don’t Say Much
Registered providers are required to comply with the NDIS Practice Standards, and are regulated by the NDIS Quality and Safeguards Commission that acts as a complaints handler and monitors safety. No extra poundage for clinical governance, incident reporting and safe medication management. These are expectations that are expected just to be there.
Dignity is as important as clinical skill. Your nurse will value your routines, your right to privacy and your right to make choices, even if they are different choices to those your nurse might make.
Care is given to you, not at you. If you do not feel comfortable, speak to the provider first, and if this fails to resolve the issue, you can contact the NDIS Commission.
We Are Not in the Home Visit.
Breastfeeding is most effective when it’s not done in isolation. Your nurse will share care plans and observations with your GP, occupational therapist, physiotherapist and support coordinator (with your permission) to ensure that everyone is on the same page.
This is particularly important following a hospital stay when a seamless transfer of care can minimise risk of patient readmission and loss of confidence.
In Australia, place is important, too. In capital cities, participants have a wide choice of providers, with longer travel times and fewer providers in regional and remote locations.
Early inquiry about travel costs, billing of travel, and telehealth visits between appointments.
Let’s Get Started – Your First 30 Days Is a Simple Roadmap.
- Collect evidence. Have your GP or specialist write a letter explaining your health requirements and required nursing care.
- Consult with your planner and/or support coordinator. Raise concerns about nursing prior to the plan meeting or a review if needs have changed.
- Shortlist providers. Match 2 or 3 and ask the above questions.
- Make an appointment for a preliminary evaluation. A registered nurse should evaluate what you need and support you to develop a plan for care.
- Have a service contract. Check hours, fees, etc. and emergency contact numbers.
- Review regularly. Care plans will change as needs change, so see your nurse every few months to review your plan.
Healthier Days, Closer to Home’ Will Be the Title of the Four-Piece Band.
The four-piece band will be titled “Healthier Days, Closer to Home.” The right nursing care can have a significant impact on the health aspect of disability, helping to make it a less frightening reality.
If you’re new to NDIS Nursing or you’re reviewing your arrangements, take some time to review the evidence, ask some good questions and find a provider who knows they don’t know their own life better than you do. You can make an excellent initial contact with your support coordinator, GP or local NDIS partner. This article is intended to provide only general information and is not to be construed as medical or legal advice. Make sure to review your plan and the most up-to-date NDIS guidelines.
Straight Answers to the Questions Everyone Asks
What Is NDIS Nursing?
NDIS Nursing: Clinical Care provided by a registered or enrolled nurse and funded under a Participant’s NDIS Plan. It assists people to maintain their health needs related to their disability, such as wound care, medication management, catheter management and management of seizures, typically at home or in the community rather than in hospital.
What Is Funded by the NDIS for Nursing Services?
The NDIS may provide funding for nursing that is directly related to a participant’s disability. These include wound management, managing continence, diabetes support, medication administration, enteral feeding, tracheostomy care, management of epilepsy and health monitoring. Access to services will be determined by the nature of services that are included in the plan and whether the services are being provided as “reasonable and necessary”.
Who Can Receive Support from the NDIS to Receive Nursing Support?
Must be an NDIS participant and have a plan with nursing support funding. The need has to relate to your disability, be reasonable and necessary and not be the responsibility of the health system, e.g. treatment in an acute hospital. Any medical evidence from your GP or specialist further bolsters your request.
What Are the Costs Associated with the NDIS Nursing Care?
Payments depend on the type of nurse, day and time of service and where the service is provided. Registered providers are required to remain within the price limits of the NDIS Pricing Arrangements and Price Limits – these are revised regularly. Before you get started, see the latest price guide on the NDIS website or query your provider for a written quote.
May Use an Unregistered Nursing Provider for My Funded Services?
Yes, plan-managed or plan-self-managed plans will allow you to use unregistered providers. Participants managed by the NDIA must engage with NDIS registered providers. In all instances, the nurse providing your care should be registered and ask to see proof prior to providing services.
What Is the Difference Between the Roles of an RN (Registered Nurse) and EN (Enrolled Nurse)?
Registered nurses have a bachelor’s level qualification and are able to do an assessment of the needs, to create a care plan and to oversee complex clinical care. An enrolled nurse is a person with a diploma qualification who works under the supervision of a registered nurse. Both must be registered with AHPRA, and the correct level will be dependent on the complexity of your health needs.
Where Can I Get NDIS Nursing for Myself or a Family Member?
Please request a letter from your GP or specialist stating your needs and recommended nursing times. Raise with your planner, Local Area Coordinator or support coordinator before the plan meeting. Enhanced nursing supports may be in addition to your plan when your needs change since you implemented your plan. Nursing supports are available to add to your plan when your needs have changed since you made your plan.
