S8 E02 – When Policy Shifts Hit Practice: An OT Perspective On What’s Next

Featuring honorary member: Muriel Cummins!

The disability landscape is changing fast Across the NDIS, early childhood and broader disability policy, reform is moving quickly and in multiple directions at once. For Occupational Therapists, these changes aren’t theoretical – they shape who can access support, how plans are built and what day-to-day practice will look like in the near future. When so much shifts at once, clarity matters. Without it, uncertainty spreads through families, providers and the workforce.

Many of the current proposals also sit within a broader cost-cutting context. That doesn’t automatically make them wrong, but it does mean we need to scrutinise what’s promised, what’s funded and what’s left unsaid.

Why advocacy is doing the heavy lifting In a reform environment this dense, it’s unrealistic to expect individual clinicians to track every consultation, policy update and operational guideline. This is where grassroots professional advocacy becomes vital, particularly when it stays closely connected to what’s happening for participants and clinicians on the ground.

Much of the strongest work at the moment is coming from groups that operate collaboratively and draw on both clinical insight and lived experience perspectives. That approach matters because these reforms are cross-system by nature – spanning disability, health, education and state-based services – so the impacts rarely sit neatly in one portfolio.

Big promises need to match real investment One of the most striking tensions in the current reform cycle is the contrast between optimistic messaging and limited detail about what people will actually receive. Thriving Kids is a clear example. The framing suggests an improved, modernised pathway for children and families, yet the proposed structure leans heavily towards information, advice and navigation, with therapy positioned as a targeted add-on rather than a core feature.

This is where Occupational Therapists need to keep translating policy language into real-world implications. Advice isn’t therapy. A screening pathway isn’t an intervention plan. Families facing disability-related functional challenges often need sustained, hands-on support that adapts over time. If systems are redesigned without that reality at the centre, the burden shifts quietly onto families and informal carers, and the downstream costs show up later in crisis services.

The missing piece is the NDIS access threshold A crucial unanswered question is who will remain eligible for the NDIS as reform progresses. Without a clear threshold, it’s impossible to design complementary supports that genuinely meet need. It also makes it difficult for families and clinicians to plan, and for services to build sustainable models.

From an Occupational Therapist lens, access must remain grounded in function. Diagnostic labels alone don’t capture the support needs that sit behind participation restrictions, environmental barriers and day-to-day capacity. If the access conversation becomes overly diagnosis-led or narrowed through administrative mechanisms, many children and families with significant needs may find themselves in limbo.

Support needs assessments and the risk of undercooked change The proposed support needs assessment framework is a foundational shift in how supports and budgets may be determined. The concern isn’t simply that the system is changing, but that it appears to be changing without enough detail to assess safety, fairness or feasibility.

At present, consultation materials offer limited information about how assessment outcomes will translate into funding decisions. There are also significant questions about tool validation and how different measures will be combined to determine budgets. When a system is used to allocate resources, accuracy and transparency aren’t optional extras – they are the safeguards. A further concern is the implied reduction in the role of allied health evidence. Occupational Therapis