Advice Support Tool

Theme: Podiatry

Sub-Theme(s): foot care, nail clipping, wound care

References:

[include any relevant referenced documents]

NDIS Act 2013 Section 34.1 (a) - (f) and 2.
NDIS Support for Participant Rules 2013
OG_PodiatryAndFootCareSupports.docx
SOP_DisabilityRelatedHealthSupports.docx

Podiatry report

Note: All criteria need to be met for the supports to be funded through the NDIS.

Criteria for reasonable and necessary supports	Is criteria met?	Considerations (including evidence used)
34.1(a) Enabling the participant’s goals and objectives (supports will assist the participant to pursue the goals and objectives in their plan)	☑️ Yes	The participant may not have a specific goal outlining podiatry support as required, however consider how the use of podiatry support may underpin and assist the participant to pursue stated plan goals.
34.1(b) Assist the participant’s social and economic participation (supports will assist the participant to undertake activities to facilitate their social and economic participation)	☑️ Yes	s47E(d) - certain operations of agencies
34.1(c) Value for money (supports represents value for money, ie the costs of support are reasonable, both in terms of the benefits achieved and the cost of alternative support)	☑️ Yes	Is there a report from a podiatrist or other health professional (Orthotist/OT)? This may be from a hospital based or independent podiatrist. This will outline if the support needs are directly linked to the disability and will include a podiatry care plan which may include treatment and prevention of foot-related problems. If orthotics, Ankle-Foot Orthoses (AFOs) or special footwear are required.
Footwear may be:

Retail - off the shelf, supportive shoes, |

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Criteria for reasonable and necessary supports

Criteria for reasonable and necessary supports	Is criteria met?	Considerations (including evidence used)
S47E(d)-certain operations of agency	Are there comparable support options which would achieve the same outcome at a substantially lower cost? What alternative supports were considered?	- Medical grade footwear — can be bought off the shelf but typically from a specialized shoe shop.

Custom footwear — made by a pedorthotist A quote or cost estimate will be provided. The report will outline how these supports will improve the participant’s life-stage outcome and the long-term benefits. Though footwear is an everyday living expense for all Australians, off-the-shelf supportive footwear that is required as a direct link to the disability is typically more expensive and therefore is reasonable and necessary to fund.

Podiatrists may also provide wound care — it is important to check that the wound care is directly causal to the disability and that there is no duplication where the podiatrist and nurse are claiming to support foot wounds. As the participant’s diagnoses may result in lifelong disability related health support needs, the need for podiatry and/or AT/shoe support may also be lifelong. The podiatrist may provide treatment and prevention of foot-related problems. The support may not reduce reliance on formal supports but may for example, increase independence s47E(d) - certain operations of agencies The podiatry report should outline if the individual needs are stable, deteriorating or if new temporary issues have arisen. A care plan will include steps for informal/formal supports to follow between podiatry appointments this may include exercises or dressings. |

Criteria for reasonable and necessary supports	Is criteria met?	Considerations (including evidence used)
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34.1(d) Support is effective or beneficial for the participant (supports will be, or are likely to be, effective for desired effect and beneficial for the participant, having regard to current good practice)
Consider NDIS Support for Participant Rules 2013 Part 3.2 and 3.3	☑️ Yes	Typically, podiatry AT/consumable support is individualized, and is unable to be trialed however, the podiatrist will outline the current supports and how these are effective or not.

The podiatry report will outline an assessment, support plan, reviews and if required training for informal/formal supports.

Where custom made AT is prescribed the cost will include manufacture and reviews to ensure optimum fit over time. This will include assessment of foot changes and pressure concerns which may result in the need to modify the orthoses/shoe. s47E(d) - certain operations of agencies | | 34.1(e) Support coordinates with but does not replace informal support (funding or provision of supports takes account of what it is reasonable to | ☑️ Yes | A podiatrist is only funded when required to complete toenail cutting or to complete clinical tasks related to foot care.

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Criteria for reasonable and necessary supports	Is criteria met?	Considerations (including evidence used)
expect families, carers, informal networks and the community to provide) Consider NDIS Support for Participant Rules 2013 Part 3.4

| 34.1(f) Support is most appropriately funded by the NDIS (supports are not more appropriately funded or provided through other general service systems or universal service obligations) Consider NDIS Support for Participant Rules 2013 Schedule 1. | ☑️ Yes | If the participant is an inpatient (hospital) it is deemed the responsibility of the health system to provide podiatry supports however requests can be considered for podiatry supports to be accessed after discharge. As per COAG - NDIS-Principles-to-Determine-Responsibilities-NDIS-and-Other-Service (1).pdf NDIS is responsible for therapy directly related to maintaining or managing a person’s functional capacity. This includes long term therapy/support directly related to the impact of the impairment and achieving incremental gains or to prevent functional decline. Where the participant resides in an Aged Care Facility the Aged Care Quality of Care Principles (2014 legislation - Quality of Care Principles 2014 (legislation.gov.au)) Part 3 Care and services — to be provided for all care recipients who need them — fees may apply, 3.7 includes the provision of therapy services including podiatry.

| ☐ No |

| Support will not cause harm (Supports will not be funded if it is likely to cause harm to the participant or pose a risk to others, or the support would be contrary to a law of a jurisdiction) Consider NDIS Support for Participant Rules 2013 Part 5.1 and 5.3 | ☑️ Yes | Has the podiatry report outlined any potential risks? s47E(d) - certain operations of agencies redacted With any clinically invasive procedure there is a level of acceptable risk of harm such as a higher risk of infection — therefore the aim is to minimize the risk of harm as it will never be completely excluded.

| ☐ No |

| Support is directly related to the participant’s disability (supports will not be funded under the NDIS if they do not relate to the | ☑️ Yes | Has the podiatry report recommended podiatry support to address functional impacts (foot care, AT/shoes) associated with disability for which the participant has gained access to the scheme? s47E(d) - certain operations of agencies redacted

| ☐ No |

Criteria for reasonable and necessary supports

Criteria for reasonable and necessary supports	Is criteria met?	Considerations (including evidence used)
participant’s disability or are day-to-day expenses or income replacement)
Consider NDIS Support for Participant Rules 2013 Part 5.1 and 5.2		s47E(d) - certain operations of agencies
redacted

Version Control

Version #	Status	Date	Modified by	Brief Description of Modification
V1.0	Cleared	30/08/2023	NIB743	Production of initial V1.0
V1.0	Cleared	05/09/2023	JIF775	Transferred to Key Advisor Advice Resources repository

Note: Document uncontrolled in hard copy