Inquiry into Independence assessments

Attention Committee Secretary

Re: Inquiry into Independence assessments.

My Background: I have been a physiotherapist for 25 years, with 24 years of those in public hospitals. Since the roll-out of NDIS on the Sunshine Coast, as part of my role in the hospital, I have written reports in conjunction with the Multi-Disciplinary team to assist people to access the NDIS. I have also worked for 9 months with MS Queensland (NGO) seeing NDIS participants, and for the past 4 months have been seeing plan managed and self managed NDIS participants. One of my strengths as a therapist is my years of closely working with a Multi-Disciplinary team (Occupational Therapists, Speech Therapists, Social Workers, Nurses, Psychologist etc). Another of my strengths is the breadth and depth of experience. Please find below some of my thoughts and concerns about the use of Independent Assessors.

The human and financial resources needed to effectively implement independent assessments;

  As a physiotherapist of 25 years who has worked extensively in a multi-disciplinary

team (MDT), I believe that an independent assessor needs to be very experienced (5+ years of clinical experience in a variety of areas), and have worked with for several years w ith a multi-disciplinary team to fully understand clients needs. I believe even a clinician with this experience, will need 2-3 hours to assess the client. To get clinicians of this calibre, and allowing adequate time with he client, and the additional recommendations will be expensive. As an experienced therapist, I believe attractive, competitive renumeration is needed to attract clinicians, as they can earn a good wage both publicly and privately with this level of expertise and remain working clinically.

The independence, qualifications, training, expertise and quality assurance of assessors;

   As a physiotherapist of 25 years who has worked extensively in a multi-disciplinary

team (MDT), I believe that an independent assessor needs to very experienced, and have worked with for several years with a MDT to fully understand clients needs. Even with an experienced clinician, who has extensive experience with a MDT, will have difficulty picking up the full impact of a clients disability in all areas. As an experienced physiotherapist I am able to pick up the physical difficulties, but the impact of disability on speech or cognition is much harder for me to fully understand and advise from an NDIS perspective. I know enough that they need Speech or

Occupation Therapy etc, but I do not believe I have the expertise to fully comprehend how much or how many hours are required.

As part of my current role in Public Health, I assist clients to apply for the NDIS. Even with my extensive experience, I do this in conjunction with my colleagues from the multidisciplinary team. Although I can make some observations of the impacts disability with speech or cognition can have on clients, I do not have the depth to fully understand in the way my colleagues do. Likewise when an experienced Speech Therapist comments on the impact the disability has on them from a Speech Perspective, they do not have the depth that I do to understand the physical limitations. I do not believe someone from one discipline will be able to fully assess the issue.

To address this issue I believe it should be a team of people who assess the client. Potentially the client has a few assessments by appropriate therapists eg by an OT, a physio and a speech therapist depending on their needs. Looking back on my 25 year career, the breadth and depth of my experience is what gives me a much more holistic view of clients and their needs. Alternatively, clients can bring their own reports, which are taken into consideration by the assessing team member. As a physiotherapist, a report from a Speech Therapist would help me to understand the potential implications.

The appropriateness of the assessment tools selected for use in independent assessments to determine plan funding;

  I understand the reasoning behind standard assessment tools, but I do not think there is a one size fits all approach. As a physiotherapist of 25 years experience, I have a "toolbox" of tools in my toolkit, but I do not use the same one with each person. For example, I have several tools I use to assess walking, but I use different tools depending on the clients needs.  I think having set tools is limiting, and will not always give a clear picture of the clients needs. Also, I understand the need to have subjective assessments, but in my experience observing what people do and objective measures are often more useful.  I have clients that say they have no balance issues, but they lack insight and I can see when they walk in how high they are at risk of falling.

To address this issue, if a person brings in a report by an independent clinician, this should be used in consideration. Also, for participants already on the scheme who are seeing therapists, the treating therapist will be the ones most familiar with their case. If the therapist the client is seeing is able to provide a report that the client can

• bring with them, and have the independent assessor consider this in their recommen dation.

Please don’t hesitate to contact me if you have any queries.

Kind regards,

BAppSc (Physio). MAppSc (Physio) APA Research Physiotherapist