Working within the NDIS can be rewarding but it also comes with complex responsibilities. For allied health providers, support coordinators and practice owners, ensuring participant safety isn’t always straightforward. Even when the right steps are taken, reporting concerns can lead to frustrating delays, unexpected consequences and, in the most tragic cases, life-or-death outcomes.

This article explores the realities of raising concerns in the NDIS – from understanding who to report to through to the emotional toll of speaking up when systems don’t respond as they should.

Many providers share the same difficult question: what happens when you do the right thing, report an issue, and no one follows up? Some have seen investigations stall until it was too late while others have been disengaged from service arrangements after raising concerns. The reality is that compliance processes can be slow and fragmented and providers who step forward often face unexpected risks.

One of the biggest challenges is knowing where to send a complaint. Different issues fall under different bodies:

NDIA – for fraud, misuse of funds and suspicious claims

NDIS Commission – for provider conduct, safeguarding and quality of care

Police and state-based agencies – for criminal, abuse or neglect concerns (for example, the NSW Ageing & Disability Commission or the Office of the Children’s Guardian)

Without clear pathways, providers can be left unsure about whether they’ve contacted the right authority and whether action will follow.

Case examples highlight the human cost of these gaps:

Fraud and non-compliance reports going unaddressed

Investigations dragging on until after a participant has died

OTs and support coordinators being disengaged after raising red flags

The heavy emotional toll of holding professional and ethical responsibilities without clear systemic support

These stories show why reporting is both necessary and, at times, incredibly difficult.

It’s no surprise that many providers think twice before submitting a complaint. 

The risks can feel personal and professional – from being removed from service arrangements to dealing with prolonged uncertainty to facing an overwhelming administrative burden. Yet not reporting also carries serious consequences.

The most effective approach is to put clear internal processes in place. This means:

Having a set threshold for when a matter requires reporting

Documenting everything – case notes, emails and conversations

Submitting reports to multiple bodies where appropriate (more is more)

Taking the emotion out of decision-making by following established procedures

Knowing when and how to escalate concerns further – whether to the media, local MPs or Ministers’ offices – if systems fail to act

There is no one-size-fits-all reporting pathway – knowing who to contact is crucial

Delayed action can have devastating outcomes including loss of life

Reporting can carry risks for providers but silence carries greater risks for participants

Internal documentation is essential for accountability and protection

Escalation beyond the NDIS is sometimes necessary when urgent risks are ignored

If in doubt, report – it’s better to act and be safe than to remain silent

NDIS Fraud Reporting and Scams Helpline – 1800 650 717 | [email protected] 

NDIS Commission – www.ndiscommission.gov.au 

NSW Ageing & Disability Commission – www.ageingdisabilitycommission.nsw.gov.au 

Office of the Children’s Guardian – for matters involving children

(Each state and territory may have its own equivalent reporting bodies.)

Reporting under the NDIS is rarely simple and providers often find themselves caught in grey areas between compliance, safeguarding and professional ethics. But having clear procedures, documenting thoroughly and knowing when and how to escalate can help protect both participants and providers.

Above all, the message is clear: if you see something, report it. Even when the system feels slow or unresponsive, speaking up remains a crucial safeguard for the people we support.

In this episode, we dive into two big conversations every occupational therapist, and anyone in the disability space, needs to hear.

First, we reflect on the reality of career uncertainty in OT. Whether you're in private practice, working for yourself, or exploring other sectors, we talk about the importance of backup plans, transferable skills, and why it’s okay to reassess your path without guilt or panic. You’ll hear honest reflections on transitioning between roles, recalibrating expectations, and staying grounded while thinking about “what’s next?”

From there, we shift gears to the recently released NDIS Ministerial Brief, obtained under Freedom of Information. We unpack:

The upcoming Notice of Impairment rollout (and the red flags it’s raising)

The move from function-based to support-needs-based planning

Concerns around simplified plans and what they might mean for funding

The confusion around new support needs assessment tools

Pilot plans for navigator roles and early intervention pathways

The NDIS’ updated debt recovery approach and examples of flagged claims

What OTs and AT suppliers need to know, especially around maintenance claims

We also reflect on what these reforms mean for participants, practitioners, and the broader workforce as we all brace for the next wave of change.

Tune in to stay informed, feel less alone in the chaos, and share a few laughs along the way.

Links & Resources:

NDIS Ministerial Brief (PDF) – available in the OT Facebook group file section

Debt Recovery Summary on the NDIS website - https://www.ndis.gov.au/about-us/improving-integrity-and-preventing-fraud/recovering-funds-owed-ndia

This week on OT Unplugged, Sarah, Nikki, and Alyce swap Oodie stories (pandas vs. champagne avocados), laugh about missing wine bottles and Lego office décor, and then get serious about something far less cozy — the way NDIS policy shifts often reach providers first through the media rather than direct communication.

The Numbers Game: What the latest NDIS quarterly report reveals — more than 739,000 participants on the scheme and growth well above original forecasts.

Children and the Scheme: Why kids under 15 continue to dominate new entrants, and what this means for families with limited alternatives outside the NDIS.

Foundational Supports on Shaky Ground: Reports suggest state governments are backing away from foundational supports, leaving families and providers with even more uncertainty.

Big Announcements, Little Warning: The upcoming productivity summit and what it signals for future scheme reforms — from eligibility pathways to funding constraints.

Diversifying Beyond the NDIS: Why pivoting to Medicare, private, aged care, and DVA isn’t straightforward, and the pitfalls for OTs stepping into new systems without proper guidance.

The “Goal” Debate: Do we expect too much from participants to frame their lives in NDIS goals? A candid chat about capacity building, maintaining skills, and what really matters.

The eternal debate: Oodies, Squiddy hoodies, or dressing gowns?

Sarah’s victory in finally evicting a Wallabies jersey from her office (although they did win, apparently).

Our upcoming Perth workshops in September with OT Services Group — and an open invite to dinner if you’re local!

Links & Resources:

Subscribe to the Verve OT Learning Newsletter  for weekly NDIS updates and training opportunities - https://www.verveotlearning.com.au/subscribe 

AFR article on foundational supports and state negotiations - https://www.afr.com/politics/federal/ndis-black-hole-risk-as-states-back-away-from-savings-measures-20250815-p5mna7

Intro to Aged Care for OTs webinar resource - https://www.wayforwardot.com/courses

This week on OT Unplugged, Sarah, Nikki and Alyce take you from heartwarming wheelchair wins to head-scratching NDIS decisions and everything in between.

We share a six-year success story that proves sometimes you don’t have to reinvent the wheel… while also diving into a “Dick Decision of the Week” that left one client trapped in their home thanks to baffling bureaucratic delays.

We unpack what the latest NDIS AAT stats really mean for OTs and participants, explore the headaches of funding periods, and share a few productivity hacks that might just change your work life (yes, including how to hide your inbox).

And because it’s never too early for some festive debate, we swap ideas for Christmas parties from sailing on shark-infested lakes to lawn bowls, dumpling-making, and maybe even axe throwing.

In this episode, we cover:

🎯 A six-year wheelchair script success story and why small tweaks can be the big win

🚫 The “Dick Decision of the Week” and the reality of NDIS delays

📊 Why 72% of NDIS AAT decisions are overturned and what that says about the system

💸 Funding period dramas and being the guinea pig to test what really works

📧 The game-changing inbox-hiding tool for email focus

🤖 Using AI tools like Heidi Health and Dictate to make case notes easier

🎄 Creative (and slightly chaotic) OT Christmas party ideas

Resources & Links:

Funding Periods Webinar with Nikki & Chris – https://www.verveotlearning.com.au/live-mastering-funding-periods-spreadsheet-tool

Heidi Health – https://www.heidihealth.com/au

Dictate App – Dictate Speech to Text on the App store

In this lively and unfiltered episode of OT Unplugged, Sarah, Nikki and Alyce dive deep into the real behind-the-scenes of OT life. From forgotten billing and chaotic clinical loads to dodgy grocery deliveries and what not to do with the NDIS logo. You'll laugh, nod in solidarity, and feel the fire of advocacy as the team navigates everything from hosting students and juggling admin to prepping for what could be a major national NDIS protest in Canberra. They also uncover some critical changes in NDIS branding rules and the disappointing disappearance of key AHPA registration resources. Whether you're buried in clinical notes, prepping for accreditation, or dreaming of blocked-out admin days (that actually stay blocked), this one's for you.

What We Cover:

✅ The "quiche from a box" lifestyle & what it says about OT survival mode

✅ NDIS logo use: what’s changing, what’s allowed, and how one brochure mishap cost a lot of stickers

✅ The silent disappearance of ARPA’s OT registration resources

✅ Burnout, boundaries & billing: why even experienced OTs forget to charge for their time

✅ Kids, clients & chaos: the impossible juggle of modern OT practice

✅ A shout-out to the amazing Samantha Connor and her challenge to Allied Health

✅ Real talk about clinical load creep, admin chaos, and the danger of too many browser tabs

✅ What's coming up in training, workshops & CPD

This week Nikki, Alyce and Sarah dive deep into the often wild, always unpredictable world of community occupational therapy. From ferrets and replica Rambo knives to renovation chaos and rogue spiders, the trio share some of their most unforgettable home visit moments and and the crucial safety lessons they’ve learned along the way. But this isn’t just a collection of wild stories. We explore the serious side of safety in OT practice:

Why risk assessments are essential and often overlooked in community and paediatric settings.

What it really means to do a "vibe check" before a home visit.

How OTs can better protect themselves (and their clients) from the unexpected.

Tips on positioning, phone safety, and building safety systems that actually work.

Whether you're a seasoned OT or just starting out, this episode is a must-listen for anyone delivering services outside the clinic walls. Plus, Alyce shares an exciting update about the launch of The OT Coach Academy and The Pediatric Hub a new community for paediatric OTs seeking practical, ongoing support.

Model Code of Practice - https://www.safeworkaustralia.gov.au/doc/model-code-practice-healthcare-and-social-assistance-industry

EOI The Pediatric Hub - https://forms.gle/wvHUUcnnHtD4MGoi9 https://www.theotcoach.au/interest-expression-paediatric-hub https://www.safeworkaustralia.gov.au/doc/model-code-practice-healthcare-and-social-assistance-industry

Booking link The Supervisors Space - https://www.trybooking.com/DEESL

In this episode of OT Unplugged, Nikki, Alyce and Sarah return from the school holiday juggle and dive straight into the increasingly challenging realities of working in the NDIS space. From the chaos of school drop-offs and camp kitchens to the harsh truths of the new NDIS price guide, the team doesn’t hold back. They share what it really looks like for OT providers navigating service cuts, plan manager pushback, and a system that’s doubling down, not backing down. You’ll hear honest reflections on: The “three A’s” of surviving NDIS reform: Advocate, Accept, Adapt Business sustainability in the face of shrinking margins Strategic pivots (like dropping travel-heavy work or moving to niche assessments) The emotional weight of turning away referrals and letting go of staff The wild inconsistencies in plan manager responses Why Section 100 reviews feel like a formality and the shocking ART stats Big changes brewing in Aged Care and Support Needs Assessments Whether you’re a sole trader or running a large team, this episode is your no-fluff guide to staying afloat while staying ethical. 🛠️ Resources Mentioned: NDIS Provider Harm Tracker - https://www.thisisanpa.org/the-harm-tracker-project Nikki’s “Invoicing Simplified” workshop - https://www.verveotlearning.com.au/Invoicing-Simplified-Prompt-Payments-&-Collections Sarah’s webinar on Section 33 & funding periods - https://www.verveotlearning.com.au/ndis-insights-unpacking-changes-to-ndis-section-33 Article on use of telehealth versus in person supports for OT -https://onlinelibrary.wiley.com/doi/10.1111/1440-1630.70036?fbclid=IwY2xjawLu6HlleHRuA2FlbQIxMQABHr1mLk6JKJ7zVPXNu56uAg28ZAwHPLAPRSeQrQvW8gs90i-z9iBt_V5P_ Info on Perth live events — coming September!

The recording of "Climbing the Mountain: Maintaining OT Presence in an Evolving NDIS" is now ready. Delivered as a presentation at the recent OTA conference by Sarah Collison and Jenny Gribbin, we are sharing the recording so that every OT navigating the NDIS can listen, reflect, and reconnect with the power of our collective journey.

This talk is a love letter to our profession. It’s the story of how OTs have climbed, scrambled, adapted, and persisted through every twist and turn of the NDIS since 2014. From the early days of no roadmap, through the storm of Independent Assessments, to the recent shake-up in pricing that’s left many of us reeling. This is a story of strength, solidarity, and staying the course.

📌 Whether you were there at the trial sites, building tools from scratch, or you’ve just joined the climb - this one’s for you.

💥 It's honest. It's fierce. It's hopeful.

In this raw and real episode of OT Unplugged, we’re back from the OT Australia Conference in Adelaide — inspired, exhausted, and now smacked in the face by July 1 changes to the NDIS Price Guide. Sarah, Nikki, and Alyce get candid about the emotional rollercoaster of returning to real life after a week of professional connection, community hugs, and the sudden reality of delivering OT services in an increasingly complex NDIS landscape. We talk tears, travel rates, KPIs, client communication, and the shifting expectations of OT businesses trying to remain viable without losing what makes the profession meaningful. Whether you’re a sole trader, part of a big team, or just hanging on right now — this episode is for you. 🧠 In This Episode: The emotional fallout after the OT Conference How we’re preparing our teams and participants for the new NDIS pricing environment The quiet costs we’ve all been absorbing — and what’s changing Why client-facing time isn’t the full picture Balancing team sustainability with ethical service delivery Portable Long Service Leave and other fun updates (NSW business owners, listen up!) The pie floater: a controversial culinary highlight 💡 Key Takeaways: You’re not alone. OTs across Australia are feeling the weight of these changes. Transparent, respectful client communication is essential right now. Many of us have been delivering gold-standard care without billing for all the effort behind it — it’s time to realign. There’s more happening behind the scenes at OTA than many realise — and the conference offered a much-needed reminder that they’re walking this path with us. This moment is tough — but it’s also a chance to reconnect with why we chose this profession.

In this week’s episode of OT Unplugged, Nikki and Alyce hold the fort while sending love and support to Sarah, who's attending a family funeral. Amidst personal challenges, EOFY chaos, and the looming OT Conference, Nikki and Alyce dive deep into the storm that is sweeping through the NDIS OT community.

From burnout and business survival to media advocacy and political silence, they discuss the emotional toll this season is taking and share practical insights into what OTs and business owners are really facing. You’ll hear stories straight from the clinic floor, how Nikki left her clinic unlocked for 24 hours (oops), and why she’s now scheduling media interviews between scopes of work.

They unpack:

- The ongoing advocacy battle - why OTs can't afford to go quiet

- Breaking down the $193.99/hr myth - what it really covers (spoiler: not your therapist's salary)

- Gap fees, travel costs, and how to communicate changes with empathy

- Why some practices are facing $10K+ monthly losses and what pivoting looks like

- The importance of scripting, planning, and transparency with clients and teams

Whether you're a solo OT, clinic owner, or employee feeling the pressure, this episode validates the overwhelm and gives voice to the collective stress - while offering tangible ways to move forward. 👉

Don’t miss Alyce’s firm “no” to solo OTs launching into NDIS right now- and Nikki’s relatable burnout moment that every OT will feel in their bones.