NDIS service agreements is a hot topic. It really all comes down to balance between choice and control for the participant and laying out expectations for each party in a formalised way. In health care in general, we don’t sign formal service agreements, as they tend to be overbearing, arduous and takes away from the face to face time that service providers have with their clients. Imagine a world whereby your General Practitioner made you sign a service agreement in order to see them on a weekly or monthly basis. It would seem quite ludicrous and rightfully so. You go into the doctor’s surgery to see them, you pay, or use your Medicare card and you leave. If you attended your appointment, you pay, if you book and cancel, you pay a cancellation fee if they have one, and everyone gets along quite well in this environment.
So why is the NDIS so different?
Service agreements take time away from the face to face ability of service providers to tend to their participants. Time is a valuable resource, in the service game it is our commodity that we sell. We have travel time to contend with, we juggle a difficult payment management system (PRODA), we field long but extremely important phone calls for much of the day, and in addition, we then place a large burden of an exhaustive service agreements as recommended by the NDIA. I understand why it is there, but the reality of it is execution needs to be carefully thought out.
What does an agreement do for the participant?
At the end of the day, it is all about the participant…. The service agreement, if done the way that the NDIA recommends, are intense, and can create a statement of formality. It can take away from the personal touch that service providers are striving for. It can feel legal and rigid. In many cases, it is rigid, and it is legal. As a participant, locking yourself into a rigid service agreement that may have a 30 day opt clause (that may or may not stand up in court anyway, but who is going to get a lawyer to look at it?) can feel like you are trapped. Where is the choice and control here? The knee jerk reaction to this is asking industry overseers to encourage participants and support coordinators to ask for shorter term service agreements. Maybe four or five per year. We are increasingly seeing this in the Allied Health space. It is an awful headache. It is starting to make Allied Health service providers less enthused about servicing the sector, which is being felt with record numbers looking increasingly likely they will opt out of providing services.
I have been working in health care for a long time and health care workers for the most part are extremely supportive of the consumer. They want to do the right thing. The answer doesn’t lie in more paperwork, it lies in better communication between the participant and the service provider, and higher standards of care. We need to bring balance into these agreements.
At Physio Inq, we make our participants aware of our terms of service. These terms are what we are expected to provide the client, as driven by our team leaders, and driven by the desire to want to be treated fairly in a commercial sense. It is essentially the rules of the game. In general, these rules shouldn’t ever change. Following this, we inform the participant as to our recommendations on the amount of treatment we feel they would benefit from, and over what time. We ask for their permission to commence the process and inform them that if they ever feel at any stage it needs to be halted, increased, decreased or simply changed, let us know and it will happen that day. There is no lock in contracts, apart from the fact that our rules of the game ensure that we always provide continuity of care, are fair and respect each other’s rights. There is no legally binding, anxiety filled paperwork that limits or reduces their choice and control over their own health care.
We all need to remember, it is about the participant. Of course, we, the service providers need some protection, but we really should move to protect our TIME, and not protect our BEHAVIOUR. If you do a good job, the client will stay. If you do a bad job, they really should leave. This gives you the feedback to do a better job. A lock in contract stops this feedback loop. Protecting our time is best done by limiting costly paperwork and improving face to face service delivery time. Improve choice and control through ceasing the protection of poor behaviour, and you will see that participants get more time with service providers and it will be of a higher quality.
Other aspects of health care do it, we should too.
Jonathan Moody
Founder Physio Inq
www.physioinq.com.au
