OT Unplugged: Community of Practice Insights

Featuring honorary member: Muriel Cummins! The disability landscape is changing fastAcross 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 liftingIn 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 investmentOne 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 thresholdA 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 changeThe 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 Therapist reports and functional evidence are central to understanding real-world needs. Excluding that evidence except in narrow circumstances risks producing plans that look tidy on paper but fail in practice. When informal support becomes a substitute, families burn outAnother thread running through current reform is the increased emphasis on informal supports. Informal care can be valuable, but it is not infinite. When systems start to assume that a person’s needs can be met because someone lives in the home, the result is often predictable: carer fatigue, family breakdown, reduced workforce participation and escalating stress. Occupational Therapists regularly see the consequences when informal supports are treated as a replacement for funded assistance rather than a complement to it. Sustainability has to be designed into the model, not wished into existence. Appeals and accountability are part of a safe systemOne of the most serious flow-on risks is how these reforms may affect review and appeal pathways. If plans become driven primarily by a single assessment outcome, participants may lose the ability to challenge specific items of funding and instead be forced to contest the assessment itself. That kind of structure can create a closed loop where the only remedy is more reassessment rather than meaningful correction. Independent oversight exists for a reason. When systems tighten decision-making power while limiting review mechanisms, the people who feel it first are participants whose supports no longer match their needs. A safer approach is slower, clearer and genuinely testableThe sector doesn’t need a halt to progress, but it does need reform that is paced and testable. If new planning frameworks are not ready, extending timelines and strengthening consultation is a responsible response, not an obstruction. Occupational Therapists have a practical perspective that policymakers often lack. We understand how support needs show up at home, at school, at work and in the community. That insight is essential if reforms are meant to improve outcomes rather than simply reorganise cost. Staying steady in the middle of uncertaintyFor many clinicians, the uncertainty is personal as well as professional. It affects confidence in service models, workforce stability and the ability to provide continuity of care. Staying connected to professional networks and advocacy efforts can help reduce isolation and ensure that concerns are captured while decisions are still being shaped. This moment will likely influence disability support for years to come. The most useful contribution Occupational Therapists can make is to keep translating policy into practice realities, and to keep pushing for systems that are fair, functional and sustainable. Key takeaways for OTs• Reform is moving quickly across multiple systems, with limited practical detail for clinicians and families• Thriving Kids risks prioritising advice and navigation over sustained, hands-on therapy• Clear, functional access thresholds are essential to avoid families falling into gaps between systems• Support needs assessments raise concerns about transparency, validation and the reduced role of allied health evidence• Over-reliance on informal supports increases burnout risk and can drive crisis outcomes• Restricting appeals to reassessment-only pathways weakens accountability and access to justice• Slower, more transparent implementation with genuine testing is the safest path forward