Managing care integration during the implementation of large-scale reforms

Abstract

Purpose The National Disability Insurance Scheme (NDIS) is a new program for the provision of support to people with disabilities in Australia. The purpose of this paper is to explore the early implementation experience of this scheme, with a particular focus on the implications of this scheme for issues of care integration. Design/methodology/approach Semi-structured interviews were conducted with 26 policymakers in the Commonwealth government charged with the design and implementation of the NDIS. Findings The authors find somewhat of a lack of clarity concerning the boundaries of the NDIS and how it will work with a range of different services in the provision of seamless and consumer-directed care. Many of the same kinds of debates about interfaces with services were detected in this study as have been highlighted in relation to UK individual funding schemes. If the NDIS is truly to support individuals with disabilities to achieve choice and control, important work will need to be undertaken in to overcome organizational and institutional boundaries. Originality/value There is little empirical data relating to the implementation of the NDIS to date. This is the first study to explore boundary issues in relation to care integration.