What is conflict of interest in Support Coordination?
Support Coordinators help potentially vulnerable participants navigate the NDIS, understand their options, and make informed decisions. It’s therefore very important that the advice Support Coordinators give is unbiased and fair.
The NDIA currently allows participants to choose Support Coordination providers who also provide other types of disability services. This means it’s possible organisations could offer Support Coordination as part of a strategy to attract NDIS participants to the other parts of their business.
A conflict of interest is a situation where an individual or organisation has competing priorities that mean their decision making could be corrupted or unethical. Possible conflicts of interest can generally be managed by making the potential issues clear to any people who could be affected, and taking consistent actions to ensure decisions are not negatively influenced.
There are two major areas in Support Coordination where conflicts can occur between what’s good (or easy) for the organisation, and what’s good for the participant. In the worst-case scenario, if service providers do not adequately manage these conflicts, they can be de-registered by the NDIA.
We believe that there is an opportunity for service providers to do more than just manage these conflicts of interest. Excellent providers will use the possibility of these conflicts as a trigger to change practice to ensure they are truly meeting the needs of participants, and to improve both their Support Coordination service and the other services they offer.
Two areas of conflict of interest – not one
There are two areas where conflict of interest can arise in Support Coordination, though unfortunately many organisations focus just on the first. Let’s explore both and consider what providers can do to go beyond simply staying out of trouble.
- Ensuring participants have genuine choice
Support Coordinators need to provide participants with the option of several service providers for each type of support they are seeking. It’s okay for one of those options to be a service delivered by another part of the Support Coordination provider’s organisation, provided the participant is not pushed towards this option.
What exactly does “several options” mean? Is it three, or five? This will depend on how specific the participant’s requirements are, and the nature of supply in their location. In some instances there may be only one option, and this may be the Support Coordinator’s organisation. If this is the case, the rationale needs to be clearly documented.
It’s crucial that the Support Coordinator keeps a record not just of the options provided to the participant, but of the participant’s response to the options and rationale for the final decision. This practice prevents Support Coordination providers presenting options “on paper” without genuinely encouraging the participant to consider them.
- Resolving issues that arise in service delivery
Let’s say a participant has chosen (from a number of options) to receive a personal care service from another part of their Support Coordinator’s organisation.
A key part of the Support Coordination role is to help participants address any issues that arise in service delivery, and ensure service providers deliver what they have promised. This may involve having challenging conversations with support workers, team leaders or managers from the service provider concerned. Importantly, organisations usually know that if they don’t resolve any issues, the Support Coordinator can help the participant to choose another provider.
These conversations can be more difficult if the Support Coordinator is seeking action or change from people down the hallway or across the room, or from the manager of a neighbouring team. Support Coordinators must keep a clear record of any issues that arise, of the actions taken, and the resolution of the issue.
Organisations must not allow any issues with hierarchy or status, or internal conflicts between teams or divisions to prevent Support Coordinators engaging the right people in discussions about service quality. It takes strong ethics and a certain amount of bravery to have these honest conversations, but it’s all part of listening to the participant, and building the service flexibly around them. That’s what operating in the new world of the NDIS will require.
Ethical, responsive organisations can see that the instant, detailed feedback available through the Support Coordinator provides great opportunities to improve and grow, right across the organisation. They don’t just respond quickly to complaints and issues, they continually work with Support Coordinators and participants to understand how well their services are meeting the needs of participants, and adjust services before issues emerge.
Regardless of an organisation’s best efforts, sometimes a participant will wish to leave and try an alternative provider. At a time when organisations are thinking in increasingly competitive terms, some providers are slow to enable this to occur.
As well as simply being the right thing to do, we strongly believe that there are significant reputational benefits for organisations who can gracefully facilitate the exit of a participant who wants to leave. How many providers say “thank you” to a participant who is leaving, and take the time to reflect on their journey and successes?
Support Coordination can drive a shift in culture within organisations – are you up for it?
Support Coordination provides a clear opportunity for providers to embrace feedback from participants, and truly support the NDIS aims of choice and control.
However, Support Coordinators cannot achieve this cultural shift alone. They need to be supported by clear policies and procedures that empower them to always represent the participant’s needs of the organisation. Strong leadership and buy-in is also needed to establish and support a culture of frank and open dialogue between teams, with a strong focus on improvement and co-design with participants.