Therapy Assistants in the NDIS

By Sarah Frost
April 4, 2021
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Therapy Assistants – Who are they, what do they do, and most importantly, how do they impact my NDIS plan? Sarah takes a deep dive examining these questions. This is a must-read for all NDIS participants.

What is a therapy assistant?

Therapy Assistants, or Allied Health Assistants, were introduced to the NDIS in March 2019 as part of a pricing review of NDIS services. The NDIS introduced Therapy Assistants to better support participants and health professionals.

The NDIS sums up the role of Therapy Assistants as follows:

“Therapy assistants can effectively support the work of therapists, alleviate workforce pressures and provide value for money for participants.” – NDIS, 2019

The role of Therapy Assistants is to support Allied Health Professionals and participants in providing therapeutic support. This generally involves implementing exercise programs under supervision of a Health Professional. Therapy Assistants are separate from Support Workers who provide Core Supports. Support Workers are responsible for everyday needs like showering, cleaning, transport and community access.

Therapy Assistants are Capacity Building Supports in the “Improved Daily Living” (CB Daily Activity) subcategory. This is the same section as Allied Health Professionals like Physiotherapists, Speech Therapists and Psychologists.

As part of the NDIS roll-out of Therapy Assistants, they introduced a two-tier payment schedule: Level 1 Therapy Assistants ($55/hour) and Level 2 Therapy Assistant ($85/hour). These billing rates are based on the qualifications of the Therapy Assistants. This is discussed further below.

What Qualifications are needed to be a therapy assistant?

No qualification or training is required to become a Therapy Assistant. As mentioned above, the NDIS has introduced two-tier pricing for Therapy Assistants.

Level 1 Therapy Assistants do not require any training or qualification. Due to this, they must be supervised at all times by an Allied Health Professional such as a Physiotherapist.

Level 2 Therapy Assistants have more freedom to work unsupervised but require relevant qualifications or experience. This is detailed in the table below which can be found on the NDIS website here.

The above table outlines the requirements for both levels of Therapy Assistants. Level 1 Assistants must be supervised directly and do not require any formal training or qualifications. Level 2 Assistants can implement programs under the direction of a Health Professional and must meet required training or qualifications to access the higher paygrade of a Level 2 Therapy Assistant.

What Regulations exist for Therapy Assistants?

Unfortunately, there are no regulations or standards of practice for Therapy Assistants in the NDIS. This creates significant concerns around the suitability and safety of Therapy Assistants working with vulnerable clients.

Without a regulatory body, there are no safeguards to protect NDIS participants who employ a Therapy Assistant. This means that Therapy Assistants are not required to undergo background checks, working with children checks or criminal history checks prior to treating clients.

There are no Australian standards of practice for Therapy Assistants. In Australia we have standards for all Health Professions to adhere to so that patients are protected, from Medical Doctors to Chiropractors. However, this does not exist for Therapy Assistants. What this means is that there are no boundaries, safeguards or protection for NDIS participants if something goes wrong during a consult with a Therapy Assistant. There is no authoritative body for patients to complain to if an incident occurs and there are no standards of practice that Therapy Assistants must comply to.

Peak bodies, such as Speech Pathology Australia, have recognised this issue and provided patients with a helpful guide to ensure that they are treated by a trained and screened Therapy Assistant.

Therapy Assistants vs Health professionals

Check out our helpful summary below of the differences between Health Professionals and Therapy Assistants. This table provides a quick summary to patients of the role of these services.

How to choose a therapy assistant

Therapy Assistants can provide a cost-effective and important role as part of your NDIS plan. We delegate to qualified and skilled Therapy Assistants to assist the delivery of Physiotherapy services. We recommend the following steps in finding the right Therapy Assistant for you:

Ensure that they have indemnity insurance. This should be the first thing that you verify with a Therapy Assistant. Indemnity insurance protects you in case of an incident during therapy. This is to ensure the safety of you and the therapist during treatment.
Always choose a qualified Therapy Assistant. It is essential that your Therapy Assistant has training and qualifications. Treating NDIS participants requires skill, knowledge and understanding. Ensure that your Therapy Assistant has a minimum qualification of a Certificate III. This aligns with recommendations by Occupational Therapy Australia and Speech Pathology Australia.
Ask about their training and experience. Do they have experience working with disability? What about your diagnosis? If they don’t – are they happy to learn? These questions are important to ask before using a Therapy Assistant.
Check all important documentation. As discussed above, Therapy Assistants do not have to undergo compulsory background checks. The Therapy Assistant should be able to provide Police Criminal Check and Working With Children Check prior to treating someone with a disability. This ensures the safety of NDIS participants and is a requirement of all other NDIS workers.
Make sure a Health Professional is involved. A health professional, such as a Physiotherapist, must delegate and supervise the Therapy Assistant. They should administer training and be in contact with the Therapy Assistant to monitor and progress treatment.

Always keep the health, safety and choice of the NDIS participant at the forefront. Finding a good team of professionals to provide treatment can make a world of difference.

If you have any concerns, questions or comments about the content of this article you are welcome to contact Homemade Physiotherapy. We are here to help.

About the Author

Sarah has spent the last decade working as a Physiotherapist in a number of healthcare settings. She developed a passion for delivering high quality care for people with disability, this led to her founding Homemade Physiotherapy in 2021.

Sarah spent the first five years of her career in a private practice setting. She gained experience working with athletes and sports teams including NRL players, Australian Rugby players, Olympic athletes and Paralympians.

Sarah values personalised, holistic and high quality Physiotherapy. Sarah Frost is a recognised industry leader as a Physiotherapy clinical educator, mentor and advocate.

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