Disabled Victorians forced to wait in hospital beds due to NDIS delays

The state government has revealed that more than 200 Victorians with a disability were stuck in hospital for an average of 160 days after they were well enough to be discharged, and blamed the hold-up on the National Disability Insurance Scheme.

A survey of 21 Victorian hospitals conducted in March and April found 208 patients deemed to be clinically ready for discharge were stranded in hospital due to NDIS-related barriers, including funding packages not being approved and accommodation not being available.

Vasilia Boahene (in the wheelchair) with her sister, Helen Milovanovic.Credit: Joe Armao

Of these, 169 acute patients were waiting for an average 118 days; 39 mental health patients were waiting 341 days on average. The longest hospital stay for an acute health patient was 625 days, and the longest stay for a mental health patient was 1156 days.

Health services say the delays are bad for disabled patients because they are staying in hospital longer than necessary. The situation also makes it more difficult for hospitals because they don’t have the beds to admit new patients.

The revelations come as Victorian hospitals struggle with ambulance ramping, overcrowded emergency departments and retaining burnt-out staff.

Health Minister Martin Foley said: “More than 200 Victorians with a disability – through no fault of their own – are stuck in our hospitals because the NDIS won’t approve their care plans.”

However, the National Disability Insurance Agency disputed the waiting figures and said the drivers of hospital discharge delays were complex and might involve issues outside of the NDIS.

“For example, NDIS participants awaiting discharge may need access to a range of state government-delivered services, including rehabilitation, housing and homelessness services, transport, mental health and justice support,” a spokesperson said.

“It would be incorrect to suggest NDIS participants in Victoria are spending an average of 160 days waiting in hospital.”

The problem is occurring nationwide, with 1140 NDIS participants awaiting a plan approval to allow them to discharge as of November 2 last year, according to Senate estimates.

Monash Health chief executive Andrew Stripp.Credit: Jason South

Monash Health chief executive Andrew Stripp said the NDIS remained a “significant complicated barrier” to ensuring patients were discharged in a timely manner.

“This means that hospital beds remain occupied by people who would be better served back in the community, and we have less capacity to admit new patients who are in genuine need of our care,” he said.

“Unfortunately, the NDIS can see hospitals as a safe place to wait for people whose needs are ‘too hard’ or ‘too complicated’. Our experience is that the NDIS processes can take weeks and months, compared to an acute hospital that works on hours and days.”

Stripp said Monash was continuing to experience high demand, including responding to the pandemic, so it was a key priority to ensure timely access to hospital beds.

Austin Health chief executive Adam Horsburgh.Credit: Chris Hopkins

“For every day that someone is delayed in their discharge, it is another day where they are not receiving optimal care, and another member of the community is unable to access hospital care.”

Austin Health chief executive Adam Horsburgh said it often took far too long for an NDIS assessment to be undertaken or for approval to be given for funding packages.

“It really does mean there’s a delay to other people being able to access the bed, as well as that individual really not being in an environment that best meets their needs,” Horsburgh said on the podcast Reasonable and Necessary: Making Sense of the NDIS.

“Unfortunately, [this] experience is very common across the health system right here in Victoria and I think across all of Australia.”

Barwon Health chief executive Frances Diver also said patients who required NDIS packages could experience delays in being discharged from hospital.

“Whilst it may be a small number of patients (four at Barwon today), these patients can experience extended stays in hospital over multiple weeks.”

Vasilia Boahene, who had a stroke in March 2021, was cleared to be discharged from a Melbourne hospital in the middle of last year.

But the 63-year-old was stranded in hospital for months while she waited for her housing and support to be approved under the NDIS.

Vasilia Boahene was stranded in hospital for months.Credit: Joe Armao

“It was shit,” said Boahene, who was isolated from her family and friends for months due to pandemic restrictions.

Boahene says the staff at the rehab hospital were lovely. “They bent over backwards, but in the end they couldn’t help me. I was there for nine months.”

Boahene’s sister, Helen Milovanovic, says an application for an NDIS plan with 24/7 support for Boahene was submitted on July 16 last year. A month later, it was rejected on the basis that there were less costly options that would meet her support needs.

It was suggested that Boahene apply for supported disability accommodation funding, with an occupational therapist to make an assessment and then submit it to the National Disability Insurance Agency.

“It is unfortunate that this information was not provided sooner, especially at the time of the planning meeting,” an NDIS planner wrote in an email seen by The Age.

“We did have a specialist team who just focused on participants awaiting discharge from hospital, however this was dissolved and it is taking some time for higher delegation to respond to our planning proposals. I recognise that there is a need for efficiency with discharge planning due to high demand for hospital beds. I can only say that you are quite within your rights to put in a complaint about the delay as I am very disappointed for Vasilia and yourselves as it is such an abrupt change of direction.”

The National Disability Insurance Agency spokesperson said its health liaison officer had been working closely with Monash Health and Boahene’s planner during her hospital stay to prioritise discharge.

“The agency approved … funding in December 2021, with her new plan approved in January. The National Disability Insurance Agency was informed earlier this month that a suitable property had been found,” a spokesperson said.

Milovanovic said her sister had been temporarily moved into an aged care facility and was hopeful she could move into permanent accommodation in July.

“That will be 18 months she’s been in some form of hospital care.”

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