Independent Support Workers vs Agencies: Helping Participants Weigh the Options

At some point, all participants will ask themselves, or will be asked by a family member who has been reading: should we use an agency or should we have our own support worker? It is one of the most important choices to make in a plan, and it is often made with imperfect information, since most of what participants have is written by one side of the comparison.

Support coordinators are the people who can make this an informed decision, and provide an accurate representation of both models. Choice and control is not limited to who the participant chooses. It's really about whether they knew their options at the time of their selection.

What the agency model offers

The agencies have employees whose work the participant pays for, rather than a relationship with a single worker. The strength is derived from that structure. Replacing a worker is not the family's responsibility, it is the agency's problem if a worker becomes ill. The organisation has supervision, training and administration. An established provider may have clinical governance, team structures and experience that an individual arrangement has to work hard to put together for those with complex needs.

The structure also determines the trade-offs. The rostered worker changes regularly and is assigned to the participant, so continuity depends on the agency and its staff, not the participant. The rates are usually at or near the highest price limits in the relevant NDIS pricing arrangements, as they include the organisation's overheads. And responsiveness varies widely, some providers can onboard within days, while others have a waitlist that lasts much longer than the need.

What the independent model offers

Independent workers are selected by the participant directly, and the relationship is person to person, not to a roster. The strengths are the opposite of the agency model. The participant chooses a worker who fits, based on language, culture, gender, interests and approach, and does not change the worker simply because someone else is available. Agreed rates tend to be lower than agency rates, thus using budgets more effectively. Arrangements can begin promptly, since there's no waiting line between the participant and the worker.

The compromises are concrete and should be named plainly. Backup is not automatic: the arrangement the participant designed is the arrangement they have, so if the worker is unwell, there's no built-in cover. A second worker or a warm shortlist is the reason to plan ahead. Coordinating agreements, expectations and communication sits more with the arrangement than with an agency. But due diligence is part of the engagement process, screening, clearances, insurance and the relevant training should be checked, and platforms that verify workers carry much of this load.

How to run the conversation

Instead of asking abstract questions about a model, go through four practical questions. Firstly, how important is it to this participant that the person keeps working the same way? It is the number one factor for many, especially those for whom trust is hard to establish, and it points most to the independent model. Secondly, how complex are the supports? The greater the clinical picture, the more the organisation's governance ought to be taken into account, and for some the registered provider is a requirement, especially if the funding is agency managed. Thirdly, who will be responsible for the coordination? An independent arrangement can be well managed by an engaged family or a capable participant; where there is neither, the agency model does more of it. Fourth, what are the goals of the budget? When funds are tight, the difference in price between models can make the difference in support.

How this plays out in practice

Imagine a woman with CP in her 20s who is funded for social and community access, and who in three months has had four different workers sent by her agency. The supports are not complicated; her mum is willing to help manage an arrangement; what she wants most is one person who knows her. The four questions are walked through, and the answer points clearly towards an independent worker selected for shared interests, with a second worker for one shift per fortnight as a designed backup. Another participant, with high intensity supports and no informal network, walks through the same four questions and may land on the same registered provider. The technique is identical. There is no single right answer.

The coordinator's line

You have to be fair about the comparison, not steer it towards your favourite answer. Record that the options have been discussed, leave it up to the individual to choose, and review the decision at intervals in the plan, since the right answer for them may change as things change.

Next steps

Use this conversation guide at every new plan where support worker arrangements have not been determined, by creating a one page version of the four questions. With full information, participants who choose an arrangement tend to stay with it for longer.