Project activities

Rural landscape with a rusty shed under a large tree

A rural private therapist framework under DisabilityCare Australia

Aim: This project will develop a quality framework to assist rural private therapists (occupational and physiotherapists, speech pathologists and psychologists) to provide ongoing, high quality, sustainable and accessible support to people with a disability.

Team: Angela Dew, Rebecca Barton, Jo Ragen

Approach: This project was independently managed by researchers at the University of Sydney and funded by a Practical Design Fund (PDF) grant from the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs. The PDF is part of the Australian Government’s commitment to introduce the National Disability Insurance Scheme (NDIS). Funded projects will develop practical ways for people with disability, their families and carers, and the disability sector and workforce to prepare for the transition to the NDIS.
As there is less access to therapy in rural and remote areas, this results in a high level of unmet need. In the context of a NDIS the private therapy workforce will have an increasingly important role in providing individualised support. Little is known about how private therapists will meet the growing demand in a significantly changing disability sector.

Outcomes: The WH&DS project sought to fill that gap by building on the information gathered from an online retention survey completed in mid 2012 by 62 private AHPs from the western area of NSW. Focus groups, interviews and online expert panels provided information to develop a quality framework that will be used to inform how rural private therapists provide ongoing, high quality, sustainable and accessible support to people with a disability.

Publications: Dew A, Barton R, & Ragen J, 2013, Enabling high quality, sustainable and accessible services: A framework for rural private therapists. Wobbly Hub Project Brief. The University of Sydney, Australia.

Rural and remote therapy service delivery model pilot projects

Aim: To test and evaluate new models of rural and remote therapy service delivery for children aged 0-8 years

Team: Anita Bundy, Angela Dew, Kim Bulkeley, Rachel Mayes and Gabrielle Hindmarsh

Approach: Using a formative evaluation approach we are currently working in partnership with ADHC Western Region to evaluate 5 pilots of different models of rural and remote therapy service delivery for children aged 0-8 years. Each project is individually tailored to meet the needs of the local community and the evaluation strategies and outcomes are similarly tailored.

Outcomes: Information will be gathered about the effectiveness of a range of different approaches which incorporate trained local support workers liaising with therapists using technology to deliver place-based therapy supports to children who have a disability.

Carers Survey – access to and preferences for therapy services

Aim: The aim of the carers’ survey was to explore the current access to and preferences for therapy services for people with a disability or developmental delay living in western NSW as reported by their primary carers. Survey questions are based on the data collected from carers via focus groups and interviews.

Team: Gisselle Gallego, Craig Veitch, Michelle Lincoln, Anita Bundy, Kim Bulkeley, Angela Dew, Jennie Brentnall, Rebecca Chedid

Approach: The research team is interested in the experiences of primary carers of people with a disability or developmental delay. This is the person who has substantial responsibility for providing unpaid care or support to a person who has a disability or developmental delay regardless of whether he or she lives with the carer or not. To find out about these experiences the team developed a survey which was available both online and in hard copy.

Outcomes: The survey will help the research team to understand the experiences and preferences of rural carers of people who have used therapy services. These valuable insights will assist with future planning and design of therapy services so to meet the needs of people in rural and remote areas.
The survey was completed by 166 carers in western NSW, 70 online and 93 using paper. Some preliminary findings include:

  • 56% of respondents were female and 44% male
  • 84% were caring for a son/daughter with a disability or developmental delay. The others were caring for a sibling (4%); grandchild (3%); foster child (3%); other relative or friend (6%)
  • Approximately 14% of respondents were caring for two or more people with a disability or developmental delay.
  • 74% of the people being cared for had received therapy services in the past two years.

More information on the results will be added to the website as they become available.

Therapist Survey – workforce retention issues

Aim: The aim of the therapist survey was to explore retention of therapists working with people with a disability in western NSW.

Team: Gisselle Gallego, Craig Veitch, Michelle Lincoln, Anita Bundy, Kim Bulkeley, Angela Dew, Jennie Brentnall, Rebecca Chedid

Approach: The survey was designed to understand disability therapy workforce retention issues and preferences in western NSW. The survey was based on data collected from focus groups and interviews with service providers.

Outcomes: The online survey was completed by 226 therapists with 199 responses being included in the final analysis (those not included either did not meet the inclusion criteria, opted out, or had incomplete information). Some findings of the survey include:

  • 93.5% of the respondents were female;
  • Median age of respondents was 38, with an average of 12 years post qualification; Respondents came from all sectors including private practice, government and non government;
  • Slightly over half of respondents were employed in full time work, with a similar figure also having dependent children;
  • The majority (87%) of the respondents were satisfied with their current job, with the highest satisfaction observed for those in private practice;
  • Respondents reported spending on average 41% of their time in direct client/carer contact, 23% indirect contact, 10% on administration, 4% on educational activities and 2.5% travelling for work related activities.

A presentation of the key finding of the survey was put together and shared in real time with participants using Adobe Connect. This presentation was followed by a question and answer session. For those who could not attend online at the time of the presentation, it was made available on Vimeo.

Focus Groups & Key Informant Interviews

Aim: Stage 2a of the project aimed to understand the current situation for therapists, carers, providers and people with a disability in Western NSW.

Team: Angela Dew, Kim Bulkeley, Craig Veitch, Michelle Lincoln, Anita Bundy, Gisselle Gallego, Jennie Brentnall.

Approach: In 2011, focus groups and individual interviews were held with 97 direct government and non-government service providers, 78 carers and 10 adults with a disability in western NSW.

Outcomes: The data collected gave the research team a real understanding of the lived experience of people with a disability, their family members and service providers living and working in western NSW. These multiple perspectives allowed the team to place a truly local lens to understanding the data which in turn informed the development of the pilot projects.
Based on the analysis of these focus groups and interviews, and combined with the findings from the policy document analysis the research team developed a model of person and family-centred therapy.
In developing this model the research team drew on the principles underlying policy and service provision by putting the person and their family at the centre surrounded by extended family and situated within their local community with government as a backdrop.


Policy Document Analysis

Aim: The purpose of the review was to gain insight into the issues currently influencing disability policy development and implementation. Additionally, gaps in key policy-related evidence were identified.

Team: Angela Dew, Kim Bulkeley, Craig Veitch, Michelle Lincoln, Anita Bundy, Gisselle Gallego, Jennie Brentnall.

Approach: Twenty seven policy documents were read and a summary of the key policy content made. This initial summary was used to assign documents into three tiers. Tier 1: overarching NSW Government policy documents including major disability-specific and general population related documents. Tier 2: ADHC specific policies, sub-divided according to whether they were client-focussed or workforce-focussed. Tier 3: ADHC operational guidelines also sub-divided into client-focussed and workforce focussed. The collation and qualitative content analysis of these documents generated themes further explored in focus groups and individual interviews.

Outcomes: In reviewing the documents taking knowledge from the literature, there were some strong drivers of future directions in the disability sector that influenced the teams thinking. Twenty seven policy documents were reviewed and based on analysis, categorized into tier 1 (higher level strategic policies) and tier 2 (specific operational policies). Tier 1 policy documents provided consistent messages about the need to develop strategies and service delivery options to address geographic, cultural and age-related barriers facing all people in New South Wales including those who have a disability. Tier 2 documents revealed a lack of attention to the practical differences between implementing the policy principles in metropolitan compared to rural areas.
Study findings identify that the implementation of metropolitan-formulated policy does not always encompass the unique challenges experienced by therapists providing services to rural people with a disability and their carers. This study highlights the importance of “rural proofing” policy to consider people who live and work in rural areas.


  • Dew, A., Gallego, G., Bulkeley, K., Veitch, C., Brentnall, J., Lincoln, M., Bundy, A., Griffiths, S. (accepted Jan 2014). Policy development and implementation for disability services in rural New South Wales, Australia. Journal of Policy and Practice in Intellectual Disabilities.

Consultations with senior managers in government and non-government organisations

Aim: To obtain the perspectives of policy makers, managers and senior therapists about the issues affecting the therapist workforce and service delivery in the disability sector in rural and remote New South Wales.

Team: Angela Dew, Kim Bulkeley, Craig Veitch, Michelle Lincoln, Anita Bundy, Gisselle Gallego, Jennie Brentnall

Approach: Information was gathered via semi-structured interviews with individuals and small groups. Head office and regional office policy-makers, along with managers and senior therapists in western NSW were invited to participate. Participants included 12 policy-makers, 28 managers and 10 senior therapists from NSW government agencies and non-government organisations (NGO’s) involved in providing services and support to people with disabilities in the region. Information was synthesised prior to using constant comparative analysis within and across data sets to identify issues.

Outcomes: Five broad themes resonated across participants’ roles, locations and service settings:

  1. Challenges to implementing policy in rural and remote NSW;
  2. The impact of geographic distrubition of workforce and clients
  3. Workforce issues – recruitment, support, workloads, retention
  4. Equity and access issues for rural clients
  5. The important role of the NGO sector in rural service delivery and support

Although commitment to providing best practice services was universal, policy-related information transfer between organistaion and employees was inconsistent. Relative recent innovations such as therapy assistants, information technology and trans-disciplinary approaches, were raised as important service delivery considerations within the region. These and other innovations are intended to extend the coverage provided by therapists. NGOs played a significant role in service delivery and support in the region, and there is also a need for therapists working for different organisation, in rural areas, to collaborate both in terms of peer support and service delivery to clients.