What Is High Intensity NDIS Support and Who Needs It?

Not all NDIS support is the same. Some participants need a higher level of care — this is called high intensity support.

If you or someone you care for has complex medical or physical needs, understanding high intensity NDIS support is important. This blog explains what it is, who needs it, and what to look for in a provider in Sydney.

What Is High Intensity NDIS Support?

High intensity support covers tasks that carry a higher level of risk — tasks that go beyond standard personal care.

They're tasks that need a support worker with specific, verified training. Not every support worker can deliver them. The worker must have the right skills for each specific task they perform.

The NDIS Quality and Safeguards Commission sets out the requirements for high intensity support under the NDIS Practice Standards. These are called the High Intensity Daily Personal Activities (HIDPA) standards. (Source: ndiscommission.gov.au)

What Tasks Count as High Intensity Support?

The NDIS Commission identifies the following as high intensity daily personal activities:

1. Complex bowel care

2. Enteral feeding and management (feeding through a tube)

3. Tracheostomy management (caring for a breathing tube in the throat)

4. Ventilator management (supporting a person who uses a breathing machine)

5. Subcutaneous injections (injections under the skin)

6. Urinary catheter management

7. Complex wound management

8. Seizure management and support

9. Severe dysphagia management (supporting a person with serious swallowing difficulties)

These supports present some of the highest risks for participants. They're also deeply personal in nature. (Source: ndiscommission.gov.au)

Who Needs High Intensity Support?

High intensity support is for participants whose disability or health condition requires clinical-level care as part of their daily routine.

This isn't only for people in hospital or residential care. Many people with high intensity needs live at home or in supported independent living. They need these supports every day to stay safe and well.

Common conditions that may require high intensity support include:

1. Acquired brain injury

2. Spinal cord injury

3. Muscular dystrophy

4. Motor neurone disease

5. Complex neurological conditions

6. High physical support needs requiring clinical care

If you're unsure whether your loved one needs high intensity support, speak with their treating team. A GP, specialist, or occupational therapist can help assess what level of support is needed.

What Makes High Intensity Support Different?

The key difference is the level of training and oversight required.

For standard personal care, a support worker completes general disability support training. For high intensity support, each worker must have verified skills for every specific task they perform. Training must be delivered or overseen by an appropriately qualified health practitioner.

According to the NDIS Commission, providers delivering high intensity support must:

1. Be registered specifically for high intensity daily personal activities

2. Ensure workers have the skills described in the NDIS High Intensity Support Skills Descriptors

3. Maintain documented training records for every worker

4. Have systems in place for risk assessment and incident management

5. Involve participants in developing their individual support plans

6. Arrange regular reviews of each participant's health status by a qualified health practitioner

(Source: ndiscommission.gov.au)

This level of oversight exists because these supports carry real risk. Getting it wrong can cause serious harm. Choosing a provider who meets these requirements is not optional — it's essential for safety.

What the NDIS Says

The NDIS Practice Standards require that providers delivering high intensity daily personal activities are registered for this specific class of support and have workers with verified, documented competency for each task they perform. Providers must also ensure each participant has an individual support plan developed in collaboration with health practitioners, and that the plan is kept current.

The revised High Intensity Support Skills Descriptors came into effect in February 2024. They set out the specific skills and knowledge workers must have for each high intensity activity. (Source: ndiscommission.gov.au — High Intensity Support Skills Descriptors (PDF))

How Help On Wheels delivers this: Help On Wheels is a registered NDIS provider delivering high intensity support across Sydney. Our workers are trained and verified for the specific high intensity tasks they perform. We develop individual support plans in collaboration with each participant's health team, and we maintain the documentation and oversight required under the NDIS Practice Standards. Our focus is on delivering safe, respectful, consistent care for participants with complex needs.

How Is High Intensity Support Funded?

High intensity support is funded under Core Supports in a participant's NDIS plan, under the Assistance with Daily Life category.

Because of the higher skill requirements involved, high intensity supports have higher price limits than standard personal care. This reflects the training, oversight, and risk management that providers must have in place.

To access high intensity support, it must be included in your NDIS plan. Here's how to make sure it is.

How to Access High Intensity Support in Sydney

Step 1 — Get documentation from your treating team. Your GP, specialist, or occupational therapist will need to document your support needs clearly. This includes the specific tasks required and the level of risk involved. Good documentation leads to better plan funding.

Step 2 — Raise high intensity needs at your NDIS planning meeting. Be specific about what supports are needed and why. Bring your documentation. If you have a Support Coordinator, they can help you prepare and present the case for high intensity funding.

Step 3 — Find a registered provider with verified high intensity workers. Not all NDIS providers are registered for high intensity daily personal activities. Ask any provider you consider whether they're registered for this support class and how they verify worker competency.

What to Ask a High Intensity Support Provider

Before you commit to a provider, ask these questions:

1. Are you registered for high intensity daily personal activities with the NDIS Commission?

2. How do you verify that your workers have the right training for the specific tasks my loved one needs?

3. How do you develop and review individual support plans?

4. Who oversees the clinical aspects of support delivery?

5. What happens if a worker is unavailable?

The answers to these questions will tell you a lot about whether a provider can safely meet your needs.

Frequently Asked Questions

What is high intensity support under the NDIS?

High intensity support covers tasks that carry a higher level of risk and require a support worker with specific, verified training. Examples include complex bowel care, tracheostomy management, ventilator management, and seizure support.

What tasks require a high intensity support worker?

The NDIS Commission identifies nine high intensity daily personal activities. These include complex bowel care, enteral feeding, tracheostomy management, ventilator management, subcutaneous injections, urinary catheter management, complex wound management, seizure management, and severe dysphagia management.

How do I know if my loved one needs high intensity support?

If your loved one requires clinical-level care as part of their daily routine, they may need high intensity support. Speak with their GP, specialist, or occupational therapist. They can assess what level of support is needed and help document it for the NDIS planning process.

How is high intensity support funded in an NDIS plan?

High intensity support is funded under Core Supports, in the Assistance with Daily Life category. Higher price limits apply compared to standard personal care. It must be included in the participant's NDIS plan.

Does Help On Wheels provide high intensity NDIS support in Sydney?

Yes. Help On Wheels provides high intensity NDIS support across Sydney. Contact our team to discuss your situation and how we can help.

How Help On Wheels Can Help

Help On Wheels provides high intensity NDIS support across Sydney. We work with participants who have complex medical and physical support needs, delivering safe, consistent care that meets the NDIS Practice Standards.

Our support workers are trained and verified for the specific tasks they perform. We develop individual support plans with your health team, and we focus on consistency so your loved one has familiar, trusted workers who understand their needs.

If you or someone you care for needs high intensity support in Sydney, contact our team. We'll take the time to understand your situation and work out the right support.

• Learn about our High Intensity Care services

• Learn about our Personal Care services

• Learn about our Support Coordination services

• Contact our team