Understanding Complex Nursing Care Under the NDIS

What is Complex Nursing Care?

Under the NDIS, complex nursing care falls within the High Intensity Daily Personal Activities support category. This is one of the highest-value support categories in the NDIS, and it covers clinical supports that go beyond what a support worker can provide — requiring registered nurse delivery or oversight.

The NDIS recognises that some participants have health needs that are clinically complex, requiring professional nursing skills to manage safely. These aren't optional extras — they're essential supports that enable participants to live safely at home rather than in hospital or residential care.

Complex nursing supports are funded at higher rates than standard personal care, reflecting the clinical qualifications and expertise required to deliver them safely. This funding is specifically allocated in your plan and can only be used with providers who have appropriately qualified staff.

Examples of Complex Nursing Supports

Complex nursing care under the NDIS can include a wide range of clinical procedures and supports:

• Tracheostomy management: suctioning, cleaning, tube changes, and monitoring for complications. Requires registered nurse expertise and vigilant observation
• PEG tube and enteral feeding: administering nutrition through a percutaneous endoscopic gastrostomy (PEG) tube, monitoring for blockages, skin care around the site, and adjusting feed rates
• Ventilator support: monitoring participants who use ventilators for breathing support, managing settings, and responding to alarms and changes in respiratory status
• Complex wound assessment and management: pressure injuries, surgical wounds, diabetic ulcers, and other wounds requiring clinical assessment, specialised dressings, and ongoing monitoring
• Subcutaneous injections: administering medications via injection, including insulin and other prescribed medications
• Complex bowel care: including enema administration, manual removal, and bowel management programs
• Urinary catheter care: insertion, maintenance, troubleshooting, and infection monitoring
• Severe dysphagia support: managing swallowing difficulties, modified texture diets, and aspiration risk

Each of these supports requires clinical training, assessment skills, and the ability to recognise and respond to complications. They cannot be safely delegated to unqualified staff.

How to Access Complex Nursing Under the NDIS

Complex nursing supports must be included in your NDIS plan under the High Intensity Daily Personal Activities category. If your plan doesn't currently include this category but you have clinical nursing needs, you can request it through:

• Plan review: ask your support coordinator or local area coordinator to request a plan review, providing evidence from your GP or specialist about your clinical needs
• Change of circumstances: if your health has changed since your last plan, you can request a plan reassessment
• New plan: if you're a new NDIS participant, ensure your clinical needs are clearly articulated during the planning meeting — bring letters from your GP, specialist, or hospital team

Your support coordinator can help ensure the right line items and funding levels are in your plan. It's important to specify the type of nursing support needed and the frequency required, as this affects the funding allocated.

Choosing the Right Provider

For complex nursing care, choosing the right provider is critical. The wrong provider can put your health and safety at risk. When evaluating providers for high intensity supports, ask:

• Do you have registered nurses on staff with experience in my specific clinical needs?
• How do you ensure clinical governance and quality? What's your incident management process?
• Will the same nurse visit me consistently, or will it be different people?
• How do you coordinate with my GP, specialist, and hospital team?
• What happens in an emergency or after hours?
• Are your nurses experienced with [specific procedure — e.g., tracheostomy care, PEG management]?

Don't settle for vague answers. A provider with genuine clinical capability will be able to answer these questions confidently and specifically.

How Evia Health Can Help

Evia Health specialises in high intensity and complex nursing supports. Our team of registered nurses has clinical experience across the full range of complex care needs — from tracheostomy and ventilator management to PEG feeding, wound care, and complex bowel care.

We deliver these supports across Melbourne's Bayside and South-East suburbs with the clinical governance, staff consistency, and professional oversight that complex care demands. Every care plan is developed by a registered nurse, and clinical supervision is maintained at every visit.

If you or a participant you support has complex nursing needs and is looking for a qualified, experienced provider, get in touch or call us on 0488 689 934. We'll discuss your clinical needs and explain how we can help.