My husband is a physio; I come from a marketing and CRM background. Together we grew a multidisciplinary allied health practice to ten clinicians in twelve months, during what I was told was the worst period the NDIS had ever seen.

I don't say that to boast. I say it because it's the whole point of what follows. It can still be done. I've seen practices grow from a single clinician to forty, and others deliberately stay at three or five and thrive. We've stayed at ten ourselves, by choice. We like being a small, local, sustainable provider. Because size was never the goal. The goal is to thrive: to be profitable, to have your evenings and weekends free, and to feel good about the road ahead. That's still very much possible. But the ground has shifted over the last 18 months: hourly therapy rates, travel and participant budgets cut significantly, at a time when the cost of living has never been higher.

Here's the thing I want you to hold onto from the start: the practices that struggle over the next few years won't be the smallest. They'll be the least prepared.

This isn't a rough patch. It's a redesign.

The government has set out to slow the scheme's growth and make it easier to govern. Under the National Cabinet sustainability framework, year-on-year NDIS growth is being pulled down from around twelve per cent to a target of eight per cent by 2026-27. That is the stated plan. A scheme that grew from roughly 400,000 participants to more than 760,000 is now being braked, hard, on purpose.

You can see the same intent in aged care. Under Support at Home, participants no longer choose their clinician directly; they get whoever sits on their provider's selected panel. More broadly, we're seeing governments favour models that centralise coordination and simplify administration. Whether or not the NDIS follows exactly the same path, the direction of travel is clear: fewer players, tighter control, easier to oversee.

With fewer referrals going round and rates cut, the market naturally becomes more competitive to operate in.

Once you see it as design rather than a period to weather, the way you respond changes. You stop waiting it out and start getting ahead of it.

What it means for us: the pool stopped growing

Here's how that plays out day to day.

For years, the pool of participants and referrals kept expanding, so there was enough new work flowing that many practices could grow simply by being there. That era is closing. When the scheme's growth is deliberately throttled, the flow of new referrals stops expanding with it.

And small providers feel this first and hardest, for reasons that have nothing to do with how good you are. Many small practices carry thinner cash reserves, so a quiet month bites deeper. And many have all their eggs in one basket, and that basket is the NDIS.

Many small providers rely heavily on a handful of referral relationships. Losing one or two can have a significant impact.

Let's be honest about who this favours

Large providers have the tailwind. They have deeper reserves to ride out a quiet month, bigger marketing budgets, and more capacity to compete for whatever work is going. And a reform agenda built around fewer, more easily governed providers structurally suits scale.

If you're a sole trader looking at all of that, it's easy to conclude the game is rigged for size.

But that story misses the most important part. Big isn't the same as safe. In a market shifting this fast, the ability to adapt matters more than size.

What small providers have that can't be bought

Large providers carry things small ones don't. Team layers. Often higher turnover. Distance from the client. Every one of those is a weakness in a market that rewards trust and speed.

You can pivot in a week where they can take months.

You often have genuine one-to-one relationships with your clients and your referrers, the kind that don't churn, the kind that pick up the phone when you call.

And you offer something that's important, and that the big providers struggle to give: continuity of care. Turnover is often higher in the larger providers, so their clients change therapists more frequently.

Your clients see the same face every visit. In a sector built on churn, that's not a nicety. It's your competitive advantage.

The catch, and it's a big one, is that none of these advantages matter unless you deliberately use them. They only become protection when you put them to work.

So what do you actually do

Getting through this well isn't about working more hours. It's about being resourceful, staying open to new ways of doing things, and getting deliberate in a few key places.

First, build a resilient business

Build systems, so a quiet patch shows up in your numbers before it shows up in your bank account. Good systems also cut the admin and the constant decision-making, freeing you to spend more time working on your business rather than just in it.

Spread your referral sources, so no single relationship can sink your month if it cools off. And look beyond the NDIS entirely. Just because funding budgets have been cut doesn't mean people stop needing care; you simply have to find them elsewhere. There are other funding streams worth building into your mix, from DVA and TAC through to private pay. And the need hasn't gone anywhere: an older generation who want to stay living well at home for longer, and children who still need their therapy even when the funding stops. When families can find a way to keep that care going, small, trusted providers are the ones best placed to be there for them.

Nurture the relationships you already have. Map your customer journey so nothing falls through the cracks, use a simple CRM to make follow-up easy, and stay in front of your existing referrers. You don't need fancy tech for any of this; a well-organised spreadsheet can do the job just fine. It costs far less to keep and grow a relationship than to win a new one, and it's exactly where small providers have the edge.

Second, become easier to recommend

Lead with what makes you different. People like working with small, local providers, so lean into that, and if you have a niche skill, promote it loudly.

Compete on brand. The usual advice is that you either go niche or diversify to survive. But there is a third path people forget: you can compete on brand. A clear, consistent, trusted brand wins clients and referrers whatever your size, and it doesn't take a big budget to build. For a small provider your brand is really your reputation, your values, and how reliably you show up, and those are things you already own.

Make yourself easy to find and refer. Use the channels that give small budgets real reach, like LinkedIn and Meta, and make sure you have a website that tells people who you are in seconds and makes it easy for referral partners and clients to send others your way.

None of that requires a big budget. It requires clarity, and acting a little ahead of the curve instead of waiting to feel the squeeze.

That's exactly why Trystan Conway and I built Smart Path. Between us we've lived both ends of the journey, from growing a local practice to ten clinicians to scaling an allied health business to around 300 clinicians and $15 million during NDIS reform. The program brings together the systems, marketing and leadership lessons we've learned along the way.

NDIS reform is a chance to build a stronger, more robust practice.

The NDIS is propped up by small businesses: the one-therapist practices, the two-clinician teams, the people doing the actual work in people's homes and communities. I left corporate marketing looking for more purpose in my career, and I've found it in the allied health community. That's why I founded Path Connect, a free community space with clinical and business professional development sessions to help independent allied health clinicians and small providers connect, collaborate and learn. And it's why I've launched Smart Path, our business growth program.

The providers who struggle over the next few years won't be the smallest. They'll be the least prepared. The ones who build stronger systems, diversify where their work comes from, invest in relationships and become easier to recommend give themselves the best chance to thrive, whatever their size. That's work worth starting now.

Sole traders and small providers can absolutely thrive through NDIS reform. And the ones who get their foundations right now are the ones who will.

If you'd like to think through where your practice is exposed and which of your strengths you could be leaning on harder, that's exactly the kind of conversation I'm here for. A good place to start is our Focus Finder, a quick way to identify your biggest opportunities.