What Does a Sustainable PBS Caseload Look Like?

Introduction

Caseload management is an essential part of surviving as a BSP. It will be the difference between you becoming incredibly stressed and pulled between conflicting priorities versus you feeling in control and on top of your caseload. It will also make a massive difference to the quality of your practice and the support you're providing. 

It is unfortunately also an often neglected part of the management process. If your manager is not actively managing your caseload and discussing it with you, then you may have to become your own advocate.

I can't overstate enough how much this will change your experience as a BSP. In my time as a BSP, I’ve had caseloads which were too low - meaning I was scrounging for work to do, and too high - meaning I was only able to focus on the top priorities while everything else waited in the background. So, to help you avoid that, we need to make sure you know how to get the right caseload for your role.

A sustainable PBS caseload isn't determined by participant numbers alone. It needs to take into account the amount of available funding, the complexity of participants, Restrictive Practice requirements, participant locations, funding periods, deadlines and the amount of time a BSP can realistically spend on billable work each week.

What I Look at to Manage PBS Caseloads

Everyone referred to you will be receiving different funding, have different funding periods, and otherwise require a little bit of thinking as to how they slot into your existing caseload. When you receive a referral, I recommend always taking a moment to consider these things. Burnout can be death by a thousand cuts and that's especially true if you end up with an unbalanced caseload due to failing to plan.

The process I've developed and used successfully over the last few years involves making a list in Excel which details the following: 

• Participant name 

• Their location (This helps me keep track of the region a BSP’s caseload is developing into)

• Available funded hours that you expect can be used for your service - break this into multiple columns if you're using different pots of funding, e.g. you also provide psychology or counselling services 

• Add a notes column - I typically use this to make funding notes, E.g. the NDIS plan is for 2 years, the participant is in a rural location 

At the bottom of this table, I'll do a sum of the total hours for each funding column and write down the number of current participants in the caseload. If you can’t imagine what I’m describing (or simply want to play around with the table yourself), download our simple Caseload Manager template for free.

How to Calculate Your PBS Caseload Health?

Before we jump into the calculations, I’d like to mention here that funding is only one measure of caseload health. Two BSPs could each have 600 funded hours but have dramatically different workloads because of:

• participant complexity;

• Restrictive Practices;

• travel;

• geographic spread;

• number of stakeholders;

• frequency of contact required;

• upcoming plan reviews/deadlines;

• new referrals which typically require more time in the first few months;

• sudden changes or increased support needs.

So this is also something that can’t be lost amongst all the numbers we’re going to talk through below. It needs to be considered within the individual caseload alongside the quantitative assessment we’ll do below.

A sustainable caseload on paper can become unsustainable gradually. One participant might be geographically inconvenient, another might have a short funding period, another might require significant stakeholder coordination, and another might have Restrictive Practice requirements. Individually, each referral may seem manageable. Together, they can create a workload that looks reasonable on a spreadsheet but is difficult to sustain in practice.

Total Hours You Can Bill Per Week

With the information we’ve gone through above and the table you’ve prepared, you can now make a rough estimate of your caseload health.

Firstly, we want to look at how many hours you could sustainably use per week. This serves two purposes - it means you know when your caseload is too low to meet your target (your organisation will typically give you a billing target to meet), and it also starts to give you the warning signs for when your caseload is getting too high, meaning you may need to speak to your Line Manager about shuffling your caseload or pausing new referrals. 

So to calculate this is very simple. You take the number of total hours in your caseload and divide it by 48. I choose 48 because it allows for a week of public holidays, a few days of sick leave, and a few weeks of annual leave. If you know you always take your 4 weeks of holidays a year then maybe decrease this down to 46-47 weeks. 

The resulting number will give you a rough estimate of how many hours of funding you can use per week. While this is only an approximation, it should give you an idea of the ballpark you’re in. In my experience, you want this number to be around 2-3 hours lower than your billing target as exactly matching is always when I start to see my team members getting stressed or getting behind. I’m not sure why this is exactly, but it’s happened too many times now to be a coincidence. It might not happen to you but I’d just start slowing down accepting new referrals when you’re hitting that number.

Funding Amount of your Caseload

You might also want to calculate the total funding amount in dollars that your caseload will bring in across the week or year, especially if you’re a sole trader or are running your own business.

You can always find the fee to multiply the hours by in the annual Pricing Schedule. Our hourly fee is found under Relationships. Make note of any participants in a rural or remote community as this has implications for funding, E.g. you may be able to charge more for travel or your services. The Pricing Schedule details where to find this information; it changes every year around July so definitely make sure you’re checking the information using the current one available from the NDIS.

Finding the Average Hours per Participant

The next calculation you’ll want to do is to find out the average amount of hours your participants are coming with. So this is where we divide the total annual hours by the number of participants on your caseload.

Although it might seem strange, working out the average funding package of your participants will give you an indication of whether you’re going to end up with a small or large caseload. In the BSP caseloads I’ve managed, I've generally found that an average of around 60–90 funded hours per participant creates a useful middle ground for a full-time BSP. Below 60 hours per participant and you’re likely to end up with 20+ people on your caseload if you’re working fulltime as it will take many more people to give you enough funding available to meet your billing target.

Whereas, if your average sits above 90 hours then you’re much more likely to have a small caseload of 10 or so participants for a fulltime BSP. In the caseloads I’ve managed, these participants have often been more complex and/or involved Restrictive Practice. Ten highly complex participants with significant stakeholder demands may represent a substantially greater workload than twenty participants with relatively straightforward support needs.

Now take this with a grain of salt as you might personally prefer having a small or large caseload. Either way, this number will still be helpful for you to determine if you’re in the range for the caseload you want.

Caseload Outcome

This is the last calculation I typically make to determine a caseload’s health. I write down what the billing target is (which may be given to you by an organisation or may be a number you’ve chosen to aim for), and then I minus the total hours you can bill per week from the billing target.

Let me show it to make it clear: Estimated sustainable weekly billable hours (e.g. 6) - Billing target (e.g. 15) = caseload outcome (e.g. -9 or 9 hours below target).

This will then give you a negative or positive number, depending on whether your caseload is below or above your billing target.

As I mentioned earlier, what works for me and my team is trying to sit on a number which is around 2-3 hours lower than the billing target. If it’s much lower than your billing target then it likely means an influx of new participants is needed (make sure you manage those deadlines!), or that you may have too many participants on your caseload and you won’t be able to make use of all their available funding.

In summary:

• Negative number → you're below your billing target and run the risk of running out of work across the year.

• Around 2–3 hours below target → preferred range based on my experience as a BSP.

• Positive number → your caseload may contain more funded hours than you can realistically use.

What to do After Determining Your Caseload’s Health?

If you’ve ended up going through your caseload using the above and finding that the total hours you can bill per week is lined up nicely with your billing target and you feel as though you have a sustainable number of participants - Congratulations, your caseload is probably just right!

However if any of the calculations ended up too low or too high, this is a chance to do something now before you end up either bored or overworked. This is where I’d bring in my Line Manager, or even your Supervisor, for a chat about your caseload and what your concern is. It might be that you have matching hours you can bill per week and your billing target, but you’re hustling nonstop across all your participants to get there. As a Line Manager, that would tell me that the average funding of your participants is too low and we need to reconfigure your caseload to shuffle out a few of the lower funded participants to colleagues with healthier caseloads whilst bringing you in a few participants with solid funding hours, e.g. 90+ for the year.

You can apply the logic I’m using across all the different scenarios that this caseload health check could result in. I’ll summarise some key ones quickly below:

• Hours you can bill = low + no. of participants = low: New referrals needed, just make sure to space them out so you don’t get steamrolled by multiple due dates in the same 1-2 months

• Hours you can bill = low + no. of participants = high: Your caseload is likely too full of participants with low funding amounts. You’re going to need to attract some new referrals or see if your Line Manager might ask your colleagues about swapping some of your low funding participants with a few of their higher funding participants.

When Caseload Redistribution Is Necessary

I don’t want to sound callous as I say things such as swapping participants, and I don’t say this lightly - changing BSPs can be an incredibly disorienting experience for participants and their families, however it needs to be clearly stated that my priority as a manager will always be on keeping my practitioners in a good mental state. It’s no good to have a BSP that is no longer functioning positively due to the strain of their caseload; everyone will suffer and that BSP is likely to experience burnout and maybe even leave the profession, causing repercussions for their entire caseload of participants. I’ve seen it a number of times before.

So sometimes, although I loathe to do it, a shuffle is necessary to keep things balanced and everyone at their best. We just need to do our best to mitigate the impacts of the transition - e.g. giving advance warning, offering a choice over the new BSP to the participant, getting the current BSP to introduce the new BSP, doing handovers so nothing is rehashed or missed, etc.

Conclusion: So, what does a sustainable PBS caseload look like?

In my experience, it’s a caseload where the BSP has enough funded work to meet their professional and organisational expectations, but enough capacity to complete that work without constantly operating at maximum capacity. The right number of participants will vary depending on funding, complexity, geography, Restrictive Practice requirements and the BSP's role. I also believe current well-being has an impact too, which is why I’m constantly checking in with my team about their feelings around their workload.

Using the above health check numbers we’ve talked through, it becomes much easier to monitor and manage your caseload. It does require keeping the Caseload Manager up to date when participants get a new NDIS plan, referring to it whenever you’re considering a new referral, and taking out entries when participant’s cases are closed. However, it will be incredibly worthwhile as it will mean you’re at much lower risk of burnout due to becoming overwhelmed by your caseload.

Please download the Caseload Manager for free from our Store if you’ve never tried to analyse your caseload before.

Now the above was just a simple walkthrough the Caseload Manager template to set up your health check. I might prepare another article in the future that focuses on the role of a Line Manager in actively managing your team’s caseloads to ensure new referrals are going to the right person and you’re proactively avoiding boredom or burnout.

Still Have Questions?

If you'd like to ask an active BSP some specific questions about managing caseloads or other aspects of the role, you can book a free 20-minute chat with Rebecca.