Hello and welcome to another Intensive Care at Home livestream today.

We’re talking about how we prevent emergencies that claim lives. The Noah Johnston lessons.

My name is Patrik Hutzel. I’m a critical care nurse of 25 years. I have worked in critical care nursing for over 25 years in three different countries where I worked as a nurse manager for over five years, and we’ve been helping families with Intensive Care at Home since 2012 here in Australia, but really all over the world with consulting and advocacy as well for families in intensive care, as well as with Intensive Care At Home. I was part of setting up Intensive Care at Home in a pioneering service in the early 2000s, and then I brought the concept to Australia in 2012, and we have been successfully operating in Australia since 2012.

I’m the Founder of Intensive Care at Home. We are Australia’s only third-party accredited specialist home nursing service for ventilator-dependent patients and Intensive Care at Home where me and my team help families in ICU to get their loved one’s home, where me and my team help families to keep their loved ones at home out of ICU, and we are getting results.

With Intensive Care at Home, we are operating all around Australia in all major capital cities, as well as in all regional and rural areas. We are covering all states and territories.

We provide tailor-made solutions for long-term ventilated adults and children with  tracheostomies, and we are providing tailor-made solutions for adults and children on a ventilator on non-invasive ventilation such as BiPAP (Bilevel Positive Airway Pressure) and CPAP (Continuous Positive Airway Pressure. We are providing tailor-made solutions for adults and children with tracheostomies at home that don’t need ventilation. We provide home ventilation weaning, cough assist management at home, home TPN (Total Parenteral Nutrition), home IV fluids, home IV potassium, home IV magnesium infusions, home IV antibiotic infusions, central line, PICC (Peripherally Inserted Central Catheter) line, Hickman’s line, port management at home. We are providing SPC (Suprapubic Catheter), IDC (Indwelling Catheter) management at home, nasogastric tube, nasojejunostomy tube, PEG (Percutaneous Endoscopic Gastrostomy) tube, PEJ (Percutaneous Endoscopic Jejunostomy) tube management at home, as well as palliative care management at home with Intensive Care at Home. We’re also providing level 2 and level 3 NDIS specialist support coordination, and we are providing TAC (Transport Accident Commission) and WorkSafe management as well, or case management as well.

So, today I want to make it all about how we make Intensive Care at Home safe and what lessons have been learned from the Noah Johnston situation. We’ll go for about 45 minutes to an hour. I want to welcome everyone joining this livestream. I also want to welcome our viewers that watch this on replay. If you enjoy my videos, like the video, subscribe to my YouTube channel so that you don’t miss any of my videos for families in intensive care and for families with Intensive Care at Home. Tick the notification bell and share this video with anyone that can benefit from what I’m talking about today. We’re also providing consulting and advocacy for families in intensive care and you can check on our sister site, intensivecarehotline.com, where we help families in intensive care, making sure their loved ones get best care and treatment so that they can eventually then also benefit from Intensive Care at Home if their condition allows them to.

Now, without further ado, in December 2025, a young man named Noah Johnston died at home. He was only 22 years old. He was ventilator-dependent. He had a tracheostomy.

According to his family, his tracheostomy tube came loose and there was no registered nurse present. Hence, he inevitably died. The Saturday Telegraph on January the 24th, 2026 ran the headline, “NDIS Cuts are a Death Sentence”. I was quoted in that article because that is exactly what I believe has happened. Noah’s mother, Kylie Johnston, fought for over two years in a legal battle with the National Disability Insurance Agency to have 24/7 registered nursing care reinstated for her son. The NDIA downgraded Noah’s care from registered nurses 24/7 with specialist training, i.e., ICU nurses and critical care trained nurses, to support workers.

Now that is a death sentence in and of itself. In January 2024, they made that decision official. In June 2024, they made his plan agency managed rather than self-managed. In December 2025, Noah died. Duh.

His mother, Kylie, told The Saturday Telegraph, “To me, he’s the most valuable, important person that’s ever been on this planet, and I’ll miss him every step of every day for the rest of my life.” As I said to the same newspaper, “It’s like flying an airplane with a cabin crew and not with a pilot. There’s not a lot of margin for error with clients at home on a ventilator or with a tracheostomy or both. That’s why an intensive care nurse needs to be there 24 hours a day,” and this is also what I’m talking about today. Everything that I’m talking about here is evidence-based, and I’ll come to the evidence a bit later. What is the actual third-party evidence? What levels of accreditation are needed to also protect the NDIS from any lawsuits? Because this is not a hypothetical scenario. This is also not a worst-case scenario. This is actually what happened to Noah Johnston who died at the age of 22 and unless the system changes and unless families know what to demand, it will happen again. It is not a matter of if, it is a matter of when.

So, who are we at Intensive Care at Home and why does third-party accreditation matter? Intensive Care at Home is Australia’s only third-party accredited specialist home intensive care nursing service, and we are third-party accredited for Intensive Care at Home for ventilation for tracheostomy care.

We hold ISO 9001:2015 quality and safety accreditation, as well as NDIS Quality and Safety Commission certification. We have been audited regularly and we have been audited regular since 2012, and like I said, no other service in Australia has achieved third-party accreditation for Intensive Care at Home nursing.

We are the specialists in that field. We’re employing, and that accreditation, the policies and procedures we have created, the intellectual property we have created, that enables us to employ over 150 critical care nurses around the country delivering our service day in, day out. Big shout out to my team here that are on the road today, Easter Sunday. So big shout out to our team, keeping our clients safe.

And that certification and accreditation also enables us to employ the most highly skilled critical care nurses in the country that come to your home. No other service provider brings a higher skill level in the community than we do. We employ hundreds of years of critical care nursing experience combined. Again, no other provider provides a higher skill level than we do in the community.

We operate across all states and territories in the country, in Australia, in all major capital cities, in all regional and rural areas which covers all states and territories. Once again, we employ specialist ICU nurses with a postgraduate critical care qualification, not general registered nurses that have never worked in ICU or in ED. Not enrolled nurses, definitely not support workers, critical care registered nurses, similar to an ICU. You can read more about our accreditation and quality framework at intensivecareathome.com/accreditationquality.

Why does accreditation matter for your family? Third-party accreditation means our clinical protocols, staff competencies, emergency response procedures, preventing emergency responses, and documentation standards, and qualification standards of staff have been independently verified, not self-assessed.

When your family member is ventilator dependent at home with or without a tracheostomy, if your family member has a tracheostomy with or without ventilation, you need more than a provider who says they can do it. You actually need proof. Let’s now look at the evidence because what our evidence-based home mechanical ventilation guidelines say and why Noah’s death makes them more important than ever.

With Intensive Care at Home, we don’t operate on instinct. We operate on evidence. We operate according to our professional conduct. Our evidence-based Mechanical Home Ventilation Guidelines which you can access at www.intensivecareathome.com, and you can see the section Mechanical Home Ventilation Guidelines, you can click on the link there, are built on the same clinical evidence-based used in leading ICUs, and we just do that very safely at home.

Here’s what those guidelines require for ventilator-dependent patients living at home. 24/7 critical care registered nurses presence, not a support worker, not an enrolled nurse, not a general registered nurse, a CCRN similar to an intensive care unit. Rigorous alarm management protocols, ventilator alarms must be responded to immediately by a clinically trained nurse, by an intensive care nurse. Tracheostomy emergency protocols, including tube displacement management, which requires immediate skill intervention. Now if Noah Johnston had any of this, he would still be alive, but the NDIS took it away, and I believe this presentation today is also for anybody working for the NDIS and their decision-makers because if something like that with Noah Johnston happens again, the NDIS might be taken to court. So I believe this presentation today is also for education for the NDIS and for the NDIA about their decision-making process so they’re not getting in trouble and having people drag them to court for preventable deaths.

We’re also having obviously third-party accredited and robust tracheostomy emergency protocols, emergency response planning which includes tube displacement management, emergency response planning documented, rehearsed, and understood by every team member on shift. Competency-based staff credentialing, nurses must demonstrate clinical competency before working unsupervised with ventilated patients. Documented clinical handover, every shift transition is a clinical handover, not a social handover. Basically, everything that we do is aligned with intensive care unit standards in the home, and the NDIS thinks they can just send a support worker. Once again that is like flying the airplane with a cabin crew instead of the pilot.

Now a tracheostomy tube can become displaced within seconds. If it is not immediately recognized and managed by a trained nurse, a patient can deteriorate and die within three minutes. This is not a clinical-edge case. This is standard tracheostomy physiology. This is why the NDIS decision to replace registered nurses with support workers for Noah Johnston was, in my professional opinion, clinically indefensible. I go as far that the NDIS has blood on their hands. It’s as simple as that.

Now also, as much as I make today’s video about Noah Johnston and how we make cases like him safe with 24-hour critical care nurses, I also need to say here that the fact is that Noah Johnston was a case that was obviously in the media, but it is also that other cases similar to Noah Johnston didn’t make it into the media. But I have reported them or we as an organization have reported them to the NDIS as well as the NDIS Quality and Safety Commission, and if anyone from the NDIS or NDIS Quality and Safety Commission is watching, you know exactly whom I talking about, and you know exactly that the families have been so traumatized there that they chose not to go to the media.

Maybe there’s also an element of shame, guilt, and embarrassment. We don’t know. We can’t read their mind, but if you are from the NDIA or from the NDIS Quality and Safety Commission, you know exactly who am I talking about because you’ve got the incidents of people dying similar to Noah Johnston on your desk. So have a read through them again and again so that it sinks in for you that support workers cannot look after the clients that we’re talking about today.

Key clinical facts. A ventilator-dependent patient with a tracheostomy requires immediate clinical intervention when the tube becomes displaced. A support worker is not trained to provide this. A critical care registered nurse actually is. This is not a matter of opinion. This is clinical evidence.

So what does third-party accreditation actually mean for your family? When we say Intensive Care at Home is Australia’s only third-party accredited Intensive Care at Home nursing service in 2026, here’s what that means in practice. An independent auditor, in this situation we’ve chosen BSI Group, came to our organization and reviewed our entire clinical operation. They reviewed our policies, procedures, clinical protocols, staff credentials, and patient outcomes. They found zero non-conformances. We hold both ISO 9001:2015 and NDIS Quality and Safety Commission certification.

No other provider has created the policies and procedures, has created the intellectual property to provide Intensive Care at Home nursing, not one in Australia. Because we have pioneered this very successful concept here and everybody else puts on their website they do Intensive Care at Home, but just copying and pasting, they have not gone through third-party accreditation. They have not built the intellectual property. They didn’t have overseas experience with Intensive Care at Home like I have and implementing it here in Australia successfully. So no other home nursing provider in Australia can say this in 2026. When your family member is on a ventilator at home, tracheostomy, home TPN, you name it, this distinction is not a marketing point. It is a life safety point.

So, what families need to know and also demand, if your family member is ventilator dependent or has a tracheostomy and is either at home or trying to get home, here’s what you need to ask every provider, every NDIS support coordinator and every NDIS planner.

• Are your nurses critical care registered nurses, not support workers, not enrolled nurses, not general registered nurses?
• Are you independently accredited by a third-party body, not self-assessed?
• Do you have documented tracheostomy emergency protocols that every nurse on shift knows?
• What is your response plan if the ventilator alarms at 3:00 AM and the nurse is the only person in the home?
• Have your nurses worked in an ICU extensively? Can you verify their clinical competency?
• Do you have a clinical governance structure?
• Do you have a nurse manager, operations manager?
• Do you have a doctor? Do you have nurse educators similar to an ICU?
• What is your clinical governance structure?

Because we have all of that here at Intensive Care at Home. We have clinical governance, we have operations managers, we have state nurse managers, we have clinical educators, we have NDIS support coordinators, we have our own ICU consultant.

If a provider cannot answer all of these questions with documented evidence, find a different provider. Your family member’s life depends on it. Noah Johnston’s story proves that. And as I said, yes, I am biased, but you can check anywhere. You can turn everything upside down. Intensive Care at Home is the only third-party accredited provider in 2026 for Intensive Care at Home nursing.

So how Intensive Care at Home can help your family? Well, we provide specialists 24/7 critical care registered nurses at home for patients who are invasively ventilated with a tracheostomy, non-invasively ventilated such as BiPAP, CPAP, APAP, VPAP which is also known for non-invasive ventilation. We are providing tailor-made solutions for tracheostomy clients without ventilation. We have successfully and we are successfully transitioning from ICU or hospital to home and provide a safe, supported discharge pathway, safe, supported discharge pathway not only for patients and families but also for hospitals.

We’re also providing services for patients who need ventilation weaning at home, cough assist management at home, who receive palliative care at home, requiring specialist nursing. We also, as part of that, comes PEG tube management, PEJ tube management, nasogastric, nasojejunostomy tube management, suprapubic or SPC management, IDC, indwelling catheter management, as well as home TPN, home IV fluids, home IV antibiotics, home IV potassium, home IV magnesium infusions which includes obviously central line, PICC line, Hickman’s line, and port management at home.

We work with a number of funding bodies which includes NDIS, which includes TAC in Victoria, WorkSafe insurers. So again, NDIS, TAC, WorkSafe, DVA, private health insurance, departments of health, hospitals directly related through hospital in the home or through ICU. And like I said, we assist families to navigate the funding and the advocacy pathways because if we didn’t know how to do that, we wouldn’t be here and we wouldn’t exist. And like I said, we also provide level 2 and level 3 NDIS support coordination as well as TAC and WorkSafe case management.

So, and coming back to the Noah Johnston situation, as you would’ve seen that, or if you have followed the case in the media, Kylie Johnston, his mom, has been very vocal about the failings of the NDIS that in the end killed her son by their decision to remove 24/7 registered nurse care. We were also telling the NDIS that by doing so that Noah’s life is at risk. Unfortunately, we have been proven right every single time because we’ve done this before. We flagged to the NDIS over and over again when clients are at risk, especially if there has been a drop in funding from 24-hour nursing care to less than that or to support workers, every single time we have alerted the NDIS that clients would die. Unfortunately, we have been proven right.

People from the NDIS or from the NDIS Quality and Safety Commission, have you still not recognized the pattern? How many more people do need to die before the penny drops? How many more times do I need to lodge an incident either with the NDIA or with the NDIS Quality and Safety Commission to say, “Hey, if you’re not reinstating or if you’re not funding 24-hour nursing care for this particular client,” always backed up by independent evidence. It’s not me saying that. I always have documents to back it up by independent nursing assessment, independent doctor assessments, by occupational therapists, functional capacity assessment, physio assessments, speech assessments, all the evidence they say.

It’s not me saying, this is just me submitting evidence saying, “Hey, have you actually seen the evidence? If you’re not considering the evidence, patients will die every single time.” Unfortunately, patients have died, and like I said, thank God to Kylie who went to the media, who went public so that everybody can know what the NDIS is doing and that people have died because of it. How many more people need to die before the penny drops?

So let’s just now break down further Noah’s situation. Like I said, Noah was 22 years old. He grew up in Port Macquarie on the New South Wales South Coast. He had a hypoxic birth injury which resulted in cerebral palsy, epilepsy, and chronic lung disease. At two years old, he had a tracheostomy. Over time, he became totally ventilator dependent. But here’s what his mother wants the world to know about Noah. He loved children’s movies. He loved having books read to him. He could communicate with an iPad before he lost the use of his hands. He radiated love. His funeral was packed. His family says he was, quote, unquote, “pure innocence.” For the first 19 years of his life, his mom, Kylie, looked after him almost entirely herself. In 2022, the family moved to Sydney so Noah could access both registered nursing care at home with Intensive Care at Home and medical care and hospital care that was no longer available in regional Port Macquarie. And then after years of fighting, the NDIA started dismantling his care.

So let’s look at the timeline of what happened to Noah. In 2022, the family moves to Sydney to access registered nursing care with Intensive Care at Home and hospital services. January 2024, the NDIA downgrades Noah’s care from registered nurses to support workers. Obviously, we immediately flagged it as a massive risk to Noah’s life, so did Kylie, his mom, so did the NDIS support coordinator. Everybody flagged it, but the NDIS was ignoring it, and have a look at what’s happened. In June 2024, the NDIA makes Noah’s plan agency managed, removing self-management. In October/November 2024, the NDIS tribunal hearing was scheduled, NDIA appointed expert backed family’s concerns. December 8th, 2025, Noah dies at home. His tracheostomy becomes loose while no registered nurse was present. On January the 24th, 2026, The Saturday Telegraph runs the story, NDIS Cuts are a Death Sentence.

Now I wanted to explain to you in clinical terms simply exactly what the absence of a registered nurse at that moment was the difference between life and death. A tracheostomy tube sits in a surgically created opening in the neck, bypassing the upper airway and going directly into the trachea. When a patient is ventilator dependent, that tracheostomy is the entire breathing pathway. There is no backup. If that tube becomes loose or displaced, the patient cannot breathe. The window of time to respond to recognize the displacement, to reinsert or secure the tube, to maintain the airway and restart ventilation is measured in minutes, in some cases, or in most cases, less than three minutes. In some cases, we’re talking about seconds, not minutes.

A critical care registered nurse trained in tracheostomy management knows exactly what to do. They practice it. They are credentialed in it. It is a clinical emergency response. A general registered nurse without ICU experience, an enrolled nurse, a disability support worker, no matter how caring they are, no matter how dedicated, is not trained for this. It is not their fault. It is not their scope of practice. But at the end of the day, they are not fit for purpose. They were never supposed to be the person in that room. Again, it comes back to what I said before, it is like flying the airplane with a cabin crew and not the pilot. And I said it in The Saturday Telegraph on the 24th of January this year and I’ll say it again today, it is like flying an airplane with a cabin crew and not with the pilot.

There’s not a lot of margin for error with clients at home on a ventilator or with a tracheostomy. That’s why an intensive care nurse needs to be there 24 hours a day. Again, it is not theory. It is evidence-based. It is practice and it has been practiced since the late 1990s in Germany, and it has been best practice since 2012 here in Australia with Intensive Care at Home. Noah’s mom, Kylie, believes Noah’s death was absolutely entirely preventable, and so do I, it was preventable, so did the independent medical expert appointed by the NDIA’s own tribunal process, Associate Professor Michael Back, who said he had never seen someone with such complex needs at home.

The NDIS has expressed condolences. They say they acted reasonably and in accordance with the NDIS Act. But here’s what I know from 25 years in critical care nursing. The system and the NDIA has failed Noah Johnston, and unless we are loud about it, unless families know what to demand, the system will fail others. And like I say, the NDIS has blood on their hands in this situation.

The clinical reality, what ventilator-dependent patients, adults, and children need at home. I want to step back from Noah’s story for a moment and talk clinical reality because I think there’s a fundamental misunderstanding in the NDIS system and in the broader community about what it actually takes to safely care for a ventilator-dependent patient at home or for a tracheostomy-dependent patient at home. Like I said, I’ve been doing this for over 25 years. I set up Intensive Care at Home in Australia in 2012 because I had hands-on experience from Germany and I had hands-on experience in intensive care, including being a nurse unit manager in intensive care, and I could see the gap. I could see patients in ICU who were stable, who didn’t need to be in ICU, who could be at home with their families, but only if the right clinical infrastructure, and more importantly, the right mindset was in place, and also very important third-party accreditation was in place.

Let me tell you what that clinical infrastructure looks like.

1.  The patient profile. The patients we care for at Intensive Care at Home are amongst the most medically complex people in Australia living outside of ICU. They may have invasive mechanical ventilation with a tracheostomy, meaning the ventilator is the only thing keeping them breathing and alive. Non-invasive ventilation via masks such as BiPAP, CPAP, VPAP, APAP, or full non-invasive dependency, this includes neuromuscular diseases such as MND (Motor Neuron Disease), ALS (Amyotrophic Lateral Sclerosis), muscular dystrophy, Guillain-Barré syndrome, also cerebral palsy, Rett syndrome, spinal injuries, ABIs (Acquired Brain Injuries), strokes, TBIs (Traumatic Brain Injuries), and the list goes on. Also, congenital conditions resulting in lifelong ventilator dependent, like Noah, high-level spinal cord injuries, also spinal muscular atrophy, for example.

2.  What can go wrong and how fast. In ICU, we have entire teams to respond to emergencies at the drop of a hat. At home, there’s one nurse, one critical care nurse. That critical care nurse must be able to recognize and respond to a tracheostomy tube displacement within seconds, manage a ventilator alarm and identify whether it is a circuit issue, a patient issue, or an equipment failure issue, perform emergency airway management, recognize early clinical deterioration, changes in breathing pattern, oxygen saturation, skin color, levels of consciousness, make a clinical decision about whether to call an ambulance, manage at home, or escalate to the treating team. These are not general registered nursing skills. These are not enrolled nursing skills. These are definitely not disability support worker skills. These are ICU nursing skills, critical care registered nursing skills.

That is what every single nurse at an Intensive Care at Home has. That’s why every single nurse at Intensive Care at Home has ICU experience, significant ICU experience. Like I said, all of our nurses have a minimum of two years critical care nursing experience. 50 to 75% of them, probably closer to 75% of our nurses have a postgraduate critical care qualification in critical care nursing and intensive care, similar to an ICU unit. That means we are able to employ hundreds of years of critical care nursing experience combined in the community. No other provider brings a higher skill level in the community than Intensive Care at Home, making sure your loved one is safe at home 24/7.

Let’s also dive a little bit deeper into the support worker risk. I want to be absolutely clear. I have nothing against support workers personally. They play a vital role in disability support, but there’s a category of patient, the ventilator-dependent patient with a tracheostomy that otherwise would be in ICU where a support worker is not an appropriate caregiver. It is not a matter of funding. It is a matter of clinical safety and it’s a matter of life or death.

Let me repeat that. The ventilator-dependent patient with or without a tracheostomy where support worker is not an appropriate caregiver, it is not a matter of funding. It is a matter of clinical safety. It is a matter of life and death. When the NDIA replaces a registered nurse with a support worker for a patient like Noah Johnston, they are not making a cost saving. They’re creating a life-threatening risk. They’ve created a death, and in Noah’s case, that risk became a reality. Where’s Jennifer McAllister? Where’s the NDIS CEO? Why have they not spoken out here? What are they doing to prevent other Noah Johnstons’ cases?

So let’s come back to safety again. Let’s look at evidence-based guidelines once again, what safe home ventilation looks like. At intensivecareathome.com, every clinical decision we make is grounded in third-party evidence and it’s grounded in third-party accreditation. We have developed comprehensive Mechanical Home Ventilation Guidelines which you can access on our website at www.intensivecareathome.com.

I want to walk you through the key elements today. These guidelines didn’t come from nowhere. They are built on decades of international research on home mechanical ventilation and on Intensive Care at Home. Like I said, I was part of setting up Intensive Care at Home successfully in Germany with the first company that was doing it there, and I was bringing the concept to Australia in 2012, after having worked in intensive care here in Australia too, where I could see that patients were kept in ICU unnecessarily, that could go home with Intensive Care at Home, and we’ve made that a reality. And we have learned many lessons from caring for the most complex patients in Australia in the community, and the guideline that comes out of this is number one, 24/7 critical care registered nurse presence.

1.  The evidence-based Mechanical Home Ventilation Guidelines have revealed that every ventilator-dependent patient with a tracheostomy or even a tracheostomy patient without ventilation, adults and children, require receiving care from intensive care nurses at home 24 hours a day with a third-party accredited service which is Intensive Care at Home. Not rostered on call, they need to be present in the home, awake, and clinically vigilant, not sleepovers, not in active shifts. Similar to an intensive care unit, every nurse needs to be awake 24 hours a day to keep caring for our clients, right? That’s why we provide a genuine alternative to a long-term stay in intensive care because we’re bringing the intensive care unit into the home.

2.  Alarm management protocols. Every ventilator has an alarm system. Those alarms mean something clinically. Our nurses are trained to interpret every alarm, respond immediately, identify the cause, and document the response. There’s no such thing as a ventilator alarm that can wait, which is, again, brings me back to Noah Johnston. His ventilator alarm couldn’t wait, and that’s why he died.

3.  Tracheostomy emergency protocols. This is the one that also directly relates to Noah Johnston. The evidence-based mechanical ventilation guidelines include detailed step-by-step tracheostomy emergency protocols that every critical care registered nurse must know before they ever go on a shift with a tracheostomy patient, tube displacement, tube blockage, cuff failure, emergency reinsertion. These are not scenarios nurses read about once, they practice them. Another very important concern here is we’re teaching our nurses to prevent emergencies in the first place. We don’t want to manage emergencies, we want to prevent them. As you would’ve heard in other realms of life, prevention is always better than cure. We always have to think about today what we need to do today to keep our clients at home tomorrow and prevent emergencies.

4.  Competency-based credentialing. Every nurse at Intensive Care at Home must demonstrate clinical competency before working independently with a ventilated adult or child. This is not a paper exercise. It is a supervised clinical assessment. We verify that every nurse can do what they need to do, not just that they say they can.

5.  Clinical handover. Every shift change at intensivecareathome.com is a formal clinical handover, the same standard use in an ICU. The incoming nurse receives a full clinical summary of the patient condition over the preceding shift, ventilator settings, oxygen requirements, secretion management, any concerns, any changes. Nothing is left to verbal memory. And once again, the evidence-based Mechanical Home Ventilation Guidelines are publicly available on our website at intensivecareathome.com.

6.  Third-party accreditation for Intensive Care at Home. We created a whole new industry with Intensive Care at Home in Australia, and that can’t happen without third-party accreditation. As a matter of fact, it must happen only with third-party accreditation making sure that a service structure like Intensive Care at Home is clinically sound, it has the clinical governance, it has the staff, it has the infrastructure, it has the intellectual property, it has the third-party tick, so to speak. And once again, because it is very difficult what we do, you must be third-party accredited. Once again, we are the only third-party accredited Intensive Care at Home nursing service in Australia in 2026.

So, now I want to spend some time on questions and answers.

Please type them in the chat pad if you haven’t done so already. I’ll just moisten my throat and then we’ll go into questions and answers and even if you’re watching this on replay and you have questions, type them below the video so that I can make a video about them so that all your questions are being answered.

So here’s a question from a viewer who says, “Is your family member currently in ICU and trying to get home?” Tell me in the chat. Are you currently dealing with an NDIS planner who doesn’t understand why your family member needs a registered nurse? Let me know. Has anyone watching this right now been told by the NDIA that a support worker is adequate for the ventilator-dependent family member?

I’ve got a question here from a viewer who says, “The NDIS has told me that my ventilator-dependent child will only be funded for support worker, ventilator-dependent child with tracheostomy as well is telling me that they can only have support workers. So what should I do?”

Well, that’s a great question. What you need to do here is:

1. Get your NDIS support coordinator if you have one to challenge the decision. The problem here is that most NDIS support coordinators do not know how to do that, right? Unfortunately, my experience is that not many NDIS support coordinators know what to do when it comes to ventilation and tracheostomy. They come with all good intentions, but their mindset often is, oh, the NDIS won’t fund nurses, because they don’t have experience with it and they don’t know what to do.

Well, we do know what to do because otherwise we wouldn’t be here, we wouldn’t be in business, and this is also why we’re providing level 2 and level 3 NDIS support coordination because our NDIS support coordinators are experts in their own rights.

So here’s what you need to do.

1. You need to challenge the decision or your NDIS support coordinator needs to challenge the decision. If you don’t have an NDIS support coordinator, please reach out to us. We can help you with one and we can help you turn the funding situation around.

So, what needs to happen?

1. You need an independent nursing assessment, which we can help you with. You need an independent medical assessment doctor’s letter, you need an independent physio assessment, speech therapy, and then finally you need an independent OT functional capacity assessment. And that then needs to go either with an S48 or with an S100.

So, another question that I, and I hope that makes sense. The other thing that you need in a situation like that is:

2. You need a complex NDIS planner. It can’t just be a standard planner. A complex NDIS planner will also help a situation like that.

Another question that another viewer sent is, “My loved one is still in ICU, and again the NDIS is telling us we can’t get nursing funding.” Again, same situation that I explained now. Get an NDIS support coordinator. Please contact us if you’re not having a lot of, if an NDIS support coordinator cannot tell you how to get funding, you got to swap them out. You got to swap them out. You got to come to us because they don’t know what they’re doing. They’re getting paid the same for an easier NDIS participant than they are getting paid for one of the more complex NDIS participants which is inevitably what we are dealing with here, right? So please talk to us about NDIS support coordination if you can’t get the funding one way or another.

Now we’ll do another Q&A at the end. In the meantime, let’s talk about accreditation once again, not because I want to sell you something, but because in the context of Noah Johnston’s death it is the most important quality marker a family can look for.

Once again, Intensive Care at Home is Australia’s only third-party accredited specialist Intensive Care at Home nursing service for ventilated patients and tracheostomy-dependent patients in 2026.

Let me explain what that means and why it matters.

Our last audit was actually in December 2025, the same month Noah Johnston died. Our organization was audited by BSI Group, one of the world’s leading independent certification bodies. They came into our organization, they reviewed our clinical governance framework, our policies and procedures, our staff competencies, our patient outcomes data, our emergency protocols, our documentation practices, our clinical governance, and also the intellectual property that we’ve built. The result, zero non-conformances, we passed with the clean slate. We passed two certifications, one is ISO 9001:2015, and also NDIS Quality and Safety Commission certification. Our NDS provider number is 4050000298. Again, you can read about our full accreditation and quality framework at intensivecareathome.com/accreditationquality.

So what does that mean for your family? When you engage Intensive Care at Home, you are not taking our word for it that we are safe and clinically excellent. You have independent third-party verified proof. No other home nursing provider in Australia can say this in 2026 for Intensive Care at Home nursing and for ventilator-dependent adults and children with or without a tracheostomy.

I also want to make a quick comparison to Germany. I trained in Germany as a critical care nurse and before coming to Australia. Germany has had a sophisticated, well-funded home mechanical ventilation system for decades. In Germany, the clinical model is clear, ventilator-dependent patients at home receive care from registered nurses with specialist qualifications, full stop. The outcomes are excellent. Patients live at home with their families. They are safe, and funding by this save 50% of the cost. ICUs have freed up beds they can use for other patients that are in need of acute critical care.

Australia is still behind, even though we’ve been operating now since 2012 very safely here in Australia. But the reason it’s behind because funding decisions like Noah Johnston’s should not be made. People should not be dying that have died that I haven’t talked about publicly as yet with names. Right now in 2026, what Intensive Care at Home is doing is proving that the model works here in Australia as well if the funding system supports it. Most of the time the funding system does support it because it’s too compelling cutting the cost of an ICU bed by 50% and ignoring that. And that is the advocacy battle I’ve been fighting for years, as a matter of fact since 2012, because the NDIA funding system in cases like Noah Johnston is actively undermining clinical safety, and that has to change before more people die and the NDIS is being responsible and held to account.

So let’s look at what families must demand right now. I want to give you practical action of the steps whether your family member is in ICU right now, whether they are already at home with inadequate care, or whether you are in the middle of an NDIS battle or any other funding agency battle. Here’s what you need to do right now.

1.  Demand an independent nursing assessment, not a funding assessment. The NDIA’s roles is funding. Clinical safety is determined by a clinician. If your family member’s care needs are being assessed by a non-clinical NDIS planner or support coordinator who has no nursing or medical background, you need to stop with them. You have the right to challenge that assessment, request that a registered nurse or medical specialist is part of the process.

2.  Understand what registered nurse means versus what a support worker means, what a general registered nurse means, what an enrolled nurse means. A registered nurse holds a university degree and is regulated by AHPRA (Australian Health Practitioner Regulation Agency). A critical care registered nurse has additional specialist ICU training. A support worker has a Certificate III or IV in disability or individual support. These are completely different scopes of practice for a ventilator-dependent patient. Only a critical care registered nurse is appropriate for overnight and unsupervised care the same during the daytime.

3.  Get the medical records, document everything, every clinical assessment, every NDIS plan, every communication with the NDIA, every medical or clinical report, any communication with an NDIS support coordinator, any communication with an NDIS planner. If your family member’s care is reduced, request written reasons. If those reasons are not clinically justified, challenge them. You have the right to appeal NDIA decisions through the Administrative Review Tribunal if needed.

4.  Contact Intensive Care at Home if your family member needs 24/7 specialist home nursing and you don’t know where to start. Call us now. We’re open 24 hours a day, seven days a week. We have helped families across Australia navigate from ICU to home, from inadequate care to proper care, from NDIS battles to funded solutions. We know the system, we know what is possible, and we will fight for your family.

Also, I want to remind you, even though you may not believe me yet, you as a family hold all the power. If you don’t give up, if you won’t take no for an answer, you get exactly what you want because the NDIS knows that you could go to the media, the NDS know that you could make a lot of noise, and they don’t want that. They give in if you don’t give in, but it is important that you don’t give in, that you never give up.

So, before I finish today, I want to come back to Noah Johnston.

His mother, Kylie, said something in The Saturday Telegraph that I can’t get out of my mind. She said:

“To me, Noah is the most valuable, important person that’s ever been on this planet, and I’ll miss him every step of every day for the rest of my life.”

I’m sure that everybody who has children feels the same way.

Kylie Johnston fought for over two years for her son. She moved her family from Port Macquarie to Sydney. She self-represented at the NDIS Administrative Review Tribunal for almost two years. She did everything right, and the system still failed Noah. I’m not going to stop talking about Noah because the next Noah Johnston is somewhere in Australia right now on a ventilator with a tracheostomy with a support worker or with a general registered nurse or with an enrolled nurse where there should be a critical care registered nurse, and their family may not know they can fight for better.

So here’s my message for you, whoever’s watching. If your family’s medical dependent at home right now or with a tracheostomy, call us today at intensivecareathome.com. If you don’t have the right level of nursing care, we will help you fight for it. If you’re in ICU trying to get home, we have done this hundreds of times. We know the way. We know what to do. If you need advocacy and someone to stand beside you when the NDIA pushes back, that is exactly what we do.

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Thank you for being here today.

I’ll see you in the next live and on my other recorded quick tip videos or blog videos during the week.

Take care of yourselves, happy Easter, and take care of the people you love.

Thank you so much.

With all of that said, with Intensive Care at Home, we are currently sending our critical care nurses into the home 24 hours a day. Therefore, we are providing a genuine alternative to long-term stay in intensive care for:

• Ventilation
• Tracheostomy
• Home BiPAP (Bilevel Positive Airway Pressure) and CPAP (Continuous Positive Airway Pressure)
• Tracheostomy care without ventilation
• Home TPN (Total Parenteral Nutrition)
• Home IV potassium
• Home IV magnesium
• Home IV antibiotics
• Home IV fluids

We’re providing:

• Cough assist management at home
• Ventilation weaning management at home
• central line, PICC (Peripherally Inserted Central Catheter) line, Hickman’s line as well as port management at home
• nasogastric tube, nasojejunostomy tube, PEG (Percutaneous Endoscopic Gastrostomy), PEJ (Percutaneous Endoscopic Jejunostomy) tube management at home
• IDC (Indwelling Catheter) and SPC (Suprapubic Catheter) management at home
• Palliative care services at home

We’re also sending our critical care nurses into the home for emergency department bypass services. We have done so successfully as part of the Western Sydney Local Health District’s In Touch program, saving approximately $2,000 per patient that we keep at home instead of them going into an emergency department.

That also means we’re in a position to cut the cost of an ICU bed by around 50%. An intensive care bed costs between $5,000 to $10,000 per bed day depending on location. Intensive Care at Home costs approximately 50% of that, and we’re freeing up the most sought-after bed in the hospital, which is the ICU bed. Most importantly, we’re improving the quality of life for patients and their families, which is a win-win situation for all stakeholders.

Our Coverage and Accreditation

With Intensive Care at Home, we’re currently operating all around Australia, in all major capital cities, as well as in all regional and rural areas. We are an NDIS approved service provider all around Australia, TAC (Transport Accident Commission) and WorkSafe in Victoria as well as the Department of Veterans Affairs all around Australia.

We’re also ISO 9001:2015 accredited. Our clients and we as a service provider have also received funding through public hospitals, private health funds as well as departments of health.

We are the only service provider in Australia that has achieved third-party accreditation for Intensive Care at Home nursing in 2025. We have been achieving this high level of accreditation since 2012. No other provider in Australia has achieved the Intensive Care at Home level of accreditation in the community and has created more intellectual property when it comes to Intensive Care at Home nursing than we have.

This puts us in a position to employ hundreds of years of critical care nursing experience combined in the community. No other service provider in 2025 employs a higher skill level in the community than we do. And that enables us to look after the highest acuity adults and children in the community in Australia safely.

If You Need Help

If you’re at home already and you’re watching this or you’re stuck in an ICU and you realize that you don’t have the right level of support, I can give you many examples where we helped clients with funding, how we advocate for funding. We had to advocate successfully for funding from our first case study to many other case studies where we had to advocate successfully for funding with the right evidence of course because it is crystal clear that disability support workers for example or registered nurses without ICU experience cannot look after ventilated clients at home whether adults or children with or without a tracheostomy and it’s simply dangerous and negligent.

There are plenty of examples where clients with support worker models or even RN (registered nurse) models without ICU experience have died at home and I have evidence to back up everything that I’m saying here because it’s a bit like flying the airplane with a cabin crew instead of the pilot and it could simply be deadly.

This can be avoided by having simply 24-hour critical care nurses at home because our clients are at high risk of medical emergencies or worse without critical care nurses 24 hours. This is actually also evidence-based in the community and is documented in our evidence-based Mechanical Home Ventilation Guidelines on our website at intensivecareathome.com.

Think about it: in an intensive care unit in a hospital, you wouldn’t have support workers or general registered nurses looking after a critical care patient on a ventilator with a tracheostomy. So why would anyone in their right mind do that in a home care environment where there are fewer resources?

Clients that have found us have been at home long-term predictably and permanently with critical care nurses. Their alternative would have been to either die or stay in ICU long-term, and our clients don’t go back to ICU. They stay at home permanently and predictably and the insurance bodies save half of the cost of an ICU. But it’s a win-win situation all around.

We can do the same for you if you’re stuck in ICU or if you’re not safe at home, which includes the advocacy for funding and the network that goes along with it. We have always successfully advocated for our clients or we have the network to successfully advocate for you and for your family member, otherwise we wouldn’t be in business. The same again is applicable for those stuck in an ICU which is similar to many of our, if not most of our cases.

Our Support Coordination Services

This is also why we are providing Level 2 and Level 3 NDIS support coordination. We have a team of experienced NDIS support coordinators, and they have a wealth of knowledge. We’re also providing TAC case management and WorkSafe case management in Victoria with Lucy McCotter.

If you’re an NDIS support coordinator or a case manager or a social worker from another organization or a hospital watching this and you’re looking for nursing care for your participants, please reach out to us as well. If you’re looking for funding for nursing care for your participants and you don’t know how to go about it and how to advocate for it, what evidence to provide, I encourage you to reach out to us as well. We have the network to make that happen. We will help you with the right level of funding and with the right level of advocacy.

We’re also providing NDIS specialist nursing assessments done by critical care nurses with a legal nurse consulting background.

Join Our Team

If you are a critical care nurse and you’re looking for a career change and you want to join a very progressive, dynamic, successful, and high-performing team of critical care nurses in the community, we are employing hundreds of years of critical care nursing experience combined.

If you’re looking for a career change, we’re currently hiring for jobs for critical care nurses in Melbourne, Sydney, Brisbane, Albury-Wodonga, Bendigo, Geelong, Warragul, and also in Wyelangta in Victoria.

If you have worked in critical care nursing for a minimum of two years, adult ICU, pediatric ICU, ED and you have already completed a postgraduate critical care nursing qualification, we will be absolutely delighted hearing from you.

I have a disclaimer though: Because we are offering tailor-made solutions for our clients which includes regular staff, our clients do also want the same staff coming over and over again because they are so vulnerable and so special. That’s why we need regular, reliable staff.

If you’re looking for agency work where you can come and go, this will not be the right fit for you. We’re looking for consistency and our clients are looking for consistency. So please only apply with us if you can give us regular and consistent availabilities for shifts and you’re really keen on building relationships with us and with our clients. Reliability is also a must.

 

For Medical Professionals and Healthcare Executives

If you’re an intensive care specialist or an ED specialist, we also want to hear from you. We’re currently expanding our medical team as well.

We can also help you eliminate your bed blocks in your ICU and in your ED for your long-term patients or for your regularly readmitting patients with our critical care nursing team at home. We’re here to help to take the pressure off your ICU and ED beds. In most cases, you won’t even pay for it. Even if you do pay for it, it is so much more cost-effective than what you’re paying for in ICU and ED settings, and you get the same level of care and simply more patient and family satisfaction because you also want to partner with your consumers.

If you are a hospital executive watching this, we can help you free up your ICU and ED beds.

International Support

If you’re in the U.S. or in the UK and you’re watching this and you need help, we want to hear from you as well. We can help you there privately with one-on-one consulting and with hiring nurses privately.

Once again, our website is intensivecareathome.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected].

If you like my videos, click the like button, subscribe to my YouTube channel for regular updates for families with Intensive Care at Home and intensive care. Click the like button, click the notification bell, and share this video with anyone who has a family member in intensive care long-term or needs to see this.

Thank you so much for watching.

This is Patrik Hutzel from intensivecareathome.com and I’ll talk to you in a few days.

Take care for now.