Nurse Next Door was built in Canada as a senior care franchise, with an operations manual, a funding model and a brand message all shaped by the Canadian market. When Amber Biesse and her husband Matt Fitton brought it to Australia in 2019, almost none of that translated directly.
The idea came from an unlikely place. In 2016, the couple sold their house and cars and moved to Vancouver so their daughter, who has an intellectual disability, could attend a specialist school. While they were there, they started asking themselves what they wanted to do next. They settled on three criteria: a sector with long term demand, a real sense of purpose, and a model that could scale. The answer drove past them, literally, when one of Nurse Next Door’s bright pink cars went by in their neighbourhood. The Canadian home care franchise happened to be looking to expand into Australia.
Proving it herself first
Biesse and Fitton didn’t launch straight into franchising. On 1 January 2019, they opened a single, corporately owned Nurse Next Door location in Melbourne and ran it themselves for a year before inviting anyone else to invest.
“The first and biggest lesson was that you can’t franchise a theory,” Biesse says. “We had the Canadian operations manual, but it was a framework built for Canada. Before we asked anyone to invest their money in Nurse Next Door, we needed to prove the model worked in Australia.”
Home care, she says, meant the business had to cope with constant, high stakes change. “We’re caring for some of the most vulnerable people in our community,” Biesse says. “A Caregiver can suddenly become unavailable, a client’s needs can change overnight and a hospital discharge can create an immediate need for care. That changes the responsibility you feel for every system, process and decision.”
“Being on the field with the team shows you things you’ll never see from the sidelines,” she says. “Working in the business every day, across recruitment, scheduling, client intakes, referral networks, clinical governance and the economics of delivering an hour of care, showed us where the pressure points were and where the model could be better. We kept testing, learning, rewriting and improving.”
By the time they signed their first franchise partner in early 2020, as the business grew through COVID, they weren’t guessing at what partners would face. “We grew Nurse Next Door Melbourne from zero to $7 million in annual turnover in under two years, which proved the systems and processes we had built for the Australian model could scale,” Biesse says. “When our first Franchise Partners joined, we weren’t designing support around what we imagined they might experience. We knew what they would face because we had lived it ourselves. Operating it ourselves gave us the knowledge and credibility to support others.”
Rebuilding the brand for Australia
The operational side of the business needed an overhaul for the Australian market. The brand itself didn’t.
“We were prepared to ‘Australianise’ almost every element of how the business operated, but we knew the brand’s heart and soul would transcend borders,” Biesse says. “The purpose, Making Lives Better, the four core values and the bold pink brand all stayed exactly as they were. Our job was to preserve what made the brand special.”
In North America, Nurse Next Door had built its messaging around senior care, with “Happier Aging” as its central line. That didn’t fit the Australian market, where the NDIS meant disability support would become a major part of the business. Today, close to half of Nurse Next Door Australia’s clients are NDIS participants.
“In Australia, I made a deliberate decision to put Making Lives Better at the centre of everything,” Biesse says. “I knew supporting people living with disability through the NDIS would form a substantial part of our business, and our brand needed to speak just as meaningfully to them as it did to older Australians. Making Lives Better isn’t defined by someone’s age, diagnosis or funding stream, so it gave us a much broader platform in Australia while staying completely true to the brand.”
“We didn’t need to change the heart of Nurse Next Door to make it relevant here,” she says. “For it to succeed, it couldn’t be a transplanted Canadian story. It had to become our Australian story.”
Compliance from day one
Biesse says the regulatory side of the business took the longest to get right, and the gap between Canada and Australia was bigger than expected.
“From the outset, we knew we couldn’t assume a model proven in Canada and the USA would work here,” she says. “During our 12 months of due diligence, we recognised that Australia had different government funding systems, different legislation and regulation, and different employment conditions. That meant rebuilding the operating model to reflect how care is funded and regulated in Australia, and how we employ and pay our people.”
“What we learned as we grew is that home care doesn’t sit within one neatly defined regulatory environment,” Biesse says. “It sits at the intersection of healthcare, aged care, disability support, employment regulation and franchising, and each new funding stream we moved into added another layer of complexity. A good example is our decision to operate as both an NDIS registered provider and a registered aged care provider. That allows us to support clients across both systems, but maintaining those registrations requires ongoing investment in governance, clinical oversight, policies and procedures, quality systems, auditing and reporting.”
“Our approach has been to invest ahead of growth,” she says. “Rather than expecting individual Franchise Partners to navigate that complexity alone, we’ve built specialist expertise, systems and support at HeartQuarters, including in clinical governance, quality and compliance, and employee relations. That investment isn’t always visible from the outside, but it’s fundamental to building a home care business responsibly. Compliance isn’t something that sits beside the business; it is part of the business.”
Hiring for the right reasons
Half of Nurse Next Door’s franchise partners are registered nurses, and the other half have personal, lived experience of caring for a loved one. Biesse says she screens out applicants who lead with the financial opportunity rather than the purpose behind the work.
Nurse Next Door now employs more than 4,000 caregivers and nurses and supports close to 4,000 clients across the country. It’s also the major sponsor of the 2026 Kismet Awards for Health & Disability Services, a national program recognising businesses across Australia’s health, disability and care sectors, with winners announced at a gala in Sydney on 26 November.
With the Support at Home aged care reforms and further NDIS changes working their way through the sector, Biesse has lived through this kind of regulatory shift before, which is part of why her experience is worth tracking as those changes land.
See how they approach care across Australia at nursenextdoor.com.au.