Delivering Safe and Sustainable Transitions from Agency to Direct Payments
A supported transition service for PHB and CHC teams to stabilise complex care, reduce agency reliance, and improve delivery confidence without increasing internal workload.
Why This Matters Now?
As Personal Health Budgets expand under national expectations, the key challenge is not the policy itself, it is delivering them safely, consistently, and without adding pressure to PHB and CHC teams.
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Transitions away from agency care rely on clear planning, realistic workforce arrangements, and agreed oversight. Without these in place, Direct Payment delivery becomes fragile.
The Problems PHB Teams Face
When agency care is under strain, PHB and CHC teams are often managing change alongside day-to-day delivery pressures. In these conditions, a small number of recurring issues tend to affect how safely and consistently Direct Payments can be supported.
Capacity
Limited dedicated PHB capacity
Clinical staff covering non-clinical activity
Insufficient time to build strong, personalised care plans
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Clarity
Lengthy or complex approval processes
Variation in practice within the same system
Uncertainty around roles, responsibilities, and escalation routes
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Capability
Variable understanding of PHBs across teams
Gaps in employer support and financial oversight
Ongoing challenges around PA recruitment, training, and retention
What This Service Delivers
This service provides structured, time-limited support to help PHB and CHC teams manage transitions from agency care to Direct Payments safely and consistently.
The focus is on stabilising delivery, reducing risk, and strengthening system readiness — not accelerating change for its own sake.
Support includes:
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Identifying suitable packages for transition
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Producing a clear, deliverable care and support plan
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Aligning indicative budgets with local PHB processes
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Employer setup and workforce planning
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Recruitment support and competency-based training
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Handover documentation to support ongoing governance
What Changes When Delivery Is Properly Supported
When transitions are planned and supported in a structured way, the impact is felt across the system.
Care arrangements become more stable. Workforce expectations are clearer. Oversight improves as delivery moves away from reactive agency cover and into arrangements that can be managed within existing PHB processes.
For PHB and CHC teams, this means fewer escalations, clearer lines of responsibility, and care packages that are more predictable to manage over time.
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How The Transition Is Supported
Each transition follows a clear, staged approach designed to protect care continuity, manage risk, and support families and PHB teams at every step.
Planning and Readiness
A suitable case is identified, expectations are agreed, and system readiness is confirmed.
​OUTCOME
A clear care and support plan with agreed delivery assumptions and PHB team sign-off.
Workforce and Employer Setup
Employer responsibilities are put in place, with support for recruitment, training, and clinical delegation where required.
​OUTCOME
A prepared workforce and employer arrangement that supports safe delivery.
Stabilisation and Handover
Delivery is reviewed, risks are addressed, and responsibility is handed back to the PHB team with clear oversight arrangements.
​OUTCOME
A stable Direct Payment arrangement with reduced reliance on agency care.
Cost and Value
This is a scoped, time-limited service focused on stabilising delivery and reducing avoidable risk.
Value is created by supporting safe transitions that reduce escalation, clarify workforce arrangements, and enable PHB teams to manage packages within existing processes once established.
Costs are agreed upfront based on the scope of the transition and the level of support required. This avoids open-ended involvement and provides clarity for commissioning and governance.
Who Is This Service For?
This service is intended for PHB and Continuing Healthcare teams who:
Are managing fragile or high-risk agency packages
Need to reduce reliance on agency provision
Want to strengthen planning and workforce readiness before transition
Require additional capacity to support complex delivery changes
This is not intended as a default route for all PHB packages.
Who Are We?
Thrive Care Solutions was created by people who have worked on both sides of PHB delivery.
We understand the operational reality of commissioning complex care, alongside the practical challenges of delivering Personal Health Budgets in real settings.
Our work combines real-world experience of managing complex Personal Health Budgets for children and young people with clinical expertise in community and children’s continuing care. This focus informs our approach to care planning, workforce readiness, and Direct Payment delivery for complex paediatric packages.
Get In Touch
Use the form below to outline the issue you are working through. We’ll respond with clear guidance on whether and how this service could help.