Positive Behaviour Support in Transforming Care: What Commissioners Expect in 2026–2029

December 10, 2025

Positive Behaviour Support (PBS) has moved from “best practice” to “core requirement” across Transforming Care services. But commissioners increasingly differentiate between providers who have PBS and those who live PBS.

For providers writing LD, autism and complex needs tenders, PBS quality is often a direct predictor of scoring success. It also underpins safe step-down transitions and long-term stability.

1. Functional assessment that starts before transition

Commissioners expect PBS specialists to complete:

Structured functional assessments in the inpatient or residential setting.
Observations across different environments and routines.
Analysis of patterns, triggers and historical restrictive practices.

This ensures the transition plan is grounded in real behavioural understanding — not assumptions.

2. A PBS plan that staff genuinely understand

The biggest differentiator between good and outstanding providers is how well frontline staff understand and use PBS strategies. Strong models include:

Team-wide PBS inductions before the person moves in.
Daily coaching during the first 4–6 weeks.
Shadowing, modelling and reflective practice sessions.

3. Data-led support, not reactive support

Commissioners increasingly request evidence of:

Daily recording of early-warning indicators.
Weekly analysis of incident patterns.
Data informing staffing levels, routines and environmental changes.

This moves PBS from a static plan to a living, responsive support model.

4. Early reduction of restrictive practices

Transforming Care is grounded in reducing restrictions. Providers must show:

A clear plan to reduce physical interventions and PRN reliance.
Alternative strategies mapped to functional assessment findings.
Regular MDT review of progress, challenges and next steps.

5. A PBS culture, not a PBS specialist

Commissioners often say: “We’re not buying a behaviour specialist — we’re buying a behaviour culture.” That means:

PBS embedded in everyday routines, language and decision-making.
Staff using proactive strategies consistently across shifts.
Managers modelling calm, confident practice.

6. PBS aligned to long-term progression

Great PBS practice accelerates independence. Commissioners expect to see:

Clear progression pathways: reducing 2:1, growing skills, increasing community access.
Risk enablement, not risk avoidance.
Alignment with Preparing for Adulthood outcomes where relevant.

In Transforming Care tenders, PBS quality can be the difference between a winning bid and a mid-table score. The providers who embed PBS culturally — not just clinically — stand out every time.

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