Valuing Care Uplift Service – BLMK Integrated Care Board

Bedfordshire, Luton and Milton Keynes Integrated Care Board

Section 117 – Residential and Supported Living
September 2024 – April 2025

Context

Bedfordshire, Luton and Milton Keynes Integrated Care Board (BLMK ICB) is responsible for commissioning a complex and diverse Section 117 caseload across residential and supported living services. Over time, individual placements had been agreed at different points and under varying market conditions, resulting in significant variation in pricing for comparable levels of need.

Alongside increasing financial pressure, the ICB recognised the importance of maintaining sustainable Section 117 provision, where uplifts needed to reflect genuine cost pressures while remaining affordable across a shared NHS and local authority funding landscape. The challenge was to move away from precedent-based inflation and towards a transparent, evidence-led approach that supported long-term market stability.

The Challenge

  • Significant price variation across Section 117 placements
  • Limited consistent evidence of provider cost structures
  • Pressure to apply inflation across a large, mixed caseload
  • Requirement for strong governance and auditability
  • Need to pilot a new approach without destabilising the market

Valuing Care’s Approach

BLMK ICB engaged Valuing Care to deliver its Uplift Service powered by Purchaser, combining specialist costing software with hands-on delivery support tailored to Section 117 commissioning.

The service was designed to help the ICB to:

  • Develop a robust understanding of the true cost of care across residential and supported living placements
  • Apply uplifts consistently and transparently, grounded in evidence
  • Avoid blanket inflation where costs could not be demonstrated
  • Release and redirect capacity to support areas of genuine sustainability pressure
  • Establish a repeatable model suitable for future Section 117 uplift cycles

Key elements of the approach included:

  • Deployment of Purchaser costing software for Residential and Supported Living Section 117 services
  • Structured collection and validation of provider costing templates
  • Benchmarking of individual placements against locally informed cost models
  • Use of aggregated outputs to support ICB-level governance and assurance
  • Ongoing provider engagement and query management throughout the process

Implementation and Delivery

The uplift programme commenced in September 2024 with a pilot review of approximately 100 Section 117 placements, allowing the ICB to test the approach, refine processes and build confidence before wider rollout.

Following the successful pilot, the remainder of the Section 117 caseload was incorporated in December 2024. Cost modelling and inflation analysis for the pilot cohort were completed in January 2025, with the full caseload completed by April 2025.

This phased delivery enabled the ICB to manage risk, maintain provider confidence and embed robust governance throughout the uplift cycle.

Outcomes and Impact

Improved Market Intelligence

Across the full review, 469 Section 117 placements were assessed across residential and supported living services. Each placement was benchmarked against Valuing Care’s cost models, providing BLMK ICB with a consistent, evidence-based view of how prices compared to a fair cost of care.

This enabled the ICB to:

  • Clearly identify placements priced significantly above modelled costs
  • Distinguish genuine cost pressures from historic price anomalies
  • Apply uplift decisions in a way that was linked to cost evidence rather than precedent

Redirecting Capacity to Support Sustainability

By moving away from a traditional blanket inflation approach, the ICB was able to release significant capacity within the overall uplift envelope.

Across both residential and supported living services, this equated to over £1.3m per annum of capacity when compared to a traditional inflationary approach. Rather than being treated as a simple saving, this capacity enabled the ICB to:

  • Target uplift support towards placements operating below fair cost
  • Reduce the risk of over-investment in already high-cost provision
  • Support the long-term sustainability of the Section 117 market
  • Strengthen financial resilience without destabilising providers

This ensured that available resources were used strategically and proportionately, supporting both affordability and market stability.

Wider Commissioning Benefits

In addition to the immediate uplift outcomes, the project delivered wider benefits for BLMK ICB, including:

  • A transparent and defensible methodology for Section 117 uplifts
  • Stronger auditability across NHS and local authority funding partners
  • Reduced reliance on manual analysis and historic precedent
  • Improved confidence in future uplift and negotiation processes
  • A scalable approach suitable for repeat annual use

Sustainability and Future Use

The 2025/26 uplift programme has established a repeatable, evidence-based framework for managing Section 117 inflation across BLMK. By embedding Valuing Care’s Uplift Service and Purchaser software, the ICB has strengthened its ability to balance financial control with market sustainability, ensuring that future uplifts are fair, targeted and grounded in the actual cost of care.