Upstream care - the future of NHS success and how industry can play its part

It should be no surprise to anyone reading this newsletter that the NHS is facing some of the most challenging times in its history. Workloads are soaring, resources are stretched wafer-thin, and there’s a real need for innovation.

The latest NHS Providers report - Providers Deliver: Shifting Care Upstream - highlights a clear way forward, shifting away from traditional hospital centred models and focusing instead on proactive, community-based care.

Read my blog – Industry on high alert as hospital pressure making general practice unsustainable – here

This shift - often called the left shift - isn’t new, but it’s never been more urgent. And for pharma, med tech and device companies, it presents a huge opportunity to step in and help the NHS deliver better care while easing the pressure on the system.

So, what does upstream care look like and where can you make a difference?

What is upstream care? And why now?

Upstream care is about prevention and early intervention. It’s about tackling health issues before they become serious enough to require hospital treatment. The goals are clear:

• Identify problems early before they escalate.
• Address the wider social determinants of health like poor housing, unemployment, education gaps and social isolation.
• Reduce unnecessary appointments, referrals and non-elective hospital admissions.

Without this shift, we’re stuck in a cycle where health issues spiral out of control, clogging up hospitals and General Practice, stretching staff to breaking point and leaving patients with suboptimal outcomes. This isn’t just a healthcare issue; it’s a societal one.

As Wes Streeting takes the reins as Health Secretary, this is the perfect time for industry to step in and show how your solutions can help drive this transformation.

And the NHS is ready to listen. In customer interviews I conducted for my 2025 online learning programme, NHS decision-makers were clear: collaboration is key. They want industry partners who understand their challenges and offer real, patient centred solutions.

A missed opportunity if the money doesn’t move

Let’s be blunt. Hospitals are likely to need a bailout in 2025. But what happens after that? If the money doesn’t follow the shift to community care, we’re just applying a sticking plaster to a systemic wound.

Imagine if Integrated Care Boards (ICBs) made those bailouts conditional on hospitals committing to a clear list of services to move out of hospital. In other words:

• Decommissioning services in hospitals and recommissioning them in General Practice or community care.
• Ensuring money, people, and resources follow the service.

Without this kind of strategic commitment, we risk the left shift never materialising and the pressures on the NHS continuing to build.

As I’ve said before, it’s time to ask hospitals: “What are you moving out?” This is an opportunity for industry to step up with solutions that align perfectly with NHS priorities.

Industry’s role: three key opportunities

1. Pharma: Driving prevention and early diagnosis

Pharma companies are uniquely positioned to align with upstream care priorities. Consider these focus areas:

• Preventative therapies: Vaccines, lipid management drugs and treatments for early-stage conditions like diabetes, heart failure and chronic kidney disease.
• Early and correct diagnosis: Diagnostic tools and treatments that identify and manage diseases before they progress. This includes conditions like cancer, cardiovascular disease and obesity.
• Tackling inequalities: Support health education programmes and improve access to newer medications in underserved communities.
• Real world evidence: Use your data to demonstrate how your therapies improve outcomes and reduce hospital demand. NHS leaders value this kind of evidence and use it to inform their decisions.

Therapies that delay or prevent disease onset will be in high demand, meaning pharma has a vital role to play.

2. Med Tech: Innovations that empower patients and clinicians

Med tech companies are perfectly placed to support upstream care with the right technology. Think about:

• Remote monitoring: Wearable devices that track key health metrics like blood glucose, blood pressure and oxygen levels. This empowers patients and gives clinicians real time data to make informed decisions.
• Portable diagnostics: Tools for early detection in community settings, such as point of care tests for infectious diseases.
• Interoperable digital solutions: Platforms that integrate seamlessly with NHS systems to improve care coordination and access.
• Value based contracts: Align solutions with measurable outcomes rather than volume, ensuring your products deliver real, tangible value to the NHS.

Med tech’s ability to combine innovation with practicality is crucial. Interoperable solutions that integrate with existing systems will make or break the success of these initiatives.

3. Device companies: Enabling safe, effective home-based care

The demand for home-based care is growing all the time. Device companies can make a real difference with:

• Portable medical devices: Ventilators, infusion pumps and smart inhalers that enable care at home.
• User-friendly tools: Devices with intuitive interfaces that help patients stick to their treatment plans. Smart pill dispensers or inhalers with built-in reminders can improve adherence.
• Chronic disease management solutions: Insulin pumps, glucose monitors and devices designed for ongoing care.
• Training and support: Provide tutorials, workshops and 24/7 technical support to ensure healthcare professionals and patients can use your products effectively.

Chronic disease management tools, like continuous glucose monitors, are prime opportunities to support proactive care.

Read my blog – Six ways to win an audience with the NHS – here

Real examples of upstream care in action

The Providers Deliver report isn’t just theory. NHS Trusts across the country are already implementing upstream care initiatives with tangible results:

• Hampshire and Isle of Wight: Addressing housing instability, unemployment and food insecurity in partnership with local authorities to improve health outcomes.
• East Lancashire Hospitals NHS Trust: Community intervention teams providing home based care to reduce emergency department visits and readmissions.
• North Staffordshire Combined Healthcare NHS Trust: Crisis cafés and community hubs offering mental health support to prevent acute inpatient admissions.
• Hereford Community NHS Trust: A proactive early intervention model offering comprehensive health checks and remote monitoring to avoid hospital admissions.

These examples show what’s possible when prevention and early intervention are prioritised. Industry can play a crucial role in making these successes the norm, not the exception.

Building the future of healthcare together

The future of the NHS depends on upstream care. Prevention, early diagnosis and community based care are essential for a sustainable healthcare system. But this transformation won’t happen without collaboration between industry and the NHS.

Think about co-developing solutions, providing training and resources and advocating for policy changes that support upstream care. When you align your efforts with NHS priorities, you’re creating lasting, meaningful partnerships that benefit patients, the NHS and your business.

If you want to explore how your products and services can support upstream care, schedule a call today.

Scott McKenzie helps pharmaceutical, medical technology and device firms get their products and services in front of the right NHS decision-makers. In 2023 alone, he helped land 53 new NHS projects. His 12-month mentorship programme offers tools, insights, and introductions to get your projects over the line. Find out more here.