Leadership and the left shift: advancing proactive and preventive healthcare
Delivering the left shift demands leadership that is pragmatic, collaborative and relentlessly focused on outcomes, writes Vani Manja.
To deliver the left shift, leaders across healthcare, industry, government and civil society must co-create a system that is responsive as well as resilient.
This article was developed and funded by Boehringer Ingelheim as part of its NHS ConfedExpo 2025 sponsorship.
The ambition within the NHS to shift care upstream – from hospitals to communities, from analogue to digital, and from reactive treatment to proactive prevention – is well established. But moving these ‘three big shifts’ from aspiration to execution requires more than policy alignment; it demands leadership that embeds prevention into the fabric of healthcare delivery and forges partnerships that turn vision into action.
Leaders must redesign care pathways to prioritise early intervention, empower communities with digital tools and personalised plans, and build cross-sector coalitions that translate policy into practice. This is not a theoretical exercise, it’s a call to action for leaders across industry, government and civil society to co-create a system that is not only responsive but also resilient.
Prevention as a system-level strategy
The NHS faces immense and complex challenges. Tackling these requires strategic resource allocation that prioritises prevention levers, joint working models that integrate care across sectors, and a patient-led system that enables individuals to actively manage their health and care.
Prevention must be reframed, not as a cost-saving measure, but as a value-creating strategy
Prevention must be reframed, not as a cost-saving measure, but as a value-creating strategy that reverses poor health outcomes, reduces acute care demand, builds healthier communities, and supports economic growth.
Medicines, too, must be recognised not only as therapeutic tools but as enablers of prevention. When integrated into early intervention strategies, they can reduce disease progression, improve quality of life, and support a sustainable healthcare system. This shift requires coordinated investment, policy reform and a new narrative – one that positions medicines as part of the prevention toolkit.
Crucially, we cannot improve what we don’t measure. Establishing meaningful metrics to track the impact of preventive care is essential to validate success and inform data-driven decisions that continuously improve patient pathways. These metrics might include reductions in emergency hospital admissions, increased uptake of screening and vaccination programmes, improvements in patient-reported outcomes, and data on health inequalities across different population groups. Metrics should guide investment, inform policy, and validate success – not just in clinical terms, but in human ones.
Reaching further through partnerships that deliver
At Boehringer Ingelheim, we are proud to be part of several pioneering collaborations that demonstrate how industry and the NHS can together drive systemic change by co-creating scalable, equitable models of care.
In collaboration with the North East and North Cumbria Integrated Care Board, through Health Innovation North East and North Cumbria, and the Hampshire and Isle of Wight Integrated Care System, we are jointly leading the SPOT CKD (Screening, Prevention, Outreach and Treatment for Health Equity) initiative. This programme aims to improve the early detection and management of chronic kidney disease, particularly in underserved communities who cannot, or do not, access the healthcare they need.
These partnerships are not just about improving today’s services, they are about building a more resilient, inclusive, and sustainable healthcare system for tomorrow
Aligned with the NHS England Renal Transformation Programme, the SPOT CKD initiative embeds a proactive ‘target, test and treat’ approach into routine practice. By closing testing gaps, monitoring at-risk individuals and delivering personalised treatment, the initiative supports the NHS prevention agenda and ensures patients receive timely, equitable and sustainable care.
Additionally, we are streamlining diagnostic and treatment pathways for rare lung cancers through our partnership with The Christie NHS Foundation Trust. This collaboration aims to standardise processes, accelerate diagnosis, and tackle inequalities in access and outcomes to targeted therapies. By contributing data to NHS England, this initiative also supports national prevention efforts and the development of expert-led guidelines, helping to shape the future of cancer care.
These partnerships are not just about improving today’s services, they are about building a more resilient, inclusive, and sustainable healthcare system for tomorrow.
The road ahead
As we look to the future, partnerships like these between industry, public health organisations, communities and patients will be essential in delivering the transformative change the NHS needs.
Delivering the left shift is not about incremental change, it’s about systemic redesign. It demands leadership that is pragmatic, collaborative and relentlessly focused on outcomes. We must move beyond pilots and pledges to build a healthcare system that is inclusive by design, digital by default, and preventive by principle.
The future of care is not solely about treating illness, it’s about enabling health. Continued leadership and collaboration will be key to breaking down barriers, driving innovation and securing better outcomes for generations to come.
Vani Manja is country managing director and head of human pharma at Boehringer Ingelheim UK and Ireland.
- Training

NHS finance for senior leaders
3 March 20279:30 - 16:00Online
Develop a greater understanding of NHS financial principles, funding flows and reporting to strengthen your confidence to effectively contribute at board level.
Leadership
Finance
- Conference

The NHS Alliance Autumn Conference 2026
26 November 20268:00 - 17:00In-person
The NHS Alliance Autumn Conference brings together senior leaders to share knowledge, discuss ideas, tackle shared challenges, & talk about how to shape the future of our health & care service.
Leadership
Cross-sector partnerships
Regulation
Social care
Health inequalities
- Network

NHS Quality and Safety Forum
12 November 202612:00 - 14:00Online
An online event designed for NHS quality and safety leaders to explore the latest developments, share best practice and network.
Quality
Regulation
- Event

From recommendations to reality: Enabling safe and effective AI adoption in the NHS
19 October 202611:00Online
Explore what the National Commission's artificial intelligence (AI) recommendations mean for the NHS and gain practical insights for safe, confident AI adoption.
Governance
Regulation
Delivery and performance
- Conference

NICON26 Conference & Exhibition: Reset for All | Action by All
7 - 8 October 2026Online and in-person
Delivery and performance
Digital
Finance
Governance
Health inequalities
Commissioning
Communications
Leadership
Improvement
Neighbourhood health
Prevention
Primary care
Social care
Workforce
Regulation
- Insights

WNHSC response to the scrutiny of the Welsh Government’s 2027-28 draft budget proposals
2 Oct 2026
The Welsh NHS Confederation welcomes the opportunity to respond to the Finance Committee’s scrutiny of the Welsh Government’s Draft Budget 2027-28 proposals.
Finance