By Marcus Coetzee, 6 June 2025
I’ve been thinking a lot about upstream versus downstream problems recently, especially in the context of the social, economic and environmental challenges that charities and governments face.
Upstream problems are the root causes and conditions that slowly emerge and eventually lead to the more visible, urgent problems that appear downstream. These often form part of a vicious cycle where the deeper causes are obscured by the fallout they produce. While it’s always more effective and less expensive to intervene upstream, these interventions require systemic thinking and can be harder to communicate and implement in the real world.
By contrast, downstream problems are more tangible. They are loud, visible and easier to rally around. This makes them politically and practically more attractive to address, even when it’s too late to avoid the damage. The austerity measures in the UK have made this tension between upstream and downstream activities even more apparent. Since 2010, public spending cuts and welfare reforms have taken their toll on communities and the organisations that serve them. Downstream problems are increasingly manifesting. For example, life expectancy plateaued around 2012 and has since declined—the first sustained reversal since World War II. This is associated with a host of intensified public health challenges.
When local authorities cut their budgets, they naturally focus on the emergencies unfolding in front of them. This seems the obvious priority. Unfortunately, this often leads to cutting the very programmes that could prevent those emergencies in the first place.
Here in Renfrewshire, where I live, we recently saw Food Train close its volunteer shopping service due to a lack of council funding. The local branch of this charity helped over 160 elderly people with shopping. The volunteers also regularly checked on their well-being since many of these service users are socially isolated. The volunteers I’ve chatted with are saddened by the decision to close such a meaningful service. Their work is clearly valuable.
Food Train’s model is a good example of an upstream intervention. It’s low-cost, person-centred, effective and largely staffed by volunteers. It helps older people stay independent and socially connected. Without it, many may now fall through the cracks. Some could end up in care homes or become reliant on more expensive services. According to an article by Third Force News, replacing the service with home carers would cost about £50 per person per week, compared to £6.52 with the charity. So, the council might save money from one budget line, but spend much more elsewhere.
When encountering situations like this, I often wonder why local authorities, despite being at the coalface of service delivery, struggle to invest in upstream solutions. Here are some of my reflections:
- It’s easier to allocate resources to problems that are visible and measurable.
- Tried-and-tested solutions are favoured over new, complex ones with uncertain outcomes.
- Budget cuts push councils to bring services in-house, putting external providers at risk of having their contracts terminated.
- Even when senior officials support innovation, the bureaucracy below can stifle it. The culture and systems will struggle to accommodate new approaches.
- Government systems tend to be deeply risk-averse and focused on avoiding waste or fraud. An unintended consequence is it slows innovation.
- And to implement something new, people often need to learn new skills and change how they work. That kind of change is slow and difficult.
Accepting this reality of constraints, rather than being constantly frustrated by it, can help us work more effectively with government. This reminds me of the Stockdale Paradox which advocates that we acknowledge the harshness of our environment, but never lose hope.
So, what can those of us promoting upstream solutions do to get traction in local and central government? Here are five strategies I’ve used:
1. Make the financial case. Show how modest, well-targeted investment can prevent much bigger spending later. Use real examples and conservative estimates that can survive scrutiny. Don’t overpromise.
2. Align with government priorities. Frame your work in terms that match their obligations and language. Help them see how your solution helps them meet their statutory duties or KPIs.
3. Combine evidence with stories. Blend data with real-life examples. Share how others, especially elsewhere in government, have succeeded with similar models. Arrange learning visits if possible. Often, what seems new and daunting is simply an older model being rebranded.
4. Make it low-risk. Start small. Propose pilots or phased approaches. In one project I’m involved with, we’re helping a council explore an outcomes-based funding model with external support. It’s a stepping stone towards a more complex investment arrangement, not a leap.
5. Be patient and persistent. Change can take years. Departments may move slowly at first but will warm up over time. Stay engaged, listen carefully and build relationships.
Promoting upstream work within government is hard. It takes time, patience and strategic thinking. But it’s worthwhile. These interventions often produce better outcomes and reduce long-term costs. Even when things don’t change straight away, we can still influence thinking, build our credibility and lay the groundwork for future success.
The UK government shows no signs of reversing its austerity policies. As public services come under greater pressure, the need for upstream solutions will only grow. Although downstream problems dominate our attention, they often have upstream causes. Tackling one without the other simply doesn’t work.
Third-sector organisations must keep improving how they explain what they do, use better evidence, and guide government partners with empathy and skill. Change may be slow, but with perseverance, upstream approaches can gain support and make a real difference.