The longstanding scale and nature of the problems confronting “left behind places” present a stark challenge to the “levelling up” agenda and institutional and policy responses in the United Kingdom (UK). Resource allocation is typically determined through inter-area competition with the aim of fostering innovation, leveraging in local resources, strengthening bids, and building local collaboration and partnerships. There should also be coordination, vertically and horizontally, across and between relevant institutions at different spatial levels, and sufficient resources appropriate to the scale of the policy goals. Supportive institutional and policy frameworks are needed at the national and even international levels, for example, through coordination and integration of policies and appropriate funding. The policy instruments of spatially targeted incentives and controls to influence the geography of capital investment and labour recruitment have also varied over time, typically with changes in government.