Download The State of NHS Philanthropy 2026 Report
The opportunity hiding in plain sight
What can charitable income, patient activity and wider sector evidence tell us about the future of NHS fundraising? This original analysis of all 209 registered NHS charities in England and Wales reveals striking differences in fundraising performance and a significant opportunity to put patient relationships at the heart of philanthropy.
Our analysis found that one acute NHS charity raised £55.56 per patient while another raised just 89p for comparable NHS care. Patients at one organisation are not 62 times more grateful. The difference points to something more important: how effectively organisations recognise, enable and develop philanthropic relationships with their patients and families.
209
registered NHS charities in England and Wales included in the analysis
62x
difference in income raised per patient between two acute NHS charities
£125m
legacy income received by NHS charities in 2024/25
The report challenges the idea that fundraising performance is mainly determined by the size, type or location of an NHS organisation. Instead, it gives leaders evidence to ask a different question: What could become possible if patients and families were given more thoughtful opportunities to express their gratitude?
Use the report to
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Assess the scale of your philanthropic opportunity
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Understand how fundraising performance varies across the NHS charity sector
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Start a different conversation with your leadership team or board
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Make the case for investment in patient-centred fundraising
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Identify the questions your organisation should be asking next.
Who is it for?
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NHS charity leaders and trustees
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NHS Trust executives
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Fundraising directors
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Clinical leaders
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National health charities and professional bodies
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Anyone interested in the future of health philanthropy.
Get your free copy
Download The State of NHS Philanthropy 2026 and discover what the evidence could mean for the future of NHS fundraising. You'll also receive occasional insights from Gemma about Grateful Giving and health philanthropy.
About the author
Gemma Downham is a specialist in NHS fundraising and patient and family philanthropy. During 17 years working in NHS fundraising, she created the NHS's first Grateful Patient Programme and led major capital campaigns for new children's and cancer hospitals. Today, through Downham Consulting, she works with health organisations, professional bodies and clinical leaders to understand their philanthropic opportunity and build programmes that patients, clinicians and fundraisers can trust.
“The response was incredible - effusive praise all round. The team had genuine lightbulb moments and came to understand the power of collaboration and individual stewardship. Gemma is a fantastic speaker and trainer.”
DIRECTOR OF FUNDRAISING, TEENAGE CANCER TRUST
“Gemma is a unique and thoughtful fundraiser who brings warmth, compassion and immense experience. She ‘gets it’, knows precisely what she’s doing and is the safest pair of hands there is.”
CLINICAL LEAD