How NHS Charities Can Build a Successful Major Gifts Programme — Even Without a Famous Brand or Capital Campaign

Many NHS charities believe major gifts are out of reach. They worry they don’t have the right projects, the right donors, or the right team. But here’s the truth: you absolutely can build a thriving major gifts programme in an NHS hospital — and you’re likely missing out by not starting sooner. 

Common Pain Points NHS Charities Face — and How to Overcome Them 

Let’s tackle some of the most frequent concerns I hear from NHS fundraisers: 

“Our hospital won’t give us a compelling project.” You don’t need a shiny new building to inspire donors. In fact a capital campaign can make it harder as it takes so long to deliver! Start by working with clinicians in one department and engaging their patients to find major donor prospects. You will build a great relationship with that department and their confidence in fundraising will soar! 

“We’re not Great Ormond Street.” True — but you don’t need to be. GOSH has built its brand over decades. You can build yours too, starting with strong relationships, great stewardship, and a clear case for support. Donors give to people and impact, not just logos. 

“We can’t recruit experienced major donor fundraisers.” That’s a challenge across the sector. The solution? Grow your own. Train your existing team in major gifts skills — listening, asking, stewarding. These skills benefit every income stream, from corporates to legacies. 

What Worked at Addenbrooke’s — and Can Work for You 

Over 13 years, we grew major gifts income from £200k in unsolicited donations to over £40 million across two campaigns. Here’s how we did it — and how you can adapt these steps to your own charity: 

1. Create a Giving Club That Makes Donors Feel Valued 

We launched the 1766 Club, with three modest giving levels (£1k, £5k, £10k). It gave donors a sense of belonging and made asking easier for fundraisers. You can create your own version — even a simple name and tiered benefits can make a big difference. 

2. Use Your Database to Find Warm Prospects 

We started with donors who had given £1,000+ personally. Many were grateful patients. Stewarding these donors well led to multi-year gifts and legacies. You likely already have these donors — they just need nurturing. 

3. Host an Inspiring Launch Event 

We invited clinicians to speak for five minutes each about projects funded by the charity. It was short, powerful, and personal. You don’t need a grand venue — in fact, the quirkier the better. Do something fun, with authentic stories and a warm atmosphere. 

4. Make the Ask — Clearly and Confidently 

We asked guests to join the Club and explained tax-effective giving. Having giving levels made it easier for new fundraisers to ask. Practice builds confidence — and donors appreciate clarity. 

5. Steward Generously and Personally 

We built trust through thoughtful updates, handwritten notes, and invitations to events. The more someone gave, the more personalised their experience. Stewardship is where loyalty — and future gifts — are born. 

6. Ask Again — Every Year 

We timed renewal asks around gift anniversaries or tax year-end. A simple, personalised letter worked wonders. Consistency matters — and even one fundraiser can make a big impact. 

Lessons for NHS Charities 

Major gifts isn’t magic — it’s relationship-building. Anyone can learn it with the right support. Train your team, mentor junior fundraisers, and build confidence through practice. 

You don’t need a capital campaign to start. Designated and departmental restricted giving can fund vital work and build momentum. When a big project does come along, you’ll be ready. 

You already have potential major donors. Grateful patients, long-time supporters, local philanthropists — they’re in your database. Start with stewardship and build from there. 

You don’t need to be GOSH — you need to be you. Your hospital has its own stories, heroes, and impact. Lean into that. Donors want to make a difference locally. 

Recruitment is hard — so invest in your existing team. Major gifts skills benefit every area of fundraising. Build a culture of asking, listening, and stewarding — and watch your income grow.