The Holy Grail of Fundraising

If you ask any NHS charity CEO or Finance Director what keeps them up at night, they’ll likely say:

“We need more unrestricted income.”

Unrestricted funding is the single most powerful thing donors can give. It allows charities to be agile, responsive, and strategic — whether that’s investing in fundraising, covering core costs, or funding impactful grants across the hospital.

But in NHS charities, growing unrestricted income is uniquely challenging.

Why It’s So Hard in NHS Hospitals

• Donors give to “their ward” or “their doctor” — it’s personal, emotional, and specific.

• Clinicians won’t refer patients if the ask is for unrestricted giving — they want to see impact in their own department.

• Fundraisers find it easier to ask for something tangible — a piece of equipment, a research project, a staff wellbeing initiative.

• Being donor-led is essential — and that often means starting with restricted gifts.

So How Do You Grow Unrestricted Income?

Here’s what’s working across NHS charities:

1. Create a “Support Your Hospital” Appeal

Use your hospital’s brand to build a campaign that feels local, urgent, and meaningful.Example: Addenbrooke’s “Help Your Hospital” appeal launched during COVID and continues today — it unlocked a wave of unrestricted giving.

2. Define the Impact of Unrestricted Giving

Don’t just say “we need core funding.” Show what unrestricted gifts do.Example: Guy’s & St Thomas’ links unrestricted giving to real outcomes:

• Tackling chronic back pain

• Supporting staff mental health

• Helping homeless patients

• Funding rehab for ICU patients

• Running wellness clinics for underserved communities

This makes unrestricted giving feel purposeful and urgent.

3. Allocate Gift Aid to Unrestricted Funds

Unless a donor explicitly restricts their gift, direct Gift Aid to support your charity’s core work.

4. Ask Major Donors to Cover Project Management

Include a percentage of their gift to cover stewardship, reporting, and charity staff time. This helps fund your infrastructure without compromising the project. A car can’t run without petrol…

5. Be Brave — Ask for General Support

You’re not asking for admin costs. You’re asking donors to support their local hospital — and that’s a powerful message.

6. Use Grateful Patient Fundraising to Upgrade Donors

It may sound counterintuitive, but starting with restricted gifts can lead to unrestricted giving. Grateful patients often give to “their ward” first — but with great stewardship, they’re happy to upgrade to unrestricted support in future gifts.

Who’s Doing It Well?

• Great Ormond Street: All non-major gifts are unrestricted — even capital appeal donations.

• Newcastle Hospitals Charity: Their strategy includes “Helping Our Hospitals Go Further” — a clear, compelling unrestricted proposition.

• Addenbrooke’s: COVID was the turning point. The community rallied around the hospital brand, and unrestricted giving soared.

• Guy’s & St Thomas’: They make unrestricted giving feel specific, impactful, and personal.

Final Thought

Unrestricted income is the fuel that powers everything else. It’s harder to ask for — but it’s worth it. With the right strategy, storytelling, and stewardship, NHS charities can grow unrestricted giving — even in a culture of ward-specific donations.

Would you like help designing your unrestricted giving strategy, donor messaging, or campaign materials? I’d love to support you.

Photo credit: lucas-k-94qPvR72FWk-unsplash