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Building on remarkable and sudden fundraising success during the Covid-19 pandemic, many National Health Service (NHS) charities in England and Wales have undergone a period of rapid organisational transformation and growth. This article explores these developments by considering how claims to distinction contribute to new organisational identities and allow access to valuable resources and funding opportunities. After situating recent developments within the policy background and key changes in governance and regulation since the 1990s, we report on interviews with directors and trustees of NHS Charities Together (NHSCT), the national membership organisation of NHS charities. These offer new insight into strategic shifts and the desire to form a distinct and unified identity for NHS charities. Highlighting ongoing tensions and debates within the sector, findings raise important questions over the role of NHS charities and their position in relation to the NHS and the state.
The role of charity in the provision of public services is of substantial academic and practitioner interest, and charitable initiative within the English and Welsh National Health Service (NHS) has recently received considerable attention. This study provides rich insights into the role that NHS-linked charities present themselves as playing within the NHS. The dataset analysed is a novel construction of 3,250 detailed expenditure lines from 676 sets of charity accounts. Qualitative content analysis of itemised descriptions of expenditure allows us to explore how these charities portray their activities. We distinguish between expenditures that can be framed as supplementary to government funding (such as amenities and comforts) and items that suggest charitable effort is substituting for government support (such as funding for clinical equipment). We also consider the claims being made through these representations, and suggest that the distinctiveness of the charity and NHS spheres are currently under question. We argue that, through their representational practices, charities are both shaping and blurring the expected roles of government and charity. Acceptance of the benefits that charitable initiative does provide, in terms of innovation, pluralism and participation, must be tempered with the realisation that charitable funds are playing a role in service provision that is not guided by clear policy, and that this has the potential to widen existing inequalities within a key public service.
Debate on the role of charitable grant-making foundations often references concerns about their lack of transparency. There has, however, been limited empirical investigation of foundation transparency levels. In this study, we report the largest-ever investigation of transparency among grant-making foundations in England and Wales. Based on a novel dataset, which captures the level of grant-specific data published by more than 2,200 foundations over five years from 2014 to 2018 (inclusive), we find that: (a) overall, these foundations are transparent in their disclosure of grant-specific data; (b) the results also paint a picture of stability – of those foundations with published trustees’ annual reports and accounts in all five years of this study, 78 per cent had the same disclosure practice throughout; and (c) a specific regulatory change mandating grant-specific disclosure has not substantially increased levels of disclosure. This study therefore provides detailed evidence that contributes to and expands the conversation on English and Welsh foundation transparency.
Charity reserve levels are widely used as a measure of financial vulnerability, of both individual charitable organisations and the wider sector. This paper assesses the mandated reporting of reserves by a large sample of British charities. We find that many charities are reporting figures that do not match the definition of reserves given by regulatory bodies. We therefore recommend caution when using extant reserves data, and that increased attention should be paid to the preparation of such data.
