Charities are a lifeline for people who struggle to access NHS services – but they’re under threat

In the face of soaring living costs, deepening poverty and financial constraints on NHS leaders, our health and care system is under immense pressure. On top of this, rising sickness levels are also increasing demand for health and care services. That means all of us are finding it harder to access healthcare, but it is especially true for those who already found it difficult to access services such as minoritised communities, people who are homeless, or those with complex care needs.

Now, more than ever, the crucial support provided by small- to medium-sized charities to support people’s health and wellbeing must not be overlooked. These charities are a lifeline to hundreds of thousands of people who struggle to access services and often experience the worst health outcomes in the country.

The vital roles these charities play is highlighted in the work of some of the 2025 GSK IMPACT Award winners, a prestigious accolade for UK health and care charities, delivered in partnership with health and care think tank The King’s Fund.

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First, let’s consider how charities help people to access NHS services in the first place. NHS services often miss those in poverty, with homeless people and those without a registered address finding it particularly hard to get into health services.

In Scotland, homelessness has surged by 11% since 2020, encompassing rough sleeping, sofa surfing, and hotel stays. The Marie Trust, a Glasgow-based charity and one of the winners of the 2025 GSK IMPACT Awards, offers counselling and psychotherapy services to support people experiencing homelessness, addiction and complex health challenges. Crucially, no formal referral or registration with a GP is required to receive care. In the year ending March 2024, The Marie Trust’s crisis intervention service saw more than 1,000 people, providing over 7,500 hours of one-to-one support.

The Marie Trust has also developed a range of partnerships with local health and care services, including with three hospitals and a mental health facility. With very little resource, the charity ensures that people admitted to hospital who are homeless receive the support they need and are helped to secure permanent tenancies so they can recover and stay well.

Stigma and fear of being judged or not listened to can also be a barrier for people needing health services and this is another area where small charities can step in to help. For example, the stigma around HIV sadly continues. George House Trust, another of the award-winning small charities based in Greater Manchester and Liverpool, has tackled this by training 18,000 healthcare professionals to reduce HIV stigma in health and care settings. It also provides advice and information to 2,600 people living with HIV, including almost 800 people under it’s ‘Ageing Well’ programme, targeted at people living with HIV over 50. Its work empowers staff, dismantles misconceptions around HIV, and uplifts the communities it serves.

Access to high-quality health and care services is also influenced by ethnicity. The NHS Race and Health Observatory found that psychotherapy services need better tailoring to meet the needs of Black and minoritised ethnic groups, who face worse health outcomes and longer waits for assessment than white British groups. Black people are also more likely to be detained under the Mental Health Act, and people with severe mental illness are at greater risk of developing other physical diseases at a younger age, and even premature death.

This year’s GSK IMPACT Awards show how small charities often step in to help redress these inequalities. Nilaari Agency works in Bristol and the surrounding area, providing culturally tailored mental health support in health centres, GP practices, churches, mosques and other faith settings. Staff at the charity also communicate in the seven most prevalent languages of the Black, Asian and minority ethnic communities in Bristol. As well as supporting people’s mental health, Nilaari also helps tackle wider factors that affect people’s mental health and wellbeing. This approach works – for example nine out of ten people reported an improvement in their mental health because of the charity’s work.

As more and more of us need ever more treatment and support, but the available funding struggles to keep pace, the NHS and health and care charities are under ever-increasing pressure to support people in the UK. These award winners provide valuable examples of smaller charities’ role in supporting health and wellbeing, filling gaps in services, and providing innovative solutions to complex needs.

But, if this type of support is to continue, government departments need to consider the funding and sustainability challenges facing the charity sector. Charities continue to experience the ‘triple threat’ of rising costs, increased demand and falling income. Charitable funders have seen a surge in demand for funding, making it much harder to obtain the same level of income from this source. NHS finances are under immense pressure, but the NHS is also a critical funder of many services provided by smaller charities. The benefits of NHS and charity partnerships are not always maximised and can be hampered by short-term funding or contracts which do not cover their full costs, meaning charities must dip into ever depleting reserves to balance the books.

As the NHS develops its 10-year plan to tackle our biggest health challenges, the relationship with smaller charities should not get lost. The government wants to shift care into the community and focus on preventing ill health in the first place. Smaller charities have been and will continue to play a vital role in achieving these aims and tackling deep-rooted inequality in health.

Without help, many charities may end up shrinking or be gone completely. Unfortunately, their loss will be felt most keenly by the people who experience the greatest marginalisation and need their services the most.

Lisa Weaks is senior associate at The King’s Fund.

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