The concerns come as the Scottish Government has admitted it held no documented assessments of what its plans to abolish Scotland’s 14 territorial health boards would mean for NHS-linked charities during the period leading up to the announcement.
READ MORE:
Officials also confirmed they held no overall assessment of the value of NHS endowment assets.
The revelations raise questions about how donations intended to benefit particular hospitals, services and patients will be protected as ministers prepare to replace the existing health boards with two new strategic bodies covering the east and west of Scotland.
In an email sent to the Office of the Scottish Charity Regulator (OSCR) on September 2, a representative of an NHS-linked charity warned that the proposed shake-up raised significant legal and financial questions.
The correspondence stated: “The confirmation that the existing territorial NHS Boards will be legally dissolved and replaced by two new legal entities raises a number of significant considerations for NHS-linked charities and the charitable assets currently held within NHS Endowment Funds (Over £350 million).”
The representative questioned whether money donated for particular hospitals or communities could legally be transferred into larger regional or national charity structures.
“It would appear that, regardless of whether funds are currently classified as unrestricted or restricted within individual NHS charities, assets held for the benefit of a particular geographical area or population could not simply transfer to a new national or regional charity structure for wider use,” the email said.
The correspondent also highlighted the importance of protecting the wishes of donors, warning that charitable funds must continue to be used for the purposes for which they were originally given.
They sought clarification on what would happen to charitable assets when existing NHS bodies were dissolved, whether geographical restrictions on donations would remain in place and whether new legal powers might be needed.
The concerns were raised as ministers developed plans for one of the most significant reorganisations of NHS Scotland since devolution.
However, a separate Freedom of Information response obtained by The Herald reveals that the Scottish Government held no relevant documented planning work concerning NHS-linked charities during the period examined.
The request sought correspondence, briefings, reports and assessments covering the period from November 1, 2025, to September 4, 2026.
It specifically asked what consideration had been given to the future of NHS charities, whether existing organisations would remain separate or merge, and how their assets might be transferred under the proposed changes.
Following an internal review, the government upheld its original response that it did not hold the requested information.
In a letter dated October 30, officials stated: “I am content no documented briefings are held for the requested time period as we are currently in the design phase of reform, including development of the business case, and work relating to the areas referenced in your request had not commenced during this time.”
Further correspondence released by OSCR shows that the concerns raised by NHS-linked charities were passed to Scottish Government officials shortly after the reforms were announced.
In an email dated September 3, an official wrote: “The concerns being raised relate to the potential impact of NHS Board restructuring on NHS-linked charities, including governance arrangements, charitable assets, donor intent, and the future structure of the charities.”
The correspondence also drew attention to a previous review of NHS endowment fund governance, carried out in 2019, and its recommendations for the sector.
By September 7, Scottish Government officials had acknowledged the issues and indicated they would be considered as the restructuring plans developed.
“The charities will be factored in as thinking on the NHS restructuring develops and colleagues are aware of the implications,” an official wrote.
The email added that a meeting with the team leading the reforms was being arranged.
OSCR has also confirmed that some information about the future of NHS-linked charities was withheld from disclosure because it related to ongoing government policy development or confidential legal advice.
Explaining its decision, the regulator said officials needed space to examine the “legal and practical implications” of potential approaches and “identify unintended consequences before recommendations are settled”.
The documents do not establish that charitable donations will be redirected away from local hospitals or that the government intends to merge existing NHS charities.
However, they highlight questions about how charitable funds will be protected when the health boards to which they are linked are replaced.
The government’s FOI response covers the period ending September 4 and does not establish whether further assessments have since been undertaken.
The Scottish Government has been contacted for comment.