Opportunities and challenges for not-for-profit healthcare organisations

We would like to thank our panel of experts – Leonard Cheshire Disability’s Andy James, Creative Support’s Anna Lunts, Avante Care & Support’s Stuart Cross, and Kerry Dearden of The Orders of St John Care Trust – for their thoughts on the key topics affecting not-for-profit healthcare organisations. We have summarised our discussion below.

Balancing purpose with income

The charitable purpose of not-for-profit organisations (NPOs) is of course fundamental to their mission, values and the way they govern their operations, deliver their services and recruit staff.

Yet there’s clearly a fine balance to be struck between focusing on that purpose while still generating income. In fact, some might say the term ‘not for profit’ is something of a misnomer because generating a surplus is not only key to continuing to provide services but the means by which services can be improved or expanded.

‘Not for dividend’ might perhaps be a better description because, of course, NPOs have the advantage of not having to concern themselves with delivering financial return for investors or shareholders.

The absence of that external influence fundamentally changes the decision-making process and means NPOs can prioritise ‘getting things done when they need doing’ – the early procurement of PPE for staff during the Covid-19 pandemic being a prime example. It also often allows NPOs to take a longer-term strategic view than their equivalents within the private sector.

Nevertheless, our panel underlined the importance of NPOs adopting a commercial approach to the way they are run, setting budgets and holding managers to account for sticking to those budgets. And while NPOs will almost always want to prioritise spending on day-to-day care, it’s important not to shy away from longer-term and equally necessary investments, like upgrading IT systems.

Ultimately, aligning a commercial approach with a value based proposition anchored by a long term mission is likely to be the best strategy for healthcare NPOs, as the two are mutually supportive. Quality of care is invariably not only at the heart of serving an NPO’s purpose, but also ensures continued demand for its services and, therefore, revenue.

The recruitment challenge

While offering people the chance to give something back to society can be a useful recruitment tool for NPOs, attracting and retaining staff is still the number one challenge for many.

Many care providers (not just NPOs) have a very transient workforce, losing as many as half of their recruits every year. This high level of churn is often put down to the low levels of pay that carers receive but the challenge of working in such a demanding sector is often a key factor cited by those leaving care.

However, there are solutions to explore here. First, it’s important to ensure new recruits get the support and training they need, especially early on. Offering perks like extra holiday and introducing staff welfare initiatives can help compensate for lower pay packages. Some NPOs in the healthcare sector have enjoyed considerable success by ensuring they do all they can to support diversity in their workforce.

As with every organisation, an NPO’s managers are fundamental to the success of its operations. Providing ongoing training and development opportunities is therefore vital to finding and retaining the managers and leaders of the future – and encouraging people to view working for a healthcare NPO as a career, not just as a job.

Growth prospects

There’s no doubt Covid-19 has shone a light on the healthcare sector, spotlighting its resilience and raising public trust in the services it provides.

However, this is no time for the sector to rest on its laurels and it needs to keep working to ensure it stays relevant to people’s changing care needs and developing a post-pandemic vision for ‘building back better’. With the UK’s aging population, there will continue to be increasing demand for healthcare services, which will deliver new growth opportunities for NPOs.

While some NPOs may choose to upgrade their existing facilities, others may opt for more radical change in the way they provide their services, for example, embracing the continuing trend for more community-based health and social care, helping people to live in their own homes for as long as possible.

And as with so many other sectors, digitisation is already transforming healthcare. NPOs will need to continue to explore the digital potential for both communicating with the people they serve and improving their care provision.

But whatever the future holds, high-quality, person-centred care and support is still what’s most important to people and that’s what the best NPOs will focus on.

These issues were discussed during a Barclays webinar, Not For Profit in the care sector, which you can listen to here.

Read related insights


Social care prepares for a digital future

Barclays Corporate explores how technology will transform the social care sector.


Barclays expert, David McHattie, shares how the bank is backing the recovery of the healthcare sector, and suggests how businesses can prepare for the future.

Industry expertise


Barclays’ award-winning financing and industry expertise supports health and social care operators and businesses across the UK.


Corporate Banking Solutions

Drawing on Barclays’ global expertise, our corporate banking solutions can help your business to transact and trade easily, manage risks and finance your plans for growth.