Leagues of Friends are charities that provide 'personal service to patients' and 'supply hospitals with equipment not likely to come from the budgeting of authorities'. Hundreds continue to exist, and many trace their origins to before the NHS's foundation in 1948. Despite the rich and growing historiographies of voluntarism and the NHS, Leagues have received little attention. This article uses case studies of Leagues in the English West Midlands to show how 'friendship' symbolised the relationship between local NHS institutions and the communities they served. The cases show that voluntarism in British healthcare has not always been based around activism and consumerism, two areas that recent scholarship has rightly highlighted, especially from the 1960s. This allows historians to interrogate the regional and local differences within, ostensibly, a highly centralised national health system.
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