The Royal Free Hospital was founded in 1828 in Greville St, Hatton Garden, by William Marsden, a young surgeon from Yorkshire. He found a young girl dying on the steps of St Andrew's, Holborn, because she could not afford admission to hospital and the only other way for the poor to obtain treatment was to be personally recommended by someone who subscribed to that hospital. The experience touched Marsden so much that he decided to open a hospital which would be free to all: poverty and sickness would be the only passports required.
The hospital was originally called the 'London General Institution for the Gratuitous Cure of Malignant Diseases.' It was just a dispensary, with no in-patient beds, and in 1832 was the only London hospital to treat victims of the cholera epidemic. Soon afterwards the name was changed to the London Free Hospital, and in 1837 when Queen Victoria became patron she changed the name to the Royal Free Hospital. In 1844 the Royal Free moved to larger premises, a former army barracks in Gray's Inn Road.
In 1877 the Royal Free became a teaching hospital when it allowed female medical students at the London School of Medicine for Women (founded 1874) to receive clinical instruction on its wards. The School of Nursing was started in 1889, and in 1895 the Royal Free became the first hospital to appoint an almoner, forerunner of the modern social worker.
During the first world war, the new outpatient block was requisitioned as an officers' ward, and many staff and students went abroad to treat soldiers. After the war, it became necessary to equip the hospital in line with advances in medicine to include a maternity wing, children's ward, nurses' home and dental clinic. Given the general poverty in England at this time, and the fact that the hospital was still dependent on voluntary contributions, much of this was made possible by the generosity of three men, Lord Riddell, Alfred Langton and Sir Albert Levy, who saved the hospital from near-closure.
On the inception of the National Health Service in 1948, the Royal Free joined with several smaller hospitals including the Children's Hospital Hampstead, the Elizabeth Garrett Anderson Hospital, the North-Western Hospital, Hampstead General Hospital and the London Fever Hospital to form the Royal Free Group. From this point there was much debate about whether the Royal Free should stay in central London or move out to Hampstead, and in 1958 the first plans for the Royal Free on its present site were produced. Construction finally began in 1968, the same year that Coppetts Wood and New End Hospital joined the Royal Free Group. Queen Mary's House joined the group in 1972. The new Royal Free was the most modern hospital in Europe, and the first to be designed with the aid of a computer. In 1974 it opened to its first patient, a London taxi driver, and in 1978, the 150th anniversary of hospital's foundation, it was officially opened by the Queen.
As a result of NHS reorganization, the Royal Free Hospital came under the control of Camden and Islington Area Health Authority between 1974 and 1982 and the Hampstead Health Authority between 1982 and 1991. In April 1991 the Royal Free Hampstead NHS Trust became one of the first trusts established under the provisions of the NHS and Community Care Act 1990. The Royal National Throat Nose and Ear Hospital joined the trust in 1996.