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2020-12-31-accounts

Charity number: 1013557

ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

UNAUDITED

TRUSTEES' REPORT AND FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 DECEMBER 2020

ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

CONTENTS
Page
Reference and administrative details of the charity, its trustees and advisers 1
Trustees' report 2 - 16
Independent examiner's report 17 - 18
Statement of financial activities 19
Balance sheet 20
Notes to the financial statements 21 - 32

ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

REFERENCE AND ADMINISTRATIVE DETAILS OF THE CHARITY, ITS TRUSTEES AND ADVISERS FOR THE YEAR ENDED 31 DECEMBER 2020

Trustees

Ms Janet Bray, Trustee Professor Catherine Nelson-Piercy, Trustee Professor Andrew Shennan OBE, Chairman Dr Kim Turner, Trustee Professor James J Walker, Trustee Ms Dianne Garland, Trustee Mr Rex Delicate, Trustee Dr Carol Cooper, Trustee Mrs Vijya Varshani, Trustee Professor Jenny Myers, Trustee Darren Reece, Trustee Dr Carol Lole-Harris, Trustee Rob Crussell, Trustee Andrea Harrington, Trustee Rachel Redman, Trustee

Company registered number

02736320

Charity registered number

1013557

Registered office

The Stables, 80B High Street, Evesham, Worcestershire, WR11 4EU

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ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

TRUSTEES' REPORT FOR THE YEAR ENDED 31 DECEMBER 2020

Action on Pre-Eclampsia Limited

Registered company number: 02736320 Registered charity number: 1013557

Trustees annual report for the year ended 31st December 2020

The trustees of Action on Pre-eclampsia present their report on account of the year ended 31 December 2020, which also comprises the directors report as required by the Companies Act 2006.

Reference and administrative details

The legal name of the charity is Action on Pre-Eclampsia Limited.

The charity is also known by its operating name APEC.

The charity’s area of operation and UK charitable registration

The charity is registered with the Charity Commission in England and Wales with charity number 1013557.

Legal structure of the charity

The charity is constituted as a company limited by guarantee, registered under the Companies Act 2006 and its governing document is a memorandum and articles of association under company legislation.

By operation of law, all trustees are directors under the Companies Act 2006 and all directors are trustees under charity legislation and have responsibilities as such under both company and charity legislation.

The trustees are all individuals.

The principal operating address, telephone number and email address of the charity are:

The Stables, 80B High Street, Evesham, Worcestershire, WR11 4EU Telephone 01386 761848 Email info@apec.org.uk Website www.apec.org.uk Social media https://twitter.com/APEC_UK https://www.facebook.com/APEC.UK/ https://www.youtube.com/c/APECUK/videos https://www.instagram.com/apec_uk/

The registered office of the charity for companies’ purposes is the same as the operating address as above.

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ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

TRUSTEES' REPORT (continued) FOR THE YEAR ENDED 31 DECEMBER 2020

The trustees in office during the year

The trustees in office on the date the report was approved were:

Ms Janet Bray – Treasurer until Sept 20th, 2020 Dr Carol Cooper – Deputy Chair of the board of Trustees Mr Rex Delicate Ms Dianne Garland Professor Catherine Nelson Piercy Professor Andrew Shennan OBE Chair of the board of trustees Dr Kim Turner Mrs Vijya Varshani Professor James J Walker (Honorary Medical Director) Prof Jenny Myers, (appointed 20th September 2020) Mr Darren Reece, (appointed 20th September 2020) – Treasurer from Sept 20th, 2020 Dr Carol Lole Harris, (appointed 20th September 2020) Mr Rob Crussell, (appointed 20th September 2020) Mrs Andrea Harrington, (appointed 20th September 2020) Rachel Redman, (appointed 20th September 2020)

During the year the trustee board had the benefit of the advice of Prof Lucy Chappell (Honorary Research Director) Prof Chappell attended the board in an advisory and non-voting capacity.

At the Annual General Meeting Prof Nelson Piercy, Prof Shennan, Dr Turner and Prof Walker retired as trustees, but are eligible for reappointment. Prof Nelson Piercy indicted her wish to retire at the AGM.

All the trustees are also members of the charity.

Objects and activities of the charity

The purposes of the charity as set out in its governing document:

The main activities undertaken in relation to those purposes during the year

• It is impossible to write this report and ignore the coronavirus pandemic. Like every charity, company, and individual we have been profoundly affected and from the outset Trustees put in place measures to temper the impact, but no-one could have predicted how long and what effect this was going on. Due to our heavy reliance on the London Marathon and changes which affected the marathon in 2020 will impact in 2021, 22 and 23 we do not see a return to “normality” before the end of 2023.

During the year, we undertook a number of study days for midwives and student midwives. We provided a free e learning package to increase the number of people reached and raised awareness through our social media channels. We are enormously grateful to the institutions, midwifery societies and hospitals who hosted us as well as the very many speakers who volunteered their time.

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ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

TRUSTEES' REPORT (continued) FOR THE YEAR ENDED 31 DECEMBER 2020

• We ran a highly successful online Experts Day online to share knowledge and experience. This was attended by a record number of senior clinicians. This was an opportunity for many of the leading thinkers in the field to come together and discuss progress on research in pre eclampsia. We are very grateful for the number of speakers who freely gave their time to this important event which continues to grow in scale and significance year on year

• We offered, and continue to offer, support to families affected by pre eclampsia through our helpline, email and social media presence. We offer verbal support, a listening ear, contact with others who have been through similar experiences and immediate referral to experts where needed. This has been especially important when mothers to be have been concerned about symptoms they may be getting. On a number of occasions women have telephoned and afterwards have felt empowered to move forward with their treatment. There have been repeated examples throughout the year when we have been able to refer women who have had problems in the past to experts in the field who have been able to advise them.

• We continue to offer support to researchers and trials ensuring that the views of women and families are heard at every level. This year has seen an escalation in the number of trials that we are supporting. In the United Kingdom it is often the case that if you wish to apply for research funding, the voice of the patient has to be heard and we have collaborated as co-investigator on a number of trials as well as providing informal and formal advice to others. During the year we undertook a number of study days for midwives and student midwives. We provided a free e learning package to increase the number of people reached and raised awareness through our social media channels.

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ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

TRUSTEES' REPORT (continued) FOR THE YEAR ENDED 31 DECEMBER 2020

The main activities undertaken during the year to further the charity's purpose for the public benefit

The main activities of the charity have been to

The trustees have had regard to the Charity Commission's guidance on public benefit in managing the activities of the charity.

The main achievements and performance of the charity during the year

Training for Midwive s

Due to the pandemic we had to curtail our programme of Study Days from March 2020 however we ran four study days in the first quarter of the year. These were as follows

Derby 21st January Gloucester 12th February Exeter 3rd March Edinburgh 11th March

We were able to provide study days for midwives, mainly working in partnership with NHS organisations, including hospital trusts, CCG's and midwifery societies. We are very grateful for the support of these groups in helping to facilitate the days.

Derby

This was perhaps the first time we have undertaken a study day in a football club suite, and we are grateful to all the speakers, Hiten Mistry, Lou Edwards, Vicky Barrett, Layla Laverlee and Lauren Lacey who gave up their time for this.

Feedback from delegates was excellent.

Gloucester

This was one of the largest study days we have run for a long time and GHNHS Trust hosted. The keynote speaker was APEC founder, Prof Chris Redman who lectured on Pathophysiology. He also recorded a film about how APEC was founded which can be found on our YouTube Channel. Other speakers were Zoe Caruthers, Fran Conti-Ramsden and Layla Laverlee.

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ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

TRUSTEES' REPORT (continued) FOR THE YEAR ENDED 31 DECEMBER 2020

Exeter

Exeter was well attended and a popular day with midwives praising the speakers who included Peter Von Dadelszen, Mel Rich and Layla Laverlee.

“The most useful was to have specialist speakers who are engaged in and know the research evidence around pre-eclampsia. The international perspective was also interesting. The day was pitched at the right level and one that I enjoyed.” – Midwife feedback.

Edinburgh

Our Edinburgh Study Day was attended by 49 midwives and was hosted by Chair of Trustees Prof Andrew Shennan, other speakers were Ruth Stevenson, Alice Beardmore Gray, Colin Murdoch and David Arnot. We hoped to return to Scotland but coronavirus prevented this form happening and we will revisit this in the future.

Online Training

After a radical overhaul of the training in 2018 to our training programme online training has bedded in well. The course was written by experts led by trustee Prof Kim Turner and a team who contributed from throughout the world. The course is aimed at midwives, though GP’s and AHP’s have also participated.

This has supported our belief that pre-eclampsia is a global issue and our resources need to be made available where they are most needed.

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ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

TRUSTEES' REPORT (continued) FOR THE YEAR ENDED 31 DECEMBER 2020

Helpline

Our helpline has continued to offer support primarily to parents; we have seen a considerable rise in calls in the later half of the year after a dip in the second quarter. We have attributed this to concern over covid. We have especially seen a growth in calls from fathers to be. Where appropriate calls have been passed to our experts and we thank the very many clinical leaders who have taken cases on our behalf, often at a point of crisis and out of hours.

Two cases studies show the breadth of the calls we receive.

Tharshi’s Story

Tharshi’s son arrived in the world in November 2020 after sudden onset pre-eclampsia at 34 weeks. Her pregnancy was going smoothly until up to 37 weeks. Blood pressure was drastically high, and protein was present in urine. Prior to this Tharshi suffered with swelling in her feet, pain in her ribs and was on aspirin from 12 weeks. She was rushed off to the hospital and diagnosed with preeclampsia.. To measure the severity of it, she had a new test which measured the amount of placenta growth factor hormone. Levels indicated that the placenta was failing, and that baby had to be delivered within 10 days.

Blood pressure and the baby’s heart rate was regularly monitored, and baby’s growth had started to reduce. Within a matter of days, test results showed that the preeclampsia had become severe, affecting both the health of Tharshi and baby. The only cure was to deliver the baby. This resulted in baby Kesavan staying in the NICU for 2 weeks. Throughout his stay, he was on a ventilator, incubator, had jaundice and a feeding tube inserted. Those were the most difficult 2 weeks. This gave me the drive to want to raise awareness of pre-eclampsia, to spread the word as by another being aware, a woman’s life could be saved.

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ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

TRUSTEES' REPORT (continued) FOR THE YEAR ENDED 31 DECEMBER 2020

Joe’s Story

Joe’s wife Gabriella was extremely ill with HELLP syndrome and he later contacted APEC for support and advice about the future. In Dec 2019 at 38 weeks pregnant Gabriella was rushed into hospital with her blood pressure spiking out of control. She had severe Pre-eclampsia and HELLP Syndrome. 10:30pm their daughter Noa was born but for Gabriella it was the beginning of a very big battle. She suffered a severe haemorrhage during delivery and hours later she entered recovery. 8pm the next evening she suffered another major haemorrhage and had emergency surgery. They were struggling to stop the bleeding and needed to transport her to another hospital for a specialist operation, but she wasn’t stable enough. She was given a 30% chance of stabilising and the bleeding to stop. After what seemed like an eternity Gabriella stabilised and was transported. She spent 3 days in intensive care and 3 more days on the maternity ward. 10 days prior to all of this 10 days Gabriella was showing a number of symptoms for HELLP and Pre-eclampsia.

Joe is very supportive of APEC and understands the need to raise awareness as well as supporting partners. He is running the London Landmarks Half Marathon 2021 for APEC and has also recorded a podcast.

We have been called in to help on significantly complex problems where parents need support to get reports out of the NHS, especially where a baby has died. These cases require patience and diligence and can take many months of work and support.

During 2020 we identified that partners were a group who weren’t being heard and plan to launch a service for them in 2021.

Research

APEC is involved in research into the causes, treatments and development of knowledge about pre-eclampsia. We firmly believe that the patient voice has to be at the heart of research and without it, research is much harder. We are involved at every stage from study design through to publication and post publication dissemination to a wider audience.

2020 brought several projects to fruition and consequently we were involved in the following papers

Validation and development of models using clinical, biochemical and ultrasound markers for predicting pre-eclampsia: an individual participant data meta-analysis.

Published in Health Technol Assess. December 2020 24(72):1-252.

Planned Early Delivery or Expectant Management for Late Preterm Pre-eclampsia (PHOENIX): A Randomized Controlled Trial, on behalf of the PHOENIX Study Group

Published in Obstetric Anesthesia Digest: September 2020 – Volume 40 – Issue 3 – p 136-137

Aspirin should be targeted to those who need it

Published in BJOG. 2020 Sep 5.

IPPIC Collaborative Network. External validation of prognostic models predicting pre-eclampsia:

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ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

TRUSTEES' REPORT (continued) FOR THE YEAR ENDED 31 DECEMBER 2020

individual participant data meta-analysis.

Published in The BMC Med. 2020 Nov 2;18(1):302.

Research priorities for pregnancy hypertension: a UK priority setting partnership with the James Lind Alliance .

Published in BMJ Open. 2020 Jul 14;10(7):e036347.

Blood pressure monitoring in high-risk pregnancy to improve the detection and monitoring of hypertension (the BUMP 1 and 2 trials): protocol for two linked randomised controlled trials.

Published in BMJ Open. 2020 Jan 23;10(1):e034593.

External validation of prognostic models predicting pre-eclampsia: individual participant data metaanalysis.

Published in BMC Med 18, 302 (2020)

The impact of pre-eclampsia definitions on the identification of adverse outcome risk in hypertensive pregnancy - analyses from the CHIPS trial (Control of Hypertension in Pregnancy Study).

Published in BJOG November 2020.

Blood pressure monitoring in high-risk pregnancy to improve the detection and monitoring of hypertension (the BUMP 1 and 2 trials): protocol for two linked randomised controlled trials.

Published in BMJ Open. 2020 Jan 23;10(1):e034593.

Planned Early Delivery or Expectant Management for Late Preterm Pre-eclampsia (PHOENIX): A Randomized Controlled Trial

Published in Obstetrical & Gynecological Survey: February 2020 – Volume 75 – Issue 2 – p 83-84

Guidance for maternal medicine in the evolving coronavirus (COVID-19) pandemic

Published by RCOG 2020

Full details can be found I the new research portal of our website https://action-on-preeclampsia.org.uk/research/

Experts Day

The pandemic meant that alongside everything else our Experts Meeting needed to be taken online. This was done via zoom and we are very grateful to Charlotte Frise of the McDonald Obstetric Medicine Society and James Howie for their help with technical aspects and making for a flawless presentation.

Taking the meeting online meant we had over 250 delegates from throughout the world sign up from a wide variety of institutions from throughout the world. This meeting is rapidly becoming the UK meeting on hypertension in pregnancy and the attendance was more than double the highest ever attendance in 2019

Speakers included Professor Marian Knight, Dr Katherine Tucker, Dr Louise Webster, Donna Fullerton, Dr Alice Beardmore Gray, Dr Tanya Robins, Prof Laura Magee, Dr Laura Ormesher, Dr Shireen Meher, Mr Umber

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ACTION ON PRE-ECLAMPSIA LIMITED (A company limited by guarantee)

TRUSTEES' REPORT (continued) FOR THE YEAR ENDED 31 DECEMBER 2020

Agarwal, Khilna Shah, Rebecca Whybrow, Prof Alex Heazell, Prof Andrew Shennan OBE, Dr Charlotte Frise and Guy Checketts.

Sessions were chaired by Prof Andrew Shennan, Prof James Walker and Prof Lucy Chappell.

The Keynote speakers were Prof Marian Knight and Kemi Badenoch MP, the first time a government minister has spoken about pre-eclampsia and the first time a Minister has spoken at this meeting.

Feedback was hugely positive.

External Bodies, publications and campaigns

We continued to be involved in baby loss awareness week which goes from strength to strength. One of the main events of the week is the parliamentary discussion in the chamber of the House of Commons where once again action on pre eclampsia was mentioned.

We have continued to campaign for greater take up of PIGF testing, especially in the devolved administrations.

We have continued to enjoy close working relationships with other baby charities through the Pregnancy and Baby Charities Network. The principal outcome from this work has been a manifesto which sets out what the charities would hope from any government. There have also been a wide range of meetings with politicians and others especially within the National Health Service where collaborative working has meant we are able to achieve more than we would as individual charities.

As a direct result of this we have expanded the reach of our study days and now try to have a talk either from ICP support or Group B Strep Support.

We have been involved in a number of clinical trials as co investigator or as patient participation lead. We were especially pleased to be involved in the continuing work of the CRADLE trial and its offshoot

HAPPEE as well as the BUMP and PHEONIX trials. We have also been involved in a considerable number of other trials.

In May action on pre eclampsia took part in the world pre eclampsia day where we coordinated a number of activities and raised the profile significantly for both the day and the charity.

We have continued to work closely alongside the ISOM, ISSHP and McDonald Obstetric Medicine Society and are grateful for these collaborations which are mutually beneficial.

The charity has also been involved in a whole host of other organisations, conferences, papers and media articles.

Worldwide Activities

We have worked with patient participation groups in the United States, Australia, New Zealand and in Ghana. We hope to expand this work in 2020 with the formation of APEC International. We also participated in the World Pre Eclampsia Day which was a great success. We worked especially closely with APEC in Ghana who continue to grow from strength to strength.

Redman Walker Award

The charity set up the Redman Walker award in 2017. This designated fund of £20,000 has been designed to recognise the efforts of young researchers. The award will work on an annual cycle with up to two awards of £500.

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ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

TRUSTEES' REPORT (continued) FOR THE YEAR ENDED 31 DECEMBER 2020

Staffing

At the end of 2019 we were sorry to lose Carol Tustin, our administrator who retired. She has been greatly missed but we were pleased to welcome Charlie in her place who has settled in well. Rowan Grigg has continued as Education Officer and Marcus Green remains CEO.

For the APEC staff 2020 presented numerous challenges. We had set out an ambitious set of plans for the year including a record number of study days, more work overseas and considerable developments, all of which needed to be shelved due to the pandemic. Days before the first lockdown we ensured staff were prepared and ready to work from home, we did this by purchasing laptops and moving work online. The staff balanced work and family life, sometimes meaning working late and into the evenings to get work done.

It was decided early on that come what may, we would not furlough any staff, and this proved to be the correct decision as the call on our services was greater than ever.

Staff very rapidly became used to daily zoom meetings which have continued throughout and there has been considerable learning about how we can be more agile in delivering the services.

The Trustees are immensely grateful to the staff for going beyond the call of duty this year. It is appreciated.

Fundraising activities during the year

APEC’s principal fundraising activity was the London Marathon where a large number of individuals once again ran for the charity. We are immensely grateful to those runners who made a massive contribution.

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ACTION ON PRE-ECLAMPSIA LIMITED (A company limited by guarantee)

TRUSTEES' REPORT (continued) FOR THE YEAR ENDED 31 DECEMBER 2020

Our members have been generous in their support which is so gratefully received. We continue to rely on voluntary donations for virtually all our income.

During the pandemic we facilitated the sale of Cradle Blood Pressure devices to NHS trusts and others meaning

We are very grateful to the trusts who supported us in 2020

• Steel Charitable Trust £5,906.00
• Adint Charitable Trust £5,000.00
• D'Oyly Charitable Trust £3,250.00
• Souter Charitable Trust £3,000.00
• WychavonCovid relief grant £10,000.00
• James Tudor Foundation £5,906.00
• Hilda Farr £5,150.00

The difference the charity's performance during the year has made to the beneficiaries of the charity

During the year we have received some very positive feedback from those who have been in contact with our charity. A number of examples of this are shown below:

2020 study days quotes

“Really interesting to see all the things that can affect your blood pressure! I’ve been a midwife for 13 years and never known of some of these such as a full bladder “

“Good revision & a reminder to colleagues as I still see patients who have been told to do early morning urines and are not taught to do MSU's for dipping!.”

“It was most useful to have specialist speakers who are engaged in and know the research evidence around preeclampsia. The international perspective was also interesting. The day was pitched at the right level and one that I enjoyed.”

(On Woman’s perspective talk) “I felt that this was one of the most valuable parts of the day. It was really useful to hear the honest patient perspective and Zoe had a way of making me consider what it would be like to be in the woman and her family’s position. I will definitely bear Zoe in mind when communicating with women and their families.”

“I really enjoyed this (patient) perspective for those who become complacent in their job role, to be reminded of the patient’s perspective is always a good thing”

“A reminder of how important good communication is”

Helpline and other quotes

“Thank you. Those words don’t seem enough but they are truly heartfelt.”

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ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

TRUSTEES' REPORT (continued) FOR THE YEAR ENDED 31 DECEMBER 2020

STRUCTURE, GOVERNANCE AND MANAGEMENT OF THE CHARITY

The methods used to recruit and appoint new charity trustees

The charity is a company and charity and follows the legislation pertaining to both. The charity is governed by its Articles and Memorandum in a trust document from 1992. Trustees are satisfied that these documents meet the needs of the charity, now and into the future.

Trustees are appointed from within the membership. The governing document allows for between 5 and 13 trustees and there are currently 15. A vote at the AGM in 2020 allowed for a wider trustee board during the pandemic and in the aftermarth.

To appoint trustees, APEC follow the Charity Commission guidelines. Specifically, we:

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ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

TRUSTEES' REPORT (continued) FOR THE YEAR ENDED 31 DECEMBER 2020

The trustees' bankers and advisors

Bankers

The Co operative Bank, 1 Balloon Street, Manchester M60 4EP CAF Bank Limited, 25 Kings Hill Avenue, Kings Hill, West Malling,, Kent ME19 4JQ Royal Bank Of Scotland, RBS Business Banking, PO Box 16204, Birmingham, B2 2WP

Accountants

Donald Reid Limited, Prince Albert House, 20 King Street, Maidenhead, Berkshire, SL6 1DT.

Solicitors

Saunders Roberts 1 Crown Court Yard, Bridge Street, Evesham, Worcestershire, WR11 4RY

Financial review

Financial review of the position at the reporting date, 31 December 2020

The charity made a profit of £45,634 compared with a loss of £821 in 2019

The trustees consider the financial performance by the charity during the year to have been satisfactory. The trustees also consider the charity to be solvent and financially sound as at 31 December 2020. The principal sources of funding for the charity come from fundraising, training courses and donations. The principal risks and uncertainties relate to certainty of funding, trustees monitor and review this and other operational/strategic risks.

Policies on reserves

In the trustees’ view, the reserves should provide the charity with adequate financial stability and the means for it to meet its charitable objectives for the foreseeable future.

The trustees propose to maintain the charity’s reserves at a level which is at least equivalent to six months operational expenditure and have done so having regards to its manner of operation of likely funding streams.

The trustees review the amount of reserves that are required to ensure that they are adequate to fulfil the charity’s continuing obligations on a quarterly basis at their trustee meeting.

Trustees are content that reserves are at a satisfactory level given the size, scope and risks to the charity at the current time. The trustees plan that the charity is a going concern and have no uncertainties other than managed risks about this.

The current reserves are in excess of the stated policy however, this reflects the generous support we received in the first year of the pandemic, trustees consider that 2022 and 2023 could be harder years for fundraising and therefore are maintaining a higher level of reserves than they would otherwise.

Availability and adequacy of assets of each of the funds

The board of trustees is satisfied that the charity's assets in each fund are available and adequate to fulfil its obligations in respect of each fund.

Plans for the Future

The charity entered 2020 with significant plans to increase the number of study days, increase the capacity of the Experts Day, undertake more fundraising and reach more families.

In March 2020 Coronavirus regulations were enacted which curtailed gatherings and prevented study days from

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ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

TRUSTEES' REPORT (continued) FOR THE YEAR ENDED 31 DECEMBER 2020

taking place and we believe at this time there is little prospect of any return to normal activity levels before summer 2023. This meant the London Marathon was postponed and public fundraising has all but vanished. Whilst remedial measures were put in place through the year to stabilise and shore up the charities position there is no doubt that the future is at best uncertain.

Staff have worked from home through much of 2020 and trustees adjudged that meeting face to face was an unnecessary risk and meetings have taken place virtually via zoom.

Employment of disabled persons

During the year we did not take any new members of staff on and employ just two individuals who are part time. Should we have a vacancy arising in the future we would ensure that all equality legislation is followed correctly. At the year end Carol Tustin retired and an open recruitment process ensured the best candidate for the job was appointed.

Details of the Independent Examiner

Daniel Reid FCA Donald Reid Limited Chartered Accountants Prince Albert House 20 King Street Maidenhead Berkshire SL6 1DT

Statement of Directors' and Trustees' Responsibilities

The charity's trustees are responsible for the preparation of the accounts in accordance with the terms of the Companies Act 2006, Charities Act 2011 and the Charities (Accounts and Reports) Regulations 2008.

Notwithstanding the explicit requirement in the extant statutory regulations, the Charities (Accounts and Reports) Regulations 2008, to prepare the financial statements in accordance with the SORP 2005, in view of the fact that the SORP 2005 has been withdrawn, the determined to interpret this responsibility as requiring them to follow current best practice and prepare the accounts according to the FRS 102 SORP 2015.

In particular, the Companies Act 2006 and charity law require the Board of Trustees to prepare financial statements for each financial year which give a true and fair view of the state of affairs of the charity as at the end of the financial year and of the surplus or deficit of the charity. In preparing those financial statements the Board is required to:

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ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

TRUSTEES' REPORT (continued) FOR THE YEAR ENDED 31 DECEMBER 2020

The law requires that the trustees must not approve the accounts unless they are satisfied that they give a true and fair view of the state of affairs of the charity and of the surplus or deficit of the charity for the year.

The Trustees are also responsible for maintaining adequate accounting records which disclose with reasonable accuracy at any time the financial position of the charity and which are sufficient to show and explain the charity's transactions and enable them to ensure that the financial statements comply with the Companies Act 2006 and comply with regulations made under the Charities Act. They are also responsible for safeguarding the assets of the charity and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

The Trustees are also responsible for the contents of the Trustees' report, and the statutory responsibility of the Independent Examiner in relation to the Trustees' report is limited to examining the report and ensuring that, on the face of the report, there are no material inconsistencies with the figures disclosed in the financial statements.

Method of preparation of accounts - Small company provisions

The financial statements are set out on pages 15 to 29.

The financial statements have been prepared implementing the Statement of Recommended Practice for Accounting and Reporting by Charities 2015 and in accordance with the Financial Reporting Standard for Smaller Entities 2015.

These accounts have been prepared in accordance with the provisions in Part 15 of the Companies Act 2006 applicable to companies subject to the small company’s regime.

This report was approved by the board of trustees on 24 August 2021 and signed on their behalf by

Professor Andrew Shennan Director and Chair of Trustees

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ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

INDEPENDENT EXAMINER'S REPORT FOR THE YEAR ENDED 31 DECEMBER 2020

Independent Examiner's Report to the Trustees of Action on Pre-Eclampsia Limited (the 'charity')

I report to the charity Trustees on my examination of the accounts of the charity for the year ended 31 December 2020.

This report is made solely to the charity's Trustees, as a body, in accordance with Part 4 of the Charities (Accounts and Reports) Regulations 2008. My work has been undertaken so that I might state to the charity's Trustees those matters I am required to state to them in an Independent examiner's report and for no other purpose. To the fullest extent permitted by law, I do not accept or assume responsibility to anyone other than the charity and the charity's Trustees as a body, for my work or for this report.

Responsibilities and Basis of Report

As the Trustees of the charity (and its directors for the purposes of company law) you are responsible for the preparation of the accounts in accordance with the requirements of the Companies Act 2006 ('the 2006 Act').

Having satisfied myself that the accounts of the charity are not required to be audited under Part 16 of the 2006 Act and are eligible for independent examination, I report in respect of my examination of the charity's accounts carried out under section 145 of the Charities Act 2011 ('the 2011 Act'). In carrying out my examination I have followed the Directions given by the Charity Commission under section 145(5)(b) of the 2011 Act.

Independent Examiner's Statement

Since the charity's gross income exceeded £250,000 your examiner must be a member of a body listed in section 145 of the 2011 Act. I confirm that I am qualified to undertake the examination because I am a member of ICAEW, which is one of the listed bodies.

I have completed my examination. I can confirm that no matters have come to my attention in connection with the examination giving me cause to believe:

  1. accounting records were not kept in respect of the charity as required by section 386 of the 2006 Act; or

  2. the accounts do not accord with those records; or

  3. the accounts do not comply with the accounting requirements of section 396 of the 2006 Act other than any requirement that the accounts give a 'true and fair' view which is not a matter considered as part of an independent examination; or

  4. the accounts have not been prepared in accordance with the methods and principles of the Statement of Recommended Practice for accounting and reporting by charities [applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102)].

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ACTION ON PRE-ECLAMPSIA LIMITED (A company limited by guarantee)

INDEPENDENT EXAMINER'S REPORT (continued) FOR THE YEAR ENDED 31 DECEMBER 2020

I have no concerns and have come across no other matters in connection with the examination to which attention should be drawn in this report in order to enable a proper understanding of the accounts to be reached.

Signed: Dated: 24 August 2021 Daniel Reid FCA

Donald Reid Limited Chartered Accountants Prince Albert House 20 King Street Maidenhead Berkshire SL6 1DT

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ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

STATEMENT OF FINANCIAL ACTIVITIES INCORPORATING INCOME AND EXPENDITURE ACCOUNT FOR THE YEAR ENDED 31 DECEMBER 2020

Unrestricted
funds
Note
2020
£
Income from:
Donations and legacies
2
119,930
Other trading activities:
Fundraising
3
45,159
Trading activities
4
150,600
Investments
5
-
Total income
315,689
Expenditure on:
Raising funds:
Voluntary income
29,921
Fundraising trading
4
112,688
Other charitable activities
127,446
Total expenditure
9
270,055
Net income / (expenditure) before other recognised gains
and losses
45,634
Net movement in funds
45,634
Reconciliation of funds:
Total funds brought forward
118,697
Total funds carried forward
164,331		 Total
funds
2020
£
119,930
45,159
150,600
-
315,689
29,921
112,688
127,446
270,055
45,634
45,634
118,697
164,331		 Total
funds
2019
£
59,688
69,826
50,113
177
179,804
24,230
28,502
127,893
180,625
(821)
(821)
119,518
118,697

The notes on pages 21 to 32 form part of these financial statements.

Page 19

ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee) REGISTERED NUMBER: 02736320

BALANCE SHEET AS AT 31 DECEMBER 2020

Note
Fixed assets
Tangible assets
14
Current assets
Stocks
15
Debtors
16
Cash at bank and in hand
Creditors:amounts falling due within one
year
17
Net current assets
Net assets
Charity Funds
Unrestricted funds
18
Total funds		 £
2,030
2,941
162,430
167,401
(3,772)		 2020
£
702
163,629
164,331
164,331
164,331		 £
8,851
5,239
109,329
123,419
(5,726)		 2019
£
1,004
117,693
118,697
118,697
118,697

The charity's financial statements have been prepared in accordance with the provisions applicable to companies subject to the small companies regime.

The Trustees consider that the charity is entitled to exemption from the requirement to have an audit under the provisions of section 477 of the Companies Act 2006 ("the Act") and members have not required the charity to obtain an audit for the year in question in accordance with section 476 of the Act.

The Trustees acknowledge their responsibilities for complying with the requirements of the Companies Act 2006 with respect to accounting records and the preparation of financial statements.

The financial statements were approved and authorised for issue by the Trustees on 24 August 2021 and signed on their behalf, by:

Professor Andrew Shennan, Chairman

The notes on pages 21 to 32 form part of these financial statements.

Page 20

ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

1. Accounting Policies

1.1 Basis of preparation of financial statements

The financial statements have been prepared in accordance with Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2015) - (Charities SORP (FRS 102)), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Companies Act 2006.

Action on Pre-Eclampsia Limited meets the definition of a public benefit entity under FRS 102. Assets and liabilities are initially recognised at historical cost or transaction value unless otherwise stated in the relevant accounting policy.

1.2 Company status

The charity is a company limited by guarantee. The members of the company are the Trustees named on page 1. In the event of the charity being wound up, the liability in respect of the guarantee is limited to £1 per member of the charity.

1.3 Income

All income is recognised once the charity has entitlement to the income, it is probable that the income will be received and the amount of income receivable can be measured reliably.

For legacies, entitlement is taken as the earlier of the date on which either: the charity is aware that probate has been granted, the estate has been finalised and notification has been made by the executor(s) to the Trust that a distribution will be made, or when a distribution is received from the estate. Receipt of a legacy, in whole or in part, is only considered probable when the amount can be measured reliably and the charity has been notified of the executor's intention to make a distribution. Where legacies have been notified to the charity, or the charity is aware of the granting of probate, and the criteria for income recognition have not been met, then the legacy is treated as a contingent asset and disclosed if material.

Donated services or facilities are recognised when the charity has control over the item, any conditions associated with the donated item have been met, the receipt of economic benefit from the use of the charity of the item is probable and that economic benefit can be measured reliably. In accordance with the Charities SORP (FRS 102), the general volunteer time of friends is not recognised.

On receipt, donated professional services and donated facilities are recognised on the basis of the value of the gift to the charity which is the amount the charity would have been willing to pay to obtain services or facilities of equivalent economic benefit on the open market; a corresponding amount is then recognised in expenditure in the period of receipt.

Income tax recoverable in relation to donations received under Gift Aid or deeds of covenant is recognised at the time of the donation.

Income tax recoverable in relation to investment income is recognised at the time the investment income is receivable.

Page 21

ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

1. Accounting Policies (continued)

1.4 Expenditure

Expenditure is recognised once there is a legal or constructive obligation to transfer economic benefit to a third party, it is probable that a transfer of economic benefits will be required in settlement and the amount of the obligation can be measured reliably. Expenditure is classified by activity. The costs of each activity are made up of the total of direct costs and shared costs, including support costs involved in undertaking each activity. Direct costs attributable to a single activity are allocated directly to that activity. Shared costs which contribute to more than one activity and support costs which are not attributable to a single activity are apportioned between those activities on a basis consistent with the use of resources. Central staff costs are allocated on the basis of time spent, and depreciation charges allocated on the portion of the asset’s use.

Fundraising costs are those incurred in seeking voluntary contributions and do not include the costs of disseminating information in support of the charitable activities. Support costs are those costs incurred directly in support of expenditure on the objects of the charity and include project management carried out at Headquarters. Governance costs are those incurred in connection with administration of the charity and compliance with constitutional and statutory requirements.

Costs of generating funds are costs incurred in attracting voluntary income, and those incurred in trading activities that raise funds.

Charitable activities and Governance costs are costs incurred on the charity's educational operations, including support costs and costs relating to the governance of the charity apportioned to charitable activities.

All expenditure is inclusive of irrecoverable VAT.

1.5 Turnover

Turnover comprises revenue recognised by the charity in respect of goods and services supplied during the year, exclusive of Value Added Tax and trade discounts.

1.6 Tangible fixed assets and depreciation

A review for impairment of a fixed asset is carried out if events or changes in circumstances indicate that the carrying value of any fixed asset may not be recoverable. Shortfalls between the carrying value of fixed assets and their recoverable amounts are recognised as impairments. Impairment losses are recognised in the Statement of financial activities incorporating income and expenditure account.

Tangible fixed assets are carried at cost, net of depreciation and any provision for impairment. Depreciation is provided at rates calculated to write off the cost of fixed assets, less their estimated residual value, over their expected useful lives on the following bases:

Plant and machinery

1.7 Interest receivable

Interest on funds held on deposit is included when receivable and the amount can be measured reliably by the charity; this is normally upon notification of the interest paid or payable by the Bank.

Page 22

ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

1. Accounting Policies (continued)

1.8 Stocks

Stocks are valued at the lower of cost and net realisable value after making due allowance for obsolete and slow-moving stocks.

1.9 Debtors

Trade and other debtors are recognised at the settlement amount after any trade discount offered. Prepayments are valued at the amount prepaid net of any trade discounts due.

1.10 Cash at Bank and in hand

Cash at bank and in hand includes cash and short term highly liquid investments with a short maturity of three months or less from the date of acquisition or opening of the deposit or similar account.

1.11 Liabilities and provisions

Liabilities are recognised when there is an obligation at the Balance sheet date as a result of a past event, it is probable that a transfer of economic benefit will be required in settlement, and the amount of the settlement can be estimated reliably. Liabilities are recognised at the amount that the charity anticipates it will pay to settle the debt or the amount it has received as advanced payments for the goods or services it must provide. Provisions are measured at the best estimate of the amounts required to settle the obligation. Where the effect of the time value of money is material, the provision is based on the present value of those amounts, discounted at the pre-tax discount rate that reflects the risks specific to the liability. The unwinding of the discount is recognised within interest payable and similar charges.

1.12 Financial instruments

The charity only has financial assets and financial liabilities of a kind that qualify as basic financial instruments. Basic financial instruments are initially recognised at transaction value and subsequently measured at their settlement value with the exception of bank loans which are subsequently measured at amortised cost using the effective interest method.

1.13 Pensions

The charity operates a defined contribution pension scheme and the pension charge represents the amounts payable by the charity to the fund in respect of the year.

1.14 Fund accounting

General funds are unrestricted funds which are available for use at the discretion of the Trustees in furtherance of the general objectives of the charity and which have not been designated for other purposes.

Designated funds comprise unrestricted funds that have been set aside by the Trustees for particular purposes. The aim and use of each designated fund is set out in the notes to the financial statements.

Page 23

ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

2. Income from donations and legacies

Unrestricted
funds
2020
£
Donations
68,380
Grants
40,550
Sponsorship
11,000
Total donations and legacies
119,930
Total 2019
59,688
3.
Fundraising income
Unrestricted
funds
2020
£
Marathon income and other fundraising events
45,159
45,159
Total 2019
69,826
4.
Trading activities
Unrestricted
funds
2020
£
Charity trading income
Charity trading income - domestic
150,600
150,600
Fundraising trading expenses
Purchases
112,688
112,688
Net income from trading activities
37,912		 Total
funds
2020
£
68,380
40,550
11,000
119,930
59,688
Total
funds
2020
£
45,159
45,159
69,826
Total
funds
2020
£
150,600
150,600
112,688
112,688
37,912		 Total
funds
2019
£
43,400
2,788
13,500
59,688
Total
funds
2019
£
69,826
69,826
Total
funds
2019
£
50,113
50,113
28,502
28,502
21,611

Page 24

ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

5. Investment income

Unrestricted
funds
2020
£
Investment income - bank interest receivable
-
Total 2019
177
Direct costs
Unrestricted
funds
£
International development
-
Travel and subsistence
528
Marketing and advertising of charitable
services
-
Expert meetings and study day costs
3,784
Website
4,619
E Learning
-
Leaflet costs
-
Wages and salaries
24,892
Pension cost
448
34,271
Total 2019
53,347		 Total
funds
2020
£
-
177
Total
2020
£
-
528
-
3,784
4,619
-
-
24,892
448
34,271
53,347		 Total
funds
2019
£
177
Total
2019
£
1,235
2,707
6,775
9,384
1,409
940
3,423
27,080
394
53,347

6. Direct costs

Page 25

ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

7. Support costs

Unrestricted
funds
£
Travel and subsistence
40
IT support
1,872
Rent payable under operating leases
5,737
Light, heat and power
2,810
Telephone, fax and internet
1,211
Stationery and printing
1,095
Liability and contents insurance
535
Resource costs
1,172
Management consultancy
64,128
Staff training
1,214
Wages and salaries
8,370
Pension cost
149
Depreciation
302
88,635
Total 2019
69,506		 Total
2020
£
40
1,872
5,737
2,810
1,211
1,095
535
1,172
64,128
1,214
8,370
149
302
88,635
69,506		 Total
2019
£
-
2,415
4,989
2,275
1,202
1,056
735
712
46,146
468
8,976
131
401
69,506

8.

Governance costs

Unrestricted
funds
2020
£
Governance - accountancy and independent examination
3,480
Legal and professional fees
1,000
Bank charges
60
4,540		 Total
funds
2020
£
3,480
1,000
60
4,540		 Total
funds
2019
£
3,480
1,500
60
5,040

Page 26

ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

9. Analysis of Expenditure by expenditure type

Expenditure on raising
voluntary income
Expenditure on fundraising
trading
Costs of raising funds
Direct and support costs
Expenditure on governance
Total 2019		 Staff costs
Depreciation
Other costs
2020
£
2020
£
2020
£
-
-
29,921
-
-
112,688
-
-
142,609
33,859
302
88,745
-
-
4,540
33,859
302
235,894
36,581
401
143,643		 Total
2020
£
29,921
112,688
142,609
122,906
4,540
270,055
180,625		 Total
2019
£
24,230
28,502
52,732
122,853
5,040
180,625

10. Turnover

All turnover arose within the United Kingdom.

11. Net income/(expenditure)

This is stated after charging:

2020 2019
£ £
Depreciation of tangible fixed assets:
- owned by the charity 302 401

During the year, no Trustees received any remuneration (2019 - £NIL). During the year, no Trustees received any benefits in kind (2019 - £NIL). During the year, no Trustees received any reimbursement of expenses (2019 - £NIL).

12. Independent Examiner's remuneration

The Independent Examiner's remuneration amounts to an Independent Examination fee of £1,080 (2019 - £1,080), and accountancy of £2,400 (2019 - £2,400).

Page 27

ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

13. Staff costs

Staff costs were as follows:

Wages and salaries
Other pension costs		 2020
£
33,262
597
33,859		 2019
£
36,056
525
36,581

The average number of persons employed by the charity during the year was as follows:

Engaged on fundraising activities
Engaged on management and administration		 2020
No.
1
1
2		 2019
No.
1
1
2

No employee received remuneration amounting to more than £60,000 in either year.

14. Tangible fixed assets

Cost
At 1 January 2020 and 31 December 2020
Depreciation
At 1 January 2020
Charge for the year
At 31 December 2020
Net book value
At 31 December 2020
At 31 December 2019		 Plant and
machinery
£
25,244
24,240
302
24,542
702
1,004

15. Stocks

Stocks
2020 2019
£ £
Finished goods and goods for resale 2,030 8,851

Page 28

ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

16. Debtors

Other debtors
Prepayments and accrued income		 2020
£
1,516
1,425
2,941		 2019
£
593
4,646
5,239

17. Creditors: Amounts falling due within one year

Trade creditors
Accruals and deferred income		 2020
£
-
3,772
3,772		 2019
£
4,548
1,178
5,726

18. Statement of funds

Statement of funds - current year

Designated funds
Designated Funds - all funds
General funds
General Funds - all funds
Other General funds
Total Unrestricted funds
Total of funds		 Balance at
1 January
2020
£
20,000
98,697
-
98,697
118,697
118,697		 Income Expenditure
£
£
-
-
-
-
315,689
(270,055)
315,689
(270,055)
315,689
(270,055)
315,689
(270,055)		 Balance at
31
December
2020
£
20,000
98,697
45,634
144,331
164,331
164,331

Redman Walker Award fund

The charity set up the Redman Walker award in 2017. The trustees have created a designated fund of £20,000 in order to finance the Redman Walker Award, which has been designed to recognise the efforts of young researchers. The award will work on an annual cycle with up to two awards of £500.

Page 29

ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

18. Statement of funds (continued)

Statement of funds - prior year

Designated Funds - all funds
General Funds - all funds
Total of funds
Summary of funds - current year
Designated funds
General funds
Summary of funds - prior year
Designated funds
General funds		 Balance at
1 January
2019
£
20,000
99,518
119,518
Balance at
1 January
2020
£
20,000
98,697
118,697
Balance at
1 January
2019
£
20,000
99,518
119,518		 Income
Expenditure
£
£
-
-
179,804
(180,625)
179,804
(180,625)
Income Expenditure
£
£
-
-
315,689
(270,055)
315,689
(270,055)
Income
Expenditure
£
£
-
-
179,804
(180,625)
179,804
(180,625)		 Balance at
31
December
2019
£
20,000
98,697
118,697
Balance at
31
December
2020
£
20,000
144,331
164,331
Balance at
31
December
2019
£
20,000
98,697
118,697

Page 30

ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

19. Analysis of net assets between funds

Analysis of net assets between funds - current year

Unrestricted
funds
2020
£
Tangible fixed assets
702
Current assets
167,401
Creditors due within one year
(3,772)
164,331
Analysis of net assets between funds - prior year
Unrestricted
funds
2019
£
Tangible fixed assets
1,004
Current assets
123,419
Creditors due within one year
(5,726)
118,697		 Total
funds
2020
£
702
167,401
(3,772)
164,331
Total
funds
2019
£
1,004
123,419
(5,726)
118,697

Page 31

ACTION ON PRE-ECLAMPSIA LIMITED

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

20. Pension commitments

The charity operates a defined contributions pension scheme. The assets of the scheme are held separately from those of the charity in an independently administered fund. The pension cost charge represents contributions payable by the charity to the fund and amounted to £597 (2019 - £525). No contributions were payable to the fund at the balance sheet date at either the current or prior period end.

Page 32