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2021-03-31-accounts

St Gemma’s Hospice

Report and Financial Statements For the year ended 31 March 2021

Charity Registration No: 1015941

Company Registration No: 02773867

St Gemma’s Hospice Report & Financial Statements 2021

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Contents

Reference and Administrative Information ........................................................................................... Trustees’ Report ................................................................................................................................... Trustees’ Responsibilities Statement ................................................................................................... Independent Auditor’s Report .............................................................................................................. Consolidated Statement of Financial Activities .................................................................................... Balance Sheets .................................................................................................................................... Consolidated Cash Flow Statement ..................................................................................................... Statement of Accounting Policies ......................................................................................................... Notes to the Group Financial Statements .............................................................................................

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Reference and Administrative Information

Charity Name St Gemma’s Hospice

Charity Registration Number 1015941

Company Registration Number 02773867

Registered Office 329 Harrogate Road Moortown Leeds LS17 6QD

Patrons

The Right Rev Marcus Stock, Catholic Bishop of Leeds The Right Rev Nick Baines, Anglican Bishop of Leeds The Earl and Countess of Harewood Professor Gerald Richards Tom Riordan CBE Arif Ahmad Zulfi Hussain MBE HM Lord-Lieutenant for West Yorkshire, Ed Anderson Marilyn Stowe Henry Cohen

Bankers HSBC Bank plc 108 Harrogate Road Leeds LS7 4NU

Investment Advisers Investec Wealth and Investment 2 Gresham Street London EC2V 7QN

Auditor Deloitte LLP Statutory Auditor 1 City Square Leeds LS1 2AL

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Hospice Leadership Team

Dr Mike Stockton

Consultant in Palliative Medicine & Chief Medical Officer

Kerry Jackson Chief Executive

Heather McClelland Chief Nurse & Registered Manager

Jason Kirk

Chief Operating Officer & Company Secretary

Board of Trustees

Dr Peter Belfield Chair of the Board Member of the Corporate Governance Committee

Sr Carmel Gorman CP

Sr Anne Hammersley CP

June Toovey

Deputy Chair of the Board Chair of the Clinical and Academic Governance Committee to February 2021; Member of the Corporate Governance Committee

Angus Martin

Chair of the Finance & Business Committee; Member of the Corporate Governance Committee

Reverend Barry Miller

Sue Ansbro

Deputy Chair of the Board Chair of the Corporate Governance Committee; Member of the Finance and Business Committee

Professor Julia Newton-Bishop (retired January 2021)

Member of the Clinical and Academic Governance Committee

Kuldeep Bajwa

Member of the Clinical and Academic Governance Committee; Diversity Champion

Hilary Barrett

Sr Therese O’Regan CP

Dr Mohammed Sattar

Member of the Clinical and Academic Governance Committee

Member of the Finance & Business Committee

Chris Schofield

Philomena Corrigan

Member of the Clinical and Academic Governance Committee; Chair of the Clinical and Academic Governance Committee from March 2021;

Member of the Corporate Governance Committee from March 2021

Member of the Finance & Business Committee

Sr Savio Steed CP

Dr Jonathan Smith

Member of the Clinical and Academic Governance Committee

Sr Eileen Fucito CP

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Trustees’ Re ort p

Our Vision:

The needs of people living with a terminal illness and those close to them are met with care, compassion and skill

Our Purpose:

St Gemma’s Hospice acknowledges the value of life and the importance of dignity in death. We provide and promote the highest quality palliative and end of life care, education and research

Our Values:

Caring - Treating each person with kindness, empathy, compassion and respect

Aspiring - Continually learning and developing; striving for excellence in everything we do

Professional - Delivering high standards through team work, a skilled workforce and good governance

Our Strategy 2018 - 2028:

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OUR
FOUNDATIONS
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Statement from the Chair and the Chief Executive

Welcome to the St Gemma’s Report and Financial Statements for the year to 31 March 2021. St Gemma’s Hospice has continued to deliver our core purpose of providing and promoting the highest quality palliative and end of life care, education and research. In this year dominated by the COVID-19 pandemic, the importance of high quality end of life care and bereavement support has been in evidence more than ever.

We have worked closely with partner providers and commissioners in Leeds, as part of the Leeds Palliative Care Network, to ensure an agile and coordinated response to meeting the complex needs and preferences of patients facing a terminal illness and their families and carers. We have altered the way our services have been provided in order to manage a host of new risks and challenges, with a relentless focus on high quality patient care, the wellbeing and safety of our staff and volunteers and the financial sustainability of St Gemma’s.

Feedback from patients and families, together with monitoring of our key clinical and operational performance indicators, have given assurance that we have continued to provide outstanding care. We have engaged with the Care Quality Commission (CQC) throughout the pandemic and we continue to closely monitor compliance with regulatory standards. We have worked closely with Public Health and Infection Control colleagues in the city to ensure effective management of COVID-19 risks and outbreaks.

The professionalism, flexibility and expertise of our staff and volunteers have been inspiring, particularly in light of the workplace, personal and family challenges that staff have had to contend with. We have introduced a range of additional staff support measures during the pandemic, from additional online information to provision of one to one staff support. We have also supported staff to establish their own Multicultural Network, a support network for our black, Asian and minority ethnic colleagues and a positive force for change within the Hospice. We are enormously grateful to all our staff for living our values of caring, aspiring and professional throughout the year.

Our education provision has seen a transformation from largely face to face teaching to significantly more online education provision, which has allowed us to educate twice as many professionals as last year, nationally as well as locally, influencing and improving the care for many more people than receive services directly from St Gemma’s. We have continued to support placements for medical, nursing and other students despite the restrictions of the pandemic, helping to secure the workforce of the future.

All our services are provided free of charge to patients, families, friends and carers. Each year our local community is incredibly generous in supporting us with

donations, legacies, fundraising, and supporting our retail chain. We are very grateful that our community continued this vital support for the Hospice,

although the restrictions imposed due to the pandemic meant that in 2020/21 many of our events had to be cancelled and our shops were closed for much of the year. We are also grateful to NHS Leeds Clinical Commisisoning Group, NHS England and Leeds City Council for providing grant funding of £6.3m, £2.7m of which was one-off funding related to COVID-19.

Despite a challenging year, we are in a solid financial position with good reserves and a robust financial plan.

We offer sincere thanks to our Board of Trustees who have been flexible and responsive, offering support, challenge and guidance to the Hospice Leadership Team during this year. We welcome our new Trustees, Professor Sir Alex Markham, who joined us in April 2021, and Will Lifford and Kim Gay who joined us in September 2021.

We are also grateful to our Patrons for their ongoing support. Sincere thanks go as always to the Sisters of the Cross and Passion, who continue to provide inspiration, support and challenge to the appointed Trustees and the Hospice Leadership Team.

Dr Peter Belfield Kerry Jackson Chair of the Board Chief Executive

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The Hospice has been part of my life in one way or another from being a little girl and if I can help in my small way to raise funds then I will do my best.

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24 Retail Outlets

List ranking: 44th

17,801 Community Nursing and Medical Contacts (2019/20: 15,979)

(2019/20: 24)

Volunteers (inc. Trustees) 950 contributed 16,442 hours (2019/20: 986) (129,813)

508

Admissions to In-Patient Unit

(2019/20: 511)

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71% 29%
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Cancer : Non Cancer Split (New Referrals) (2019/20: 71%, 29%)

31% CCG Core Grant

(2019/20: 28%)

1,986 Day / STAR* Services Contacts (2019/20: 1,711)

Retail 435,528 Items Sold (2019/20: 1,169,228)

284

(2019/20: 270)

11 days Average In-Patient Length of Stay (2019/20: 13 days)

*Support, Therapy and Resources

**Survey not completed during 2020 due to COVID-19 pandemic

Strategic Report

St Gemma’s Hospice is a registered charity. Our objectives are the:

The Trustees have referred to the guidance contained in the Charity Commission’s general guidance on public benefit when reviewing the aims and objectives of the Hospice and in planning future activities which are set out in this report.

Our services are open to patients over the age of 18 regardless of race, religion, sexual orientation, age or diagnosis. We provide care to people with a range of diagnoses including cancer, neurological conditions and end stage respiratory and heart disease. We also provide support to families and carers including children and young people.

The Hospice team provides specialist palliative care, where the patient has unresolved needs that exceed the expertise of the referring team, and end of life care. Care is provided by our specialist team of doctors, nurses, social workers, therapists, counsellors and spiritual care workers and by our team of vital support staff and volunteers. Much of our care is provided in people’s own homes and care homes, with care also offered in our In-Patient Unit and Day Services in Moortown. Our Day Services offer was largely provided to people in their own homes during 2020/21 due to the COVID-19 pandemic.

St Gemma’s care is individual and holistic, seeking to alleviate symptoms such as pain and breathlessness as well as supporting people’s emotional and spiritual wellbeing. We recognise the unique physical, emotional, social and spiritual needs of each person and place a high value on respect, choice and empowerment.

Our services are free to patients and those close to them, but they are not free to provide. The local community continues to provide thousands of volunteer hours every year as well as providing significant funding through donations, fundraising and gifts in wills. We are extremely grateful for the amazing generosity of local people.

2020/21 was an extraordinary financial year. We received £2m of COVID-19 grant income from NHS England. This funding, together with grant

income received from NHS Leeds Clincal Commissioning Group, meant that our NHS funding in 2020/21 represented 50% of the total income generated by St Gemma’s Hospice.

The Hospice is subject to regular review by the Care Quality Commission. The latest unannounced inspection was on 13 July 2016 when St Gemma’s Hospice services were rated as Outstanding.

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The Year Under Review

Strategic Priorities

During 2019/20 we identified a number of strategic areas of focus for 2020/21. These were in line with our ten year Hospice Strategy, which is outlined further in the Looking Ahead section on page 19.

We had already determined through our ongoing service reviews that population changes will increase the demand for our care over the coming years. The COVID-19 pandemic, which began in March 2020, made dramatic changes to our world in so many significant ways, including highlighting further the importance of a good death and the need for support for the bereaved.

Continuing to provide high quality patient care, rapidly transforming services to meet the changing environment of a pandemic, and securing our financial stability quickly became the highest priorities for the organisation. We have not, however, lost sight of our longer strategic goals during this period.

Responding to the COVID-19 Pandemic

been the most difficult year the Hospice has ever faced.

Important areas to highlight relating to our response to COVID-19 pandemic include:

The risks and realities of the COVID-19 pandemic have dominated the 2020/21 year. The Hospice Senior Leadership Team has pulled together, making collective decisions, adapting and balancing competing risks, and engaging regionally and locally with other care providers. We have ensured that high quality patient and family care and professional education have continued and that the safety and wellbeing of our staff and volunteers have been prioritised throughout.

The number of patients and families we cared for was stable compared with the prior year. However, as a result of the COVID-19 pandemic we saw an increase in the complexity of patient need resulting from late referrals for care, fewer face to face consultations in primary and secondary care and social isolation impacting on people’s physical and mental wellbeing.

We have continued to engage with our local community and we are enormously grateful for their ongoing support and understanding during what has

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St Gemma’s staff and volunteers have responded incredibly well and continued to put the needs of patients and families at the centre of all they do. Hospice leaders have worked hard to make sure staff have had the support they need, in teams or individually, and continue to do so; the pandemic is not yet over and the effects will continue to be felt for some time to come.

Providing High Quality Clinical Care

We measure the quality of our clinical care in a variety of ways including patient outcome measures, patient and family feedback, complaints, service evaluation and audit, patient safety incidents, benchmarking, staff views and the findings of national and local reviews.

Patient safety is central to everything we do at St Gemma’s. We monitor safety using a range of measures and investigate areas that raise concern. In 2020/21 we introduced an Incident Review meeting to discuss all incidents and present Root Cause Analyses as required. A learning bulletin is created quarterly to share learning and encourage incident reporting. Our key performance indicators for 2020/21 do not give rise to any significant areas of concern.

Throughout 2020/21 we conducted a bereaved carers’ survey for families of patients who died on the In-Patient Unit. We received 158 responses and heard the following:

----- Start of picture text -----
Question/Topic Response
Relative died in the right 96% Yes
place
Relief of pain 95% very satisfied/
satisfied
Relief of symptoms other 93% very satisfied/
than pain satisfied
Cared for with dignity 99% very satisfied/
satisfied
Respecting wishes before 93% very satisfied/
and after death satisfied
----- End of picture text -----

It was her request to pass away in St Gemma’s so we were very happy that she managed to get a bed and have her last wish granted.

During July 2020 we surveyed patients and families who were receiving care from our Community Clinical Nurse Specialist service. We received 52 responses and 100% of people felt they were or their relative was treated with respect, that nurses were helpful in assessing their problems and they felt listened to. 94% felt involved in decisions about care and 98% felt satisfied or very satisfied with the overall service provided by the Community Nursing team.

For the first time we also undertook focused experience work with those patients and families receiving services from our Social Work and Therapy (Physiotherapists and Occupational Therapists) services. From 34 responses, we found that 100% of respondents were satisfied or very satisfied with the Therapy service provided and 96% with the Social Work service. For both services 100% of respondents felt they or their relative were treated with respect, that Social Workers/Therapists were helpful in assessing their problems and they felt listened to. 94% felt involved in decisions about their care.

Across all our surveys we asked if people felt they could ask a question or raise a concern. For 99% of 239 responses, the answer was yes.

We also found high levels of satisfaction from patients and families with the changes that were made to the way we offered our services during the pandemic.

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Delivering Clinical Quality Improvements

Securing our Financial Future

St Gemma’s Hospice is committed to continuous quality improvement with a focus on professional development for clinical teams, service improvements for patients and families and ensuring the best use of resources. We keep patients at the centre of everything we do, whether in working with them to personalise their care or building services that respect individuality.

St Gemma’s Hospice provides services free of charge to patients, families, friends and carers.

2020/21 saw fundamental changes to the basis of our funding due to COVID-19, with St Gemma’s shops closed for much of the year, events cancelled and corporate and community activities significantly curtailed.

In addition to establishing and reporting on our own consistent measures of quality and safety, we submit safety data to the Hospice UK’s benchmarking programme, and have quarterly meetings with NHS commissioners locally to review citywide hospice services.

Each year St Gemma’s identifies priorities for clinical quality improvement, set out in our Quality Account. The priorities are in line with our Hospice Strategy and informed by evidence, patient and family feedback, staff suggestions, learning from incidents and complaints and engagement with partners in the city. Delivery of our priorities for 2020/21 was delayed due to the pressures of the pandemic, although good progress was made in a number of areas.

The priorities were:

We are particularly proud of our work to support homeless and vulnerably housed people with a terminal illness and at the end of life. This work, which has been delivered in collaboration with a number of partner organisations in Leeds, has resulted in a significant increase in the number of patients cared for, and has made a huge difference to their quality of life and death, and facilitated supporting their families in bereavement. The project has been shortlisted for the Nursing Times Team of the Year Award.

Our local community continued to be incredibly generous. Donations to our charity shops during the pandemic were exceptional, creating enough stock to fill 22 containers in addition to our Bramley warehouse and retail trading was strong when we reopened our shops. Customers were also able to shop online with our improved eCommerce offer, which we are looking to improve further in 2021/22. Gifts in memory of a loved one continued at prepandemic levels, despite the restrictions around funeral attendances, with new initiatives to support in memory fundraising such as a ‘Much Loved’ tribute and fundraising page. Our annual Light up a Life event was moved fully online with a live stream which was very successful.

The Hospice is very grateful to the people who show kindness and generosity by leaving a gift in their will to St Gemma’s. Legacy income for 2020/21 reached over £1.2 million with a strong legacy pipeline and plans being developed to improve our legacy infrastructure for 2021/22.

Individual giving through appeals was much more successful than in previous years, as was our newly outsourced lottery. These are good examples of where the Covid pandemic has challenged the norms and the approach to income generation and where the team, supported by the Hospice Leadership Team, has delivered new activity to boost valuable income but also to establish new, successful models for the future.

We are extremely appreciative of all those who make donations, take part in fundraising events, leave a gift in their Will, donate their time through volunteering or help the Hospice in any way. It would simply not be possible to raise the money needed for patient and family care without this support.

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Despite the generosity and support of our local community, the pandemic had a significant impact on our fundraising, retail and wider income generating activities. The challenges of the pandemic were embraced positively and allowed the team to review historical fundraising practices and to foster a culture of change, invention and innovation with a number of new initiatives implemented that will support income generation for years to come. We continue to review our voluntary income generation opportunities and plans in depth.

In addition to our grant funding of £3.6m from NHS Leeds Clinical Commissioning Group, we also received one off grant funding of £2m from NHS England as well as local authority COVID-19 support grants. We are actively engaged in local, regional and national discussions about future NHS funding support, including playing an active part in the new Integrated Care System for West Yorkshire.

Despite the pressures of this unusual year, we made a decision not to cut services or make any staff redundant, due to our strong reserves position, robust financial forecasting and the importance of building on St Gemma’s services for the long term.

We continue to review all our services on an ongoing basis to ensure we are operating as efficiently as possible, that we are spending wisely in delivering our care, and that we are responsive to the changing palliative and end of life care needs of local people.

Delivering High Quality Research & Education

The Academic Unit of Palliative Care (AUPC) has seen major adaptation and innovation during 2020/21.

Patient recruitment to research projects was paused as a result of the COVID-19 pandemic, but the AUPC continued to undertake office-based research and publish extensively, with 21 papers in peer reviewed journals.

New grant income of £350k was secured for CAPTURE, a multi-centre cluster randomised feasibility trial of a cancer pain assessment toolkit for use in oncology outpatient services. Other ongoing research projects include ACCESSA (Access to palliative care for Black, Asian and Minority Ethnic communities across Yorkshire and the East Midlands), research that is being extended to other centres.

In our Learning and Teaching Department we have further increased our focus on tele-education and have adapted our external education delivery to healthcare professionals in response to the challenges of the pandemic. Our comprehensive training programme includes courses on Advanced

Communication Skills; the European Certificate in Palliative Care; Advance Care Planning (ACP) and Communication

Skills; End of Life Care Training and a Clinical Nurse Specialist Regional Programme. Many of these courses have been offered regionally and nationally as well as locally, and to a broader range of attendees than in the past.

In addition we have produced and provided a specific range of training courses across health and social care during the pandemic, for example on Infection Prevention and Control, and on Virtual Verification of Expected Adult Death, funded by Health Education England (HEE). 126 people participated in the HEE sessions, including nursing homes, community practitioners, GP practices, hospices and prisons.

We have provided clinical placements at St Gemma’s for 98 students from a range of programmes including medicine, nursing and allied healthcare. We also provided end of life care training for pre-registration nurses and apprenticeship nurses.

We provide a comprehensive internal training programme for staff which consists of face to face and online learning through our Learning Management System (LMS).

We offer apprenticeship opportunities and currently have two staff on clinical apprenticeships including one Registered Nursing degree student.

We continue to grow and establish vital links with other palliative care providers, hospices, universities, hospital trusts and HEE. The learning and teaching programme is continuously being evaluated, reviewed and modified, and is highly adaptable to the workforce, and to healthcare and funding changes.

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Enhancing Hospice Culture for Staff and Volunteers

In 2019/20 St Gemma’s participated in The Sunday Times Best Companies Survey, achieving a ranking of 18th in the Times Top 100 Not for Profit Organisations. We did not participate in the survey in 2020/21, but we retained a focus on staff wellbeing and remained mindful of the areas for improvement identified in the Times Top 100 survey.

During the year new initiatives to support staff in their work/life balance and to promote mental health and wellbeing included:

Resilience workshops run by our Complementary Therapists focussing on how to cope in challenging and stressful times

• Staff Wellbeing Conference in October 2020, comprising a week of virtual events.

In addition, to show St Gemma’s appreciation of staff, all those staff members on site early in the pandemic were offered free staff meals (March – June 2020) and all staff received an additional ‘wellbeing’ day off during 2020/21.

Our Employee Engagement Group has played a key role in developing the wellbeing offer. At all times we endeavour to provide employees with good working conditions, a healthy work/life balance and opportunities for development.

As a Hospice with an ethnically diverse workforce we have supported staff from black, Asian and minority ethnic backgrounds to create a Multicultural Network. Staff are enthusiastic about this initiative, which creates a collective space to share experiences, learn from one another and influence Hospice practice.

In July 2020 we undertook an internal staff survey which focused upon staff experience of working for St Gemma’s during the pandemic. Of the 47% of staff who responded, we heard the following:

----- Start of picture text -----
Question Very satisfied/
satisfied
How satisfied are you 86%
with how St Gemma’s has
communicated with staff
during the pandemic?
How satisfied are you with how 85%
St Gemma’s has supported
your personal and workplace
wellbeing?
How satisfied are you with the 94%
way St Gemma’s has continued
to manage key services?
Do you feel you have been 94%
given adequate information
and advice to feel safe during
the pandemic?
If applicable, do you feel you 88%
have been adequately trained
in the safe use of Personal
Protective Equipment (PPE)?
Given the way the Hospice has 94%
responded to the COVID-19
pandemic, are you confident in
St Gemma’s ability to plan for
the future?
----- End of picture text -----

In November 2020, concerns were raised with the Care Quality Commission (CQC) by a member of staff about the culture and behaviours on St Gemma’s In-Patient Unit (IPU). We conducted an extensive investigation involving all staff on the

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unit. The investigation was led by the Director of Transformation & Culture who worked closely with the Chief Nurse. CQC requested an assurance report regarding our response to this notification; they were satisfied with the Hospice response.

The investigation found that Hospice values and behaviours are held at the heart of the majority of staff working within the St Gemma’s In-Patient Unit, but that behaviours of a small number of staff needed to be addressed and this has now been done. We identified a number of areas where improvements can be made and these have formed the basis of an IPU Culture Improvement Plan which we have begun to deliver.

We greatly value our volunteer workforce as an integral part of the Hospice. In 2020/21 our volunteer provision significantly reduced from around 130,000 hours to 16,442 hours due to the impact of the pandemic on retail, events and other clinical and support services.

Despite this reduction, volunteers have continued to support us in a number of critical areas, including our Board of Trustees, who have increased their engagement in order to support the Hospice Leadership Team in making key decisions and to gain assurance during the pandemic. Volunteers have also continued to support our bereavement and spiritual care services, Hospice shops, e-commerce and fundraising events and in maintaining our Hospice gardens.

All volunteers were provided with guidance from departmental line managers on COVID-19 safety including participation in the Hospice testing programme and completing personal COVID-19 risk assessments. Volunteers continued to be updated by their departments and all received a monthly volunteer e-newsletter.

We are now developing a new, ambitious volunteering plan for the Hospice to start to implement during 2021/22.

Ensuring Equality, Diversity and Inclusion

One of our aims for 2020/21 was to improve accessibility to our services across a number of different groups and communities. As part of the work done through our internal Involve Group, we now routinely report the ethnicity of our patient population, benchmarked against citywide data. The ethnic mix of patients cared for by St Gemma’s during the year showed greater diversity than our population overall. The data highlights some ethnic groups that are still under-represented which is the basis of ongoing work.

Our Involve Group is tasked with keeping diversity, inclusivity, accessibility and community engagement high on the Hospice agenda. Colleagues work across the city to better understand the changing demographics of the population and identify any gaps in service provision or engagement. We meet regularly with the Community Engagement Group who act as advocates for our services in their local communities. Due to the pandemic the group has been unable to meet but we have maintained contact through Leeds Involving People and aim to re-establish our meetings as soon as possible.

During the year we have continued to support other groups who may find access to palliative and end of life care more difficult, including patients with learning disabilities and people who are homeless or vulnerably housed. We work very closely with groups across the city to learn from the experiences of others and to build our own learnings into future care provision.

We are passionate about creating

an inclusive workplace that promotes and values diversity in all of its forms. We recognise the difference diversity and inclusion make to the services we provide, internally and externally.

We have made significant progress with our Trustees and the leadership team in fostering and cultivating an inclusive work environment and report back regularly to the Board on our achievements in this area.

We were again placed 44th in the Inclusive Companies Top 50 Employers list (2021).

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This award recognises the efforts of organisations in moving towards a truly diverse workforce, and their commitment to equality and inclusion. We were proud to receive this position again in our second year of participation as recognition of our work, and also as a guide to how we can continue to develop in this area. The position was particularly significant as many larger national organisations have now joined the list.

We remain a Disability Confident Employer and hold Leeds Commitment to Carers status.

Community Engagement

St Gemma’s has been an important part of the Leeds community for over 42 years. The Hospice and its vital services only continue thanks to the ongoing support and interest of the whole community.

It is a priority to continue to promote the work of the Hospice, the impact of our work across the city and the ongoing need for support. We do this across a range of channels including social media, websites, our chain of charity shops across Leeds, a supporter newsletter and a monthly e-bulletin. We send regular news stories to the local media, and we advertise on local radio, in newspapers, community magazines and on buses and billboards. Market research commissioned by St Gemma’s and carried out in June 2020 by an external agency, Trinity McQueen, found St Gemma’s Hospice brand to be ranked number 1 in Leeds for spontaneous awareness ahead of larger, national charities such as Oxfam and British Heart Foundation. The research also highlighted that 49% of respondents heard, saw or read about the Hospice in a shop window, highlighting the importance of the retail chain on overall brand awareness.

We usually attend community events to promote our services and engage with different audiences. This was difficult in the past year as many events were cancelled, but we still tried to keep in contact with the community via online channels. The annual Leeds Dying Matters event continued with a range of virtual support groups and ‘death cafés’ across the city. We look forward to getting back out into our community as soon as possible.

Delivering Digital Innovation

The COVID-19 pandemic required us to work differently to continue to provide high quality, effective care and support to our patients and families. We rapidly established a process and system for remote consultations, enhanced our

tele-education offer to support the broader system locally, regionally and nationally, and ensured that as many staff members as possible could work remotely with access to all required systems and resources.

We made progress in all areas of our plan during 2020/21;

We are continuing with our ambitious digital transformation plans throughout 2021/22. To support these changes we have created a designated reserve to support digital developments (£250k) and have established a cross Hospice Digital Transformation Group (DX Group) to oversee and coordinate these plans.

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18 St Gemma’s Hospice Report & Financial Statements 2021

Looking Ahead

St Gemma’s Strategy provides a framework for the long-term development of services under three pillars of Impact, Connect and Extend, supported by foundations of scope, quality and sustainability. Our Strategy has been developed considering national best practice, the needs and wishes of patients, families and staff, as well as the social and economic environment, anticipated growth in need, and the requirement for services to be flexible and responsive to user needs. Our Strategy is consistent with the city wide End of Life Care Strategy adopted by providers and commissioners across Leeds, a strategy which has recently been updated by city-wide partners.

Our key areas of focus for 2021/22 will be:

We will also have a particular focus in 2021/22 on community services, including ongoing improvements to triage processes and review of pathways for patients with a non-cancer diagnosis. We will continue to work with partners in the Leeds Palliative Care Network as we review the whole model of palliative and end of life care in community settings.

• Securing our Financial Future: we have developed a revised five year financial outlook and an updated budget for 2021/22 and our financial outlook is healthy. Our focus in the coming year will be on innovative growth of our voluntary income generation lines, and continuing to build on our relationships with the NHS locally, regionally and nationally, including fully engaging with the new Integrated Care System, to secure our long term NHS funding. We will continue to fully engage with and respond to the financial challenges of the pandemic.

• Developing the Academic Unit of Palliative Care: with the retirement of the St Gemma’s Professor of Palliative Care, we are working closely with the University of Leeds to secure the long term future of our research activity. We are also planning changes to our education provision to increase resources available to continue expansion of our offer.

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Financial Review

Year on Year Income Review

The Financial Statements comply with the Charities Act 2011, the Companies Act 2006 and the Charities Statement of Recommended Practice (SORP) applicable to charities preparing their accounts in accordance with the Financial Reporting Standard (FRS 102).

The statement of financial activities shows a deficit for the year of £104,314 (2020: surplus £533,514) prior to any gains or losses on investments. Total income for the year was £11,485,382 (2020: £11,633,424) representing a small decrease of £148,042 (1.3%).

This is an incredible financial achievement reflecting all the hard work of staff at St Gemma’s in responding and managing the significant challenges brought about by COVID-19. We are also thankful to our generous donors who have continued to support St Gemma’s at a time when our financial resources and the whole healthcare system were under significant pressure.

COVID-19 has brought unprecedented financial challenge to the sustainability of the Hospice during 2020/21. We are grateful for the support of NHS Leeds Clinical Commissioning Group (£3.7m) and financial support from NHS England received via Hospice UK (£2m). This ensured Hospice capacity was maintained during the pandemic and more importantly meant we did not cut or reduce vital services when needed most.

We furloughed the majority of our shop staff and temporarily closed shops in response to the Government lockdowns during 2020/21. We took advantage of the key Government schemes allowing us to claim furlough payments of £417,641 (Coronavirus Job Retention Scheme) and Retail Support Grants totalling £270,781 (2020: £450,000).

Shop income of £1,143,461 (2020: £2,987,331) represents a year on year decrease of £1,843,870 (62% reduction) across our charity shops.

As expected, trading conditions were adversely affected throughout the financial year due to the impact of COVID-19 and the Government imposed lockdowns. We re-opened our shops 12 April 2021; weekly sales income has perfomed above prepandemic trading levels. This financial performance gives confidence in our budget setting 2021/22 and longer term financial planning.

Income from donations, trusts, grants and fundraising events of £2,134,883 (2020: £2,387,912) has decreased by £253,029 (10.6%) excluding government grants. This reflects strong growth in trust grants of £200,000, mainly linked to a one off payment generously donated on the closure of a charitable fund, offset by a reduction of £455,869 across donations and events. The impact of COVID-19, Government lockdowns and restrictions led to the cancellation of many fundraising events. We have delivered a number of successful events since July 2021 achieving key financial targets in what continues to be a very competitive Leeds market-place. The impact of COVID-19 will continue to influence our fundraising and events during 2021/22.

Total expenditure of £11,589,696 (2020: £11,099,910) increased by £489,786 which represents an increase of 4.4%. This increase is due to the annual pay award and the financial pressures as a direct result of the pandemic including £168,643 invested in Personal Protective Equipment (PPE) for all of our staff and a further £57,454 on IT equipment to support hybrid working. We continue to control expenditure and drive improvements to support our long-term financial plan.

The investment portfolio generated a surplus of £1,246,821 (2020: loss of £646,088). The 12 months to 31 March 2021 saw the portfolio post a sharp recovery in its value as global equity markets responded positively to the financial support that central banks and governments offered in response to the Coronavirus pandemic. At the end of the period, the portfolio value stood above the value it was at before the pandemic began with the portfolio having more than recouped its losses.

The investment portfolio is managed for long term growth in both its capital value and the level of income it can generate. For the year to March 2021 the portfolio’s total return was 26.8% compared to a benchmark of 21.0%.

Total Return (%) One Year 3 Years 5 Years
Portfolio 26.8 26.5 54.2
Benchmark 21.0 17.2 42.5
RPI +3% Objective 4.7 16.6 31.6
FTSE 100 21.9 7.1 32.4
ARC* 24.5 21.6 42.9

*Asset Risk Consultants

(produce peer group performance indices for charities)

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At year end the investment portfolio was valued at £6,536,193 (2020: £5,320,401) with investment management fees of £27,282 (2020: £28,251). Overall investment income was £174,166 (2020: £219,069) of which the investment portfolio contributed dividend payments of £161,915 (2020 £192,054). The remaining £12,251 (2020: £27,015) was generated from bank interest on approved short and medium term deposits. Investment income has reduced 2020/21 and this is a direct result of the pandemic. Banks are offering lower deposit rates and more companies are retaining funds rather than making dividend distributions to shareholders.

The portfolio is managed by external fund managers (Investec) and performance is monitored by the Finance and Business Committee. All investment decisions are made in accordance with the approved investment policy.

This policy sets out the investment powers, objectives, the types of investment and the benchmarks used for performance monitoring. A range of benchmarks are used to assess investment performance including a bespoke benchmark, agreed with the external fund managers, that reflects the Trustees’ wish for good returns balanced with the need to limit risk. At the year end the portfolio was invested in a mixture of equities (70%), fixed interest bonds (14%), property (3%), cash (6%) and alternative assets (7%).

St Gemma’s Hospice Services Ltd (trading subsidiary) continued to sell bought in goods and provide room hire on a commercial basis in the Academic Unit of Palliative Care. The company made a net surplus of £16,946 (2020: £19,663) in the year which will be transferred to the Hospice under Gift Aid.

----- Start of picture text -----
£1,237k
Donations £1,202k
£1,220k 2018/19
£1,958k
Legacies £1,479k 2019/20
£1,254k
2020/21
£156k
Trusts £261k
£464k
CCG £2,881k
£3,567k
Grant £3,578k
£0k
CCG £0k
Other £114k
£0k
Government £450k
£688k
NHS £0k
£0k
England £2,015k
£1,033k
Fundraising £925k
£451k
£3,047k
Shops £2,987k
£1,143k
Other £537k £762k Other Income - 4.9% Donations - 10.6%
Income £558k £558k £1,220k
Shops - 10.0%
£1,143k
Legacies - 10.9%
£1,254k
Fundraising - 3.9%
£451k
Overall Income Trusts - 4.0%
NHS England - 17.5% 2020-21 £464k
£2,015k
£11.5m
Government - 6.0%
£688k
CCG Grant - 31.2%
£3,578k
CCG Other - 1.0%
£114k
----- End of picture text -----

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Reserves

The Board of Trustees operates a risk-based approach to determine the levels of reserves needed to cover key financial risks and support the long term strategy and five year plan.

The general reserves are drawn from unrestricted funds, excluding funds designated for future expenditure and those funds already invested in fixed assets. The unrestricted general reserve is currently £8,385,066 (2020: £7,472,574) which covers the assessed financial risks. The increase of £912,492 is mainly due to the unrealised gain from investments offset by transfers into the designated reserves.

Total designated reserves at 31 March 2021 were £4,279,138 (2020: £3,979,809) of which £2,797,900 (2020: £3,171,708) has been invested in fixed assets. During 2020/21, the Board has agreed the transfer of £750,000 into designated reserves;

See notes 15, 16 and 17 of the financial statements for further information on reserve utilisation.

Fixed Assets and Investments

The movements in fixed assets and investments during the period are set out in notes 10 and 11 to the financial statements. The Board of Trustees has the power to invest the charity’s money in the manner they consider most beneficial for the purposes of St Gemma’s Hospice.

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St Gemma's is amazing, everyone was incredibly welcoming and flexible to whatever we wanted to learn about JJII

Structure, Governance and Management

St Gemma’s Hospice was founded in 1978 by the Sisters of the Cross and Passion who retain ultimate control of the company. The members of the company all belong to this congregation.

The Hospice is a charitable company limited by guarantee and a registered charity. The company was set up under a Memorandum of Association which established the objects and powers of the company and is governed under its Articles of Association.

The directors of the company are also charity Trustees for the purposes of charity law and are known as the Board of Trustees. Trustee Indemnity Insurance is provided for the benefit of the Trustees.

The Trustees have complied with the duty (set out in section 4 of the Charities Act 2006) to have due regard to public benefit guidance published by the Charity Commission.

The Board of Trustees consists of the current members of the company who serve for a term of five years and such other persons who are elected in a general meeting to hold office for an initial term of three years after which they are eligible for re-election.

At 31 March 2021 there were five members of the Board of Trustees who were representatives of the Sisters of the Cross and Passion. The remaining members of the Board of Trustees have been recruited for their experience and skills in relevant areas including medicine and nursing, finance, legal and commerce. The Trustees who served during the year are set out on page 4.

The Board of Trustees is responsible for overseeing the Hospice’s strategy and performance. It is chaired by Dr Peter Belfield. The Board has overall responsibility for ensuring the organisation is managed efficiently, approves the strategy and oversees its implementation. The Board powers are detailed in the Memorandum of Association and Articles of Association.

Full meetings of the Board of Trustees are held at least four times a year to review the performance

of the Hospice and to agree any major changes to the strategy or financial plans. These are supported by focussed strategy and development sessions. In 2020/21 the Board has met on a monthly basis, by video conference, to strengthen governance and support key decision making in response to COVID-19.

During the year, the Hospice had more than the maximum number of Trustees (12) as recommended in the Charity Governance Code (Section 5.6.2). This was to enable the managed transition of a number of known Trustee retirements and also to accommodate the representation of the Sisters of the Cross and Passion. The Board values the support and wise counsel provided by the Sisters through this Constitutional arrangement.

The Board is supported by three Committees that meet on a quarterly basis:

Clinical and Academic Governance Committee – Chair, Philomena Corrigan This Committee has delegated responsibility for oversight of clinical governance, clinical strategy and academic strategy and delivery.

Corporate Governance Committee – Chair, Sue Ansbro

This Committee has delegated responsibility for oversight of Hospice corporate governance arrangements, risk management and compliance with the Charity Governance Code. The Committee is also responsible for Board succession planning, recruitment of Trustees and the setting of Hospice Leadership Team salaries.

Finance and Business Committee – Chair, Angus Martin

This Committee has delegated responsibility for oversight of the financial strategy, annual budget, income generation and longer term financial planning. The Committee is also responsible for overseeing the investment of Hospice funds and recommending the appointment of an investment manager to the Board.

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During 2020/21 we completed an independent Governance review of the Board and its supporting Committees in line with the Charity Governance Code. This report highlighted strong governance systems and a well-run and well organised Board which worked effectively and productively with the Hospice Leadership Team (HLT).

Scheme of delegation

The Board has approved a scheme of delegation under which the majority of operational management and decision making is delegated to the Chief Executive. The Chief Executive has a key role in the management and monitoring of service delivery, patient satisfaction, financial performance, the assessment and control of risk, and the prioritisation and allocation of resources.

The HLT reports to the Board and its Committees, leading on strategy development, overseeing the provision of Hospice services and managing risk. The HLT is supported by Heads of Department, closely managing day to day service provision. On 1 April 2021 St Gemma’s strengthened its Hospice Leadership Team. The HLT comprises the Chief Executive, Kerry Jackson; Chief Nurse, Heather McClelland; Chief Medical Officer and Consultant in Palliative Care, Dr Mike Stockton; Director of Transformation and Culture, Clare Russell; Director of Income Generation, Mark Flannery and Chief Operating Officer, Jason Kirk. The Chief Executive and HLT are not members of the Board and have no beneficial interest in the company.

Senior Staff Pay

The pay of the senior staff is reviewed by the Board of Trustees, through its Remuneration Committee. The amount paid to senior employees is carefully considered compared to other roles in the market and is benchmarked against other local hospices and national hospice reward and charity reward surveys and data. Best practice recommendations on setting remuneration, including those of the National Council for Voluntary Organisations (NCVO) are also taken into consideration. The Hospice also directly employs four medical consultants on NHS equivalent contracts, in line with national agreements.

The levels paid are those necessary to ensure a well-run, effective organisation in line with regulatory requirements. Competitive salaries also help the Hospice to attract, recruit and retain the best possible calibre of staff, in a competitive environment.

Risk Management and Principal Risks

The Board has overall responsibility for establishing and maintaining the whole system of internal control and the management of risk, including reviewing the effectiveness of internal controls. The Board has adopted a risk-based approach to establishing and maintaining internal controls, which are embedded within day to day management and governance processes.

The Board of Trustees assesses and reviews the management of the major risks to which the charity and its subsidiary company, St Gemma’s Hospice Services Limited, are exposed, including financial, clinical and business risks.

The risk register is developed by the HLT and is scrutinised by the relevant Committees and Board on a quarterly basis. The Chief Operating Officer undertakes an annual governance review that considers how the Hospice complies with the Charity Governance Code.

The key financial risks facing the Hospice are:

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in end of life care. We also have Hospice Leadership Team representation on key work streams that influence the development of the Leeds integrated care partnership.

COVID-19 has brought unprecedented challenge to the funding environment at the same time we are dealing with rising demand and increased costs for providing key services.

Information Governance

We continue to strengthen Information Governance arrangements across the Hospice. This includes compliance with the Charity Governance Code, reviewing Information Commissioner’s Office (ICO) guidance and submission of the NHS Data Security and Protection Toolkit (DSPT) which enables us to measure and publish performance against the National Data Guardian’s ten data security standards.

Trustees Fundraising Statement

Income Generation at St Gemma’s is conducted by a team of fundraisers and retail staff directly employed by the charity and led by the Director of Income Generation. The Hospice also generates Lottery income through an external partner (Local Hospice Lottery) and their team of directly employed lottery fundraisers. There have been no failures to comply with the standards set by these organisations and St Gemma’s is fully committed to the delivery of high quality, engaging and compliant fundraising activity.

The Trustees of the Hospice monitor the activities of the Income Generation team via quarterly meetings of the Finance and Business Committee. The Chair of the Committee also meets monthly with the Chief Operating Officer and Director of Income Generation. During the year we have also strengthened our financial governance arrangements by creating the Income Review Group that reports directly to the Finance and Business Committee through a nominated Trustee.

Going Concern

The Trustees have reviewed the cash position of the Hospice and the cash forecasts for twelve months from the date of signing the financial statements. As part of our annual financial planning arrangements, the Board approved budget plans 2021/22 and supporting five year financial outlook in considering the sustainability of the Hospice.

They are satisfied that the charity has a reasonable expectation of continuing in operational existence for the foreseeable future and so they have continued to adopt the going concern basis in preparing the financial statements.

In so far as the Trustees are aware:

This confirmation is given and should be interpreted in accordance with the provisions of s418 of the Companies Act 2006.

Auditor

Deloitte LLP have expressed their willingness to continue as auditor for the next financial year.

The Trustees’ Report, including the Strategic Report, was approved by the Board and signed on its behalf on 17 November 2021 by:

Dr Peter Belfield

Chair of the Board of Trustees

Policies to protect vulnerable individuals are in place and all fundraisers are aware of their responsibilities in this area. During 2020/21 there were two complaints (2020: 2) relating to the Hospice’s fundraising activities and none (2020: 2) relating to the chain of charity shops. All were resolved satisfactorily during the year.

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St Gemma’s Hospice Report & Financial Statements 2021 27

Trustees’ Responsibilities Statement

The Trustees (who are also directors of St Gemma’s Hospice for the purposes of company law) are responsible for preparing the Trustees’ Annual Report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice) including FRS 102 “The Financial Reporting Standard applicable in the UK and Republic of Ireland”.

Company law requires the Trustees to prepare financial statements for each financial year which give a true and fair view of the state of affairs of the charitable company and the group and of the incoming resources and application of resources, including the income and expenditure, of the charitable group for that period. In preparing these financial statements the Trustees are required to:

The Trustees are responsible for keeping adequate accounting records that disclose with reasonable accuracy at any time the financial position of the charitable company and enable them to ensure that the financial statements comply with the Companies Act 2006. They are also responsible for safeguarding the assets of the charitable company and the group and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

In so far as the Trustees are aware:

The Trustees are responsible for the maintenance and integrity of the corporate and financial information included on the charitable company’s website. Legislation in the United Kingdom governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions.

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Independent Auditor’s Report to the members of St Gemma’s Hospice Limited

Opinion

In our opinion the financial statements of St Gemma’s Hospice Limited (the ‘charitable company’) and its subsidiaries (the ‘group’):

We have audited the financial statements which comprise:

accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.

Conclusions relating to going concern

In auditing the financial statements, we have concluded that the trustees’ use of the going concern basis of accounting in the preparation of the financial statements is appropriate.

Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the group’s and the charitable company’s ability to continue as a going concern for a period of at least twelve months from when the financial statements are authorised for issue.

Our responsibilities and the responsibilities of the trustees with respect to going concern are described in the relevant sections of this report.

Other information

The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102 “The Financial Reporting Standard applicable in the UK and Republic of Ireland” (United Kingdom Generally Accepted Accounting Practice).

Basis for opinion

We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under those standards are further described in the auditor's responsibilities for the audit of the financial statements section of our report.

The other information comprises the information included in the annual report, other than the financial statements and our auditor’s report thereon. The trustees are responsible for the other information contained within the annual report. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon.

Our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the course of the audit, or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether this gives rise to a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact.

We have nothing to report in this regard.

We are independent of the group and of the parent charitable company in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the Financial Reporting Council’s (the ‘FRC’s’) Ethical Standard, and we have fulfilled our other ethical responsibilities in

Responsibilities of Trustees

As explained more fully in the trustees’ responsibilities statement, the trustees (who are also the directors of the charitable company for the purpose of company law) are responsible for the preparation of the financial statements and for being satisfied that they give a

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true and fair view, and for such internal control as the trustees determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error.

In preparing the financial statements, the trustees are responsible for assessing the group’s and the parent charitable company’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the trustees either intend to liquidate the group or the parent charitable company or to cease operations, or have no realistic alternative but to do so.

Auditor’s responsibilities for the audit of the financial statements

Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor's report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements.

A further description of our responsibilities for the audit of the financial statements is located on the FRC’s website at: www.frc.org.uk/auditorsresponsibilities. This description forms part of our auditor’s report.

Extent to which the audit was considered capable of detecting irregularities, including fraud Irregularities, including fraud, are instances of noncompliance with laws and regulations. We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud. The extent to which our procedures are capable of detecting irregularities, including fraud is detailed below.

We considered the nature of the group’s industry and its control environment, and reviewed the group’s documentation of their policies and procedures relating to fraud and compliance with laws and regulations. We also enquired of management about their own identification and assessment of the risks of irregularities.

We obtained an understanding of the legal and regulatory frameworks that the group operates in, and identified the key laws and regulations that:

statements. These included UK Charities Act and UK Companies Act; and

We discussed among the audit engagement team, including significant component audit teams and relevant internal specialists regarding the opportunities and incentives that may exist within the organisation for fraud and how and where fraud might occur in the financial statements.

As a result of performing the above, we identified the greatest potential for fraud or non-compliance with laws and regulations in the following areas, and our specific procedures performed to address them are described below:

In common with all audits under ISAs (UK), we are also required to perform specific procedures to respond to the risk of management override. In addressing the risk of fraud through management override of controls, we tested the appropriateness of journal entries and other adjustments; assessed whether the judgements made in making accounting estimates are indicative of a potential bias; and evaluated the business rationale of any significant transactions that are unusual or outside the normal course of business.

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In addition to the above, our procedures to respond to the risks identified included the following:

Report on other legal and regulatory requirements Opinions on other matters prescribed by the Companies Act 2006

We have nothing to report in respect of these matters.

Use of our report

This report is made solely to the charitable company’s members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our audit work has been undertaken so that we might state to the charitable company’s members those matters we are required to state to them in an auditor’s report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the charitable company and the charitable company’s members as a body, for our audit work, for this report, or for the opinions we have formed.

In our opinion, based on the work undertaken in the course of the audit:

Sarah Anderson FCCA (Senior statutory auditor)

For and on behalf of Deloitte LLP Statutory Auditor Leeds, United Kingdom 22 November 2021

In the light of the knowledge and understanding of the group and parent charitable company and their environment obtained in the course of the audit, we have not identified any material misstatements in the strategic report or the directors’ report included within the trustees’ report.

Matters on which we are required to report by exception

Under the Companies Act 2006 we are required to report in respect of the following matters if, in our opinion:

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Consolidated Statement of Financial Activities (Including consolidated income and expenditure account) For the year ended 31 March 2021


For the year ended 31 March 2021
-
- -
- -
- -
- -
- -
- -
- -
- -
-
- -
- - -
- -
-
-
-
-
-
- -
- -
- - -
-

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Consolidated Statement of Financial Activities (Including consolidated income and expenditure account) For the year ended 31 March 2021

There were no other recognised gains or losses other than those listed above and the net income for the year. All income and expenditure derive from continuing activities.

See note 15 for comparative Consolidated Statement of Financial Activities analysed by funds.

The accounting policies and notes on pages 36 to 54 form part of these accounts.

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Balance Sheets As at 31 March 2021

The surplus of the parent charity for the year for Companies Act purposes is £1,142,507 (2020: deficit of £112,574). As permitted by Section 408 of the Companies Act 2006, no separate Statement of Financial Activities is presented in respect of the parent charity.

The financial statements on pages 32 to 54 were approved and authorised for issue by the Board of Trustees on 17 November 2021 and signed on its behalf by:

Dr Peter Belfield Chair of the Board of Trustees

Company Number: 02773867

The notes on pages 40 to 54 form part of these accounts.

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Consolidated Cash Flow Statement For year ended 31 March 2021

The notes on pages 40 to 54 form part of these financial statements.

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Statement of Accounting Policies For year ended 31 March 2021

Company and charitable status

St Gemma’s Hospice, a public benefit entity, is incorporated in England and Wales as a charitable company limited by guarantee not having a share capital. The Sisters of the Cross and Passion are the members of the company. Each member has undertaken to contribute to the assets in the event of winding up a sum not exceeding £1. The charity is a registered charity. The registered office is given on page 3.

Basis of accounting

The financial statements have been prepared under the historical cost convention with the exception of investments which have been included at market value. The financial statements have been prepared in accordance with Statement of Recommended Practice “Accounting and Reporting by Charities (SORP 2019)” 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 2020 and the Companies Act 2006.

The Company meets the definition of a qualifying entity under FRS 102 and has therefore taken advantage of the disclosure exemption available to it in respect of its separate financial statements in relation to presentation of a cash flow statement.

The principal accounting policies are set out below.

Basis of consolidation

The consolidated financial statements comprise St Gemma’s Hospice and its wholly-owned subsidiary undertaking, St Gemma’s Hospice Services Limited. The summarised profit and loss account for the subsidiary is shown in note 1. The results of the subsidiary are consolidated on a line by line basis.

Preparation of the financial statements – going concern basis

The principal risks facing the charity are discussed in the Trustees’ report. COVID-19 has brought

unprecedented challenge to the financial sustainability of the Hospice. Trustees have considered budget plans and a revised five year financial outlook in considering the sustainability of the Hospice. The Trustees have also reviewed the cash position of the charity and cash forecasts at the date of signing the financial statements and are satisfied that the charity will be able to meet all of its financial commitments for at least twelve months from the date of signing.

As a consequence, the Trustees believe that the charity is well placed to manage its financial risks successfully. After making enquiries, the Trustees have a reasonable expectation that the charity has adequate reserves to continue in operational existence for the foreseeable future. Accordingly, the Trustees continue to adopt the going concern basis in preparing the financial statements.

Income

Income is recognised when the Group and Charity has entitlement to the funds, any performance conditions attached to the items of income have been met, it is probable that the income will be received and the amount can be measured reliably.

Income received by way of donations, fundraising events,

trading, legacies and NHS Leeds Clinical Commissioning Group receipts are credited in the accounts when the charity is legally entitled to the income and the amount can be quantified with reasonable accuracy. These are shown gross before deductions of related expenses and net of VAT. Lottery income is from Local Hospice Lottery and the joint lottery with Sue Ryder Wheatfields Hospice and is included net after associated expenditure.

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. Where legacies have been notified to the

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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 a treated as a contingent asset and disclosed where material.

Income tax recoverable on income received and bank interest received are included in these accounts on the accruals basis.

Deferred income includes amounts received in respect of grants received for work to be carried out in the next financial year.

Donated professional services and donated facilities are recognised as income 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 by the charity of the item is probable and that economic benefit can be measured reliably.

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. The full value of the freehold peppercorn rent is not valued due to the prohibitive cost of doing so.

All income arises in the United Kingdom.

Expenditure

Expenditure is recognised once there is a legal or constructive obligation to make a payment to a third party, it is probable that settlement will be required and the amount of the obligation can be measured reliably. Expenditure is classified under the following activity headings as follows.

Costs of raising funds include the costs incurred in generating voluntary income, fundraising trading costs, including the costs of running the charity shops, and investment management costs.

Charitable expenditure has been analysed by activity, these costs enable the Hospice to meet its charitable aims and objectives.

Support costs relate to those functions that assist the work of the Hospice but do not directly undertake charitable activities. Support costs

include back office costs, finance, personnel, payroll and governance costs which support the charity’s activities. Governance costs are associated with the governance arrangements of the charity. They include compliance with statutory and constitutional requirements, expenditure incurred on Board of Trustees meetings and legal advice for the Trustees. These costs have been allocated between cost of raising funds and expenditure on charitable activities. The bases on which support costs have been allocated are set out in note 7.

Expenditure is included in the Statement of Financial Activities inclusive of any VAT which cannot be recovered.

Fund accounting

General funds are unrestricted funds which are available for use at the discretion of the Board of Trustees in the furtherance of the general objectives of the charity. Designated funds are amounts that have been put aside at the discretion of the Board of Trustees. Restricted funds are funds subject to specific conditions imposed by donors. Where restricted funds are received

for the purchase of fixed assets then the funds are transferred to designated funds once the purchase has been made. See Notes 16 and 17 for further information on funds and funds utilisation.

Tangible fixed assets Tangible fixed assets are stated at cost, net of depreciation.

Tangible fixed assets individually costing more than £1,000 are capitalised and included in the accounts at cost. Provision is made for depreciation on all tangible assets at rates calculated to write off the cost of each asset over its expected useful life as follows:

Improvements to leasehold property costs - 5% per annum on a straight line basis

Fixtures and fittings - 10% per annum on a straight line basis

Motor vehicles - 25% per annum on reducing balance basis

Computers - 25% per annum on a straight line basis

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Investments Investments are included in the financial statements at market value. The Statement of Financial Activities includes the net gains and losses arising on revaluations and disposals throughout the year.

Current investments represent monies invested in shortterm liquid money market instruments.

In the parent charity balance sheet, investments in subsidiary undertakings are measured at cost less impairment.

Stock

Stock of purchased goods is valued at the lower of cost and net realisable value. Items donated for resale are not included in the financial statements until they are sold.

Employee benefits

The Hospice operates two pension schemes. A defined benefit scheme with the National Health Service Superannuation Scheme, is only available to staff who have previously contributed to the scheme. The administration of this scheme is dealt with by the National Health Service Pension agencies. In addition there is a Group Personal Pension Scheme administered by Standard Life which is available to all other employees. Contributions to both Schemes are charged directly to the Statement of Financial Activities. Differences between contributions payable in the year and contributions actually paid are shown as either accruals or prepayments in the balance sheet.

Operating leases

Rentals under operating leases are charged on a straight-line basis over the lease term, even if the payments are not made on such a basis. Benefits received and receivable as an incentive to sign an operating lease are similarly spread on a straightline basis over the lease term.

Financial instruments

Financial assets and financial liabilities are recognised when the Group becomes a party to the contractual provisions of the instrument. All financial assets and liabilities are initially measured at transaction price (including transaction costs). The charity and group only have financial assets and financial liabilities of a kind that qualify as basic financial instruments. With the exception of

fixed asset investments, basic financial instruments are initially recognised at transaction value and subsequently measured at their settlement value.

Trade and other debtors are recognised at the settlement amount due after any trade discount offered. Prepayments are valued at the amount prepaid net of any trade discounts due. Current asset investments includes 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. Creditors and provisions are recognised where the charity has a present obligation resulting from a past event that will probably result in the transfer of funds to a third party and the amount due to settle the obligation can be measured or estimated reliably. Creditors and provisions are normally recognised at their settlement amount after allowing for any trade discounts due.

Taxation

The company is a registered charity and has no liability to corporation tax on its charitable activities.

The trading subsidiary is liable to corporation tax on its taxable profits. Current tax, including UK corporation tax and foreign tax, is provided at amounts expected to be paid (or recovered) using the tax rates and laws that have been enacted or substantively enacted by the balance sheet date.

Deferred tax is recognised in respect of all timing differences that have originated but not reversed at the balance sheet date where transactions or events that result in an obligation to pay more tax in the future or a right to pay less tax in the future have occurred at the balance sheet date. Timing differences are differences between the group’s taxable profits and its results as stated in the financial statements that arise from the inclusion of gains and losses in tax assessments in periods different from those in which they are recognised in the financial statements.

Deferred tax is measured at the average tax rates that are expected to apply in the periods in which the timing differences are expected to reverse, based on tax rates and laws that have been enacted or substantively enacted by the balance sheet date.

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Deferred tax is measured on a non-discounted basis.

Critical accounting judgements and key sources of estimation uncertainty

In the application of the Group’s accounting policies described above, the Trustees are required to make judgements, estimates and assumptions about the carrying amounts of assets and liabilities that are not readily apparent from other sources. The estimates and associated assumptions are based on historical experience and other factors that are considered to be relevant. Actual results may differ from these estimates.

The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised if the revision affects only that period, or in the period of the revision and future periods if the revision affects both current and future periods.

The Trustees do not consider there are any critical judgements or sources of estimation uncertainty requiring disclosure.

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Notes to the Group Financial Statements For year ended 31 March 2021

1. NET INCOME FROM TRADING ACTIVITIES OF SUBSIDIARY

The charity has a wholly owned subsidiary, St Gemma’s Hospice Services Limited which is incorporated in the UK and registered in England. The company undertakes trading activities including the sale of bought in goods and the provision of room hire within the St Gemma’s Academic Unit of Palliative Care. A summary of its trading results for the period is shown below. The company donates its taxable profit to St Gemma’s Hospice under Gift Aid. Audited accounts will be filed with the Registrar of Companies.

2. INCOME FROM DONATIONS, LEGACIES AND TRUSTS

In 2021 grants include unrestricted government grants of £270,781 (2020: £450,000) relating to the COVID-19 retail grant scheme and restricted furlough income from the Coronavirus Job Retention Scheme which totalled £417,641.

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3. INCOME FROM OTHER TRADING ACTIVITIES

The sales of donated and purchased goods in 2021 includes donations under retail gift aid of £27,125 (2020: £708,880) and the associated gift aid of £6,700 (2020: £175,093). St Gemma’s Hospice had 24 shops at the year end (2020: 24) although they were not trading at 31 March 2021 due to COVID-19.

4. INCOME FROM CHARITABLE ACTIVITIES

The NHS England awarded funding to allow the Hospice to make available bed capacity and community services from April 2020 to July 2020 and Nov 2020 to Mar 2021 to provide support to people with complex needs in the context of the COVID-19 pandemic.

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5. INVESTMENT INCOME

6. ANALYSIS OF EXPENDITURE

Day / STAR* Services

*Support Therapy and Resources

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ANALYSIS OF EXPENDITURE (continued) 2020 Comparatives 2020 Direct Costs 2020 Support Cosls 2020 Total Expenditure on raising funds Costs of selling donated goods Costs of raising in(x)rne from donalions. legacies. trusts and fundraising events Investment management fees Cost of wholly c>wned subsidiary: Rcom hire PUr￿aS￿l goods 2.093,408 140,497 2,233,905 1.182.395 28.251 102.225 1.284,620 28,251 18.444 50,365 18,444 50,365 3.372,863 242,722 3,615,585 Expendlture on charltable actlvltles Provision of Hospice services Inpatient Care Community Care Day Servi￿5 Bereavement Support Education and research 4,402,092 1,077,948 585,941 175.200 454,017 639,436 80,097 25,743 16.175 27,676 5,041,528 1.158,045 611,684 191,375 481,693 6.695.198 789.127 7.484,325 Total gxpenditurg 10,068,061 1,031,849 11,099,910 St Gemma's Hospice Report & Financial Statements 2021 43

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8. NET INCOME/ (EXPENDITURE) FOR THE YEAR

9. ANALYSIS OF STAFF COSTS, TRUSTEES REMUNERATION AND EXPENSES AND THE COST OF KEY MANAGEMENT PERSONNEL GROUP AND CHARITY

The number of Group employees whose emoluments, excluding pension contributions and employers’ national insurance, but including benefits in kind, were in excess of £60,000 was:

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9. ANALYSIS OF STAFF COSTS, TRUSTEES REMUNERATION AND EXPENSES AND THE COST OF KEY MANAGEMENT PERSONNEL GROUP AND CHARITY (continued)

The key management personnel of the parent Charity, listed on page 4, are the same as the Group. The total remuneration (including pension contributions and employers’ national insurance) of the key management personnel of the Group for the year totalled £494k (2020: £496k).

As shown above, St Gemma’s Hospice has employed seven individuals who earned over £60,000. Three of these are medical consultants who are directly employed on NHS equivalent contracts, in line with national agreements. The others are members of the Hospice Leadership team (HLT), responsible for running the Hospice. The Chief Executive is not the highest paid employee.

No trustees received remuneration during the current or prior year. No travel or subsistence expenses were paid to trustees during the current or prior year.

10. TANGIBLE FIXED ASSETS

All tangible fixed assets are used for or to support charitable purposes.

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11. FIXED ASSET INVESTMENTS

The unlisted investment represents an investment in the subsidiary undertaking:

Name of Subsidiary Class of Shares Held Percentage of Shares Held
St Gemma’s Hospice Services Limited Ordinary 100%

St Gemma's Hospice also holds a minority share in an unlisted investment, Hospice Quality Partnership, which was acquired for £10.

Listed Investments

The historic cost of listed fixed asset investments at 31 March 2021 was £4,829,705 (2020: £4,668,014). The investments are managed by an external fund manager. The funds can be analysed as follows:

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12. DEBTORS

13. CREDITORS: amounts falling due within one year

Included in Other Creditors is £241,138 (2020: £215,447) received by St Gemma’s in the role of host of the Leeds Palliative Care Network, which involves collaborative working with other palliative and end of life care providers in Leeds.

14. DEFERRED INCOME

The deferred income figure includes £8,830 for monies received to support our Academic Unit of Palliative Care in the delivery of the CNS ECHO project. £31,896 has been received from the Leeds CCG for controlled drugs funding. In addition, £14,475 has been received in advance for training courses delivered by the Academic Unit of Palliative Care.

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15. COMPARATIVE CONSOLIDATED STATEMENT OF FINANCIAL ACTIVITIES

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15. COMPARATIVE CONSOLIDATED STATEMENT OF FINANCIAL ACTIVITIES (continued)

16. UNRESTRICTED FUNDS

)

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16. UNRESTRICTED FUNDS (continued)

The maintenance and Gardens fund is for ongoing building maintenance work to ensure that the Hospice is kept to the highest possible standard. The fixed asset fund represents reserves invested in fixed assets and each year a transfer is made equivalent to the value of additions in the year.

£150,000 was received in the prior year from the Sisters of the Cross and Passion for future building plans; this is included within the Building Development Reserve, which has had a further £200,000 transferred from general funds at the year end.

The Digital Development Reserve and COVID-19 Response Reserve have been created to support the Transformation Programme.

The Transformation fund is desginated to support ongoing service development needs of the Hospice.

17. RESTRICTED FUNDS

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17. RESTRICTED FUNDS (continued)

The children’s bereavement service is funded by Children in Need to employ children’s bereavement workers.

The competency framework for nursing staff was funded by Leeds Clinical Commissioning Group. Health Education England provided funding to support the End of Life Care Outcomes project being undertaken within the Academic Unit of Palliative Care.

The Citywide education programme was set up to improve the provision of palliative care across the city.

The Hospice to Hospital In Reach project, Enhanced Digitisation for the In Patient Unit, Mental Health Clinical Nurse Specialist, Patient and Family Engagement and Dedicated Space for Young People’s Service are all funded by NHS Leeds Clinical Commissioning Group.

The transfers represent expenditure on capital items within the different restricted funds.

YEAR ENDED 31 MARCH 2020 COMPARATIVES

18. ANALYSIS OF NET ASSETS BETWEEN FUNDS

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18. ANALYSIS OF NET ASSETS BETWEEN FUNDS (continued)

19. NOTES TO THE CASHFLOW STATEMENT

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20. FINANCIAL COMMITMENTS

At the balance sheet date the total future minimum lease payments under non-cancellable operating leases:

21. PENSION COMMITMENTS

The Hospice contributes to two pension schemes. A defined benefit scheme operated by the National Health Service Superannuation Scheme, which is only available to staff who have previously contributed to the scheme. The administration of the scheme is dealt with by the National Health Service Pension agencies. Contributions to this scheme are paid in respect of current service, and there is no liability to the Hospice in respect of past service. In addition, there is a Group Personal Pension Scheme, which is a defined contribution pension scheme, administered by Standard Life, which is available to all employees.

The charge to the Statement of Financial Activities of £596,632 (2020: £559,007) represents contributions to the funds during the period. This can be broken down into NHS £333,952 (2020: £314,629), Standard Life £262,680 (2020: £244,378). Contributions payable to the Standard Life scheme at the year end date totalling £24,474 (2020: £23,807) are included in creditors.

22. RELATED PARTIES

Control

Throughout the period, St Gemma’s Hospice was ultimately controlled by the Congregation of the Sisters of the Cross and Passion of our Lord Jesus Christ. The members of the company all belong to this Congregation.

Transactions

The Congregation retains freehold title to the Hospice which is let to the company on a long term lease for peppercorn rent. During 2020 £150,000 was received from the Sisters of the Cross and Passion as a grant towards future building plans.

Trustee donations

The aggregate amount of cash donations received from Trustees during the year was £220 (2020: £1,473). This does not include income received from Trustees in relation to the purchase of tickets or items at fundraising events.

Trustee relationships

Schofield Sweeney has provided legal advice in relation to the Hospice’s lease arrangements. Chris Schofield (Trustee) is Chairman of Schofield Sweeney.

23. JOINT ARRANGEMENT

St Gemma’s Hospice has an arrangement with Sue Ryder Wheatfields to operate a joint lottery for fundraising purposes, which is administered by Sterling Lotteries.

The income received during the year from this lottery was £92,323 (2020: £107,802) and is included in note 3.

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St Gemma’s Hospice Report & Financial Statements 2021

St Gemma’s Hospice is a local, independent charity, providing expert medical and nursing care to thousands of local people every year – all free of charge to patients and their families.

If you would like more information about our work, please contact us:

St Gemma’s Hospice 329 Harrogate Road Moortown Leeds, LS17 6QD

Website: www.st-gemma.co.uk Email: postmaster@st-gemma.co.uk Hospice Reception: 0113 218 5500

www.twitter.com/stgemmashospice

www.facebook.com/st.g.hospice

Registered Charity No. 1015941 56 St Gemma’s Hospice Report & Financial Statements 2021