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2021-03-31-accounts

KSS AIR AMBULANCE CHARITY KENT SURREY SUSSEX

Annual Report

Year ending 31[st] March 2021

.KS t• AlrAmbulonce Kentswrey Su *? Yi. A Year Like No Other

Coptents

06 | Introduction from our Chair 07 | Introduction from our CEO 08 | In the Past Year. . . 10 | Strategic Report Part One 10 | Our Purpose 14 | Our Achievements - Delivering Outstanding Treatment and Care 24 | Our Achievements - Making a Difference 28 | Our Achievements - Generating and Inspiring Support 40 | Our Achievements - Aspiring for Excellence in all we do 50 | Ambition and Vision for the Future 53 | Saying Thank You 54 | Strategic Report Part Two 54 | Our Financial Review 59 | Managing our Finances 64 | How we Operate 66 | Our Fundraising Approach 68 | Governance 70 | Public Benefit 72 | Independent Auditor's Report 76 | Our Accounts 77 | Consolidated Statement of Financial Activities 78 | Consolidated Balance Sheet 79 | Balance Sheet 80 | Consolidated Cashflow Statement 81 | Notes to the Financial Statements

5

Introduction from our Chair

This is my last annual report as I will step down as Chair of KSS on 8[th] December 2021 and, in writing my introduction, I can reflect on the charity’s exceptional performance during this last financial year.

It is an enormous credit to our clinical

and operational teams that, throughout the pandemic, not a single shift has been missed despite higher than average staff absences. Standard operating procedures, designed for the introduction of a new inter-hospital transfer service, were rapidly adapted for the exacting requirements of transporting COVID-19 positive and other critically ill patients by both road and air. This involved providing highly skilled crews to transfer these patients between hospitals when necessary at the request of Public Health England. The first of these transfers took place on Christmas Day 2020 and expert advice from our Senior Leadership Team has informed national policy.

As a charity embedded within the communities that we serve, that places great emphasis upon face to face community fundraising often involving volunteers, the lockdown measures presented a significant threat to our financial stability. Very rapidly, overcoming the new constraints of having to work from home, our Income Generation, Marketing and Communications Team launched an emergency appeal for the first time. This exceeded expectations and over £1.5 million was raised within six months, which includes a grant of £374,375 received from government in response to an application by Air Ambulances UK. This was an exceptional performance by dedicated, hard working staff and we are extremely grateful to the many people who have

given to KSS in different ways, including the donation of gifts in kind.

In September 2020, the charity’s outstanding performance was recognised when, amidst strong national competition, KSS was selected for the Charity Times Charity of the Year (with an income of over £10M) Award. Everyone, including our loyal donors and volunteers, deserves to take credit from this accolade. The achievements of the last year only serve to reinforce a deep rooted commitment to continuous improvement and to finding new ways to improve patient outcomes. The Trustees’ decision to invest in KSS’s own research programme is indicative of a strategic intention to generate new understanding of pre-hospital emergency medicine and to share this nationally and internationally. In the last year a £500,000 research grant was jointly awarded to KSS, in collaboration with the University of Surrey and South East Coast Ambulance from the National Institute for Health Research live video transmission from 999 callers using the GoodSAM app. Two paramedics have also successfully completed the first year of their PhDs.

On behalf of the Board of Trustees I would like to take this opportunity to express our heartfelt gratitude to David Welch and all members of staff and to our volunteers and supporters for their loyalty and dedication during difficult times. As outgoing Chair, I would like to acknowledge and thank my fellow Trustees who give their time and considerable wisdom voluntarily and bring a wealth of skills and resourcefulness to this exceptional charity. My successor Barney Burgess not only brings superb qualities and experience to this role he is a former patient and I wish him the very best in a role which he is ideally suited to fulfil.

Dr Helen Bowcock OBE DL, Chair

6

Introduction from our CEO

I am so very proud and privileged to have led our incredible charity through a year which has presented challenges on an unprecedented level, but has also been a year filled with collaboration, tenacity and hope. In March 2020, COVID-19 significantly impacted the world we operate in. Team KSS have faced, and continue to face, the multiple obstacles presented by COVID-19 with determination, courage and a resilience to ensure we continue to serve the communities of Kent, Surrey and Sussex. My heartfelt thanks and appreciation to everyone who has worked so tirelessly to enable our 24/7 service to operate without interruption throughout.

None of this would be possible without the amazing contribution of all of our staff, the generosity of our supporters and the commitment of our Trustees and volunteers, all of whom are such an integral, valued part of Team KSS. The phenomenal response we received to our Coronavirus Emergency Appeal is reflective of the innate desire among our communities to support each other and we remain forever grateful to our generous supporters for doing so.

Having been driven by our purpose and staying true to our values throughout 2020-2021, we are more committed than ever to meet the challenges that 20212022 will bring. As well as ensuring our service continuity, we will continue to look to our culture and strategy - The KSS Way - to take

bold collaborative action to continuously innovate to improve our service and strive towards our vision of an end to preventable loss of life from medical emergency.

I am continually inspired by the commitment and resilience of Team KSS, and I look forward to all we can achieve together in the coming year to reach more patients and ensure they achieve the best possible outcome. I am utterly committed to ensuring we continue to put people at the heart of all we do; to be a truly purpose driven and values led organisation that delivers maximum benefit for our patients.

My sincere thanks and appreciation go to our outgoing Chair, Dr Helen Bowcock, whose inspirational leadership as Chair has enabled KSS to succeed and thrive. It is testament to Helen’s passion, commitment and guidance that KSS continues to grow, develop and continuously improve on our service and the impact we make. Helen will be missed incredibly but leaves KSS in a strong and resilient position on which to build for the future and deliver a strategy that will enable us to ensure the best possible outcomes for our patients across the communities we serve. I very much look forward to working closely with our new Chair and former patient Barney Burgess and continuing to work with our inspirational Board of Trustees to deliver on our purpose and further develop our strategic direction.

I thank each and every individual who aids us on our journey and enables us to provide our world-leading pre-hospital emergency service.

Your support is as critical as our care.

#CaringTheKSSWay

David Welch, CEO

7

In the Past Year . . .

We continued to develop our culture and strategy – The KSS Way – embedding our values and goals into our activity and planning and considering how best to work towards our vision while ensuring service continuity and the continuous development and improvement of our core service.

We remained fully operational throughout the Coronavirus pandemic and extended our service capabilities to transfer critically ill patients between ICUs.

In September 2020 we celebrated in the success of winning the Charity Times Charity of the Year Award (income more than £10M). This prestigious award was open to national and regional charities and not-for-profit organisations from across the UK.

8

Between 1[st] April 2020 and 31[st] March 2021

We performed 2,645 missions We treated 1,490 patients

We had the support of 172 Volunteers and 3,850 fundraisers

Our volunteers gave 87 virtual talks to community groups across Kent, Surrey and Sussex

Our trading company (Air Ambulance Promotions Ltd) made a gift aided donation of £7.3M to KSS from lotteries and raffles, paying £377K in prizes to 727 winners

1,799 people gave us a regular gift

We had a record year for income; raising £17.4M of which 86% was from generous supporters and fundraising activity

We raised £2.94M from legacy donations which was the most raised in any year to date

We published six research papers

Support from our community led to donations increasing year-on-year by 99% to £2.4M

All of this was only possible thanks to the dedication, generosity and kindness of our supporters and volunteers. THANK YOU!

9

Part One Our Purpose ••

About us

of every day as we provide 24/7 care, 365 days a year. Team KSS is a highly skilled, diverse multi-disciplinary team of doctors, paramedics, dispatchers, pilots, fundraisers, marketers and governance, finance and HR support staff. We deliver world-class, prehospital emergency medical treatment and care at the scene and utilise our state-of-theart helicopters to transport patients to the most appropriate Major Trauma Centre or NHS hospital for their ongoing care. We also utilise our rapid response vehicles to take our team to the scene if our helicopters are unavailable.

Kent, Surrey & Sussex Air Ambulance Trust (KSS) is now in its 31[st] year as an Air Ambulance charity at the forefront of Helicopter Emergency Medical Services (HEMS) with a strong reputation for excellence nationally and internationally.

Costing £15.2M annually to operate, of which 86% comes from the generosity of our supporters, we serve a population of 4.8 million people plus a transient population of 90 million, making us one of the busiest Air Ambulances in the UK. Since our inception, we have operated over 35,000 missions. We operate out of Redhill Aerodrome and are headquartered in Rochester City Airport.

Enabling the best possible outcomes for our patients drives us every day to improve the service we provide, to reach more patients, and to have more of an impact on our communities.

At KSS, we are people centred, purpose driven and values led. Our purpose of saving lives and ensuring the best possible patient outcomes drives us every minute

Our Vision

An end to preventable loss of life from medical emergency

Our Purpose

Saving lives and ensuring the best possible patient outcomes

11

Our culture and strategy – The KSS Way

vision for the future; to innovate and ensure we continue delivering a world-leading, cutting edge, pre-hospital emergency service, saving more lives and improving many more patient outcomes.

At KSS, we are proud to #CareTheKSSWay. We are people centred, purpose driven and values led.

The KSS Way sets out the world we want to see and our strategy for making it happen. It helps us focus and prioritise the areas which will make the most difference to the outcomes of our patients and communities. It is our culture and strategy – what we do to deliver on our purpose and how we do it by staying true to our values and always keeping people at the heart of all we do. It provides a framework for how we will plan, execute and manage our work and how we interact with others. It sets out our ambitious

During 2020-2021, we began to embed our values throughout KSS and introduced our goals as targets we work towards to deliver on our purpose. In 2021-2022, we will develop our five-year business plans and outline our strategic objectives aligned to our goals, to further define how we will ensure we achieve maximum impact for our patients and communities.

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Our goals

We deliver outstanding treatment and care

We make a We generate and difference inspire support

We aspire for excellence in all we do

Our values

Our values are our guiding standards of behaviour both internally within our staff team and externally with our patients, supporters, and volunteers. We stay strong to what we believe in, how we treat people, and how we behave in order to deliver on our purpose.

Trusted Generating trust in everyone we engage with

Dedicated Dedicated to ensuring the best possible outcomes for our patients and communities

Innovative Collaborative Pushing the boundaries Embracing through research and collaboration innovation to better and partnership meet the needs of to achieve the our patients and best for our expectations of patients our supporters

Caring Caring for people and putting people at the heart of all we do

Innovative Pushing the boundaries through research and innovation to better meet the needs of

13

Our Achievements

Delivering Outstanding Treatment and Care

14

Strategic objective

To realise the full potential of our assets and develop our organisational agility and resilience to respond to demand

Our service

to our 24/7 service and effectively enable us to bring the A&E department directly to the patient, no matter the weather conditions. Our highly skilled and experienced doctors and paramedics can perform life-saving hospital-level procedures at the scene of an incident, including administering general anaesthetic and undertaking surgery, often in challenging environments.

Our life-saving service is built around the patient journey, to ensure we meet the critical needs of our patients and enable their best possible outcome, by the rapid delivery of high-quality pre-hospital care directly to the scene. Our two advanced, state of the art AW169 helicopters are capable of delivering our crews across the region in under 30 minutes. We also have four rapid response vehicles which are vital

Number of missions: 2,645 (2020: 2,622), including 924 night time missions (2020: 1,019)

Proportion of missions by aircraft versus car: 65% versus 35% (2020: 66% versus 34%)

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Mission type

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Types of Mission
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800
756
627
600
530
400
241
209
200
117 98
37 19
11
0
Road Accidental Medical Assault Intentional Inter-hospital Sport/leisure Exposure Other Other
traffic injury self-harm transfer transport
collision
Types of mission
Number of Jobs
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Patient results
600
514
502
500
400
326
300
200
148
100
0
Ground escort Ground assist Aircraft carry Pronounced life
Result extinct
Number of patients
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Our patients

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Patients by age and gender
300
192
250
167
154
139
200 135
150 95
89
100
43
38 54 57 57 64 53
50 41 46
23 26
6
2 0 0 0 0 0 0 1 0 0 0
0
n/a 0 10 20 30 40 50 60 70 80 90
Age of patients Male Female
Number of patients
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1,490 patients treated (compared with 1,626 in 2020)

*this drop is due to the quiet period during lockdown which resulted in less activity.

of patients were male (compared with 71% in 2020) 71%

73 patients (compared with 60 in 2020) were classified as Code Red This means they had significant bleeding which may have required the urgent administration of blood products, either during the pre-hospital phase of care or shortly after arrival at hospital

287 patients defined as having a traumatic brain injury (19%)

258 patients (compared with 296 in 2020) in cardiac arrest when crew arrived on scene (17%)

256 patients requiring emergency anaesthetic (17%)

104 patients receiving blood products (7%)

17

The fight against COVID-19

The Coronavirus pandemic had, and continues to have, a significant impact on KSS, both in terms of how we deliver our service and how we raise funds.

The safety and wellbeing of our patients and staff was our priority at all times, whilst ensuring we could continue to serve our communities. We invested in additional equipment so that we could operate safely in a high-risk environment during the pandemic including the provision of PPE. We made necessary changes to our working practices such as adapting our helicopters to ensure infection prevention was optimised.

Throughout the pandemic, we were committed to remaining fully operational 24/7, meaning we did not miss one single shift. We were ready, willing and able to give our fullest contribution to support our NHS in the fight against COVID-19. We stood up an additional crew and dedicated

specialist on-call support so we were able to work in partnership with the wider NHS and South East Coast Ambulance Service (SECAmb) to assist with the transfer of 117 patients requiring critical care between ICUs across the region. Where possible and when required, due to the extraordinary pressures facing ICUs in the South East, this included the transfer of critically ill COVID-19 patients.

Such inter-hospital transfers for critically ill patients involves highly complex planning and procedures, requiring the high-level skills of clinicians with experience of both critical care and the delivery of care outside of hospitals. Our crews, which include a specialist pre-hospital emergency medicine doctor and paramedic, have both of these skill sets, meaning we are able to support the COVID-19 pandemic effort.

18

Maximising our impact through our service delivery

In order to achieve our objective of realising the full potential of our current assets and developing our organisational agility and resilience to respond to demand, we focused on four main areas in terms of our service delivery.

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Area Achievements in 2020-2021
Medical, quality and safety
Programmed development of in-flight This year we have continued the development of our in-flight
procedures procedures programme which culminated with the publication
of our paper describing the feasibility of performing emergency
Integration of research and innovation anesthetic in the cabin of our aircraft. Our progress has however
outputs into Standard Operating Procedures been somewhat slowed by the Coronavirus pandemic as we have
had to repeat a number of the development stages to ensure that,
in the context of performing procedures wearing COVID-19 level 3
PPE, they remained safe. This work has now been completed and
we are preparing to start the final stage of our programme which
will involve in-flight trials.
Accommodation service for crews initially COVID-19 has impacted upon our ambition to explore
through East Surrey Hospital; explore on- accommodation services for our crews. We have as a result
base and off-base options for 2020-2021 and sourced temporary off base local accommodation options for
beyond our crews.
Maintain CQC inspection standards Our last CQC inspection in January 2020 achieved an outstanding
rating across all five focus areas; that we are safe, effective,
caring, responsive to people's needs and well-led. Throughout
the pandemic, we have continued our internal CQC compliance
protocols, audits and action plans to ensure our service continues
to maintain and improve the standards of care both we and our
patients expect. During the pandemic, the CQC has implemented
an emergency support framework and transitional regulatory
approach which requires us to meet with a CQC inspector every
six months to discuss any issues that are encountered, ensure
we continue to meet the regulatory standards and provide an
opportunity to share lessons learnt and best practice.
Time Critical Transfer Pilot
Launch of the Time Critical Transfer Pilot The Time Critical Transfer Pilot that we as a service launched in
which adds another dimension to our service 2019 has continued this year. The investment in aviation, medical
equipment and training that was necessary to launch the Transfer
Pilot meant that as a service we were ideally positioned with
the resources and skills necessary to step this service up into an
interim Critical Care Transfer Service. This was done in partnership
with NHS colleagues to meet the extraordinary challenges that
have faced critical care and the NHS over the year.
Operationalising instrument flight
Commencing multi-year initiative, working The required additional performance-based navigation training
with the Civil Aviation Authority (CAA) to has been completed for our instrument rated pilots and we are
operationalise instrument flight, to enhance now at early stages of the development of our first two instrument
our resilience approach sites.
Crew engagement plan and consultation, We have continued to discuss our aspirations for instrument
building change-readiness for flying informally with our crew. Due to the challenges of the last
12 months, we decided not to launch a formal staff consultation.
instrument flight
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Area Achievements in 2020-2021
Benefits realisation
Exploring commercialising training capability Unfortunately, due to the impacts of COVID-19, we were unable
and earning income across both sites to develop this area.
Retaining the MD902 in order to maximise The 902 has been retained across the year and was responsible
availability and service resilience for generating an additional 22% of availability.
Supporting 24-hour helipad provision in The King's College Hospital helipad remains the only 24-hour
London, initially funding King's College Major Trauma Centre hospital helipad in London. This vital
Hospital and exploring options with development has enabled in excess of 50 additional patients this
St George's Hospital year alone to be rapidly delivered by aircraft at night to a Major
Trauma Centre.
We have continued to develop the single operating base model
Refining single base operating model and which this year has focused on developing the base fall-back
driving Rochester operational benefits options at Rochester - implementing a revised aircraft and car
deployment plan, and commencing a day launch audit, revised
launch procedures and a night landing site trial.
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Service development

Throughout 2020-2021, as well as facing the challenges posed by the pandemic, we have continued to develop our strategy and consider how we can evolve and develop to continually improve our care, help more people and have even more of an impact on our communities. As well as being dedicated to developing our core service, we have considered how we can work collaboratively to change the pattern of death from medical emergency, in terms of developing education, training and early intervention opportunities and providing a patient and family support service. We will undertake more research, mapping and analysis to comprehensively scope the development of such services in the coming year.

Clinical governance

In order to enable excellence in service delivery and thus provide the best possible care to patients, KSS is committed to investing time and resource in a transparent, robust clinical governance programme. This includes the education and training of our staff to ensure they are prepared for their complex and challenging role, and to maintain and develop their skills. Ongoing training and development necessitate commitment, resilience, focus and hard work.

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Clinical Governance meetings KSS undertook 45 such sessions during the year, involving Clinical and
Operational Teams and including training sessions delivered to emeritus
clinicians. We had to adapt these sessions to be COVID-19 safe.
Supervised shifts Supervised shifts where a HEMS consultant flies as an additional member
of the team to assess performance and provide feedback and direction for
improving patient care are key elements of our governance and training
processes. In 2020-2021, 626 patient encounters representing 24% of all
activity received direct supervision.
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20

Mission reviews

Audit and performance

Objectives and performance metrics

Target of no unexpected deaths within 48 hours of care by our teams

We ensure that every mission is reviewed. Within the spirit of a Just Culture, discussions take place in relation to key missions to identify possible areas for improvement against objectives and performance metrics as described below.

In order to improve our clinical and operational performance, KSS continuously undertakes audits to allow us to benchmark our performance and highlight areas for improvement. Audits are undertaken by medical students, paramedics, nurses and doctors, within a culture of collaboration and continuous personal development.

We consider it imperative to understand why patients die in order to review and ascertain that every possible action to help that patient, and prevent their death, was undertaken.

This process also allows for retrospective analysis of which patients may have benefitted had new treatments been available and helps to inform decisions about adopting new practice. Understanding the cause of death also plays a large part in shaping the nature and methods of training delivery to ensure our teams are as prepared as possible for the type and nature of injuries they may face. This is a complex area and one of focused ongoing research by KSS.

Training

Each year, two cohorts of new doctors join KSS to work full time for up to one year. They begin with an intensive training programme delivered by our experienced paramedics and doctors during which they are continuously evaluated.

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||| |---|---| |•|Training includes both classroom lectures and simulations or| |‘moulages’ of the real situations that the crews encounter. This is a| |very significant part of the training which helps build and cement the| |foundation of safe and effective pre-hospital care.| |•|The doctors and paramedics are rigorously tested not only on their| |clinical knowledge, but on areas such as communication skills with| |other crew members and with the patient.| |•|The base in Hangar 10 at Redhill includes a training centre offering| |classrooms and sufficient space to deliver the moulages.| |•|In addition to our own staff, student paramedics from the University| |of Surrey, Canterbury Christchurch University and from SECAmb| |attend the courses.| |As a result of COVID-19 we modified how we delivered our training by| |reducing the size of the faculty, ensuring more online delivery of lectures| |and introducing rigorous COVID-safe practices for face-to-face teaching,| |simulations and moulages.| |In 2020-2021, five doctors successfully completed the training course,| |enabling them to progress to a 6-8-week period of clinical supervision to| |gather experience and hone their pre-hospital skills.| |All the staff that progressed directly into the direct supervision phase of| |their training met the required standards to fly as part of the crew without| |direct supervision. Throughout their time with KSS, they have received| |frequent ongoing supervision sessions, recorded and logged by their| |clinical supervisors.| |Sharing best practice|There is a strong commitment to sharing best practice locally and| |internationally and increasing interest from doctors from other countries to| |work for KSS.|

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21

Spotlight on our collaboration value

Our collaboration value is fundamental to all we do in order to deliver on our purpose of saving lives and ensuring the best possible patient outcomes, and to looking to the future as to how we can save more lives and have an even greater impact on our communities. Our team works in close strategic collaboration with SECAmb and our hospital network partners, including the three Major Trauma Centres that serve our region, playing a critical role in the chain of care.

The multifaceted and extremely complex needs of our critically ill and injured patients necessitates a coordinated, networked approach which supports patients through all aspects of their care journey. This spans

from the point of call for help, through their time in hospital and beyond into rehabilitation and their return home. We are committed to working beyond our formal agreement with SECAmb, the NHS Ambulance service that covers our region, to embrace opportunities for effective partnership working.

We are also committed to sharing our learning, to enhance the sector and drive improvements in practice. Throughout the pandemic, we engaged with other Air Ambulance charities and Air Ambulances UK to ensure the provision of mutual support and that lessons learned are maximised.

22

Our plans for next year

Our plans for next year involve both examining how we can improve our core service, and how we can develop and extend our service to have more of an impact on our communities.

We are committed to the model of continuous improvement in relation to our service. In 2021-2022 we will explore novel approaches to improving trauma dispatch, continue to support the creation and delivery of a pan-regional transfer coordination function, and conduct an activity and response analysis to identify areas of inequality of access to services. We will also explore enhanced technologybased decision support adjuncts and continue to work collaboratively with SECAmb for mutual benefit and to develop a full suite of integrated clinical management plans.

We have thought differently about how we can continue to evolve and modify the need for our service. We intend to undertake research and data analysis to identify which areas in the education and early intervention arena could have the most significant impact on our service, and then run pilot projects to assess effectiveness and scalability. We also intend to examine

collaborative opportunities for lay education and Community First Responder schemes.

Ensuring the best possible outcomes for our patients is our purpose as a charity, and we are exploring further how we can support our patients in the long-term.

We intend to run a pilot project examining how we can continue to support our patients and their families through their recovery and beyond, including the provision of bespoke KSS services alongside signposting to existing support services provided by trusted partners. This service will also provide us with the valued opportunity to better understand the impact and contribution we make to the outcome of our patients. This will inform how we continue to evolve our service to best meet patient need and deliver the necessary life-saving interventions that enhance the speed and potential of their recovery.

In addition to progressing on these areas, a continued priority will be continuing to deliver our life-saving service and ensuring the safety and wellbeing of our staff throughout the ongoing Coronavirus pandemic.

23

Our .'Achievements .ifARr*gce 14 OLTOil

Strategic objective

To provide the evidence for our sector, develop new knowledge to improve the service, and share the knowledge so we save lives everywhere

world seriously. We continue to grow in the number and complexity of our research projects which aim to both improve patient care and have the potential to deliver nextgeneration pre-hospital care. We are proud of our high research output in the face of the pandemic as this is so critical to us striving towards our vision of an end to preventable loss of life from medical emergency. We published six research papers in 2020-2021, several gaining international recognition, helping to save lives nationally and internationally.

We operate a world-leading Research and Development programme with an incredibly active portfolio. This programme continues to grow and break ground in terms of innovative developments that influence our practice and shape practice across the UK and beyond.

As a team, we are continuously looking at new ways to innovate and embrace new technology. We take our commitment to share our experience and work with other emergency medical services around the

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Area Achievements in 2020-2021
Exploring more funding opportunities
Continue to support part-time grant advisor to oversee We have worked hard to support grant applications and,
funding strategy and opportunities in partnership with University of Surrey and SECAmb, have
been successful in being jointly awarded a £500K research
Create a grant pipeline for reporting and tracking grant grant to undertake the UK’s first randomised clinical trial of
progress and success rates, and internal engagement video assisted dispatch.
Create capacity to bring in external research support
consultancy (e.g. medical statistics, health economics)
as required
Investing in additional roles
Replicate the PhD paramedic model of funding to The Research Team continues to grow with one PhD within
increase research capacity KSS and one PhD being run in partnership with SECAmb.
Make allowance for one additional 0.5 FTE per year We now have a part time Senior Researcher supporting
over the life of the strategy KSS and we are exploring further PhD projects.
Creating the right internal environment
Implement a ring-fenced research and innovation Our research registry now has over 30 ongoing live
budget for staff, equipment, publications and projects – the highest number to date.
presentations
The Research Team continues to collaborate and share
Implement research training into education strategies knowledge with our Communications Team to enhance
and invest in infrastructure at Redhill
awareness of research papers as they are published.
Implement mechanisms for ideas to get surfaced and
acted upon (pipeline, portfolio, interface between
clinical and ops)
Implement a communications process to maximise
internal and external impact of research
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25

Spotlight on our innovation value

KSS fosters a culture of innovation and effective collaboration, as we continue to improve the scope and quality of the care we provide, and ensure we reach as many patients as possible. We are dedicated to continuing to develop our core, life-saving HEMS to ensure KSS remains at the forefront of delivering the best possible care.

We spearhead medical and technological innovation in the sector and are continuously innovating and striving to improve our treatments, technologies and cutting-edge equipment. We share our knowledge and expertise so our impact is felt worldwide and apply our learning to our current practice in order to help more patients and improve their outcomes.

26

Our plans for next year

Our plans for next year focus on consolidation of our research performance as we emerge from the Coronavirus pandemic, as well as further strengthening the size and capability of our team to increase our research input and the size and magnitude of our research projects. As always, we intend to broaden our impact in terms of innovation, as well as investigating improved methods of data access and management. This is so that we can continue to develop our longerterm research project of how we can best measure and demonstrate patient outcomes, and the impact of our service on our patients and communities.

In 2021-2022, we will go live with two major research projects including using portable microwave brain scanners in a pilot study and a major randomised clinical trial using live video streaming from 999 callers to improve our dispatch accuracy. In addition, we will continue to deliver our current programme of continuously improving patient care through reviewing and optimising our practice. Specific areas of focus include pre-hospital anaesthesia and blood product transfusion.

We also have plans to extend the dissemination of our research, through translation of key research findings to have more of an impact on our lay audiences, and dissemination via wider mechanisms including digital methods. We also intend to support the delivery of education campaigns and valuable content creation to help drive forward our early intervention agenda and raise our profile.

We rose to a phenomenal challenge in pulling together a dedicated Critical Care Transfer Service during the Coronavirus pandemic and, as always, we are dedicated to sharing our learning and are currently writing a research paper to summarise our experience to share lessons with the global pre-hospital community.

Saroj

“I found Saroj out cold on the bathroom floor; his eyes had rolled back and his body had twisted strangely as he fell. I ran to call an ambulance and was told over the phone how to give CPR…KSS arrived and attached the LUCAS machine, which delivers chest compressions mechanically - it was critical in maintaining CPR. Without KSS I have no doubt that my husband would not be here today.”

SARAH, WIFE OF FORMER KSS PATIENT SAROJ

27

Our Achievements

28

Strategic objective

To diversify our income streams in order to strengthen our resilience as a charity and enable our growth and sustainability

To ensure our brand drives value and influence

KSS achieved significant successes during the past year against the toughest climate charities across the world will hopefully ever face, by responding with agility and innovation and seizing available fundraising opportunities. COVID-19 suddenly and severely impacted our ability to fundraise, with several income streams being paused for prolonged periods.

We had a record year for income, with our total income being £17.44M, compared with £16.27M in 2019-2020 which represents an increase of 7%. This outstanding achievement was only possible thanks to the inspiring generosity and commitment of our supporters during an unprecedented year – with 86% of our income from donations and fundraising activity.

29

Coronavirus Emergency Appeal

In April 2020, we launched our first ever Emergency Appeal, triggered by a projected shortfall in our core funding due to the cancellation of major fundraising events, combined with the increased costs associated with operating a safe service during the pandemic including full infection prevention controls for our crew, patients and aircraft. We have needed to invest in specialist equipment and protective wear to ensure our staff have the necessary resources to stay safe and can continue to save as many lives as possible 24 hours a day, seven days a week.

Together, along with our hugely dedicated and generous supporters, we raised more than £1.5M within six months of our Emergency Appeal launching, including a £374,375 Government grant via Air Ambulances UK. We are extremely grateful for this exceptional generosity and support.

Innovation in fundraising

We had to drastically change our approach to fundraising, by embracing innovative ideas and exploring digital approaches previously unexplored by KSS, and by continuing the diversification of our income streams.

Following the success of our Run 31 digital campaign, we have shared our learnings within the Air Ambulance community and further afield.

Thanks to all of Team KSS, we have remained utterly focused on our purpose whilst being able to explore new income generation streams to ensure our growth, resilience and future financial sustainability.

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Our supporters

Our supporters inspire us every day through their sheer determination to raise funds and awareness of our cause. This year in particular it has been so vitally important to engage with our supporters on a frequent basis, to thank them for their ongoing support and dedication to KSS through immensely challenging times.

Spotlight on our caring value

This year more than ever, we ensured our caring value was at the centre of all our activity. We reached out to our supporters via two Thankathons to express our gratitude and show how much we value them for continuing to support our cause during a difficult time. We sent out 20,000 handwritten cards, 3,000 emails and called over 250 people to thank them for supporting our Coronavirus Emergency Appeal.

Our incredible volunteers rose to the challenge to support our communities - litter-picking in our local areas, signing up as NHS responders or vaccinators, and supporting us to join forces with the Kent MS Therapy Centre and Pfizer to assemble and distribute more than 200 welfare packs across Kent. Our volunteers also supported each other during lockdown, creating a Facebook page to stay engaged.

Our Thankathon card, designed by Phoebe Harkup, aged eight – granddaughter of former patient Geoff Harkup, who was airlifted by KSS in October 2018.

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Noel, Murray and Emily completing Run 31
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Spotlight on our supporters

The Miles family from Chelwood Gate raised over £14.7K throughout 2020-2021 by undertaking a series of gruelling challenges. Son Murray was just five-years-old when he ran a marathon across five days to support us. Then in January 2021 the family of three took on Run 31 setting themselves an extra challenge of completing the fundraiser in just one day. The Miles Family are truly inspiring and embody such determination and dedication to KSS.

Murray was also selected as a finalist for the BBC Radio Sussex Make A Difference Heroes Awards. He was one of three finalists for the Young Achiever of the Year category which recognises the achievements of people under the age of 18 who have demonstrated maturity beyond their years.

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Noel

“It was a regular Tuesday morning. I was heading off for a busy day at work. I kissed my wife, Emily, goodbye and also said goodbye to our five-year-old son, Murray.

I was on my motorbike near Tonbridge at a junction, with right of way to go straight ahead, when a car drove across the flow of traffic straight into me. The next thing I knew, I was lying on the ground and couldn’t feel my legs. I quickly realised that my injuries were severe and that I was fighting for my life.

I was subsequently told that I would not be alive today if it wasn’t for KSS – and, apparently, even the KSS team at the scene were unsure as to whether I would survive. The Helicopter Emergency Medical Service (HEMS) crew gave me a general anaesthetic and thoracostomies, which helped to reinflate my lungs, before lifting me on a stretcher to the nearby field where the ambulance had landed.

I had very low blood pressure and no pulse. Once on board, they gave me three units of blood and plasma and kept me alive for the 10 minutes it took to get to King’s. I know that if I was in a road ambulance, with a journey time of around one hour, it is highly unlikely I would have survived. I also know that if it wasn’t for the specialist training and skills of the KSS team in being able to deliver their service under extreme pressure, I would not be here today.

My injuries have been life-changing and I am paralysed from the waist down. It’s been a tough road to recovery. From lying on the side of the road believing that I may never see my son grow up to processing the realities of what paralysis means for my life ahead and the impact of that on Emily and Murray. I have

had to take time to grieve for the life that I had planned but know I will never be able to have. I am immensely proud of my family. Murray has taken it all in his stride. He is aware that I wouldn’t be here today if it wasn’t for KSS and he decided to fundraise for the charity that saved my life. So far, he has raised over £12K through a number of different sports challenges, including running the equivalent of a marathon over five days, which at the age of five is quite an achievement. In addition, Murray, Emily and I supported KSS’s Run 31 fitness fundraiser. True to form for our family, instead of running the 31 miles over 31 days, we challenged ourselves to complete 31 miles all in one day – 31[st] January - with Murray cycling, Emily running and me pushing myself along in my wheelchair. My family and I are now very much part of KSS.

Since my accident, I have had to re-focus and remind myself of what’s important in life and I have learned the hard way what a beautiful thing it is to be alive. When I hear the birds, hug my family or watch Murray playing sport, I know that none of it would be possible without KSS.

KSS is a crucial, life-saving charity, hugely reliant on raising significant funds from the public every year. Fundraising for them is the least we can do.”

NOEL MILES, KSS FORMER PATIENT AND SUPPORTER

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Area Achievements in 2020-2021
Diversification of income
Further diversify our fundraising strategy, We achieved a record year of high-level donations despite being
to focus on gaining the support of Major unable to launch our planned Giving Club or meet with supporters
Donors and securing funding from Trusts and face-to-face.
Foundations
Strengthening our identity
Develop our identity to reflect The KSS Way Following a comprehensive consultation exercise in 2019-2020,
we made tactical developments in order to strengthen and future
proof our identity.
Increasing our reach
Engage with a different demographic of Our plans for a series of supporter engagement events to be held
supporter by increasing our digital presence across our regions had to be reconsidered in light of the pandemic
and led to us developing a series of online events. This gave us
the opportunity to engage with our current supporters as well
as providing us with a new audience which aided our plans to
diversify our supporter base.
Social media
We increased our following across all social media platforms by
15,119 followers, a 37.1% increase, and generated 14,082,336
impressions throughout year.
Digital offering
We established a digital supporter newsletter, Mission Update,
which was sent monthly to over 27,500 people.
We introduced Mission Update Live, a short online event
highlighting a specific activity. We have held two up to this point
with around 2,000 views each.
We launched Brew with the Crew, viewed over 60,000 times across
three online events.
We held a number of bespoke webinars for our major donors,
corporates and key partners to showcase equipment and vehicles.
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Area Achievements in 2020-2021

Delivery of income generation activity to meet our ambitious target Continue to adapt our fundraising We were unable to hold any physical fundraising events approaches and practice in the light of the throughout 2020-2021 due to COVID-19 restrictions. It was ongoing pandemic including continuing our of paramount importance to prioritise the safety of our staff, Coronavirus Emergency Appeal to meet our patients, supporters, volunteers and the wider community. In expected fundraising shortfall addition to our successful Coronavirus Emergency Appeal, our Income Generation, Marketing and Communications Team worked together to explore new acquisition methods and engagement opportunities to raise awareness and create further publicity.

Events

Virtual fundraising events were extremely successful in engaging a wider audience and will continue alongside in-person events. We raised over £218K through the 2.6 Challenge, 30 for 30, Run 31, and Squat 3100.

Individual giving

We explored alternative acquisition methods. This included a cold door drop to 200,000 homes, raising over £48K (which was double its target). This activity was repeated with the same level of success.

Lottery

Canvassing is the most effective way to raise awareness of our lottery scheme but was put on pause due to COVID-19 related restrictions. Instead, we launched two telephone campaigns to encourage more chances to win and engage with those who had previously cancelled their direct debit. Both saw huge success and presented an opportunity to engage with our existing supporters. We raised over £227K in annualised value through our Lottery Upgrade campaign. We delivered a Lottery Reactivation campaign to encourage lapsed supporters to re-engage which generated an annualised value of over £225K. Over 4,000 lottery players took at least one additional entry. Our planned Car Raffle was also cancelled but replaced with a Summer Draw (raising £188K) which became our most successful raffle to date. There was then further success with our 2020 Christmas Draw (raising £221K) and our Christmas card appeal which raised £140K from donations and card sales.

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----- Start of picture text -----
Area Achievements in 2020-2021
Delivering an exceptional supporter experience
Focus on donor stewardship and thanking our Processes and procedures were quickly adapted to ensure
valued supporters we could continue providing an outstanding supporter
experience whilst working remotely. We focused more
heavily on individual giving and our digital offering,
increasing the level of supporter stewardship through email
newsletters, online events and more. We contacted over
20,000 supporters through two Thankathons to express our
sincere and heartfelt thanks for their ongoing dedication
and generosity, particularly during such a difficult year.
We also updated how we thank supporters, including
introducing phone calls and handwritten cards into the
supporter journey, and changed our letter templates to
make them more supporter focused. We continued to
implement our Supporter in the Room approach in order
to demonstrate our appreciation and respect for our
supporters.
We undertook monitoring and analysis of complaints
and compliments received which helped ensure we were
quick to respond to any issues identified and were able to
improve our processes to increase supporter satisfaction.
Communicating our impact
Improve the ways in which we can utilise our We published 11 patient stories on our website which were
evidence and impact stories to communicate our then shared through various channels including campaigns
purpose and generate support and commitment to such as Air Ambulance Week, what3words awareness,
our cause Summer Draw and Appeal, Mission Update, Brew with the
Crew and more.
Where possible we used integrated campaigns to create
greater impact of each story to generate further support.
For example, Saroj’s story featured in our Christmas
Appeals, Christmas Brew with the Crew and Restart a
Heart Day.
We also found creative ways to thank our supporters,
including personal video messages, invites to webinars and
our hugely successful Thankathons.
It was also vitally important to evidence our impact
internally with Team KSS to engage and motivate staff
during unprecedented times. Regular, honest, two-way
communication has been vital and new channels were
introduced including monthly briefings, Tea at Two, one to
ones with our CEO, volunteer coffee mornings and more.
A weekly CEO newsletter continues to be sent and
engaged with well. Our communication methods have
proved to be successful in keeping colleagues connected,
updated and to celebrate collective successes.
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Spotlight on our trusted value

As part of our trusted value, we take our responsibility to keep our supporters and volunteers up to date with our activity and achievements very seriously. This was also the case during lockdown where our team and CEO conducted webinars with supporters, volunteer coffee mornings, and Brew with the Crew.

We undertook engagement sessions with supporters throughout the year and sent 52 newsletters to keep volunteers engaged and informed. We also made a personal wellbeing phone call to all our volunteers.

Philanthropy

2020-2021 was a significant year for KSS to develop relationships with key stakeholders and high value supporters as part of our approach to diversifying our income streams. We met with several supporters virtually to provide targeted updates on our work and impact, identified philanthropic opportunities to meet their needs and interests and secured a number of significant donations. We submitted a small number of applications to Trusts and Foundations and were pleased with the response which we will continue to build on in the next financial year. This is a key growth area for KSS that we are excited to develop.

Legacies

We are always honoured and humbled when someone chooses to leave a gift to us in their Will regardless of the size of the gift. In 2020-2021 more people left us a gift in their Will than ever before, delivering the highest legacy income we have ever received. Whilst we weren’t able to welcome the families of those who had left us a gift to our bases, we’re looking forward to the time that it will be safe and appropriate to resume those visits. We’re also proud of the innovative work we did to make it easier than ever before for people to leave us a gift in their Will despite the challenges presented by COVID-19.

172[volunteers in 2020-2021 (211 in 2019-2020)] 37

Our volunteers

Our fantastic volunteers are an integral part of Team KSS. From our committed Trustees who provide invaluable support, encouragement and guidance, to our fundraising volunteers who help raise awareness and generate commitment to our cause by inspiring others to support us, we owe you all our heartfelt thanks.

hold due to COVID-19 but as a people centred organisation, we strived to keep our dedicated volunteers updated and engaged throughout. We greatly benefitted from the support of 172 volunteers throughout the year who, alongside other activity, delivered 87 virtual talks to community groups across Kent, Surrey and Sussex.

In 2020-2021 despite the restrictions, we continued to move forward with our volunteering strategy of ensuring we provide volunteers with the best possible experience, and also ensuring our volunteering base mirrors our strategy. A large proportion of our volunteering activities were put on

We are so eternally grateful for the support we continued to receive from our volunteers despite the ongoing challenges and restrictions and look forward to next year when we hope to be able to welcome our volunteers back to working with us face-to-face.

Volunteer stories

Warren Porritt - Kent

“In the summer of 2017, I started volunteering and I’ve never looked back. I’ve been involved with so many things including talking at schools, sports events, corporate events, cheque presentations and village fete information stands. Volunteering makes me feel really proud of the charity, it makes me feel fulfilled, and it's really amazing closure and therapy for me to talk about my accident. My kids wouldn’t have a dad if it weren’t for KSS, volunteering is the least I can do.”

Alan Barnes is a volunteer with his wife, Janet - Sussex

“Our volunteering began one bank holiday weekend when we were stuck in a long traffic jam caused by a car accident on the motorway. The ambulances struggled to get to the incident and Janet and I discussed how an air ambulance could reach the scene so much quicker. We talked about what an amazing service the air ambulance provides and decided that we would get involved by volunteering. Over the years we have been involved in a wide range of volunteering activity, from selling raffle tickets to win a car through to helping with collection boxes at events such as horse riding and motorbike shows. We are very proud of the role we play as volunteers and feel very much part of the KSS community.”

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Our plans for next year

Our plans for next year involve the continued diversification of our income streams to appeal to different demographics of supporters. This will involve the further development of our Trust and Foundations income stream, developing an events portfolio that meets COVID-19 regulations, and a return to lottery canvassing in May 2021.

We will continue to develop our supporter experience offering, replicating the success of our online offering in an offline format. We also plan to undertake our first supporter experience consultation exercise in order to inform ongoing improvements. We will continue to engage with our volunteers, and very much look forward to welcoming them back to face-to-face activities when it is safe to do so. We will also continue with our strategy of increasing and diversifying our active volunteer base, promoting an attitude of inclusiveness, to support our income generation and service delivery plans.

We have exciting plans for increasing the reach, profile and impact of our activity via a communications and marketing strategy that engages with different audiences and helps to raise awareness of our status as a charity, with the aim of increasing intention to support KSS.

We will also implement our developed identity across a range of channels, which includes developing our Identity Guidelines and supporting staff to fully embrace and communicate our identity. We will undertake a further community survey to ensure we can track key metrics in relation to the impact of our identity.

We are excited to share our strategy and vision for the future externally in our communities, with an engagement exercise planned for later in 2021-2022 (COVID-19 permitting).

Neil Sadler - Sussex

“I was a police officer in Sussex for 30 years and began volunteering for KSS when I retired. I’m always overwhelmed by the generosity of members of the public when I’m involved with collections - so many people have come up to me over the years to let me know that KSS helped to save the life of one of their friends, colleagues or family members.

We have volunteer coffee mornings and regular email updates from the CEO and other team members. Some people from KSS even rang me up during lockdown to check I was OK - it made me feel valued for the role I play.”

Myra Baston - Surrey

“I am a practicing physiotherapist and had seen the Air Ambulance land many times when I was doing locum work at St Richard’s Hospital in Chichester and was always impressed by what I saw.

I value the flexibility of being a KSS volunteer. This enables me to fit the volunteering around my job – there’s no requirement to do a fixed number of hours each month.”

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Our Achievements

40

Strategic objective

To enable engaged and highly capable people To enable capabilities that help get the job done effectively

Our people - Team KSS

In this year of uncertainty and challenge, Team KSS have demonstrated their dedication, passion and strength in remaining driven by our purpose and ensuring that people remain at the centre of all we do.

KSS believes strongly in ensuring that the strategic direction of our organisation is co-produced by our Trustees, staff, volunteers, supporters and stakeholders to ensure it captures the passion, commitment and word-leading nature of our organisation. We began a long-term process of staff engagement and consultation in 2019-2020 which has carried forward to 2020-2021 and beyond where we continue to engage with staff regarding our strategic direction and the production of our business plans.

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Spotlight on our caring value

The safety and wellbeing of Team KSS was a clear priority through this challenging year. We acted swiftly to ensure our staff were equipped to move to a home-working environment as required, enabling them to stay safe whilst offering flexible working arrangements to support those with caring commitments during lockdown. We also quickly made adaptations to both our bases to meet with required restrictions and ensure a COVID-safe environment for our staff.

We introduced a range of initiatives to support staff wellbeing, ensuring staff remained engaged and connected. This included senior managers conducting regular virtual check-ins with staff, investing in wellbeing resources for Team KSS (including the 87% App), and introducing informal engagement opportunities including our fortnightly, virtual Tea at Two

informative session. This was an opportunity for the whole of Team KSS to hear updates from the CEO and Senior Leadership Team. In January 2021, we launched Wellbeing Month, introducing a range of initiatives to ensure wellbeing is perceived as a collective endeavour within KSS, and one that is prioritised and advocated for.

We remained agile and became much more digitally proficient, delivering digital induction and training for our teams and ensuring digital communication and engagement became the ‘new normal’ as a way of keeping our team motivated and engaged.

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Spotlight on our dedicated value

At KSS, we are dedicated to staff engagement and ensuring Team KSS are able to shape and contribute to the ongoing development of our organisation. As well as ensuring staff remained connected throughout our enforced period of remote working, we continued with the provision of consultation and feedback mechanisms for staff, to ensure their thoughts and suggestions could be gathered and taken on board in order to ensure KSS remains a great place to work. We undertook a comprehensive annual staff survey in July

2020 which covered a range of issues including experiences of working from home, COVID-related concerns, opinions of communication, and future plans. The results of this survey were communicated to staff, alongside an action plan to address key issues raised through the survey. In particular, this led to the creation of our four working groups to be introduced in 2021-2022 covering Wellbeing; Equality, Diversity and Inclusion; Culture; and Environment.

97% 100% agree that KSS takes are proud to positive action on work for KSS health and wellbeing

92% would recommend KSS as a place to work

Remuneration

The pay of all staff is reviewed annually although the remuneration of seconded clinical staff on NHS salaries is governed by public sector arrangements. In view of the nature of us being a healthcare charity, all operational and clinical staff directly employed by KSS are benchmarked against their equivalent NHS grades. The salaries of all non-clinical staff are benchmarked against similar sized organisations and charities delivering equally complex and demanding outputs.

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Our key management personnel

The management of KSS is undertaken by our Chief Executive (CEO), David Welch, supported by a Senior Leadership Team who lead on strategic work in each of their Directorates. The team are outlined below.

CEO

A D Welch

Senior Leadership Team

L J Curtis MBE – Executive Director of Service Delivery L D Harris – Executive Director of Income Generation, Marketing and Communications D A Hooton – Director of Marketing and Communications (resigned August 2020) I W Howick - Executive Director of Corporate Services (appointed July 2020) J B Lack – Director of Finance and Support (retired September 2020) Prof. R M Lyon MBE – Associate Medical Director Dr M Q Russell MBE – Medical Director (stepped down August 2020) Dr D J Bootland - Medical Director (appointed August 2020)

Our Board of Trustees

Our committed Board of Trustees are responsible for ensuring KSS is effectively and properly run and governed, and that we meet our overall purpose as a charity.

Further details on their roles and our objective of ensuing effective governance is included in the chapter – How we Operate.

The Trustees who served during the year were as follows.

Chair

Dr H A Bowcock OBE DL

Trustees

P J Barrett MBE (reappointed March 2021) D H B Burgess (Vice Chair) M J Docherty A M Farrant (reappointed March 2021) T S N Oakes (Honorary Treasurer) (reappointed March 2021) Prof. A Rhodes P D Stewart (reappointed March 2021)

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Our new Corporate Services Directorate

2020-2021 was a significant year for the growth and development of our new Corporate Services Directorate which was restructured following the retirement of our Director of Finance and Support. We introduced three new key roles including an Executive Director of Corporate Services, supported by a Head of Finance and a Head of Governance and Compliance and

have invested in the continued professional development of the existing team. The new team are seeking to automate internal processes to make them even more efficient and effective as well as utilising their skills to support the wider KSS Team in matters of compliance, risk and good governance.

Charity Times' Charity of the Year Award (income over £10M)

We were delighted to win the Charity of the Year Award in September 2020. According to Charity Times;

“The awards attracted hundreds of high-quality entries, which were then evaluated by an expert independent judging panel. KSS was praised for continuing to deliver critical lifesaving services despite the pandemic, and for proactively looking across the world to help preparedness. Judges said it excelled across all its delivery areas.”

Our CEO, David Welch said “What an amazing achievement in our 31[st] year to have been named Charity of the Year for an award organised by Charity Times. Every member of the KSS team has played a significant role in our success and I am immensely proud of this accolade.”

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Our plans for next year

Introduce four working groups to continue to develop and embed our people centred culture: Wellbeing; Equality, Diversity and Inclusion; Culture; and Environment.

Work towards the automation of our processes to increase efficiency and deliver a new finance system.

Introduce bi-annual People Pulse surveys to measure staff engagement in addition to a comprehensive annual staff survey which takes place in July each year.

Further refine our metrics and KPIs used to track performance.

Launch the Freedom to Speak Up Guardian initiative to help embed a trusted, caring and just culture within KSS in order to improve the experience of Team KSS, promote learning and improvement and protect patient safety and the quality of care.

Continue with our development of best practice policies.

Refine the appraisal system to help ensure every member of Team KSS is able to directly link their role and objectives to our values and organisational objectives, further embedding our purpose driven approach.

Introduce the SECAmb Wellbeing Hub to further support staff wellbeing.

Establish our detailed five-year business plans and review our organisational structure.

Conduct a tendering process for a new Learning Management System.

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1£ p¥•

Ambition and Visio for the Future . li DOCTOR

Embracing The KSS Way

Continuing the development of our future strategic plans remains a priority.

in the power of collaboration, a value that we embrace through increased collaborative working with our NHS and ambulance service colleagues, in order to play an even more critical role in the chain of care.

This has also been the case during this unprecedented year, where despite the challenges faced by COVID-19, the team has continued to collaborate strategically to further develop and define our future plans and our strategy for delivering on our purpose and striving towards our vision.

Alongside our ambitious plans, we have also focused on how to continue ensuring our resilience and sustainability as a charity which provides such a critical service to our communities. Our future plans include the further diversification of our income streams to continue to grow our supporter base and inspire support from a wide demographic, as well as continuing to introduce innovative fundraising and marketing initiatives.

Our focus has been how we can continue to deliver and develop our core HEMS work, alongside how we can extend our service to help more patients achieve their best possible outcome. We want to help create a future where there is less medical emergency, where we can influence the need for our core service by equipping our communities to provide critical first response, and where critically ill patients are able to benefit from ongoing patient and family support to enable their best possible future. As a people centred organisation, our objectives align with the patient’s journey where we have considered how to make the most beneficial impact at each stage.

As we continue to face the challenges created by COVID-19 including remote working, our future plans involve further activity to embed our people centred, caring culture and ensuring we offer a safe, welcoming, supportive and inclusive environment for Team KSS.

In the coming year, we are excited to share The KSS Way externally with our communities, to communicate our future plans and strategy for ensuring we can offer maximum benefit to our patients.

As always, our strategic thinking and plans are embedded within our values base of being Caring, Trusted, Dedicated, Innovative and Collaborative. We believe passionately

Changing the pattern

KSS HEMS Delivery and Development

Develop KSS Patient Aftercare

Explore KSS In the Community

Enable rapid community response, saving lives and improving the outcomes for more patients

Support patients to the best possible recovery while using our learning to inform future outcomes

Continuously improve world-leading, pre-hospital critical care

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Our five-year organisational objectives

During 2020-2021, Team KSS have come together through facilitated virtual sessions to articulate our strategic objectives for the next five years. This work will be continued into 2021-2022 in order to develop detailed five-year business plans linked to our objectives and aligned with our goals.

----- Start of picture text -----
To deliver, develop an d To deliver patie n t
extend our high-quality centred research and
service to meet the share our knowledge
needs of our patients and learning to
and communities maximise our impact
W e deli v er outstanding We make a dif f erence
treatment and ca r e We invest in research and
innovation to demonstrat e
We deliver outstanding our impact, break new
specialist treatment, ground, influence policy and
care and support to give practice, and ensure we play
our patient s their best the m o st collaborative r ole
possible outcome possible in the health sector
Our and wider community
Goals
We generate and W e aspire for
inspire support excellence in all we do
We generate support and We work hard to do our very best, wit h
com m itment (both financial and safety always at the core, to be a w e ll led,
non-financial) from our prof e ssional, indepen d ently regulated
communities and partners charity with an outstanding team that
to ensure the growth and provides increased benefit to our patients
sustainability of KSS a nd the communities we serve
----- End of picture text -----

To deliver a diverse To support the growth income portfolio to and ambition of KSS enable our growth and enhance it's and the delivery of ability to function as our purpose a professional, best practice, outstanding charity which delivers maximum benefit and is a great place to work

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Saying Thank You

Our sincere thanks and gratitude to our fantastic supporters and volunteers who have excelled in supporting us through our most challenging year ever.

We thank you on behalf of every patient we treat and care for.

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Part Two Financial Review

Income

Despite the initial uncertainty faced by the charity sector as a whole in this year, our total income was £17.435M , compared with £16.269M in 2019-2020 which represents an increase of 7.2% . Once again, our incredible donors and supporters are instrumental in contributing to our income, with 86% (2020: 88%) of all income raised by the communities we serve.

14% 4% 32% 50% Donations and legacies Trading Income Fundraising Charitable activities and investment income

Donations and legacies of £5.685M (2020: £4.374M) and our trading income of £8.668M (2020: £8.733M) predominantly from our well supported lottery, represents 82% (2020: 81%) of our income. This would not be possible without the dedication and hard work of Team KSS including our staff, volunteers, lottery canvassers and most importantly, without the continued support and generosity from the communities we serve.

Income from fundraising and events of £0.729M (2020: £1.191M) decreased by 39% on last year’s figure. Despite the lockdown and the ban on face to face events, our online community presence resulted in strong support through the year, including Run 31 and 30 for 30 campaigns.

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Expenditure

Total expenditure decreased by 1.4% to £15.211M (2020: £15.427M), primarily due to the reduction in fundraising and trading activity of £0.344M. At the same time, charitable expenditure increased by £0.128M.

1. The cost of raising funds increased by £0.234M (11%) to £2.442M (2020: £2.208M). This is mainly due to the continuation of our strategic increase in resourcing the Income Generation, Marketing and Communications (IGMC) Team, begun in the previous year, with an offsetting saving, as one-off costs of design, development and marketing of the new website did not recur. The staff cost increased by 44% to £1.509M. The one-off costs of design, development and marketing of the new website to increase engagement, awareness and understanding of our charity and create the foundation of our future digital marketing strategy in 2020 did not recur, resulting in a reduction of £0.304M and a return to a run rate consistent with prior periods.

2. The increase in the cost of raising funds was more than offset by a decrease in the costs of the trading subsidiary by £0.578M (33%) to £1.161M (2020: £1.738M). This was driven primarily by the lockdown and the curtailing of doorto-door canvassing activity during the year due to the Coronavirus pandemic. Lottery membership fell through the year by 14% (2020: growth of 4%) with 85,875 plays in the weekly regular draw at the end of March 2021 (2020: 99,953 plays).

3. Charitable expenditure increased by

1% to £11.609M (2020: £11.481M). Direct charitable expenditure on the provision of HEMS services increased by 3% to £10.313M (2020: £10.061M), while management and administration charges decreased by 9% to £0.647M (2020: £0.719M) due to careful cost management through the year.

Air Ambulance Promotions Ltd (AAPL)

Our trading company’s turnover fell very slightly year on year to £8.668M (2020: £8.734M) a decrease of 0.8%. At the year end, membership of the main lottery decreased by 14% to 85,875, with 51,878 (60%) of the members also entering the weekly Superdraw. The weekly draw known as “24/7” raises funds specifically for the night flying service and by the end of the year, there were 5,918 (2020: 6,151) regular players. Total sales from the three weekly lottery draws and raffles amounted to £8.622M; a decrease of 0.8% on the previous year (2020: £8.689M). At the same time, the profit for the financial year increased by 6.8% to £7.285M (2020: £6.822M). This is primarily due to the cessation of canvassing during the year. While this has resulted in a short-term increase in profitability, the resulting impact on lottery membership is unsustainable in the long-term.

Total merchandise and brand licencing sales amounted to £45,456 (2020: £45,216) an increase of 0.7% due to the strong support for Christmas card sales offsetting the cessation of merchandise sales and reductions in royalties from logo usage and rags collections through the lockdown period.

The directors of the company agreed to gift aid each year’s taxable profit to KSS. This amounted to £7.285M for the year, including the remaining taxable profits of £1.588M at the year end.

The company continues to closely monitor and manage the activities of its professional fundraisers, Tower Lotteries and Purity Fundraising, taking into account the requirements of our licence with the Gambling Commission and the requirements of the Fundraising Regulator. Face-to-face canvassing activities remained suspended throughout 2020-2021,

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and resumed in May 2021 following the relaxing of COVID-19 lockdown rules. The directors are confident that canvassing levels, merchandise sales and use of logo will continue to recover as the economy emerges from lockdown.

Managing risk

How we manage risk

Furthering our charitable objectives means balancing risks and opportunities. Our management processes allow for both bottom-up and top-down risks to be identified, assessed and mitigated. The objective is to quantify risk as accurately as possible and assess potential impact on

strategic objectives, consider risk appetite in each area and ensure all appropriate mitigations are in place. This in turn allows for the proper prioritisation of decisions and future operational activity. We continue to invest in our risk management and compliance capabilities as part of an evolving process.

Our risk register (RADAR) records all risks which are separated into key departmental domains – and are reviewed regularly through departmental meetings and escalated to the Senior Leadership Team as required, with the highest scoring risks also being presented to the Audit and Risk (A&R) Committee for discussion, before being discussed at Board level.

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The most significant risks we faced in 2020-2021

The Coronavirus pandemic presented several escalated and new risks which were deemed most significant for KSS during this period.

----- Start of picture text -----
Risk to operational delivery KSS created its own COVID-19 escalation protocol based on its risk
due to a COVID-19 outbreak assessment and as a result made the decision to lockdown the operating
amongst staff base at Redhill and limit it to essential staff only. It created a COVID-19
safe environment and developed and introduced new systems of work and
equipment modifications. KSS did not drop a single shift during the year
thanks to the diligence and skill of the team.
Risk of COVID-19 and Brexit These risks have been carefully monitored throughout the period. KSS are
impact on supply chain and in regular contact with critical partners, including their aircraft and medical
potential impact on critical supply providers and business continuity plans have been developed where
needed, such as increasing stockholding and diversification of the supply
partners chain.
Risk of loss of income The uncertainty of the Coronavirus pandemic meant loss of income was
a significant risk to KSS at a time when it was foreseen that our services
could be in high demand. This was further compounded by the threat of
further waves and ongoing or new lockdown measures affecting door to
door canvassing. However, the Emergency Appeal was a success and KSS
developed new virtual fundraising events which have mitigated the risk as
shown in our results.
The risk of adverse impact on Our frontline staff adapted to new COVID-19 secure protocols and offered a
staff wellbeing patient transfer service for critically ill patients between ICUs which brought
many new challenges. Many of our staff also hold positions in emergency
care departments across the NHS and were facing many challenges in
these additional roles. Many KSS staff had to adapt to meeting targets in a
home-working environment and at a time where regular income generating
activities were unable to be carried out. This risk was carefully managed
throughout the year as outlined in the ‘Aspiring for Excellence in All We Do’
section and as a result we did not experience any significant increases in
staff abstraction related to wellbeing.
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The most significant risks we face in the year ahead

As well as continuing to mitigate against the risks outlined above, this coming year we face the additional significant risks with regards to the potential disruption to supply chains, which has affected certain areas of medical supplies. We continue to engage with our critical suppliers and ensure KSS has robust business continuity plans to combat any failures in suppliers or supply chain, as far as practically possible. Our COVID-19 escalation framework remains active and is reviewed and amended with the changing data and government guidance.

We also continue to monitor the risks associated with the Coronavirus pandemic on the wellbeing of our workforce both operationally and as staff return to the office.

Reduction in income remains a risk as the country recovers from the Coronavirus pandemic due to the potential impact on the economy and individual disposable income, as well as the potential impact of inflation. These continue to be closely monitored. The IGMC Team continue to diversify their income generation streams and the charity seeks to maintain 12 months of operating reserves to mitigate the risk.

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Managing our Finances

Going concern

Trustees have reviewed forecasts that have been sensitised to reflect the ongoing impact of the Coronavirus pandemic, emergence from lockdown and the corresponding likely impact on income and expenditure. Trustees confirm that they consider the going concern basis to remain appropriate as the charitable company has adequate resources to continue in operational existence for the foreseeable future. The risks continue to be mitigated by our diverse income streams, with plans to maximise opportunities from fundraising events, Trusts and Foundations, and the substantial lottery and raffle memberships, supported by the return to canvassing.

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Reserves

Reserves

Restricted Reserves

Designated Funds

The reserves policy was reviewed during the course of the year by the Audit and Risk Committee and its proposals were adopted by the Trustees.

In accordance with the Charity Statement of Recommended Practice (SORP), KSS holds two types of reserves:

Unrestricted Reserves

General Funds

Note that the Future Helicopters Fund is supported in part by certain unquoted investments. KSS has decided to lease aircraft from a reputable specialist company, and for commercial reasons it has simultaneously loaned this company money for the aircraft purchases. These are loans which are repaid with interest at a commercial rate. The usable reserves will therefore gradually increase. In due course, existing assets may require replacement, further assets may be purchased and loans made.

Policy on General Funds

KSS is very largely reliant on fundraising and donations for its activities and its expenditure can vary depending on demand and activity. KSS holds reserves to mitigate these risks, plus other unexpected events such as the ongoing Coronavirus pandemic.

Designated (Unrestricted) Funds

A total sum of £16.860M has been designated as follows:

As part of its overall aircraft procurement programme, KSS loaned, at programme

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start, 50% of each new aircraft’s costs to its aviation provider – Specialist Aviation Services (SAS) – for a 10-year period at a commercial interest rate.

KSS loaned SAS £6.707M for the acquisition of two AW169 aircraft and the loans are included in the Future Helicopters Fund. As the monies are repaid over the term of the loan, the interest received will usually be reinvested in the Future Helicopters Fund to allow KSS to prepare for future aircraft procurement.

During the year to 31[st] March 2021, the Trustees chose to transfer a further £2.9M to the fund, reflecting their commitment to investment in a future helicopter fleet which will meet the needs of KSS and the communities we support.

The fund for future helicopters stands at £10.930M (2020: £7.780M).

The fixed assets reserves presently stand at £4.930M (2020: £5.324M) representing the net book value of assets utilised by KSS. The property fund retains a balance of £1M (2020; £0M), this reflects the break options in the Redhill lease, and consideration to any further building development which may be required in future.

Restricted Reserves

KSS retained a Restricted Funds balance of £0.125M (2020: £0.133M). A full analysis is shown at Note 14.

Changes in fixed assets

The movements in tangible fixed assets during the year are set out in note 7 to the financial statements.

closure of the service would be potentially catastrophic to the public we serve.

Consideration is given to the reliability of the income streams individually and over reliance on any particular income stream. KSS seeks to further diversify its income streams to reduce overall risk of failure due to external factors affecting one of these streams e.g. the lottery.

KSS has a ‘ground up’ approach to risk management and any concerns regarding a significant change in a particular income stream will be detected and acted upon quickly, so that the wider team can respond. Consideration is also given to future operational and capital expenditure, which informs Board decisions in relation to the target level of general funds required to provide long-term security of KSS’ activities. The financial state of KSS remains healthy, but Trustees are very conscious of the significant liabilities and commitments made by KSS, especially in the leasing and operation of aircraft, and the fact that KSS is almost entirely reliant on public donations for its income. KSS received 12% (2020: 12%) of charitable activities expenditure from NHS funding.

Having regard to the current macroeconomic conditions, the Board’s long-term objectives and foreseeable demand-led expenditure profile, the Board recommends a target of up to 12 months of general funds, subject to short term reductions to support strategic fixed asset investments and operational requirements. This sum presently stands at £14.887M (2020: £13.599M) which represents 11.7 months expenditure (2020: 10.6 months).

Risk based approach

KSS has a five-year budget forecast that is reviewed at least annually. Due to the lifesaving nature of our work, there is a low-risk approach taken with regards reserves, as

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Investment Policy and Performance

The A&R Committee is charged with ensuring a suitable asset allocation strategy for the investment portfolio taking professional advice where needed. KSS seeks to keep sufficient cash and near cash to cover known short-term cash flow requirements and day to day working capital requirements.

Balances over the liquidity requirements may be invested longer-term in various Board approved vehicles including bank deposits, investment funds, loans and any other investments that the Board may from time to time deem to be appropriate e.g. social investments. The Trustees have considered their appetite with regard risk and accordingly KSS’ longer-term reserves should be invested to grow at least in line with inflation to mitigate inflationary risk. They should also generate income to support the continuing activities of KSS. Beyond that, KSS seeks to obtain the best financial total return from its longer-term reserves, generally within a medium degree of investment risk. The horizon for the longer-term investments is up to five years but consideration is given to the portfolio of investments to ensure there remains access to funds in the short-term in order to provide any funding needs of KSS beyond its known cash flow requirements.

Investments are diversified, with the aim of avoiding over-exposure in any particular institution, although the majority of our bank deposits are currently held with a single UK National bank.

The KSS' ethical investment policy precludes investment in tobacco and also avoids investment in companies that generate more than 10% of revenue from alcohol manufacture, armaments, gambling, pornography and pay day loans.

Investment performance

The Trustees are permitted by the KSS’ Articles of Association to invest KSS monies not immediately required for its own purpose in such investments, securities or property as may be thought fit. The Trustees consider it appropriate to hold reserves in a combination of cash, low risk investment funds (Ruffer – targeting to preserve capital and beat returns on cash deposits), and balanced risk investment funds (Smith & Williamson – targeting returns of CPI + 3%).

At the year end, KSS had £8.088M portfolio with Smith & Williamson which is managed based on a multi- asset portfolio strategy which aims to achieve a combination of capital growth and income distributions over the long-term. Dividends are rolled over and there is no entry in these accounts, therefore, for investment income from this source.

Loans are assessed on a case-by-case basis and actioned only with approval of the Board. It is understood that in taking investment risk the capital value can go down as well as up.

The base currency of the investment portfolio is Sterling and short-term bank cash reserves are held primarily in Sterling. Within the longer-term reserves, investments may be made in an appropriate proportion of non-Sterling assets. Hedging to mitigate foreign exchange risk is permitted.

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The Trustees monitored Smith & Williamson’s own total return as follows:

----- Start of picture text -----
Investment Performance Portfolio MSCI PIMFA CPI+3%
Total Return Balanced Index
Since inception (May 2018) to 31 [st] March 2021 19.49 % 13.53% 12.61%
----- End of picture text -----

At the year end, KSS had a £10.833M portfolio with Ruffer.

The portfolio is invested entirely in one in-house fund with the aim of delivering positive returns regardless of how the financial markets perform and at a higher rate than would be achieved by depositing funds in cash. At 31[st] March 2021, the holding was valued at £10.833M (2020: £6.189M).

The Trustees monitored Ruffer’s own total return as follows:

----- Start of picture text -----
Investment Performance Portfolio FTSE Bank rate
All-Share index
Since inception (March 2019) to 31 [st ] March 2021 26.4% 3.3% 0.8%
----- End of picture text -----

Investments are also made as cash deposits with banks (NatWest, Scottish Widows, Charities Aid Foundation) and on terms between 30 days and one year, ensuring that funds are maturing on a regular basis should KSS’ short-term cash flow requirements need supplementing. We constantly monitor interest rates; however, these remain low during the year, resulting in a very small level of interest received of £3,222 (2020: £16,359).

The total unrealised gain from all investments amounted to £2.812M (2020: loss of £0.030M).

legal costs, stood at £2.267M (2020: £2.572M). The loan is secured by a charge over the helicopter.

On 21[st] December 2017, KSS entered into a second secured loan agreement with SAS (Surrey and Sussex) Limited to lend 50% of the purchase price, £3.628M for a second AW169 helicopter (G-KSSC) at an interest rate of 4.781% over a 10-year term. During the year, interest of £0.149M (2020: £0.164M) was accrued and paid over. At the year end the outstanding balance on the loan, including unamortised legal costs, stood at £2.995M (2020: £3.325M). The loan is secured by a charge over the helicopter.

On 8[th] February 2016, KSS entered into a secured loan agreement with SAS (Kent) Limited to lend 50% of the purchase price, £3,079M, for the new AW169 helicopter (G-KSST) at an interest rate of 4.771% over a 10-year term. During the year, interest of £0.113M (2020: £0.127M) was accrued and paid over. At the year end the outstanding balance on the loan, including unamortised

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How we erate -KSSC

Our structure

Kent, Surrey and Sussex Air Ambulance Trust is a charitable company; a charity registered in England and Wales and a company limited by guarantee registered in England and Wales.

Our Registered Charity Name Kent, Surrey & Sussex Air Ambulance Trust

Our Registration Numbers Registered Company No. 2803242 Registered Charity No. 1021367

Our Registered Office The company is incorporated and domiciled in the UK. The address of our registered office is as follows. Air Ambulance Building Rochester City Airport Maidstone Road Chatham Kent ME5 9SD Email: hello@aakss.org.uk Website: aakss.org.uk

Charitable objects

The principal activity of KSS is to relieve sick and injured people in South East England and surrounding areas by providing a Helicopter Emergency Medical Service (HEMS) and Air Ambulance service for the benefit of the community.

As part of our cycle of continuous improvement we are reviewing our objects following reflection from our work during the Coronavirus pandemic to ensure maximum public benefit.

Key advisors

Principal Bankers

Auditors

National Westminster Bank Plc

Crowe U.K. LLP Riverside House 40-46, High Street Maidstone Kent ME14 1JH

Chatham (A) Branch 148, High Street Chatham Kent ME4 4DB

Investment Managers

Smith & Williamson 25, Moorgate London EC2R 6AY Ruffer, LLP 80, Victoria Street London SW1E 5JL

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Our fundraising approach

KSS is thankful to our fantastic supporters and volunteers who continue to demonstrate their commitment and give so very generously to our cause. We truly value every contribution we receive and are committed to ensuring this is reflected in the ethical, efficient way we manage donations which is evident in our range of policies and practices we have in place.

It has cost us £11.609M to provide our services this year. Of this 12% of this came from NHS funding and we need to raise the balance through fundraising.

We apply a diverse approach to raising our valued funds including community fundraising, events, funding from grant making trusts and foundations, legacies, direct marketing, and cultivating longterm support from the corporate sector and our valued major donors. Our highly popular and successful lottery and raffles, undertaken by KSS’ subsidiary trading company – Air Ambulance Promotions Ltd (AAPL) - are a fantastic way to guarantee regular income for KSS which allows for strategic planning. In addition, for the first time in our history as a charity, we launched an successful Emergency Appeal to make up for our projected funding shortfall caused by the Coronavirus pandemic.

As well as our events and partnerships raising much needed funds, they also play a critical role in raising our profile and awareness of our charity status in order to generate support towards KSS in the communities in which we serve, and beyond.

We prioritise ensuring our supporters feel valued and appreciated demonstrated by the comprehensive Thankathon activity we undertook during 2020-2021.

How we work

Team KSS work hard to raise our muchneeded funds, and inspire and generate support in the community, as well as

ensuring all our practice meets our regulatory requirements and our own ethical standards. We have a number of procedures in place to ensure this is the case.

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During lockdown, our team worked closely with agencies to work on new COVID-19 secure protocols to ensure preparedness for when canvassing re-commenced (May 2021).

KSS is a people centred organisation and ensuring the wellbeing of our supporters is a key priority. We are committed to protecting individuals who may be potentially vulnerable; our staff or those individuals working for us receive regular, appropriate training and guidance on how to manage donations carefully and sensitively from potentially vulnerable individuals.

Our fundraising promise

We are registered with the Fundraising Regulator and as part of our Fundraising Promise we strive to ensure that all our fundraising is conducted in a fair and responsible way and in line with The

Code of Fundraising Practice principles and standards.

Our values base is applied to all our fundraising activity; we are committed to transparency and openness for our donors and supporters and welcome scrutiny in relation to how our funds are managed and spent to the benefit of all who may need our service. Our Fundraising Promise is published on our website ( aakss.org.uk/ about-us/our-fundraising-promise/ ), and our engagement and activity with supporters is embedded in our practices and processes for ethical fundraising and the highest levels of governance. We comply with data protection regulation and make it easy for people to choose how we communicate with them, what they receive, and to also tell us if they no longer wish to hear from us.

Managing complaints

We strive to be a trusted, ethical organisation which offers fairness and transparency to our supporters. However, within our culture of continuous improvement, we acknowledge there may be times when we fail to meet our own high standards. When this does occur, our priority is ensuring that we deal with the situation as quickly and effectively as possible, and that we learn from the experience and put measures in place to prevent a recurrence. We take complaints very seriously and treat them as an opportunity to improve. We are always very grateful when we hear from people who are willing to take the time to help us make these improvements.

In 2020-2021 we received 271 complaints and 285 compliments relating to the nonservice delivery side of our work. Each complaint was fully investigated and resolved in line with our Complaints Policy which is published on our website to aid transparency ( aakss.org.uk/complaintsprocedure ). Our learning and reflection from these complaints help refine and shape our practice.

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Governance

The Trustees, who are also the directors under Company law, maintain an on-going review of governance with reference to guidance from the Charity Commission, the Fundraising Regulator and the Charity Governance Code. KSS had a Board of eight Trustees serving during this financial period who meet quarterly and are responsible for the strategic direction and policy of KSS.

Trustee appointment

KSS is committed to an open, transparent and fair appointment process for applicants. A Board skills audit is undertaken annually and Trustee vacancies to fulfil the specific skills needed are widely publicised. Candidates are selected based upon the relevance of their skills and experience and their enthusiasm for serving as a KSS Trustee.

The appointment of new Trustees follows a nomination process involving a Nominations SubCommittee comprising the Chair, the relevant Sub-Committee Chair, the CEO and one or two other Trustees. The process is as follows:

Declaration of interest

Trustees have a legal obligation to act in the best interests of the charity and in accordance with the charity’s governing documents. KSS ensures a register of Trustees' interests is maintained and updated. This requires Trustees to declare their current, and previous employment in which they have a financial interest, any appointments including other trusteeships or directorships, significant investments or shareholdings and any notable gifts or hospitality received in relation to KSS. They are also asked to declare any conflicts of interest both on this register and at the beginning of each Board meeting.

All Trustees give of their time freely and no Trustees received remuneration in this year. Details of Trustees’ expenses and related party transactions are disclosed in note 16 to the accounts.

Board meetings

Our Board of Trustees meets four times per year and is responsible for providing governance for, and leadership to, KSS. The CEO and Senior Leadership Team attend all Board meetings.

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Scheme of delegation

Our Scheme of Delegation, which was reviewed and updated by the Board in June 2021, sets out the extent to which the Board has delegated responsibilities to its Committees and to the CEO, and which decisions are reserved for the Board. The Scheme of Delegation empowers and enables timely and effective action by staff working in partnership for the benefit of KSS and its patients. It ensures an appropriate level of delegation from the Board of Trustees so that there is effective input into decision-making. It also ensures that Trustees can fulfil their legal and constitutional duties through levers which enable them to delegate, monitor and if necessary, withdraw the delegated authority if it is considered in the interests of the charity and its service users.

Our decision-making structure - our Committees

KSS operates an effective Committee structure which reflects our strategic approach and key areas of activities, and which allows for effective governance. All Trustees are required to be a member of at least one Committee which meet quarterly, in advance of our Board meetings.

Our Committees are outlined in the table below alongside the Trustees who attend these committees. Each of the Committees work to a Terms of Reference approved by the Board.

----- Start of picture text -----
Audit and Risk Purpose is to support the Board in executing its D H B Burgess (Chair)
Sub-Committee responsibilities around risk management, internal controls, T S N Oakes
P D Stewart
governance and compliance, coordinating financial scrutiny
and oversight of all KSS funds, budgets and financial
performance.
Clinical Purpose is to provide oversight to the Board of Trustees Prof. A Rhodes (Chair)
Governance & in relation to Clinical Governance and Service Delivery. Dr H A Bowcock OBE DL
Service Delivery The committee supports the Service Delivery Team in
Advisory developing and delivering strategies and plans and makes
Committee
recommendations to the Board on behalf of its members.
The Committee also maintains financial oversight of relevant
budgets.
Income Purpose is to provide oversight to the Board of Trustees M J Docherty (Chair)
Generation, in relation to the charity’s Income Generation, Marketing A M Farrant
Marketing and and Communications strategies and plans. The Committee P J Barrett MBE
Communications supports the Income Generation and Marketing and
Advisory
Communications Teams in developing and delivering
Committee
strategies and makes recommendations to the Board on
behalf of its members. The Committee also maintains
financial oversight of all Income Generation, Marketing and
Communications budgets.
AAPL Board KSS’ trading company. M Boutcher (Chair)
D Mantz
L D Harris
A D Welch
A M Farrant
P J Barrett MBE
----- End of picture text -----

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Public benefit

The Trustees have complied with the duty under the Charities Act 2011 to have due regard to public benefit guidance published by the Charity Commission which can be illustrated as follows:

Under the list of descriptions of purposes in the Charities Act 2011, KSS falls under the description of the advancement of health and saving lives; a broad description which extends beyond treatment and provision of care to the provision of items or services and facilities to ease suffering or assist recovery of people or provide comfort for patients.

The main activities undertaken to further purposes for the public benefit is the provision of expert pre-hospital emergency treatment and care. The nature of our work means the missions are often of a highly traumatic nature and we are proud of our world-class team of highly specialised doctors and paramedics who are driven every day by our purpose of saving lives and ensuring the best possible patient outcomes. This wide public benefit is inclusive of all. As well as the direct public benefit for those who have required our services, the wider public are reassured that the service is available in their area.

Our fleet of helicopters and rapid response vehicles can transport our doctors and paramedics to our patients 24/7, 365 days per year. There are times where transporting our specialised teams via ground response is more appropriate as we cover very highly populated areas of Kent, Surrey and Sussex. Weather also affects if an aircraft can be deployed, and so having the option of rapid response vehicles ensures we continue to challenge ourselves to provide the best method of service delivery.

As a part of the patients, often long, recovery, we facilitate base visits and ongoing dialogue to enable patients to gain a greater understanding of our intervention with them.

Our crews are specialists in pre-hospital emergency care and KSS offers training opportunities through secondments and employment opportunities to ensure this highly specialised knowledge is shared within the wider medical community.

KSS participates in clinical audit and research to ensure the public benefit from pre-hospital interventions is led by science and to ensure a continuous cycle of improvement and innovation. This research is shared widely across other pre-hospital service providers ensuring KSS has an impact and public benefit on both a national and international platform.

KSS, in alignment with our collaboration value, advocates for partnership working across the sector and regularly attends Air Ambulances UK facilitated groups to come together with other Air Ambulance charities sharing learning to enhance public benefit.

KSS offers a wide range of volunteering opportunities which are known to have a public benefit with regards social contact and learning new skills.

We engage with our audiences and communities through our social media channels, to share key educational messaging (e.g. in support of Restart a Heart Day) and raise the profile of our service.

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Statement of Trustee responsibilities

The Trustees are responsible for preparing the Annual Report and the financial statements in accordance with applicable law and regulations.

Charity law requires the Trustees to prepare financial statements for each financial year in accordance with United Kingdom Generally Accepted Accounting Practice (United Kingdom Accounting Standards and applicable law). The financial statements are required by law to give a true and fair view of the state of affairs of the Charity and of the profit or loss of the Charity for that period.

Disclosure of information to Auditors

Insofar as each of the Trustees of the Charity at the date of approval of this report is aware, there is no relevant audit information (information needed by the company’s auditors in connection with preparing the audit report) of which the company’s auditors are unaware and each Trustee has taken all of the steps that he/she should have taken as a Trustee in order to make himself/herself aware of any relevant audit information and to establish that the company’s auditors are aware of that information.

In preparing these financial statements, the Trustees are required to:

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

The Trustees are responsible for the maintenance and integrity of the corporate and financial information included on the Charity’s website.

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..........................................................................................
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Dr H A Bowcock OBE DL Chair of Trustees

This report was approved by the Board on 8[th] December and signed on its behalf.

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Independent Auditor's Report

Opinion

We have audited the financial statements of Kent, Surrey & Sussex Air Ambulance Trust (the 'Charitable Company') for the year ended 31[st] March 2021, which comprise the statement of comprehensive income, the balance sheet, the statement of changes in equity and the related notes, including a summary of significant accounting policies. 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).

In our opinion the financial statements:

the Financial Reporting Council's Ethical Standard and we have fulfilled our other ethical responsibilities in 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 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

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. We are independent of the Charitable Company in accordance with the ethical requirements that are relevant to our audit of the financial statements in the United Kingdom, including

The other information comprises the information included in the Annual Report other than the financial statements and our auditor's report thereon. TheTrustees 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

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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.

Opinions on other matters prescribed by the Companies Act 2006

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

Matters on which we are required to report by exception

In the light of the knowledge and understanding of the Charitable Company and its environment obtained in the course of the audit, we have not identified material misstatements in the Trustees’ report.

Responsibilities of Trustees

As explained more fully in the Trustee's responsibilities statement set out on page 73, the Trustees are responsible for the preparation of the financial statements and for being satisfied that they give a 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 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 Charitable Company or to cease operations, or have no realistic alternative but to do so.

We have nothing to report in respect of the following matters in relation to which the Companies Act 2006 requires us to report to you if, in our opinion:

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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.

Irregularities, including fraud, are instances of non-compliance 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 obtained an understanding of the legal and regulatory frameworks within which the company operates, focusing on those laws and regulations that have a direct effect on the determination of material amounts and disclosures in the financial statements. The laws and regulations we considered in this context were the Companies Act 2006 and Taxation legislation.

We identified the greatest risk of material impact on the financial statements from irregularities, including fraud, to be the override of controls by management and the recognition of revenue. Our audit procedures to respond to these risks included:

with laws and regulations and if there are any known instances of non-compliance;

Owing to the inherent limitations of an audit, there is an unavoidable risk that we may not have detected some material misstatements in the financial statements, even though we have properly planned and performed our audit in accordance with auditing standards. We are not responsible for preventing noncompliance and cannot be expected to detect non-compliance with all laws and regulations.

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

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Use of our report

This report is made solely to the Charitable Company's shareholders, 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 shareholders 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 shareholders, as a body, for our audit work, for this report, or for the opinions we have formed.

....................................................................................................

Darren Rigden (senior statutory auditor) For and on behalf of

Crowe U.K. LLP Statutory Auditor Riverside House 40-46 High Street Maidstone Kent ME14 1JH

17[th] December 2021

75

r4• &• Our Accounts

CONSOLIDATED STATEMENT OF FINANCIAL ACTIVITIES

(INCORPORATING AN INCOME AND EXPENDITURE ACCOUNT) YEAR ENDED 31[st] MARCH 2021

Notes Unrestricted Restricted Total Funds Total Funds
Funds Finds 2021 2020
Income: £ £ £ £
Donations and legacies 3 5,596,252 88,492 5,684,744 4,374,171
Charity activities 3 1,683,418 405,176 2,088,594 1,662,886
Trading activity 3 8,517,634 150,165 8,667,799 8,733,127
Investment income 3 265,244 - 265,244 307,700
Other income 3 729,109 - 729,109 1,190,731
Total income 16,791,657 643,833 17,435,490 16,268,615
Expenditure:
Raising funds 5 2,410,959 30,802 2,441,761 2,207,958
Charitable activities 5 11,037,580 571,221 11,608,801 11,480,916
Cost of sales trading
subsidiary
5 1,160,674 - 1,160,674 1,738,317
Total expenditure 14,609,213 602,023 15,211,236 15,427,191
Operating surplus 2,182,444 41,810 2,224,254 841,424
Unrealised gains/(losses) on
investments
8 2,812,281 - 2,812,281 (30,113)
Net income 4,994,725 41,810 5,036,535 811,311
Transfer between funds 50,017 (50,017) - -
Net movement in funds 5,044,742 ( 8,207) 5,036,535 811,311
Reconciliation of funds:
Fund balances brought forward 26,702,469 133,063 26,835,532 26,024,221
Fund balances carried forward 31,747,211 124,856 31,872,067 26,835,532

The above statement contains all the gains and losses recognised in the current and preceeding year.

All operations are continuing.

The notes on pages 81-97 form part of these financial statements.

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CONSOLIDATED BALANCE SHEET 31[st] MARCH 2021

Notes Total Funds Total Funds
2021 2020
Fixed Assets: £ £
Tangible assets 7 4,930,331 5,323,815
Investments 8 24,308,772 17,131,431
29,239,103 22,455,246
Current Assets:
Stocks 9 876 3,492
Debtors 10 520,894 1,074,955
Cash at bank and in hand 11 3,427,644 4,768,238
3,949,414 5,846,685
CREDITORS:amounts
fallingdue within oneyear
12 1,316,450 1,466,399
NET Current Assets 2,632,964 4,380,286
NET Assets 31,872,067 26,835,532
Reserves:
Designated Funds 14 16,860,367 13,103,803
General Funds 14 14,886,844 13,598,666
Restricted Finds 14 124,856 133,063
31,872,067 26,835,532

Approved by the Board on 8[th] December and signed on its behalf:

Dr H A Bowcock OBE DL Chair of Trustees

The notes on pages 81-97 form part of these financial statements.

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BALANCE SHEET 31[st] MARCH 2021

Registered charity no. 1021367 Registered company no. 2803242

Notes Total Funds Total Funds
2021 2020
Fixed Assets: £ £
Tangible assets 7 4,930,331 5,323,815
Investments 8 24,308,774 17,131,433
29,239,105 22,455,248
Current Assets:
Debtors 10 2,639,887 1,679,833
Cash at bank and in hand 11 1,040,323 3,592,625
3,680,210 5,272,458
CREDITORS:amounts
fallingdue within oneyear
12 1,047,246 892,172
NET Current Assets 2,632,964 4,380,286
NET Assets 31,872,069 26,835,534
Reserves:
Designated Funds 14 16,860,367 13,103,803
General Funds 14 14,886,846 13,598,668
Restricted Finds 14 124,856 133,063
31,872,069 26,835,534

Approved by the Board on 8[th] December and signed on its behalf:

Dr H A Bowcock OBE DL Chair of Trustees

The notes on pages 81-97 form part of these financial statements.

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CONSOLIDATED CASH FLOW STATEMENT YEAR ENDED 31[st] MARCH 2021

Reconciliation of NET Income Resources to NET Cash
Infow from Operating Activities
Total Funds
2021
Total Funds
2020
£ £
NET Incoming Resources 2,224,254 841,424
Investment Income (3,221) (16,359)
Interest accrued on loan to SAS (262,023) (291,341)
(Proft)/Loss on disposal of Fixed Assets (11,230) (10,493)
Amortisation 11,975 11,975
Depreciation 514,313 487,732
(Increase)/Decrease in Stock 2,616 (371)
Decrease/(Increase) in Debtors 554,061 201,310
(Decrease)/Increase in Creditors (149,949) (426,868)
New Cash Infow from Operating Activities 2,880,796 797,009
Returns on Investment
Interest received 3,221 16,359
Capital Expenditure and Financial Investments
Purchases of Tangible Fixed Assets (121,581) (304,166)
Proceeds from Disposal of Tangible Fixed Assets 11,982 19,784
Investments made in year (5,000,000) (2,000,000)
Proceeds on disposal of investment - 63,966
Loan repayments received 884,988 884,988
NET Cash Flow from Capital Expenditure and Financial Investments (4,224,611) (1,335,428)
NET Cash Infow (1,340,594) (522,060)
Cash in Bank in Hand
Opening Balance at 1stApril 2020 4,768,238 5,290,298
NET Cash Infow for the year (1,340,594) (522,060)
Closing Balance at 31st March 2021 3,427,644 4,768,238

80

Notes to the financial statements

1. Accounting Policies

General Information

The principal activity of the charity is to relieve sick and injured people in South East England and surrounding areas by providing a Helicopter Emergency Medical Service (HEMS) and Air Ambulance service for the benefit of the community.

The company is incorporated and domiciled in the UK. The address of its registered office is

Air Ambulance Building Rochester City Airport Maidstone Road Chatham Kent ME5 9SD

The following accounting policies have been applied consistently in dealing with items which are considered material in relation to the Group’s financial status.

a) Basis of preparation

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 the Republic of Ireland (FRS102) - (effective 1 January 2019) – (Charities SORP (FRS 102)), the Financial Reporting Standard applicable in the UK and the Republic of Ireland (FRS 102) and the Companies Act 2006.

KSS 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 note. Accounting standards require the Trustees to consider the appropriateness of the going concern basis when preparing the financial statements. The Trustees have taken notice of the Financial Reporting Council guidance, which requires the reasons for this decision to be explained. The Trustees regard the going concern basis as remaining appropriate as the company has adequate resources to continue in operational existence for the foreseeable future. Thus, they continue to adopt the going concern basis of accounting in preparing the annual financial statements.

b) Basis of consolidation

The Statement of Financial Activities (SOFA) and Balance Sheet consolidate the financial statements of KSS and its subsidiary undertaking, Air Ambulance Promotions Limited. The results of the subsidiary are consolidated on a line by line basis.

In accordance with Section 408 of the Companies Act 2006, KSS has not presented its statement of financial activities. The excess of income over expenditure of KSS was £5.04M (2020: shortfall (£0.291M)).

c) Fund accounting

Designated Funds

Unrestricted funds that are earmarked for a particular purpose by the Trustees. The aim and use of each designated fund are set out in note 14.

General Funds

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

Restricted Funds

Funds which are to be used in accordance with specific restrictions imposed by donors or which have been raised by the Charity for particular purposes. The cost of raising and administering such funds is charged against the specific fund. The aim and use of each restricted fund are set out in note 14.

81

Investment income and gains or losses on quoted investments are allocated to general funds, unless otherwise stated.

d) Incoming resources

All incoming resources are included in the SOFA when KSS is legally entitled to the income and the amount can be quantified with reasonable accuracy. For legacies, entitlement is the earlier of the charity being notified of an impending distribution or the legacy being received.

Gifts donated for resale are included as income when they are sold. Donated facilities are included at the value to KSS where this can be quantified, and a third party is bearing the cost.

A corresponding charge is made to the relevant overhead account. No amounts are included in the financial statements for services donated by volunteers.

e) Resources expended

All expenditure is accounted for on an accruals basis and has been classified under headings that aggregate all costs related to the category. Where costs are not directly attributed to particular headings, they have been allocated to activities on a basis consistent with the use of the resources.

Fundraising and publicity costs are those incurred in seeking voluntary contributions and do not include the cost of disseminating information in support of the charitable activities.

Charitable expenditure is that expenditure directly in connection with the objects of the Charity and includes management and support costs.

f) Tangible fixed assets

and depreciation

Tangible fixed assets are capitalised and included at cost including any incidental expenses of acquisition. Depreciation is provided on all tangible fixed assets at annual rates calculated to write off the cost, less estimated residual value, of each asset

evenly over its anticipated useful life, as follows: -

----- Start of picture text -----
Leasehold improvements straight line over the term
of the respective lease.
Plant and equipment 10% on cost
20% on cost
Office equipment
Computer equipment 25% on cost
Helicopter equipment 20% on cost
Motor vehicles 25% on cost
----- End of picture text -----

g) Investments

Listed investments are stated at market value at the balance sheet date. The SOFA includes the net gains and losses arising on revaluations and disposals throughout the year.

Unlisted investments (including investments in subsidiaries) are measured at cost less accumulated impairment.

Loans and other accounts receivable and payable, are initially measured at present value of the future cash flows and subsequently at amortised cost using the effective interest method.

h) Stock

Stock consists of purchased goods for resale.

Stocks are valued at the lower of cost and net realisable value. Items donated for resale or distribution are not included in the financial statements unless they are sold or distributed.

i) Value added tax

Irrecoverable value added tax is included within the expenditure to which it relates.

j) Operating leases

Rentals applicable to operating leases are charged to the SOFA over the period in which the cost is incurred. Details of operating lease commitments are as shown in note 6.

82

k) Pensions

KSS operates a defined contribution pension scheme for its employees. Contributions to this scheme are charged to resources expended as they fall due. KSS has no potential liability other than the payment of these contributions.

l) Corporation tax

No provision has been made for corporation tax, as KSS is able to claim full statutory exemption subject to the proper application of all its charitable reserves.

m) Liabilities

Liabilities are recognised when KSS has an obligation to make payment to a third party.

n) Scratch card prizes

Scratch card prizes are recognised as a percentage of ticket sales in line with the theoretical prize pay-out for that game.

o) Financial instruments

KSS 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 loans which are subsequently measured at amortised cost using the effective interest method.

2. Judgements in Applying Accounting Policies and Key Sources of Estimation Uncertainty

The company may be required to make estimates and assumptions concerning the future. These estimates and judgements are based on historical experience and other factors, including expectations of future events that are believed to be reasonable under the circumstances. The resulting accounting estimates will, by definition, seldom equal the related actual results. The principal areas where judgement was exercised are as follows:

i) Tangible and intangible fixed assets: the directors annually assess both the residual value of these assets and the expected useful life of such assets which is currently judged to be up to 10 years, based on experience.

ii) Recoverability of trade debtors: the directors annually assess whether a bad debt provision is required or doubtful debtor balances.

iii) Stock provisions: the directors regularly assess the age and quality of stock and will make necessary provisions based on the net realisable value of the stock held.

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3. Incoming Resources

Unrestricted Restricted Total Funds Total Funds
Funds Funds 2021 2020
Donations and Legacies: £ £ £ £
Donations (not arising from events) 2,282,979 88,492 2,371,471 1,192,974
Legacies & in Memorium 3,268,231 - 3,268,231 3,017,937
Collection Boxes 45,042 - 45,042 163,260
5,596,252 88,492 5,684,744 4,374,171
Charitable activities:
Intangible income -
cars loaned by sponsor
6,863 - 6,863 4,366
Intangible income on drugs
& medical consumables
11,742 - 11,742 17,347
Intangible income -
armed forces, doctors salaries
72,805 - 72,805 80,898
Clinical staff funded by NHS 1,439,239 - 1,439,239 1,400,000
Government grants - 405,176 405,176 -
Lease income 141,549 - 141,549 148,392
Student placements,
seminars and research
- - - 1,383
Proft/(Loss) on disposal of fxed assets 11,230 - 11,230 10,492
Exchange rategains/(loss) (10) - (10) 8
1,683,418 405,176 2,088,594 1,662,886
Income from Trading Subsidiary 8,517,634 150,165 8,667,799 8,733,127
Investment income
Bank deposit interest 2,000 - 2,000 11,425
Interest on loan 262,023 - 262,023 291,341
Bank deposit interest -
tradingsubsidiary
1,221 - 1,221 4,934
265,244 - 265,244 307,700
Other income
Group fundraising and events 729,109 - 729,109 1,190,731
TOTAL INCOME 16,791,657 643,833 17,435,490 16,268,615

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4. Net Income from Trading Activities of Subsidiary

KSS has one trading subsidiary that is incorporated in the UK, Air Ambulance Promotions Limited (registered no. 02674568). KSS owns 100% of the issued share capital of the company. A summary of its trading results is shown below:

Total Funds Total Funds
2021 2020
£ £
Turnover 8,667,799 8,734,277
Cost of Sales 1,058,364 1,574,812
Gross Proft: 7,609,435 7,159,465
Interest receivable 1,221 4,934
7,610,656 7,164,399
Less overheads
Administrative expenses 102,311 163,505
Income from subsidiary 7,508,345 7,000,894
Comprising:
General Funds 7,358,180 6,857,430
Restricted Funds 150,165 143,464
Total income from subsidiary 7,508,345 7,000,894

The turnover includes £NIL (2020: £1,150) relating to sales of merchandise to KSS. External trading therefore amounted to £8,667,799 (2020: £8,733,127) and is included in the consolidated Incoming Resources note 3.

Air Ambulance Promotions Limited gift aided the year-end profit of £7,508,305 (2020: £7,000,894) to KSS and this was paid by 9[th] September 2021.

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5. Analysis of Total Resources Expended

Unrestricted Restricted Total Funds Total Funds
Funds Funds 2021 2020
Raising Funds: £ £ £ £
Staff Costs 1,478,443 30,802 1,509,245 1,048,975
Consultancy Fees 53,094 - 53,094 36,277
Advertising, promotion and publicity 92,454 - 92,454 395,936
Other Costs 786,968 - 786,968 726,770
2,410,959 30,802 2,441,761 2,207,958
Direct Charitable Expenditure:
Air Ambulance running costs 6,533,924 530,322 7,064,246 6,915,167
Paramedics Costs 1,059,402 - 1,059,402 1,037,066
Clinical Managers 401,250 - 401,250 423,616
Doctors 1,080,563 - 1,080,563 1,006,326
Operational Employees 495,389 - 495,389 503,871
Research and Education 21,873 40,899 62,772 30,596
Dep’n of Helicopter Equipment 150,234 - 150,234 143,978
9,742,635 571,221 10,313,856 10,060,620
Management and Administration
Staff Costs 335,495 - 335,495 330,517
Professional Fees 96,149 - 96,149 100,326
Other Costs 215,038 - 215,038 287,984
646,682 - 646,682 718,827
Supporting Costs and Depreciation
Property Expenses 426,438 - 426,438 496,642
Depreciation 221,825 - 221,825 204,827
648,263 - 648,263 701,469
Total Charitable Expenditure 11,037,580 571,221 11,608,801 11,480,916
Trading Subsidiary Cost 1,160,674 - 1,160,674 1,738,317
TOTAL EXPENDITURE 14,609,213 602,023 15,211,236 15,427,191

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6. Total Resources Expended

Total resources expended is stated after charging:

6. Total Resources Expended
6. Total Resources Expended
Total resources expended is stated after charging: Total Funds Total Funds
2021 2020
£ £
Auditors’ remuneration - as auditors 18,500 17,864
- for taxation services 1,500 500
- for professional advice provided 2,220 7,637
Operating leases - land and buildings 227,798 227,295
- helicopter (including pilotage standing charges) 5,394,773 5,145,614
- cars 21,828 28,439
- offce equipment 26,070 15,418
Depreciation 514,313 487,732
Staff costs 2021 2020
£ £
Wages and salaries 2,559,156 2,239,720
Social security costs 245,932 213,704
Pension costs 253,261 212,170
3,058,349 2,665,594

Two ex-gratia payments totalling £13,167 were made in the year by way of compensation for the termination of employment. (2020: one payment of £2,534)

The average number of employees excluding Trustees, analysed by
function was:
2021 2020
Management and administration 15 15
Fundraising and publicity 33 26
Direct charitable expenditure, includingsecondees and emeritus 50 48
98 89

The full time equivalent number of staff is 83 (2020:75) including 68 full time (2020:59) and 30 part-time (2020: 30). Of this number 27 (2020: 22) FTE are secondees.

Seven (2020: ten) employees earned more than £60,000 during the year in bandings as follows:

2021 2020
£60k-£70K 2 4
£70k-£80K 3 4
£80k-£90K - 1
£90K-£100K 1 -
£100K-£110K -
1
£150K-£160K 1 -

87

The total amount of employee benefits received by the nine (2020: eight) members of the Senior Management team was £741,188 (2020: £636,010)

Included within direct charitable expenditure is the cost of staff not directly employed by KSS. This mainly relates to the cost of doctors on board the helicopters who are employed directly by the NHS and the military £820,990 (2020: £800,336) and NHS Clinical Managers and Paramedics £963,676 (2020: £879,823).

7. Tangible Fixed Assets

Group
and Charity
Redhill
Base
Helicopter
Equipment
(Incl plant)
Motor
Vehicles
Computer
Equipment
Offce
Equipment
Rochester
Base
Total
Cost £ £ £ £ £ £ £
At 1stApril 2020 2,414,290 1,097,453 200,441 311,892 182,244 2,362,369 6,568,689
Additions - 69,536 41,594 10,451 - - 121,581
Disposals - (62,394) (51,766) (3,595) - - (117,755)
At 31st March 2021 2,414,290 1,104,595 190,269 318,748 182,244 2,362,369 6,572,515
Depreciation
At 1stApril 2020 223,777 475,396 119,678 134,716 77,497 213,810 1,244,874
Disposals - (61,643) (51,766) (3,594) - - (117,003)
Charge for the year 99,403 150,234 33,497 76,494 35,022 119,663 514,313
At 31st March 2021 323,180 563,987 101,409 207,616 112,519 333,473 1,642,184
NET book values at
31st March 2021 2,091,110 540,608 88,860 111,132 69,725 2,028,896 4,930,331
At 31st March 2020 2,190,513 622,057 80,763 177,176 104,747 2,148,559 5,323,815

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8. Fixed Asset Investments

Group Listed Unlisted Total
Investments Investments
Market Value £ £ £
At 1stApril 2020 11,109,302 6,022,129 17,131,431
Additional Investment in Year 5,000,000 - 5,000,000
Interest Accrued - 262,023 262,023
Repayment of Loans - (884,988) (884,988)
Amortisation - (11,975) (11,975)
Increase/(Decrease) in valuation 2,812,281 - 2,812,281
At 31st March 2021 18,921,583 5,387,189 24,308,772
Charity Shares in Listed Unlisted Total
Subsidiary Investments Investments
Company
Market Value £ £ £ £
At 1stApril 2020 2 11,109,302 6,022,129 17,131,433
Additional Investment in Year - 5,000,000 - 5,000,000
Interest Accrued - - 262,023 262,023
Repayment of Loans - - (884,988) (884,988)
Amortisation - - (11,975) (11,975)
Increase/(Decrease) in valuation - 2,812,281 - 2,812,281
At 31st March 2021 2 18,921,583 5,387,189 24,308,774

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Group and Charity Original Total
Cost
Listed investments comprises the following: £ £
Smith & Williamson Portfolio 7,000,000 8,088,045
Ruffer LLP Portfolio 9,000,000 10,833,538
At 31st March 2021 16,000,000 18,921,583
Unlisted investments comprise the following: 2021 2020
£ £
Helicopter Loans 5,262,190 5,897,130
Enterprise Investment 125,000 125,000
At 31st March 2021 5,387,190 6,022,130
2021 2020
Movement on listed investments £ £
Market Value at the Beginning of Year 11,109,302 9,203,381
Additions in Year 5,000,000 2,000,000
Disposals in Year - (63,966)
16,109,302 11,139,415
Market Value at End of Year 18,921,583 11,109,302
Increase/(Decrease) in value 2,812,281 (30,113)
Subsidiary Balance Sheet 2021 2020
The Assets and Liabilities of the subsidiary were: £ £
Current Assets
Stock 876 3,492
Debtors 110,055 660,803
Cash at Bank 2,387,322 1,175,614
2,498,253 1,839,909
Creditors: Amounts Falling Due Within One Year 2,498,251 1,839,907
At 31st March 2021 2 2
Capital and reserves:
Called up share capital 2 2
Proft and loss account - -
2 2

90

Air Ambulance Promotions Limited gift aided to the charity the profits of £1,588,466 in two tranches, the final amount on 9[th] September 2021 (2020: £1,102,983) and all loans and monies due by Air Ambulance Promotions Limited to KSS are secured by a first floating charge created on 30[th] March 1994 on the subsidiary company’s assets.

9. Stocks

. Stocks
Charity Group
2021 2020 2021 2020
£ £ £ £
Goods for resale at cost - - 876
3,492

10. Debtors

10. Debtors
Charity Group
2021 2020 2021 2020
£ £ £ £
Trade Debtors 157,328 59,345 157,328
93,615
Current Account with Subsidiary 2,229,047 1,265,680 - -
Other Debtors 935 13,283 110,991 158,154
Prepayments and Accrued Income 252,577 341,525 252,575 823,186
2,639,887 1,679,833 520,894 1,074,955

11. Cash in Hand and at Bank

11. Cash in Hand and at Bank
Charity Group
2021 2020 2021 2020
£ £ £ £
Investment Deposit Accounts 103,574 3,445 103,574 3,445
Other Bank Accounts 936,272 3,588,830 3,323,578 4,764,278
PettyCash 477 350 492 515
1,040,323 3,592,625 3,427,644 4,768,238

12. Creditors: Amounts Falling Due Within One Year

Charity Group
2021 2020 2021 2020
£ £ £ £
Trade Creditors 583,990 396,091 618,503 415,422
Other Taxation and Social Security 98,558 81,177 98,558 81,177
Other Creditors 30,641 7,254 35,348 28,530
Accruals and Deferred Income 334,057 407,650 564,041 941,270
1,047,246 892,172 1,316,450 1,466,399

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13. Financial Instruments

13. Financial Instruments
Financial Assets Charity Group
2021 2020 2021 2020
£ £ £ £
Financial Assets Measured at Amortised Cost 27,561,829 21,842,411 27,830,157 21,789,613
Financial Liabilities Charity Group
2021 2020 2021
2020
£ £ £ £
Financial Liabilities Measured at Amortised Cost 941,188 757,032 987,156 786,427

Financial assets measured at amortised cost comprise cash at bank, trade debtors, loans to SAS and listed investments.

Financial Liabilities measured at amortised cost comprise trade creditors, and accruals.

14. Analysis of Funds

Unrestricted Designated and General Funds

The Unrestricted funds are available for the purposes of KSS, to be spent as the Trustees see fit to meet the objectives of KSS. An element of these funds, £16,860,367 (2020: £13,103,803) has been defined as designated funds and earmarked for the future helicopter acquisition, property relocation and including the net book value of the fixed assets. A full analysis is detailed below. The balance of £14,886,844 (2020: £13,598,666) has been classified as General funds.

The General Funds are not specifically earmarked but equate to 11.7 months of expenditure and are used to further the objectives of KSS.

Designated Funds As at 31st
March 2020
Utilised /
Released
New
Designations
As at 31st
March 2021
£ £ £ £
Fixed Assets 5,323,815 (515,065) 121,581 4,930,331
Property Relocation - - 1,000,000 1,000,000
Future Helicopters 7,779,988 (11,975) 3,162,023 10,930,036
13,103,803 (527,040) 4,283,604 16,860,367

The Fixed Assets fund is the net book value of Fixed Assets.

The Property Relocation fund is an amount set aside as a contribution toward the potential cost of relocation if the charity were required to move either of its bases.

The future helicopter fund includes the value of the loans made to SAS for the acquisition of the two AW169 helicopters - £6.707M - plus the legal costs incurred of £0.120M. The legal costs are being amortised over the term of each loan and are charged to the fund, whilst the interest received on those loans during the period is added to the fund. In addition, a further £2.9M has been provided by the Trustees reflecting their commitment to investment in a future helicopter fleet which will meet the needs of KSS and the community they support.

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Movements in Funds

Movements in Funds
Group General Designated Total
Unrestricted
Restricted Total Funds
2021
Total Funds
2020
£ £ £ £ £ £
Balance at 1stApril 2020 13,598,666 13,103,803 26,702,469 133,063 26,835,532 26,024,221
Total Income 16,529,634 262,023 16,791,657 643,833 17,435,490 16,268,615
Total Expenditure (14,082,173) (527,040) (14,609,213) (602,023) (15,211,236) (15,427,191)
(Loss)/gain on investments 2,812,281 - 2,812,281 - 2,812,281 (30,113)
Transfers between funds (3,971,564) 4,021,581 50,017 (50,017) - -
Balance at 31st March 2021 14,886,844 16,860,367 31,747,211 124,856 31,872,067 26,835,532
Charity General Designated Total
Unrestricted
Restricted Total Funds
2021
Total Funds
2020
£ £ £ £ £ £
Balance at 1stApril 2020 13,598,668 13,103,803 26,702,471 133,063 26,835,534 26,024,223
Total Income 15,368,959 262,023 15,630,982 643,833 16,274,815 14,531,449
Total Expenditure (12,921,498) (527,040) (13,448,538) (602,023) (14,050,561) (13,690,025)
(Loss)/gain on investments 2,812,281 - 2,812,281 - 2,812,281 (30,113)
Transfers between funds (3,971,564) 4,021,581 50,017 (50,017) - -
Balance at 31st March 2021 14,886,846 16,860,367 31,747,213 124,856 31,872,069 26,835,534

Analysis of Net Assets Between Funds

Group General Designated Total
Unrestricted
Restricted Total Funds
2021
Total Funds
2020
£ £ £ £ £ £
Tangible Fixed Assets - 4,930,331 4,930,331 - 4,930,331 5,323,815
Investments 12,378,736 11,930,036 24,308,772 - 24,308,772 17,131,431
Cash 3,302,788 - 3,302,788 124,856 3,427,644 4,768,239
Other Assets and Liabilities (794,680) - (794,680) - (794,680) (387,953)
14,886,844 16,860,367 31,747,211 124,856 31,872,067 26,835,532
Charity General Designated Total
Unrestricted
Restricted Total Funds
2021
Total Funds
2020
£ £ £ £ £ £
Tangible Fixed Assets - 4,930,331 4,930,331 - 4,930,331 5,323,815
Investments 12,378,738 11,930,036 24,308,774 - 24,308,774 17,131,433
Cash 915,467 - 915,467 124,856 1,040,323 3,592,625
Other Assets and Liabilities 1,592,641 - 1,592,641 - 1,592,641 787,661
14,886,846 16,860,367 31,747,213 124,856 31,872,069 26,835,534

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Restricted Funds

Restricted Funds
As at Income Resources Transfers As at
Group & Charity 31st March Resources Expended between 31st March
2020 Funds 2021
£ £ £ £ £
Training centre 20,027 - - - 20,027
Night fying - 150,165 (150,165) - -
Fidelity mannequins 23,902 - - - 23,902
Ultrasound 7,031 - - - 7,031
Autopulse – cardiac
support pump
7,500 - - - 7,500
Compact suction units 1,021 - - - 1,021
Load bearing vests 1,100 - - - 1,100
Rescue warming mats 371 - - - 371
Research 40,899 - (40,899) - -
Training equipment 11,098 - - - 11,098
Lions equipment 114 36,111 (1,081) (33,907) 1,237
Flying suits 20,000 20,000 (3,471) - 36,529
AAUK - COVID-19 grant - 374,375 (374,375) - -
Tempus ALS systems
fund
- 5,000 - (5,000) -
Oxylog ventilator - 11,110 - (11,110) -
Uniform, kit bag and
oxygen masks - 1,170 (1,170) - -
Kent fuel costs - 15,000 - - 15,000
Kent Air Ambulance - 25 (25) - -
Difbrillator pads - 75 (35) - 40
Furlough - 30,802 (30,802) - -
133,063 643,833 (602,023) (50,017) 124,856

The transfer of funds amounting to £50,017 includes the capitalised items:

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Restricted funds

Restricted funds represent funds held for the provision of emergency equipment and resources for use in Kent, Surrey and Sussex. These funds include:

----- Start of picture text -----
Training centre fund Grant received from the Libor Fund for the development of a Hi Fidelity training centre
Night flying fund Receives the profits from the 24/7 weekly draw operated by Air Ambulance
Promotions Limited and other donations. The funds are used in support of the night
flying operations
Fidelity mannequins fund Donations specifically for the purchase of Fidelity mannequins
Ultrasound fund For grants and other donations for ultrasound diagnostic equipment
Autopulse – cardiac
Donations and grants towards the costs of cardiac support pumps
support fund
Compact suction units fund Donations specifically for the purchase of compact suction units
Load bearing
Donations for the on-going cost of load bearing vests used by the crew
vests fund
Rescue warming
Donations given for the purchase of rescue warming mats
mats fund
Research legacy fund Legacies received for research purposes for diagnosis and treatment
Training equipment
Donations received to buy medical training equipment
fund
Lions equipment Donations from the Lions Club International. During the year the Lions Club purchased a
rapid response vehicle
Flying suits fund Donations from Tesco Groundwork UK to provide flying suits for the HEMS crew
AAUK - COVID-19 Grant Government provided support to the Air Ambulance sector during the initial impact
of COVID-19 to deal with the pandemic, and these funds were distributed through Air
Ambulances UK for use in COVID-19 missions
Tempus ALS systems
Donations and grants provided to support the purchase of a Tempus ALS system
fund
Oxylog ventilator Donations and grants provided to support the purchase of Oxylog ventilators
Uniform, kit bag Donations and grants provided to support the purchase of uniforms, kit bag
and oxygen masks and oxygen masks
Kent fuel costs
Donations received to support the cost of fuel in flying missions in Kent
Kent Air Ambulance Legacies received to support the activities of KSS in Kent
Defibrillator pads Donations received to purchase defibrillator pads
Furlough Government provided support for staff placed on furlough during the pandemic
----- End of picture text -----

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15. Operating Lease Commitments

At the balance sheet date, the company’s full commitments over the term of each operating lease or, as in the case of the Redhill Hangar 10 until the next break clause of 13[th] March 2022, were as follows:

,
2022, were as follows:
1 year 2 to 5 More than Total
or less years 5 years commitments
£ £ £ £
Land & Buildings
Redhill Hangar 10 197,072 - - 197,072
Rochester 20,000 80,000 245,315 345,315
217,072 80,000 245,315 542,387
Aviation capability 4,746,519 18,986,074 11,092,549 34,825,142
Vehicles 25,632 48,701 - 74,333
Offce Equipment 15,418 12,852 - 28,270
Total Lease Commitments 5,004,641 19,127,627 11,337,864 35,470,132

Expiry date:

Rochester Redhill Hangar 10

Length of unexpired leases at 31[st] March 2021: Redhill Hangar 10

Rochester Helicopters - KSST & KSSC

2[nd] July 2038 12[th] March 2042

20.96 years 17.25 years 7.33 years

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16. Related Party Transactions

The following related party transactions took place with AAPL in the year:

2021 2020
£ £
Gift aided lottery and Raffe profts 5,696,782 5,718,936
Gift aided AAPL Profts 1,588,466 1,102,983
Total gift aided donations 7,285,248 6,821,919
Recharges for Staff costs 191,283 163,050
Recharges for property and administration 31,314 15,925
Total Recharges 222,597 178,975
Purchases of Merchandise - 1,150

During the year to 31[st] March 2020, £22,981 was paid to Barretts Mini, a member of Barretts of Canterbury Ltd of which Paul Barrett is owner and Managing Director for the purchase of one car which was the first prize in the ‘Win a Car’ raffle sponsored by Air Ambulance Promotions Limited. There was no corresponding activity in the year to 31[st] March 2021.

During the year to 31[st] March 2020, Hazelhurst Trust, of which Helen Bowcock is a Trustee made a donation of £25,000. There was no corresponding donation in the year to 31[st] March 2021.

During the year to 31[st] March 2020, White & Sons, of which Andrew Farrant is a Director, gave a donation of £1,958. There was no corresponding donation in the year to 31[st] March 2021.

Amounts Paid to Trustees

During the year to 31[st] March 2020, Dr Helen Bowcock, the Chair of Trustees, incurred legal expenses totalling £24,006 in fulfilling her role as Trustee. These costs were reimbursed to Helen Bowcock, the payment being made under the provisions of clause six of the charity's Articles of Association. There was no corresponding expense in the year to 31[st] March 2021.

Trustee Expenses

No Trustees were paid expenses during the year (2020: two Trustees were paid £496). Included in Management and Administration costs is the cost of Trustees’ liability insurance (including professional indemnity cover) amounting to £5,585 (2020: £6,895).

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