OpenCharities

This text was generated using OCR and may contain errors. Check the original PDF to see the document submitted to the regulator.

2021-12-31-accounts

Doctors of the World UK Report and Financial Statements

For the year ended 31 December 2021

Contents

Welcome from the president 3
Trustees’ report 4
What we do and why we do it 5
What we achieved in 2021 6
International 7
UK 8
Advocacy work 11
Our organisation 12
Racial and social justice at Doctors of the World UK 13
What the future holds 14
International 15
UK 16
Organisational structure 17
Financial review and highlights 20
Acknowledgement of support 22
Statement of trustees’ responsibilities 23
Independent Auditor’s Report 24
Statement of fnancial activities 27
Balance sheet 28
Statement of cash fows 29
Notes to the fnancial statements 30
Back cover page 42

Welcome from the president

We are all busy, we have our own lives and priorities, and it is sometimes easier not to listen, to block out and even to deny the reality of the circumstances and challenges faced by many people living in our country. As a doctor I find it very hard to accept that people would choose not to go to a health care worker when they, their families, their children are sick, for fear of consequences of what I or my colleagues would do or report or ‘the system’ would facilitate. It is hard to appreciate the reality for people who have experienced hardships beyond that which most people could relate, and then who feel that they are not just unwelcome, but targeted. Denial of medical treatment to someone with health need is not something that any doctor could countenance. Being presented with a bill for medical care well beyond what you can afford. Living in fear of being reported by your midwife by attending antenatal care. Surely this does not happen in the UK these days? It is easier not to listen.

I am proud that Doctors of the World and our Médecins du Monde network choose to listen and to act to support vulnerable people in the UK and abroad to access healthcare.

2021 was a year where the wider impacts of the COVID-19 pandemic hit home; unsurprisingly this was disproportionate with the most vulnerable in our society most affected with exacerbation of barriers to healthcare and information, and social exclusion. The political landscape altered with changes to immigration policy and UK overseas aid creating a more challenging context both for people living in already very difficult circumstances and organisations seeking to support them. Doctors of the World stepped up. We adapted our operating model to continue to provide healthcare services and medical and social consultations. We adopted innovations, for example, to ensure provision of prescriptions and clinical consultations. We provided practical support and facilitated access to healthcare and integration into the health system. Our COVID-19 guidance and translated material was downloaded over 85,000 times and has become a key tool in the UK pandemic response. Our COVID advocacy projects mobilised organisations and influenced policy. Our mobile clinic work expanded to better serve the most vulnerable groups including rough sleepers and people seeking asylum stuck in initial home office accommodation and military barracks sites without proper access to healthcare.

Meanwhile, our Safe Surgeries initiative, further expanded and has been endorsed by the British Medical Association, the Royal College of General Practitioners and NHS England as key to supporting access to primary care. Through our actions, Doctors of the World has become well recognised in the UK for our expertise in health inequalities and widening access to medical services, providing evidenced-based advice, guidance and comment to government, healthcare commissioners and providers and the media. Médecins du Monde international programmes continued to deliver and adapted to provide COVID-19 specific and health and care provision in nearly 70 countries worldwide. Our programmes deliver in some of the most challenging international contexts including supporting those living in extreme poverty, with acute and chronic health needs, undergoing enforced migration and affected by acute emergencies and natural disasters.

Our organisation is evolving, and we have continued to work to become stronger and more diverse. The work of our National Health Advisors (our Experts by Experience advisory group) is already having impact well beyond our organisation, co-producing best practice documents and polices on lived experience involvement for the charity sector. In 2022 we will continue to evolve to ensure inclusivity within our organisation and network and in the way we work, and seek to influence through example.

I would like to thank our staff and volunteers who are simply incredible. Their drive, their passion for making a difference, allied with their skill and expertise is what make us what we are. A huge thank you also to our supporters – you are our family, and your donations keep us going and drive us to make greater impact and enable us to do what we need to do.

With our supporters and partners, we will continue to serve those who need us and fight for universal and equitable access to healthcare as a fundamental human right.

Thank you for reading this report and for all your support!

Dr James Elston President

Doctors of the World UK: Report and Financial Statements 2021

3

Trustees’ report

The trustees present their report together with the audited financial statements for the year ended 31 December 2021.

Reference and administrative details

Registered office

29th Floor One Canada Square London E14 5AA

www.doctorsoftheworld.org.uk

Charity name: Doctors of the World UK

The company changed its name from Médecins du Monde UK on 26 April 2010.

Company registration number: 3483008 Charity registration number: 1067406

Board of trustees / directors

The following individuals are the trustees, also directors, who served during the year and who continue to serve:

Auditor

Sayer Vincent LLP Invicta House, 108-114 Golden Lane London, EC1Y 0TL

Bank

Lloyds Bank 3-5 Whitechapel Road London E1 1DU

Dr. Tim Dudderidge

President until 10th September 2020

Dr. James Elston

Appointed 24th July 2019 President from 11th September 2020

Elaine Connor

Treasurer Resigned 5th May 2022

Julia McDonald

Treasurer Appointed 6th May 2022

Dr. Hannah Theodorou

Joint Vice President

Dr. Lisa Harrod-Rothwell

Joint Vice President

Dr. Peter Gough

Karl Shuker

Avril Lee

Colin Herrman Appointed 25th Sept 2021

Philomene Uwamaliya Appointed 4th Feb 2022

Noun Gigir Appointed 4th Feb 2022

Doctors of the World UK: Report and Financial Statements 2021

Doctors of the World UK: Report and Financial Statements 2021

4

4

What we do and why we do it

Doctors of the World UK is part of the international Médecins du Monde network. We work at home and abroad to empower excluded people and marginalised communities to claim their right to health while fighting for universal access to healthcare. In 2021, the network delivered 417 innovative medical programmes and evidence-based advocacy initiatives to improve access to healthcare in 74 countries.

Our expert staff and volunteers find and treat vulnerable people around the world – and they won’t rest until everyone everywhere gets the healthcare they need. Our vision is of a world where barriers to health have been overcome, where health is acknowledged as a fundamental right.

Our four priority areas are:

People in crisis

We provide life-saving humanitarian healthcare in times of war and natural disasters.

People in vulnerable situations This includes advocating for the right to health, in terms of both physical and mental health, across Europe for migrants, people experiencing homelessness, Gypsies and Travellers.

In the UK, Doctors of the World runs clinics in London, a national advice line, outreach programmes and a policy and advocacy programme. At these volunteer-staffed clinics, we work withmarginalised people such as people seeking asylum, survivors of trafficking, undocumented people, sex workers and people with no fixed address by providing medical care, information and practical support.

Since opening in 1998, Doctors of the World has directly helped more than 21,500 people in the UK.

People at risk of harm

This especially refers to those at risk from HIV or hepatitis C, such as drug users and sex workers.

Women and girls

We believe strongly in the right to sexual and reproductive health, and work to empower women and girls around the world to access sexual and reproductive health services.

Doctors of the World UK: Report and Financial Statements 2021 5

What we achieved in 2021

International

COVID-19 global response

Since its inception, Médecins du Monde has been responding to disease outbreaks in low-income countries around the world.

From the Ebola crises in Sierra Leone and the Democratic Republic of Congo, to plague in Madagascar and cholera outbreaks in Haiti, Angola and Mozambique, our expert staff and volunteers have been on the ground working to limit the spread of disease and its impact on vulnerable populations.

When the COVID-19 pandemic struck, the network’s 17 chapters, including the UK, were suddenly faced with a deadly disease outbreak on their own doorsteps, as well as restrictions on the movement of people and shortages of medical supplies.

They overcame these challenges to launch programmes to fight COVID-19 in 67 countries, scaling up operations in countries where programmes already existed and identifying new areas of need.

The effects of COVID-19 were felt worldwide but it was the poorest countries that were and continue to be the hardest hit, with factors such as a pre-existing disease burden, conflict, inadequate shelter and sanitation, and political and economic instability contributing to their vulnerability.

Applying decades of experience fighting disease outbreaks, Doctors of the World worked to limit the spread of COVID-19 and reduce its impact on vulnerable populations.

We did this through activities such as health promotion and awareness raising, training local health workers in infection prevention and control, supplying personal protective equipment, running mobile clinics, and providing psychosocial support to health workers and COVID-19 patients.

We were also able to adapt many of our existing health programmes to address COVID-19 impacts and adapted our operating models to continue supporting excluded communities and ensuring access to healthcare.

Doctors of the World UK: Report and Financial Statements 2021 7

UK

Our service users

Everyone living in the UK is entitled to free primary care, regardless of immigration status. Yet 84% of the patients we supported in 2021 were not registered with a GP, despite having lived in the UK for six years on average before accessing our services. 46% of people did not understand the NHS system or their rights to access healthcare.

As the pandemic led to job losses, people who were already vulnerable were plunged into further poverty and destitution. Patient data from 2021 shows that 67% of the patients we asked were homeless or staying in temporary accommodation and 84% of those asked were living below the poverty line (65% and 84% respectively in 2020).

Many of our service users (44%) were people with undocumented immigration status, while 46% were people seeking asylum in the UK (a higher proportion than in 2020 in part due to our outreach services into Home Office accommodation sites). Many were too afraid to see a doctor due to fear of immigration enforcement.

The Home Office has long used the NHS to enforce its ‘hostile environment’ policies. Stricter policies have been introduced in hospitals that require them to report unpaid bills and patient information for immigration purposes as part of the NHS charging regime. NHS bodies and doctors themselves have also been requested to share migrant patients’ private data.

People we serve are routinely dissuaded from accessing vital care due to Home Office encroachment into the health service. Moreover, very ill people have told us that they have been wrongly denied vital treatment for serious conditions such as cancer and heart disease under the current charging regulations, which are complex and often poorly applied. Worryingly, we have heard some pregnant migrant women avoided antenatal care altogether due to fear of high healthcare bills and immigration enforcement.

How we responded

In the clinic, on outreach and through remote consultations, our volunteer doctors and nurses provide consultations and prescriptions for our patients, while caseworkers help them to register with a GP so that they have ongoing access to a doctor. We offer an additional service specifically for women and children, who often face significant barriers to healthcare.

In 2021, we supported more than 900 people through 799 social consultations and 236 medical consultations.[1] The COVID-19 pandemic presented many challenges, but we were able to quickly and safely adapt our services to provide medical care, information, and practical support to people in vulnerable circumstances across the UK.

Working remotely, the advice line team answered 1,325 calls and arranged remote consultations with our doctors, who provided 149 prescriptions free of charge to our service users. Our Safe Surgeries network expanded, reaching over 750 practices across 55 cities and towns, and we continued to advocate for equitable access to healthcare for everyone living in the UK. We also provided outreach to excluded groups in London and launched a pilot project in Birmingham.

Our staff and volunteers also spend many hours persuading people who are very sick or heavily pregnant that the risk of not accessing the healthcare they need outweighs their fears of the hostile environment. It routinely causes great distress to people who are already in a vulnerable situation

1 Due to changes in our consent process, this data is based on those who provided consent for their data to be included in reports

Doctors of the World UK: Report and Financial Statements 2021

8

East London clinic

The East London Clinic is at the heart of what we do in the UK. At the end of March 2020, as the UK went into lockdown due to COVID-19, we temporarily closed the clinic and put the necessary measures in place to begin delivering our services remotely through telephone and video consultations. Our East London clinic reopened in July 2021 initially in a limited capacity due to continuing COVID-19 precautions, prioritising supporting those in the most vulnerable circumstances with face-to-face consultations, alongside our remote services. Meeting the specific needs of our service users and ensuring their safety, along with the safety of our volunteers and staff, has remained at the centre of our operations as our response to COVID-19 continued in 2021.

Despite the many challenges the pandemic presented, we were able to adapt our clinic services quickly and safely to remotely support 900 people through 799 social consultations and 266 medical consultations in 2021. A partnership with Zavamed Healthcare meant service users who had a remote consultation received prescriptions delivered to their home free of charge in lieu of existing arrangements for service users who were seen face to face in clinic.

Advice line

After moving to a remote service in March 2020, our advice line and casework service continued to operate five days a week. Volunteers manning the remote advice line answered 1325 calls in 2021.

The advice line team provides support and expert advice to patients and allied organisations with healthcare access issues. They also spend a considerable amount of time carrying out follow up advocacy for people who are struggling to access the NHS and other services and who, for various reasons, may find it difficult to advocate for themselves.

COVID-19 pandemic response

As well as providing medical care, advice, and practical support remotely, our doctors, nurses and caseworkers screened patients for COVID-19, offered information on government guidance in the service user’s language, and explained how to access COVID-19 services through the NHS. Advice line data for 2021 shows 14 callers were experiencing symptoms of COVID-19.

Women and children’s project

Doctors of the World’s female service users are among the most marginalised women in the country and our Women and Children’s Project supports hundreds of women and their families each year. In 2021, 42% of our 900 service users were women. 71% of the pregnant women we worked with had not accessed antenatal care before contacting Doctors of the World. Our staff and volunteers provide vital services to these patients, including health assessments, STI screenings, and information and advice on accessing NHS services.

They also spend time advising pregnant women about NHS charges for antenatal care and signpost them to organisations that can help them to negotiate a payment plan. For those who are ineligible for free NHS care, it costs around £7,000 for a package of antenatal care and delivery in an uncomplicated pregnancy.

The NHS charging regime makes the situation very complex for women in vulnerable circumstances, who might struggle financially and have often survived traumatic experiences at home and in the UK. We therefore work to reassure and support them to access antenatal care, in the best interests of themselves and their child. There are also several circumstances in which a women may be eligible for free NHS care which they may not be aware of themselves, in which case Doctors of the World provide advice and advocacy where appropriate.

Doctors of the World UK: Report and Financial Statements 2021 9

In 2021, we also supported 130 children aged between 0 and 18 years. We try to ensure the children are safe and are adequately cared for. We help their families to register with a GP and support them to participate in the UK’s childhood immunisation programme by signposting and providing information about the process, as well as screening for safeguarding and support needs within families, linking them with other social support services and networks.

During our outreach to Home Office accommodation sites, we identified safeguarding needs of newly arrived asylum seekers who were unaccompanied minors with age disputes and worked with local councils and the wider migrant sector to coordinate a response and investigate the issue with the Home Office.

Outreach services

In 2021, we continued to deliver outreach services including delivering COVID-19 vaccinations in London, and our outreach in hotels accommodating people seeking asylum delivering initial health assessments as well as supporting GP registration. We also continued working with rough sleepers in the City of London, supporting their access to primary healthcare and screening for acute medical needs. We concluded our pilot outreach service in Birmingham in April 2021, having supported 30 people to access healthcare during the project period. Due to the restrictions posed by the COVID-19 pandemic, services were mostly delivered remotely. We continued to provide HIV and STI screening in our clinics, and via outreach services.

New projects

In May 2021, we published a report summarising the extreme unmet health and service needs of sex workers in East London, based on rapid assessment incorporating qualitative (e.g., semi-structured interviews) and quantitative approaches conducted at the height of the pandemic.

We also ran a 12-month project supporting people from the Gypsy, Roma, Traveller, Boater and Showmen communities, a new population for Doctors of the World UK, with extremely high levels of unmet healthcare needs. This project launched in February 2022.

Doctors of the World UK: Report and Financial Statements 2021

10

Advocacy work

COVID-19 response

In December 2020 we launched our new COVID-19 Advocacy Project. The project had three key objectives:

Through the project we secured key clarifications and changes to the vaccination rollout in the UK to make it more inclusive for everyone living in our community. This included clarification on the workings of the National Booking System, NHS England made its “Find a walk-in coronavirus (COVID-19) vaccination site” webpage permanent and UK Health Security Agency (previously Public Health England) clarifying the circumstances in which data is shared with other government authorities as well as the non-chargeable status of the booster jabs.

The translated resources were downloaded over 85,000 times since the beginning of the pandemic, with over 10,000 of those since the beginning of the vaccine project from a purposedly-built website that since its launch in August, the Hub has been viewed 21,000 times.

Safe Surgeries

In 2021 our network of Safe Surgeries continued to expand across the country reaching 636 GP practises by the end of the year. Alongside this, the Initiative has also been endorsed by the British Medical Association, the Royal College of GP and promoted by NHS England as one key solution to support GP registration in our patient groups during the pandemic.

Challenging the hostile environment

As part of our work challenging the hostile environment in healthcare, we commissioned a report by the Institute of Public Policy Research (IPPR) that proposes simple and workable reforms to migrant healthcare policy that would improve access to all NHS services for everyone living in the UK.

The report proposes changing the current policy so that everyone who is living in the UK, regardless of their immigration status, is eligible for free secondary healthcare. This means when seeking medical care, a person would no longer need to arbitrarily prove their immigration status.

Collaborative work

Amongst the 40 media pieces we secured during the Vaccine Advocacy Project, the most high profile one was the joint investigation by the Bureau of Investigative Journalism, The Independent[2] and Channel 4. This gave us the opportunity of launching a ‘Write to your MP’ action as part of the Hands Up for Our Health Coalition, of which Doctors of the World is a key founder and convener. The action called on MPs to improve access to vaccines in their constituency resulted in 1,094 letters sent to MPs.

2 https://www.independent.co.uk/news/ uk/home-news/undocumented-vaccinecovid-nhs-migrants-uk-b1882555.html

Doctors of the World UK: Report and Financial Statements 2021

11

Our organisation

Board of Trustees

The capacity and expertise of our Board of Trustees was expanded with the addition of four new board members who brought expertise in the legal field, lived in experience and the medical profession.

Strategic Plan 2020-2022

In 2020, we started working towards the aims and objectives of the Strategic Plan 2020-2022. The plan was developed in 2019 in collaboration with staff, trustees, and volunteers, and sets clear goals for the coming years.

Despite the uncertainty created by the COVID-19 pandemic, the plan remained relevant throughout 2020 and we made good progress towards the objectives. For example, we achieved our target for unrestricted funding in September – three months earlier than forecast – a good step towards achieving our objective of financial independence.

Remote working

The safety of our staff, volunteers and patients is paramount. In March 2020, following the arrival of COVID-19, we reviewed and re-orientated our work practice and service provision, supporting staff and volunteers to adopt remote working practices. We also welcomed new staff and volunteers, who were provided with office equipment and onboarded remotely.

We provided information on financial assistance for remote working and regularly consulted with staff and volunteers on their needs and preferences for a future return to the office. When COVID-19 restrictions permitted, we reopened the East London clinic with a revised operating model, and robust infection control measures on resuming face to face care, while also organising regular online meet ups to promote staff wellbeing.

Co-production with experts by experience

In 2021, we continued implementing and developing our co-production project in partnership with our expert by experience advisory group, the National Health Advisors (NHA), to ensure refugees and migrants have greater influence over Doctors of the World’s work. Throughout 2021, the NHA group worked in partnership with DOTW UK to collectively deliver the organisation’s mission, including:

Our co-produced resources have reached thousands of people;

The NHA group continued to work as an equal partner in the project and developed guidance and governance documents to champion co-production within and beyond the Doctors of the World.

12 Doctors of the World UK: Report and Financial Statements 2021

Racial and social justice at Doctors of the World UK

In 2020, we carried out a review of diversity and inclusion at Doctors of the World UK, surveying staff and volunteers (including trustees) to better understand the challenges we face in addressing inequalities that exist in the organisation. The survey was completed by 77% of trustees, 100% of Senior Management Team (SMT) staff, 90% of non-SMT staff and 91% of volunteers.

Although we understood that there were areas of the organisation that required significant change to reflect the diversity of the communities we serve, the survey highlighted some issues particularly starkly. It was clear that people who identify as Black, Asian and minority ethnic were underrepresented in Doctors of the World’s leadership and disproportionately held lower paid and more insecure roles within the organisation. We recognise that the issues identified in the survey are likely to reflect structural inequality within the organisation, require further exploration and we will prioritise investigation and ensure we address issues and determinants.

Following this initial survey, we established an advisory group to advise on how to take the findings of the survey forward. The group consists of staff, both SMT and non-SMT, volunteers (including trustees) and National Health Advisors, who provide scrutiny and advice on Doctors of the World’s progress in achieving organisational goals related to racial and social justice within the organisation.

Doctors of the World’s goals are:

To live up to our anti-racist values and commitment to racial justice, as an organisation we will make concrete changes to address the inequality that exists within our own organisation, continue to monitor our progress, and strive to do better.

Doctors of the World UK: Report and Financial Statements 2021 13

What the future holds WE

International

COVID-19

As COVID-19 causes suffering, illness, and death around the world, the Médecins du Monde network’s global response to the pandemic will continue. Doctors of the World UK will promote the network’s efforts to curb the spread of COVID-19 and to protect the most vulnerable, while building local capacity and calling for universal access to healthcare, including COVID-19 vaccination. Where unmet financial needs arise, we will respond by launching fundraising appeals where necessary.

UK aid cuts

In 2020, the UK Government announced that it would cut aid spending from 0.7% of national income to 0.5% – a reduction of more than £4 billion. The cuts are not split evenly, with some programmes having funding reduced by 85% or more, and affect conflict-ravaged countries such as Syria and Yemen, where the Médecins du Monde network runs health programmes. With the Bond network of non-government organisations working in international development, we will continue to urge the government to reconsider aid cuts and to reinstate the commitment to 0.7% of national income.

Disasters and emergencies

Doctors of the World UK will continue to develop its readiness to respond to disasters and emergencies, in particular by raising funds for Médecins du Monde programmes through digital campaign materials that can be activated at short notice when news of an emergency breaks.

Doctors of the World UK: Report and Financial Statements 2021

15

UK

Programmes

We will continue to offer a range of services – via our East London clinic, remotely via our national advice line and via outreach to support the many people living in the UK who find it impossible to access mainstream health services, despite being fully entitled to them.

We will focus on restabilising our core services post the COVID-19 pandemic, re-recruiting clinical and non-clinical volunteers to support the reopening our East London clinic to full capacity and re-establishing our face-to-face Women and Children’s services. We will also embed our remote clinical consultations - which evolved due to the COVID-19 pandemic – into our core service delivery, so that we are able provide full social and medical consultations to those unable to reach our clinics going forwards,

As our face-to-face services reopen with more capacity, we will consolidate our new approach to HIV and STI screening in our East London clinic, training staff and volunteers on best practice in offering and supporting screening to overcome misconceptions, enable informed decision making thereby driving uptake. We also intend to begin the process of restoring the provision of key healthcare services delivered in partnership with other organisations at our East London clinic before the pandemic, such as optical services and family planning.

Our outreach services continue to broaden. In 2022 we will be working with rough sleepers in two London boroughs, we will continue to work in Home Office initial accommodation, and we will continue our newly founded work with Gypsy, Roma, Traveller, Boater and Showman communities, learning about the specific healthcare access needs and exclusions experienced by people from these communities, and supporting them to obtain the healthcare they are entitled to.

Expert by Experience work

We will continue to work in partnership with our National Health Advisor group to embed coproduction principles across the organisation This work will focus both on influencing the policies and practices of decision makers at government level and within the healthcare system and contributing to agenda-setting and decision making within our organisation.

The NHA group will continue to shape services, policy, and campaign activities and engage with migrant communities about their right to health through training sessions and resources.

Policy and advocacy

We will continue to produce translated resources to help ensure migrant communities understand their healthcare rights in the UK and can access essential information on health topics and services in their language.

We will also work to ensure equal access to COVID-19 vaccination through the COVID-19 Vaccine Advocacy Project, drawing on the experiences of our patients and our links with clinicians and migrant and health organisations to influence the UK’s vaccination programme and to produce resources for patients, service providers and policymakers.

As demand for our expertise in refugee and migrant healthcare rights grows, we will continue to deliver training and information sessions to key stakeholders, including healthcare professionals and NHS staff. We will expand the Safe Surgeries national network to improve access to healthcare services for excluded groups across the UK. In partnership with NHS England, we have launched an e- learning module that will make our Safe Surgeries training more accessible than ever. We will continue to provide support, resources, and guidance to GP practices and Clinical Commissioning Groups, as well as sharing examples of best practice and reporting on access to GP registration.

Lastly, we will publish testimonies and analysis the experiences of our patients to drive change in key policy areas. We will continue to engage with the government, politicians, and other key stakeholders to reform migrant healthcare policies and ensure that everyone is able to access the healthcare they need.

We will maintain an active role in the Médecins du Monde network, contributing to international policy actions and reports.

16 Doctors of the World UK: Report and Financial Statements 2021

Organisational structure

Overview

Doctors of the World UK is a registered charity in England and Wales and part of the Médecins du Monde international network. It is an independent organisation that shares the values and principles of the Médecins du Monde network and benefits from its technical and financial support if needed.

The charity Doctors of the World UK is a company limited by guarantee and governed by its Memorandum and Articles. The directors of the company are also trustees for the purposes of charity law and meet monthly to review the activities and future plans of Doctors of the World UK, and to receive and consider financial updates and forecasts.

The day-to-day management of the organisation is delegated to the Director of Development who is responsible for executing the strategic and operational plans agreed by the trustees.

A Senior Management Team meets weekly. It is responsible for delivery of the organisation’s strategy and policies.

Senior Management Team

Trustees

All trustees give their time voluntarily and receive no compensation or benefits from Doctors of the World UK. The trustees are covered by an indemnity insurance policy, which is renewed annually.

Trustees are recruited to ensure a spread of relevant skills across the Board. All trustee roles are advertised with an open and transparent process with interview. Applications are treated equally regardless of their source. The aim is to have a Board that is balanced in terms of diversity and that includes people with the skill sets the charity needs.

These include medical field experience, finance, marketing, fundraising, and legal and compliance skills and experience.

Remuneration policy

The salaries of Doctors of the World UK staff are periodically benchmarked against comparable organisations, including other charities, Doctors of the World UK aims to set salaries equivalent to the median for such organisations. All posts are evaluated based on agreed, organisation-wide criteria that determine the grade and salary for the post, the details of which are available to all staff in the staff handbook.

We aim to recruit, subject to experience, at the lower to medium point within a band, providing scope to be rewarded for excellence. The overall goal of the charity’s pay policy is to offer fair pay to attract and keep appropriately qualified staff to lead, manage, support and/ or deliver the charity’s aims.

Doctors of the World UK: Report and Financial Statements 2021

17

Future plans

We review our aims, objectives, and activities each year as part of the budget process. This review looks at what we achieved and the outcomes of our work in the previous 12 months.

The review also looks at the success of each key activity and the benefits they have brought to those groups of people we are set up to help. This enables us to ensure our aims, objectives and activities remain focused and enable us to deliver our strategic objectives.

We have referred to the guidance contained in the Charity Commission’s general guidance on public benefit when reviewing our aims and objectives and in planning our future activities. In particular, the trustees consider how planned activities will contribute to the aims and objectives they have set.

Doctors of the World UK plans to continue the activities outlined above subject to funding.

Volunteers

Our ability to secure essential care for people in vulnerable circumstances depends upon support from volunteers. They are at the heart of our organisation.

In the UK, volunteers staff our clinics, run our advice line and casework services, and help run our administrative office. During the COVID-19 pandemic, our clinical and non-clinical volunteers worked from home to continue to deliver the services people needed. We ensure our team is fully equipped and supported to face the challenges inherent in this kind of work.

During the pandemic, we adapted our training and supervision mechanisms to ensure our volunteers were well supported throughout their work with us.

Overseas, we depend upon the skills, dedication, and determination of a broad range of volunteers to deliver network initiatives. They work hard to coordinate emergency and longterm programmes in conflict and non-conflict settings to ensure that medical care is available to those who need it most.

Fundraising approach

Our volunteers and frontline staff make such a difference to people’s lives because of their expertise and empathy. We want all our professional relationships to emulate their warmth and support, and that informs our fundraising approach.

We foster a personable and competent fundraising team, who build strong and enduring relationships with our supporters, so that their support of Doctors of the World UK continues to evolve and goes beyond a one-off event. We stay in regular contact, offering tips on good fundraising, supporting our fundraisers’ creative efforts, and keeping them up to date on the difference their time, energy and money makes to the organisation.

We remain committed to using the money from our donors and fundraisers in the wisest and most ethical ways; and are happy that our voluntary income streams deliver a good return on investment. We have made improvements to our online payment systems to ensure giving to Doctors of the World UK online is as easy and rewarding as possible. We do our fundraising inhouse as much as possible, including interacting with donors through our Supporter Service staff.

18 Doctors of the World UK: Report and Financial Statements 2021

Throughout the year, we approached companies who could provide paid-for fundraising services. In all cases we completed careful and considered due diligence on the organisations and the amount of time and effort we would need to put in, versus the income we would likely receive.

We worked with a consultant to solicit donations on our behalf by email and a digital mobilisation agency to craft a fundraising campaign. Our policies and approach to fundraising standards are outlined below:

In 2021, we remained registered with the Fundraising Regulator, adhering to their Code of Fundraising Practice. We had no instances of non-compliance with the code during the year. Our Supporter Care team responded to all queries. There were no complaints concerning our fundraising activities. We would take any complaints very seriously and use them to improve both our service and performance for the future.

Giving to Doctors of the World UK should be a great experience. We have a supporter promise on our website as a set of standards for how we work, and the service our donors and fundraisers can expect from our team. If our donors ever feel we are falling short of our standards, we make it easy for people to contact us and we always take care to put it right.

We ensured our privacy policy was updated in line with the data protection legislation and regulation, and that it was accessible to all on our website. Lastly and most importantly, at the forefront of our minds is that all our work simply would not be possible without our supporters, donors, partners, volunteers, and fundraisers.

Grant making policy

Part of our charitable activity is undertaken by making grants to organisations within the Médecins du Monde network to facilitate their participation in programmes that meet our objectives. The grants are made to successful chapters who fulfil the agreed criteria for each programme and who are best suited to deliver the objectives of the activity.

We also remained members of the Institute of Fundraising and continued to ensure staff are fully trained – and understand their responsibilities – in their respective areas.

Doctors of the World UK: Report and Financial Statements 2021 19

Financial review and highlights

Overview

Total income for the year was £1,585,073 (2020: £1,750,332), whilst expenditure was £1,625,924 (2020: £1,445,144).

Of these amounts, restricted income during 2021 was £742,831 (2020: £1,034,150) and restricted expenditure was £875,942 (2020: £815,277), the decrease in income reflecting reduction of COVID funding that was received in 2020.

2021 saw the unrestricted fund increase to £264,212 (2020: £177,520) mainly due to the surpluses remaining on project that had closed during the year. The Board of Trustees regularly undertakes an assessment of risks, including financial risks, and ensures that reserves are maintained at a level that will ensure that the organisation’s core activities continue. The Board closely monitors the financial performance of the organisation through monthly reviews of financial information, including monitoring performance against the latest Budgetary information.

The sources of income the charity uses have been reliable against forecast. The pandemic led to additional unexpected funding and there has been strong public support for the work we do. The risks presented by COVID-19 remain low but are regularly monitored. Based on the current assumptions underlying the 2022 Budget and the Plan exercises, the Financial Statements have been prepared on a going concern basis.

Reserves policy

The unrestricted reserves at the end of the year under review were £264,212 (2020: £177,520 and restricted reserves were £299,367 (2020: £426,910).

Restricted reserves represent the amount paid by donors to undertake specific programmes, which were recognised in the financial year under review; expenditure relating to this fund will be incurred during 2022. Doctors of the World UK does not carry any designated funds. £238,648 unrestricted reserves are available to meet overheads and/or undertake charitable actions as decided by the trustees and management as well as being invested in fixed assets.

Doctors of the World UK’s reserves policy stipulates that our organisation seeks to hold the equivalent to three months’ running costs as an unrestricted fund and that reserves are maintained at a level, which will ensure that the organisation’s core activity should continue during periods of unforeseen difficulties. At the end of 2021, the unrestricted reserve represented 3.59 months of budgeted costs (2020: 4.06 months).

The Board of Trustees periodically undertakes an assessment of financial risk and re-building the reserves is an ongoing priority, which is being worked towards through investment in fundraising capacity and continual cost monitoring allied with a continued cost saving programme

Risk management

A risk register records the identified risks that Doctors of the World UK is exposed to. It is updated on a regular basis and, where appropriate, systems and procedures have been adopted to mitigate these risks.

Internal controls have been established to ensure that, where possible, expenditure has been properly authorised, and income is properly accounted for and that procedures are in place to ensure compliance with the health and safety of staff, volunteers, service users and visitors.

Risk assessments are carried out continuously by the senior management team and the risk register is reviewed by the Board of Trustees quarterly.

20 Doctors of the World UK: Report and Financial Statements 2021

----- Start of picture text -----
Principal risks and uncertainties Mitigation
Unrestricted income does Annual budgets set with unrestricted income targets. Progress
not cover overhead costs against target is reported monthly to the board and forecasts are
updated quarterly.
Income and expenditure monitored monthly via management
accounts and a ‘financial pipeline’ meeting, flagging any risks/
opportunities and identifying any corrective measures needed.
Review and update five-year plan to determine the longer term
prospects of the organisation and budget expenditure accordingly.
Small deficits can be met from existing reserves.
Failure to deliver quality Donor proposals are co-authored and agreed by Doctors of the
programmes in line with World UK and the International programmes teams. All grant
donor requirements conditions are shared and agreed by all participating Médecins du
Monde network teams before signing.
Programme level risk registers are maintained and reviewed on a
regular basis.
Doctors of the World UK submits regular reports to donors
and updates on any changes. Internal field monitoring visits are
included in the planned activities schedule.
Due diligence and oversight from Doctors of the World UK over all
grants implemented in association with other chapters.
Loss of partners/donor trust/ Daily monitoring of media activity.
support caused by damage to
the organisation reputation Organisational policies in place to ensure best practice governance
and media communication protocols.
Reputational crisis management protocol agreed.
COVID-19 impact on Weekly report on income against targets.
fundraising and operations
Monthly flash report on financial position.
COVID-19 to be added to the Risk Register.
Treasurer informed of fundraising underperformance, if it occurs.
----- End of picture text -----

Doctors of the World UK: Report and Financial Statements 2021 21

Acknowledgement of support

Donation of rent-free offices

Doctors of the World UK would like to record its thanks for the support of the Canary Wharf Group and its Chair and CEO, Shobi Khan. They have provided the organisation with rent-free office space in the Canary Wharf Estate since 1998 and have committed to do so until June 2024.

Donors and supporters

Barrow Cadbury Trust Canary Wharf Management City Bridge Trust

City and Hackney Clinical Commissioning Group

City of London Corporation Elton John Foundation Fast Track Cities

Greater London Authority Imperial College London

Joseph Rowntree Charitable Trust

London Catalyst

London Community Response Fund

Metro Centre (FTC project)

Metropolitan Housing Trust Ltd NHIR

NHS England

Paul Hamlyn Foundation Pickwell Foundation

Refugee Action

Sam and Bella Sebba Charitable Trust

The Tolkien Trust

The AB Charitable Trust Tower Hamlets Clinical Commissioning Group

Trust for London

University of Birmingham University College London

University College London Hospitals NHS Foundation Trust

We would like to thank all the donors who helped us in 2021 and whose ongoing support makes it possible for us to continue to provide access to healthcare for people in vulnerable situations, both in the UK and internationally.

22 Doctors of the World UK: Report and Financial Statements 2021

Statement of trustees’ responsibilities

The trustees confirm that they have complied with the duty in section 17 of the Charities Act 2011 to have due regard to public benefit guidance published by the Charity Commission. The trustees (who are also directors of Doctors of the World UK for the purposes of company law) are responsible for preparing the trustees’ report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice). Company law requires the trustees to prepare financial statements for each financial year, which give a true and fair view of the situation of the charitable company and of the incoming resources and application of resources, including the income and expenditure, of the charitable company for the year.

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

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

As far as the trustees are aware:

Approval

This report has been prepared in accordance with the special provisions applicable to companies subject to the small companies’ regime. It was approved by the Board of Directors and Trustees on 27[th ] September 2022 and signed on its behalf by:

Dr James Elston President

Doctors of the World UK: Report and Financial Statements 2021 23

Independent Auditor’s Report to the members of Doctors of the World UK

Opinion

We have audited the financial statements of Doctors of the World UK (the ‘charitable company’) for the year ended 31 December 2021 which comprise the statement of financial activities, balance sheet, statement of cash flows and notes to the financial statements, including significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including FRS 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:

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 UK, including the FRC’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 Doctors of the World UK’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.

Other Information

The other information comprises the information included in the trustees’ annual report other than the financial statements and our auditor’s report thereon. The trustees are responsible for the other information contained within the annual report. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon. Our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the course of the audit, or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether this gives rise to a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact.

We have nothing to report in this regard.

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

24 Doctors of the World UK: Report and Financial Statements 2021

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’ annual report. 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:

Responsibilities of trustees

As explained more fully in the statement of trustees’ responsibilities set out in the trustees’ annual report, the trustees (who are also the directors of the charitable company for the purposes of company law) 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.

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 are set out below.

Doctors of the World UK: Report and Financial Statements 2021 25

Capability of the audit in detecting irregularities

In identifying and assessing risks of material misstatement in respect of irregularities, including fraud and non-compliance with laws and regulations, our procedures included the following:

• In addressing the risk of fraud through management override of controls, we tested the appropriateness of journal entries and other adjustments, assessed whether the judgements made in making accounting estimates are indicative of a potential bias and tested significant transactions that are unusual or those outside the normal course of business.

Because of the inherent

limitations of an audit, there is a risk that we will not detect all irregularities, including those leading to a material misstatement in the financial statements or non-compliance with regulation. This risk increases the more that compliance with a law or regulation is removed from the events and transactions reflected in the financial statements, as we will be less likely to become aware of instances of non-compliance.

The risk is also greater regarding irregularities occurring due to fraud rather than error, as fraud involves intentional concealment, forgery, collusion, omission or misrepresentation.

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

Use of our report

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

Noelia Serrano

(Senior statutory auditor)

Date: 28[th] September 2022

for and on behalf of Sayer Vincent LLP Statutory Auditor Invicta House, 108-114 Golden Lane LONDON, EC1Y 0TL

26 Doctors of the World UK: Report and Financial Statements 2021

Statement of financial activities (incorporating an income and expenditure account) For the year ended 31 December 2021

2021 2020
Unrestricted Restricted Total Unrestricted Restricted Total
Note £ £ £ £ £ £
Income from:
Donations and legacies 2 644,241 22,804 667,045 668,001 54,621 722,622
Charitable activities
International actions 3 - 156,057 156,057 - 25,947 25,947
National actions 3 177,139 563,970 741,109 47,604 953,582 1,001,186
Other income – desk licence fees 20,862 - 20,862 577 - 577
Total income 842,242 742,831 1,585,073 716,182 1,034,150 1,750,332
Expenditure on:
Raising funds 4 446,419 - 446,419 466,747 - 466,747
Charitable activities
International actions 4 22,629 165,513 188,142 21,942 40,833 62,775
National actions 4 257,932 733,431 991,363 141,178 774,444 915,622
Total expenditure 726,980 898,944 1,625,924 629,867 815,277 1,445,144
Net expenditure before transfers 6 115,262 (156,113) (40,851) 86,315 305,188
Transfers between funds (28,570) 28,570 - 3,927 (3,927) -
Net outgoing resources
and net movement in funds 86,692 (127,543) (40,851) 90,242 214,946 305,188
Reconciliation of funds:
Total funds brought forward
Total funds carried forward
177,520
264,212
426,910
299,367
604,430
563,579
87,278
177,520
211,964
426,910
299,242
604,430

Doctors of the World UK: Report and Financial Statements 2021 27

As at 31 December 2021

Company registration number 3483008

Balance sheet

2021 2020
Note £ £ £ £
Fixed assets:
Tangible assets 11 112,912 48,008
112,912 48,008
Current assets:
Stock 12 2,286 1,599
Debtors 13 271,251 229,154
Cash at bank and in hand 510,850 666,975
784,387 897,728
Liabilities:
Creditors: amounts falling due within one year 14 333,720 341,306
Net current assets 450,667 556,422
Total net assets 15 563,579 604,430
The funds of the charity:
Restricted income funds 16 299,367 426,910
Unrestricted income funds 16 264,212 177,520
Total charity funds 563,579 604,430

Approved by the trustees on 27[th] September 2022 and signed on their behalf by:

Dr James Elston President

Doctors of the World UK: Report and Financial Statements 2021

28

Statement of cash flows For the year ended 31 December 2021

Note 2021 2020
Cash fows from operating activities £ £ £ £
Net cash (used in) / provided by operating activities 17 (59,631) 276,964
Cash fows from investing activities
Purchase of fxed assets
(96,494) (14,015)
Net cash used in investing activities (96,494) (14,015)
Change in cash and cash equivalents in the year (156,125) 262,949
Cash and cash equivalents at the beginning of the year 666,975 404,026
Cash and cash equivalents at the end of the year 510,850 666,975

Doctors of the World UK: Report and Financial Statements 2021 29

Notes to the financial statements For the year ended 31 December 2021

1 Accounting policies

a) General information

Doctors of the World UK is a charitable company limited by guarantee and is incorporated in England and Wales. The registered office address is 29th floor, One Canada Square, London E14 5AA.

b) 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 Republic of Ireland (FRS 102) - (Charities SORP FRS 102), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Companies Act 2006.

Assets and liabilities are initially recognised at historical cost or transaction value unless otherwise stated in the relevant accounting policy or note.

c) Public benefit entity

The charitable company meets the definition of a public benefit entity under FRS 102.

d) Going concern

The trustees consider that there are no material uncertainties about the charitable company’s ability to continue as a going concern.

Key judgements that the charitable company has made which have a significant effect on the accounts include the likelihood of renewal of institutional grants.

The trustees do not consider that there are any sources of estimation uncertainty at the reporting date that have a significant risk of causing a material adjustment to the carrying amounts of assets and liabilities within the next reporting period.

e) Critical accounting estimates

and areas of judgement

In the view of the trustees in applying the accounting policies adopted, no judgements were required that have a significant effect on the amounts recognised in the financial statements nor do any estimates or assumptions made carry a significant risk of material adjustment in the next financial year.

f) Income

Income is recognised when the charity has entitlement to the funds, any performance conditions attached to the income have been met, it is probable that the income will be received and that the amount can be measured reliably. Income includes associated gift aid tax reclaims.

Income from government and other grants, whether ‘capital’ grants or ‘revenue’ grants, is recognised when the charity has entitlement to the funds, any performance conditions attached to the grants have been met, it is probable that the income will be received and the amount can be measured reliably and is not deferred.

Income received in advance of the provision of a specified service is deferred until the criteria for income recognition are met.

g) Donations of gifts, services and facilities

Donated professional services and donated facilities are recognised as income when the charity has control over the item or received the service, any conditions associated with the donation have been met, the receipt of economic benefit from the use by the charity of the item is probable and that economic benefit can be measured reliably.

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

an equivalent and corresponding amount is then recognised in expenditure in the period of receipt.

h) Interest receivable

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

i) Fund accounting

Restricted funds are to be used for specific purposes as laid down by the donor. Expenditure which meets these criteria is charged to the fund.

j) Expenditure and irrecoverable VAT

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

Irrecoverable VAT is charged as a cost against the activity for which the expenditure was incurred.

k) Allocation of support costs

Resources expended are allocated to the particular activity where the cost relates directly to that activity. However, the cost of overall direction and administration of each activity, comprising the salary and overhead costs of the central function, is apportioned on the following basis which are an estimate, based on staff time, of the amount attributable to each activity.

Where information about the aims, objectives and projects of the charity is provided to potential beneficiaries, the costs associated with this publicity are allocated to charitable expenditure.

Where such information about the aims, objectives and projects of the charity is also provided to potential donors, activity costs are apportioned between fundraising and charitable activities on the basis of area of literature occupied by each activity:

Unrestricted funds are donations and other incoming resources received or generated for the charitable purposes.

30 Doctors of the World UK: Report and Financial Statements 2021

Notes to the financial statements (continued) For the year ended 31 December 2021

1 Accounting policies (continued)
l) Grants payable o) Stocks
Grants payable are made to third Stocks are stated at the lower of cost
parties in furtherance of the charity’s and net realisable value. Donated items
objectives. Single or multi-year grants of stock, held for distribution or resale,
are accounted for when either the are recognised at fair value which is the
recipient has a reasonable expectation amount the charity would have been willing
that they will receive a grant and the to pay for the items on the open market.
trustees have agreed to pay the grant
without condition, or the recipient has p) Debtors
a reasonable expectation that they will
receive a grant and that any condition
attaching to the grant is outside of the
control of the charity.
Trade and other debtors are recognised at
the settlement amount due after any trade
discount ofered. Prepayments are valued
at the amount prepaid net of any trade
Provisions for grants are made when discounts due.
the intention to make a grant has been
communicated to the recipient but there is q) Cash in bank and in hand
uncertainty about either the timing of the
grant or the amount of grant payable.
Cash at bank and cash in hand includes cash
and short term highly liquid investments
m) Foreign Exchange with a short maturity of three months or
less from the date of acquisition or opening
Monetary assets and liabilities in foreign of the deposit or similar account. Cash
currencies are translated into sterling at balances exclude any funds held on behalf
the rates of exchange ruling at the balance of service users.
sheet date. Transactions in foreign
currencies are translated into sterling at r) Creditors and provisions
the exchange rate prevailing at the date of
the transaction. Exchange diferences are
taken into account in arriving at the net
incoming resources for the year.
Creditors and provisions are recognised
where the charity has a present obligation
resulting from a past event that will
probably result in the transfer of funds
n) Tangible fxed assets to a third party and the amount due to
settle the obligation can be measured
Purchases are capitalised as fxed or estimated reliably. Creditors and
assets where the price exceeds £350. provisions are normally recognised at their
Depreciation costs are allocated to settlement amount after allowing for any
activities on the basis of the use of trade discounts due.
the related assets in those activities.
Assets are reviewed for impairment if
circumstances indicate their carrying value
may exceed their net realisable value and
value in use.
The charity only has fnancial assets and
fnancial liabilities of a kind that qualify as
basic fnancial instruments. Basic fnancial
instruments are initially recognised at
transaction value and subsequently
Where fxed assets have been revalued, measured at their settlement value with
any excess between the revalued amount the exception of bank loans which are
and the historic cost of the asset will be subsequently measured at amortised cost
shown as a revaluation reserve in the using the efective interest method.
balance sheet.
Depreciation is provided at rates s) Pensions
calculated to write down the cost of each The charity provides staf who have
asset to its estimated residual value over completed their probation period access
its expected useful life. The depreciation to a Group Personal Pension scheme
rates in use are as follows: with Scottish Widows. For contributing
• Computer equipment
4 years
members of staf the charity contributes
6% of salary.
• Fixtures and fttings
5 years
• Motor Vehicle
7 years
t) Operating Leases
Restricted fxed assets are initially
recognised within restricted funds.
Following completion of the programme
the asset and any associated depreciation
are derecognised and transferred into
unrestricted funds.
Rentals payable under operating leases,
where substantially all the risks and
rewards of ownership remain with the
lessor, are charged to the Statement of
fnancial activities on a straight line basis
over the minimum lease term.

Doctors of the World UK: Report and Financial Statements 2021 31

Notes to the financial statements (continued) For the year ended 31 December 2021

----- Start of picture text -----
||||| |---|---|---|---| |2a Income from donations and legacies (current year)| |2021| |Unrestricted|Restricted|Total| |£|£|£| |Functioning grants from Médecins du Monde France|168,652|-|168,652| |Other donations and gifts|475,588|22,804|498,392| |644,241|22,804|667,044| |2b Income from donations and legacies (prior year)|

----- End of picture text -----

----- Start of picture text -----
||||| |---|---|---|---| |2020| |Unrestricted|Restricted|Total| |£|£|£| |Functioning grants from Médecins du Monde France|191,000|-|191,000| |Other donations and gifts|477,001|54,621|531,622| |668,001|54,621|722,622| |Other donations and gifts include the provision by Canary Wharf Management of rent free offices|

----- End of picture text -----

Other donations and gifts include the provision by Canary Wharf Management of rent free offices to the value of £161,237 (2020: £152,063) and no Digital Support in 2021 (2020: £1,576)

Doctors of the World UK: Report and Financial Statements 2021

32

Notes to the financial statements (continued) For the year ended 31 December 2021

3 Income from charitable activities
Hackney CCG
Tampon Tax Project Women's Migrant Hub
Haringey Council
Trust for London – Right to Care
Trust for London GLA
Tolkien Trust
Paul Hamlyn Foundation
Joseph Roundtree Charitable Trust
British Red Cross Society (Children in Need)
NHS England
Big Lottery
City of London
The Metro Centre Ltd and Spectre CIC
University College London
North East London CCG
City Bridge Trust
Other income from National Actions
Sub–total for National Actions
MdM Spain - European Union Aid
Elton John AIDS Foundation - Armenia
Sub–total for International Actions
Total income from charitable activities
Unrestricted
£
-
-
-
-
-
-
-
-
-
-
-
84,739
-
-
77,400
-
15,000
Restricted
£
-
-
-
37,500
48,557
-
74,300
56,972
-
22,492
-
-
79,995
23,737
-
65,000
155,418
2021 2020
Total
£
37,200
22,590
6,324
75,250
-
160,000
67,200
56,440
12,478
24,288
63,551
70,154
59,996
-
-
52,500
293,215
Total
£
-
-
-
37,500
48,557
-
74,300
56,972
-
22,492
-
84,739
79,995
23,737
77,400
65,000
170,418
177,139
-
-
563,970
557
155,500
741,109 1,001,186
25,947
-
557
155,500
- 156,057 156,057 25,947
177,139 720,028 897,167 1,027,133

Other income from National Actions includes the donation of volunteer time and programme expenses for clinic and caseworker activities to the value of £49,756 (2020: £103,178).

Doctors of the World UK: Report and Financial Statements 2021 33

Notes to the financial statements (continued) For the year ended 31 December 2021

Staf costs (Note 7)
Fundraising and publicity costs
Direct activity costs
Grant funding (Note 5)
Other costs
Support costs
Governance costs
Total expenditure 2021
Cost of
raising funds
£
167,992
55,187
84,830
-
17,469
Charitable activities Charitable activities Governance
costs
£
7,023
-
-
-
10,283
Support
costs
£
74,676
-
-
-
332,522
International
actions
£
2,893
-
2,398
154,714
25,713
National
actions
£
528,947
-
161,277
-
-
2021
Total
£
781,531
55,187
248,505
154,714
385,987
325,478
113,918
7,023
185,718
2,424
-
690,224
290,856
10,283
17,306
-
(17,306)
407,198
(407,198)
-
1,625,924
-
-
446,419 188,142 991,363 - - 1,625,924
Staf costs (Note 7)
Fundraising and publicity costs
Direct activity costs
Grant funding (Note 5)
Other costs
Support costs
Governance costs
Total expenditure 2020
Cost of
raising funds
£
181,630
62,538
-
-
-
Charitable activities Charitable activities Governance
costs
£
-
-
-
-
10,336
Support
costs
£
78,971
-
-
-
296,392
International
actions
£
494
-
1,053
39,286
-
National
actions
£
426,047
-
348,397
-
-
2020
Total
£
687,142
62,538
349,450
39,286
306,728
244,168
222,579
-
40,833
21,942
-
774,444
130,842
10,336
10,336
-
(10,336)
375,363
(375,363)
-
1,445,144
-
-
466,747 62,775 915,622 - - 1,445,144

34 Doctors of the World UK: Report and Financial Statements 2021

Notes to the financial statements (continued) For the year ended 31 December 2021

5 Grant making
Grants to
institutions
2021
2020
£
£
£
Cost
Médecins du Monde – France
149,714
149,714
29,175
Médecins du Monde – Spain
5,000
5,000
Médecins du Monde – Belgium
-
-
10,111
At the end of the year
154,714
154,714
39,286
5 Grant making
Grants to
institutions
2021
2020
£
£
£
Cost
Médecins du Monde – France
149,714
149,714
29,175
Médecins du Monde – Spain
5,000
5,000
Médecins du Monde – Belgium
-
-
10,111
At the end of the year
154,714
154,714
39,286
5 Grant making
Grants to
institutions
2021
2020
£
£
£
Cost
Médecins du Monde – France
149,714
149,714
29,175
Médecins du Monde – Spain
5,000
5,000
Médecins du Monde – Belgium
-
-
10,111
At the end of the year
154,714
154,714
39,286
5 Grant making
Grants to
institutions
2021
2020
£
£
£
Cost
Médecins du Monde – France
149,714
149,714
29,175
Médecins du Monde – Spain
5,000
5,000
Médecins du Monde – Belgium
-
-
10,111
At the end of the year
154,714
154,714
39,286
5 Grant making
Cost
Médecins du Monde – France
Médecins du Monde – Spain
Médecins du Monde – Belgium
At the end of the year
Grants to
institutions
£
149,714
5,000
-
2021
£
149,714
5,000
-
154,714 154,714 39,286

The above grants to other Médecins du Monde chapters reflect the collaborative nature of the implementation of international grants, whereby Doctors of the World UK works with other chapters who fulfil the agreed criteria for each programme and who are best suited to deliver the objectives of the activity.

6 Net expenditure before transfers for the year
This is stated after charging / crediting:
Depreciation
Operating lease rentals:
Property
Equipment
Auditor’s remuneration (excluding VAT):
Audit
Foreign exchange loss / (gain)
2020
22,459
21,351
1,020
7,800
(3,938)
2021
31,589
21,351
2,076
8,200
2,128

Doctors of the World UK: Report and Financial Statements 2021 35

Notes to the financial statements (continued) For the year ended 31 December 2021

7. Analysis of staff costs, trustee remuneration and expenses, and the cost of key management personnel

----- Start of picture text -----
|||| |---|---|---| |Staff costs were as follows:| |2021|2020| |£|£| |Salaries and wages|693,182|611,168| |Social security costs|50,860|45,284| |Employer’s contribution to defined contribution pension schemes|37,489|30,690| |781,531|687,142|

----- End of picture text -----

The following number of employees received employee benefits (excluding employer pension costs) during the year between:

----- Start of picture text -----
|||| |---|---|---| |2021|2020| |£70,000 - £79,999|-|1| |£80,000 - £89,999|1|-| |The total employee benefits (including pension contributions) of the key management personnel were £266,440|

----- End of picture text -----

The total employee benefits (including pension contributions) of the key management personnel were £266,440 (2020: £280,721).

The charity trustees were not paid or received any other benefits from employment with the charity in the year (2020: £nil). No charity trustee received payment for professional or other services supplied to the charity (2020: £nil).. Trustees’ expenses represents the payment or reimbursement of travel and subsistence costs totalling £451 (2020: £268) incurred by 1 (2020: 2) member relating to attendance at MDM Network Meeting.

8 Staff numbers

The average number of employees (head count based on number of staff employed) during the year was as follows:

----- Start of picture text -----
|||| |---|---|---| |2021|2020| |No.|No.| |International actions|0.1|0.5| |National actions|18.0|17.7| |Fundraising and Communications|4.9|3.5| |Office management and admin|5.0|3.0| |Total headcount|28.0|24.7|

----- End of picture text -----

36 Doctors of the World UK: Report and Financial Statements 2021

Notes to the financial statements (continued) For the year ended 31 December 2021

9 Related party transactions

Médecins
However,
du Monde France are considered to be a related party due to its right to appoint a trustee to the
that appointee has no power to exercise any more control or infuence than any other trustee.
du Monde France are considered to be a related party due to its right to appoint a trustee to the
that appointee has no power to exercise any more control or infuence than any other trustee.
du Monde France are considered to be a related party due to its right to appoint a trustee to the
that appointee has no power to exercise any more control or infuence than any other trustee.
du Monde France are considered to be a related party due to its right to appoint a trustee to the
that appointee has no power to exercise any more control or infuence than any other trustee.
du Monde France are considered to be a related party due to its right to appoint a trustee to the
that appointee has no power to exercise any more control or infuence than any other trustee.
du Monde France are considered to be a related party due to its right to appoint a trustee to the
that appointee has no power to exercise any more control or infuence than any other trustee.
du Monde France are considered to be a related party due to its right to appoint a trustee to the
that appointee has no power to exercise any more control or infuence than any other trustee.
Board.
Grants paid Grants
Received

Other paid/
(received)
net
Balance
payable at
year end
Balance
receivable at
year end
£ £ £ £ £
Médecins du Monde – France 149,714 168,652 - 173,620 84,395

10 Taxation

The charitable company is exempt from corporation tax as all its income is charitable and is applied for charitable purposes.

11 Tangible fxed assets
Fixtures and
fttings
Computer
equipment
Motor
Vehicle
Total
£
£
£
£
Cost or valuation
At the start of the year
76,897
41,374
69,947
188,217
Additions in year
22,472
7,827
66,195
96,494
Disposals in year
-
-
-
-
At the end of the year
99,369
49,200
136,142
284,711
Depreciation
At the start of the year
70,536
27,922
41,752
140,209
Charge for the year
7,697
6,139
17,754
31,589
Disposals in year
-
-
-
-
At the end of the year
78,232
34,061
59,505
171,799
Net book value
At the end of the year
21,137
15,139
76,636
112,912
At the start of the year
6,361
13,452
28,195
48,008
All of the above assets are used for charitable purposes.
Fixtures and
fttings
£
76,897
22,472
-
Computer
equipment
£
41,374
7,827
-
Motor
Vehicle
£
69,947
66,195
-
Total
£
188,217
96,494
-
99,369 49,200 136,142 284,711
70,536
7,697
-
27,922
6,139
-
41,752
17,754
-
140,209
31,589
-
78,232 34,061 59,505 171,799
21,137 15,139 76,636 112,912
6,361 13,452 28,195 48,008

Doctors of the World UK: Report and Financial Statements 2021 37

Notes to the financial statements (continued) For the year ended 31 December 2021

12 Stock
2021 2020
£ £
Medical supplies 2,286 1,599
2,286 1,599
13 Debtors
2021 2020
£ £
Other debtors 142,176 89,991
Prepayments 37,170 39,622
Accrued income 91,905 99,541
271,251 229,154
14 Creditors: amounts falling due within one year
2021 2020
£ £
Trade creditors 233,456 222,287
Taxation and social security 17,783 15,855
Other creditors 13,648 29,175
Accruals 68,833 71,342
Pension contributions - 2,647
333,720 341,306
15a Analysis of net assets between funds (current year)
General
unrestricted Restricted Total funds
£ £ £
Tangible fxed assets 25,564 87,348 112,912
Net current assets
Net assets at the end of the year
238,648
264,212
212,019
299,367
450,667
563,579
15b Analysis of net assets between funds (prior year)
15b Analysis of net assets between funds (prior year)
General
unrestricted Restricted Total funds
£ £ £
Tangible fxed assets 5,024 42,984 48,008
Net current assets
Net assets at the end of the year
172,496
177,520
383,926
426,910
556,422
604,430

Doctors of the World UK: Report and Financial Statements 2021

38

Transfers
At the end
of the year
£
£
-
-
-
1,392
-
355
-
3,820
-
48,848
-
31,952
-
-
-
13,917
-
20,000
-
-
-
40,957
-
13,199
-
6,487
-
11,682
-
64,235
-
26,054
23,002
-
-
9,944
-
449
5,568
-
-
-
-
-
-
-
-
6,077
-
-
-
-
28,570
299,367
(28,570)
264,212
(28,570)
264,212
-
563,579
Transfers
At the end
of the year
£
£
-
-
-
1,392
-
355
-
3,820
-
48,848
-
31,952
-
-
-
13,917
-
20,000
-
-
-
40,957
-
13,199
-
6,487
-
11,682
-
64,235
-
26,054
23,002
-
-
9,944
-
449
5,568
-
-
-
-
-
-
-
-
6,077
-
-
-
-
28,570
299,367
(28,570)
264,212
(28,570)
264,212
-
563,579
16a Movements in funds (current year)
Restricted funds:
National actions
London Clinics
Volunteer donations in kind
Other restricted donations and grants
Young Refugees Health & Welfare
British Red Cross Society
Clinic move to Stratford
Other restricted donations
Right to Care Project
Trust for London
Mobile Clinic - Outreach
Other restricted donations and grants
Volunteer donations in kind
Mobile Clinic - Vehicle
Help Refugees
Other restricted Donations
MdM Network Observatory Report
MdM USA - Open Society Foundation
Safer Surgeries Project
Paul Hamlyn Foundation
Clinical Commissioning Groups
Joseph Roundtree Charitable Trust
Policy & Advocacy - General
Tolkien
Other restricted donations
International actions
Gaza Appeal
Yemen
MDM France
EU Aid Projects
Mozambique Appeal
Refugee Appeals
East Africa Famine Appeal
Global Clinic Crowdfunder
Elton John AIDS Foundation - Armenia
Other restricted donations
Total restricted funds
Unrestricted funds:
General funds
Total unrestricted funds
Total funds
At the start
of the year
£
-
44
7,403
46,766
55,198
82,566
-
13,249
-
2,861
56,556
1,502
(3,497)
3,301
108,404
55,200
(23,002)
9,944
449
(20,701)
284
20
(46)
7,733
-
22,675
Income
& gains
£
42,156
68,997
-
-
111,257
85,867
7,600
-
20,000
-
44,300
16,560
36,972
30,564
-
122,502
-
-
-
-
-
557
-
-
155,500
-
Expenditure
& losses
£
(42,156)
(67,649)
(7,048)
(42,946)
(117,607)
(136,482)
(7,600)
668
-
(2,861)
(59,899)
(4,863)
(26,989)
(22,183)
(44,169)
(151,648)
-
-
-
15,133
(284)
(577)
46
(1,656)
(155,500)
(22,675)
Transfers
£
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
23,002
-
-
5,568
-
-
-
-
-
-
At the end
of the year
£
-
1,392
355
3,820
48,848
31,952
-
13,917
20,000
-
40,957
13,199
6,487
11,682
64,235
26,054
-
9,944
449
-
-
-
-
6,077
-
-
426,910 742,831 (898,944) 28,570 299,367
177,520 842,242 (726,980) (28,570) 264,212
177,520 842,242 (749,982) (28,570) 264,212
604,430 1,585,074 (1,625,924) - 563,579

Doctors of the World UK: Report and Financial Statements 2021

39

Transfers
At the end
of the year
£
£
-
-
-
44
-
7,403
-
46,766
-
55,198
-
82,566
-
-
-
13,249
-
2,861
-
56,556
-
1,502
-
(3,497)
-
3,301
-
108,404
(3,927)
55,200
-
(23,002)
-
-
-
(20,701)
-
284
-
20
-
(46)
-
7,733
-
33,069
(3,927)
426,910
3,927
177,520
3,927
177,520
-
604,430
Transfers
At the end
of the year
£
£
-
-
-
44
-
7,403
-
46,766
-
55,198
-
82,566
-
-
-
13,249
-
2,861
-
56,556
-
1,502
-
(3,497)
-
3,301
-
108,404
(3,927)
55,200
-
(23,002)
-
-
-
(20,701)
-
284
-
20
-
(46)
-
7,733
-
33,069
(3,927)
426,910
3,927
177,520
3,927
177,520
-
604,430
16b Movements in funds (prior year)
Restricted funds:
National actions
London Clinics
Volunteer donations in kind
Other restricted donations and grants
Young Refugees Health & Welfare
British Red Cross Society
Clinic move to Stratford
Other restricted donations
Right to Care Project
Trust for London
Mobile Clinic - Outreach
Other restricted donations and grants
Volunteer donations in kind
Mobile Clinic - Vehicle
Help Refugees
MdM Network Observatory Report
MdM USA - Open Society Foundation
Safer Surgeries Project
Paul Hamlyn Foundation
Clinical Commissioning Groups
Joseph Roundtree Charitable Trust
Policy & Advocacy - General
Tolkien
Other restricted donations
International actions
Gaza Appeal
Ebola Appeal
EU Aid Projects
Mozambique Appeal
Refugee Appeals
East Africa Famine Appeal
Global Clinic Crowdfunder
Other restricted donations
Total restricted funds
Unrestricted funds:
General funds
Total unrestricted funds
Total funds
At the start
of the year
£
-
44
19,366
8,455
26,047
637
-
22,527
2,861
56,139
18,178
11,502
18,002
-
437
-
8,311
(27,018)
284
1,814
274
10,631
33,473
Income
& gains
£
103,178
-
12,478
249,495
75,250
141,178
-
-
-
67,200
-
18,486
99,869
130,000
126,191
-
-
10,825
-
-
-
-
-
Expenditure
& losses
£
(103,178)
-
(24,441)
(211,184)
(46,099)
(59,249)
-
(9,278)
-
(66,783)
(16,676)
(33,485)
(114,570)
(21,596)
(67,501)
(23,002)
(8,311)
(4,508)
-
(1,794)
(320)
(2,898)
(404)
Transfers
£
-
-
-
-
-
-
-
-
-
-
-
-
-
-
(3,927)
-
-
-
-
-
-
-
-
At the end
of the year
£
-
44
7,403
46,766
55,198
82,566
-
13,249
2,861
56,556
1,502
(3,497)
3,301
108,404
55,200
(23,002)
-
(20,701)
284
20
(46)
7,733
33,069
211,964 1,034,150 (815,277) (3,927) 426,910
87,278 716,182 (629,867) 3,927 177,520
87,278 716,182 (629,867) 3,927 177,520
299,242 1,750,332 (1,445,144) - 604,430

40 Doctors of the World UK: Report and Financial Statements 2021

Notes to the financial statements (continued) For the year ended 31 December 2021

16c Purposes of restricted funds in current year and prior year

National actions

The fund for National actions is established based on restricted donations to further our work in the UK, primarily in support of our UK clinics and other national programmes.

International actions

The fund for International actions is established based on restricted donations to further our work outside the UK.

Credit balances on individual grant funds represent amounts where income has been recognised upon receipt and expenditure will be incurred in future periods. Debit balances represent amounts where donors make settlement for grant expenditure in arrears, and such amounts have or are to be received in future periods.

Transfers to restricted funds represent support from unrestricted funds to programmes where restricted funding has not been sufficient to deliver programme initiatives. Transfers from restricted funds represents support for unrestricted funding following completion of programme activities and reporting requirements.

17 Reconciliation of net (expenditure) / income to net cash fow from operating activities
2021 2020
£ £
Net expenditure for the reporting period (40,851) 305,188
(as per the statement of fnancial activities)
Depreciation charges 31,589 22,459
Increase in stocks (687) 653
Increase in debtors (42,097) (45,769)
Decrease in creditors (7,586) (5,567)
Net cash used in operating activities (59,631) 276,964
18 Legal status of the charity
The charity is a company limited by guarantee and has no share capital.
The liability of each member in the event of winding up is limited to £1.

19 Operating lease commitments

The charity’s total future minimum lease payments under non-cancellable operating leases is as follows for each of the following periods:

following periods:
Property Equipment
2021 2020 2021 2020
£ £ £ £
Less than one year 29,296 30,000 3,267 2,094
One to fve years 46,385 77,500 - 885
75,681 107,500 3,267 2,979
20 Controlling party
There is no single ultimate controlling party.

Doctors of the World UK: Report and Financial Statements 2021

41

DOCTORS OF THE WORLD UK

A registered charity and company Limited by Guarantee Company number: 3483008 • Charity number: 1067406