THAMES VALLEY AIR AMBULANCE 2024 1999 ANNUAL REPORT ACCOUNTS For the year ended 3151 March 2024 Company number: 04062250 Contents Welcome Chair's introduction Caring for patients since 1999 Paul's story Behind every number is a real person with a story Year in review A year with education in focus Sharing learning on a global stage The training doesn't stop once you're on board Our new space brings new opportunities Meet our new clinical educators CPR champions work to close the'confidence gap, How you supported us What's next? Financial review Strurture, governance and management Approach to fundraising Statement of Trustees, responsibilities Independent auditor s report Financial statements Reference and administrative details 12 13 14 15 .16 17 22 25 26 27 31 59 Welcome In 1999. our service first took to the skies. Since then. we've changed a lot. We've flown many different helicopters. expanded our fleet to include critical care response vehicles, become an independent healthcare provider. received an Outstanding rating from the Care Quality Commission, and achieved our own Air Operator's Certificate. in this report. and in doing so we ushered in a new phase for our charity. As ever, everything we do is possible because of the generosity of our community and people like you. Our loyal supporters have kept us going strong for 25 years. Looking back at where we started, we have achieved things we wouldn't have thought POS5ible. I'm excited to see what more we can do, together, in the years to come. This Annual Report brings us into our 25th year. You will read how we are continuing to deliver against our ambitious strategy, pushing forwards to achieve our goals and striving to give everybody in our community the best chance of surviving and recovering from an emergency. As well as delivering on things we had planned. we've also had to deal with things we could not have foreseen.The fire in our HQ in 2022 gave us two options: do we seek to replicate what came before, or do we use this as an opportunity to do more? As ever with our organisation. we chose the more challenging path but the one that took us to the best possible destination.This year. we opened our new Education Centre and made space for ground operations, which you'll read more about /v• Amanda McLean Chief Executive Officer Chair's introduction l find myself in the slightly strange position of writing an introduction for a report on work that happened under my predecessor. Sarah Roberts. But it also allows me the chance to thank Sarah for all her efforts on behalf of the charity and to introduce myself to you, our valued supporters. Sarah, who was Chair of the Board ofTrustees from January 2019 to March 2024, oversaw some key moments in Thamesvalley Air Ambulance history. In this report, you'll read about another year of growth and success under Sarah's Stewardship, including weathering a fire in our office and seeing that as an opportunity to open a brand-new bespoke training and education space. In hertime as Chair, Sarah gave up a huge amount of her personal time to lead the charity through a step-change in our approach and ambitions. She helped us to not only meet but exceed our expectations, despite unexpected twists and turns in the road. For me. this is a'welcome back, rather than a brand- new start. I'm returning to the charity as Chair, after previously being a trustee from 2014-2020.1'm so excited to be back, bringing with me my passion for aviation, my knowledge of the charity's history and where we came from, and my enthusiasm for where we're heading.This report shows what a fantastic position we're in as we look ahead to the next phase of our strategy, and I'm delighted to be able to build on such solid foundations in the years to come. Chris Bannister Chair With your support, we can continue to provide the best possible service to the people who are at the heart of every decision we make: our patients. Caring for patients since1999 If you were to suffer a critical injury or life threatening medical emergency, you would want to know help was nearby.That's why we exist. We're here for you and your loved ones. Whoever you are.Wherever and whenever you need us. In Berkshire. Buckinghamshire and Oxfordshire. Paul Bardon isjust one of the thousands of patients that we help everyyear. When he needed us, we were there. Providing hospital-level care at the roadside and supporting his recovery beyond. Our purpose To give everybody within our community the best chance of surviving and recovering from an emergency. "None of us think this will happen to us. We put money in a tin and forget about it. But, if you ever need the support of Thames Valley Air Ambulance, they will be there for you. Without the charity, I would probably be dead. But without public support. the tharity couldn't exist." Paul Bardon, Former Patient Our mission Together, we'll do everything in our power to protect, save and revive lives. with the best critical care at the scene and beyond. Paul's story Paul was on his wayto workwhen he noticed a car on the roadside, half in a ditch, with a visibly shaken female driver. For Paul, a member of his local Search and Rescue team, the decision to pull over wasn't ever in question. WATCH PAUL'S STORY Paul remembers standing on the verge of the road, waving to approaching cars to warn them to slow down. One passing car slowed. but a second car did not manage to hit the brakes in time and collided with the vehicle in front before slamming into the broken-down vehicle. with Paul pinned between the two. It all happened in an instant. Hanging upside down in a scissor position. his right leg was trapped between the cars and his left leg was in the ditch. 'old you'being stripped away. In many ways it's worse than the actual injury itself. I didn't feel like a parent, I felt like a child. In front of my children. I hated being seen in my wheelchair and 501 stopped seeing a lot of my friends." It was during this time that our Aftercare team provided a real source of support for Paul and his family.Though they had first met in the John Radcliffe, the ongoing contact would prove most valuable for Paul. Soon the Ambulance Service and the Fire Service were on scene, and theThamesValley Air Ambulance helicopter was on its way. Paul remembers hearing the approaching helicopter and then some new boots came into view: those of our expert crew. Paul was given ketamine to manage his pain and he was placed onto a scoop and carefully brought out of the ditch and into an ambulance. Paul's ongoing relationship with our charity led to him fronting our Christmas Appeal in 2023."None of usthinkthis will happen to us.we put money in a tin and forget about it. But, if you ever need the support of Thames Valley Air Ambulance, they will be there for you. Without the charity, I would probably be dead. But without public support, the charity couldn't exist." At the John Radcliffe Hospital. Paul was rushed Straight into surgery. His right leg was amputated that morning. Paul stayed in hospltal for a little over three weeks."It had been difficult in hospital" he explains,"But going home was harder. in a way. I was clinically OK to leave. but physically and emotionally I was a wreck. I felt I had lost my identity as well as my leg." Paul provided the voiceover for a powerful animation that was shortlisted for a Smiley charity Film Award. His support for our appeal and bravery speaking to the media helped us to raise vital funds for our lifesaving cause. It was a privilege to tell his story and to be part of his recoveryjourney this year. Thankyou, Paul. Paul recalls:"I grieved for who l used to be. When something like this happens to you. you feel the Behind every number is a real person with a story During the year ended 31st March 2024: We were called out -£i- 3,232 times We treated 2,069 patients We were dispatched Oxfordshire Bu(kinghamshire 563 times by helicopter times by Critical Care Response Vehicle Berkshire INTERA(T WITH OUR MISSION MAP 65 Surrounding arÈas We record every call out as a separate figure to patient numbers. Not every call out results in treatment, but our crew are readyfor every eventuality. 42 Surrounding areas 596 Oxfordshire 714 Buckinghamshire 717 Berkshire We responded to 1,214 777 443 434 cardiac arrests medical emergencies accidental injuries road traffic collisions 154 72 71 67 intentional self-harm assaults sports/leisure injuries others 689 patients 541 intubations received enhanced pain relief were performed 370 patients received an ultrasound 151 patients needed a heated blanket We treated 1,856 213 adults tjé children 84 of the children we attended were underfive. We supported over 1.000 people through our Aftercare service. helping both patients and their loved ones as they rebuild their lives. Thanks to our Aftercare Manager based in the John Radcliffe Hospital, our crews received clinical feedback on all the patients that we transported to this major trauma centre. "It can be very rewarding to leam that your patient is recovering well; educational to leam that your susperted diagnosis wasn't entirely corrert, and it provides closure to learn that someone you invested so heavily in has passed away- because not knowing is far often more frustrating than knowing. The embedded hospital Aftercare speaalist has been the most significant and noticeable positive addition to our team in the last eight yeark" Doctor Edward Norris-cervetto Year in review We've had another jam-packed year, working towards the eight goal$ Set out in our strategy. We deliver outstanding and consistent critical care READ OUR STRATEGY We set up and opened our new state-of-the-art Pre-Hospital Education Centre.Training is now being delivered from the new space. including the introduction of bespoke arterial line courses. We reach the patients who need us We made significant steps forward in our aim to have a doctor on every vehicle, so that we provide consistent care across all hours of operation. Our crews were called out 3,232 times, more than ever before. We continued to work with nine other air ambulance charities across the country using whole blood as part of the swi￿ (Study of Whole Blood in FrontlineTrauma) trial. We continued to monitorthe critical care need outside of our core operating hours and review the Critical Care Staff Responder scheme trial that began last year as a response to this. We began the review of our dispatch processes as part of our work to maximise how we identify patients where we can make a difference. We collaborate for greater impact We took part in Air Ambulance Week, to raise awareness of the amazing work done by air ambulance charities up and down the country. We care beyond the scene We took part in presentations or panel discussions at key events for our sector, such as the Oxford School of Emergency Medicine conference, the UK ECPR (Extracorporeal Cardiopulmonary Resuscitation) Summit, and the East Anglia Air Ambulance cardiac arrest conference. Our Aftercare service trebled its reach, supporting over 1,000 people. The Aftercare team was highly commended at the AAUK IAir Ambulances UK) awards of excellence. We can now provide access to free legal support for our patients, increasing our ability to help patients and their families well beyond the time of their incident or illness. We continued to work closely with South Central Ambulance Service to raise awareness of when our crews can make a real difference in our community. The Aftercare team have expanded further, with the appointment of a Safeguarding Officer. Our future is sustainable and financially secure Our fundraising income reached £11.9m in 2023-24. As a result of data insight we applied new thinking to existing fundraising activities such as our Christmas raffle 2023 which brought in more vital funds than ever before. We launched the Chair's Circle in January 2024. a community of like-minded local philanthropists, whose membership provides funding for our long-term projects, so we can focus on giving everyone in our community the best possible chance when the worst happens. IltpD Our community are connerted and engaged Our survey results into CPR awareness revealed a'confidence gap, in our community, so we launched our CPR Champions volunteer scheme, with training sessions now being held across the region by our 15 trained volunteers. Some inspirational former patients stepped forward to tell their story. including Peter who fronted our m05t successful raffle ever, and Paul, whose story of survival you can read on page 4. *¢r* Our people are skilled, supported, motivated and proud of the difference we make Our governance, systems, and processes are robust and transparent We trained non-clinical staff in how to support the bereaved. Our new Chair of the Board ofTrustees. Chris Bannister. was appointed in March 2024. We have increased our ability to provide feedback on patient outcomes to our crew, which has significantly contributed to their wellbeing and professional development. We moved to a new finance system and a new supporter database, both of which will improve efficiency and provide a more tailored experience for supporters and staff. We have continued to celebrate and recognise where our staff have gone above and beyond with our colleague recognition awards. 10 A year with education in focus We want to push the boundaries of outstanding critical care for the patients of tomorrow by leading the way in pre-hosPltal emergency medicine education.This year we made significant strides forward in this ambition, with the creation of our state-of-the-art space for Clinical Education, and the introduction of Clinical Educators.This focus also extended beyond our own teams. as we shared learnings on a global scale and closed the knowledge gap in CPR within our wider community. Sharing learning on a global stage The training doesn't stop once you're on board This year, we led a survey of all UK HEMS (Helicopter This year three new paramedics and three doctors Emergency Medical Service) organisations to find joined the team. As with all new clinical trainees, out more about which drugs are used to induce they were enrolled on ourflagship training course: pre-hospital anaesthesia.Though there is a growing Foundations in Pre-Hospital Critical Care. This trend towards a more patient-centred approach. four-day intensive course. provides the foundation with more flexibility to decide what drug is best for knowledge and skills for starting a career in pre- that individual, prior to this study there was a lack of hospital critical care. It is the building blocks for consensus across the UK. providing high acuity, low occurrence procedures, such as open chest surgery (thoracotomyl.The course enables clinicians to experience high- fidelity scenarios, based on real-life examples, and enables learning in a safe, supported environment. We sought to address that.The findings of the survey were not only shared with colleagues across the country, but we went global with ourfindings. We presented at the Oslo HEMS Conference in December 2023 published in the BMC Emergency Medicinejournal. But the training doesn't stop there. Even once they're fully on board, we continue to develop the skills and abilities of our Critical Care Paramedics. This year we ran 26 training sessions, including arterial access training, additional training in paediatric emergencies and developing skills in pre-hospital ultrasound. In June 2023, our crews also took part in a potential terrorist attack training scenario, practicing alongside other emergency services. Our new space brings new opportunities Historically. our only option for the delivery of internal training was to use RAF Benson, where space was limited. We often had to utilise training facilities at partner sites to provide additional courses and education. All our clinicians are required to undertake a Review of Clinical Competencies every two years. This provides organisational assurance that our clinicians are skilled, supported and motivated to carry out practical procedures when it matters the most. Paramedics and doctors undertake a series of high-fidelity scenarios where their skills are put to the test.To ensure robustness in the process, our Medical Leads were externally validated forthe first time this year, to enable them to assess our clinicians to the same exacting standards. Our expanded Stokenchurch footprint included the development of a bespoke Pre-Hospital Education Centre.The centre officially opened on 9th January 2024, with the first course being held just one week later. Our new education centre gives our crew access to state-of-the-art facilities and bespoke training areas. For example, our skills Sulte, where our crew are assessed on complex medical procedures. Or the immersive suite. with a resuscitation bay and a fully furnished living room. to help crews train in realistic settings. This represents a huge milestone in our wider strategic journey and commitment to education and life-long learning.we aspire to become a regional and national leader in pre-hospital critical care education. Our new space means we can deliver an annual internal education programme that enables our clinicians to deliver consistent and outstanding critical care, at the scene and beyond. It also gives us the opportunity to work with partner organisations to develop and deliver a range of commercial training courses that focus on pre-hospital critical care. Meet our new clinical educators Our paramedics and doctors are dispatched to the most critical incidents in our community. So. we need to make sure they are trained regularly and always ready for whatever a shift may bring. To help drive forward our ambitious education strategy, this year we introduced the brand-new role of Clinical Educator.This is a job that some of our Critical Care Paramedics are taking on, in addition to their work on the frontline of saving lives. Critical Care Paramedic Emma is one of those Stepping into the new role."My fellow Clinical Educators and I have really hit the ground running'she explains."In January we organised our Review of Clinical Competencies training at our new Pre-Hospital Education Centre. which keeps our clinicians on top of new techniques and best practice. It's all about making sure we are as prepared as possible for the range of intense Situations we can find ourselves in." Our training keeps crews feeling confident in how to deal with the highest priority incidents and we use some amazing kit to make it as realistic as possible.Training like this means our crews are ready for every eventuality. But it wouldn't be possible without your support. So, from Emma and the rest of our education team, thankyou for keeping our crew at the pinnacle of what's possible. "From lrfelike manikins of all ages to staged simulations, we make our education space feel as muth like a real Kene as we (an. We are always reflerting on how we (an make our training more realistic and immersive. We have people arting as bystanders and we often stage scenarios outside, to replicate the types of dirtrartions we might face in real lrfe.Thisall means we can prartise procedures rangingfrom suryical airways to emergen(y c-sertions. These tethniques prepare our crews to help save lives." Emma Gray, Clinical Educator {Critical Care Paramedic) 13 CPR champions workto close the'confidence gap, "In November 2022,1 suffered a cardiac aThest whilst driving to work. Thankfully, a Thames Valley Air Ambulance (rew were soon on the scene. giving me lifesaving CPR and defibrillation. The amazing care they provided is the reason I'm here today. What happened to me inspired me to'pay itforward, and become a CPR (hampion. I hope I can give people the confidence to help when every second (ounts. They might just ￿ve a life like mine." According to our research, almost a third of people in our community would not feel confident giving CPR if they witnessed a cardiac arrest, despite 57% receiving some form of CPR training in the past. Only 39Wo would feel confident using an automated external defibrillator (AED). indeed one in ten (9 % ) did not know what a defibrillator was. Almost half of those surveyed {4696} said fear of doing harm would be the reason they did not step in. Jane Kidd, CPR (hampion With 6096 of the out-of-hospital cardiac arrests we attend happening in the home and over a quarter 128¥01 in a public place, this year we urged people to get clued up on what to do if they witness a cardiac arrest. We called on people to volunteer for our new CPR Champions scheme and were overwhelmed with enthusiastic responses. We now have 15 trained volunteers delivering CPR awareness courses across Berkshire, Buckinghamshire and Oxfordshire. They are working to boost confidence and knowledge in our community. By empowering people to step in. our CPR Champions could one day save a life. BOOK A SESSION WITH A CPR CHAMPION o o o t)tJEJ 1/3 39% 46% A third of people in our community would not feel confident giving CPR Only 39% would feel confident using an automated external defibrillator (AED) Almost half of those surveyed (46 %) said fear of doing harm would be the reason they did not step in. 14 How you supported us 111 Our total fundraising income was £11.9m You helped us raise nearly £12m this year through Cost of a mission £2,100 Lottery is the average cost of each Critical Care Response Vehicle mission Legaaes £3,950 is the average cost of each helicopter mission Individual giving For every £1 spent Community income £1 Trusts and foundations Raffle £0.4m 64p Corporate donations operating our lifesaving service 36p generating funds to ntinue being there for our community in the future 15 What's next? You've read about our exciting education centre, which opened its doors during this reporting period. In April 2024, we then moved our ground operations from RAF Benson to Stokenchurch House, meaning our crew are more readily available and better located for reaching the patients who need us at the start and end of shifts. It also means most staff are based in one location for the first time. 2024 Our ground operations relocated The feedback from the crew. as well as Operations Support staff, has been resoundingly positive about the benefits of the new space in terms of efficiency and teamwork. We look forward to sharing more about the impact of this move with you, our supporters. QY69 OKF We have been celebrating our 25th anniversary throughout 2024, with our Big Birthday Bash held in June. We hope you were able to join us to celebrate this milestone year. Here's to the next 251 READ OUR RECENTSTORIES 2024 We celebrated our 25th anniversary FIND OUT MORE ABO_UTTHA¥ES YALLEY AlRA4IULIXEH￿ * Iv￿RA￿S 11- > 16 PONSE Financial review Trustees report for the year ended 31A March 2024 The Trustees (who are also directors of the charity for the purposes of the Companies Act) present their annual report together with the audited financial statements ofThames Valley Air Ambulance {the charity and the Group) for the year ended 31" March 2024.The Trustees confirm that the annual report and financial statements of the charity and the Group comply with the current Statutory requirements, the requirements of the charity and the Group's governing document and the provisions of the "Statement of Recommended Practice (SORP)" Accounting and Reporting by Charities. 17 Review of activities The result5 of the year to 31" March 2024 and financial position of the charity at that date are as shown in the financial statements later in this document. The result for the year was a total gross income of £12.7 million1£12.2 million excluding investment gains) with a net increase in funds of £0.5 million, bringing total funds to £16.3 million.These funds are earmarked as outlined below in the charity s reserves policy. Fundraising income grew to almost £12m, which is a key milestone in our fundraising growth strategy. This demonstrates the incredible support of our donors, who continue to donate and fundraise even with the backdrop of a cost-of-living crisis where many households are struggling financially. We are so grateful for the unwavering supportthe charity receives from the local community and beyond. The principal sources of income are shown below, and in further detail in the notes to the financial statements. 202>24 £m 2022-23 £m Source of income Lottery Individual giving Legacies Community income Other income 2.6 Trusts & foundations Corporate donations Raffle 0.4 GrandTotal 122 Fundraising income of £1 1.9m is calculated as total income less"other income.. Other income include5 bank interest, gifts in kind and income from charitable activities. The results in this set of accounts are for the Group, which include the charitys two wholly owned subsidiaries, Thames Valley Air Ambulance (Trading) Limited, and Thamesvalley Air Ambulance (Leasing) Limited.The latter was established to operate the finance lease with Babcockfor the helicopter acquired in 2015- this arrangement has now come to an end and the Leasing company is now dormant.The trading subsidiary carries out various activities, but the majority of income is from textile recycling. Profit5 made by both subsidiaries are Gift Aided to the charity under existing HMRC legislation. so that no corporation tax become5 payable. 18 Charitable expenditure Of the total expenditure of £12.2m. £7.9m was spent on charitable activities and £4.4m was spent raising further funds to continue operating the service in future years.This means that for every £1 spent, 64p was spent operating the air ambulance service, with 36p being spent on generating funds to ensure we can continue to operate the service in the future. £7.9m Charitable expenditure £4.4m Raising funds Investment policy and performance Investments have been held with two fund managers. Cazenove Capital and CCLA Investment Managers Limited. since 2015.TheTrustees regularly review the charity's investments. to ensure there is an appropriate balance of risklreturn, that is considered alongside the overall financial performance of the charity.The business plan is considered to ensure thatfuture cash needs are taken into consideration when deciding on the range of investments held. These investments are held on a long-term basis.The service provided by Cazenove is a discretionary service, so day to day investment decisions are taken bythem, guided by the investment policy set byThames Valley Air Ambulance. Both funds have made satisfactory returns since investing, and generated returns that are commensurate withTrustees'expectations. The charity holds a significant portion of its investments in a sustainable growth fund with Cazenove.This fund is focussed on investments that demonstrate strong environmental, social and governance IESGI principles, and is part of the charity's strategy to become more sustainable in the long term. In addition,Thames Valley Air Ambulance's wholly owned subsidiaryThamesValley Air Ambulance (Leasing) Limited purchased a helicopter in 2015.The helicopter was then transferred to Babcock under a long term finance lease arrangement, whereby Babcock repaid the loan to the charity over a number of years, with a fixed rate of return being generated.This arrangement came to end in September 2022 with the loan balance being repaid to the charity. Trustees consider that they have adopted an appropriately balanced approach to risk and returns forthe reserves currently being held, which is suitably prudent and long term in its approach. 19 Reserves policy A new reserves policy was adopted in May 2022. which outlined the charity's approach to funds over the course of the new strategy period12022 onwards). It also clarified the language used around funds and reserves. with reserves defined as- "Reserves are that part of a charity's unrestricted funds that are freely available to spend on any of the charity's purposes." It also specified that the fixed asset fund would be reported as part of designated funds, rather than general funds. This means that effectively, reserves and general funds are one and the same thing in this set of accounts. which the charity hopes provides more transparency over its approach to reserves. Under the policy, the target level of reserves is set to cover a doomsday scenario involving a catastrophic1055 of income, leading to the organisation being unable to continue to operate as a going concern. If it was then deemed that the charity would be unable to recover. continuity of patient care is of paramount importance and therefore the reserves target is set as six months net expenditure with a 50% drop in income, plus a further six months of operational and support costs to ensure the charity can carry out a managed winding down and passing of the critical care service onto another provider. When the budget for 2023-24 was set. this target amounted to £8.7m. During the year,Trustees agreed to hold the following designated funds: The existing technology fund. established in the previousfinancial year. will be maintained at £150k A new aircraft maintenance fund, to coverthe cost of replacing significant parts not covered under our maintenance agreements (mainly displays and avionics) - £IOOk A new risk fund, to cover risks around legal and professional fees. insurance excesses. and doctor costs- £50k Total funds at the end of the financial year were £16.3m, of which £12.5m were held as general funds, compared to the target of £8.7m.This is summarised in the belowtable. Reserves Restricted funds £000 443 Designated fund-fixed assets 3.036 Designated fund-technology Designated fund - aircraft maintenance Designated fund - risk General funds 150 50 12,473 Total 16,252 In line with the strategy. the charity is planning on running deficit budgets for two to three years in order to invest in the future of the organisation, enabling us to continue providing and improving the lifesaving service that we operate while also bringing our reserves levels closer to the target set out in the policy. 20 Risk management The charity has a well-established risk management system in place.This is led by the Director of Operations (Quality and Patient Safety) and actively managed by the Head of Data Protection and Compliance.The framework is used to identify and manage key risks that could affect the charity's ability to meet its objectives, and to agree, implement and monitor mitigation measures where necessaryto manage those risks. The impact and likelihood of occurrence of each risk is carefully reviewed. to ensure each risk gets appropriate management attention. During the lastyear all risks have undergone a detailed review to apply the charity's risk appetite statement, with each risk being categorised accordingly. The most significant risks and their associated mitigation measures are reviewed at each committee and Board meeting, with the full risk register reviewed at Board level on an annual basis. In addition, the three sub- committees regularly review the key risks that specifically applyto their areas of responsibility. The risk5 Wlth the highest residual ratings li.e. after control measures have been put in place) on the risk register at the end of the financial year are summarised below. alongside actions taken to mitigate the impact of these risks on the charity. Risk Measure5 taken to mitlgate Regular vulnerability scanning, staff awareness training, Cyber E55entia15 accreditation, data encryption, MFA and firewall5. Excessive retention of special category, DPIAS carried out for all relevant data activities, Information patient identifiable data or personal Sharing Protocols and Data Sharing Agreements in use, retention data results in non-compliance with register in place, Privacy Policy kept up to date and published on UK GDPR principles website, training for staff. Mid-air collision laircraftl Appropriate training for aviation staff, equipment including traffic collision avoidance systems, radar coverage from external agencies. Contract and regular reviews. effective management and reporting at quarterly Teviews, quality control calls implemented, SUPFX)rt in recruitment of new canvassers. Cyber security Lottery provider fails either as a key Source of funding for the charity or due to their failure to meet regulatory requirements Loose articles in the aircraft causing interference with flying control Appropriate training provided to crews. appropriate clothing provided, aircraft cabin cleaning and inspections implemented, restraining strap provided. TheTrustees recognise the need for adequate financial controls to enable the charityto effectively manage the resources under its control.The existing financial controls are reviewed regularly by the executive team and Trustees, and they are regularly updated by management within a system of continuous improvement. Trustees and senior management are requested at each Board of Trustees meeting to identify any potential conflicts of interest between them and the charity. and annually in a process that is overseen bythe charity's auditors. 21 Structure, governance and management Public benefit Thames Valley Air Ambulance provides a critical care emergency service by air ambulance or CCRV, and medical crew who are available for tasking in response to 999 emergency calls 365 days a year. All assets and their crews are able to bring an enhanced level of medical care to patients. While the helicopter can convey patients to the most appropriate hospital or medical facility. those to whom a CCRV responds are conveyed by land ambulance if required. The charity also offers support to patients. their families, and crews who have been involved in any incidents attended byThames Valley Air Ambulance, through patient liaison service Aftercare. TheTrustees run the charity with due regard to the public benefit guidance issued by the Charity Commission, and the Charities Act 2022. Governing document TheThames Valley Air Ambulance is a company limited by guarantee governed by its Memorandum and Articles of Association dated 29th June 2021. It is registered in England as a charity with the Charity Commission (registered number 1084910). The charity has two wholly owned subsidiaries.ThamesValley Air Ambulance (Trading) Limited, which has been established for a number of years to manage the charity's trading activities. andThamesValley Air Ambulance (Leasingl Limited, which is currently dormant. The Board and committees TheTrustees exercise governance by meeting as a Board every quarter to review strategy and performance, oversee risks, and ensure that the charity complies with all legal and regulatory requirements.Three committees to the Board of Trustees also meet every quarter- they are- Fundraising and Engagement, Medical and Operations, and Risk, Finance and Planning. A fourth committee. Remuneration. meets as required but at least annually.These committees report on relevant issues to the Board ofTrustees. and oversee the main risks relevant to their specific areas of responsibility. Each committee comprises a numberof appointed Trustees, with the CEO and members of the Executive Team attending as required. The Board's overall purpose is to set strategyfor the charity, and to ensure that the management are delivering on the agreed objectives for the charity.TheTrustees ensure that the charity is operated against a frameworkof achieving a clear public benefit. Within the charity, emphasis is put on building good working relationships between Trustees and senior members of the charityto ensure Board and committee meetings fulfil their objectives. A key part of this 15 offering the opportunity forTrustees to meet on a regular basis in person.This is achieved in two ways, firstly by arranging for Board meetings to take place face to face and secondly via regular away days.The away days allow for deeper learning and more detailed conversations on a variety of topics. 22 Appointment of new Trustees Clear rules are in place in the Articles of Association and TrusteeTerm Policy for the length of tenure forTrustees. NewTrustees are generally recruited using a specialist recruitment firm. who manage the initial part of the process working closely with the Chair. An interview process with a number of the existingTrustees then follows. to ensure that the Board maintains an appropriate blend of skills to manage all aspects of the running of the charity. All new Trustees receive a comprehensive induction into the workings of the charity. ThreeTrustees retired during the year.The retiring Trustees were Richard Pearce, David Davis and the Chair, Sarah Roberts.The current Board of Trustees would like to thank them all for their service to the charity. The charity wishes to highlight the tremendous impact that Sarah Roberts had during her time as Chair, overseeing a number of huge successes such as receiving an"Outstanding"rating from the Care Quality Commission, obtaining our Air Operations Certificate. and expanding our headquarter5, a5 well as being a passionate, dedicated and approachable leader. Joining the Board during the year are two newTrustees- Hamish Cormackand Chris Bannister. Chris Bannister has been elected as the charity's Chair. Trustee training and induction Once aTrustee is appointed they are sent a variety of documentation to enable them to familiarise themselves with the inner workings of the organisation.The charity's Governance Book covers the Articles of Association, Trustee Role Profiles and Committee Terms of Reference, amongst a number of other documents. The Trustees are also given access to the charity's risk register and bank of policies. Continuing their induction, newTrustees have a series of meetings with senior members of staff across the organisation and otherTrustees so that they obtain an initial overview of the whole organisation and have the opportunity to ask que5tions.They are also encouraged to visit headquarters where they will informally meet Staff. The charity's Operations and Clinical Education space is now based at headquarters, which will allowTrustee5 to also hear from staff who work on the operational side of the charity, with an opportunity to see the Critical Care Responsevehicles up close, view demonstrations of skills from clinical staff and ask any questions they may have. An induction visit to RAF Benson, to see where the helicopter is based, will continue to be encouraged. 23 Once aTrustee takes up their role with Thames Valley Air Ambulance they are required to complete a suite of online training with topics ranging from health and safety to GDPR compliance. All Trustees are required to complete this training every two years.Trustees with a clinical background also complete some further modules. On a continuing basis, Trustees will also be sent information about relevant courses and training to enable them to select any that they feel will assist their ongoing development. Staff and volunteers As at 31 St March 2024 there were 103 volunteers active across the three counties helping the charity (an increase from 74 at the end of the prioryearl. The charity has recruited new volunteers across all volunteer roles. including 15 volunteers in the new CPR Champion role who will be delivering a CPR Awareness project across the three counties. An updated volunteer strategy will be in place from 2024-25. in line with the NCVO'sVision forvolunteering, as well as the Investing in Volunteers Quality standard. which the charity will be looking to attain in 2025-26. Further new volunteering roles are under development across the charity, such as the Operations Support Volunteer role and the Thanking Champion role.we continue to look at how to broaden our corporate volunteering offer. The volunteer community is being strengthened through opportunities to meet up, and recognition of the role ourvolunteers play highlighted across the organisation. It is notable that 7 volunteers have also now become legacy pledgers. further underlining the strong commitment many of our volunteers have toThamesValley Air Ambulance. The charity relies heavily on its volunteers, who will continue to play a pivotal role in its fundraising activities and acting as charity ambassadors in contact with the communities of Berkshire, Oxfordshire and Buckinghamshire. Our trustees also act in a voluntary capacity. During the year ended 31, March 2024. the charity had an average of 128 full or part-time staff. A new pay policy was implemented in March 2023, which ensures that all roles are benchmarked at least annually. Any pay policy changes are approved by the CEO. Notwithstanding this. the level of remuneration for the CEO and COO is set by the Remuneration Committee, who also Set the annual cost of living award for staff.The Board approve the budget for staff salaries on an annual basis. Regulation The charity is regulated by the Charity Commission under its status as a registered charity and by the Gambling Commission for its lottery and raffle activities.The charity has also paid its voluntary levy to the Fundraising Regulatorfor the current year and is subscribed as an organisational member of the Chartered Institute of Fundraising. As an independent healthcare provider,Thames Valley Air Ambulance is registered with the Care Quality Commission {CQCI.The Registered Manager is Adam Panter, and the Nominated Individual is Amanda McLean. During the most recent CQC inspection. carried out in January 2020. the charity received an Outstanding rating. The charity is also regulated by the Civil Aviation Authority ICAAI. as a result of running an Air Operator Certificate IAOCI in-house. 24 Approach to fundraising Like many charities,ThamesValley Air Ambulance relies solely on the financial support of the community it serves, and receives no regular government funding. We employ staff whose primary role is to undertake fundraising activities, supporting and stewarding those individuals and groups that are raising funds on our behalf. Our fundraising staff are expected to act in a professional manner at all times. followthe Fundraising Regulator's Code of Conduct, and, are encouraged to undertake training with the Chartered Institute of Fundraising to develop their knowledge. Fundraising staff receive a salary. but do not have the opportunityto earn a performance bonus. In addition, we work with Lottery Fundraising Services (LFS), a third-party fundraiser, to manage and develop our highly successful lottery, and to recruit new supporters to our committed giving program. LFS employs a team of canvassers that are dedicated toThamesValley Air Ambulance, to find new supporters that wish to support the charity, plus some back office staff to provide the administration and management required to operate our lottery. Canvassers are inducted byThamesValley Air Ambulance when they firstjoin the team. and receive a full induction from LFS, focusing on the LFS Canvassers Charter. the Gambling Commission Licensing Codes and Conditions of Practice. Fundraising Regulator Code of Practice. and on the Standards of behaviour expected when they interact with the public. All of the staff at LFS are qualified as"Dementia Friends'through the Alzheimer's Society's accreditation to protect vulnerable persons. Thames Valley Air Ambulance is subscribed as an organisational memberof the Chartered Institute of Fundraising, and is a paid up member of the Fundraising Regulator. BothThamesValley Air Ambulance and LFS hold a society lottery licence with the Gambling Commission. remaining compliant with their codes of practice respectively. LFS is a registered ELM (External Lottery Management company). On an ad-hoc and infrequent ba5isThames Valley Air Ambulance has used professional telephone and face-to-face fundraising suppliers to recruit and re-engage with donors, who all record calls, and jointly induct theirteams with Thames Valley Air Ambulance. Any complaints our fundraising activity may generate are recorded and investigated by the fundraiser and reviewed by the appropriate line manager to ensure future learning opportunities in fundraising.ThamesValley Air Ambulance is pleased that our fundraising activity generates few complaints annually- during the financial year 2023-24, 38 complaints were received, and all were resolved12022-23- 37 complaints, all resolved). 25 Statement of Trustees, responsibilities Statement of Trustees, responsibilities TheTrustees (who are also the directors ofThames Valley Air Ambulance for the purposes of company law) are responsible for preparing the Trustees'Report lincluding the group strategic report) and the financial statements in accordance with applicable law and United Kingdom Accounting Standards Iunited Kingdom Generally Accepted Accounting Practice). Company law requires theTrustees to prepare financial statements for each financial year. Under company law theTrustees must not approve the financial statements unless they are sat15fied that they give a true and fairview of the state of affairs of the charitable company and the Group and of the incoming resources and application of resources, including the income and expenditure, of the charitable group for that period. In preparing those financial statements. the Trustees are required to: Select suitable accounting policies and then apply them consistently: Observe the methods and principles in the Charities SORP: Makejudgments and estimates that are reasonable and prudent", State whether applicable UKAccounting Standard5 have been followed, subject to any material departures disclosed and explained in the financial statements; and Prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charitable group will continue in operation. TheTrustees are responsible for keeping adequate accounting records that are sufficient to show and explain the charitable company and the Group's transactions, and disclose with reasonable accuracy at any time the financial position of the charitable group, and enable them to ensure that the financial statements comply with the Companies Act 2006.They are also responsible for safeguarding the assets of the charitable company and the Group and hence fortaking reasonable steps for the prevention and detection of fraud and other irregularities. TheTrustees are responsible for the maintenance and integrity of the corporate and financial information on the charitable companys website. Legislation in the United Kingdom governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions. Provision of information to auditor Each of the persons who areTrustees at the time when thisTrustees'Report is approved has confirmed that: so far as that Trustee is aware. there is no relevant audit information of which the charitable groups auditor are unaware.and thatTrustee has taken all the steps that ought to have been taken as a Trustee, in order to be aware of any information needed by the charitable group's auditor in connection with preparing their report, and to establish that the charitable group's auditors are aware of that information. This report, incorporating the Group strategic report, was approved bytheTrustees, in their capacity as Company Directors, on 15th October 2024, and signed on their behalf, by: Chris Bannister, Chair 26 Independent Auditor's Report to the members of Thames Valley AirAmbulance Opinion We have audited the financial statements ofThamesValley Air Ambulance for the year ended 31" March 2024 which comprise the Consolidated Statement of Financial Activities, the Group and Charitable Company s Balance Sheets, Consolidated Statement of Cash Flows, and notes to the financial statements, 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: Give a true and fair view of the state of the groups and of the parent charitable company's affairs as at 31, March 2024 and of the groups and parent charitable company's net movement in funds, including the income and expenditure, forthe year then ended- Have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice; and Have been prepared in accordance with the requirements of the Companies Act 2006. Basis for opinion We conducted our audit in accordance with International Standards on Auditing IUKI IISAS IUKII 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 group 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 theTrustees'use of the going concern basis of accounting in the preparation of the financial statements is appropriate. Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the group's ability to continue as a going concern for a period of at least 12 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. 27 Other information TheTrustees are responsible for the other information.The other infomiation comprises the information included in theTrustees'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. In connection with our audit of the financial statements. 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 audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements. we are required to determine whether there is a material misstatement in the financial statements or a material misstatement of the other information. If, based on the work we have performed, we conclude that there is a material mi55tatement of thi5 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: The information given in theTrustees'Report (which includes the Strategic report and the directors, report prepared for the purposes of company law) for the financial yearfor which the financial statements are prepared is consistent with the financial statements; and The strategic report and the directors'report included within theTrustees'Report have been prepared in accordance with applicable legal requirements. Matters on which we are required to report by exception In light of the knowledge and understanding of the group and the parent charitable company and its environment obtained in the course of the audit, we have not identified material misstatements in theTrustees'Report (which incorporates the strategic report and the directors'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: Adequate accounting records have not been kept by the parent charitable company; or The parent charitable company financial statements are not in agreement with the accounting records and returns,. or Certain disclosures ofTrustees'remuneration specified by law are not made", or We have not received all the information and explanations we require for our audit. 28 Responsibilities of Trustees for the financial statements As explained more fully in theTrustees'responsibilities statement set out on 26 theTrustees (who are also the directors of the charitable companyfor the purposes of company lawl 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 theTrustees 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, theTrustees are responsible for assessing the group's and the parent charitable company s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless theTrustees either intend to liquidate the group orthe parent charitable company orto 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 aboutwhetherthe 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 {UKI 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 procedure5 are capable of detecting irregularitie5, including fraud is detailed below. Based on our understanding of the group and the environment in which it operates, we identified that the principal risks of non-compliance with laws and regulations related to charity and Company Law applicable in England and Wales and compliance with the requirements of the Care Quality Commission, and we considered the extent to which non-compliance might have a material effect on the financial statements.we also considered those laws and regulations that have a direct impact on the preparation of the financial statements such as the Companies Act 2006 and the Charities Act 2011. We evaluated management's incentives and opportunities forfraudulent manipulation of the financial statements (including the risk of override of controls), and determined that the principal risks were related to posting inappropriatejournal entries to revenue and management bias in accounting estimates. Audit procedures performed by the engagement team included: Inspecting correspondence with regulators and tax authorities; Discussions with management including consideration of known or suspected instances of non- compliance with laws and regulation and fraud; Evaluating management's controls designed to prevent and detect irregularities,- Identifying and testing journals. and Challenging assumptions andjudgements made by management in theircritical accounting estimates. 29 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 statetnents or non-compliance with regulation.Thi5 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 for the audit of the financial statements is located on the Financial Reporting Council's website at: www.frc.org.ukJauditorsresponsibilities.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, forthis report, orfor the opinions we have formed. Lee Stokes (Senior Statutory Auditor) For and on behalf of Haysmacintyre LLP, Statutory Auditor 10 Queen Street Place, London, EC4R I AG Date: 2211012024 30 Financial statements Consolidated statement of financial artivities (incorporating an income and expenditure account) Forthe year ended 31st Marth 2024 Unrestricted fund5 2024 Restricted funds 2024 Total funds 2024 Total funds 2023 Note Income from: Donations and legacies Charitable activities Other trading activities Investments 7,444,580 65.282 4,071,204 147.647 11.728,713 502,415 7.946,995 65.282 4.071,204 147.647 12,231,128 6,669,078 12.220 4,274,127 106.117 11,061,542 Total infome 502,415 Expenditure on: Raising fund5 Charitable activities 4,386,923 7.659.765 12.046ffj88 4.386,923 7,862.412 12.249,335 4,112,518 7.310.110 11,422,628 202.647 202,647 Total expenditure Net gains / Ilossesl on investments IL055esl / gains on foreign exchange 15 526.597 526.597 1355.2911 21,465 121,9901 121,990) Net income / lexpenditurel 186,632 299,768 486.400 1694,9121 Net movement in funds 186.632 299.768 486.400 1694,9121 Reconciliation of funds: Total funds brought forward Total funds carried forward 15,622,468 15.809.100 142,905 442,673 15,765,373 16,251.773 16,460,285 15,765,373 The consolidated statement of financial activities includes all gains and losses recognised in the year. All transactions are derived from continuing activities. The notes on pages 35 to 58 form part of thesefinancial statements. 31 Consolidated balance sheet As at 31st March 2024 Company number: 04062250 2024 2023 Note Fixed assets Tangible assets Investments 14 15 3,335,452 7,771,411 2,508,773 6,744,814 Total fixed assets 11.106,863 9.253,587 Current asset5 Stock Debtors due within one year Cash at bank and in hand 16 17 23 3,574 2,718,341 5,024,266 7,746.181 3,647,131 2,752,929 6,400,545 Total current assets Creditor5'. amounts falling due within one year Net current assets 18 11,200,5821 11,193,435) 5,199,963 6,552.746 Total a55et5 le55 current liabilitie5 16.306,826 15,806,333 Provisions 19 155.0531 140.9601 Total net a55ets 16.251,773 15.765,373 Charity funds Restricted funds 20 442,673 142,905 Unrestricted funds Designated funds General funds 20 20 3,335,758 12.473.342 2,944,096 12.678.372 Total unrestricted funds 15,809,100 15,622,468 Total funds 16,251,773 15.765,373 Thefinancial statements were approved and authorised for issue bytheTrustees and signed on their behalf by: Christopher Bannister Ichairl Paul Dilley (Trusteel Date: 15th October 2024 The notes on pages 35 to 58 form part of these financial statement& 32 Charity balance sheet As at 3151 March 2024 Company number: 04062250 2024 2023 Note Fixed assets Tangible assets Investments 14 15 3.335.452 7,771,413 11,106.865 2.508.773 7,244,815 9,753.588 Total fixed assets Current asset5 Debtors due after more than one year Cash at bank and in hand 17 3,628,544 2,701,430 6,329,974 2,717,761 4,415,288 7,133,049 Total current assets Creditors.. amounts falling due within one year Net current assets 18 11.193.527) 5,136,447 11,181.7411 5,951,308 Total a55et5 le55 current liabilitie5 16.243,312 15.704,896 Provisions for liabilities 19 155,0531 140,9601 Total net assets 16,188.259 15,663,936 Charity funds Restricted funds 20 442,673 142,905 Unrestricted funds Designated funds General funds 20 20 3,335,758 12,409,828 15,745,586 2,944,096 12,576,935 15,521,031 Total unrestricted funds Total funds 16,188,259 15,663,936 The surplus for the year for Companies Act purposes comprises the net income for the year plus other realised gains and losses and was a surplus of £524,32312023: deficit of £611,897). Thefinancial statements were approved and authorised for issue bytheTrustees and signed on their behalf by: Christopher Bannister Ichairl Paul Dilley (Trusteel Date: 15" October 2024 The notes on pages 35 to 58 form part ofthese financial statement& 33 Consolidated statement of cash flows For the year ended 31st March 2024 2024 2023 Note Cash flows from operating activities Net cash used in operating activities 22 1706,4141 12,091,854) Cash flows from investing activities Income from investments Purchase of tangible fixed assets Purchase of investments Proceeds from sale of investments 147,647 11.211.570) 11,097,618) 597.618 11,564,923) 106,117 1948,2721 1875,0001 875.000 1842,155) 14 15 15 Net cash used in investing a