Magpas,. . AIR AMBULANCE Magpas Air Ambulance Annual Report 2023-24 MagpasAirAmbulance magpasairambulance Magpas_charity magpas.org.uk ar arah Walter MAGPAS AIR AMBULANCL- ANNUAL REPORT 2023-24 CONTENTS WELCOME.......... OUR YEAR IN NUMBERS..................... OUR PURPOSE & CULTURE........................................ STATEMENT OFPUBLIC BENEFIT..................................... . OUR VISION, MISSION & VALUES......... OUR HISTORY.................. OUR STRATEGIC GOALS 2023-28............................... 10 REFLECTING ON OUR 2023-24 ACHIEVEMENTS ....... 12 13 ADVANCING KNOWLEDGE & SKILLS..................................... 19 24 32 REPORTS, ACCOUNTS & ADMINISTRATIVE DEfAILS... 36 TRUSTEES'RESPONSIBILITIES STATEMENT........................... 37 INDEPENDENT AUDITORS'REPORT....................................... 38 OUTSTANDING PATIENT CARE... SUSTAINABILITY & RESILIENCE........................................... NUR TURING POSITIVE PAR TNERSHIPS . FINANCIAL REVIEW & ACCOUNTS......... 42 REFERENCE & ADMINISTRATIVE DETAILS............................. 63 ' *,i￿)I MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023_24 Welcome from our CEO, CHAIR & MEDICAL DIRECTOR The 2023-24 annual report and accounts provides us with an opportunity for us to reflect on the past year. We are pleased to share some of the significant steps and milestones that Magpas Air Ambulance has celebrated over the last 12 months. team provides is only possible thanks to you-our supporters! One of our biggest achievements in 2023 was the opening of our purpose-built airbase, HQ and training facility. At last, giving our clinical team one of the best air ambulance facilities in the UK, with high fidelity simulation training rooms, crew welfare facilities and a dedicated area for patients and their families. The bespoke design of the facility was entirely planned to flow in a way that saves vital minutes in our activations, which has meant that we have been able to get to many more patients in need and provide lifesaving clinical interventions in medical emergencies even faster. In that time, thanks to our wonderful supporters and the efforts of our dedicated staff, we have made significant progress towards achieving our strategic objectives, as well as laying the groundwork for even more exciting developments to come. In 2023-24, Magpas Air Ambulance experienced its busiest year on record, with our advanced medical team being dispatched to 1,981 patients in life- threatening emergencies across 13 counties. This was an 18.5/0 increase in activations compared to the previous financial year, evidencing the increasing need for this vital service in the East of England and beyond. We were pleased to host our Royal Patron, Her Royal Highness The Princess Royal, who officially opened our new building in September 2023 and welcomed hundreds of supporters and stakeholders. During the visit. The Princess Royal met our clinicians and patients to hear about the huge difference this facility will bring to our team, as well as to the people of Cambridgeshire, Bedfordshire and surrounding counties. For 53 years, Magpas Air Ambulance has been there for our patients, and their needs remain at the foref ront of everything we do as an organisation. However, the lifesaving care our medical MAGPAS AIR AMBULANCE= ANNUAL REPORT 2023-24 It was also our privilege to award 30 of our doctors, paramedics and aviation crew with their Coronation Medals from His Majesty King Charles111; these medals were awarded to frontline workers who have given a huge amount of commitment to providing urgent care in the five years leading up to the coronation. in and around Peterborough and the Fenland area. Every year, we need to raise £6.5million to provide our air ambulance service 24/7. and it is only with the support of the communities we serve that we can achieve this. Thank you for helping us be there for patients in their moment of need. In the last year we have continued to operate three dedicated clinical services. comprising," our primary service, based in Cambridgeshire, where our team responds via helicopter and rapid response vehicles (RRV) 24/7- our Luton service, which sees a doctor paramedic team operating two days a week, serving the Bedfordshire community via a RRV; and our Advanced Paramedic (AP) service, which sees four of our most experienced paramedics responding solo via RRV in Cambridgeshire, particularly Finally, we would like to take this opportunity to thank our workforce for their significant contributions to the outstanding performance of this service in the past year. Magpas Air Ambulance is proud of the dedicated and caring culture we have created-something many describe as a family. Thank you to everyone who makes it such a great family and one we are all so proud to be a part of. Daryl Brown John Bridge Dr Simon Lewis DipHE BA MA MBE DL OBE DL FRCEM FIMC Chief Executive Officer Chair of the Board of Trustees Medical Director MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 Ouryear IN NUMBERS Our team was called (xrt to thats Q 1,981 18.5% emergency missions... more activations than the previous 12 months They travelled provided and treated 103k 1,817 air & road miles... hours of lifesaving care... 1,167 a patients in need 598 including hospita14evel treatments were given... 54 95 164 surgical procedures sedations general anaesthetics Ill KV71 YFM MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 IKAMBULAh I11!ryl: We moved into now home to brand new purposfrbuift base in Alconbury Weald, fomally opened by HRH The Princess Royal... ou oa DU DO 45 33 clinical staff charty Staff We received donations of from over £6m+ 52,000 to support our lifesaving service... incredible supporters ..thaYs We filmed volunteers donated their time and resources to support us... 38% episodes of the new series, Rescue 999.. Seconds to Save a Life more than last year Our communty team trained former patients and famity members engaged in our new Patient Voices forum 7,015 people how to deliver lifesaving CPR MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 Our purpose Magpas Air Ambulance trustees have given careful consideration to the Charity Commission's guidance on the Public Benefit Requirement under the Charities Act 2011; setting the charity s objectives, activities and services with this in mind. As Magpas Air Ambulance benefits the public by providing anybody in the East of England and beyond with potentially lifesaving pre-hospital emergency medicine-whenever they need it, wherever they need it, and at no cost-the trustees consider that the charity meets :: . the important principles of the public benefit requirement. Our vision Deliver the best pre-hospital emeryency care to our patients. Our mission To save lives and limit disability by tsking enhanced emergency care to patients in their moment of need. Our values We are caring, pioneering, dedicated and proud. rf4a MAGPAS AIR AMBULANCE= ANNUAL REPORT 2023-24 Our history SAVING LIVES SINCE 1971 In 1971, two local GPS, Dr Neville Silverston MBE and Dr Derek Cracknell MBE, could see people needlessly dying in road traffic collisions and vowed to do something al)out it. What started out as voluntary GPS responding via pagers and attending road traffic collisions in their own cars, is now the most advanced doctors and critical care paramedics providing specialist pre-hospital emergency medical care to patients across the East of England and beyond, 24/7. Neville explains, °When I set up Magpas over 50 years ago. it was at a time when the UK death rate-as a result of road accidents-was over 8,000 people a year, when the ambulance service was not run by the NHS and there was no such thing as an A&E consultant. Responding via a helicopter air ambulance or one of the charity's three rapid response vehicles, the medical team now provides treatments and surgical procedures wherever their patients. life-threatening incident occurs and attend a huge breadth of medical emergencies. "I recruited 720 GPS in Cambridgeshire to attend every accident in every location, 24 hours a day. With the support of the population we served, we raised the funds to equip every doctor with medical and radio equipment.. But the service we provided was basic, in comparison to what this organisation has become today." Over 50 years on from Derek and Neville's brainchild, Magpas Air Ambulance has treated over 70.000 patients; saving lives and keeping families together for generations. "Magpas AirAm ulance is now a leading air ambulance charity, staffed by specialist doctors and critical care paramedics, and has saved tens of thousands of lives." Neville Silverston MBE and Dr Derek Cracknell MBE MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 Our strategic goals 2023-28 Magpas Air Ambulance produces a comprehensive five-year strategic plan, accompanied by detailed annual objectives. Every year, the achievement of these objectives is reviewed alongside the progress made against the five-year plan. 10 MAGPAS AIR AMBULANCE- ANNUAL REPORT 2023-24 oITrsrANDING PATIEKfcARE ADVANCING KNOWLEDGE frs￿LLS Our goal We will provide outstanding clinical care to all of our patients by investing in training our clinicians; providing cutting edge equipment; and advancing what is currently possible, with a strong underpinning clinical governance to ensure we improve outcomes for our patients. Oiir goil We will ensure the highest standards of quality and outcomes across the organisation through the continual development and growth of training and knowledge for staff, partners and communities in which we serve. Oui. challer)i.j:- We recognise the power of our people and data: however. we are challenged by having the skills, systems and technology to effectively develop performance and knowledge. Our challenge We are challenged by access to clinical and patient data and dedicated time for our clinicians away from patient care, to support professional activities that enhance clinical care. NURTURING POSITIVE PARTNERSHIPS susrAINABILrrY & RESILIENCE Our goal We will establish strong relationships and partnerships. and a reputation that makes us the top choice for collaboration, enabling us to accomplish our charitable aims and mission to the highest standard. Our goal We will create a strong, resilient and caring organisation by investing in diverse and sustainable income streams, minimising our environmental impact and developing the wellbeing and resilience of our people. Our challenge We recognise that working collaboratively and through partnerships is more effective, but we need to develop the skills, capacity and confidence of our people to be able to build and nurture strong relationships. Our challenge We are used to reacting to immediate need and capabilities, but we need to take a longer term view; planning investment in sustainable income streams and reducing our carbon emissions. MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 11 Reflecting on our 2023-24 ACHIEVEMENTS Read on to learn more about how we've performed against our strategic goals in 2023-24. Doctor R" 12 MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 Outstanding patient care The past financial year was Magpas Air Ambulances busiest 12 months on record, as the teams of advanced doctors and paramedics responded to 1,981 emergencies, across 13 counties in and around the East of England-an 18.5% increase on the previous year. In totsl, Magpas Air Ambulance spent 132 more hours saving lives in 2023-24 compared to the previous 12 months. Following the same patterns as recent years, life-threatening medical emergencies such as cardiac arrests remained the number one reason for activation, followed by patients injured in road traffic collisions, accounting for 66 % of the service's emergency call outs combined. The Care Quality Commission Magpas Air Ambulance's service is currently rated 'oLrtstanding' by the Care Quality Commission (CQC). After moving into the new Magpas Air Ambulance base, the charity will be required to have another inspection soon, but this time with Director of Operations, Natalie Church, as the service's registered manager. Positively, of the 358 patients Magpas Air Ambulance treated in cardiac arrest, 71° of them were reported to have received bystander CPR prior to the emergency team's arrival-something the charity is working very hard to increase through its Community CPR training. Outstanding CareQuality Commission There's no doubt that moving into the new Magpas Air Ambulance base, designed for faster dispatch times and located in a more central area near the region's major truck roads, has helped the charity reach even more patients this year. Natalie was appointed to this role in October last year (taking over from the charity CEO), meaning she ensures that everyone who uses the service Magpas Air Ambulance provides has their needs met. As a registered manager, Natalie also shares legal responsibility to meet the requirements of regulations and will be the CQC'S key contact for the service. Magpas Air Ambulance's five clinical leads, focusing on clinical operations, training and development, patient engagement, clinical effectiveness and informatics have also been working hard to push boundaries and improve the service even further over the past 12 months, which you can read more about overthe next few pages. a family we can't thank the Magpas Air Ambulance team enough. To think they walk our streets doing ,,h heroic deeds and facing such tragedies is beyond human expectation. We as a family are in awe of ery single one of you and wanted to let you know our deepest gratitude. With the strongest heartfelt thank you to those that attended that morning, l am forever grateful and in awe of you." A family member of a patient, who sadly could not be saved MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 13 Putting patients and their loved ones first Kate's story The new Magpas Air Ambulance base has a dedicated space for patients and their families to meet the team that treated them and ask questions. away from the bustle of day-to-day operations. "Am I dead?" Kate asked endured just two days bef Kate was riding with her c Kate suffered severe injuri The Magpas Air Ambulanc can perform outside of a h sight-saving surgical proc Kate remained in hospital here I became aware of ho severe head injury. She continues, "When I se emergency medical Care t experience of this charity. I In 2023-24 the charity held its first patient open evening and introduced a new Patient Voices forum. Here, patients and loved ones use their unique perspectives of the service to shape the care Magpas Air Ambulance delivers. Their support influences our communication with future patients and their families, and the aftercare support Magpas Air Ambulance provides to them. This included feeding into the design and wording of the organisation's new'thinking of you, and bereavement cards. "I have such appreciation and deep gratitude for this lifesaving service." 14 MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 e woke up in intensive care, with no recollection of the life-changing accident she had oup when her front wheel went down a pothole, catapulting her off the bike. e hit the ground, including broken ribs. a punctured lung, a fractured skull and a brain bleed. laced Kate under general anaesthetic to protect her traumatic brain injury-a procedure they hanks to their advanced medical training and equipment. They also performed a potentially fore airlifting Kate to Addenbrooke's Hospital. nth and spent another month with the Brain Injury Rehabilitation Trust. Kate explains, -It was ant the early intervention of Magpas Air Ambulance had been." limiting the long-term impact of m Air Ambulances mission statement.. to save lives and limit disability by taking enhanced s in their moment of need, it still almost reduces me to tears. It perfectly summarises my ch appreciation and deep gratitude for this lifesaving service." ¥. MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 15 AIR AMBUUKE oxygenl Arterial lines and point of care testing pressure) more quickly and respond to changes immediately which could increase their chances of survival. Thanks to joint working between clinical and fundraising departments, Magpas Air Ambulance has begun to trial the use of arterial lines for blood pressure readings-a method considered the gold standard when it comes to such monitoring and currently used in intensive care units in hospital. Arterial lines are regularly used in the hospital setting on critically ill patients and offer continuous and accurate readings. alongside a wealth of other valuable insights into a patient's condition (e.g. potassium levels, carbon dioxide levels and a clearer understanding of a patient's heart function). To gain this reading out of hospital, an arterial line is inserted into a patient's peripheral artery using a cannula. The line is then connected to a monitor, which provides accurate, beat-to-beat readings. The charity achieved funding to buy the training equipment and will implement the use of arterial lines in its clinical service in the summer 2024. Magpas Air Ambulance previously used a non-invasive method of monitoring blood pressure with a reading taken every three minutes. Being able to monitor a patient's blood pressure continuously means the team can pick up episodes of hypotension (a drop in a patient's blood Advanced paramedics Magpas Air Ambulance became the first air ambulance charity to work collaboratively with the East of England Ambulance Service NHS Trust to deliver a new resource to Cambridgeshire. 16 MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 itical Care Paramedic James Chalmers & Doctor Fiqry Fadhlillah and the Magpas Air Ambulance teams. In 2023, Magpas Air Ambulance saw its first full year of advanced paramedic provision. In the past 12 months, the service has continued to prove its worth with the four team members responding to 539 patients in need, accounting for 27 % of all of Magpas Air Ambulance's missions. As well as treating seriously ill and injured patients, the advanced paramedics also provide additional support to ambulance crews (who may not have attended traumatic events before), both on scene and with follow up debriefs, to help them process what are often very difficult incidents. The four advanced paramedics providing this additional service have worked with Magpas Air Ambulance for almost 50 years collectively. Between them, they have pushed barriers, raised clinical standards and won awards as they provide the best possible care they can with Magpas Air Ambulance and the ambulance service. Four of the charity's most experienced critical care paramedics took on new roles as advanced paramedics in critical care. These advanced paramedics still work with doctors on board the helicopter, but they also provide critical care working alone in rapid response vehicles too, complementing our existing air ambulance service and allowing us to get to even more patients. In 2023-24, several of the advanced paramedics have also undertaken independent prescribing courses. These university courses will give the paramedics-who are not currently able to prescribe drugs without a doctor present-the authorisation to do so for the patients they see independently, boosting the service they can provide even further. Responding from the Magpas Air Ambulance airbase in Alconbury Weald. the team of advanced paramedics provide the community with dedicated, rapid access to advanced medical care- supporting both the ambulance service °Being deployed to a slightly lower threshold of incident compared to air ambulances means we can prevent MagpasAirAmbulance from being called to something unnecessarily-saving the service for those who need it most-by treating the patient ourselves with the advanced skills we can bring Or we can identify earlier if they need the highest level of care available outside of a hospital, that an air ambulance team provides." Steve Chambers, Advanced Paramedic MAGPAS AIR AMBULANCE. ANNUAL REPORT 2023-24 17 Ap MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 Advancing knowledge & skills Training the next generation of lifesavers Magpas Air Ambulance has been a leading pre-hospital emergency medicine (PHEM) training provider since the early 2000s and the charity worked to get PHEM approved by the General Medical Council as a sub-specialty in 2012. In 2023-24, the charity's Clinical Lead for Training and Development reviewed the training Magpas Air Ambulance provides and added a new element to the two-week course that takes place twice a year: night simulation training. Something that isn't included in other training courses across the country, this portion of the training aims to increase the fidelity of the clinical simulations undertaken. as well as demonstrate the physiological, emotional and mental stress the environment puts the medics under. With 38*0 of Magpas Air Ambulance's missions occurring in the hours of darkness, this training has been invaluable to the clinicians who have not experienced working in the pre-hospital environment before, and has now become a staple of the charity's PHEM training programme. At the end of Magpas Air Ambulance doctors, training periods they take the Fellowship in Immediate Care exam (the highest qualification in PHEM). In 2023-24, Magpas Air Ambulance doctors made up over 50/0 of the medics across the country who passed the national exam (parts A & B) first time. "We both have a background in anaesthetics. so it felt exciting as it was daunting to suddenly use our skills to work on the streets instead of within our safe operating theatres. Magpas Air Ambulance prepares us with a course that simulates this, filled with scenario training and skill stations. The highlight of the course was the evening simulation session. on a dark, cold February night, which was added to the course last year to train us as realistically as possible.- Dr Rob Verheul and Dr Milly Gordon MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 19 Developing skills As well as running the bi-annual training courses, Magpas Air Ambulance provides training and development opportunities for all its clinicians year-round. Over the past 12 months the organisation's clinical leads have worked to find new ways to extend the training provided throughout the year. speakers and experts in their field providing workshops to finesse various clinical skills and expand knowledge. Magpas Air Ambulance has also provided CPD days to external medics this year too. For example, a group of Addenbrooke's Hospital consultants and nurses had slow-time adult and paediatric intubation training to refresh and improve vital skills they may not get to practice very often. Separating what was originally Magpas Air Ambulance's monthly development day into two," now 'learning from cases, provides clinicians with a monthly chance for open and honest retrospective discussion following incidents, and clinical professional development days. have a range of focuses. In 2023-24 Magpas Air Ambulance also worked with emergency services partners, such as Cambridgeshire Fire and Rescue Service, to provide mutually beneficial joint training sessions. These CPD days are open to all of Magpas Air Ambulance's doctors and paramedics, and have included dedicated specialist training sessions, external 20 MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 SWIFT trial This trial is run through NHS Blood and Transplant, and Magpas Air Ambulance has already enrolled 12 patients so far. Magpas Air Ambulance is proud to contribute to clinical trials to support improvement in services and clinical excellence. One trial that began in 2023-24 is SWIFT (the Study of Whole blood in Frontline Trauma), which examines if there is a difference in outcome to patients who are given whole blood or blood components- with whole blood not being used before within the NHS. SWI FT Study of Whole blood In Frontline Trauma We're excited about the opportunity to administer blood pre-hospitally, potentiall making a lifesaving difference for our patients. Thank you foryour support as we hel contribute to groundbreaking pre-hospital research., Shaunna Truskinger. Critical Care Paramedi Suffolk a Ca bridgeshire Bloodrunners www.servsc.org.uk MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 21 Community CPR Magpas:: AIR AMBULANCE In 2023-24, Magpas Air Ambulance trained over 7,000 people in the vital lifesaving skills of CPR and how to use a defibrillator via the Charitys Community CPR programme-a 40% increase on Community -*CPR after the training, 100% of participants came away feeling confident to use their skills in the event of an emergency. In this time frame, Magpas Air Ambulance's Community CPR trainer, supported by a team of volunteers, taught at a variety of community groups. schools and events-including Anglian Water's Time Out for Life, online conference with over 6,000 attendees. Diversity and inclusivity have been a priority this year as Magpas Air Ambulance delivered sessions to women's groups, including Cambridge Diverse Women's groups and Women's Aid Luton. The charity has also worked with the Cambridge GRT Gypsy and Romany Traveller Lead to deliver training at their drop-in centres and sessions were held at Cambridge Regional College for young people with learning difficulties. Magpas Air Ambulance also made the inequalities of CPR between men and women its primary focus on International Women's Day. 2023-24 saw Anglia Ruskin University student paramedics take on a 24-hour CPR-a-thon, which raised money for Magpas Air Ambulance and was even endorsed by Strictly Come Dancing's Craig Revel Horwood. Donate a Day Magpas Air Ambulance's corporate CPR programme, Donate a Day, offers local businesses and organisations the opportunity to train the next generation of community lifesavers-by taking on a day of CPR and defibrillator training for their staff, and an additional day of training for a school or group in their local community. In the past 12 months, the charity facilitated 63 of these sessions. One student from Hazeldene School, which benefitted f rom the Donate a Day programme, commented. "I really enjoyed learning on the light up dummy. I can't wait to tell my mum that I can do it." We lost someone recently to a cardiac arrest. I now feel much more confident I would know what to do if it happened again.- Recipient of Magpas Air Ambulance community CPR training 22 MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 23 14 Sustainability & resilience Planting for Good On Sunday, 26th and Monday, 27th November, 262 green-thumbed volunteers planted more than 2,000 trees at the Magpas Air Ambulance base during National Tree Week, in partnership with the Woodland Trust. designed to minimize its impact on the environment; and create calm and natural surroundings for the charity's patients and their family members to feel relaxed and safe when they visit the building, as well as for the Magpas Air Ambulance clinicians. Despite the cold and wet conditions, members of the public, schools and local businesses-along with representatives from the Navy, RAF and local fire and police forces-all got involved. Together, they planted 2,000 fully fledged trees and whips, as well as shrubs and wild flowers. Daryl Brown MBE DL, Chief Executive Officer commented, -It was so lovely to see the community come together to help us with this monumental task. Between us all, we managed to get every tree planted-but it was a real team effortl We had Cambridgeshire County Council take part, as well as the Highways Agency and businesses from Alconbury Weald and across Cambridgeshire. It was particularly heart-warming to be able to involve local These trees will not only help offset the charity's carbon footprint, they also complement Magpas Air Ambulance's bespoke building, which has been 24 MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 families and school children too, who planted pansies outside our visitors, centre. We can't thank every single person who helped us enough, this is a really special group of people who will have a lasting impact on our charity and our local environment for manyyears to come.- From internal benefits such as promoted cross-department working and new processes explored and installed, to external wins including increased local visibility and community engagement, and benefits to the environment. The Planting for Good campaign was an all- round success and was even shortlisted for 'Campaign of the Year, in this year's Chartered Institute of Fundraising (East Anglia) Awards. The event itself had benefits that have extended far beyond what the charity first imagined. Awareness of Magpas Air Ambulance was boosted among local residents and businesses, which has since led to fundraising and volunteering opportunities, including three people who have gone on to volunteer regularly with the charity. The campaign also raised £2.000 through tree sponsorship over the two days alone to help care for the trees in future-something Magpas Air Ambulance is now building on after seeing the appetite for this kind of support, including installing a 'tree of life, in the base's welcome area which honours those who have sponsored a tree or had a tree dedicated to their memory. Growing a greener service One of Magpas Air Ambulances strategic goals is to minimise its impact on the environment and reduce the charitys carbon emissions. When the new base was being built, it was created in a way to ensure it maximises renewable energy. This is achieved through integrated design measures such as solar shading, natural ventilation through louvres, and nearly 100 PV panels on the roof. The solar panels are not only creating an opportunity for the charity to be greener MAGPAS AIR AMBULANCE- ANNUAL REPORT 2023-24 25 than ever before but are also helping with overhead costs-f reeing up more funds that can be diverted towards the running of the lifesaving service. pool car, which can be booked by anyone requiring to travel for charity purposes, as well as an electric car dedicated to the Community CPR programme provided across Cambridgeshire and Bedfordshire daily. Additionally, with a single tree reducing CO by up to one tonne in its lifetime, the 2,000 trees planted in the grounds of the Magpas Air Ambulance base in 2023 will significantly help offset the charity's carbon footprint for many years to come. Lifesaving fundraising 2023-24 was another successful year for Magpas Air Ambulance fundraising, with a focus on continuing to develop and grow predictable and sustainable income streams. As part of Magpas Air Ambulance's commitment to sustainability, other positive steps have been made, such as introducing ten electric vehicle charging points in the airbase carpark. These have encouraged staff to travel greener, especially as rates have been set extremely competitively with a basic charge to staff and clinicians. and a commercially competitive rate for passing public users. The fundraising team successfully exceeded the target for the year, raising over £6million to fund the charity s lifesaving service across a range of income streams. The Magpas Air Ambulance lottery and superdraw continued to be the charity's biggest source of income, generating over £3.5million from an average of 68,350 chances to win every week. To reduce event travel costs and environmental impact, Magpas Air Ambulance also invested in a fully electric 26 MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 The charity also continued to invest in increasing income from regular giving supporters, welcoming a further 3,000 supporters to the charity this year, who make vital monthly donations. Ambulance to invest in new equipment and treatments that will improve patient care, as well as participate in groundbreaking clinical trials that could save even more lives in the future. As well as the above, Magpas Air Ambulance's amazing supporters also donated in response to the charity s bi- annual magazine, purchased Christmas cards and supported the winter appeal. A number of supporters also completed some amazing challenges throughout the year. Participants raised money by running the Cambridge Half Marathon, took to the skies in charity wing walks and skydives, and even walked on fire. Many others held events in their local communities in support of Magpas Air Ambulance, with charity staff and volunteers attending over 200 events in the past 12 months. Dr Adriana Cordier, who featured in the 2023 Christmas appeal, commented, -The loyalty and generosity of our Magpas Air Ambulance supporters never fails to humble and amaze me everyyear. We know that saving lives is a team effort and you are all a vital part of that team." In 2023-24, the number of people who volunteer for Magpas Air Ambulance increased by 38 %. This has meant that the charity has been able to have a presence at more community events than ever before and, with volunteers contributing over 800 hours at the charity's airbase, this supporter group has Gifts in wllls left to Magpas Air Ambulance exceeded £1 million for the first time ever. This is an increasingly important source of funding for the charity. Not only supporting vital ongoing operations but also enabling Magpas Air Doctor Adriana Cordier MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 27 saved the charity over £9,000 based on the national minimum hourly wage. The charity was also fortunate to receive support f rom a range of corporate organisations this financial year, such as the Cambridge Business Golf Society, which raised £25,000 for Magpas Air Ambulance-the most the society has ever raised for a charity of the year. companies donating 146 hours of time to Magpas Air Ambulance this year. Community groups have also been a huge part of Magpas Air Ambulance's fundraising success in 2023-24. The Upwood Ukuleles, who ask for donations in lieu of performance fees, added to their ever-growing fundraising total of £71,000 and have been named finalists in BBC Radio Cambridgeshire's Make a Difference awards. The Magpas Air Ambulance Community CPR Donate a Day Scheme continued to grow too, with 39 corporates funding lifesaving CPR and defibrillation training for their staff, as well as funding an additional day of training to support a local community group or school to also learn these vital skills. The charity s work with organisations has also seen an increase in the number of corporate volunteers supporting the service, with Magpas Air Ambulance has also seen schools, such as Bedford Prep School, prove you're never too young to get involved with local charities; multiple festivals and concerts took place in aid of Magpas Air Ambulance, often celebrating former patients; and there was even a sponsored Magpas Air Ambulance tattoo event at the Tattoo Denl Magpas Air Ambulance received O (zero) fundraising complaints in the financial year of this report, (O 'zero' in 2022-23). Grants & Trusts '" Support from grants and trusts continued to be a key income source for Magpas Air Ambulance, with the charity raising more than £214,000 through grant and trust income.: in 2023-24. Support from these organisations is so important. particularly as they help Magpas Air Ambulance to deliver capital projects and fund the latest lifesaving equipment. Acknowledgements While we formally acknowledge all our funders, generous contributions, our special thanks go to the following for making a notable contribution to our work during the last financial year: John Apthorp Charity The Valiant Charitable Trust The Hobson Charity The James Tudor Foundation The Rowney Trust Payne Gallwey Charitable Trust Persimmon Homes The Golderest Charitable Trust Hedley Foundation Better Community Business Network Skipton Charitable Foundation The Hudson Foundation The Grace Trust The Charlotte Heber-Percy Charitable Trust The Childwick Trust,, 28 MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 Allistair's story At 5:30am on Tuesday, 20th June 2023, Allistair and Michelle were asleep at home in Ely. Suddenly, Michelle was woken by her husbands body jolting next to her-he was suffering a cardiac arrest. Ali's heart had stopped beating, Michelle describes, "he gave his last breath, and was gone." medical care in his home: placing him in a medically induced coma and taking over his breathing. Once stable, they took him to Royal Papworth Hospital for surgery, monitoring him throughout the journey. After calling 999, Michelle began performing CPR. She explains, "It was only 7 5 minutes before help arrived, but at the time, it felt like forever. I was fighting to bring my husband back to life, and I was so grateful when the ambulance crew could take over." Michelle continues, -on day three he was brought out of his coma. It was a huge relief that, both physically and neurologically, he'd come through it well. Only 7 in 10 people survive an out- of-hospital cardiac arrest in the UK. Without Magpas AirAmbulance's quick intervention, Ali wouldn't be here today." An EEAST paramedic crew restarted Ali's heart using a defibrillator. Shortly afterwards, the Magpas Air Ambulance team arrived. Ali has since gone on to make an excellent recovery, he is now one of the charity's permanent volunteers and he, Michelle and their running club have raised £3,790 for the service that saved his life. Thanks to their advanced training, Magpas Air Ambulance Doctor Rich and Critical Care Paramedic Thomas were able to provide Ali with hospital-level MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 29 Financial strategy Magpas Air Ambulance raised £6,334,381 (2022-23: £7,220,047) through fundraising activities and income for the new base build in the 12 months ended 30 June 2024, around £600k ahead of our income target for the year. Income was around £886k less than a comparable period in the previous year, due to the base build completing and therefore a reduction in capital donations associated with the build costs of this project. 2023-24 total expenditure is £5,214,359 for the 12-month period ended 30 June 2024, compared to £6,146,691 in the previous 12-month period ended 30 June 2023. This reduction is due to the temporary loss of aircraft due to the prepack administration sale of the company who previously provided helicopter services to Magpas Air Ambulance. At the year-end. there were total funds of £5,075,800 (2022-23: £3,995,275). The charity aims to maintain three months, worth (£1.1 m) of operating capital as unrestricted reserves, it currently has £1,651,235 (2022- 23: £273,136) after fixed assets which are not able to be easily sold. The charity plans to further grow income and help maintain 30 MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 our reserves in future years to support planned developments in clinical activity. rapid response vehicles, delivering exactly the same level of care to the same number of patients as we would usually expect to treat. The lack of a helicopter lease generated a significant saving to the charity operating budget of around £l.I m. Removing base build income, the charity raised £6,161.811 through its fundraising and other activities for the 12-month period ended 30 June 2024. compared to £5,869,758 in the previous 12-month period ended 30 June 2023. A new helicopter has been procured and is due to be delivered to Magpas Air Ambulance in September 2024 to enable the charity to resume air operations. Magpas Air Ambulance continues to work hard to diversify and grow fundraising income in order to advance patient care and meet the changing needs of our patients. Base financing Magpas Air Ambulance supporters are vital to charity and we continue to need and be thankful for the support from the public, community, corporate organisations and grant funders. The new Magpas Air Ambulance airbase, HQ and training centre which the charity occupied during the financial period boasts many operational benef its. The new building is also signif icantly more energy efficient and helps move the charity towards being a NET zero organisation, supporting the Magpas Air Ambulance Green Plan. Helicopter lease During the financial year, in February 2024, the company that had supplied our helicopter through a lease arrangement was sold via a prepack administration deal. The project had a total cost of £7m. The charity successfully raised a significant amount in donations, non-repayable grants and donated goods/services to help fund the project, and the trustees also approved a £3.9m loan via Charity Bank and SIB, to guarantee completion of the project. The Magpas Air Ambulance contract was not sustained through the sale and this was reported to the Charity Commission as a potential Significant Incident (SIR), which has since been closed by the Charity Commission with no action required. The SIB grant is repaid within five years and the Charity Bank loan is repayable over 20 years. The charity continues to seek additional grants and donations to repay loans early and reduce the financial burden of servicing these loans. As a direct result, Magpas Air Ambulance operated for a period of five months within the financial year without an aircraft. During this period, the charity continued responding to medical emergencies 2417 using our fleet of MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 31 Nurturing positive partnerships A royal base opening On 12th September 2023 Magpas Air Ambulance staff, clinicians, fornier patients and supporters witnessed an important milestone in the charitys history as HRH The Princess Royal opened Magpas Air Ambulances state-of-the-art airbase and headquarters. the development ofthe new base. It was an honourto welcome HRH The Princess Royal, as well as the local community, to the site of the new base at Alconbury Weald and show her around the building she's been so pivotal in helping Magpas Air Ambulance achieve. HRH The Princess Royal became Magpas Air Ambulance's Patron after she visrted the charity's previous operations base in February 2020, and had been a part of the journey ever since-attending various Magpas Air Ambulance events throughoLrt On the day, HRH The Princess Royal heard from former patients and clinicians about the difference the base will make, and unveiled a plaque, which has become a treasured part of the new building. 32 MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 Multi-faith blessing Tee-rific corporate support Shortly after the airbase opening, Cambridgeshire faith leaders gathered at the new Magpas Air Ambulance base to bless the building. Every now and then, Magpas Air Ambulance sees fundraisers who take their support to the next level, such as East Anglia based recruitment consultants, The ONE Group. The event was attended by 14 senior faith and community leaders giving a very broad representation of the community Magpas Air Ambulance serves. The cornpany started supporting Magpas Air Ambulance in 2008 following a staff vote, and since then they've volunteered. fundraised and raised awareness of the charity through many innovative ways. The event was open to those of any faith and those of no faith to reflect on the important work of the charity. The ONE Group's flagship fundraiser, however, is their annual golf day. What started as an event with 20 attendees has grown into one of the most premium charity golf days in the region-with an annually fully booked event hosting 100 golfers. This yearwas The ONE Group's 16th event, and their extraordinary fundraising efforts mean they have now raised over £150,000 for Magpas Air Ambulance, equating to 50 lifesaving missions. Those in attendance put positive thoughts and energy onto the building and those who work and volunteer within it, after hearing from the charity's co-founder, Dr Neville Silverston MBE. who spoke about the origins of Magpas Air Ambulance and how it's grown and developed over the past 53 years. MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 33 tF' A token of thanks Room hire To markThe King & Queen's Coronation, a special commemorative medal has been awarded to all those who participated in the Coronation, as well as serving frontline members of the emergency services, prison services and the Amied Forces as a token of the nations thanks. At the Magpas Air Ambulance base, there is a variety of meeting spaces available to hire by corporates and community groups. The brand-new, accessible building with floor-to-ceiling windows, technology and facilities to suit all business needs has proved a huge hit for those seeking out spaces in the local community to meet. This summer, Deputy Lieutenant of Cambridgeshire, Mr Chris Parkhouse, presented the medals to many of Magpas Air Ambulance's doctors, critical care paramedics and flight crew, who keep the people of Cambridgeshire, Bedfordshire and beyond safe 24/7. With the visitors. centre, boardroom and a small meeting room accommodating between l 0-50 guests, the meeting spaces have not only raised more funds for the lifesaving service, but built new relationships between the charity and the community it serves too. The medal acts as a thank you gift from the nation, which has been awarded to around 400,000 deserving frontline workers across the country. Magpas Air Ambulance is delighted to have over 30 of these exceptional individuals qualify in their time with the charity. 34 MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 Our workforee Magpas Air Ambulance welcomed six new doctors to the clinical team in 2023-24, as well as eight non-clinical staff members. In the past year, the charity has continued to implement and develop new and existing ways to not only support its workforce, but to attract future employees. critical care paramedics and advanced paramedics are undertaking a variety of masters degrees in advanced practice to further their education and careers. These rnodules focus on the development of their clinical practice, whilst the APS, concentrate on the independent prescribing of additional drugs. One way the charity has been supporting both clinical and non-clinical staff members is through continued learning and development. In the past 12 months, two staff members began a new apprenticeship: the Data Driven Professional Programme run by The Imperial College and Corndel. This amazing opportunity, worth over £12,000 per person, has been fully funded by a corporate sponsor sourced by Corndel and offered to all air ambulances via Air Ambulances UK. Another aspect of Magpas Air Ambulance's workforce support comes in the form of its wellbeing committee. In 2023-24, a critical care paramedic became the first clinical team membertojoin the committee- providing valuable insight and support- and the four existing members undertook the RSPH Level 3 Award in Mental Health FirstAid, boosting their knowledge and increasing their skills available to all staff. The charty also publicly supported various awareness initiatives this year, including Remembrance Day, Armed Forces Week Volunteers, Week and Pride. In addition, Magpas Air Ambulance's MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 35 Reports, accounts and ADMINISTRATIVE DETAILS Read on for our trustees. responsibilities statement; independent auditors. report; financial review and accounts; and reference and administrative details. 36 MAGPAS AIR AMBULANCL- ANNUAL REPORT 2023-24 Trustees. responsibilities statement The trustees (who are also directors of Magpas Air Ambulance for the purposes of company law) are responsible for preparing the Trustees, Annual Report and the financial ststements in accordance with applicable law and United ￿ngdoM Accounting Standards (United lfjngdom Generally Accepted Accounting Practice). Company law requires the trustees to prepare financial statements for each financial year. Under company law, the trustees must not approve the financial statements unless they are satisfied that they give a true and fair view of the state of affairs of the charitable company and of the incoming resources and application of resources, including the income and expenditure, of the charitable company for that period. In preparing these 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 2019 (FRS 102) make judgements and estimates that are reasonable and prudent; state whether applicable UK Accounting Standards have been followed, subject to any material departures disclosed and explained in the financial statements; prepare the financial statements on the going concem basis unless it is inappropriate to presume that the charitable company will continue in operation 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. In so far as the trustees are aware: there is no relevant audrt information of which the charitable company's auditor is unaware: and the trustees have taken all steps that they ought to have taken to make themselves aware of any relevant audit information and to establish that the auditor is aware of that information. The trustees are responsible for the maintenance and integrity of the corporate and financial information included on the charitable CoMpan￿S website. Legislation in the United Kingdom governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions. In preparing this report, the Trustees have taken advantage of the small companies exemptions provided by section 415A of the Companies Act 2006. Approved by the Board of Trustees and signed on its behalf by: John Bridge OBE DL Chairman, Board of Trustees Date. 19 September 2024 MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 37 Independent auditors report to the members of Magpas Air Ambulanee Opinion We have audited the financial statements of Magpas Air Ambulance (the'charitable companl) for the year ended 30 June 2024 which comprise the Statement of Financial Activities incorporating the Income and Expenditure Account, the Balance Sheet, the Cash Flow Statement and the notes to the financial statements, including significant accounting estimates. 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: give a true and fair view of the state of the charitable company's affairs as at 30 June 2024, and of its incoming resources and application of resources, including its income and expenditure, for the 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 (UK) (ISAS (UK)) and applicable law. Our responsibilities under those standards are further described in the Auditorfs 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 coneern In auditing the financial statements, we have concluded that the Trustees. use of the going concern basis of accounting in the preparation of the financial statements is appropriate. Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the charity's ability to continue as a going concern for a period of at least twelve months from when the financial statements are authorised for issue. Our responsibilities and the responsibilities of the Trustees with respect to going concern are described in the relevant sections of this report. 38 MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 Other information The trustees are responsible forthe other infomation. The other information comprises the information included in the trUSt￿s, annual report, other than the financial statements and our auditor's report thereon. Our opinion on the financial statements does not cover the other information and, except to the extent othemise explicitty stated in our report we do not express any form of assuran￿ conclusion thereon. In connection with our audit of the financial statements, our responsibilty is to read the other information and, in doing so, consider whetherthe other information is materialty inconsistent with the financial statements or our knowledge obtained in the audlt or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whetherthere 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 misstatement of this other information, we are required to report that fact. We have nothing to report in this regard. Opinion 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 the Trustees, Annual Report, incorporating the Directorfs Report for the financial year for which the financial statements are prepared is consistent with the financial statements; and The Directors, Report has been prepared in accordance with applicable legal requirements. Matters on which we are required to report by exception In the light of our knowledge and understanding of the charitable company and its environment obtained in the course of the audit. we have not identified material misstatements in the trustees. report. 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 b&n kept, or returns adequate for our audit have not been received from branches not visited by us; or the financial statements are not in agreement with the accounting records and returns; or certain disclosures of trustees, remuneration specified by law are not made; or we have not received all the information and explanations we require for our audit. the trustees were not entitled to prepare the financial statements in accordance with the small companies, regime and take advantage of the small companies, exemptions in preparing the directors, report and from the requirement to prepare a strategic report. MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 39 Responsibilities of trustees As explained more fully in the trustees, responsibilities statement in the Trustees, 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. Audito¢s responsibilities for the audit of the financial statements Our objectives are to obtain reasonable assurance aboLrt whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditorfs report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAS (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements. Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud. The extent to which our procedures are capable of detecting irregularities, including fraud is detailed below= We gained an understanding of the legal and regulatory framework applicable to the Charity and how it operates and considered the risk of the Charity not complying with the applicable laws and regulations including fraud in particular those that could have a material impact on the financial statements. This included those regulations directly related to the financial statements. In relation to the Charity this included employment law, financial reporting and health & safety. The risks were discussed with the audtt team and we remained alert to any indications of non- compliance throughout the audit. We carried out specific procedures to address the risks identified these included the following: We reviewed systems and procedures to identify potential areas of management override risk. In particular. we agreed the financial statements to underlying records and we carried out testing of journal entries and other adjustments for appropriateness. We reviewed accounting policies for evidence of management bias and ensured that the accounting policies were correctty applied to the financial statements. We reviewed minutes of Trustee Board meetings. We have enquired of management about any actual or potential litigation claims, and any known instances of non-compliance - none were identified as a result of our enquiries. MAGPAS AIR AMBULANCE: ANNUAL REPORT 2023-24 Ak. 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 nonfompliance 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