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2022-03-31-accounts

healthcare quality improvement partnership

Healthcare Services Benchmark Health Patient Outcomes Measure National Improve Audit Measure Improve Evaluate National Quality Improvement Evaluate Impact Patient Outcomes Benchmark Clinical Effectiveness Health

HQIP Trustees’ Report and Accounts April 2021–March 2022

www.hqip.org.uk

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Trustees

Professor Dame Carrie MacEwen, DBE (Chair) Alastair Henderson (Vice-chair) Philip Grimshaw Baker Michael Chapman – resigned 4 August 2021 Sarah Dunnett (Treasurer) – resigned 24 March 2022 Kalwant Grewal (Treasurer) – appointed 22 March 2022 Susan Masters Miles Sibley - resigned 3 February 2022 Dr Victoria Tzortziou Brown, OBE Gillian Coverdale – appointed 18 November 2021 Janice Gabriel – appointed 18 November 2021 Peter Bloomfield – appointed 18 November 2021

Chief Executive: Jane Ingham

Registered office: 27A Harley Place, London W1G 8LZ Email: communications@hqip.org.uk Website: www.hqip.org.uk Twitter: @HQIP

Company registration number: 6498947 (England and Wales) Charity registration number: 1127049

Auditors: Moore Kingston Smith LLP, 9 Appold Street, London EC2A 2AP Bankers: Lloyds Bank Plc, 39 Threadneedle Street, London EC2R 8AU Solicitors: Cameron’s Solicitors LLP, 27A Harley Place, London W1G 8LZ VWV Solicitors, Narrow Quay House, Narrow Quay, Bristol, BS1 4QA

healthcare quality improvement partnership

Contents

HQIP and our vision 4
Chair and CEO statement 5
Our year in numbers 6
Strategic report
Strategic objectives		 8
8
Achievements and performance 8
The future 13
Trustees’ report 14
Financial report 15
Independent auditor’s report 18
Statement of fnancial activities for the year to 31 March 2022 22
Balance sheet 31 March 2022 23
Statement of cash fows for the year ended 31 March 2022 24
Notes to the accounts 2021-22 25
Appendix: HQIP programmes and audits, 2021-22 47

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trustees’ report and accounts 2021-22

HQIP and our vision

An independent organisation led by a consortium of the Academy of Medical Royal Colleges, the Royal College of Nursing and National Voices, our primary aim is to improve health outcomes by enabling those who commission, deliver and receive healthcare to measure and improve the services provided. We achieve this by supporting robust quality improvement through national programmes of clinical audit, confidential enquiries and registries.

Specifically, we commission, manage and develop the National Clinical Audit and Patient Outcomes Programme (NCAPOP) on behalf of NHS England, the Welsh Government and, in some cases, other devolved administrations and crown dependencies. This programme is comprised of circa 40 projects that collect and analyse data supplied by local clinical teams, in order to provide a national benchmarked picture of care standards for a wide range of conditions. We also host the National Joint Registry (NJR), who collect, analyse and report on data for hip, knee, ankle, elbow and shoulder joint replacement procedures. Described as a global exemplar of an implantable medical device registry, the NJR, which covers England, Wales, Northern Ireland, the Isle of Man and Guernsey continues to be the largest orthopaedic registry in the world, with an international reputation and now with around 3.7 million procedure records submitted.

Our work – and its value – goes far beyond data collection and managing clinical audits and registries- it supports evidencebased best practice. We publish a wide range of reports and infographics and host a dedicated benchmarking website, National Clinical Audit Benchmarking (NCAB), which provides a visual snapshot of individual Trust data alongside national benchmarks. We also offer a range of resources and tools, including guidance and online learning as well as videos, case studies and themed ‘signpost’ updates. All of which aim to help healthcare professionals to understand local and clinical improvement need, and deliver effective and safe services. This support is further enhanced by our highly-specialised advisory and knowledge transfer services.

HQIP seeks to promote and celebrate the benefits and impact of clinical audit and quality improvement work in healthcare, hosting Clinical Audit Awareness Week (with awards for local ‘clinical audit heroes’). Everything we do aims to share our knowledge and maximise the impact of the data collected.

But we cannot do this alone...

We are committed to collaborating with a wide range of stakeholders. We instigate and develop relationships at national and local levels, including those involved in policy, health service planning and delivery, and research. Our work is aligned with other national bodies and their quality improvement programmes. As such, we interact with a broad spectrum of professional leadership bodies and organisations, including: NHS England and NHS Digital; the Department for Health and Social Care (DHSC); the governments of the devolved nations and crown dependencies (Scotland, Wales, Northern Ireland, Jersey, Guernsey and Isle of Man); the Care Quality Commission (CQC); The National Institute for Health and Care Excellence (NICE); the Faculty of Medical Leadership and Management (FMLM); the National Quality Improvement (Incl. Clinical Audit) Network (N-QI-CAN); Health Data Research UK; the Health Foundation; the Independent Healthcare Providers Network; and the Private Healthcare Information Network, among others.

Critically, HQIP also pro-actively reaches out to those who receive healthcare services, creating opportunities for meaningful two-way engagement with patients, carers and representatives (for example charities). This engagement plays a vital role in our work, from planning through to delivery e.g. patient involvement in the development of programme specifications and the production of patient-friendly reports. Central to this is our voluntary Service User Network (SUN), an advisory group of patients and carers who provide input into our work and its outputs. We are very grateful for their time and commitment. We pride ourselves on this two-way channel of communication, demonstrating our open and adaptable approach to involving patients and carers in all areas of our work.

For more information about us, our programme of work and our outputs, go to www.hqip.org.uk.

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We wish to begin by offering our thanks, and paying our respects, to everyone involved in managing, and affected by, COVID-19. When we look back on the remarkable events of the height of the pandemic, it is with astonishment. Not only because of the devastation it wreaked on so many lives, but also because of the response of everyone working in healthcare. Thanks to you all, we can now begin to look forward, and with hope.

That hope, however, is not a baseless expectation or desire for recovery. It is built on a tangible foundation that can lead to change, supporting robust and effective services - namely data. And that’s where HQIP, and the work we commission, has been able to play an important role this year. Throughout much of the pandemic, the majority of our audits and programmes continued to collect data and generate evidence for meaningful improvement. In some cases we even saw a ‘COVID-influenced’ acceleration, with a move to live surveillance, providing real-time data to NHS England and other national agencies to support the nation’s response to the virus.

Data is very much at the forefront of not only HQIP’s thoughts but also the wider healthcare sector at this time. Knowing where to allocate our resources for maximum impact is now more important than ever. We are proud to manage circa 40 clinical programmes that have produced 70 reports, with almost 400 recommendations in 2021/22. We are also aware of the need to support expedient, as well as robust, planning for the future. 2022 saw the implementation of a number of changes to the National Clinical Audit and Patient Outcomes Programme (NCAPOP) which will ensure that it is fit-for-purpose for our increasingly digital era. These changes can be summarised as ‘less is more’ but are the result of a huge amount of painstaking thinking and consultation. If you would like to know more, HQIP’s Medical Director, Professor Danny Keenan, explains all in a concise blog article.

We would like to tell you about a few other developments for 2022. We are delighted that Clinical Audit Awareness ~~—~~ Week – complete with the Audit Heroes Awards – took place again in June 2022, in collaboration with the National Quality Improvement (Incl. Clinical Audit) Network (N-QI-CAN). We are also making the most of our role as a bridge between the providers and users of healthcare data to make two new publications available. Firstly, a new series of themed ‘one-stop shop’ newsletters to signpost to key quality improvement reports and resources (the first edition, out in March 2022, was about maternity and newborn care). And we are planning to launch a new ‘quality improvement magazine’ in the autumn of 2022. Designed to supplement this annual report, it will be an ‘easy-read’ around the issues relating to data-informed quality improvement and aims to engage the wider healthcare sector.

More information on our projects can be found on the HQIP website. We are excited to see them (together with the resultant reports and outcomes) come to fruition, and hope that you will join us in our enthusiasm by sharing details of these resources with your colleagues. Finally, we wish to thank our multitude of collaborators and supporters – which spans a range of local and national organisations and data providers through to healthcare professionals, policy makers and patients. Together, and with the appropriate ‘foundations’, we feel sure that we can continue to meet the needs of – and demonstrate improved outcomes for – patients, both now and in the future.

Best regards,

Carrie MacEwen, DBE, Jane Ingham, Chair CEO

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trustees’ report and accounts 2021-22

Our year in numbers

1 April 2021 to 31 March 2022

----- Start of picture text -----
Programme outputs
70 396 29 4
Programme reports Recommendations Infographics In-focus
published reports
National Joint Registry (NJR) National Clinical Audit
Benchmarking (NCAB) website
Data analysed:
4,987 Users
84,998 77,830 8,292 Sessions
Hips Knees
1 221 Document (PDF) downloads
,
5,529 760 710
429 File (CSV) downloads
Shoulders Elbows Ankle
replacements
14 Audits added
Peer-reviewed journal articles
20 Requests
featuring NJR data Data access 80
processed
Events Tenders
3 Health inequality webinars 75 Health inequality webinar attendees (average) 2 COVID-related extensions agreed
Community of 21 Community of practice
3 practice sessions session attendees (average) New contracts awarded
7
Online NCAPOP seminar attendees Tenders commenced
40 4
----- End of picture text -----

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----- Start of picture text -----
eLearning completed
Trainee doctors: Introduction to Introduction to quality
55 How do we know we are 778 quality improvement 670 improvement for
doing a good job? for healthcare patients and public
professionals
Training Resource views
10 Data, data, data,
for NHS executive/board trainees
Introduction to The duty of
Measuring for improvement, developing good confidentiality
11
for registrar trainees data applications (Understanding
(Understanding Health Data
Health Data Access) Access) video
video
Patient and carer engagement 2,107
767
18 Involvement in commissioning (projects)
Including: 5 Focus groups
An introduction to Professor Danny
Feedback presented at Specification applying for HQIP Keenan in
10 Development Meetings datasets video conversation with
Sam Bartlett-Pestel
5 Involvement in scoring and evaluation of tenders 54 podcast
Richard Driscoll Memorial Award
65
4 2021 case studies
m ee
Mailing list HQIP website
subscribers
316,771 108,594 4
2,367 Homepage unique page visits Downloads Blog articles
New subscribers
HQIP on Twitter
26,020
166
1,490 198,547 512 5,528
Total subscribers
(31 March 2022)
Tweets Mentions Impressions New Total followers
followers (31 March 22)
S ia
7
----- End of picture text -----

trustees’ report and accounts 2021-22

Strategic report

In shaping our objectives and planning our activities, the Trustees have considered the Charity Commission’s guidance on public benefit, including the guidance Public benefit: running a charity (PB2) . The Trustees confirm that they have complied with the duty in section 17 of the Charities Act 2011 to have due regard to public benefit guidance published by the Charity Commission.

Strategic objectives

In order to deliver our vision of improving health outcomes, a set of strategic objectives has been developed to inform all our activities. As such, we commit to:

1. Commission, manage, support and promote national and local programmes of quality improvement, using best management and procurement practice to ensure robust results and actionable recommendations. This includes the National Clinical Audit and Patient Outcomes Programme (NCAPOP), and the National Joint Registry on behalf of NHS England and other healthcare departments and bodies.

2. Ensure patients and carers remain at the heart of our work through continued, strategic involvement in all relevant processes and projects.

3. Support healthcare professionals to review and improve their practice by providing opportunities to share best practice, through education and training programmes, as part of promoting an integrated approach to quality improvement.

4. Inform and influence national healthcare policy by effectively communicating our work and that of our partners.

5. Encourage wide use of robust data for quality improvement of care, offering patient choice, promoting patient safety, supporting revalidation and service accreditation, commissioning, service redesign, and research.

6. Be an efficient, well run organisation which supports staff development and welfare.

Achievements and performance

This section provides an overview of HQIP’s performance over the period from 1 April 2021 to 31 March 2022. In addition, short vignettes have been included in order to illustrate our impact in relation to specific activities and, where relevant, online links have been provided. Further information about HQIP generally can be found on our website: www.hqip.org. uk. Our key achievements this year include:

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Spotlight: The National Child Mortality Database (NCMD)

Of particular note was the work – and growing influence – of the NCMD in understanding child mortality. This data was used:

More information about NCMD

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trustees’ report and accounts 2021-22

Spotlight: Increasing the impact of the National Clinical Audit and Patient Outcomes Programme (NCAPOP)

In order to increase the impact of the NCAPOP we introduced a number of changes to revise and refresh the outputs for new contracts going forward , including:

I thought the course was excellent. I am very new to the role of Clinical Audit and it was really informative.

HQIP eLearning course (Introduction to QA) participant, 2022

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healthcare quality improvement partnership

Spotlight: Health inequalities webinar series

We were delighted to host a series of online workshops with our audits and data providers, as well as other guests from HQIP Service User Network (SUN), NHS England, NQICAN, CQC, NICE and NHS Digital, focusing on health inequalities in the spring of 2022. The aim of these events was to explore collaboratively how we can use the NCAPOP projects to identify, measure and address health inequalities, with seven key themes emerging:

5. Data quality could be improved

6. Obtaining and using routine data presents challenges

7. We need to support the use of outputs by healthcare services.

The workshops were an excellent opportunity to hear from project leads, providers of data and patients about how we can all work together to tackle known health inequalities. As a result, we committed to ensuring that the NCAPOP supports NHS England’s Core20PLUS5 approach to reducing health inequalities, and work on this continues.

1. There is plenty of opportunity for impact

2. There is widespread support for the work

3. Addressing health inequalities is a broad challenge

4. We need to tackle the challenge of missing data

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trustees’ report and accounts 2021-22

Spotlight: Patient and carer focus group in action

Through BEAT, SEED and The SUNNetwork –

Cambridgeshire we invited ten service users and carers to share their experiences of using Eating Disorder Services in a 90 minute focus group. We asked them about their main areas of concern, what provided the greatest benefit and about where they would like to see improvements. We also focused on what resources they might find useful as audit outputs. Attendees were honest and open about their experiences and raised the following key points:

We received lots of similar useful information about what types of resources would be most useful to service users and this included: regional statistics; information about typical treatment pathways and length of service; signposting; and information about service user involvement. Focus groups have proved to be a successful way of learning from people with lived experience. They are often open and bond over their shared experiences.

Thank you for including us… It’s great to know that service user voices are being heard and involved from the beginning.

Focus group participant, 2022

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production of a suite of tools and resources to support engagement in the event (held 13-17 June 2022). www.hqip.org.uk/clinical-audit-awareness-week

Future plans

Planned activity for 2022-23

The underpinning themes influencing and shaping our work programme for the coming year are:

Some of the key activities planned for 2022-23 are:

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trustees’ report and accounts 2021-22

Trustees’ report

The Trustees, who are also directors of the charity for the purposes of the Companies Act 2006, present their report with the financial statements of the charity for the year ended 31 March 2022. The Trustees have adopted the provisions of the Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (The FRS 102 Charities SORP including Update Bulletin 2).

Statement of Trustees’ responsibilities

The Trustees are responsible for preparing their Report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice).

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

The Trustees are responsible for keeping proper accounting records which disclose with reasonable accuracy the financial position of the charitable company and to 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:

The Trustees’ Annual Report is approved by the trustees of the Charity. The Strategic Report, which forms part of the Annual Report, is approved by the Trustees in their capacity as directors in company law of the Charity.

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healthcare quality improvement partnership

Financial report

Results for the year

Fig 1: Where our funding comes from

Fig 2: How we spend our money

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trustees’ report and accounts 2021-22

During the year ended 31 March 2022, HQIP received income totalling £22,641,017 (2021: £20,719,346) of which £20,872,786 (2021: £19,136,113) was for restricted purposes, and £1,768,231 (2021: £1,583,233) was for the general purposes of the charity including management support fees of £1,300,000 (2021: £1,300,000).

Income included £12,334,657 (2021: £9,331,515) to finance national clinical audits. In addition, HQIP collected subscriptions of £2,009,700 (2021: £2,019,500) from NHS Trusts on behalf of NHS England to support national audits. The Scottish Government contributed £139,162 (2021: £311,089) to NCAPOP programmes.

In 2021-22, income for the Clinical Outcome Review Programmes totalling £2,112,717 (2021: £2,821,353) was collected from all UK Administrations. This included funding for the National Child Mortality Database. The Department of Health and Social Care provided £206,020 (2021: £185,783) for development of a Perinatal Mortality Review Tool.

In 2021-22, the National Joint Registry (NJR) collected subscriptions totalling £3,246,010 (2021: £3,423,026). Other income of £782,863 (2021: £773,045) included supplier contributions, and data access fees. NJR funds are managed in a separate bank account which is used solely to fund the work of the Registry.

Grants totaling £10,052 (2021: £54,779) were received from the Health Foundation. Income of £30,410 (2021: £53,023) was received for a pilot project with the Independent Healthcare Providers Network.

Expenditure

In 2021-22, HQIP commissioned and managed national clinical audit contracts with a total value of £11,499,456 (2021: £11,336,342).

Expenditure on the Clinical Outcome Review Programmes, was £3,567,936 (2021: £3,483,561 after prior year adjustment). Expenditure on the Learning Disabilities Mortality Review was £Nil (2021: £275,674).

Expenditure on the management and development of the National Joint Registry was £3,329,365 (2021: £3,414,077).

Expenditure on National Clinical Audit Benchmarking was £8,720 (2021: £7,510). Expenditure on other Quality Improvement and Development activities was £21,120 (2021: £131,428).

Other direct charitable expenditure, including support costs, totalled £2,224,243 (2021: £2,038,100 after prior year adjustment).

Financial position

The balance sheet at 31 March 2022 shows total funds of £15,773,895 (2021: £13,783,718 after prior year adjustment), including restricted funds totalling £13,085,931 (2021: £11,509,723 after prior year adjustment) and unrestricted funds comprising general funds of £2,235,627 (2021: £1,689,596), tangible and intangible fixed assets of £5,898 (2021: £17,710) and designated funds of £446,439 (2021: £566,689).

At 31st March 2022, the charity retained free reserves of £2,235,627 (2021: £1,689,596).

Reserves policy

The Trustees have examined the requirement for free reserves, i.e. those unrestricted funds not invested in tangible or intangible fixed assets, designated for specific purposes or otherwise committed. The current policy is that the level of free reserves should be equivalent to six to twelve months’ staffing commitments (forecast at £1,031,768 to £2,063,536 in 2022-23). The actual free reserves of £2,235,627 at March 2022 were slightly above this range but the Trustees consider this acceptable in the context of the current environment.

There are, in addition, designated funds of £446,439 (see Note 17). The designated Stability fund is available to support the charity in the event of unexpected expenditure. Trustees keep this position under regular review.

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Structure, governance and management

HQIP is a company limited by guarantee and incorporated on 11 February 2008. It was registered as a charity on 4 December 2008. The governing document is the Memorandum and Articles of Association. HQIP was founded by a consortium of three organisations: the Academy of Medical Royal Colleges, the Royal College of Nursing, and National Voices.

Each organisation appoints representatives to act as directors and these individuals, together with the treasurer, form the Trustees of the organisation and the Board of directors. A process for induction of new Trustees is in place and ongoing training for Trustees is available as required.

The Trustees handle matters of strategic planning and policy, including sign-off of the charity’s strategic and operational plans. The Chief Executive has delegated responsibility for managing the charity and handling operational matters of policy and delivery.

Remuneration for all staff, including key management personnel, is set by reference to periodic salary benchmarking.

Risk management

Risk 1: Dependency on one substantive contract

Mitigation: Role of Director of Operations for Business Development appointed to lead efforts in diversifying income and reducing dependency; strategy and implementation plan for 2019-2023 adopted to support a move to multiple income streams and HQIP onto a more sustainable footing. New strategic framework for 2023-2026 under development with refined aims and objectives based on learning during previous period. In addition, more senior and QI focused resources will be recruited into HQIP to build on areas of success.

Risk 2: National opt out impact on integrity of robust national data

Mitigation: Close discussions with NHSE and DHSC to understand and raise awareness of implications; further extension of compliance deadline to July 2022.

Risk 3: Impact of Covid

Mitigation: Additional procurement resource was taken on to manage the peak of procurements occurring during 2021-22 as a result of the bottleneck created by Covid.

Approved by the Trustees of Healthcare Quality Improvement Partnership company registration number 06498947 (England and Wales) and signed on their behalf by:

The Board of Trustees maintains a comprehensive Risk Register which is reviewed and discussed at every Board Meeting. Risks fall into 4 categories:

Trustee Carrie MacEwen, Chair. Approved on: 17 November 2022

The probability and impact of each risk is calculated and the charity’s mitigation strategy for each is considered.

The principal risks are considered to be:

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trustees’ report and accounts 2021-22

Independent auditor’s report to the members of Healthcare Quality Improvement Partnership

Opinion

We have audited the financial statements of Healthcare Quality Improvement Partnership (‘the company’) for the year ended 31 March 2022 which comprise the Statement of Financial Activities, the Balance Sheet, the Cash Flow Statement 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 FRS 102 ‘The Financial Reporting Standard Applicable in the UK and Republic of Ireland’ (United Kingdom Generally Accepted Accounting Practice).

In our opinion the financial statements:

Basis for opinion

We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs(UK)) and applicable law. Our responsibilities under those standards are further described in the Auditor’s Responsibilities for the audit of the financial statements section of our report. We are independent of the charitable company in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the FRC’s

Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.

Conclusions relating to going concern

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

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

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

Other information

The other information comprises the information included in the annual report, other than the financial statements and our auditor’s report thereon. The trustees are responsible for the other information. 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

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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 misstatement of this other information, we are required to report that fact.

We have nothing to report in this regard.

Opinions on other matters prescribed by the Companies Act 2006

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

Matters on which we are required to report by exception

In the light of the knowledge and understanding of the company and its environment obtained in the course of the audit, we have not identified material misstatements in the strategic report or the trustees’ annual report.

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

Responsibilities of trustees

As explained more fully in the trustees’ responsibilities statement set out on page 14, the trustees (who are also the directors of the charitable company for the purposes of company law) are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such internal control as the trustees determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error.

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

Auditor’s responsibilities for the audit of the financial statements

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

As part of an audit in accordance with ISAs (UK) we exercise professional judgement and maintain professional scepticism throughout the audit. We also:

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trustees’ report and accounts 2021-22

We communicate with those charged with governance regarding, among other matters, the planned scope and timing of the audit and significant audit findings, including any significant deficiencies in internal control that we identify during our audit.

Explanation as to what extent the audit was considered capable of detecting irregularities, including fraud

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

The objectives of our audit in respect of fraud, are; to identify and assess the risks of material misstatement of the financial statements due to fraud; to obtain sufficient appropriate audit evidence regarding the assessed risks of material misstatement due to fraud, through designing and implementing appropriate responses to those assessed risks; and to respond appropriately to instances of fraud or suspected fraud identified during the audit. However, the primary responsibility for the prevention and detection of fraud rests with both management and those charged with governance of the charitable company.

Our approach was as follows:

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There are inherent limitations in the audit procedures described above. We are less likely to become aware of instances of non-compliance with laws and regulations that are not closely related to events and transactions reflected in the financial statements. Also, the risk of not detecting a material misstatement due to fraud is higher than the risk of not detecting one resulting from error, as fraud may involve deliberate concealment by, for example, forgery or intentional misrepresentations, or through collusion.

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 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 any party other than the charitable company and charitable company’s members as a body, for our audit work, for this report, or for the opinions we have formed.

Neil Finlayson (Senior Statutory Auditor)

for and on behalf of Moore Kingston Smith LLP, Statutory Auditor 6th Floor 9 Appold Street London EC2A 2AP Date: 18 November 2022

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trustees’ report and accounts 2021-22

Statement of financial activities for the year to 31 March 2022

----- Start of picture text -----
Unrestricted Restricted Total Total
Funds Funds 2022 2021
As restated
Note £ £ £ £
INCOME AND
EXPENDITURE
Income
Income from 2 1,096 1,095 2,191 6,000
Investments
Charitable Activities
Management, 3 1,752,080 20,871,691 22,623,771 20,697,946
development and
promotion of Clinical
Audit
Other income 4 15,055 - 15,055 15,400
Total Income 1,768,231 20,872,786 22,641,017 20,719,346
Expenditure
Charitable activities
Management, 5 1,375,980 19,274,860 20,650,840 20,686,692
development and
promotion of Clinical
Audit
Total Expenditure 1,375,980 19,274,860 20,650,840 20,686,692
Net Income 7 392,251 1,597,926 1,990,177 32,654
Transfers between 21,718 (21,718) - -
funds
Net movement in funds 413,969 1,576,208 1,990,177 32,654
Balances brought 2,273,995 11,509,723 13,783,718 13,751,064
forward at 1 April 2021
Balances carried 2,687,964 13,085,931 15,773,895 13,783,718
forward at 31 March
2022
----- End of picture text -----

All gains and losses arising in the period have been included in the statement of financial activities and relate to continuing operations.

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healthcare quality improvement partnership

Balance sheet 31 March 2022

2022 2022 2021 2021 ~~a~~ Notes £ £ £ £ As restated As restated ~~ee~~ Fixed assets ~~eee ee ee a~~ Intangible fixed assets 11 - - ~~a~~ Tangible fixed assets 12 5,898 17,710 ~~eS a A A~~ 5,898 17,710 ~~es~~ Current assets ~~a a~~ Debtors due within 1,584,602 891,781 13 one year ~~a~~ Cash at bank and ~~ee ee~~ 20,748,831 ~~ee~~ 18,148,690 in hand ~~PT |~~ 22,333,433 19,040,471 Creditors: amounts 14 6,565,436 5,274,463 falling due within one year ~~pot~~ Net current assets 15,767,997 13,766,008 ~~a~~ Total net assets 15,773,895 13,783,718 ~~es A A a Caa CC~~ Funds and reserves ~~a~~ Restricted funds 15 13,085,931 11,509,723 ~~a~~ Unrestricted funds ~~a~~ General fund 2,235,627 1,689,596 ~~a~~ Tangible fixed 16 5,898 17,710 assets fund ~~aeeee~~ Designated funds 17 446,439 566,689 ~~A~~ 2,687,964 2,273,995 ~~a~~ 15,773,895 13,783,718 ~~a~~

Approved by the Trustees of Healthcare Quality Improvement Partnership company registration number 06498947 (England and Wales) and signed on their behalf by:

Trustee Carrie MacEwen, Chair. Approved on: 17 November 2022

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Statement of cash flows for the year ended 31 March 2022

----- Start of picture text -----
2022 2021
£ £
As restated
Cashflow from operating activities
Net cash provided by operating activities 2,600,612 96,690
Cashflows from investing activities
Investment income and interest received 2,191 6,000
Proceeds from sale of tangible fixed assets 1,570 -
Payments to acquire tangible fixed assets (4,232) (1,936)
(471) 4,064
Net increase in cash and cash equivalents 2,600,141 100,754
Cash and cash equivalents at the beginning of the year 18,148,690 18,047,936
Cash and cash equivalents at end of year 20,748,831 18,148,690
Reconciliation of net income to net cash flow from
operating activities
Net income / (expenditure) including endowments 1,990,177 32,654
Adjustments for:
Depreciation charge 14,437 15,523
Loss on disposal of fixed assets 37 -
Interest receivable (2,191) (6,000)
(Increase)/Decrease in debtors (692,821) 921,875
Increase/(Decrease) in creditors 1,290,973 (867,362)
Net cash inflow / (outflow) from operating activities 2,600,612 96,690
----- End of picture text -----

The charity has no net debt and accordingly no net debt note is presented.

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Notes to the accounts 2021-22

1. Accounting policies

a) Basis of accounting

These financial statements are prepared on a going concern basis, under the historical cost convention.

The financial statements have been prepared in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102). The Charitable Company is a public benefit entity for the purposes of FRS 102 and therefore the Charity also prepared its financial statements in accordance with the Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (The FRS 102 Charities SORP including Update Bulletin 2), the Companies Act 2006 under the provision of the Large and Medium-sized Companies and Groups (Accounts and Reports) Regulations 2008 (SI 2008/410) and the Charities Act 2011.

The financial statements are prepared in sterling, which is the functional currency of the company.

Monetary amounts in these financial statements are rounded to the nearest pound.

b) Going concern

The trustees have assessed whether the use of the going concern basis is appropriate and have considered possible events or conditions that might cast significant doubt on the ability of the charity to continue as a going concern. The trustees have made this assessment for a period of at least one year from the date of approval of the financial statements. In particular the trustees have considered the charity’s forecasts and projections and have taken account of pressures on grant income. After making enquiries the trustees have concluded that there is a reasonable expectation that the charity has adequate resources to continue in operational existence for the foreseeable future. The charity therefore continues to adopt the going concern basis in preparing its financial statements.

c) Income

Income is recognised net of VAT in the period in which the charity is entitled to receipt and the amount can be measured with reasonable certainty. Income is deferred only when the charity has to fulfil conditions before becoming entitled to it or where the donor or funder has specified that the income is to be expended in a future accounting period. Income is only recognised for amounts that are probable at the date of preparation of the accounts. Any further amounts received after this date are recognised in subsequent periods.

Funding from government and other agencies have been included as income from charitable activities where these amount to either a contract for services or the charity has acted as agents. However where the money is given in response to an appeal or with greater freedom of use, for example monies for core funding, then this has been treated as a donation.

d) Expenditure and the basis of apportioning costs

Expenditure is included in the Statement of Financial Activities when incurred and excludes attributable VAT where it can be recovered.

Expenditure comprises the following:

i) The costs of activities in furtherance of the charity’s objects comprise expenditure on the charity’s primary charitable purposes as described in the trustees’ report. Such costs include:

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trustees’ report and accounts 2021-22

ii) Support costs represent indirect charitable expenditure. In order to carry out the primary purposes of the charity it is necessary to provide support in the form of personnel development, financial procedures, provision of office services and equipment and a suitable working environment. Such costs are allocated across the activities of the charity based on an estimate of staff time.

e) Cash and cash equivalents

Cash and cash equivalents include cash in hand, deposits held at call with banks, other short-term liquid investments with original maturities of three months or less, and bank overdrafts.

f) Fund accounting

Restricted funds comprise monies whose use is restricted to a specific purpose, or is subject to donor imposed conditions.

Designated funds comprise monies set aside out of unrestricted general funds for specific future purposes or projects.

The fixed assets fund comprises the net book value of the charity’s fixed assets, the existence of which is fundamental to the charity being able to perform its charitable work and thereby achieve its charitable objectives. The value represented by such assets should not be regarded, therefore, as realisable.

General unrestricted funds represent those monies which are freely available for application towards achieving any charitable purpose that falls within the charity’s charitable objects.

g) Tangible fixed assets

All assets costing more than £500 and with an expected useful life exceeding one year are capitalised. Depreciation is provided at the following annual rates in order to write each asset off over its estimated useful life:

h) Intangible fixed assets

Intangible fixed assets include the development costs of the website and are stated at cost less accumulated amortisation and accumulated impairment losses. Amortisation is recognised so as to write off the cost of assets less their residual values over their useful lives on the following basis:

i) Operating lease

Rentals payable under operating leases are charged to the Statement of Financial Activities as incurred over the terms of the lease.

j) Pension contributions

i) NHS Scheme: It is not possible for HQIP to identify its share of the underlying scheme liabilities in relation to the NHS final salary pension scheme, consequently the scheme is accounted for as a defined contribution scheme and the cost of the scheme is equal to the contributions payable to the scheme for the accounting period. Those employers contributing under Direction status have their pension cost contributions charged to operating expenses as and when they become due.

ii) Defined contribution scheme: The cost of the scheme is equal to the contributions payable to the scheme for the accounting period.

k) Employee benefits

The costs of short-term employee benefits are recognised as a liability and an expense.

l) Financial instruments

The charity has elected to apply the provisions of Section 11 ‘Basic Financial Instruments’ of FRS 102 to all of its financial instruments. Financial instruments are recognised in the charity’s balance sheet when the company becomes party to the contractual provisions of the instrument. Financial assets and liabilities are offset, with the net amounts presented in the financial statements, when there is a legally enforceable right to set off the recognised amounts and there is an intention to settle on a net basis or to realise the asset and settle the liability simultaneously.

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With the exceptions of prepayments and deferred income all other debtor and creditor balances are considered to be basic financial instruments under FRS 102. See notes 13 and 14 for the debtor and creditor notes.

m) Judgements and key sources of estimation uncertainty

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

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

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

2. Interest receivable

----- Start of picture text -----
Unrestricted Restricted Total
Funds Funds 2022
£ £ £
Bank interest receivable 1,096 1,095 2,191
Unrestricted Restricted Total
Funds Funds 2021
£ £ £
Bank interest receivable 3,000 3,000 6,000
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3. Income from charitable activities

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Income from contracts Unrestricted Restricted Total
Funds Funds 2022
£ £ £
NHS England & Wales
Management Support Fee 1,300,000 - 1,300,000
NCAPOP Audits - 12,334,657 12,334,657
NCAPOP Subscriptions - 2,009,700 2,009,700
Subscriptions Admin Fees 20,300 - 20,300
All UK Administrations and Crown Dependencies
CORP Programme Income - 2,112,717 2,112,717
NCAPOP (Scottish Contributions) - 139,162 139,162
Programme Management Fees 389,991 - 389,991
Department of Health & Social Care - 206,020 206,020
NJR Subscriptions Income - 3,246,110 3,246,110
NJR Other Income - 782,863 782,863
Health Foundation Grants - 10,052 10,052
Data Access Requests 35,250 - 35,250
Other New Business 6,539 30,410 36,949
Total 1,752,080 20,871,691 22,623,771
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3. Income from charitable activities (continued)

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Income from contracts Unrestricted Restricted Total
Funds Funds 2021
£ £ £
NHS England & Wales
Management Support Fee 1,300,000 - 1,300,000
NCAPOP Audits - 9,331,515 9,331,515
NCAPOP Subscriptions - 2,019,500 2,019,500
Subscriptions Admin Fees 20,500 - 20,500
All UK Administrations and Crown Dependencies
CORP Programme Income - 2,821,353 2,821,353
NCAPOP (Scottish Contributions) - 311,089 311,089
Programme Management Fees 213,208 - 213,208
Department of Health & Social Care - 185,783 185,783
NJR Subscriptions Income - 3,423,026 3,423,026
NJR Other Income - 773,045 773,045
Health Foundation Grants - 54,779 54,779
Data Access Requests 25,125 - 25,125
Other New Business 6,000 213,023 219,023
Total 1,564,833 19,133,113 20,697,946
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4. Other income

----- Start of picture text -----
Unrestricted Restricted Total
Funds Funds 2022
£ £ £
Miscellaneous income 15,055 - 15,055
Unrestricted Restricted Total
Funds Funds 2021
£ £ £
Miscellaneous income 15,400 - 15,400
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5. Charitable activities

----- Start of picture text -----
Unrestricted Restricted Total
Funds Funds 2022
£ £ £
Management, development and promotion of clinical audit
National Clinical Audit & Patient Outcomes Programme
(NCAPOP)
NCAPOP Audits - 11,499,456 11,499,456
Clinical Outcome Review Programmes
Programme Costs - 3,567,936 3,567,936
Staff Costs 489,213 431,025 920,238
Support Costs 877,332 - 877,332
1,366,545 15,498,417 16,864,962
National Joint Registry (NJR)
NJR Programme Costs - 2,427,115 2,427,115
Staff Costs - 713,514 713,514
Support Costs - 188,736 188,736
- 3,329,365 3,329,365
Clinical Outcomes Publication
National Clinical Audit Benchmarking 8,720 - 8,720
8,720 - 8,720
Quality Improvement and Development
Support to local audit - 20,279 20,279
Education & Training 715 - 715
Staff Costs met from Health Foundation Grants - 126 126
715 20,405 21,120
New Business Activities
Direct Costs - 74,216 74,216
Staff Costs 352,457 352,457
-
426,673 426,673
1,375,980 19,274,860 20,650,840
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5. Charitable activities (continued)

----- Start of picture text -----
Unrestricted Restricted Total
Funds Funds 2021
£ £ £
As restated As restated
Management, development and promotion of clinical audit
National Clinical Audit & Patient Outcomes Programme
(NCAPOP)
NCAPOP Audits - 11,336,342 11,336,342
NCAPOP Retendering & Support Costs - 1,917 1,917
Clinical Outcome Review Programmes
Programme Costs - 3,483,561 3,483,561
Learning Disabilities Mortality Review - 275,674 275,674
Staff Costs 636,306 384,433 1,020,739
Support Costs 800,825 - 800,825
1,437,131 15,481,927 16,919,058
National Joint Registry (NJR)
NJR Programme Costs - 2,549,891 2,549,891
Staff Costs - 616,697 616,697
Support Costs - 247,489 247,489
- 3,414,077 3,414,077
Clinical Outcomes Publication
Clinical Outcomes Publication - 31,350 31,350
National Clinical Audit Benchmarking 7,510 - 7,510
7,510 31,350 38,860
Quality Improvement and Development
Support to local audit 5,000 15,654 20,654
Education & Training 9,523 - 9,523
Staff Costs met from Health Foundation Grants - 101,251 101,251
14,523 116,905 131,428
New Business Activities
Direct Costs - 56,061 56,061
Staff Costs - 127,208 127,208
- 183,269 183,269
1,459,164 19,227,528 20,686,692
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6. Support costs

----- Start of picture text -----
Contract Mgt & National Joint Stability Fund Total Total
Commissioning Registry 2022 2021
Per MOU
----- End of picture text -----

Contract Mgt &
Commissioning		 National Joint
Registry
Per MOU		 Stability Fund Total
2022		 Total
2021
£ £ £ £ £
Staff costs (Core Team
Apportioned)		 527,911 132,071 - 659,982 576,438
Procurement Consultancy - - 120,250 120,250 61,400
Finance Consultancy 11,870 - - 11,870 -
Other Staff Costs and Sundry
Expenses		 2,115 - - 2,115 897
Staff Training 2,303 - - 2,303 5,014
Staff Recruitment 24,315 - - 24,315 4,020
Advertising & Publicity - - - - 400
Financing & Bank Charges 945 393 - 1,338 1,058
Hire of Offce Equipment - - - - 467
Working from Home Costs 83 - - 83 1,191
Website Design and hosting 2,490 - - 2,490 2,620
Marketing Automation 13,035 - - 13,035 20,768
Premises Costs (Rent & Facilities
Charges)		 12,092 4,927 - 17,019 193,592
Computer Equipment & Software 20,343 8,159 - 28,502 27,418
IT Support 32,908 13,037 - 45,945 45,697
Printing, Stationery & Offce
Supplies		 7,308 - - 7,308 2,756
Postage and Courier Costs 4,547 - - 4,547 1,263
Telephone 9,608 4,986 - 14,594 12,882
Other Accommodation Costs and
Room Hire		 198 - - 198 1,260
Travel, Subsistence &
Accommodation		 431 - - 431 92
Service User Network 18 - - 18 25
Subscriptions 508 - - 508 386
Communications 3,580 - - 3,580 2,701
Other Meeting Costs inc. Catering - - - - 69

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6. Support costs (continued)

----- Start of picture text -----
Contract Mgt & National Joint Stability Fund Total Total
Commissioning Registry 2022 2021
Per MOU
£ £ £ £ £
Insurance 33,622 14,225 - 47,847 42,210
Professional Fees - HR 2,643 3,820 - 6,463 2,721
Consultancy
Professional Fees - IT Consultancy 6,816 1,528 - 8,344 -
Depreciation 14,437 - - 14,437 15,523
Loss on Disposals 37 - - 37 -
Governance:
Audit Fees 11,802 4,563 - 16,365 15,820
Other auditor's remuneration - - - - 3,722
Legal and other Governance 11,117 1,027 - 12,144 5,904
Costs
757,082 188,736 120,250 1,066,068 1,048,314
----- End of picture text -----

Support costs have been allocated on the basis of staff time expended in each area as follows:

----- Start of picture text -----
2022 2021
Commissioning and contract management of clinical audit 757,082 786,825
National Joint Registry 188,736 247,489
Stability Fund 120,250 14,000
1,066,068 1,048,314
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7. Net movement in funds

This is stated after charging:

Unrestricted Restricted Total
2022
£ £ £
Auditor's remuneration
Statutory audit services 11,403 4,887 16,290
Depreciation 14,437 - 14,437
Operating Lease Rentals 15,000 - 15,000
Unrestricted Restricted Total
2021
£ £ £
Auditor's remuneration
Statutory audit services 11,074 4,746 15,820
Other services 2,605 1,117 3,722
Depreciation 15,253 - 15,253
Operating Lease Rentals 179,760 - 179,760

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8. Employee and staff costs

----- Start of picture text -----
2022 2021
£ £
As restated
Wages and Salaries 2,108,113 1,873,106
Social Security Costs 242,255 214,737
Pension Costs (Aegon Scottish Equitable) 114,217 96,307
Pension Costs (NHS) - 11,104
Pension Admin Charges 2,080 1,900
Cost of Secondments 155,506 115,850
Cost of Agency Staff 24,146 129,329
2,646,317 2,442,333
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Staff costs have been allocated as follows:

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2022 2021
£ £
As restated
Management, development and promotion of clinical audit 920,238 1,020,739
National Joint Registry 713,514 616,697
Quality Improvement and Development 126 101,251
New Business Activities 352,457 127,208
Support Costs 659,982 576,438
2,646,317 2,442,333
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8. Employee and staff costs (continued)

The average number of employees during the period and the actual numbers at 31 March 2022 calculated on a full time equivalent basis, analysed by function, was as follows:

----- Start of picture text -----
2022 2022 2021 2021
Av No. Actual Av No. Actual
Charitable activities
Contract Management & Commissioning 13.1 12.4 11.2 13
NJR Team 11.0 11.0 9.1 11
Management and Core Services 11.4 13.1 9.2 11
TOTAL 35.5 36.5 29.5 35
----- End of picture text -----

The number of employees who earned £60,000 per annum or more during the period was

2022 2021
£60,000-70,000 2 3
£70,000-80,000 5 4
£80,000-90,000 2 4
£90,000-100,000 4 -
£100,000-110,000 - 1
£110,000-120,000 - 1

Key management personnel include the Trustees, Chief Executive (and senior staff reporting directly to the Chief Executive). The total employee benefits of the charity’s key management personnel were £436,348 (2021: £452,527).

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9. Trustees’ remuneration

None of the Trustees received any remuneration in respect of their services during the period (2021: £Nil).

During the year out of pocket travelling expenses amounting to £Nil were reimbursed to Trustees (2021: £Nil).

The charity has purchased insurance to protect the charity from any loss arising from the neglect or defaults of its trustees, employees and agents and to indemnify the trustees or other officers against the consequences of any neglect or default on their part. The insurance premium paid by the charity during the period totalled £47,847 and provides cover up to a maximum of £10,000,000 (any one claim or the aggregate during one period of insurance - being 12 months).

10. Taxation

HQIP is a registered charity and therefore is not liable for income tax or corporation tax on income derived from its charitable activities, as it falls within the various exemptions available to registered charities.

11. Intangible fixed assets

Website
development
costs
Cost £
At 1 April 2021 and 31 March 2022 61,089
Amortisation
At 1 April 2021 and 31 March 2022 61,089
Net Book Values
At 31 March 2022 -
At 31 March 2021 -

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12. Tangible fixed assets

Fixtures, fttings &
equipment
Cost £
At 1 April 2021 92,042
Additions 4,232
Disposals (50,809)
At 31 March 2022 45,465
Depreciation
At 1 April 2021 74,332
On Disposals (49,202)
Charge for the Year 14,437
At 31 March 2022 39,567
Net Book Values
At 31 March 2022 5,898
At 31 March 2021 17,710

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13. Debtors

----- Start of picture text -----
Unrestricted Restricted Total
2022 2022 2022 2021
£ £
Trade Debtors - 528,634 528,634 413,637
VAT Refundable - - - 193,169
Prepayments & Other Debtors 30,230 872,478 902,708 88,341
Accrued income - 153,260 153,260 196,634
30,230 1,554,372 1,584,602 891,781
----- End of picture text -----

14. Creditors: Amounts falling due within one year

----- Start of picture text -----
2022 2021
£
As restated
Trade Creditors 4,370,131 3,250,819
Other Creditors 47,175 33,283
Tax and social security 450,374 59,790
Accruals 1,627,772 1,696,261
Deferred income 69,984 234,310
6,565,436 5,274,463
----- End of picture text -----

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15. Restricted funds

----- Start of picture text -----
At 1 April Income Expenditure Transfers At 31 March
2021 2022
£ £ £ £ £
As restated
NCAPOP Audits 6,220,004 12,334,657 (11,773,419) 446,453 7,227,695
- -
NCAPOP Subscriptions 2,009,700 (432,204) (1,577,496)
NCAPOP Scottish Extensions - 139,162 - (139,162) -
NCAPOP Transition Costs 139,822 - - - 139,822
- - -
Development of Clinical Service Accreditation 22,887 (22,887)
- -
CORP Programme Costs including PMRT 2,318,737 (3,567,936) 1,249,199
-
National Joint Registry 5,017,711 4,030,068 (3,329,365) 5,718,414
- - -
Support to local audit (20,279) 20,279
- -
Health Foundation Grant QI Fellow (9,926) 10,052 (126)
Independent Sector Pilot Project 59,072 30,410 (89,482) - -
- -
Health Foundation - Understanding Data 2,141 (3,717) 1,576
Access
HDR UK Metadata Onboarding 58,012 - (58,332) 320 -
11,509,723 20,872,786 (19,274,860) (21,718) 13,085,931
----- End of picture text -----

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15. Restricted funds (continued)

----- Start of picture text -----
At 1 April Income Expenditure Transfers At 31 March
2020 2021
£ £ £ £ £
As restated As restated As restated
NCAPOP Audits 6,878,596 9,205,461 (11,384,342) 1,520,289 6,220,004
- -
NCAPOP Subscriptions 2,019,500 (384,635) (1,634,865)
Consultant Outcomes Publication - - (31,350) 31,350 -
NCAPOP Scottish Extensions - 311,089 - (311,089) -
NCAPOP Transition Costs 139,822 - - - 139,822
- - -
NCAPOP Retendering (1,917) 1,917
- - -
Development of Clinical Service Accreditation 22,887 22,887
-
CORP Programme Costs including NMCRR & PMRT 3,688 3,133,190 (3,483,561) 346,683
- - -
Learning Disabilities Mortality Review 275,674 (275,674)
National Joint Registry 4,225,490 4,199,071 (3,414,077) 7,227 5,017,711
- - -
Support to local audit (15,654) 15,654
-
Health Foundation Grant QI Fellow 24,597 (39,083) 4,560 (9,926)
Surgical mesh data requirements 11,051 - - (11,051) -
Independent Sector Pilot Project 16,549 53,023 (10,500) - 59,072
Health Foundation - Understanding Data Access 39,336 54,779 (88,347) (3,627) 2,141
-
HDR UK Metadata Onboarding 160,000 (98,388) (3,600) 58,012
11,637,690 19,136,113 (19,227,528) (36,552) 11,509,723
----- End of picture text -----

NCAPOP - National Clinical Audit and Patient Outcomes Programme

Management of the National Clinical Audit and Patient Outcomes Programme (NCAPOP), servicing existing contracts and commissioning new audits according to priorities agreed by NHS England. A list of NCAPOP audits supported in 202122 appears in the Appendix.

Clinical Outcomes Publication

Clinical Outcomes Publication is an NHS England initiative managed by HQIP, to publish quality measures at individual consultant, team and unit level using national clinical audit and administrative data.

Development of Clinical Service Accreditation

Development of Clinical Service Accreditation – in order to accurately assess the performance of clinical services in relation to established standards and implement ways to continuously improve these.

NJR - National Joint Registry

To fund work to ensure that patients obtain the best clinical care during and following their joint replacement operation. To provide patients, clinicians, healthcare purchasers, commissioners, regulators and implant suppliers with evidence as to which are the best performing implants, ensuring that NHS and other healthcare resources are best used. NJR funds are held in a separate bank account.

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15. Restricted funds (continued)

CORP - Clinical Outcome Review Programmes

Confidential enquiries designed to stimulate improvements in safety and effectiveness by enabling clinicians, managers and policy makers to learn from adverse events and other relevant data. Coverage is UK-wide, and the programme includes the following topics: deaths following medical and surgical intervention; suicides and homicide among people with mental illness; a child health review; and, maternal, infant and perinatal mortality. One further programme has been commissioned –a national child mortality database.

Health Foundation Grant for QI Clinical Fellow

The grant funds Dr. Ian Woolhouse as Senior Healthcare QI lead two days per week. The aim is to develop and deliver an explicit systematic QI-led approach to commissioning the NCAPOP, improving its capacity to reduce variation and improve patient outcomes.

Mesh Registries

HQIP was commissioned by the Department of Health and Social Care (DHCS) to undertake a feasibility study to investigate urogynaecological surgical mesh data requirements.

Independent Sector Pilot Project

Will establish the viability, challenges and barriers to flowing data from independent sector providers into the National Clinical Audit and Patient Outcomes Programme. The end result will be a feasibility report providing recommendations on how to support the independent sector to engage more fully with national clinical audit.

Understanding Health Data Access

A project seeking to provide researchers and the public with relevant and easy to follow videos, guidance, support and top tips for applying for and accessing health data. The project is drawing on the views of and collaborative inputs from patients and the public and clinical and research experts.

Health Data Research UK - Metadata Onboarding and Process Improvement Grant

HQIP is working to improve the quality and visibility of the information publically available on the healthcare datasets we commission. We have worked with our dataproviders to develop the information required to list our datasets on the HDR UK Innovation Gateway as well as contributing to a variety of other Alliance initiatives to enhance the use of health data for research and innovation.

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16. Fixed assets fund

----- Start of picture text -----
At 1 April Additions Depreciation/ Disposals At 31 March
2021 Amortisation 2022
£ £ £ £ £
Fixtures, fittings, 17,710 4,232 (14,437) (1,607) 5,898
equipment
17,710 4,232 (14,437) (1,607) 5,898
At 1 April Additions Depreciation/ Disposals At 31 March
2020 Amortisation 2021
£ £ £ £ £
Fixtures, fittings, 31,297 1,936 (15,523) - 17,710
equipment
31,297 1,936 (15,523) - 17,710
----- End of picture text -----

The fixed assets fund represents the net book value of the charity’s fixed assets.

17. Designated funds

The income fund of the charity includes the following designated funds which have been set aside out of unrestricted funds by the trustees for specific purposes:

----- Start of picture text -----
At 1 April New Utilised/ At 31 March
2021 designations released 2022
£ £ £ £
-
Stability Fund 566,689 (120,250) 446,439
-
566,689 (120,250) 446,439
At 1 April New Utilised/ At 31 March
2020 designations released 2021
£ £ £ £
-
Stability Fund 580,689 (14,000) 566,689
-
580,689 (14,000) 566,689
----- End of picture text -----

The Trustees designated a Stability Fund in 2018 and its purpose is described in the Reserves Policy section of the Trustees’ Annual Report.

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trustees’ report and accounts 2021-22

18. Analysis of net assets between funds

----- Start of picture text -----
General Fixed Designated Restricted Total
Fund assets Fund Funds Funds 2022
£ £ £ £ £
Fund balances at 31 March 2022 are
represented by:
Tangible fixed assets - 5,898 - - 5,898
Current assets 2,635,249 - 446,439 19,251,745 22,333,433
Current liabilities (399,622) - - (6,165,814) (6,565,436)
Total Net Assets 2,235,627 5,898 446,439 13,085,931 15,773,895
----- End of picture text -----

----- Start of picture text -----
General Fixed Designated Restricted Total
Fund assets Fund Funds Funds 2021
£ £ £ £ £
As restated As restated
Fund balances at 31 March 2021 are
represented by:
Tangible fixed assets - 17,710 - - 17,710
Current assets 1,801,032 - 566,689 16,672,750 19,040,471
Current liabilities (111,436) - - (5,163,027) (5,274,463)
Total Net Assets 1,689,596 17,710 566,689 11,509,723 13,783,718
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19. Contractual commitments

At 31 March 2022 the charity had no commitments in respect of contract payments approved for national clinical audits and which had not been accrued due to necessary milestones not being achieved by providers at the year end.

20. Contingent liabilities

The charity conducted a VAT health check in the year to ensure continuing compliance with latest VAT regulations and has noted some potential further VAT liabilities due to HMRC. Work on this is ongoing and the value of any such liabilities cannot yet be reliably quantified and consequently no provision has been made.

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21. Leasing commitments

At 31 March 2022 the charity had total commitments under non-cancellable leases falling due as follows:

----- Start of picture text -----
2022 2021
£ £
Under 1 year - 15,000
- 15,000
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22. Pension commitments

HQIP operates a money purchase pension scheme for most employees. In the previous year one member of staff was eligible for Direction status and HQIP therefore contributed to the NHS Pension Scheme for this employee.

The NHS Pension Scheme is an unfunded, defined benefit scheme that covers NHS employers, general practices and other bodies, allowed under the Secretary of State, in England and Wales. As a consequence it is not possible for HQIP to identify its share of the underlying scheme liabilities. The scheme is accounted for as a defined contribution scheme and the cost of the scheme is equal to the contributions payable to the scheme for the accounting period.

Employers contributing under Direction status have their pension cost contributions charged to operating expenses as and when they become due. Employer contribution rates are reviewed every four years (previously five years) following an actuarial investigation carried out by the scheme actuary. On advice from the actuary the contribution rate may be varied from time to time to reflect changes in the scheme’s liabilities. At the last actuarial investigation on which contribution rates were based (31 March 2016) employer contributions were set at 20.6% of pensionable pay.

A copy of the actuarial investigation and latest resource accounts can be viewed on the NHS Business Services Authority website: http://www.nhsbsa.nhs.uk/ Pensions?Valuations.aspx

Total pension costs in the period were £114,217 (2021: £107,411) and £20,087 (2021: £21,240) were payable at 31 March 2022.

23. Related party transactions

There were no reportable related party transactions in 2022 or 2021.

24. Liability of members

The charity is constituted as a company limited by guarantee. In the event of the charity being wound up members are required to contribute an amount not exceeding £10.

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trustees’ report and accounts 2021-22

25. Prior year adjustment

A prior year adjustment has been made in connection with costs relating to 2020-2021 that were not accrued.

The effect of this adjustment on the results is shown below:

At 31 March 2021 At 31 March 2021 At 31 March 2021
As previously reported
£		 Adjustment
£		 As restated
£
Changes to the Balance Sheet
Creditors (4,950,966) (323,497) (5,274,463)
Net current assets 14,089,505 (323,497) 13,766,008
Restricted funds 11,833,220 (323,497) 11,509,723
Total funds 14,107,215 (323,497) 13,783,718
Changes to the Statement of Financial Activities
Charitable activities expenditure 20,363,195 323,497 20,686,692
Net income/(expenditure) 356,151 (323,497) 32,654

There was no impact on funds as at 1 April 2020.

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APPENDIX: HQIP programmes and audits, 2021-22

National Clinical Audits

Adult Diabetes:

Breast Cancer in Older Patients

Cardiovascular Disease Prevention Audit, CVDPREVENT

Care at the End of Life

Chronic Obstructive Pulmonary Disease with Asthma:

Dementia: Care in General Hospitals

Early Inflammatory Arthritis Audit

Emergency Laparotomy

Falls and Fragility Fracture:

National Gastro-intestinal Cancer Audit:

National Joint Registry

National Vascular Registry

National Neonatal Audit Programme Obesity (commissioned April 2021)

Paediatric Diabetes

Paediatric Intensive Care Audit Prostate Cancer Audit

Psychosis Audit Seizures and Epilepsy in Children and Young People

Sentinel Stroke Audit Programme

Clinical Outcome Review Programmes

Mental Health

Child Health

Medical and Surgical

Maternal and Newborn Infant

Lung Cancer

Mortality Review Programmes

Maternal and Perinatal

National Child Mortality Database

National Cardiac Audit Programme (transitioned to Argent and GEN Commissioning Support Unit June 2022)

Non-NCAPOP Commissions

Perinatal Mortality Review Tool

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27A Harley Place, London W1G 8LZ communications@hqip.org.uk @HQIP

www.hqip.org.uk