**Healthcare Services HealthPatient 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 2022–March 2023
www.hqip.org.uk
TRUSTEES’ REPORT AND ACCOUNTS **2022-23**
## **Trustees**
Professor Dame Carrie MacEwen, DBE (Chair) Alastair Henderson (Vice-chair) – _resigned 17 November 2022_ Philip Grimshaw Baker – _resigned 17 November 2022_ Kalwant Grewal (Treasurer) – _resigned 11 April 2023_ Susan Masters Dr Victoria Tzortziou Brown, OBE – _resigned 17 November 2022_ Gillian Coverdale Janice Gabriel Peter Bloomfield Rosemary Jarvis – _appointed 25 January 2023_
## **Chief Executive:**
Jane Ingham – _resigned 31 July 2023_ Chris Gush – _appointed 1 August 2023_
**Registered office:** 27A Harley Place, London W1G 8LZ **Email:** communications@hqip.org.uk **Website:** www.hqip.org.uk **X:** @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
|Contents||
|---|---|
|**HQIP and our vision**|**4**|
|**Chair and CEO statement**|**6**|
|**Our year in numbers**|**8**|
|**Strategic report**
**Strategic objectives**|**10**
**10**|
|**Achievements and performance**|**10**|
|**Future plans**|**15**|
|**Trustees’ report**|**16**|
|**Financial report**|**17**|
|**Independent auditor’s report**|**20**|
|**Statement of fnancial activities for the year to 31 March 2023**|**24**|
|**Balance sheet 31 March 2023**|**25**|
|**Statement of cash fows for the year ended 31 March 2023**|**26**|
|**Notes to the accounts 2022-23**|**27**|
|**Appendix: HQIP programmes and audits, 2022-23**|**47**|
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TRUSTEES’ REPORT AND ACCOUNTS **2022-23**
## HQIP and our vision
The Healthcare Quality Improvement Partnership (HQIP) is 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 clinical audit, national programmes and registries.
More 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 the case of some projects, other devolved administrations and crown dependencies. This programme covers the National Clinical Audit Programme and Clinical Outcome Review Programmes which comprise of circa 40 projects that collect and analyse data supplied by clinicians, in order to provide a national picture of care standards for a wide range of conditions. We also host the National Joint Registry (NJR), which collects and reports on data for hip, knee, ankle, elbow and shoulder joint replacement procedures. The NJR is the largest register of its kind in the world, and covers England, Wales, Northern Ireland, the Isle of Man and the State of Guernsey.
Our work – and its value – goes far beyond data collection and managing clinical audits and registries; the outcomes support evidence-based 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, themed ‘signpost’ updates and a Quality Improvement (QI) magazine, all of which help the audit and wider healthcare communities to implement local and national improvements, and to deliver effective and safe services. This support is further enhanced by our highlyspecialised QI advisory services.
**Healthcare Services Benchmark HealthPatient Outcomes Measure National Improve Audit Measure Improve Evaluate National Quality Improvement Evaluate Impact Patient Outcomes Benchmark Clinical Effectiveness Health**
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HEALTHCARE QUALITY IMPROVEMENT PARTNERSHIP
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 ‘clinical audit heroes’) in collaboration with the National Quality Improvement (inc Clinical Audit) Network (N-QI-CAN). From the creation of guidance to enable the sharing of data beyond the confines of the healthcare sector, through to reviewing the metrics used in audits (and a range of activities in between), everything we do aims to share our knowledge and maximise the impact of the data collected. However, we cannot do this alone...
We are committed to collaborating with a wide range of stakeholders, both within and beyond the healthcare sector. We seek out and develop relationships at both 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; 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 (inc Clinical Audit) Network (N-QI-CAN); Health Data Research UK; the Health Foundation and the Q Community; 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 engagement with patients, carers and their communities and representatives. This engagement plays a vital role in our work, from planning right through to delivery, and key examples include patient involvement in the development of programme specifications as well as in the production of patient-friendly reports. Central to this work, is our Service User Network (SUN), an advisory group of patients and carers who provide input into our work and its outputs. 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.
## **HQIP Chief Executive Officer (CEO)**
In August 2023, Jane Ingham retired from her role as CEO at HQIP. We would like to take this opportunity to thank Jane for her 10 years of service, working to improve patient outcomes, and also to welcome HQIP’s new CEO, Chris Gush. Find out more here.
**Health MeasureQuality Improvement National Benchmark Evaluate Clinical Effectiveness Impact Evaluate Health Patient Outcomes Measure Healthcare Services Impact Health Benchmark Patient Outcomes Quality Improvement Evaluate National Improve**
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## TitleChair and CEO statement
## **2022-23: Not just back to the future, but back to the data-informed future**
This was a year in which we, along with everyone else in healthcare, were able - albeit tentatively - to turn our attention back to the future. While COVID-19 continued in its various guises (one in 13 people in the UK were reported to have the virus at the end of March 2022[1] ), it was clear that the sector needed to plan for recovery. But what did this mean in practice, and what was feasible, in an already overstretched service?
It was apparent to all, from policy makers to frontline clinicians, that the answer lay in taking a targeted approach. Identifying where resources were needed most, and where they would make the greatest difference, to achieve maximum impact. In other words, it was clear that we needed to ‘follow the data’.
_“Taking an evidence-informed approach to improvement would help to reduce burden and support a ‘smart’ approach to healthcare design”_
So, the value of audit and clinical outcome data was never greater than in 2022-23. Taking an evidenceinformed approach to improvement would help to reduce burden and support a ‘smart’ approach to
healthcare design – and this was exemplified by changes introduced to the National Clinical Audit and Patient Outcomes Programme (NCAPOP), which we commission on behalf of NHS England. With over 40 programmes and audits, there was a wealth of healthcare data available, but the real challenge was to translate it into positive actions that target change where needed. That is why we introduced new measures to reduce the number of metrics, make reports and other outputs more succinct, and improve the timeliness of data. In October 2022, we were also delighted to take a new approach to commissioning. The National Cancer Audit Collaborating Centre encompasses multiple cancer audits, and offers efficiencies as well as opportunities for greater knowledge and best-practice sharing.
Changes such as these were the result of the culmination of extensive experience in managing the NCAPOP. Our work up to this point meant that we were in a position to commission programmes that were both aware of the sector’s needs and cognisant of the NHS approach to impact (more on which can be found on the NHS England IMPACT website). This, no doubt, influenced HQIP being re-awarded the contract from NHS England to continue commissioning the NCAPOP from 1 April 2023 for three years (with an option to extend for a further two years). We are delighted with this news and look forward to delivering a programme that supports providers and commissioners to improve patient outcomes, while minimising burden on all involved.
Other highlights this year include the relaunch of Clinical Audit Awareness Week (CAAW), following a break due to the pandemic. We also launched a new
> 1 Figures from the week ending 26 March 2022 from the Office for National Statistics indicated that 4.9 million people (one person in 13) in the UK had COVID-19. This was the highest recorded number of cases since COVID records began in April 2020.
online magazine-like publication, CORNERSTONE, that aims to support a wide range of healthcare stakeholders with Quality Improvement (QI). The first (2023) edition contained articles on patient safety, public engagement and health inequalities, among others. We look forward to sharing the 2024 edition from the end of 2023. More information on these projects, and all our work and outputs, can be found on the HQIP website.
_“We could not continue to run an audit programme that is both targeted and meaningful without the dedication and support of the audit community or those who plan, deliver and receive healthcare”_
Director of the veterinary charity RCVS Knowledge, has been appointed as HQIP’s CEO from 1 August 2023. He is committed to building on Jane’s work, and to collaborating with stakeholders to deliver quality improvement and improve patient outcomes.
Finally, we wish to end on a note of thanks. It goes without saying that we could not continue to run an audit programme that is both targeted and meaningful without the dedication and support of the audit community or those who plan, deliver and receive healthcare. Indeed, without the combined efforts of the entire healthcare community, we could not support ‘looking back to the data-informed future’.
Best regards,
**Carrie MacEwen, DBE LLD Jane Ingham, FRSE MD FRCOPhth FRCS CEO Chair**
On a personal note, we each have some news to share. We are proud to say that Carrie (HQIP’s Chair of the Board of Trustees) was appointed as the Chair of the General Medical Council (GMC) in May 2022, becoming only the second woman to hold the post since the GMC was established. Then, after ten years at the helm at HQIP, Jane has decided to retire in the summer of 2023. We are delighted that Chris Gush, Executive
TRUSTEES’ REPORT AND ACCOUNTS **2022-23**
## Our year in numbers
## **1 April 2022 to 31 March 2023**
**----- Start of picture text -----**
National Clinical Audit and Patient Outcome Programme outputs
64 368 44 25 40
Reports Recommendations Infographics Impact Peer-reviewed
published reports publications featuring
HQIP-commissioned data
National Joint Registry (NJR) Tenders
Data analysed:
11 New NCAPOP contracts awarded
99,043 98,469 13
Hips Knees
NCAPOP contract
Peer-reviewed
5 extensions
journal articles
6,780 817 880 on research
using NJR data
Shoulders Elbows Ankle HQIP supplier
replacements 4 contracts awarded
Applications
Data access
41 received
PF C—)- @o© A&é
@ca db
eLearning
Introduction to quality improvement for Introduction to quality improvement for
healthcare professionals patients and public
2,028 Completed sessions 1,292 Completed sessions
978 Self-certification completed 521 Self-certification completed
**----- End of picture text -----**
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**Patient and carer engagement 3 3 9 6 Focus Feedback presented Involvement in Richard Driscoll groups at Specification scoring and evaluation Memorial Award Development Meetings of tenders 2022 case studies**
**----- Start of picture text -----**
National Clinical Audit Benchmarking (NCAB) website
14 11,197 15,507 49,605 2,136
Datasets Users Sessions Pageviews Downloads (csv
added
and pdf files)
HQIP on social media Mailing list
Twitter (X as of 2023) followers New
5,998 (at 31 March 2023) 992 subscribers
LinkedIn followers Total active contacts
4,260 (at 31 March 2023) 30,334 (31 March 2023)
HQIP website
133,740 206,681 767,655 278,013
Users Sessions Pageviews Resource pageviews
**----- End of picture text -----**
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TRUSTEES’ REPORT AND ACCOUNTS **2022-23**
## Strategic report
In shaping our objectives and planning our activities, the Trustees have considered the Charity . The Commission’s guidance on public benefit, including _Public benefit: running a charity (PB2)_ 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 informs 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 2022 to 31 March 2023. In addition, short vignettes have been included to illustrate our impact in relation to specific activities and, where relevant, online links have been provided. Further information about HQIP can be found on our website: www.hqip.org.uk. Our key achievements this year include:
- ຉ Continued with the delivery of the on-going National Clinical Audit and Patient Outcomes Programme (NCAPOP), publishing 44 infographics and 64 reports, featuring 368 recommendations, across a multitude of clinical disciplines ranging from asthma to vascular health.
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## **Spotlight:** National Cancer Audit Collaborating Centre (NATCAN)
From October 2022, we commissioned a set of new cancer programmes on behalf of NHS England and the Welsh Government. The National Cancer Audit Collaborating Centre, hosted by the Royal College of Surgeons of England, heralded a new approach, encompassing multiple new national cancer audits. In the first instance, this comprised: breast (including primary and metastatic), ovarian, pancreatic, nonHodgkin Lymphoma, and kidney cancer. However, the intention is to add further cancer audits over time, in order to take advantage of the opportunities for knowledge and best practice sharing, as well as efficiencies, afforded by this umbrella approach.
- ຉ Work continued to introduce changes to the National Clinical Audit and Patient Outcomes Programme (NCAPOP), to support targeted improvements in healthcare, particularly important for a service recovering from the COVID-19 pandemic. New measures include:
- reducing the burden on data providers, taking the number of metrics down to ten and ensuring that routine data is used if possible
- changing outputs to make reports more succinct
- improving timeliness of data provision, with near real-time dynamic reporting (which may be subject to subsequent adjustments) and subsequent fully quality-assured annual data.
This new Centre is part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP), and was funded by NHS England and the Welsh Government, with £5.4m for an initial period of three years. It aims to:
- provide regular and timely evidence to cancer services where patterns of care in England and Wales may vary
- support NHS services to increase the consistency of access to treatments and help guide quality improvement initiatives
- stimulate improvements in cancer detection, treatment and outcomes for patients, including survival rates.
- ຉ Awarded 11 new contracts as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP) including the National Audit of Psychosis, the National Vascular Registry and the National Clinical Audit of Stroke as well as the Clinical Outcome Review Programme (CORP) on Maternity, Newborn and Infant care. We also agreed five NCAPOP contract extensions including the National Audit of Dementia, and the Medical and Surgical Clinical Outcome Review Programme (CORP), in addition to four contracts to support the day-to-day running of HQIP.
- ຉ Developed and published four new in-focus reports, together with our 2022 annual impact report. Alongside a summary of national, system, local and public key impacts relating to HQIP’s audits and programmes, these additional reports looked in greater detail at the impact of National Emergency Laparotomy Audit (NELA), the Maternity and Perinatal Audit (NMPA), the National Bowel Cancer Audit (NBOCA), and the National Oesophago-Gastric Cancer Audit (NOGCA).
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TRUSTEES’ REPORT AND ACCOUNTS **2022-23**
## **Spotlight:** National Clinical Audit and Patient Outcomes Programme (NCAPOP)
Following a competitive tendering process, we were delighted to be re-awarded a contract by NHS England to commission the National Clinical Audit and Patient Outcomes Programme (NCAPOP), from 1 April 2023 for three years (with an option to extend for a further two years). This contract was the culmination of many months of work, to ensure that we will continue to deliver a programme that would meet not only the needs of NHS England but also those of healthcare planners, providers and, of course, patients.
## **HQIP Carbon Reduction Plan: Net zero by 2050**
In preparing for the NCAPOP contract, we published a Carbon Reduction Plan (CRP), which commits HQIP to achieving Net zero emissions by 2050. This is in accordance with the UK Government’s commitment under the Climate Change Act and the NHS Net Zero Supplier Roadmap. Continued carbon reduction will be achieved through effective supply chain management and HQIP’s asset register.
- ຉ Hosted National Joint Registry (NJR) which analysed data on 99,043 hips, 98,469 knees, 6,780 shoulders, 817 elbows and 880 ankle replacements. A total of 13 peer-reviewed journal articles, featuring research using NJR data, were also published. In addition, the NJR implemented its 2022-25 Strategic Plan and continued with the delivery of activities in its 2022-23 annual plan including: The development of enhanced data collection to reflect changes in orthopaedic clinical practice across all joints; a successful historical data quality audit of elbow surgery, with registry procedure records rising from 6,544 to 11,090; new performance metrics for knee surgery; and a new approach to patient engagement to bring the patient voice more strongly into the structure, work and activities of the NJR.
- ຉ The National Audit of Cardiovascular Disease Prevention in Primary Care (CVDPrevent)’s educational outreach activities reached over 43 Primary Care Networks (PCNs) or practice teams, supporting them to use their dashboard and data, and apply them in their area.
- ຉ This year saw a significant change in the structure of HQIP’s Service User Network (SUN), to support Patient and Public Involvement (PPI) in our work. In consultation with members, we looked at options to increase SUN membership and diversity, and this resulted in a flexible approach to taking part. We created a simple online sign-up form, and enabled members to pick and choose their involvement based on interest, availability or any other need they might have. The result was 33 new members up to 31 March 2023 (with the numbers still increasing), to whom we sent newsletters and emails with various opportunities to get involved.
- ຉ We continued to engage with patients, carers and communities on a broad range of activities to ensure our work continues to be relevant and meaningful. This involved engagement throughout the commissioning process, including: focus groups that fed into three specification development meetings; scoring of nine tenders using feedback from specification engagement; and patient/carer involvement in nine evaluation meetings.
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## **Spotlight:** Patient and Public Involvement in mental health
In February 2023, HQIP met with eight people with lived experience of mental health services – specifically loved ones of people who died by suicide and/or those who have been suicidal themselves. Participants were Lived Experience Influencers from The Samaritans and members of HQIP’s Service User Network. We asked them a number of questions around the information and support that would be useful, in order to help us understand the needs of service users and their loved ones, as we developed the specification for the Mental Health Clinical Outcome Review Programme. This identified the following needs:
- More data, to understand successive and protective factors
- More involvement of families and carers in the data, and
- Improvement in the support that is available after inpatient care, with 24/7 access to help e.g. links to charities and services.
We also asked the group for ideas for topics for inclusion in the programme. This resulted in useful suggestions including the link between healthcare inequalities and suicide, with particular emphasis on those with neurodivergence.
- ຉ Ensured representative patient and carer engagement in the National Obesity Audit, by establishing a user panel comprising a diverse group of people from all over England with lived experience of using a variety of services. We created a flyer which we shared with relevant networks and charities and on social media. The panel first met in May 2022 and their feedback was fed into the early stages of the audit, guiding the development of metrics and outputs such as a webpage on the HQIP website and a dashboard.
- ຉ Ran the 2022 Richard Driscoll Memorial Award, to celebrate excellent public and patient involvement in the National Clinical Audit and Patient Outcomes Programme (NCAPOP). The winning entry was Epilepsy12, in recognition of exceptional collaboration with young people and families, its embedded approach to engagement, and the flexible, inclusive nature of the Youth Advocates group. In addition, the judges (which included members of our Service User Network) selected two commended entries: the National Child Mortality Database (NCMD) and the National Audit of Breast Cancer in Older Patients (NABCOP). Case studies on the winning and commended projects, as well as a number of other entries, were developed and shared on the HQIP website.
- ຉ Enabled healthcare providers to benchmark their performance against national data in an increased number of clinical areas, with the verification and publication of 14 new datasets on the National Clinical Audit Benchmarking (NCAB) platform. These span a range of clinical disciplines, including paediatric diabetes and intensive care as well as prostate and breast cancer.
- ຉ In collaboration with NCAPOP data providers, the Care Quality Commission (CQC), the NHS Model Health System and key Trust colleagues, we held a National Clinical Audit Benchmarking (NCAB) Future Forum in November 2022, to assess options for modernising and streamlining data processing. As a result, a set of success criteria for modernised consolidated reporting, and key themes for future development to improve data processing, were agreed.
- ຉ Supported local audit and quality improvement in NHS Trusts across the country by working with the National Quality Improvement (incl. Clinical Audit) Network (N-QI-CAN). We presented at all of N-QI-CAN’s national meetings, and responded to questions and feedback from participants, bringing the local audit perspective into our commissioning work, and disseminating national developments and findings.
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TRUSTEES’ REPORT AND ACCOUNTS **2022-23**
## **Spotlight:** Clinical Audit Awareness Week
2022 saw the relaunch of Clinical Audit Awareness Week (CAAW) from 13-17 June, following a break due to the COVID-19 pandemic. Run in collaboration with the National Quality Improvement (incl. Clinical Audit) Network (N-QI-CAN), it is a national campaign to promote and celebrate the benefits and impact of clinical audit and quality improvement work in healthcare.
- Patient safety
- Patient advocate
- Influencing change
-
- Health inequalities
- Future-proofing healthcare.
The winning and commended entries were announced at five daily Lunch & Learn events, hosted by N-QI-CAN, during CAAW 2022.
The campaign included the 2022 Clinical Audit Heroes Awards, which recognised – and shared best practice from - five categories:
The 2022 campaign and awards were our most successful to date, with more website visitors and social media engagement than ever before.
- ຉ Held a final workshop in a series of four on health inequalities, with presentations from Bola Owolabi, Director of Health Inequalities at NHS England and Improvement, as well as members of HQIP’s Service User Network. The findings from our workshops were shared with key stakeholders, with the aim of improving the data available in this important area.
- ຉ Continued our successful series of themed ‘onestop shop’ newsletters to signpost to key quality improvement reports and resources from both HQIP and the wider sector, with new editions on Children & Young People’s Health and Mental Health in the summer and autumn of 2022.
- ຉ Supported NHS England in developing the Quality Accounts List 2023/24, facilitating a scoping process and preparing recommendations for review. Trusts use this List to plan clinical audit activity for the upcoming financial year, as well as to support the development of retrospective annual Quality Account reports. The List, which was published in early 2023, comprises national audits, clinical outcome review programmes and other quality improvement projects that NHS England advises Trusts to prioritise for participation.
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## **Spotlight:** NEW Quality Improvement (QI) publication
We published a new style of publication to support Quality Improvement (QI), aimed at a wide range of healthcare stakeholders. CORNERSTONE is an online ‘magazine-like’ publication, with short, easy-to-read articles on key issues, enabling busy professionals to dip in and out of it as needed. The first edition included articles on:
- The importance of healthcare data
- Patient safety
- The impact of national clinical audit
- Engaging patients
- Healthcare inequalities, and
- Focusing on the right data for impact.
- ຉ Enabled access to HQIP-managed data by processing 41 data access requests.
- ຉ In collaboration with the Health Foundation, NIHR and the MRC, we developed a recorded presentation and supporting leaflet to provide an overview of our datasets and our data access process, as well as highlight top tips and common pitfalls in applying for data.
- ຉ Continued with a series of insightful blog articles, to support clinical audit and Quality Improvement, including _Taking the long view: Future-proofing healthcare and Collecting data is just the start_ , which was written for the BMJ Leader series.
- ຉ Raised awareness of the impact of National Data Opt-out (NDO), which enables people to remove their identifiable data from uses beyond their own healthcare, through a single register. We also communicated the importance of striking a balance between respecting the rights of individuals and promoting the importance of complete and unbiased data. We worked intensively with national bodies
developing the NDO exemption process and, wherever there were demonstrable impacts, we supported our projects in gaining exemption.
- ຉ Our New Business Development (NBD) strategy was reviewed and significantly updated to reflect a broader and more ambitious approach. The revised strategy set out an impact-orientated and values-driven approach to building a wider portfolio of HQIP work, with a focus on Quality Improvement (QI), thought leadership, and capacity building and partnership development.
- ຉ We secured commissioned projects for delivery in 2023-24, including a Maternity project on behalf of NHS England that will look at ‘Understanding what matters to users of Maternity services in England: Listening to unheard voices’.
- ຉ Continued our focus on Equity, Diversity and Inclusion (EDI) with regular working group meetings, which resulted in improvements (such as the addition of an accessibility statement on the HQIP website) for both staff and our wider stakeholder groups.
## **Future plans**
## **Planned activity for 2023-24**
The underpinning themes influencing and shaping our work programme for the coming year are:
- Leveraging our expertise to increase our impact
- National clinical audit for local quality improvement
- Metrics for improvement
- Technology for agile working, and
Some of the key activities planned for 2023-24 are:
- Embedding of the new NCAPOP contract
- Establishment of an NJR patient network
- Programme of communications activity focussing on celebrating the NJR’s 20th anniversary
- Project to ensure communication with the right target audiences
- Work on developing new business projects
- Harnessing our assets for wider value (data to information).
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TRUSTEES’ REPORT AND ACCOUNTS **2022-23**
## 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 2023. 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:
- Select suitable accounting policies and then apply them consistently
- Comply with applicable accounting standards, including FRS 102, subject to any material departures disclosed and explained in the financial statements
- State whether a Statement of Recommended Practice (SORP) applies and has been followed, subject to any material departures which are explained in the financial statements
- Make judgements and estimates that are reasonable and prudent
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:
- There is no relevant audit information of which the charitable company’s auditor is unaware; and
- The Trustees have taken all the steps that they ought to make themselves aware of any relevant audit information and to establish that the auditor is aware of that information.
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.
- Prepare the financial statements on a going concern basis unless it is inappropriate to presume that the charitable company will continue in business
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## **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 **2022-23**
During the year ended 31 March 2023, HQIP received income totalling £21,633,878 (2022: £22,641,017) of which £20,049,827 (2022: £20,872,786) was for restricted purposes, and £1,584,051 (2022: £1,768,231) was for the general purposes of the charity including management support fees of £1,300,000 (2022: £1,300,000).
Income included £11,418,770 (2022: £12,334,657) to finance national clinical audits. In addition, HQIP collected subscriptions of £2,029,500 (2022: £2,009,700) from NHS Trusts on behalf of NHS England to support national audits. The Scottish Government contributed £179,216 (2022: £139,162) to NCAPOP programmes.
In 2022-23, income for the Clinical Outcome Review Programmes totalling £2,151,526 (2022: £2,112,717) was collected from all UK Administrations. This included funding for the National Child Mortality Database. The Department of Health and Social Care provided £121,573 (2022: £206,020) for development of a Perinatal Mortality Review Tool.
In 2022-23, the National Joint Registry (NJR) collected subscriptions totalling £3,385,630 (2022: £3,246,110). Other income of £717,090 (2022: £782,863) 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 £Nil (2022: £10,052) were received from the Health Foundation. Income of £Nil (2022: £30,410) was received for a pilot project with the Independent Healthcare Providers Network.
## **Expenditure**
In 2022-23, HQIP commissioned and managed national clinical audit contracts with a total value of £11,986,379 (2022: £11,499,456).
Expenditure on the Clinical Outcome Review Programmes, was £2,991,412 (2022: £3,567,936).
Expenditure on the management and development of the National Joint Registry was £3,753,045 (2022: £3,329,365).
Expenditure on National Clinical Audit Benchmarking was £7,870 (2022: £8,720). Expenditure on other Quality Improvement and Development activities was £25,248 (2022: £21,120).
Other direct charitable expenditure, including support costs, totalled £2,224,474 (2022: £2,224,243).
## **Financial position**
The balance sheet at 31 March 2023 shows total funds of £16,419,345 (2022: £15,773,895), including restricted funds totalling £13,752,867 (2022: £13,085,931) and unrestricted funds comprising general funds of £2,200,913 (2022: £2,235,627), tangible and intangible fixed assets of £19,126 (2022: £5,898) and designated funds of £446,439 (2022: £446,439).
At 31st March 2023, the charity retained free reserves of £2,200,913 (2022: £2,235,627).
## **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 nine months’ operating commitments (forecast at £1,368,870 to £2,053,305 in 2023-24). The actual free reserves of £2,200,913 at March 2023 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.
18
HEALTHCARE QUALITY IMPROVEMENT PARTNERSHIP
## **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 external salary benchmarking.
The principal risks are considered to be:
## **Risk 1: Dependency on one substantive contract**
Mitigation: Recruitment to new role, Associate Director for Healthcare Quality Improvement, which leads efforts in diversifying income and reducing dependency. New strategic framework for 2023-2026 adopted with refined aims and objectives based on learning during previous period.
## **Risk 2: Failure in Information Governance management**
Mitigation: External DPO contracted following internal staff changes and the onboarding process included full review of policies and procedures.
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: 23 November 2023
## **Risk management**
The Board of Trustees maintains a comprehensive Risk Register which is reviewed and discussed at every Board Meeting. Risks fall into five categories:
- Governance
- Operational
- Financial
- Environmental/external
- Compliance (laws and regulations)
The probability and impact of each risk is calculated and the charity’s mitigation strategy for each is considered.
19
TRUSTEES’ REPORT AND ACCOUNTS **2022-23**
## 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 2023 which comprise the Statement of Financial Activities, the Balance Sheet, the Cash Flow Statement and notes to the financial statements, including significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including FRS 102 ‘The Financial Reporting Standard Applicable in the UK and Republic of Ireland’ (United Kingdom Generally Accepted Accounting Practice).
In our opinion the financial statements:
- give a true and fair view of the state of the charitable company’s affairs as at 31 March 2023 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.
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.
## **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
## **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.
20
HEALTHCARE QUALITY IMPROVEMENT PARTNERSHIP
In connection with our audit of the financial statements, our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether there is a material misstatement in the financial statements or a material misstatement of the other information. If, based on the work we have performed, we conclude that there is a material 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:
- the information given in the strategic report and the trustees’ annual report for the financial year for which the financial statements are prepared is consistent with the financial statements; and
- the strategic report and the trustees’ annual report have been prepared in accordance with applicable legal requirements.
## **Matters on which we are required to report by exception**
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:
- adequate accounting records have not been 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.
## **Responsibilities of trustees**
As explained more fully in the trustees’ responsibilities statement set out on page 16, 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.
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.
21
TRUSTEES’ REPORT AND ACCOUNTS **2022-23**
## **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:
- Identify and assess the risks of material misstatement of the financial statements, whether due to fraud or error, design and perform audit procedures responsive to those risks, and obtain audit evidence that is sufficient and appropriate to provide a basis for our opinion. The risk of not detecting a material misstatement resulting from fraud is higher than for one resulting from error, as fraud may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal control.
- Obtain an understanding of internal control relevant to the audit in order to design audit procedures that are appropriate in the circumstances, but not for the purposes of expressing an opinion on the effectiveness of the charitable company’s internal control.
- Evaluate the appropriateness of accounting policies used and the reasonableness of accounting estimates and related disclosures made by the trustees.
- Conclude on the appropriateness of the trustees’ use of the going concern basis of accounting and, based on the audit evidence obtained, whether a material uncertainty exists related to events or conditions that may cast significant doubt on the charitable company’s ability to continue as a going concern. If we conclude
that a material uncertainty exists, we are required to draw attention in our auditor’s report to the related disclosures in the financial statements or, if such disclosures are inadequate, to modify our opinion. Our conclusions are based on the audit evidence obtained up to the date of our auditor’s report. However, future events or conditions may cause the charitable company to cease to continue as a going concern.
- Evaluate the overall presentation, structure and content of the financial statements, including the disclosures, and whether the financial statements represent the underlying transactions and events in a manner that achieves fair presentation.
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.
22
HEALTHCARE QUALITY IMPROVEMENT PARTNERSHIP
Our approach was as follows:
- We obtained an understanding of the legal and regulatory requirements applicable to the charitable company and considered that the most significant are the Companies Act 2006, the Charities Act 2011, the Charity SORP, and UK financial reporting standards as issued by the Financial Reporting Council.
- We obtained an understanding of how the charitable company complies with these requirements by discussions with management and those charged with governance.
- We assessed the risk of material misstatement of the financial statements, including the risk of material misstatement due to fraud and how it might occur, by holding discussions with management and those charged with governance.
- We inquired of management and those charged with governance as to any known instances of noncompliance or suspected non-compliance with laws and regulations.
- Based on this understanding, we designed specific appropriate audit procedures to identify instances of non-compliance with laws and regulations. This included making enquiries of management and those charged with governance and obtaining additional corroborative evidence as required.
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: 27 November 2023
23
TRUSTEES’ REPORT AND ACCOUNTS **2022-23**
## Statement of financial activities for the year to 31 March 2023
**----- Start of picture text -----**
Unrestricted Restricted Total Total
Funds Funds 2023 2022
Note £ £ £ £
INCOME AND
EXPENDITURE
Income
Income from 2 9,379 46,522 55,901 2,191
Investments
Charitable Activities
Management, 3 1,531,539 20,003,305 21,534,844 22,623,771
development and
promotion of
Clinical Audit
Other income 4 43,133 - 43,133 15,055
Total Income 1,584,051 20,049,827 21,633,878 22,641,017
Expenditure
Charitable activities
Management, 5 1,605,537 19,382,891 20,988,428 20,650,840
development and
promotion of
Clinical Audit
Total Expenditure 1,605,537 19,382,891 20,988,428 20,650,840
Net Income/ 7 (21,486) 666,936 645,450 1,990,177
(Expenditure)
Transfers between funds - - - -
Net movement in funds (21,486) 666,936 645,450 1,990,177
Balances brought 2,687,964 13,085,931 15,773,895 13,783,718
forward at 1 April 2022
Balances carried 2,666,478 13,752,867 16,419,345 15,773,895
forward at 31 March 2023
**----- 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.
24
HEALTHCARE QUALITY IMPROVEMENT PARTNERSHIP
## Balance sheet 31 March 2023
|~~LSS~~|~~LSS~~|**2023**
~~LSS~~|**2023**
~~LSS~~|**2022**
~~LSS~~|**2022**|
|---|---|---|---|---|---|
|~~SS~~
~~ee~~|Notes
~~LSS~~
~~SS~~|**£**
~~LSS~~
~~SS~~|**£**
~~LSS~~
~~SS~~|£
~~LSS~~
~~SS~~|£
~~SS~~|
|**Fixed assets**
~~SS~~
~~ee~~
~~ee~~|~~SS~~|~~SS~~|~~SS~~|~~SS~~|~~SS~~|
|Intangible fixed assets
~~ee~~
~~ee~~
~~ee~~|**11**|~~a~~|**-**
~~a~~||-|
|Tangible fixed assets
~~ee~~
~~ee~~
~~ee~~|**12**
~~a~~|~~a~~
~~a~~|**19,126**
~~a~~||5,898|
|~~ee~~
~~ee~~|~~a~~|~~a~~
~~a~~|**19,126**
~~a~~||5,898|
|**Current assets**
~~ee ~~
~~a~~|~~a~~
~~ee~~|~~a~~
~~eeee~~|~~ee~~|~~ee~~|~~ee~~|
|Debtors due within
one year
~~a~~
~~a~~
~~ee~~|**13**
~~ee~~
~~ee~~|**326,252**
~~eeee~~
~~ee~~|~~ee~~
~~eee~~|1,584,602
~~ee~~
~~eee~~|~~ee~~
~~eee~~|
|Cash at bank and
in hand
~~a~~
~~ee~~|~~ee ~~
~~ee~~|**21,395,404**
~~eeee~~
~~ee~~|~~ee~~
~~eee~~|20,748,831
~~ee~~
~~eee~~|~~ee~~
~~eee~~|
|~~ee~~|~~ee~~|**21,721,656**
~~ee ~~|~~eee~~|22,333,433
~~eee~~|~~eee~~|
|**Creditors:**amounts
falling due within
one year
~~ee~~
~~ee~~|**14**
~~ee~~
~~A~~|**5,321,437**
~~ee~~
~~A~~|~~eee~~|6,565,436
~~eee~~|~~eee~~|
|**Net current assets**
~~ee~~
~~ee~~
~~ee~~|~~ee~~
~~A~~
|~~ee ~~
~~A~~
|**16,400,219**
~~eee~~
|~~eee~~
|15,767,997
~~eee~~
|
|**Total net assets**
~~ee ~~
~~ee~~|~~A ~~
|~~A~~
|**16,419,345**
||15,773,895
|
|~~eea~~
~~ee~~|~~a~~|~~a~~
~~a~~|~~a~~|~~a~~|~~a~~|
|**Funds and reserves**
~~a~~
~~a~~
~~ee~~|~~a~~
~~a~~|~~a~~
~~a~~
~~a~~|~~a~~
~~a~~|~~a~~
~~a~~|~~a~~
~~a~~|
|Restricted funds
~~a~~
~~ee~~|**15**
~~a~~|~~a~~
~~a~~|**13,752,867**
~~a~~|~~a~~|13,085,931
~~a~~|
|Unrestricted funds
~~ee~~
~~a~~||~~a~~||||
|General fund
~~a~~
~~ee~~|~~ee~~|**2,200,913**
~~eeee~~|~~ee~~|2,235,627
~~ee~~|~~ee~~|
|Tangible fixed
assets fund
~~a~~
~~ee~~
~~ee~~|**16**
~~ee~~|**19,126**
~~eeee~~|~~ee~~|5,898
~~ee~~|~~ee~~|
|Designated funds
~~ee ~~
~~ee~~
~~ee~~|**17**
~~ee ~~
~~A~~|**446,439**
~~eeee~~
~~a~~|~~ee~~|446,439
~~ee~~|~~ee~~|
|~~ee~~
~~ee~~
~~ee~~|~~A~~
~~a~~|~~a~~
~~a~~|**2,666,478**||2,687,964|
|~~ee ~~
~~ee~~|~~A ~~
~~a~~|~~a~~
~~a~~|**16,419,345**||15,773,895|
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. Approved on: 23 November 2023
25
TRUSTEES’ REPORT AND ACCOUNTS **2022-23**
## Statement of cash flows for the year ended 31 March 2023
**----- Start of picture text -----**
2023 2022
£ £
Cashflow from operating activities
Net cash provided by operating activities 612,210 2,600,612
Cashflows from investing activities
Investment income and interest received 55,901 2,191
Proceeds from sale of tangible fixed assets - 1,570
Payments to acquire tangible fixed assets (21,538) (4,232)
34,363 (471)
Net increase in cash and cash equivalents 646,573 2,600,141
Cash and cash equivalents at the beginning of the year 20,748,831 18,148,690
Cash and cash equivalents at end of year 21,395,404 20,748,831
Reconciliation of net income to net cash flow from
operating activities
Net income / (expenditure) including endowments 645,450 1,990,177
Adjustments for:
Depreciation charge 7,620 14,437
Loss on disposal of fixed assets 690 37
Interest receivable (55,901) (2,191)
Decrease/(Increase) in debtors 1,258,350 (692,821)
(Decrease)/Increase in creditors (1,243,999) 1,290,973
Net cash inflow from operating activities 612,210 2,600,612
**----- End of picture text -----**
The charity has no net debt and accordingly no net debt note is presented.
26
HEALTHCARE QUALITY IMPROVEMENT PARTNERSHIP
## Notes to the accounts 2022-23
## **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 Mediumsized 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.
## **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.
## **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 and contract 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.
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:
- National Clinical Audit and Patient Outcomes Programme: amounts expended on the commissioning of national clinical audits
- Clinical Outcome Review Programmes: commissioning and managing enquiries and reviews
- National Joint Registry: expenditure relating to the management and development of the Registry
27
TRUSTEES’ REPORT AND ACCOUNTS **2022-23**
- Quality improvement and development activities: expenditure relating to the promotion and advancement of clinical audit as a means of improving the provision of healthcare.
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:
- Furniture and general office equipment: 20% per annum based on costs
## **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:
- Website development costs: 33% per annum based on costs
## **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) 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.
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.
- Computer and similar equipment: 33% per annum based on costs
28
HEALTHCARE QUALITY IMPROVEMENT PARTNERSHIP
## **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 2023
£ £ £
Bank interest receivable 9,379 46,522 55,901
Unrestricted Restricted Total
Funds Funds 2022
£ £ £
Bank interest receivable 1,096 1,095 2,191
**----- End of picture text -----**
29
TRUSTEES’ REPORT AND ACCOUNTS **2022-23**
## **3. Income from charitable activities**
**----- Start of picture text -----**
Income from contracts Unrestricted Restricted Total
Funds Funds 2023
£ £ £
NHS England & Wales
Management Support Fee 1,300,000 - 1,300,000
NCAPOP Audits - 11,418,770 11,418,770
NCAPOP Subscriptions - 2,029,500 2,029,500
Subscriptions Admin Fees 20,500 - 20,500
All UK Administrations and Crown Dependencies
CORP Programme Income - 2,151,526 2,151,526
NCAPOP (Scottish Contributions) - 179,216 179,216
Programme Management Fees 186,789 - 186,789
Department of Health & Social Care - 121,573 121,573
NJR Subscriptions Income - 3,385,630 3,385,630
NJR Other Income - 717,090 717,090
Data Access Requests 24,250 - 24,250
Total 1,531,539 20,003,305 21,534,844
**----- End of picture text -----**
30
HEALTHCARE QUALITY IMPROVEMENT PARTNERSHIP
## **3. Income from charitable activities (continued)**
**----- Start of picture text -----**
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
**----- End of picture text -----**
## **4. Other income**
**----- Start of picture text -----**
Unrestricted Restricted Total
Funds Funds 2023
£ £ £
Miscellaneous income 43,133 - 43,133
Unrestricted Restricted Total
Funds Funds 2022
£ £ £
Miscellaneous income 15,055 - 15,055
**----- End of picture text -----**
31
TRUSTEES’ REPORT AND ACCOUNTS **2022-23**
## **5. Charitable activities**
**----- Start of picture text -----**
Unrestricted Restricted Total
Funds Funds 2023
£ £ £
Management, development and promotion of clinical audit
National Clinical Audit & Patient Outcomes Programme
(NCAPOP)
NCAPOP Audits - 11,986,379 11,986,379
Clinical Outcome Review Programmes
Programme Costs - 2,991,412 2,991,412
Staff Costs 707,247 438,477 1,145,724
Other Direct Costs - 1,278 1,278
Support Costs 890,420 - 890,420
1,597,667 15,417,546 17,015,213
National Joint Registry (NJR)
NJR Programme Costs - 2,793,159 2,793,159
Staff Costs - 809,729 809,729
Support Costs - 150,157 150,157
- 3,753,045 3,753,045
NCAB
National Clinical Audit Benchmarking 7,870 - 7,870
7,870 - 7,870
Quality Improvement and Development
Support to local audit - 25,248 25,248
- 25,248 25,248
New Business Activities
Staff Costs - 187,052 187,052
- 187,052 187,052
1,605,537 19,382,891 20,988,428
**----- End of picture text -----**
32
HEALTHCARE QUALITY IMPROVEMENT PARTNERSHIP
## **5. Charitable activities (continued)**
**----- 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
NCAB
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
**----- End of picture text -----**
33
TRUSTEES’ REPORT AND ACCOUNTS **2022-23**
## **6. Support costs**
**----- Start of picture text -----**
Contract National Joint Stability Fund Total Total
Mgt & Registry 2023 2022
Commissioning Per MOU
**----- End of picture text -----**
||**Contract**
**Mgt &**
**Commissioning**|**National Joint**
**Registry**
**Per MOU**|**Stability Fund**|**Total**
**2023**|**Total**
**2022**|
|---|---|---|---|---|---|
|||||||
||£|£|£|**£**|£|
|Staff costs (Core Team
Apportioned)|633,537|104,801|-|**738,338**|659,982|
|Procurement Consultancy|-|-|-|**-**|120,250|
|Finance Consultancy|-|-|-|**-**|11,870|
|Other Staff Costs and
Sundry Expenses|2,015|700|-|**2,715**|2,115|
|Staff Training|6,475|-|-|**6,475**|2,303|
|Staff Recruitment|6,013|-|-|**6,013**|24,315|
|Financing & Bank Charges|663|885|-|**1,548**|1,338|
|Working from Home Costs|2,444|-|-|**2,444**|83|
|Website Design and hosting|3,456|-|-|**3,456**|2,490|
|Marketing Automation|14,220|-|-|**14,220**|13,035|
|Premises Costs (Rent &
Facilities Charges)|-|-|-|**-**|17,019|
|Computer Equipment & Software|23,483|5,510|-|**28,993**|28,502|
|IT Support|77,131|15,400|-|**92,531**|45,945|
|Printing, Stationery &
Offce Supplies|4,320|-|-|**4,320**|7,308|
|Postage and Courier Costs|2,586|-|-|**2,586**|4,547|
|Telephone|7,604|4,200|-|**11,804**|14,594|
|Other Accommodation Costs
and Room Hire|-|-|-|**-**|198|
|Travel, Subsistence &
Accommodation|3,433|-|-|**3,433**|431|
|Service User Network and Patient
& Carer Engagement Costs|184|-|-|**184**|18|
|Subscriptions|713|-|-|**713**|508|
|Communications|4,260|-|-|**4,260**|3,580|
|Other Meeting Costs inc. Catering|1,146|-|-|**1,146**|-|
34
HEALTHCARE QUALITY IMPROVEMENT PARTNERSHIP
## **6. Support costs (continued)**
**----- Start of picture text -----**
Contract National Joint Stability Fund Total Total
Mgt & Registry 2023 2022
Commissioning Per MOU
£ £ £ £ £
Insurance 31,107 13,753 - 44,860 47,847
Professional Fees - 6,033 1,798 - 7,831 6,463
HR Consultancy
Professional Fees - IT Consultancy 6,063 - - 6,063 8,344
Depreciation 7,620 - - 7,620 14,437
Loss on Disposals 690 - - 690 37
Governance:
Audit Fees 16,605 3,110 - 19,715 16,365
Legal and other 28,538 - - 28,538 12,144
Governance Costs
Trustee expenses 81 - - 81 -
890,420 150,157 - 1,040,577 1,066,068
**----- 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 -----**
2023 2022
Commissioning and contract management of clinical audit 890,420 757,082
National Joint Registry 150,157 188,736
Stability Fund - 120,250
1,040,577 1,066,068
**----- End of picture text -----**
35
TRUSTEES’ REPORT AND ACCOUNTS **2022-23**
## **7. Net movement in funds**
This is stated after charging:
||**Unrestricted**|**Restricted**|**Total**
**2023**|
|---|---|---|---|
||£|£|**£**|
|**Auditor's remuneration**||||
|Statutory audit services|16,605|3,110|**19,715**|
|Depreciation|7,620|-|**7,620**|
|||||
||**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|
36
HEALTHCARE QUALITY IMPROVEMENT PARTNERSHIP
## **8. Employee and staff costs**
**----- Start of picture text -----**
2023 2022
£ £
Wages and Salaries 2,231,354 2,108,113
Social Security Costs 267,777 242,255
Pension Costs (Aegon Scottish Equitable) 127,231 114,217
Pension Admin Charges 2,006 2,080
Cost of Secondments 191,603 155,506
Cost of Agency Staff 60,872 24,146
2,880,843 2,646,317
**----- End of picture text -----**
Staff costs have been allocated as follows:
**----- Start of picture text -----**
2023 2022
£ £
Management, development and promotion of clinical audit 1,145,724 920,238
National Joint Registry 809,729 713,514
Quality Improvement and Development - 126
New Business Activities 187,052 352,457
Support Costs 738,338 659,982
2,880,843 2,646,317
**----- End of picture text -----**
37
TRUSTEES’ REPORT AND ACCOUNTS **2022-23**
## **8. Employee and staff costs (continued)**
The average number of employees during the period and the actual numbers at 31 March 2023 calculated on a full time equivalent basis, analysed by function, was as follows:
**----- Start of picture text -----**
2023 2023 2022 2022
Av No. Actual Av No. Actual
Charitable activities
Contract Management & Commissioning 13.8 13.7 13.1 12.4
NJR Team 11.8 9.9 11.0 11.0
Management and Core Services 12.8 13.6 11.4 13.1
TOTAL 38.4 37.2 35.5 36.5
**----- End of picture text -----**
The number of employees who earned £60,000 per annum or more during the period was
||**2023**|**2022**|
|---|---|---|
|£60,000-70,000|**3**|2|
|£70,000-80,000|**2**|5|
|£80,000-90,000|**3**|2|
|£90,000-100,000|**2**|4|
|£100,000-110,000|**1**|-|
Defined pension contributions in respect of the above higher-paid employees totalled £52,367 (2022: £57,159)
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 **£433,323** (2022: £436,348).
38
HEALTHCARE QUALITY IMPROVEMENT PARTNERSHIP
## **9. Trustees’ remuneration**
None of the Trustees received any remuneration in respect of their services during the period (2022: £Nil).
During the year out of pocket travelling expenses amounting to **£81** were reimbursed to one Trustee (2022: £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 **£44,860** 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 2022 and 31 March 2023|61,089|
|**Amortisation**||
|At 1 April 2022 and 31 March 2023|61,089|
|**Net Book Values**||
|**At 31 March 2023**|-|
|At 31 March 2022|-|
39
TRUSTEES’ REPORT AND ACCOUNTS **2022-23**
## **12. Tangible fixed assets**
||**Fixtures, fttings &**
**equipment**|
|---|---|
|**Cost**||
|At 1 April 2022|45,465|
|Additions|21,538|
|Disposals|(16,367)|
|At 31 March 2023|50,636|
|**Depreciation**||
|At 1 April 2022|39,567|
|On Disposals|(15,677)|
|Charge for the Year|7,620|
|At 31 March 2023|31,510|
|**Net Book Values**||
|**At 31 March 2023**|19,126|
|At 31 March 2022|5,898|
40
HEALTHCARE QUALITY IMPROVEMENT PARTNERSHIP
## **13. Debtors**
**----- Start of picture text -----**
2023 2022
£ £
Trade Debtors 176,150 528,634
Prepayments & Other Debtors 61,465 902,708
Accrued income 88,637 153,260
326,252 1,584,602
**----- End of picture text -----**
## **14. Creditors: Amounts falling due within one year**
**----- Start of picture text -----**
2023 2022
£ £
Trade Creditors 3,256,905 4,370,131
Other Creditors 32,576 47,175
Tax and social security 423,312 450,374
Accruals 1,460,644 1,627,772
Deferred income 148,000 69,984
5,321,437 6,565,436
**----- End of picture text -----**
41
TRUSTEES’ REPORT AND ACCOUNTS **2022-23**
## **15. Restricted funds**
**----- Start of picture text -----**
At 1 April Income Expenditure Transfers At 31 March
2022 2023
£ £ £ £ £
NCAPOP Audits 7,227,695 11,444,610 (12,173,986) 1,025,955 7,524,274
NCAPOP Subscriptions - 2,029,500 (439,200) (1,590,300) -
NCAPOP Scottish Extensions - 179,216 - (179,216) -
NCAPOP Transition Costs 139,822 - - - 139,822
CORP Programme Costs including PMRT - 2,273,099 (2,991,412) 718,313 -
National Joint Registry 5,718,414 4,123,402 (3,753,045) - 6,088,771
- - -
Support to local audit (25,248) 25,248
13,085,931 20,049,827 (19,382,891) - 13,752,867
**----- End of picture text -----**
**----- 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 NMCRR & 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 -----**
42
HEALTHCARE QUALITY IMPROVEMENT PARTNERSHIP
## **15. Restricted funds (continued)**
## **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 2022-23 appears in the Appendix.
## **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.
## **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.
## **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.
43
TRUSTEES’ REPORT AND ACCOUNTS **2022-23**
## **16. Fixed assets fund**
**----- Start of picture text -----**
At 1 April Additions Depreciation/ Disposals At 31 March
2022 Amortisation 2023
£ £ £ £ £
Fixtures, fittings, 5,898 21,538 (7,620) (690) 19,126
equipment
5,898 21,538 (7,620) (690) 19,126
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
**----- 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
2022 designations released 2023
£ £ £ £
Stability Fund 446,439 - - 446,439
446,439 - - 446,439
**----- End of picture text -----**
**----- 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
**----- 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.
44
HEALTHCARE QUALITY IMPROVEMENT PARTNERSHIP
## **18. Analysis of net assets between funds**
**----- Start of picture text -----**
General Fixed Designated Restricted Total
Fund assets Fund Funds Funds 2023
£ £ £ £ £
Fund balances at 31 March 2023 are
represented by:
Tangible fixed assets - 19,126 - - 19,126
Current assets 2,562,677 - 446,439 18,712,540 21,721,656
Current liabilities (361,764) - - (4,959,673) (5,321,437)
Total Net Assets 2,200,913 19,126 446,439 13,752,867 16,419,345
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 -----**
45
TRUSTEES’ REPORT AND ACCOUNTS **2022-23**
## **19. Contractual commitments**
At 31 March 2023 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 prior 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.
## **21. Leasing commitments**
At 31 March 2023 the charity had no commitments under non-cancellable leases (2022: £Nil).
## **22. Pension commitments**
HQIP operates a money purchase pension scheme which is open to all employees.
Total pension costs in the period were £127,231 (2022: £114,217) and £19,504 (2022: £20,087) were payable at 31 March 2023.
## **23. Related party transactions**
There were no reportable related party transactions in 2023 or 2022.
## **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.
46
HEALTHCARE QUALITY IMPROVEMENT PARTNERSHIP
## APPENDIX: HQIP programmes and audits, 2022-23
## **National Clinical Audits**
Adult Diabetes:
- National Diabetes Foot Care Audit
- National Diabetes Inpatient Safety Audit
- Transition and Young Type 2
- National Pregnancy in Diabetes
- National Core Diabetes Audit
National Cardiac Audit Programme _(transitioned to Argent and GEN Commissioning Support Unit June 2022)_
- Adult Cardiac Surgery
- Congenital Heart Disease Audit
- Heart Failure Audit
- Heart Rhythm Management Audit
- Myocardial Ischemia Audit Programme
- Percutaneous Cardiac Intervention Audit
- Diabetes Prevention Programme
- Gestational Diabetes
Breast Cancer in Older Patients
Cardiovascular Disease Prevention Audit, CVDPREVENT
Care at the End of Life
National Respiratory Audit Programme:
- COPD secondary care
- Pulmonary rehabilitation
- Adult asthma
- Asthma Children and Young People
- COPD and Asthma Primary care (Wales only)
National Audit of Dementia
National Early Inflammatory Arthritis Audit
National Emergency Laparotomy Audit
Falls and Fragility Fracture:
- Fracture Liaison Service Database
- Inpatient Falls
- National Hip Fracture Database
Lung Cancer
National Maternal and Perinatal Audit
National Cancer Audit Collaborating Centre (NATCAN) _(established October 2022)_
- National Audit of Primary Breast Cancer
- National Audit of Metastatic Breast Cancer
- National Ovarian Cancer Audit
- National Pancreatic Cancer Audit
- National Non-Hodgkin Lymphoma Audit
- National Kidney Cancer Audit
National Gastro-intestinal Cancer Audit:
- Bowel Cancer Audit
- Oesophago-Gastric Cancer Audit
- National Joint Registry
National Vascular Registry
National Neonatal Audit Programme
National Obesity Audit
National Paediatric Diabetes Audit
Paediatric Intensive Care Audit
Prostate Cancer Audit
National Clinical Audit of Psychosis
Seizures and Epilepsy in Children and Young People
Sentinel Stroke Audit Programme
47
TRUSTEES’ REPORT AND ACCOUNTS **2022-23**
## **Clinical Outcome Review Programmes**
Mental Health
Child Health Medical and Surgical Maternal and Newborn Infant
## **Mortality Review Programmes**
National Child Mortality Database
## **Non-NCAPOP Commissions**
Perinatal Mortality Review Tool _(contract ended September 2022)_
48
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