2023-03-31-accounts

West Midlands Central Accident Resuscitation Emergency Team

(A company limited by guarantee)

Annual Report and Financial Statements

31 March 2023

Company registration number: 06816145 Charity registration number: 1129027

West Midlands Central Accident Resuscitation Emergency Team

Contents

Reference and Administrative Details	3
Trustees’ report	4
Trustees' responsibilities in relation to the financial statements	15
Independent examiner's report	16
Statement of financial activities	17
Balance sheet	18
Notes to the financial statements	19

West Midlands Central Accident Resuscitation Emergency Team Reference and Administrative Details

Charity name	West Midlands Central Accident Resuscitation Emergency Team
Charity registration number	1129027
Company registration number	06816145
Principal office	West Midlands Fire Service Headquarters. 99 Vauxhall Road, Nechells,
	Birmingham, West Midlands B7 4HW
Registered office	C/O West Midlands Fire Service Headquarters. 99 Vauxhall Road, Nechells,
	Birmingham, West Midlands B7 4HW
Trustees	C J Ledbury
	Dr J Hulme (Resigned 8 June 2023)
	Dr I P Russell
	D J Wilson (Appointed 5 October 2022)
	Dr R S Steyn (Resigned 5 October 2022)
	M J Ward
	R B Draycott
	S A Hodgetts
	Sir K M Porter
	N P C Jones (Appointed 5 October 2022)
Chairman	Sir K M Porter
Officer	M Boylan, Clinical Director
	A Thurgood, Deputy Clinical Director
Patron	Sir K Porter, Honorary President
Bankers	Unity Trust Bank, NINE Brindley Place BIRMINGHAM, B1 2JB
	LLOYDS Bank PLC, 4 The Cross, WORCESTER, WR1 3PY
Accountant	KellyATC Ltd, 20 Blackmore Road, Malvern, WR14 1QT

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West Midlands Central Accident Resuscitation Emergency Team

Trustees' Report for the Year Ended 31 March 2023

The Trustees (who are also the directors of the charity for the purposes of the Companies Act) present their annual report together with the financial statements of West Midlands Central Accident Resuscitation Emergency Team (the company) for the year ended 31 March 2023. The trustees are responsible for the general control and management of the charity, all aspects of governance and reporting of the charity and taking decisions about what is to be done and how money is to be raised and spent.

The financial statements have been prepared in accordance with the accounting policies set out in notes to the accounts and comply with the charity’s governing document, the Charities Act 2011 and the Charities SORP (FRS 102.)

Constitution

The charity is a company limited by guarantee and was set up by a Memorandum of Association.

The company is constituted under a Memorandum of Association and is a registered charity (number 1129027).

Method of appointment or election of trustees

The management of the company is the responsibility of the Trustees who are elected and co-opted under the Terms of Association.

The Trustees are appointed by invitation of the Board and have to be confirmed each year at the Annual General Meeting.

Policies adopted for the induction and training of Trustees

New Trustees are provided with a Trustee Induction Pack which includes information on their legal obligations under Charity and Company Law, the content of the Memorandum and Articles of Association and the processes on decision making within the organisation. These documents are also available at any time for any Trustee via a dedicated webpage. Trustees are also encouraged to attend meetings of the Board of Directors to familiarise themselves with the operations of the organisation. The Charity encourages trustees to attend, at their discretion, appropriate external training events where these will be of use for the undertaking of the role. Updates and Circulars on governance/role/charity issues are circulated by email to help apprise trustees of current issues affecting their role as trustees and new information from the Charity Commission.

Organisational Structure and decision making

The company is limited by guarantee and registered as a charity under the Charities Act 2011. It is governed by its Memorandum and Articles of Association issued on 11 February 2009. The company enjoys charitable status for taxation purposes.

No Director has any beneficial interest in the charitable company. (All directors are members of the company and guarantee to contribute a maximum of £10 each in the event of a winding up.)

West Midlands Central Accident Resuscitation and Emergency Team, is a company incorporated in England and Wales. The CARE team has a board of directors who meet at least Bi-annually and are responsible for the strategic direction and policy of the charity. The committee is represented by a variety of professional backgrounds relevant to the work of the charity. The Hon President and Hon Secretary also sit on the committee but have no voting rights.

Risk Management

The trustees have a risk management strategy that includes:-

• An annual review of the risks the charity may face

• The establishment of systems and procedures to mitigate those risks identified in the plan

• The implementation of procedures designed to minimise any potential impact on the charity should they materialise

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West Midlands Central Accident Resuscitation Emergency Team

Trustees' Report for the Year Ended 31 March 2023

OBJECTIVES AND ACTIVITIES

Aims of the Charity

• The relief of persons suffering injury or illness by the provision of immediate medical care.

• To advance the study of immediate medical care by the provision of training and research.

The charity provides an enhanced care team for mobilisation by West Midlands Ambulance Service University NHS Foundation Trust. This is the main platform from which the aims of the charity are achieved.

A remarkable voluntary prehospital medical team

The team derives its strength from the generous outpouring of kindness and unwavering positive support from its members. Given that a substantial segment of our team volunteer their time and expertise without compensation, and recognising the demanding nature of their daily responsibilities, the remarkable clinical achievements we have accomplished over the past year become all the more noteworthy. As the Clinical Director, I wish to express my profound appreciation to every member of the CARE team, regardless of the extent of their individual contributions.

Operational Activity of the Charity

Throughout the course of this year, the team has effectively addressed a diverse array of clinical scenarios within the dynamic setting of Birmingham and its surrounding areas. These scenarios have called for the team's expertise and swift action in various critical situations. Notably, the team has executed several highly consequential clinical interventions that stand as testaments to their advanced skillset and commitment to saving lives. Among these interventions, the administration of blood products has been instrumental in stabilising patients during instances of severe haemorrhage, providing them with the vital components necessary to restore their blood volume and optimise their chances of recovery. Moreover, the administration of prehospital anaesthesia, encompassing analgesia and sedation techniques, has been an essential component of the team's arsenal in managing cases where rapid and controlled sedation and pain relief is imperative for patient comfort and effective medical intervention.

One of the most remarkable achievements of the team has been their successful execution of a resuscitative thoracotomy in the prehospital environment. The team's ability to perform such a complex intervention outside the controlled hospital setting underscores their capability to deliver advanced medical care under challenging circumstances. The team has demonstrated exceptional interoperability with West Midlands Ambulance Service’s MERIT and has worked seamlessly with them on several serious incidents.

These interventions collectively reflect the team's unwavering commitment to pushing the boundaries of prehospital care and ensuring that patients receive the best possible treatment even before reaching the hospital doors. Their adaptability, resourcefulness, and skill in executing these interventions underscore their dedication to saving lives and making a profound impact on the well-being of those they serve.

SCHEME ACTIVITY April 2022 – March 2023

Data supplied by RADAR

Cont. SCHEME ACTIVITY April 2022 – March 2023

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West Midlands Central Accident Resuscitation Emergency Team

Trustees' Report for the Year Ended 31 March 2023

Data supplied by RADAR [* the discrepancy 225/313 is possibly down to data input error on RADAR]

• Of 1482 activations, we arrived on scene 894 times.

• 567 of the 1482 activations were for CAT 1 cases which accounted for 63.4% of all cases.

• Average time spent on scene for these 894 cases was 00:27:54

• Of these 894 cases we were first on scene 313 * times.

Data kindly supplied by WMAS

Age Group of Patients where MD097 and MD099 arrived at scene	Age Group of Patients where MD097 and MD099 arrived at scene
Age Group	Count	%
Infant (Under 1)	7	0.8%
Toddler (1-4 yrs)	63	7.2%
Child (5-15 yrs)	66	7.5%
Adult	739	84.5%
Grand Total	875

Data kindly supplied by WMAS

Attended Cardiac Arrests by Month for MD097 and MD099

Month	Count
Apr-22	11
May-22	12
Jun-22	16
Jul-22	13
Aug-22	14
Sep-22	10
Oct-22	6
Nov-22	8
Dec-22	17
Jan-23	11
Feb-23	7
Mar-23	13
Grand Total	138

Data kindly supplied by WMAS

TEAM MEMBERSHIP

• Clinical Team Leads – 21 people

• Clinical Support – 22 people

• UHB PHEM – 9 people

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• Trainees – 11 people

• Military Affiliate – 3 people

• Clinical Advisory Group – 7 people

• Clinical Observers – 2 people

Around 80% members of the charity are volunteers, the rest are prehospital emergency medicine [PHEM] Fellows who are funded by their employer to undertake CARE team duties.

UNIVERSITY HOSPITAL BIRMINGHAM - PHEM FELLOWS

• The PHEM fellow program which commenced in Feb 2020 is now well established and supports the 7-day CARE Team daytime service provision.

• Fellow posts are UHB funded:

• 60% EM

• 40% PHEM split posts with 1-2 days a week apportioned to CARE Team duties.

• Fellows follow the standard Clinical Team Lead sign off process, including a 5-day induction package, PHACTS Course and experiential training.

• The team hosted the following PHEM Fellows during the period of 2022 - 2023. This list includes those incoming and outgoing from the PHEM Fellowship for this period.

• Dr Simon Meredith [EM]

• Dr Lewis Miller [EM]

• Dr Dan Stephenson [EM]

• Dr Joe Weston-Price [EM]

• Dr Jake Turner [EM]

• Dr Jen Scallan [EM]

• PHEM Fellows are recruited biannually to spread the training burden (i.e., existing signed off PHEM fellows provide the main bulk of training shifts for new Fellows)

• The clinical fellow recruitment, induction and rota is managed but Dr Matthew Boylan.

• PHEM Fellows are used to support the clinical governance of the team e.g.,

• TEG meeting coordination

• Controlled Drug ordering and management

• Clinical case review

• To support the increased demand for Clinical Support for fellow shifts the team supports placements for Defence Medical Service MERT Nurses/Paramedics and a UHB EM Nurse with funded PHEM time specifically to support the PHEM Fellow shifts.

• There are weekly clinical fellow case discussions on Wednesday mornings held at the UHB ED. These are chaired by Level 8 PHEM consultants. These meetings allow for the discussion of significant cases thus promoting the on-going training and development of the PHEM fellows once they are signed off and no longer directly supervised. The meetings are mostly attended by current fellows and previous fellows who wish to remain involved have been allowed to do so: this is helpful given how many of them have gone on to develop on professional PHEM platforms and harnesses some of that experience. When a fellow is on CARE shift on a Wednesday morning the clinical team also join.

CLINICAL TEAM LEADS

• The team currently has (21) active Clinical Team Leads.

• We currently have several trainees in the process of training to be Clinical Team Leads

• A recruitment phases was delivered in Dec 2022 and selected a number of Clinical Team Leads and Clinical Supports.

CLINICAL SUPPORT

• The team currently has (22) active Clinical Support members.

• Several trainees completed sign-off to become clinical support members in 2022.

• We have (11) Trainees in the process of training to become Clinical Support Members.

• We have several Defence Medical Service MERT Nurses, and Defence Medical Paramedics trained as Clinical Support.

• • Clinical support development training is led by Simon Cartwright

MILITARY AFFILIATE

• The Team currently has several Military affiliate members.

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• Current military affiliate membership fee is £200 per affiliate member per annum

• The team provides 2 x Clinical Team Leads and 2 x Clinical Support funded slots on the PHACTS course per annum and 4 x places on each CARE Team induction course.

VEHICLE COMMANDER (VC) POOL

• The Vehicle Commander Pool was established in 2020 and is primarily overseen by Peter Bowles. On an annual basis, Peter assesses the VC pool's activity over the past 12 months. Within this evaluation, he evaluates the involvement of VC pool members in terms of shifts contributed. If any members fall below a specific threshold in their contributions, he initiates communication with them and subsequently removes them from the group for the following year. This step aims to facilitate new recruitment efforts and ensure a continuous influx of paramedics. This Vehicle Commander pool continues to work well and provides high quality experienced blue light trained drivers for the team. The Vehicle Commander is primarily responsible for emergency response driving en route and scene safety at scene freeing the clinical team up to concentrate on the provision of clinical care. As paramedics all Vehicle Commanders can also support the provision of clinical care. The Vehicle Commander pool has already proven to be a useful tool for identifying WMAS paramedics that are able to devote sufficient time to support the team and have proven to work well within the team. This led to the decision to use the Vehicle Commander Pool as the feeder for Paramedic Clinical Support recruitment.

FLEET MANAGEMENT

• Mr Dave Kane is the fleet lead for the CARE team and manages the regular servicing of our Volvo and Land rover discovery. Despite regular servicing, both these vehicles continue to experience regular emergency visits to the garage which he also coordinates.

• Mr Emir Battaloglu will be undertaking a fleet management strategy review with a view to planning the introduction/purchase of new vehicles for the next 5 years.

RECRUITMENT

• Mr Dan Knight is the lead for recruitment for the CARE team and has been instrumental in re-writing the recruitment and selection policy as well as heading up the recruitment of our new trainees.

INDUCTION COURSE

• Dr Dan Stephenson has been the lead for the CARE Team’s induction course which was delivered in the first week of March 2023.

CLINICAL ADVISORY GROUP (CAG)

• The clinical advisory group was formed to retain experienced CARE team members that have progressed to complete PHEM training and/or work for one of the funded Enhanced Care Teams (MERIT/TAAS/MAAC) across the region.

• Due to evolving career commitments these personnel have historically struggled to maintain sufficient shift frequency to maintain operational currency and therefore have left the team. The CAG was set up as a means of retaining these experienced personnel to support the team’s clinical supervision, clinical feedback, peer review of shifts and other aspects of governance support.

• The team has (7) CAG Members who provide some support to the senior cover rota and if required, case review process.

APPOINTMENT OF A NEW CLINICAL DIRECTOR

• After seven years as the CARE team's clinical director, Dr Matthew Boylan indicated that he will be stepping down from the role to take up the clinical leadership of WMAS MERIT.

• At the time of this report’s publication, Mr Andrew Thurgood would have been in post as the new clinical director for a year (appointed September 2022).

• The new organisational structure as illustrated later in this report will be implemented.

PHEM PROGRESSION

• Appropriately experienced Clinical Team Leads may choose to undertake enhanced skills training in Level 7/8 PHEM competencies such as advanced surgical techniques and sedation.

• Clinical Leads are encouraged to work towards gaining the necessary pre-requisites to be eligible to sit the Fellowship in Immediate Medical Care (FIMC) examination from the Royal College of Surgeons Edinburgh and subsequent application for level 7 or 8 PHEM practitioner status with the Faculty of Prehospital Care.

• Members of the team who went on to pass the Fellowship in Immediate Medical Care (2022/23):

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• Steph Cowan 2022

• 4 members of the team passed the Diploma in Immediate Medical Care (2022/23)

PRE-HOSPTAL ADVANCED SIMULATION in TRAUMA & EMERGENCY RESUSCITATION

• PHASTER: This course is designed to provide high-fidelity simulation training to prehospital practitioners – the venue to this course is chosen for its realism and added impact factor. The CARE team provide the framework and leadership for this course. The CARE team members who have attended the course have gain great value in the high-quality learning.

• Course lead – Dr Steph Cowan

• Course outline

• Candidate led clinical decision making & advanced interventional procedures

• Direct supervision, with video feedback & mentorship

• High fidelity, surgical & resuscitation manikins

• Multi-disciplinary & multi-specialty faculty from pre-hospital emergency medicine, trauma surgery & critical care specialists

• Team based approach, with human factors and resource management

• A number of CARE Team personnel attended PHASTER in the year 2022 – 2023

PRE-HOSPITAL ADVANCED CADAVERIC TRAUMA SKILLS (PHACTS) COURSE

• PHACTS : The course is specific to trauma skills training in the pre-hospital setting and focuses on providing CARE Team members with exposure to those skills that are rarely performed. Member of the CARE team are encouraged to attend PHACTS as part of the sign off process for clinical team leaders.

• Course lead – Mr Emir Battaloglu

• Course outline.

• Candidate led clinical decision making & advanced interventional procedures

• Direct supervision, with coaching & mentorship

• 2:1 candidate to instructor ratio

• Multi-disciplinary & multi-specialty faculty from pre-hospital emergency medicine, trauma surgery & critical care specialists

• Team based approach, with human factors and resource management

• Pre-course instructional teaching & learning tools

• A number of CARE Team personnel attended PHACTS 2022 – 2023

FIRST THURSDAY CARE TEAM TRAINING EDUCATION AND GOVERNANCE SESSIONS [TEG]

• Each first Thursday of the moth see the delivery of high-quality informative training and education for the CARE Team members. Member of the team present a case and explore learning from the reflections of these cases.

• External speakers have been invited and have presented specialist input to the program with great success.

• These sessions are still hybrid to enable the greatest impact, but we are encouraging members to engage face-to-face with these sessions.

• Recording of these sessions are made and published on the CARE Team’s Basecamp information portal.

• Dr Jen Scallan is the lead for TEG’s.

THIRD THURSDAY FPHC/CARE TEAM REGIONAL EDUCATION SESSIONS

• The West Midlands CARE team has a long history of providing pre-hospital training opportunities to aspiring prehospital providers in the voluntary aid, emergency service and medical undergraduate communities across the West Midlands. At the core of this training is the monthly Third Thursday evening educational sessions delivered on behalf of the Faculty of Prehospital Care at the Royal Orthopaedic Hospital. These lectures cover a variety of prehospital topics and are delivered by a wide range of local and national subject matter experts.

• Recording of these sessions are made and published as podcasts and published widely.

• A regular educational report to the Faculty of Prehospital Care is made by Mr Peter Bowels.

• Mr Peter Bowels is the lead for the third Thursday CARE Team Sessions.

THORACOTOMY SIMULATOR

• The West Midlands has the highest UK knife crime rate, with 10,000 reported victims in the past 3 years. Youth involvement is increasing - a UK teenager is stabbed every 9 days. PHEM services attend critically injured victims who need urgent hospital transfer, including rare roadside prehospital resuscitative surgery. Some require immediate resuscitative thoracotomy, a

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Trustees' Report for the Year Ended 31 March 2023

complex procedure due to rising knife crime rates. In 2021, PHEM performed 17 such procedures. Training costs hinder skill maintenance.

• The SIMBODIES® Pro Manikin thoracotomy trainer offers immersive, realistic, and portable training. It facilitates technical and team skills practice, including airway, intubation, ventilation, and cardiac procedures, addressing critical challenges for successful outcomes.

• Funding: The team successfully secured a £50,000 grant from the County Air Ambulance Trust HELP appeal to purchase a SIMBODIES® Pro Manikin thoracotomy trainer.

• Project Leadership: Dr Matthew Boylan and Mr Emir Battaloglu lead on this project for the CARE Team.

RESEARCH & EVOLVING PROJECTS

• Elective Students have been involved in the following CARE Team projects

• Continuing Pelvic Binder project

• Beginning project into traumatic blindness and incidence/Number Needed to Treat for lateral canthotomy

• Neuroprotective measures in prehospital management for trauma brain injury

• Prehospital pain management

• Paramedic perspectives on enhanced care team benefits and barriers to requesting support

• Projects coordinator: Mr Emir Battaloglu.

Financial Review

• The main expenditures in 2022-23 relate to vehicle operations (fuel/repairs/servicing) and the purchase of specialist medical consumables.

• The CARE Team received several grants throughout the reporting period which have allowed the purchase of small items of medical equipment.

• The West Midlands Ambulance Service University NHS Foundation Trust continues to support the team by providing basic medical consumables helping to reduce our operational costs.

• The team continues to demonstrate its value to the wider prehospital system.

RESERVES POLICY

• The Trustees have established a policy whereby the unrestricted funds not committed or invested in tangible fixed assets should be built up by the charity to account for 12 months of the expenditure of the organisation in addition to predictable wind-up costs.

• Unrestricted free reserves at the year-end were £81,219 (2022 £99,204)

• Restricted reserves at the year-end were £90,880 (2022 £70,893)

• Restricted reserves are planned to be spent in the following financial year to purchase xxxx

GRANTS

• Throughout 2022 - 2023, the team raised £33,920

• Following Mr Richard Smith’s move overseas at the end of 2022 we have seen a drop in grant applications as we were unable to get a replacement fundraising coordinator.

• Several applications have been submitted in 2022.

• County Air Ambulance Trust HELP appeal – for extension of annual £30K operating costs.

• CARE Team CREDO box inserts and covers.

COUNTY AIR AMBULANCE TRUST HELP APPEAL

• The County Air Ambulance Trust HELP appeal continue to support the team with an annual donation of £30,000 (which they have also agreed to continue for a further 5 years thanks to the work of our chairman).

• Without the continued support of the County Air Ambulance Trust HELP appeal the CARE Team charity would not be in the strong position that it is in today – we are extremely grateful for the support they provide the team and are pleased that they have committed to continue supporting the team for a further 5 years.

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Trustees' Report for the Year Ended 31 March 2023

CODE RED FILMING

• The team were invited to participate in the channel 5 “CODE RED” series by WMAS and hosted Producer Directors on shifts over a period of 5 months.

• The team have received very positive feedback from the series which is still being screened. The team has received £5000 from CURVE media as a donation for the support we gave them during the filming process.

RADAR AND RISK MANAGEMENT

• Enhancing clinical governance : Clinical governance serves as the cornerstone of modern healthcare, ensuring patient safety, quality of care, and organisational excellence. RADAR remote software aligns with the seven pillars of clinical governance, offering the CARE team the tools and capabilities to over watch its standards of care and activity. By using RADAR, we can enhance our clinical governance practices which enables us to drive continuous improvement.

• Cases attended/responded to: Clinical teams complete a "Case Event" report using the RADAR system following each clinical case they are involved in. Cases that fulfil specific predetermined criteria, such as instances involving sedation, cardiac arrest, or surgical procedures, trigger a flagging mechanism, prompting a review on the RADAR platform. These flagged cases undergo review on a weekly or bi-weekly basis. Most cases are concluded with no further action required, as no issues are identified during the review. However, if there are any concerns or inquiries, the Clinical Lead responsible for that shift is notified. They provide additional information or clarification, which is then appended to the case event before it is finalised. In situations involving significant deviations from established standards or sentinel cases, a relevant Key Performance Indicator (KPI) assessment is conducted. The results of this assessment are attached to the event form and forwarded to the clinical team for the day to gather feedback. The utilisation of KPIs proves valuable in rendering the feedback more objective and less subjective. Should a substantial concern arise or if there are repeated "major" breaches in the Key Performance Indicators, the case is elevated to the attention of the Clinical Director for a thorough review. There have been no clinical director referrals. Cases that present opportunities for team learning are proposed for discussion during the Training Education and Governance meetings, which are held monthly.

• Risks and incidents: RADAR is used for reporting events within the team and allows for the leadership team to track events and establish solutions to mitigate the problems reported.

• Audits: RADAR has been used provide WMAS with data reports on governance compliance around level 3 safeguarding and the senior leadership team reports on blood transfusion training compliance. RADAR has been used provide WMAS with data reports on governance compliance around eDBS.

• Cost : RADAR costs £600 per month.

CONTROLLED DRUGS

• The team were successful in its application for a Home Office Controlled Drug licence, which was previously issued under temporary processes due to COVID-19.

• The application involved a rigorous inspection by the Home Office to our premises on 7th December 2022.

• Our standards were commended, resulting in the approval to hold Controlled Drugs on Bournbrook Fire Station.

NEW ACCOUNTABLE OFFICER FOR CONTROLLED DRUGS

• Mrs Sarah Hodgetts has assumed the role of the CARE Team's Accountable Officer and has been instrumental in liaising with the WM Police Controlled Drug Officer for the destruction of expired Controlled Drugs. I appreciate Sarah's invaluable support in this critical area of governance. (AT)

WMAS IMMEDIATE CARE GOVERNANCE

• The CARE Team is a member of the West Midlands Ambulance Service University NHS Foundation Trust Immediate Care Governance Committee which ensures that immediate care schemes comply with Trust Quality Governance requirements, as outlined in the CQC Essential Standards of Quality and Safety.

• It also provides senior clinical discussion and recommendations on all clinical matters affecting the care delivered by enhanced clinicians. Recommendations and proposals are taken to the Professional Standards Group if they impact the wider Trust.

WMAS SENIOR LEADERSHIP TEAM

• A program of informal and scheduled meetings with Mr Aidan Brown and Mr Jim Hancox from ambulance service’s senior leadership team has enabled enhanced mutual awareness of each organisation's activities and provides an opportunity for partnership development between WMAS and the CARE Team. These meetings are working well.

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West Midlands Central Accident Resuscitation Emergency Team

Trustees' Report for the Year Ended 31 March 2023

ACHIEVEMENTS AND PERFORMANCE

• Through a combination of direct clinical response, education and training the CARE team continues to achieve its charitable aims and continues to demonstrate the provision of high standard enhanced care across the region.

FUNDRAISING 2022 - 23

• The goal for 2022 - 23 is to press on with fundraising particularly around the area of vehicle funding which is a risk to the team as one vehicle is near to the end of its operational use.

• We estimate an annual income requirement of £30,000 just to support the operational aspects of the service including team insurances, accounting fees, and administrative costs.

STRATEGIC OBJECTIVES 2023

• Develop an ICGC approved training pathway for Advanced Care Practitioners (ACPs) to transition to the Clinical Team Lead (CTL) role.

• Establish Prehospital Care Program

OPERATIONAL OBJECTIVES 2023

• Delivery of thoracotomy enhanced simulation training utilising the CARE Team SIMBODIES® Pro Manikin thoracotomy trainer

• • Recruit x4 PHEM fellow[s] for 2023-24

• Recruit clinical leads and clinical supports for 2023-24

• Support members of the CARE team with the attendance of Pre-hospital Advanced Cadaveric Trauma Skills course

• Delivery of Pre-hospital Advanced Simulation in Trauma & Emergency Resuscitation

• Consolidate CARE Team junior membership

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West Midlands Central Accident Resuscitation Emergency Team

Trustees' Report for the Year Ended 31 March 2023

Reference and Administrative details

TRUSTEE GROUP

Chair

• Professor Sir Keith Porter

Honorary Secretary

• Mr Matthew Ward

Trustees

• Mr Carl Ledbury

• Dr Ian Russell

• Mr Dave Wilson

• Mrs Sarah Hodgetts

• Mr Russell Draycott

• Mr Nick Jones

• Mr Matthew Ward - Resigned [2023]

• Dr Jon Hulme - Resigned [2023]

• Dr Styn – Resigned [2022]

Accountancy & bookkeeping

• Mrs Kelly Philpotts

STRUCTURE, GOVERNANCE AND MANAGEMENT

Some of the names in this organisational matrix may have changed by the date of publication, but the structure remains accurate.

CARE TEAM MOVES TO CHARITABLE INCORPORATED ORGANISATION

• The CARE Team has moved to become a CIO to take advantage of the reduced administrative burden, separate legal identity, and limited liability for its trustees. The legal requirements and responsibilities associated with being a CIO have been offered by the CARE Team’s account.

BANKING

• The CARE Team has two bank accounts:

• UNITY Trust Bank

• LLOYDS Bank

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West Midlands Central Accident Resuscitation Emergency Team

Trustees' Report for the Year Ended 31 March 2023

CHAIRMAN OF THE TRUSTEES

• The Chair, Honorary Secretary, and esteemed Trustees extend heartfelt gratitude to the entire team for their unwavering dedication and significant contributions that have driven the Team's progress.

• Our position in the broader Pre-Hospital and Emergency Medicine (PHEM) community, as well as among ambulance and emergency services, underscores our key role as a primary provider of advanced care in the region. Particularly noteworthy, we consistently receive positive feedback from both patients and clinicians, validating our professionalism and outstanding teamwork during on-scene operations.

• May I take this opportunity to convey our deep appreciation to Dr Matthew Boylan for his exceptional contributions as Clinical Director. His leadership and hard work over the years has undoubtedly led to the team's current esteemed position.

SMALL COMPANY PROVISIONS

This report has been prepared in accordance with the small companies regime under the Companies Act 2006 and in accordance with the Charities SORP (FRS 102).

Approved by the Board on 13[th] December 2023 and signed on its behalf by:

Signature(s)

Full name(s)

Prof Sir Keith PORTER Chairman of the Trustees Date:

Mr Andrew THURGOOD Clinical Director Date:

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Trustees' Responsibilities in relation to the Financial Statements

The trustees (who are also directors of West Midlands Central Accident Resuscitation Emergency Team for the purposes of company law) are responsible for preparing the Trustees' Annual Report and the financial statements in accordance with applicable law and the United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice).

Company law requires the trustees to prepare financial statements for each financial year which give a true and fair view of the state of affairs of the charitable company and of the incoming resources and application of resources, including income and expenditure, of the charitable company for that period. In preparing these financial statements, the trustees are required to:

• select suitable accounting policies and then apply them consistently;

• observe the methods and principles in the Charities SORP;

• make judgements and estimates that are reasonable and prudent;

• state whether applicable UK accounting standards have been followed, subject to any material departures disclosed and explained in the financial statements; and

• prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charitable company will continue in business.

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

The trustees have had regard to the Charity Commission’s guidance on public benefit in managing the activities of the charity.

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Independent Examlnerfs Reportto tho Trust•88 of West Mldlands Centrdl Acddant Regusdtatlon Emer8enryTeam l report on the accouThtsof the cornparyforthe yearended 31 March 2023, whlth ar?s•l outon pa8e5 17to 27. R4speth rwioA4bimiesoFlrugt¢esgndexamlnv Thetru5teeslwhoarealsothedlre(torsofthecompanyforthepurp05esofcompanylawlareresponsibleforthe prepAfatlon of the accounts. The trustees conswer that an 4utht Is not requlred for thls year under sectlon 144121 of the Chirltles Att 20111tr2011Actl that￿ IndePendent￿mInI￿an tsneeded. H•¥tn8 Sltlsfied mysell th•t th•dty b rtot sublert to 4udlt ur#Jer Part 16 of the cOm￿nIeS Act 2006 and15 dl8lble for depEndent examlnatlon. It Is my re5ponslbllltyto.' examlne theoccounts urthr5e￿OTh 145 oftht 2011Act; rollow the procedures lald down In theGeneral DectlonsObYn bytheCharftyConwnlMlon undersectkni 145151 Ibl tsf the 2011 Act,. and ewthèth•rwtlcul•rm•ttersh•com to my1tten￿0n. exwnln•Uonw•Jcrrd outln •ccorthrKerfththeGEneral Dlre£tlonsWven bytheCh•rltyCwmbssh)rt.An èx•mlnitlon Ind￿leS • r￿eW of the •CttUnilni recortls kept by the •ftd i Compar1￿ of ihe accounts P￿sented wlth th05e r•cords. Italsolndudesconslderatlonof anyunusuol Item50Tdlsclosuresln theat(ouThtyind setlrr4ewl•Mtlonsfrom you •$ Irusiee$¢orKernlng any such m8tters. The proceduresundertakendo Thotpro￿de al11hee￿dence thatwould berequlred In in •udltJnd consequenifyno oplnlon138l¥w •5 to whelherthe •ccounts present a'¢rue ond falr ￿ew, and the report Is Ilmlttd tt those matters stttyrt In thest•t•ment below. In coThnectlon 411th myex•mln•tlon, M mjtterhji cometo my pttentloTh: 11) AdthWves m re•sonabl•c•useio bdl•¥ethitln amift)•wl•I￿peCtthe roqulroments.. to keep account1￿[l￿￿1￿ accorthnrqw1th$4¢tsDn386ofth• Comp•nl•sAct2C¥)6: •nd Èpartittountswhlchlt£ord￿Ihtha¢cOUn￿fiercord$, comp1v￿ththe￿￿￿piI0eVeqYlrerneTrts of Mctlon 3% of the Compjnles Act 2006 and the methods and ￿IK1pS of th• St•temMt of R•cOMme￿IedPrl¢tlCe:Acco￿ftwfi8ènd Reportlniby Ch•rltles not ￿efi or 12) to whkh, Irb my oplnlon, ittentlon should bedrawn In order toeMbk*a pfoptr und•rst•ndln8of the unts to bert•che Ellzabeth Needham AC4cfAIVAT) Ins¥tuleof CharteredA¢counthrts. En8land al￿wate$ Kendall Wadley LLP Grnnt• Lodge 71 Graham Rotd mal¥e￿ WA14 2JS 13th December 2023 16

West Midlands Central Accident Resuscitation Emergency Team

Statement of Financial Activities (including Income and Expenditure Account and Statement of Total Recognised Gains and Losses) for the Year Ended 31 March 2023

Note Income and endowments from: Donations and legacies 3 Income from charitable activities 4 Total income and endowments Expenditure on: Raising funds Charitable activities 5 Total expenditure Net income/(expenditure) before other recognised gains and losses Other recognised gains/(losses) Gains and losses on revaluation of fixed assets Net movements in funds Reconciliation of funds Total funds brought forward Transfers Total funds carried forward	Unrestricted Restricted Total Funds 2023 Total Funds 2022 £ £ £ £ 39,165 50,000 89,165 102,620 64 - 64 10,526
	39,229 50,000 89,229 113,146
	- - - - 57,014 30,213 87,227 77,102
	57,014 30,213 87,227 77,102
	(17,785) 19,787 2,002 36,044
	- - - - (17,785) 19,787 2,002 36,044
	99,204 70,893 170,097 134,053 (200) 200 - -
	81,219 90,880 172,099 170,097

All of the Charity's activities derive from continuing operations during the above periods.

17

The notes on pages 19 to 27 form an integral part of these financial statements.

West Midlands Central Accident Resuscitation Emergency Team

Company registration number: 06816145

Balance Sheet as at 31 March 2023

Note Fixed assets Tangible assets 9 Investments Current assets Debtors 10 Cash at bank and in hand Creditors: Amounts falling due within one year 11 Net current assets Net assets The funds of the charity: Restricted funds Unrestricted funds Revaluation reserve Unrestricted income funds Total unrestricted funds Total unrestricted funds	2023 £ £ 104,838 1 104,839 5,725 67,322 73,047 (5,787) 67,260 172,099 90,680 - 81,419 81,419 172,099	2023 £ £ 104,838 1 104,839 5,725 67,322 73,047 (5,787) 67,260 172,099 90,680 - 81,419 81,419 172,099	2022 £ £ 84,392 1 84,393 24,097 65,674 89,771 (4,067) 85,704 170,097 70,893 - 99,204 99,204 170,097	2022 £ £ 84,392 1 84,393 24,097 65,674 89,771 (4,067) 85,704 170,097 70,893 - 99,204 99,204 170,097
		104,839 67,260		84,393 85,704
	73,047 (5,787)		89,771 (4,067)
	- 81,419		- 99,204
		172,099		170,097
		90,680 81,419		70,893 99,204
		172,099		170,097

For the financial year ended 31 March 2023, the charity was entitled to exemption from audit under section 477 of the Companies Act 2006.

The members have not required the charity to obtain an audit of its accounts for the year in question in accordance with section 476 of the Act.

The directors acknowledge their responsibilities for complying with the requirements of the Act with respect to accounting records and the preparation of accounts.

These accounts have been prepared in accordance with the provisions applicable to companies subject to the small companies regime.

Approved by the Board on 13[th] December 2023 and signed on its behalf by:

.........................................

Prof K Porter Trustee

18

The notes on pages 19 to 27 form an integral part of these financial statements.

West Midlands Central Accident Resuscitation Emergency Team

Notes to the Financial Statements for the Year Ended 31 March 2023

1 Accounting policies

Summary of significant accounting policies and key accounting estimates

The principal accounting policies applied in the preparation of these financial statements are set out below. These policies have been consistently applied to all the years presented, unless otherwise stated.

Statement of compliance

The financial statements have been prepared in accordance with Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2015) - (Charities SORP (FRS 102)), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Companies Act 2006.

Basis of preparation

The charitable company meets the definition of a public benefit entity under FRS 102. Assets and liabilities are initially recognised at historical cost or transaction value unless otherwise stated in the relevant accounting policy notes.

Going concern

At the time of approving the financial statements the trustees have a reasonable expectation that the charity has adequate resources to continue in operational existence for the foreseeable future. Thus the trustees adopt the going concern basis of accounting in preparing the financial statements.

Fund accounting policy

Unrestricted income funds are general funds that are available for use at the trustees' discretion in furtherance of the objectives of the charity.

Further details of each fund are disclosed in note 14.

Income and endowments

Donations are recognised when the Charity has been notified in writing of both the amount and settlement date. In the event that a donation is subject to conditions that require a level of performance by the Charity before the Charity is entitled to the funds, the income is deferred and not recognised until either those conditions are fully met, or the fulfilment of those conditions is wholly within the control of the Charity and it is probable that these conditions will be fulfilled in the reporting period.

Legacy gifts are recognised on a case by case basis following the grant of probate when the administrator/executor for the estate has communicated in writing both the amount and settlement date. In the event that the gift is in the form of an asset other than cash or a financial asset traded on a recognised stock exchange, recognition is subject to the value of the gift being reliably measured with a degree of reasonable accuracy and the title to the asset having been transferred to the Charity.

Gifts in kind are recognised in different ways dependent on how they are used by the charity:

(i) Those donated for resale produce income when they are sold. They are valued at the amount actually realised. (ii) Those donated for onward transmission to beneficiaries are included in the statement of financial activities as incoming resources and resources expended when they are distributed. They are valued at the amount the charity would have had to pay to acquire them.

(iii) Those donated for use by the Charity itself are included when receivable. They are valued at the amount the Charity would have had to pay to acquire them.

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West Midlands Central Accident Resuscitation Emergency Team

Notes to the Financial Statements for the Year Ended 31 March 2023

Donated services and facilities

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

In accordance with the Charities SORP (FRS 102) the volunteer time of friends is not recognized. Readers should refer to the trustees’ annual report for more information about their contribution.

Expenditure

Liabilities are recognised as soon as there is a legal or constructive obligation committing the charity to the expenditure. All expenditure is accounted for on an accruals basis and has been classified under headings that aggregate all costs related to the category.

Costs of raising funds are the costs associated with attracting donations and legacies.

Charitable expenditure comprises those costs incurred by the charity in the delivery of its activities and services for its beneficiaries. It includes both costs that can be allocated directly to such activities and those costs of an indirect nature necessary to support them.

Support costs

Support costs include central functions and have been allocated to activity cost categories on a basis consistent with the use of resources, for example, allocating property costs by floor areas, or per capita, staff costs by the time spent and other costs by their usage.

Taxation

The Charity is considered to pass the tests set out in Paragraph 1 Schedule 6 of the Finance Act 2010 and therefore it meets the definition of a charitable company for UK corporation tax purposes. Accordingly, the Charity is potentially exempt from taxation in respect of income or capital gains received within categories covered by Chapter 3 Part 11 of the Corporation Tax Act 2010 or Section 256 of the Taxation of Chargeable Gains Act 1992, to the extent that such income or gains are applied exclusively to charitable purposes.

Fixed assets

Individual fixed assets costing £100 or more are initially recorded at cost.

Depreciation

Depreciation is provided on tangible fixed assets so as to write off the cost or valuation, less any estimated residual value, over their expected useful economic life as follows:

Office equipment 33% & 20% straight line Motor vehicles 33% straight line Medical equipment 20% straight line

Investments

Fixed asset investments are included at market value at the balance sheet date.

Realised gains and losses on investments are calculated as the difference between sales proceeds and their market value at the start of the year, or their subsequent cost, and are charged or credited to the statement of the financial activities in the period of disposal.

Unrealised gains and losses represent the movement in market values during the year and are credited or charged to the statement of financial activities based on the market value at the year end.

Stock

Stock is valued at the lower of cost and net realisable value, after due regard for obsolete and slow moving stocks. Net realisable value is based on selling price less anticipated costs to completion and selling costs. Items donated for resale or distribution are not included in the financial statements until they are sold or distributed.

20

West Midlands Central Accident Resuscitation Emergency Team

Notes to the Financial Statements for the Year Ended 31 March 2023

Trade Debtors

Trade debtors are amounts due from customers for merchandise sold or services performed in the ordinary course of business. Trade debtors are recognised initially at the transaction price. They are subsequently measured at amortised cost using the effective interest method, less provision for impairment. A provision for the impairment of trade debtors is established when there is objective evidence that the Charity will not be able to collect all amounts due according to the original terms of the receivables.

Cash and Cash Equivalents

Cash and cash equivalents comprise cash on hand and call deposits, and other short-term highly liquid investments that are readily convertible to a known amount of cash and are subject to an insignificant risk of change in value.

Liabilities

Trade creditors are obligations to pay for goods or services that have been acquired in the ordinary course of business from suppliers. Accounts payable are classified as current liabilities if the Charity does not have an unconditional right, at the end of the reporting period, to defer settlement of the creditor for at least twelve months after the reporting date. If there is an unconditional right to defer settlement for at least twelve months after the reporting date, they are presented as non-current liabilities.

Trade creditors are recognised initially at the transaction price and subsequently measured at amortised cost using the effective interest method.

Operating leases

Leases in which substantially all the risks and rewards of ownership are retained by the lessor are classified as operating leases. Rentals payable under operating leases are charged in the Statement of Financial Activities on a straight-line basis over the lease term.

Financial instruments

Financial assets and financial liabilities are recognised when the charity becomes a party to the contractual provisions of the instrument. Financial liabilities and equity instruments are classified according to the substance of the contractual arrangements entered into. An equity instrument is any contract that evidences a residual interest in the assets of the Charity after deducting all of its liabilities.

All financial assets and liabilities are initially measured at transaction price (including transaction costs), except for those financial assets classified as at fair value through profit or loss, which are initially measured at fair value (which is normally the transaction price excluding transaction costs), unless the arrangement constitutes a financing transaction. If an arrangement constitutes a financing transaction, the financial asset or financial liability is measured at the present value of the future payments discounted at a market rate of interest for a similar debt instrument.

a legally enforceable right to set off the recognised amounts and the Charity intends either to settle on a net basis, or to realise the asset and settle the liability simultaneously.

Financial assets are derecognised when and only when a) the contractual rights to the cash flows from the financial asset expire or are settled, b) the Charity transfers to another party substantially all of the risks and rewards of ownership of the financial asset, or c) the Charity, despite having retained some, but not all, significant risks and rewards of ownership, has transferred control of the asset to another party.

Financial liabilities are derecognized only when the obligation specified in the contract is discharged, cancelled or expires.

21

West Midlands Central Accident Resuscitation Emergency Team

Notes to the Financial Statements for the Year Ended 31 March 2023

2 Statement of Financial Activities – Prior Year

Note Income and endowments from: Donations and legacies 3 Income from charitable activities 4 Total income and endowments Expenditure on: Raising funds Charitable activities 5 Total expenditure Net income/(expenditure) before other recognised gains and losses Other recognised gains/(losses) Gains and losses on revaluation of fixed assets Net movements in funds Reconciliation of funds Total funds brought forward Transfers Total funds carried forward	Unrestricted Restricted Total Funds 2022 Total Funds 2021 £ £ £ £ 45,420 57,200 102,620 143,111 10,526 - 10,526 6,797
	55,946 57,200 113,146 149,908
	- - - - 56,906 20,196 77,102 72,490
	56,906 20,196 77,102 72,490
	(960) 37,004 36,044 77,418
	- - - - (960) 37,004 36,044 77,418
	100,164 33,889 134,053 56,635 - - - -
	99,204 70,893 170,097 134,053

• 3 Donations and legacies

Donations and legacies Appeals and donations Grants Grants – other agencies	Unrestricted Funds Restricted Funds Total Funds 2023 Total Funds 2022 £ £ £ £ 5,245 50,000 55,245 8,720 33,920 - 33,920 93,900
	39,165 50,000 89,165 102,620

Of the donations and legacies income in 2023, £nil related to restricted funds.

The Charity received a donation in kind from Bournbrook Fire Station for the use of premises, the value of which could not be quantified and therefore has not been included in these financial statements.

The Charity are granted the use of the Teams primary response vehicle by Jaguar Land Rover (JLR). In return the Team provide observer opportunities for JLR clinical personnel. The ownership of the vehicle remains with JLR. The cost of this could not be quantified and so has not been included in these accounts.

22

West Midlands Central Accident Resuscitation Emergency Team

Notes to the Financial Statements for the Year Ended 31 March 2023

4 Income from charitable activities

Educational Income Expenditure Direct Costs Consumables (Pharmacy) Consumables (non-pharmacy) Depreciation of medical equipment Staff training Insurance Protective clothing Consultancy fees Support costs Rent Telephone and fax Subscriptions Sundry expenses Accountancy fees Independent examiner’s fee Bank charges Depreciation of Motor Vehicles Depreciation of office equipment Total expenditure		Unrestricted Funds £ 64		Restricted Funds £ -		Total Funds 2023 £ 64		Total Funds 2022 £ 10,526
		64		-		64		10,526
		Unrestricted £ 4,661 26,509 5,086 500 430 1,073 - 38,259 1,440 1,645 9,917 595 3,336 720 135 - 967 18,755 57,014		Restricted £ - 4,565 9,048 - - - - 13,613 - - 1,200 - - - - 15,400 - 16,600 30,213		Total 2023 £ 4,661 31,074 14,134 500 430 1,073 - 51,872 1,440 1,645 11,117 595 3,336 720 135 15,400 967 35,355 87,227		Total 2022 £ 5,491 23,454 14,206 - 936 7,059 256
								51,402
								1,320 1,154 5,276 2,056 2,344 720 739 11,549 542 25,700
								77,102

5 Expenditure

23

West Midlands Central Accident Resuscitation Emergency Team

Notes to the Financial Statements for the Year Ended 31 March 2023

……continued

5 Expenditure – comparative year

Expenditure – comparative year
Direct Costs Consumables (Pharmacy) Consumables (non-pharmacy) Depreciation of medical equipment Staff training Insurance Protective clothing Consultancy fees Support costs Rent Telephone and fax Subscriptions Sundry expenses Accountancy fees Independent examiner’s fee Bank charges Depreciation of Motor Vehicles Depreciation of office equipment Total expenditure		Unrestricted £ 5,491 22,929 6,084 - 936 7,059 256 42,755 1,320 1,154 5,276 2,056 2,344 720 739 - 542 14,151 56,906		Restricted £ - 525 8,122 - - - - 8,647 - - - - - - - 11,549 - 11,549 20,196		Total 2022 £ 5,491 23,454 14,206 - 936 7,059 256 51,402 1,320 1,154 5,276 2,056 2,344 720 739 11,549 542 25,700 77,102				Total 2021 £ 1,887 23,830 7,680 725 1,025 22,192 3,067 60,406
										1,440 1,140 2,074 4,512 1,668 720 125 - 405 12,084
										72,490

6 Governance costs

Accountancy fees Independent examiner’s fee Consultancy fees	2023 2022 £ £ 3,336 2,344 720 720 - 256 4,056 3,320

7 Trustees' remuneration and expenses

No trustees received any remuneration during the year.

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West Midlands Central Accident Resuscitation Emergency Team

Notes to the Financial Statements for the Year Ended 31 March 2023

8 Net expenditure

Net expenditure is stated after charging:

	2023	2022
	£	£
Depreciation of tangible fixed assets	30,501	26,297

9 Tangible fixed assets

Cost As at 1 April 2022 Additions Disposals As at 31 March 2023 Depreciation As at 1 April 2022 Charge for year As at 31 March 2023 Net Book Value As at 31 March 2023 As at 31 March 2022	Office Equipment £ 23,642 947 - 24,589 20,930 967 21,897 2,692 2,712	Motor Vehicles £ 75,792 - - 75,792 41,141 15,400 56,541 19,251 34,651	Unrestricted Medical Equipment £ 64,599 - - 64,599 46,671 5,086 51,757 12,842 17,928	Restricted Medical Equipment £ 45,242 50,000 - 95,242 16,141 9,048 25,189 70,053 29,101	Total £ 209,275 50,947 - 260,222 124,883 30,501 155,384 104,838
					84,392

Of the fixed assets £89,304 (2022 £63,753) related to restricted funds.

10 Debtors

Trade Debtors Prepayments and accrued income		2023 £ 3,200 2,525 5,725		2022 £ 20,087 4,010
				24,097

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West Midlands Central Accident Resuscitation Emergency Team Notes to the Financial Statements for the Year Ended 31 March 2023

11 Creditors: Amounts falling due within one year Other creditors Accruals and deferred income 12 Members' liability	2023 £ 5,787 - 5,787		2022 £ 4,067 - 4,067

The charity is a private company limited by guarantee and consequently does not have share capital.

13 Related parties

Controlling entity - The ultimate control of the Charity lies with the trustees who are also directors for the purpose of company law.

Subsidiary – The Charity owns 100% shareholding of WMCT PHEM ACADEMY Ltd (Previously West Midlands Care Team (Trading) Ltd) – which is a dormant trading company registered under company number 06770849

14 Movement in funds

General Funds Unrestricted income fund Restricted Funds Henry Surtees Foundation The George Henry Collins Charity Land Rover The John Avins Trust County Air Ambulance Rowlands/Saintbury Total funds of the charity		At 1 April 2022 £ 99,204 16,401 1,000 34,651 914 14,230 3,697 70,893 170,097		39,229 - - - - 50,000 - 50,000 89,229 Incoming resources £		(57,014) (8,297) (1,200) (15,400) (135) (3,794) (1,387) (30,213) (87,227) Resources expended £		(200) - 200 - - - - 200 - Transfer of funds £		81,219 At 31 March 2023 £	81,219 At 31 March 2023 £
											8,104 - 19,251 779 60,436 2,310
											90,880
											172,099

Purposes and restrictions in relation to the funds:

2023 restricted funds

The Henry Surtees Foundation : for the purchase of pre-hospital blood transfusion equipment The George Henry Collins Charity: For purchase of Ultrasound upgrade

Land Rover: For provision of motor vehicle

The John Avins Trust: Purchase of Mircel Syringe Pump

County Air Ambulance: For the purchase of Rhesus Thoracotomy Mannequin

The Rowlands/Saintbury Trusts : for the purchase of LUCAS mechanical chest compression device

26

West Midlands Central Accident Resuscitation Emergency Team

Notes to the Financial Statements for the Year Ended 31 March 2023

......... continued

General Funds Unrestricted income fund Restricted Funds Henry Surtees Foundation The George Henry Collins Charity Land Rover The John Avins Trust County Air Ambulance Rowlands/Saintbury Total funds of the charity		At 1 April 2021 £ 100,164 9,868 - - 914 18,024 5,083 33,889 134,053		55,946 10,000 1,000 46,200 - - - 57,200 113,146 Incoming resources £		(56,906) (3,467) - (11,549) - (3,794) (1,386) (20,196) (77,102) Resources expended £		- - - - - - - - - Transfer of funds £		99,204 At 31 March 2022 £
										16,401 1,000 34,651 914 14,230 3,697 70,893
										170,097

Purposes and restrictions in relation to the funds:

2022 restricted funds

The Henry Surtees Foundation : for the purchase of pre-hospital blood transfusion equipment The George Henry Collins Charity: For purchase of Ultrasound upgrade

Land Rover: For provision of motor vehicle

The John Avins Trust: Purchase of Mircel Syringe Pump

County Air Ambulance: For the purchase of Zoll-X series

The Rowlands/Saintbury Trusts : for the purchase of LUCAS mechanical chest compression device

15 Net assets by fund

Tangible Assets Investments Current Assets Creditors : Amounts falling due < 1yr Net Assets		Unrestricted Funds £ 15,534 1 71,671 (5,787) 81,419	Restricted Funds £ 89,304 - 1,376 - 90,680		Total Funds 2023 £ 104,838 1 73,047 (5,787) 172,099		Total Funds 2022 £ 84,392 1 89,771 (4,067)
							170,097

Of the net assets in 2022, £70,893 related to restricted funds.

27