## **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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## **West Midlands Central Accident Resuscitation Emergency Team**
## **Trustees' Report for the Year Ended 31 March 2023**
- 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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## **West Midlands Central Accident Resuscitation Emergency Team**
## **Trustees' Report for the Year Ended 31 March 2023**
- 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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## **West Midlands Central Accident Resuscitation Emergency Team**
## **Trustees' Report for the Year Ended 31 March 2023**
- 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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## **West Midlands Central Accident Resuscitation Emergency Team**
## **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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## **West Midlands Central Accident Resuscitation Emergency Team**
## **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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## **West Midlands Central Accident Resuscitation Emergency Team**
## **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.
15
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
20111tr*2011Actl that IndePendentmInIan tsneeded.
H•¥tn8 Sltlsfied mysell th•t th•dty b rtot sublert to 4udlt ur#Jer Part 16 of the cOmnIeS Act 2006 and15 dl8lble for
depEndent examlnatlon. It Is my re5ponslbllltyto.'
examlne theoccounts urthr5eOTh 145 oftht 2011Act;
rollow the procedures lald down In theGeneral D*ectlonsObYn bytheCharftyConwnlMlon undersectkni 145151
Ibl tsf the 2011 Act,. and
ewthèth•rwtlcul•rm•ttersh•*com to my1tten0n.
exwnln•Uonw•Jc*rr*d outln •ccorthrKe*rfththeGEneral Dlre£tlonsWven bytheCh•rltyCwmbssh)rt.An èx•mlnitlon
IndleS • reW of the •Ctt*Unilni recortls kept by the •ftd i Compar1 of ihe accounts Psented wlth th05e
r•cords. Italsolndudesconslderatlonof anyunusuol Item50Tdlsclosuresln theat(ouThtyind set*lrr4ewl•Mtlonsfrom you
•$ Irusiee$¢orKernlng any such m8tters. The proceduresundertakendo Thotprode al11heedence thatwould berequlred
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Ilmlttd tt* those matters stttyrt In thest•t•ment below.
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11) *A*dthWves m re•sonabl•c•useio bdl•¥ethitln amift)•wl•IpeCtthe roqulroments..
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of Mctlon 3% of the Compjnles Act 2006 and the methods and IK1p*S of th• St•temMt of
R•cOMmeIedPrl¢tlCe:Accoftwfi8ènd Reportlniby Ch•rltles
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Ellzabeth Needham AC4cfAIVAT)
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Kendall Wadley LLP
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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.
19
## **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.
24
## **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|
25
## **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