2022-06-30-accounts - The London Pathway

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The London Pathway

Operating as Pathway

Annual Report and Financial Statements

Year ended 30 June 2022

Company Limited by Guarantee Registration Number 07210798 (England and Wales)

Charity Registration Number 1138741

Contents

Reports

Reports
Reference and administrative details	1
Trustees’ report	2
Independent auditor’s report	22
Financial statements
Statement of financial activities	26
Balance sheet	27
Statement of cash flows	28
Notes to the financial statements	32

Pathway

Reference and administrative details

Trustees	Lady Rhona Bradley
	Mr Martin Cheeseman (Appointed 1 July
	2021)
	Prof Steve Field (resigned 30 April 2022)
	Dr Vanya Gant
	Mr Richard Guest
	Prof Andrew Hayward
	Ms Cathy James OBE
	Sir Ian Kennedy
	Ms Leslie Ann Morphy OBE (Chair)
	Mr Stephen Robertson (Vice Chair)
	Mr Simon Tuttle
Chief Executive	Mr Alex Bax
Finance "Director" and Company	Ms Stephanie Swan
Secretary
Medical "Director" and Secretary to	Dr Nigel Hewett (resigned 30 June 2022)
the Faculty for Homeless and	Dr Christopher Sargeant (appointed 1
Inclusion Health	August 2022)
Registered office	4th Floor East
	250 Euston Road
	London, NW1 2PG
Company registration number	07210798 (England and Wales)
Charity registration number	1138741
Auditor	Buzzacott LLP
	130 Wood Street
	London
	EC2V 6DL
Bankers	The Co-operative Bank
	Business Customer Services
	PO Box 250
	Skelmersdale
	WN8 6WT

Trustees’ report: Year ended 30 June 2022

The trustees of the charity present their annual report and audited financial statements for the year ended 30 June 2022. This is the first full year following Pathway becoming a subsidiary of Crisis UK whilst retaining its stand-alone charitable status.

This report has been prepared in accordance with Part 8 of the Charities Act 2011 and constitutes a directors’ report for the purposes of company law.

The financial statements have been prepared in accordance with the accounting policies set out on pages 29 to 31 of the attached financial statements and comply with The London Pathway’s Memorandum and Articles of Association, applicable laws and 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 United Kingdom and Republic of Ireland (FRS 102).

Structure, Governance and Management

Governing document

This report has been prepared in accordance with Part 8 of the Charities Act 2011.

During the reporting period the charity was governed by a Memorandum and Articles of Association incorporated on 1 July 2021 when Crisis UK became The London Pathway’s sole member.

The charity is constituted as a charitable company limited by guarantee and has no share capital. Its company registration number is 07210798.

The charity has adopted the trading name of ‘Pathway’ to reflect its expansion into geographical areas outside London.

Organisation structure

Pathway is managed by a number of trustees including a trustee representing Crisis UK’s Board of Trustees and is administered by officers who deal with the operation of the charitable company. The trustees meet quarterly, and any new trustees are appointed with the agreement of the current trustees. One trustee resigned from the charity during the year. A list of the current trustees is set out on page 1.

Small groups of Trustees are established and meet as required to discuss specific topics in year. In 2021-22 two small groups have been set up: i) to produce a risk policy for the charity and to discuss how the strategic risk register should be assessed; and ii) to review the current pay arrangements given the looming cost of living pressures. Recommendations from the sub-groups are taken to full Board meetings for decisions. The Chair of Trustees meets the Chief Executive regularly and the trustee charged with reviewing finances meets with the Finance and Administration Director before the full Board meeting and the Remuneration SubCommittee which meets annually to review pay and make recommendations of pay increases to the full Board.

Trustees’ report: Year ended 30 June 2022

Structure, Governance and Management (continued)

Key management personnel

Pathway’s key personnel are the Chief Executive, Finance and Administration Director, and Medical Director. Dr Nigel Hewett who had been Medical Director and Secretary to the Faculty for Homeless and Inclusion Heath left the charity on 30 June 2022, and his replacement Dr Christopher Sargeant was appointed on 1 August 2022.

Following recommendations from key management personnel, the full Board reviewed the staff structure and remuneration of all current staff and vacant posts in 2020/21 including the key personnel and agreed the annual pay award. The benchmarks used to assess pay are either the NHS Agenda for Change pay rates for Pathway staff working in hospitals or National Joint Council (NJC) pay scales for all other posts.

Recruitment, appointment and training of trustees

A trustee is a member of the Board of Trustees of the charity and a director of the charitable company for the purposes of the Companies Act 2006.

In accordance with Clause 12 of the Articles of Association of Pathway, the Trustees shall comprise of between eight and twelve Trustees who are appointed by the Trustees. The Trustees who were Trustees as at 1 July 2021 continued as Trustees of the Charity and no more than one Trustee appointed by Crisis UK was a Member Appointed Trustee. Each Trustee was appointed for a three year term. At the end of each term a Trustee shall retire from office but may be re-appointed by the body that appointed them. No Trustee will serve in office for more than nine consecutive years provided, but in exceptional circumstances a Trustee may be reappointed annually thereafter if it is in the best interests of the Charity to do so, and the Trustees resolve unanimously that they be reappointed.

A Trustee may resign from his/her post by written notice to the Trustees. Clause 13 of the Articles provides conditions in which a Trustee’s term of office automatically terminates.

Each Trustee is provided with an information pack which provides details on the duties and roles of Charity Trustees, a copy of Pathway's constitution, the strategic plan, the previous year’s annual accounts and the standing orders and standing financial instructions.

Potential Trustees are invited to attend up to three board meetings as observers, and prior to their appointment to the Board they meet the Chair and senior officers of Pathway to discuss the Charity’s aims, objectives and direction.

Trustees are kept up to date regularly with changes relating to Charity legislation by the circulation of newsletters from the Charity Commission.

Members of the Board of Trustees have no beneficial interest in the charitable company.

For the year 2021/22, there were eleven trustees. Professor Stephen Field resigned from the Board at the end of April 2022.

A joint Crisis and Pathway recruitment exercise for additional and replacement trustees is currently underway.

Trustees’ report: Year ended 30 June 2022

Structure, Governance and Management (continued)

Organisation and decision making process

Running of the day to day activities of the charity is delegated to the Chief Executive and his senior team. This helps the trustees govern more effectively, although they remain collectively responsible for the charity.

Levels of expenditure delegated to officers are set out in the standing financial instructions.

The draft budget and staff structure for Pathway were presented to Board of Trustees for discussion and were approved by the Board at their April meeting. Progress reports were presented to the quarterly meetings of the Board. An additional strategic meeting was convened in April 2022 to discuss Pathway’s strategic direction and its priorities for the forthcoming period.

New job descriptions, associated levels of remuneration and annual pay awards are submitted to the Board for discussion and approval.

Where decisions are required between meetings these are carried out through urgent action procedures, and depending on the decision required, this may be through written contact with every trustee or with the Chair and Vice Chair. All urgent decisions taken between meetings are reported to the Board at the next possible meeting for ratification.

From 1 July 2021, a signed operational agreement with Crisis UK came into force, and minutes of the Board meeting confirmed as an accurate record by the Chair are submitted to Crisis UK.

The senior appointment of a replacement Medical Director and Secretary to the Faculty for Homeless and Inclusion Health was a two stage process: an interview with a sounding board made up of representatives of partners and interested parties including Crisis UK which made a recommendation to a panel made up of Trustees, the Chief Executive and a representative of the Experts by Experience group.

Risk management

The trustees have assessed the major risks Pathway is exposed to, in particular those relating to the specific operational areas of the charity, its assets and its finances.

Two key risks for the Charity continue to be the loss of key personnel and the impact of the continuing pandemic. These are addressed as follows:

The Trustees manage the risks that might ensue at the loss of key personnel by ensuring staff are supported, paid appropriately and that their knowledge of systems is shared with other staff members and the Board of Trustees. Trustees also intend to introduce succession planning wherever possible.
The Covid-19 pandemic continued to be a risk throughout the reporting period and is still a risk going forward. At all times, Pathway has followed the advice from the Government and the medical experts, and took a number of actions to address the Covid-19 pandemic some of which continue:

Trustees’ report: Year ended 30 June 2022

Structure, Governance and Management (continued)

Organisation and decision making process (continued)

 we included the latest advice and concerns about Covid-19 in newsletters which were circulated to 1,000+ members of the Faculty for Homeless and Inclusion Health and updated our website with the latest thinking, advice and activity on Covid-19 for our client group
 primarily staff continued to work from home as far as is practicable with regular meetings held by video conference including full Board meetings

The trustees believe that they have established effective systems to mitigate these and other operational and business risks which are kept under review.

The Trustees are developing a specific risk policy for Pathway and this will be submitted to a full Board meeting for approval later in the year.

Objectives

Objects of the Charity and Principal Activities

The objects of the charity are to advance such purposes as are charitable for the advancement of healthcare for, and for the relief of need of, people experiencing homelessness or at risk of homelessness and others often excluded from society, including, but not exclusively, alcoholics, drug users and those suffering from mental or physical health problems ('excluded people') by, but not exclusively:

(a) the development of targeted healthcare and nursing support for excluded people;

(b) the provision of follow-up support after their discharge from hospital; and

(c) the provision of healthcare-related education and training for excluded people and for staff and volunteers working with excluded people.

The trustees confirm they have complied with the duty in section 47(5) of the Charities Act to have due regard to public benefit guidance published by the Charity Commission.

Implementation of Objectives

It is the intention of the trustees that funding should be secured and used to work on advancing healthcare services for homeless people and other excluded groups. In formulating and applying these objects, the trustees have regard for the guidance of the Charity Commission on Public Benefit.

Objectives

Pathway’s strategic plan sets the objectives as:

Over the next five years, capitalising on the certainty and increased capacity that flows from becoming part of the Crisis Group, Pathway will build on its position as:

a recognised leader in the field of healthcare for people experiencing homelessness and other multiply excluded groups

Trustees’ report: Year ended 30 June 2022

Objectives (continued)

an organisation that puts service users at its centre
an agent of change working within and in partnership with the NHS and other services
the leader of a growing cohort of dedicated, specialist professional health workers putting compassion at the heart of their practice, especially through development of The Faculty of Homeless and Inclusion Health

In addition, Pathway and Crisis UK agreed a shared sub-set of objectives:

Increase the number of dedicated hospital teams that work with patients who are homeless across the country, to ensure they receive better quality care and are not discharged from hospital into homelessness
Work with the NHS and wider health and social care services to help them prevent homelessness through evidence-based programmes such as Housing First and Critical Time Interventions that will ensure people get the support they need to leave homelessness behind for good
Campaign for the changes needed to save lives and demonstrate the positive health outcomes of immediate access to good quality emergency accommodation
Fill in knowledge gaps in inclusion health and homelessness research, including how to improve services, narrow health inequalities, assess the impact of government policies and the solutions needed to end homelessness for good

Pathway has agreed six strategic aims to deliver both sets of objectives:

To support existing Pathway hospital teams, foster more teams and build a national inclusion health care quality network
To identify, develop, test, champion and replicate new clinical interventions and models of care for inclusion health groups, maximising any opportunities that flow from NHS policy and funding changes
To stimulate or lead research on gaps in care or evidence, better service structures and new interventions, working with NHS organisations, academia and the wider health sector and research sector
To use evidence and the authority of clinical and lived experience perspectives to increase our national influence and drive widespread, systemic change across the UK health and social care sectors
To support and develop the Faculty of Homeless and Inclusion Health as the independent voice and national network for inclusion health professionals
To maintain a strong organisation and maximise the opportunities of joining together with Crisis.

Trustees’ report: Year ended 30 June 2022

Activities, Achievements and Performance

Aim 1: To support existing Pathway hospital teams, foster more teams and build a national inclusion health care quality network

1. New hospital teams in Pathway Partnership Programme and network

 Five new Pathway teams established and supported as part of the Pathway Partnership Programme in: St George’s, Tooting (launched end November); Imperial (St Mary’s) and Chelsea and Westminster (launched mid-December); Homerton, Hackney (launched 24 February); Croydon Health Services NHS Trust (7 December); Outer North West / Ealing / Northwick Park (launched 6 June).
 Following the completion of a needs assessment funded by Kent and Medway CCG, a six month pilot Pathway team was established on 19 April and is being supported in the Queen Elizabeth the Queen Mother Hospital in Margate.
 Following the completion of a needs assessment Plymouth CCG to the Pathway Partnership Programme and is currently setting up a team that will cover University Hospital Plymouth.
 East London Commissioners (Barking and Dagenham and Havering) are keen to explore the Pathway approach.

2. Pathway needs assessments

 Needs assessments have been completed for East Kent, Plymouth, Sheffield, three areas of Warwickshire and Barking and Dagenham.
 Needs assessments are in progress for the fourth and final area of Warwickshire and also Devon-wide excluding Plymouth

3. Refine and deliver a structured quality support package for Pathway hospital teams

 The online Pathway team support manual has been updated and refined throughout the year
 Two network meetings and a series of regular online masterclasses on key topics have been held online in the year for all Pathway teams. Topics have included: Trauma Informed Communication Skills and Setting Limits; Deteriorating Health and End of Life Care; Trafficking and Modern Day Slavery.
 Pathway teams have been supported to collect and analyse data from their work to support business cases for ongoing funding
 Pathway teams were given complimentary places to the Faculty for Homeless and Inclusion Health’s International Symposium in March 2022 and to the annual CPD in Inclusion Health morning

Trustees’ report: Year ended 30 June 2022

Activities, Achievements and Performance (continued)

Aim 1: To support existing Pathway hospital teams, foster more teams and build a national inclusion health care quality network (continued)

4. Existing teams

 The teams in Leeds, Hull and Salford remained committed to being part of the Pathway Partnership Programme and are receiving regular support
 University College London Hospital has indicated its intention to sign up to Pathway’s Partnership Programme and a bespoke agreement is being prepared for signature
 The remaining eight existing teams (The Royal London, Brighton & Sussex University Hospital, Bradford Royal Infirmary, Manchester Royal Infirmary, King’s Health Partners, covering Guy’s and St Thomas,’ King’s College Hospital and South London and the Maudsley and Bristol Royal Infirmary) have not yet joined Pathway’s Partnership Programme, but are invited to attend the regular network events

5. Expand and improve access to specialist legal advice for homeless patients

 Existing and new Pathway teams, partner mental health services and TB outreach services have been provided with specialist Tier 2 legal advice service for targeted patients, funded by Trust for London
 Funding secured from St Martin’s in the Field Charity’s Frontline programme to expand the specialist Tier 2 legal advice service for Pathway teams outside of London and also for more in-depth and complex legal issues for Pathway teams across the UK
 A training session held as part of the Faculty for Homeless and Inclusion Health’s International Symposium in March 2022
 Half yearly network meeting held online to share knowledge and learning for Pathway Teams with legal advisers

Aim 2: To identify, develop, test, champion and replicate new clinical interventions and models of care for inclusion health groups, maximising any opportunities that flow from NHS policy and funding changes

1. End of Life care work

 After a series of developmental ‘communities of practice,’ developing training and support networks with volunteers in Hull and Birmingham invitations have been issued to a series of ‘train the trainer’ opportunities. These sessions will test the viability of training cohorts of facilitators who can use the materials developed through the programme to date to develop their own local specialist homelessness/palliative care ‘community of practice’ quality improvement networks. The programme is being developed in partnership with Marie Curie and the UCL Institute of Psychiatry.
 end of life care on-line toolkit maintained and further training resources and quality support tools built

Trustees’ report: Year ended 30 June 2022

Activities, Achievements and Performance (continued)

Aim 2: To identify, develop, test, champion and replicate new clinical interventions and models of care for inclusion health groups, maximising any opportunities that flow from NHS policy and funding changes (continued)

1. End of Life care work (continued)

 awareness of homelessness across NHS palliative care networks continued to be raised

2. Medical Respite / Intermediate Care

 Healthy London Partnership together with Pathway have fought for and secured beds at the Mildmay hospital to be commissioned London-wide for intermediate step down care for homeless patients. The commissioning of the service relied on much of data from Pathway’s previous needs assessments to make the case for the beds.

Aim 3: To stimulate or lead research on gaps in care or evidence, better service structures and new interventions, working with NHS organisations, academia and the wider health sector and research sector

1. Pathway Fellows programme

 We have added to the Pathway Fellows during the year and they now number 20.
 Pathway Fellow Dr Aaminah Verity’s NHS England funded study of how to improve access to primary care for inclusion health groups is well advanced. A set of good practice standards have been drafted, ‘secret shopper’ work with Groundswell is well under way, and a set of consultation events with primary care colleagues has been arranged for early autumn. Pathway’s EBE group acts at the lived experience sounding board for the study. Discussions are under way on how to ensure the findings have maximum impact. Dr Bola Owolabi has invited Dr Verity, to present her work on markers for health inequalities in primary care to NHSE.
 Pathway was represented at a national network meeting of Health Education England’s (HEE) ‘enhancing generalist skills’ medical education programme. Pathway Fellows have contributed significantly (Dr Zana Khan, Dr Chris Sargeant) to development of HEE thinking in this field. We have also contributed to the development of new NHSE health inequalities training modules on the ‘e-learning for health’ portal.
 Serena Luchenski – Pathway’s public health fellow at the UCL Collaborative Centre for Inclusion Health has had the proposal for an inclusion health text book accepted by Elsevier. We have worked with her to identify subject authors and an editorial advisory group. Serena restarted her own doctoral research project, exploring the potential for preventive health services to improve outcomes for people experiencing homelessness, with a focus on the potential for hospitals to do more, and is gathering data from sites with and without Pathway teams.

Trustees’ report: Year ended 30 June 2022

Activities, Achievements and Performance (continued)

2. Lived experience involvement

 Pathway’s cohort of Experts by Experience (EbE) contributed to various research steering groups, and NHS policy development exercises etc. including supporting the Institute for Public Policy Research’s development of new lobbying materials to improve Universal Credit for people with multiple complex needs (based on our joint research), and attending and coproducing an NHS-led conference on lived experience in the health service; filming with Chris Barton and Dr Caroline Shulman to contribute to a film exploring how homeless patients are treated by NHS staff
 Representatives of Pathway’s EbE group participated in recruitment of Pathway’s Communications Officer and Medical Director
 Representatives of Pathway’s EbE group participated in training sessions for new Pathway teams and ran an online session at the annual CPD day in Brighton
 Members of Pathway’s EbE supported to attend and participate in the Faculty for Homeless and Inclusion Health’s International Symposium
 Two of Pathway’s EbEs joined the Chief Executive and Communications Officer at the NHS Confederation Expo in Liverpool at the end of June

3. Policy and research

 2021/22 was the first year of Pathway as partner of the Homeless Health Consortium along with Homeless Link and Groundswell. The consortium is part of the Voluntary, Community and Social Enterprise’s (VCSE) Health and Wellbeing. Funding is for three years. In year 1, we contributed to a project called ‘Bridging the Gap’: a review of the health training needs of homeless charity sector staff; and led a project to co-produce, with frontline professionals and people with lived experience of homelessness, ways to overcome barriers to GP registration. For year 2, we have completed initial scoping work on two projects: i) training frontline staff in A&E in doing Mental Capacity Act assessments, ii) improving access to dentistry for people experiencing homelessness.
 Pathway produced an inclusion health policy briefing paper to influence the Government’s now-delayed Health Disparities White Paper. We secured the signatures of a range of other charities to amplify impact and create momentum for change in the sector. We continue to work together to engage with and influence officials in readiness for a new Cabinet.

Trustees’ report: Year ended 30 June 2022

Activities, Achievements and Performance (continued)

3. Policy and research (continued)

 The NHSE&I funded Health Care Support Worker (HCSW) project (in conjunction with Groundswell, the RPSH and DWP) is making gradual progress. Four Trusts (Pennine Healthcare, Cumbria, Northumbria, Tyne & Wear Trust, Black Country Healthcare, and North & East Hertfordshire) have joined the project. Following initial trust engagement, a local cohort of unemployed people with lived experience of homelessness is recruited and offer a three day pre-employment training programme. The Trusts then move to recruit participants into ring-fenced HCSW posts. Consultants have been appointed to evaluate the project. The project has suffered multiple delays as Trusts and potential candidates navigate pandemic related pressures and wider staffing and recruitment challenges.

Aim 4: To use evidence and the authority of clinical and lived experience perspectives to increase our national influence and drive widespread, systemic change across the UK health and social care sectors

1. Strategic Relationships and Influence on relevant and regulatory bodies

 Manchester Health and Social Care Partnership – Pathway representatives spoke in the opening session of a Greater Manchester homeless health conference on 20th September. The event was attended by over 100 people from services across the Greater Manchester area with over 100 more watching online. Presentations covered lots of excellent local practice and confirmed how much inclusion health is beginning to become a standard, well understood area of practice. Manchester colleagues remain very appreciative of our high level input and are keen for our ongoing support as they develop their Integrated Care Partnership.
 NICE Guidance for integrated health and social care for people experiencing homelessness published on 16 March 2022. Pathway and the Faculty for Homeless and Inclusion Health had long advocated for such guidance and contributed to the consultation prior to its publication along with topic advisor Prof Andrew Hayward (Pathway Trustee). The guidance is hugely supportive of our work and endorses many of the things we have discovered and argued for over the years including: Endorsing multidisciplinary team working; in-reach and out-reach services; services that focus on relationship forming and building trust; lower caseloads leading to better outcomes; peer involvement across all services; availability of specialist intermediate care; and safeguarding being a huge and often missed opportunity
 In June 2022 Pathway and the Faculty signed up in support of a Faculty of Public Health campaign to highlight the potential for safe injecting environments to reduce the numbers of overdose related drugs deaths in the UK. A high profile launch event took place in the House of Commons on 6th June.

Trustees’ report: Year ended 30 June 2022

Activities, Achievements and Performance (continued)

1. Strategic Relationships and Influence on relevant and regulatory bodies (continued)

 Following a one-off roundtable co-convened with the Kings Fund’s Chief Executive Richard Murray, the two organisations have agreed to work together to create a programme for the new Integrated Care Systems leaders to encourage them to think about inclusion health populations and what they should do to commission better, more integrated services. We intend to work with 6-8 Integrated Care Systems from around the country over the summer and into autumn. Invitations to participate were sent out from the Kings Fund in June. Partners in the project include Groundswell and the Healthy London Partnership.
 The Health Disparities White Paper is due for publication this summer. It focuses on geographical and ethnic health disparities, with a strong emphasis on ‘choice’ and behaviors. Pathway submitted a policy paper to Office of Health Disparities (OHID) to influence their proposals on homelessness and inclusion health.
 Working together with Crisis UK Pathway developed and jointly promoted a series of amendments to the Health and Social Care Bill. Core amendments sought to place an additional duty on the new Integrated Care Partnerships when preparing their strategies, and alongside broader health inequalities duties, to have regard to “the need to improve health outcomes for Inclusion Health populations.” This led us to propose a legal definition of Inclusion Health populations: “Inclusion Health Populations are identifiable groups who experience social exclusion and elevated levels of morbidity and mortality when compared to otherwise equivalent groups.” Finally, we proposed adding the word ‘housing’ into the bill where general duties in relation to integration between health and social care are framed. The committee stage in the House of Lords commenced on 11 January and 13 Peers spoke in support of our amendments on 13th January, more than any other amendment in the debate. Julia Neuberger (UCLH Chair) gave a particularly powerful supportive speech, mentioning both Find and Treat and Pathway as exemplars.
 Pathway, in partnership with Crisis UK, is providing advice on policy developments supporting implementation of the Health and Care Act, including statutory guidance on the duty to collaborate. Pathway’s EbE group are involved in the consultation on Department of Health and Social Care’s new statutory guidance on the duty to co-operate
 Following a meeting of the Faculty’s mental health network a detailed response to NHS England’s current consultation on the revisions to the Mental Health ‘Long Term Plan’ is in preparation
 Pathway is represented at NHS England’s Health Inequalities Improvement Network. The network is chaired by Dr Bola Owolabi. New homeless health guidance for A&E departments, produced at our request, is expected from NHSEI shortly. Bola is keen to meet our EBE’s after their exchanges at the conference.

Trustees’ report: Year ended 30 June 2022

Activities, Achievements and Performance (continued)

1. Strategic Relationships and Influence on relevant and regulatory bodies (continued)

 Pathway attends the Healthy London Partnership Homelessness Leadership group and regional board meetings. There are now four thematic working groups on out of hospital care; mental health and substance mis-use; primary care; and intermediate care. Pathway staff or Fellows have contributed to most of these networks. We have been commissioned by HLP to support a London-wide audit of reasons homeless hospital patients are ‘bed-blocked’ or get otherwise unsatisfactory discharges.
 Covid-19 – Pathway published a position statement on the risks of Omicron (by Profs Hayward and Storey) on 10th December, following which late in December Housing Minister Eddie Hughes MP announced a further injection of short-term funding for crisis accommodation for people experiencing homelessness. This followed a joint letter from Crisis and Pathway, and a Ministerial round table with Eddie Hughes and Gillian Keegan, the then Minister of State in the Department of Health. The funding was allocated to local authorities. Find and Treat and other services reported large numbers of Covid outbreaks in the hostel sector at that time.

2. Child and Adolescent Mental Health Services (CAMHS) to do more to prevent homelessness before it happens, among young people with teenage contacts with CAMHS services

“The Mouse” film was screened and the wider project presented at the CAMHS teachers annual conference in October. Detailed feedback was gathered based on a questionnaire designed by Clinical Director Dr Simon Lewis, then analysed by our civil service fast streamer. RESILIENT 1 curriculum development completed in early January. First structured delivery of the RESILIENT 1 intervention - the pilot phase - took place at Simmons House Adolescent Unit over six weeks in spring 2022. The sessions generated lots of practical learning to develop the teaching and support materials. Evaluation of the trial has started with completion expected late summer 2022. It is hoped that the evaluation will help the project access mainstream funding and reduce reliance on charitable funding.
Following completion of the scoping literature review by the Evidence Based Practice Unit at the Anny Freud Centre, largely confirming our thesis that there is vanishingly little evidence in relation to longer term outcomes for younger people who have been in tier 4 CAMHS units in adolescence, we have identified core institutional partners to support the development of a national policy commission. The commission will help us to better understand long-term outcomes for this population and identify any interventions that might help – invitations to members have been issued and first meeting planned for autumn 2022

Trustees’ report: Year ended 30 June 2022

Activities, Achievements and Performance (continued)

Aim 5: To support and develop the Faculty of Homeless and Inclusion Health as the independent voice and national network for inclusion health professionals

1. Support the Faculty of Homeless & Inclusion Health to improve service quality for homeless and other marginalised groups of patients

The Faculty has supported a special interest group on mental health and has developed a new students’ network. Four meetings of the mental health sub-group were held in the year.
Faculty meetings were held using internet technology and were well attended
We have further developed the Faculty’s communications including use of social media (Twitter: 5,000 followers) and regular electronic newsletters
Faculty membership at July 2022 stands at 1,400 members.
A meeting of the National Inclusion Health Hospital Nurses Network was convened, with over 30 nurses sharing the challenges of working with homeless patients in hospital. The session concluded with the group agreeing they wanted to meet again on a regular cycle.

2. Inter-professional learning, education and training

The MSc module in Inclusion Health developed by the Faculty for Homeless and Inclusion Health in partnership with University College London was run as a blended online and live programme. The annual Inclusion Health CPD day at the University of Brighton was run online in summer 2022.

3. Continue to develop, coordinate and promote the annual Faculty international conference

On 16 and 17 March 2022 we held the tenth Faculty for Homeless and Inclusion Health international symposium over three days using a hybrid of in-person and internet technology: “Sustain and embed the success of ‘Everyone In’ and not go backwards now and in the next decade”. The event was split between Manchester and London. Specific highlights included a main plenary with Dame Carol Black, Manchester Mayor Andy Burnham, Julia Unwin’s discussion with our Experts by Experience, a presentation from Pathway Fellow Dr Aaminah Verity on making health inequalities visible in primary care, and the closing panel session with Dr Bola Owolabi and our EBE panel. Our EBE’s played a significant role across the two days

Trustees’ report: Year ended 30 June 2022

Activities, Achievements and Performance (continued)

Aim 6: To maintain a strong organisation and maximise the opportunities of joining together with Crisis

1. Business Sustainability

The first full year of the merger with Crisis with Pathway remaining a separate but subsidiary Charity. Not only has this given Pathway some financial sustainability but has also provided opportunities to do more for the beneficiaries that we have in common as we work more closely together. The new arrangement came into force on 1 July 2021 and we continued to receive pro-bono legal advice and support from Clifford Chance until the conclusion, the value of which has been included in the accounts, and we are truly grateful for their generous support.
Pathway Partnership Programme (previously known as Social Franchise of Pathway Hospital Team Model). We intend to continue to roll out our model using this programme and as reported under Aim 1 we are making progress with new teams. Currently there are eight teams who have signed our partnership/social franchise agreement, an increase of three from last year and we are expecting at least a further three to sign up in 2022/23. We are constantly updating the manual that accompanies the programme.
We continued to receive donations from new Members to the Faculty as part of our voluntary contributions scheme, but these are not yet sufficient to cover the cost of the Faculty.
VAT registration – the income from the support fees for the Partnership Team exceeded the current VAT threshold, and Pathway became VAT registered at the end of 2021

2. Strategic and Business Planning

Work commenced to refine Pathway’s strategic priorities with initial discussion at a special meeting of Pathway’s Board of Trustees in April. This contributed to our refresh of our joint priorities with Crisis and will continue into the Autumn as we consider Pathway’s longer term strategy.

3. Marketing Strategy and Communications

We developed further marketing materials for the roll out of Pathway hospital team model as part of the Pathway Partnership Programme
We are continuing to receive pro-bono legal support from Wiggin LLP to help us trademark our Pathway logos - this work is ongoing, and the value of the support is included in the accounts. We are truly grateful for their ongoing generous support with this work.
Work has started to comprehensively refresh Pathway’s website
Two sessions were held for Pathway staff and Fellows together with Crisis colleagues and the Frameworks Institute learn about new work on framing health inequalities.

Trustees’ report: Year ended 30 June 2022

Activities, Achievements and Performance (continued)

Aim 6: To maintain a strong organisation and maximise the opportunities of joining together with Crisis (continued)

4. Core Staffing Structure

We reviewed our core staffing structure against our strategic plan as part of our strategic plan development and budget process in early 2021 and have recruited staff to the expanded core team.
We hosted a secondment of a fast streamer for six months from the Civil Service – her remuneration was covered by his substantive employer. The value of this remuneration has been included in the accounts. She worked on a range of projects including providing support to the Pathway Partnership Project; analysis of the feedback questionnaire from the screening of the Mouse film at the CAMHS teachers conference; and the Homeless Health Consortium’s project on how to improve homeless people’s access to GP services.
We developed a system for performance review early in 2022, and this is being implemented from 1 July 2022

5. Fundraising

The World Doctors’ Orchestra (WDO) chose Pathway as their beneficiary charity for their two concerts in England in 2021 which included performances by Dame Evelyn Glennie. More than 1,600 people attended the concerts and the total amount raised for Pathway from the concerts was £129,012 including Gift Aid. It has been agreed that a substantial amount of this will be used in the development of a discrete Pathway Fellows programme with two main strands: a leadership development opportunity: working with the Staff College to directly invest in the development of the younger Fellows (£20K per annum); and a parallel programme of clinical development grants - perhaps three grants of £10K per annum to develop a particular area of work or new clinical practice within inclusion health. Our sincere thanks go to members of the WDO for choosing Pathway as their charity.
Pathway continued to be registered with the Fundraising Regulator

6. Awards

Pathway is one of the finalists in the London Housing Foundation’s annual homelessness awards. The application is for all our input supporting the creation of five new teams in London over the last year: Croydon, St Georges, Imperial/Chelsea and Westminster, Ealing/Northwick Park, and the Homerton and Hackney Centre for Mental Health. The awards ceremony is in October 2022.

7. Data Protection

Pathway completed and submitted the NHS Digital Data Security and Protection Toolkit towards the end of the year. Part of this work required a register of data to be held and maintained and work is currently underway to produce a revised Data Security and Protection Policy which will be submitted to a future Board meeting for approval.

Trustees’ report: Year ended 30 June 2022

Activities, Achievements and Performance (continued)

Review of financial position

Total income for the year amounted to £1,409,101 (15 months to 30 June 2021- £1,346,915). The associated expenditure for the period was £1,009,311 (15 months to 30 June 2021 - £1,062,162). This gives a net surplus for the period of £399,789 (15 months to 30 June 2021 - net surplus of £284,753). Total reserves to be carried forward to 2022/23 are £1,215,973 (30 June 2021 - £816,184).

The principal sources of funds in 2021/22 were:

	£
Crisis UK –a grant towards core funding for the year ended 30 June	500,000
2021 (restricted)
The Oak Foundation –the final grant payment towards core funding	250.000
(unrestricted)
World Doctor’s Orchestra –cumulative donations from two concerts	129,012
held in Autumn 2021 (unrestricted)
St Martin in The Fields Charity’s Frontline Programme- 1st payment	100,000
of three year grant for access to specialist legal casework for Pathway
hospital teams and for Tier 2 legal advice for Pathway’s team outside
London (restricted)
Trust for London– 2nd payment of a three year grant to provide Tier 2	45,000
legal advice to Pathway’s London hospital teams and mental health teams
(restricted)
Rayne Foundation– 2ndpayment of a three year grant towards the	30,000
production of the Mouse training film and associated materials for young
people with mental health issues and further work on Resilient project
(restricted)
Homeless Link– 1styear of three year grant to be partner of the	26,985
Homeless Health Consortium, part of the VCSE Health and Well Being
Alliance (restricted)
Kent and Medway CCG– grant for needs assessment and for follow up	23,500
support for pilot service in East Kent (restricted)

Just over 81% (£818,233) of the expenditure can be attributed directly to Pathway’s core activities including £18,750 which relates to the pro-bono secondment of a Civil Service Fast Streamer for six months, with just under 19% (£190,860) related to support work including governance of which £5,571 relates to the pro-bono legal advice about the merger with Crisis, and £27,208 relates to pro-bono legal support around trademarking Pathway’s logos. An amount of £218 was paid for fundraising materials to support the World Doctors Orchestra concerts in 2021/22 (£NIL for fundraising in 2020/21).

Trustees’ report: Year ended 30 June 2022

Activities, Achievements and Performance (continued)

Reserves policy

At 30 June 2022 Pathway holds reserves of £1,215,973 (£563,050 restricted and £652,923 unrestricted). At their meeting in May 2021 the Trustees agreed to leave unchanged the reserves policy of retaining unrestricted reserves to cover four months basic overheads (estimated at £288,000). The unrestricted reserve of £652,923 includes: a reserve of £125,412 from the World Doctors Orchestra donation which is retained to support the development of younger Pathway Fellows and also to provide a programme of clinical grants; a reserve of £238,695 from the final payment of the core grant from the Oak Foundation which will be used to support the 2022/23 work programme, which leaves a residual reserve of £288,816 that provides sufficient funds to cover management, administration and support costs and to respond to emergency situations for 2022/23. Restricted reserves are balances of funding secured for specific projects, where the funding organisation requires the funding to be used on this work, and where work is continuing. Pathway records specific costs against these funds as they are incurred.

Plans for Future Periods

We will continue to work towards the objectives set out in our strategic plan:

Pathway will build on its position as:

a recognised leader in the field of healthcare for people experiencing homelessness and other multiply excluded groups
an organisation that puts service users at its centre
an agent of change working within and in partnership with the NHS and other services
the leader of a growing cohort of dedicated, specialist professional health workers putting compassion at the heart of their practice, especially through development of The Faculty of Homeless and Inclusion Health

And, Pathway and Crisis will work together to

ensure that the health service, through its contact with people who are homeless, fulfils its potential in actively resolving homelessness.
advocate for policy responses to homelessness that save lives and promote positive health outcomes.

We will do this by:

continuing to work to spread the Pathway hospital team model through our Pathway Partnership Programme and thereby secure a sustainable income stream for the core Pathway Charity;
continuing to provide a programme of structured support and learning opportunities to hospital teams that are part of our partnership programme

Trustees’ report: Year ended 30 June 2022

Activities, Achievements and Performance (continued)

Plans for Future Periods (continued)

developing a programme to support Child and Adolescent Mental Health Services to do more to prevent homelessness before it happens among young people with teenage contacts with CAMHS services, including by hosting a national policy commission to help us better understand long-term outcomes for this population and identify any interventions that might help;
publishing a joint Pathway and Crisis 'state of the nation' report on homeless and inclusion health
publishing a joint Pathway and Crisis research and policy report on improving postdischarge support and care for people experiencing homeless
continuing to provide consultancy to commissioners for needs assessments to identify whether there is sufficient need for a Pathway hospital team, including completing those currently in progress for Warwickshire and Devon
creating a blueprint for closer joint working between Pathway partnership teams and Crisis Skylight Centres.
working with the Kings Fund, Groundswell and the Healthy London Partnership to create a programme for the new Integrated Care Systems leaders to encourage them to think about inclusion health populations and what they should do to commission better, more integrated services.
working with Crisis on a policy project to support prevention legislation proposals, with a focus on the duty to collaborate to prevent homelessness
participating in the Homeless Health Consortium with partners Homeless Link and Groundswell including leading on two projects: training frontline A&E staff in doing Mental Capacity Act assessments and improving access to dentistry for people experiencing homelessness.
building our core team and use the increased capacity to fulfil the ambitious aims set out in our strategic plan, including deploying a substantial grant secured from the Fidelity UK Foundation to employ someone to manage business development and spread of Pathway activities over the next two years

Statement of Trustees' Responsibilities

The Trustees (who in this reporting period are also directors of Pathway for the purposes of company law) are responsible for preparing the Trustees’ report and financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice).

Company law requires the Trustees to prepare financial statements for each financial period which give a true and fair view of the state of affairs of the charitable company and of the income and expenditure of the charitable company for that period.

Trustees’ report: Year ended 30 June 2022

Statement of Trustees' Responsibilities (continued)

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 Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable to the United Kingdom and Republic of Ireland (FRS 102);
make judgements and estimates that are reasonable and prudent;
state whether applicable United Kingdom 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 operation.

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.

Each of the Trustees confirms that:

so far as the Trustee is aware, there is no relevant audit information of which the charitable company’s auditor is unaware; and
the Trustee has taken all the steps that he/she ought to have taken as a Trustee in order to make himself/herself aware of any relevant audit information and to establish that the charitable company’s auditor is aware of that information.

This confirmation is given and should be interpreted in accordance with the provisions of s418 of the Companies Act 2006.

The Trustees are responsible for the maintenance and integrity of the corporate and financial information included on the charitable company’s website. Legislation in the United Kingdom governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions.

The above report has been prepared in accordance with the special provisions of Part 15 of the Companies Act 2006 relating to small companies.

Trustees’ report: Year ended 30 June 2022

Statement of Trustees' Responsibilities (continued)

Approved and authorised by the Board of Trustees on 17 October 2022 and signed on its behalf by:

Leslie Morphy Chair of Pathway

Independent auditor’s report: Year ended 30 June 2022

Independent auditor’s report to the member of The London Pathway

Opinion

We have audited the financial statements of The London Pathway (the ‘charitable company’) for the year ended 30 June 2022 which comprise the statement of financial activities, the balance sheet, the statement of cash flows, the principal accounting policies and the notes to the financial statements. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102 ‘The Financial Reporting Standard applicable in the UK and Republic of Ireland’ (United Kingdom Generally Accepted Accounting Practice).

In our opinion, the financial statements:

 give a true and fair view of the state of the charitable company’s affairs as at 30 June 2022 and of its income and expenditure for the period then ended;
 have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice; and
 have been prepared in accordance with the requirements of the Companies Act 2006.

Basis for opinion

We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under those standards are further described in the auditor’s responsibilities for the audit of the financial statements section of our report. We are independent of the charitable company in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the FRC’s Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.

Conclusions relating to going concern

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

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

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

Other information

The other information comprises the information included in the annual report and financial statements, other than the financial statements and our auditor’s report thereon. The Trustees are responsible for the other information contained within the annual report and financial statements. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon.

Independent auditor’s report: Year ended 30 June 2022

Other information (continued)

Our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the course of the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether this gives rise to a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact.

We have nothing to report in this regard.

Opinions on other matters prescribed by the Companies Act 2006

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

 the information given in the Trustees’ report, which is also the directors’ report for the purposes of company law, for the financial period for which the financial statements are prepared is consistent with the financial statements; and
 the Trustees’ report, which is also the directors’ report for the purposes of company law, has been prepared in accordance with applicable legal requirements.

Matters on which we are required to report by exception

In the light of the knowledge and understanding of the charitable company and its environment obtained in the course of the audit, we have not identified material misstatements in the Trustees’ report. We have nothing to report in respect of the following matters in relation to which the Companies Act 2006 requires us to report to you if, in our opinion:

 adequate accounting records have not been kept, or returns adequate for our audit have not been received from branches not visited by us; or
 the financial statements are not in agreement with the accounting records and returns; or
 certain disclosures of Trustees’ remuneration specified by law are not made; or
 we have not received all the information and explanations we require for our audit.

Responsibilities of Trustees

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

Independent auditor’s report: Year ended 30 June 2022

Responsibilities of Trustees (continued)

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

Auditor’s responsibilities for the audit of the financial statements

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

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

 We obtained an understanding of the legal and regulatory frameworks that are applicable to the charitable company and determined that the most significant are the Companies Act 2006, the Charities SORP FRS 102, the Charities Act 2011 and those in relation to safeguarding specifically in the context of safeguarding adults and adult protection.
 We understood how the charitable company is complying with those legal and regulatory frameworks by making inquiries to management and those responsible for legal, compliance and governance procedures. We corroborated our inquiries through our review of Trustee meetings and papers provided to the Trustees.
 We assessed the susceptibility of the charitable company’s financial statements to material misstatements, including how fraud might occur. Audit procedures performed by the engagement team included:
 Identifying and assessing the design and implementation of controls in place to prevent and detect fraud;
 Challenging assumptions and judgments made by management and the Trustees in its significant accounting estimates;
 Identifying and testing journal entries, in particular adjustments made at the periodend for financial statement preparation; and
 Assessing the extent of compliance with relevant laws and regulations by reviewing correspondence with regulators and legal advisors;

A further description of our responsibilities for the audit of the accounts is located on the Financial Reporting Council’s website at www.frc.org.uk/auditorsresponsibilities. This description forms part of our auditor’s report.

Independent auditor’s report: Year ended 30 June 2022

Use of this report

This report is made solely to the charitable company’s member, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our audit work has been undertaken so that we might state to the charitable company's member those matters we are required to state to them in an auditor's report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the charitable company and the charitable company's member as a body, for our audit work, for this report, or for the opinions we have formed.

Katharine Patel (Senior Statutory Auditor) For and on behalf of Buzzacott LLP, Statutory Auditor 130 Wood Street London EC2V 6DL

Date: 14 November 2022

Statement of financial activities: Year ended 30 June 2022 (Including an Income and Expenditure Account)

Notes	Un- restricted funds £	Restricted funds £	Year ended 30 June 2022 Total £	Un- restricted funds £	Restricted funds £	15-month period to 30 June 2021 Total £
Income: Donations and legacies Income from charitable activities Grants 2 Research and project income 2 Total income Expenditure: Expenditure on charitable activities 3 Total expenditure Net income (expenditure) and net movement in funds for the period 5 Reconciliation of funds Total funds brought forward at 1 July 2021 Total funds carried forward at 30 June 2022	190,437 250,000 144,553	1,127 748,441 74,542	191,564 998,441 219,095	120,438 38,500 52,252	37,029 918,466 180,230	157,467 956,966 232,482
	584,990	824,110	1,409,100	211,190	1,135,725	1,346,915
	183,502	825,809	1,009,311	286,859	775,303	1,062,162
	183,502	825,809	1,009,311	286,859	775,303	1,062,162
	401,488 251,435	(1,699) 564,749	399,789 816,184	(75,669) 327,104	360,422 204,327	284,753 531,431
	652,923	563,050	1,215,973	251,435	564,749	816,184

The statement of financial activities includes all gains and losses recognised in the period.

All income and expenditure derived from continuing activities in the above two financial periods.

The accounting policies and notes on pages 29 to Error! Bookmark not defined. form part of these financial statements.

Balance sheet: 30 June 2022

Notes	30 June 2022 £	30 June 2022 £	30 June 2021 £	30 June 2021 £
Current assets Debtors 9 Cash at bank Liabilities Creditors falling due within one year 10 Net assets The funds of the charity Unrestricted funds 11 Restricted funds 12 Total charity funds 13	108,705 1,258,315	1,215,973	63,747 897,345	816,184
	1,367,020 (151,047)		961,092 (144,908)

		652,923 563,050		251,435 564,749
		1,215,973		816,184

The accounting policies and notes on pages 29 to Error! Bookmark not defined. form part of these financial statements.

These financial statements were approved by the Board of Trustees for issue on 17 October 2022 and signed on its behalf by:

Leslie Morphy Chair

The London Pathway, Charity Registration no 1138741 Company Registration No: 07210798

Statement of cash flows: Year ended 30 June 2022

Notes	Year ended 30 June 2022 £	15-month period to 30 June 2021 £
Cash flow from operating activities: Net cash provided by operating activities A Change in cash and cash equivalents in the period Cash and cash equivalents at 1 July 2021 B Cash and cash equivalents at 30 June 2022 B	360,970	377,317
	360,970 897,345	377,317 520,028
	1,258,315	897,345
Notes to the statement of cash flows for the year ended 30 June 2022.

A Reconciliation of net movement in funds to net cash provided by operating activities

	Year ended 30 June 2022 £	15-month period to 30 June 2021 £
Net movement in funds (as per the statement of financial activities) Adjustments for: (Increase) decrease in debtors Increase (decrease) in creditors Net cash provided by operating activities	399,789 (44,958) 6,139	284,753 2,418 90,146
	360,970	377,317
Analysis of cash and cash equivalents	30 June 2022 £	30 June 2021 £
Cash at bank Total cash and cash equivalents	1,258,315	897,345
	1,258,315	897,345

Notes to the financial statements: Year ended 30 June 2022

1. Accounting policies

The principal accounting policies adopted, judgements and key sources of estimation uncertainty in the preparation of the financial statements are laid out below.

Basis of preparation

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 United Kingdom and Republic of Ireland (FRS 102) (Charities SORP FRS 102) and the Charities Act 2011. The financial statements have been prepared under the historical cost except for the modification to a fair value basis as specified in the accounting policies below.

The Charity constitutes a public benefit entity as defined by FRS 102.

All financial information is presented in British Pounds Sterling (£), the Charity’s functional currency, and has been rounded to the nearest pound (£).

Critical accounting estimates and judgements

The preparation of financial statements requires the use of certain critical accounting estimates and judgements. It also requires the Trustees’ to exercise judgement in the process of applying accounting policies. Estimates and judgements are continually evaluated and are based on historical experience and other factors, including an expectation of future events that are believed to be reasonable under the circumstances. Although these estimates are based on the Trustees’ best knowledge of the amount, event or actions, actual results may differ from those estimates.

There are no areas requiring the use of estimates and critical judgements that may significantly impact on the Charity’s financial activities and financial position.

Assessment of going concern

The Trustees have assessed whether the use of the going concern assumption is appropriate in preparing these financial statements. The Trustees have made this assessment in respect to a period of one year from the date of approval of these financial statements.

The Charity has prepared forecasts and budgets for a three year period to 2024/25 which provide the Trustees with detailed costs for Pathway projects currently undertaken and proposed, together with an indication of how projected costs could be scaled back should funding levels fall. The Trustees and the management team are currently in discussion with both existing and prospective funding bodies regarding future grant awards and are optimistic that further funding will be available to meet future expenditure and allow the Charity to meet its liabilities as they fall due. Having considered the Charity’s budget forecasts and the Charity’s cash reserves at 30 June 2022 of £1,215,973, the Trustees are satisfied that there will be sufficient future funds to allow the Charity to continue as a going concern.

Fund accounting

Unrestricted funds are funds which are available for use at the discretion of the Trustees in furtherance of the general objectives of the charitable company and which have not been designated for other purposes.

Notes to the financial statements: Year ended 30 June 2022

1. Accounting policies (continued)

Fund accounting (continued)

Restricted funds are funds which are to be used in accordance with specific restrictions imposed by the donors. The aim and use of each restricted fund are set out in the notes to the financial statements. Expenditure incurred in fulfilling the objective of each restricted fund is charged against the fund balance and shown in the relevant expenditure category in the Charity’s statement of financial activities.

Income

Income from donations is recognised in the period in which the Charity becomes entitled to the donation and where receipt is probable and its amount can be measured reliably.

Income from grants is recognised when the Charity has entitlement to the funds, any performance conditions attached to the grant have been met, it is probable that the income will be received and the amount can be measured reliably and is not deferred.

Income for the provision of commissioned research and other projects is recognised when the Charity is entitled to receipt, any performance conditions have been met and the amount can be measured reliably.

Income from Pathway Partnership agreements in which the Charity provides a programme of support to hospital teams following the Pathway model is recognised as services are provided under the terms of the agreement.

Income from donated services are recognised at fair value provided that the value can be reliable measured. Fair value is determined by reference to the open market price that the Charity would pay for the services provided.

Expenditure

Expenditure is recognised once there is a legal or constructive obligation to make a payment to a third party, it is probable that settlement will be required and the amount of the obligation can be measured reliably. It includes VAT where it cannot be recovered.

Expenditure on charitable activities

Expenditure on charitable activities includes the costs of delivering the Pathway services and other activities undertaken for the purposes of the Charity. Included is the direct cost of the Pathway service and an apportionment of support costs.

Support and governance costs

Support costs are those functions that assist the work of the Charity but do not directly undertake charitable activities. Support costs include administration, personnel and governance costs. Governance costs include audit costs and legal costs relating to the Charity’s compliance with regulation and good practice.

Financial instruments

The Charity only holds basic financial instruments as defined in FRS102. The financial assets and financial labilities and their measurement basis is as follows:

Notes to the financial statements: Year ended 30 June 2022

1. Accounting policies (continued)

Financial instruments (continued)

Financial assets – trade debtors, other debtors and accrued income are basic financial instruments and are debt instruments measured at amortised cost as detailed in note 9. Prepayments are not financial instruments.

Cash at bank – is classified as a basic financial instrument and is measured at face value.

Financial liabilities – trade creditors and accrued expenses are financial instruments and are measured at amortised cost as detailed in note 10.

Financial assets and liabilities

Financial assets and financial liabilities are recognised in the balance sheet when the Charity becomes party to the contractual provisions of the instrument.

Debtors

Trade and other debtors are initially recognised at their settlement amount and subsequently at amortised cost or their recoverable amount. Impairment provisions are recognised when there is objective evidence, such as significant financial difficulties on the part of the counterparty or default or a significant delay in payment, that the Charity will be unable to collect all of the amounts due.

Prepayments are valued at the amount prepaid.

Cash at bank

Cash at bank represents cash that is available on demand or has a maturity of less than three months from balance sheet date. Deposits for more than three months but less than one year are disclosed as short term deposits.

Creditors and provisions

Creditors and provisions are recognised when there is an obligation at the balance sheet date as a result of a past event, it is probable that a transfer of economic benefit will be required in settlement, and the amount of the settlement can be measured or estimated reliably.

Creditors and provisions are initially recognised at fair value, being the amount the Charity anticipates it will pay to settle the debt, and subsequently at amortised cost.

Pensions

Employer’s contributions in respect of defined contribution pension schemes are charged to the statement of financial activities in the year in which they are payable to the scheme.

Short term employment benefits

Short term employment benefits such as salaries and compensated absences (holiday pay) are recognised as an expense in the year in which the employees render service to the Charity. Any unused benefits are accrued and measured at the amount the Charity expects to pay to the employees to settle the unused entitlements.

Notes to the financial statements: Year ended 30 June 2022

2. Income from charitable activities

Income from charitable activities
	Un- restricted funds £	Restricted funds £	Year to 30 June 2022 £
Grants Crisis UK The Oak Foundation St Martin-in-the Field Charity – Frontline Programme Trust for London Rayne Foundation VCSE Alliance Homeless Health Consortium via Homeless Link Texel Foundation NHS England / Innovation Other grants Total grants Research and project income Pathway Partnership Fees (Hull, Salford, Leeds, Hackney, St George’s. Ealing, Imperial) East Kent CCG Devon CCG University College London Hospital NHS Foundation Trust NHS NE London CCG Sheffield CCG Queen’s Nursing Institute Other projects Total research and project income 2022 Total funds from charitable activities	— 250,000 — — — — — — —	500,000 — 100,000 45,000 30,000 26,986 20,000 19,770 6,685	500,000 250,000 100,000 45,000 30,000 26,986 20,000 19,770 6,685
	250,000	748,441	998,441
	134,583 — — — — — — 9,970	— 23,500 20,000 13,800 7,862 5,000 4,380 —	134,583 23,500 20,000 13,800 7,862 5,000 4,380 9,970
	144,553	74,542	219,095
	394,553	822,983	1,217,536

Notes to the financial statements: Year ended 30 June 2022

2. Income from charitable activities (continued)

Income from charitable activities(continued)
Comparatives	Unrestricted funds £	Restricted funds £	15 month period to 30 June 2021 £
Grants The Health Foundation NHS England / Innovation The Oak Foundation Crisis UK Texel Foundation Trust for London Rayne Foundation Isla Foundation Marie Curie Health Education England Manchester Health & Social Care Partnership Other grants Total grants Research and project income University College London Hospital NHS Foundation Trust Franchise Fees (Hull, Salford, Leeds, Hackney, Croydon) NHS NE London CSU (Healthy London Partnership) Queen’s Nursing Institute Guy’s & St Thomas’ Hospital NHS Foundation Trust Sheffield CCG Other projects Total research and project income 2021 Total funds from charitable activities	— — 38,500 — — — — — — — — —	205,915 199,532 156,031 164,718 50,000 45,000 30,000 18,260 14,810 10,000 10,000 14,200	205,915 199,532 194,531 164,718 50,000 45,000 30,000 18,260 14,810 10,000 10,000 14,200
	38,500	918,466	956,966
	— 33,750 — — 16,667 — 1,835	102,694 — 31,330 25,826 — 10,000 10,380	102,694 33,750 31,330 25,826 16,667 10,000 12,215
	52,252	180,230	232,482
	90,752	1,098,696	1,189,448

Notes to the financial statements: Year ended 30 June 2022

3. Expenditure

Expenditure
	Unrestricted funds £	Restricted funds £	Year to 30 June 2022 £
Charitable activities *Direct costs* Pay costs including staff costs Consultants’ fees Staff training Printing Patients’ costs Patients’ legal advice Travel and subsistence Catering Volunteer/Service User expenses Conference provision Marketing and design Stationery Telephone IT Equipment Equipment Costs – medical respite Total direct costs *Support costs* Pay costs including staff costs Recruitment costs Staff training Marketing and design Insurance Bank and payroll charges Catering Legal advice (pro-bono) IT Equipment Stationery Total support costs Fundraising costs Stationery Marketing and Design Total fundraising costs Governance costs Legal Fees (pro-bono) Catering Audit and accountancy fees Total governance costs 2022 Total expenditure	104,447 18,068 1,972 1,800 428 — 1,117 298 4,786 420 — 280 — — —	291,906 291,316 2,226 225 4,763 45,654 3,403 312 8,034 33,877 1,307 4,019 119 550 (3,093)	396,353 309,384 4,198 2,025 5,191 45,654 4,520 610 12,820 34,297 1,307 4,299 119 550 (3,093)
	133,616	684,618	818,234
	17,050 — 57 — — — — 27,208 — —	106,109 9,279 3,352 2,070 5,389 910 648 — 530 1,967	123,159 9,279 3,409 2,070 5,389 910 648 27,208 530 1,967
	44,315	130,254	174,569
	— —	34 184	34 184
	—	218	218
	5,571 — —	— 536 10,183	5,571 536 10,183
	5,571	10,719	16,290

	183,502	825,809	1,009,311

Notes to the financial statements: Year ended 30 June 2022

3. Expenditure (continued)

Expenditure(continued)
Comparatives	Unrestricted funds £	Restricted funds £	15-month period to 30 June 2021 £
Charitable activities Direct costs Pay costs including staff costs Consultants’ fees Staff training Printing Patients’ costs Patients’ legal advice Hospital Teams – incentive grants Travel and subsistence Catering Volunteer/Service User expenses Conference provision Marketing and design Stationery Insurance Equipment Costs – PPE Total direct costs Support costs Pay costs including staff costs Staff training Marketing and design Legal advice Insurance Bank and payroll charges Legal advice (pro-bono) Stationery Total support costs Trustees’ expenses Legal Fees (pro-bono) Audit and accountancy fees Total governance costs 2021 Total expenditure	95,996 1,650 3,259 222 4,412 — — — — (125) — — 38 — —	215,192 296,220 2,675 806 10,699 26,666 100,000 1,333 640 6,113 5,000 2,870 3,947 336 39,718	311,188 297,870 5,934 1,028 15,111 26,666 100,000 1,333 640 5,988 5,000 2,870 3,985 336 39,718
	105,452	712,215	817,667
	84,610 209 — 4,920 955 12,562 499	57,238 114 3,505 — 181 — —	141,848 323 3,505 4,920 1,136 12,562 499
	103,755	61,038	164,793
	69,296 8,356	— 2,050	69,296 10,406
	77,652	2,050	79,702

	286,859	775,303	1,062,162

Notes to the financial statements: Year ended 30 June 2022

4. Staff costs including key management personnel

Staff costs including key management personnel
	Year to 30 June 2022 £	15-month period to 30 June 2021 £
Wages and salaries Social security costs Pension contributions	445,195 42.256 12,245	409,562 33,091 10,796
	499,696	453,449

No staff was seconded to the core team in 2021-22 (one in 2020).

In 2021-22, one member of staff was seconded from the Civil Service with costs estimated at £18,750 for wages and salary (none in 2020-21: £nil).

One employee earned over £80,000 in year ended 30 June 2022 with their salary band falling between £80,001 - £90,000 full time equivalent. In the year ended 30 June 2021, the banding was £80,001 - £90,000 full time equivalent.

The average monthly number of employees (including key management personnel) during the year to 30 June 2022 was 13 (2021 – nine). On a full time equivalent basis, the number of employees was:

of employees was:
	Year to 30 June 2022 No.	15-month period to 30 June 2021 No.
Care Navigators Key Management (CEO, Medical Director & Finance Director) Senior Healthcare Navigator Coordinator / Healthcare Advisor Senior Clinician Senior Nurse and Occupational Therapist Head of Policy and Programmes Communications Officer Senior Project Manager Project Manager Research and administration	0.0 1.7 0.6 0.2 1.2 0.4 0.7 0.7 1.0 1.7	0.4 1.6 0.6 0.0 0.8 0.0 0.8 0.0 1.0 1.1
	8.2	6.3

Key management personnel

Key management personnel are those persons having authority and responsibility for planning, directing and controlling the activities of the Charity and are represented by the Trustees and the Executive Management Team, which comprise the Chief Executive, Finance and Administration Director and the Medical Director.

The number of key management personnel in the year to 30 June 2022 was three (2021 – three) (Full time equivalent basis: 1.7 (2021: 1.6)).

Notes to the financial statements: Year ended 30 June 2022

4. Staff costs including key management personnel (continued)

The total emoluments received by the key management personnel in the year ending 2022:

	Year to 30 June 2022 £	15-month period to 30 June 2021 £
Salaries Employer’s NI & Pension contributions	146,876 19,445	165,782 20,957
	166,321	186,739

Trustees’ remuneration

None of the Trustees nor any persons connected with them received any remuneration as a result of them holding the office of Trustee during the current period or preceding year.

5. Net movement in funds

This is stated after charging:

Year to 30 June 2022 £	15-month period to 30 June 2021 £
Auditors’ remuneration . Statutory audit services 10,120	8,490

6. Trustees’ expenses

No expenses were paid to Trustees during the period (2021: £nil).

7. Trustees’ indemnity insurance

The charitable company purchased insurance to cover the Trustees for costs and expenses incurred in respect of claims arising out of an actual or alleged wrongful act committed in good faith. It is not possible to identify separately the cost of the indemnity insurance.

8. Taxation

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

9. Debtors

Debtors
	30 June 2022 £	30 June 2021 £
Trade debtors Accrued income Prepayments	67,110 3,809 37,786	750 30,972 32,025
	108,705	63,747

Notes to the financial statements: Year ended 30 June 2022

10. Creditors: amounts falling due within one year

Creditors: amounts falling due within one year
	30 June 2022 £	30 June 2021 £
Trade creditors Other creditors Taxes and social security Accruals Deferred income	21,766 9,179 27,598 15,837 76,667	39,879 51,451 9,305 13,023 31,250
	151,047	144,908

Deferred income represents Pathway Partnership income where the programme of support will be delivered in 2022/23.

11. Unrestricted funds

Unrestricted funds
	At 1 July 2021 £	Income £	Expenditure £	At 30 June 2022 £
General unrestricted funds	251,435	584,990	(183,502)	652,923
	At 1 April 2019 £	Income £	Expenditure £	At 31 March 2020 £
General unrestricted funds	327,104	211,190	(286,859)	251,435

Notes to the financial statements: Year ended 30 June 2022

12. Restricted funds

	At 1 July 2021 £	Income £	Expenditure £ (536,970) 17,315 3,093 - (953) (10,732) (556) (660) (2,120) (75,868) - (38,847) (155) - (14,508) (4,380) - (144) (1,000) (544) (5,082) (50,709) (7,943) - (3,590) (9,350) (5,425) (5,716) (16,319) (13,744) (7,787) (2,091) (526) (475) (1,672) (1,329) (1,786) - - (236) -	At 30 June 2022 £
Crisis UK The Health Foundation Department of Health Royal Free NHS Foundation Trust Justlife Foundation Texel Foundation London Catalyst Clothworkers Company Warwickshire County Council The Oak Foundation Queen Mary University London Trust for London Health Education England Grocers’ Company University College London Hospitals NHS Foundation Trust Queen’s Nursing Institute UCLH Friends Stephen Clark Charitable Settlement London Solicitors Company Rayne Foundation Isla Foundation NHS England/Innovation Marie Curie British Geriatrics Society Manchester Health & Social Care Partnership Royal Borough of Kensington & Chelsea (West London ICS) NHS Sheffield CCG NHS Devon CCG NHS Kent and Medway CCG St Martin in the Fields Charity Homeless Link (for VCSE Alliance) Institute of Public Policy Research NHS NE London CCG NHS Barking & Dagenham CCG NHS Plymouth CCG Greater London Authority Donation for Mouse Film Donations for patients phones UCLH Donations for Faculty for Homeless & Inclusion Health – Faculty members Hackney Council Mental Health & Rough Sleeping Donation	69,002 30,166 7,464 35,000 953 14,284 879 669 12,601 97,188 2,350 13,374 2,800 4,500 710 — 818 3,377 1,000 10,000 11,001 182,406 14,810 5,700 9,400 6,500 5,029 — - — - - — 4,450 4,900 1,329 1,786 1,258 5,677 236 3,132	500,000 - - - - 20,000 - - - - - 45,000 - - 13,800 4,380 - - - 30,000 - 19,770 - - - 3,500 5,000 20,000 23,500 100,000 26,985 3,185 7,862 - - - - - 1,128 - -		32,032 22,481 10,557 35,000 - 23,552 323 9 10,481 21,320 2,350 19,527 2,645 4,500 2 - 818 3,233 - 39,456 5,919 151,467 6,867 5,700 5,810 650 4,604 14,284 7,181 86,256 19,198 1,094 7,336 3,975 3,228 - - 1,258 6,805 - 3,132
	564,749	824,110	(825,809)	563,050

Notes to the financial statements: Year ended 30 June 2022

12. Restricted funds (continued)

Comparatives	At 1 April 2020 £	Income £	Expenditure £	At 30 June 2021 £
Greater London Authority The Health Foundation Department of Health Royal Free NHS Foundation Trust Justlife Foundation The Coop, Homed and other – Donations for Brighton Texel Foundation London Catalyst Clothworkers Company Warwickshire County Council Mental Health & Rough Sleeping Donation Hackney Council Crisis UK The Oak Foundation Queen Mary University London Trust for London AB Charitable Trust Health Education England Grocers’ Company University College London Hospitals NHS Foundation Trust Queen’s Nursing Institute UCLH Friends Stephen Clark Charitable Settlement London Solicitors Company Rayne Foundation Isla Foundation Marie Curie British Geriatrics Society NHS England/Innovation Manchester Health & Social Care Partnership Royal Boro Kensington & Chelsea (West London ICS) NHS NE London CSY (Healthy London Partnership) Sheffield CCG Barking & Dagenham CCG Plymouth CCG NE London CCG Donation for Mouse Film Donations for patients phones UCLH Donations for Faculty for Homeless & Inclusion Health	4,035 39,648 7,464 35,000 1,685 4,763 14,071 1,528 16,234 18,925 3,132 7,261 4,135 18,804 2,350 44 2,765 7,630 4,500 — — 818 3,629 1,000 — — — — — — — — — — — — — 1,258 3,648	— 230,915 — — — — 50,000 1,000 — — — — 164,718 156,031 — 45,000 - 10,000- — 102,694 25,826 — — — 30,000 18,260 14,810 5,700 199,532 10,000 7,500 31,330 10,000 5,000 4,900 480 10,000 — 2,029	(2,706) (240,397) — — (732) (4,763) (49,787) (1,649) (15,565) (6,324) — (7,025) (99,851) (77,647) — (31,670) (2,765) (14,830) — (101,986) 25,826 — (252) — (20,000) (7,259) — — (17,126) (600) (1,000) (31,330) (4,971) (550) — (480) (8,214) — —	1,329 30,166 7,464 35,000 953 — 14,284 879 669 12,601 3,132 236 69,002 97,188 2,350 13,374 — 2,800 4,500 710 — 818 3,377 1,000 10,000 11,001 14,810 5,700 182,406 9,400 6,500 — 5,029 4,450 4,900 — 1,786 1,258 5,677
	204,327	1,135,725	(775,303)	564,749

Notes to the financial statements: Year ended 30 June 2022

12. Restricted funds (continued)

Crisis

Following the merger of Crisis and Pathway the core-funding grant of £500,000 was paid in four tranches. Agreement was received to carry forward the uncommitted balance of £30,000 to be earmarked for priority policy projects agreed with Crisis.

The balance of £2,032 of an earlier year’s grant to support Experts by Experience at the Faculty for Homeless and Inclusion Health’s conference was spent for their attendance at the 2022 conference.

The Health Foundation

Funding of £389,430 was awarded in prior years to continue the exploration of social franchising and licensing into the validation phase of spreading Pathway’s hospital team model and to secure a sustainable funding stream for the core Charity. A small amount of funding remains which relates to committed legal work associated with branding and updating of the website now renamed Pathway Partnership Programme.

Department of Health

In October 2013, a grant of £469,145 was secured from the Department of Health’s Homeless Hospital Discharge Fund to develop a pilot medical respite centre. Work continued during 2015/16 to develop, launch and implement a pilot project Pathway to Home. Reports of Pathway’s work on medical respite were published in 2016, and a seminar to showcase and discuss various studies was held in January 2017. Work continues to consider ways to develop the medical respite and other step down options for homeless patients leaving hospital.

Royal Free NHS Foundation Trust

In December 2017, the Royal Free NHS Foundation Trust agreed that the funds being held for a pilot service in their hospital of £20,000 plus a further £15,000 could be used to explore and develop provision for homeless patients leaving the hospital.

Texel Foundation

A grant of £20,000 was awarded from October 2021 to support the work of the Faculty for Homeless and Inclusion Health.

London Catalyst

A grant of £1,000 towards patient dignity for use by the Pathway teams in the Royal London Hospital and UCLH.

Clothworkers Company

A grant of £32,000 was made in June 2019 to support and train homeless people to teach professionals about homelessness, give voice to the most excluded and speak out about homelessness.

Notes to the financial statements: Year ended 30 June 2022

12. Restricted funds (continued)

Warwickshire County Council

Funding of £20,000 was provided in prior years for the development of needs assessments and associated business cases for Pathway teams at four hospitals across the county. Three needs assessments have been completed and work continues on the final one.

The Oak Foundation

In September 2018, The Oak Foundation approved a grant of £337,668 over two years to build on the research end of life care project for homeless people by developing further, implementing and evaluating the training programme for agencies working with homeless people. The project, entitled Palliative Care Training, commenced in September 2018. Work continues on the project with the agreement of the funder.

Queen Mary University London (QMUL)

In September 2018, QMUL paid £29,600 to Pathway which is a grant awarded by Barts Charity for an assessment of needs for a Pathway team in Newham hospital. Work commenced in December 2018 and a draft needs assessment and business case were completed towards the end of 2019. The cost of GP input was lower than estimated, and £19,299 of unspent funding was repaid to QMUL in February 2020. The remaining balance of funding is being held to take forward the needs assessment.

Trust for London

The grant of £135,000 grant awarded in March 2020 is to continue and extend the access to Tier 2 legal advice further to include two mental health teams. Contracts for services were renewed to legal firms in July 2021 for the second year.

Health Education England

A grant of £17,400 from Health Education England was paid to Pathway in March 2018 for the provision of the 2[nd] National Socially Inclusive Dentistry conference which was held in Birmingham in December 2018. The balance of funding is earmarked for the Oral Health subgroup of the Faculty for Homeless and Inclusion Health.

Grocers’ Company

In February 2018, the Grocers’ Company awarded a grant to Pathway for the development and piloting of a Mental Health and Trauma training resource. Work on the project began in 2018, and pilots of the training module were run throughout 2019. Plans are underway to take this work forward in 2022/23.

University College London Hospitals NHS Foundation Trust

UCLH NHS Foundation Trust approved a business case in 2013 to fund four sessions a week of a GP for its Pathway led hospital homeless team and also to provide a second nurse for the service. Funding was provided for GP sessions until the retirement of the GP and the appointment of a new integrated care consultant. When the new postholder took up post in 2021 he took clinical responsibility for the UCLH team.

Notes to the financial statements: Year ended 30 June 2022

12. Restricted funds (continued)

Queen’s Nursing Institute

An agreement to second Pathway’s Nursing Fellow for one day per week to support partnership working at the Queen’s Nursing Institute (QNI) was extended until the end of September 2021.

UCLH Friends

A grant of £4,880 was agreed to produce and publish a handbook that could be given to homeless patients attending or admitted to UCLH. The booklet was launched in the autumn 2018 and was reprinted in May 2019. Residual funding is held for further reprints of the booklet.

Stephen Clarke Charitable Settlement

In October 2018, Pathway received a grant of £4,000 towards the cost of supporting the work of the Pathway team in Bristol.

City of London Solicitors’ Company

In February 2019, the City of London Solicitors’ Company awarded a grant of £1,000 towards the continued provision of legal advice to homeless people in hospital on housing and other related issues in London hospitals where there is a Pathway team.

Rayne Foundation

In March 2021 funding of £90,000 spread over three years was awarded for the further development of the Resilient work to prevent children and young people under the care of CAMHS from becoming homeless.

Isla Foundation and British Geriatrics Society

Funding of £18,260 was received in January 2021 from Isla Foundation and £5,700 in March 2021 from the British Geriatrics Society for work to develop and test a reproducible screening tool and short frailty questionnaire for reporting presence of frailty amongst residents in hostels. The work is continuing into 2022.

NHS England / Innovation

In March 2021, Pathway received £150,000 grant funding for a project - ‘Pathways to inclusive employment’ - to work with seven NHS Trusts to recruit people with personal experience of homelessness to train as Health Care Support Workers. The work will include identifying and addressing barriers to employment in the NHS, and to develop a policy and practice toolkit for wider application and adoption of evaluated processes. The project is in partnership with Groundswell and the Royal Society for Public Health who have received separate grant funding and have separate roles. Pathway is responsible for Pathway’s to inclusive employment’

In August 2020, a small grant of £9,950 was made for call off policy advice on homeless and inclusion health.

Notes to the financial statements: Year ended 30 June 2022

12. Restricted funds (continued)

NHS England / Innovation (continued)

Early in 2021, grant funding of £19,732 was provided to make an information film for NHS staff about the experiences of homeless patients attending hospital called ‘Someone Please Listen’. Filming has been delayed due to Covid-19 restrictions but restarted in summer 2021 and continues.

In March 2021, grant funding of £19,850 was approved for the further development and testing of webinars about end of life and palliative care for people living in hostels. The testing has been carried out by organisations in Hull and Birmingham, and work continues to spread the work.

In January 2022, grant funding of £19,770 was paid for work on palliative care, bereavement and homelessness - quantifying the problem and developing tools to obtain feedback on experience.

Marie Curie

A grant of £14,810 for work on palliative care for people with unsettled status was made in March 2021. Work on the project began in February 2022.

Manchester Health and Social Care Partnership

Funding of £10,000 was provided at the beginning of 2021 to provide call off policy advice and support on homeless and inclusion health.

Royal Borough of Kensington and Chelsea (West London ICS)

Grant funding of £7,500 received in June 2021 for a study collecting and analysing baseline data about homeless patients attending hospital which will be used to assess what additional services are required in the wider West London area. An additional £3,500 was received in February 2022 to continue the work ahead of implementing a hospital team for St Mary’s and the Chelsea and Westminster.

NHS Sheffield CCG

Funding of £15,000 was provided for the development of a needs assessment and associated business case for a Pathway team at hospitals serving the Sheffield area. The final needs assessment was submitted to commissioners for consideration and discussions are ongoing.

NHS Devon CCG

Funding of £20,000 was provided for the development of a needs assessment and associated business case for a Pathway team at hospitals serving the whole of Devon excluding Plymouth. The needs assessment is expected to be finished in autumn 2022.

NHS Kent and Medway CCG

Funding of £15,000 was provided for the development of a needs assessment and associated business case for a Pathway team at hospitals serving East Kent. Following the completion of the needs assessment, a six month pilot service was implemented in spring 2022 and funding of £8,500 was paid for training and support of the service.

Notes to the financial statements: Year ended 30 June 2022

12. Restricted funds (continued)

St Martin in the Fields Charity

The grant of £300,000 grant, receivable in equal instalments over three years, from St Martin’s Charity Frontline Fund was awarded in December 2021 is to provide access to Tier 2 specialist legal advice to Pathway teams outside of London and to provide access to specialist case work for all Pathway teams. Contracts for services have been issued to legal firms in spring and early summer 2022.

Homeless Link

Funding for the first of three years as partner of the Homeless Health Consortium, part of the VCSE Health and Wellbeing Alliance. Other partners are Homeless Link (lead partner) and Groundswell. Projects in 2021/22 included participation in ‘Bridging the Gap’: a review of the health training needs of homeless charity sector staff; and to a smaller piece of work to review issues in relation to GP registration for the homeless population. Projects for 2022/23 will focus on access to dentistry and training of frontline A&E staff in Mental Capacity Act assessments.

Institute of Public Policy Research (IPPR)

Funding as a minor partner in a Lloyds Bank Foundation funded project to research the impact of Universal Credit on people with multiple complex needs. The IPPR was the lead partner who consulted Pathway’s EbE group in their research, their findings and proposals.

NHS North East London CCG

Funding of £7,862 for participation in Pathway Fellow Dr Aaminah Verity’s study of how to improve access to primary care for inclusion health groups. Pathway’s EBE group acts at the lived experience sounding board for the study.

NHS Barking and Dagenham CCG

Funding was provided to support the development of a needs assessment for a Pathway team at hospitals serving Barking and Dagenham.

Plymouth Hospital NHS Trust

In June 2021 funding of £4,900 was provided to support the development of a needs assessment for a Pathway team at Plymouth hospital. We are currently supporting the development of a Pathway Team which will become part of the Pathway Partnership Programme.

Greater London Authority

The grant paid for support and evaluation of a short-term pilot Pathway Homeless team in St Mary’s Hospital funded by Cold Weather Funding. The pilot was cut short due to Covid-19.

Notes to the financial statements: Year ended 30 June 2022

12. Restricted funds (continued)

Justlife Foundation

In April 2014, the collaborative partnership led by Justlife Foundation was awarded funding from Brighton and Hove NHS Clinical Commissioning Group (CCG) to continue the service Pathway+ in Brighton. As lead partner, Justlife Foundation received the funding and paid Pathway on a staged basis. The service was re-tendered during 2016, and Arch Health CIC won the contract from 1 February 2017. The remaining funds held by Pathway from Justlife Foundation for the Brighton service paid for miscellaneous expenses and reflective practice for the team.

Donation for Mouse Film

A legacy donation of £15,000 from the estate of Miss Ros Bax was received in March 2021. Of this, £10,000 was a restricted contribution towards the completion of the training film: The Mouse which is aimed at preventing homelessness in young people accessing CAMHS services.

13. Analysis of net assets between funds

Analysis of net assets between funds
	Unrestricted funds £	Restricted funds £	Total 30 June 2022 £
Current assets Current liabilities 2022 net assets	736,095 (83,172)	630,925 (67,875)	1,367,020 (151,047)
	652,923	563,050	1,215,973
Comparatives	Unrestricted funds £	Restricted funds £	Total 31 March 2021 £
Current assets Current liabilities 2021 net assets	296,438 (45,003)	664,654 (99,905)	961,092 (144,908)
	251,435	564,749	816,184

14. Related party transactions

No transactions have taken place with organisations in which a member of the board of Trustees has an interest.

15. Controlling party

On 1 July 2021, Crisis UK became the controlling party by virtue of being the sole member.

16. Member’s liability

Crisis UK as the sole member of the charitable company undertakes to contribute to the assets of the company in the event of it being wound up while it is a member or within one year after it ceases to be a member, not exceeding £1.