2024-06-30-accounts

Homeless & Inclusion Health

The London Pathway

Operating as Pathway

Annual Report and Financial Statements

Year ended 30 June 2024

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

Charity Registration Number 1138741

Contents

Reports
Reference and administrative details	4
Trustees’ report	3
Independent auditor's report	22
Financial statements
Statement of financial activities	26
Balance sheet	27
Statement of cash flows	28
Principal accounting policies	29
Notestothefinancialstatements	32

Pathway

Reference and administrative details

Trustees Lady Rhona Bradley Mr Martin Cheeseman Prof Yvonne Doyle CB Dr Vanya Gant - resigned 23 October 2023 Mr Richard Guest Ms Cathy James OBE - resigned 3 July 23 Ms Joanne Land Prof Mohammed Sultan Mahmud Ms Leslie Ann Morphy OBE (Chair) Mr Anthony Omo Mr Stephen Robertson (Vice Chair) - resigned 8 July 2024 Mr Simon Tuttle Prof Graham Foster — appointed 8 February 2024 Ms Kathleen Palmer — appointed 8 July 2024

Chief Executive Mr Alex Bax Finance "Director" and Company Ms Stephanie Swan Secretary Medical "Director" and Secretary to Dr Christopher Sargeant the Faculty for Homeless and Inclusion Health Policy and Programmes Director Ms Dee O’Connell 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

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Reference and administrative details

Bankers The Co-operative Bank Business Customer Services PO Box 250 Skelmersdale WN8 6WT

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Trustees’ report Year ended 30 June 2024

The trustees of the charity present their annual report and audited financial statements for the year ended 30 June 2024. This is the third 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

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. Three trustees resigned from the charity during the period 1 July 2023 to 31 July 2024, and two new trustees were appointed. 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 2023-24 small groups met to: i) review the current pay arrangements given the looming cost of living pressures — its recommendations are made to the full Board; ii) initiate planning for the replacement of the Chair of the Board when she stands down in 2025; and iii) provide critique on a funding application. 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. Prof Yvonne Doyle chairs the advisory group that supports the work on the Pathway Partnership Programme.

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Trustees’ report Year ended 30 June 2024

Structure, Governance and Management (continued)

Key management personnel

Pathway’s key personnel are the Chief Executive, the Finance and Administration Director, the Medical Director, and the Policy and Programmes Director.

Following recommendations from the Trustees’ sub-committee meeting and key management personnel, the full Board reviewed the staff structure and remuneration of all current staff and vacant posts 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 automaticaily 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 2023/24, there were twelve trustees. Cathy James OBE resigned from the Board in July 2023, Dr Vanya Gant resigned in October 2023 and Stephen Robertson resigned in July 2024.

In 2024, Martin Cheeseman’s term as a Crisis Trustee ended aiong with his role as the Member appointed trustee. Following this, Pathway’s Trustees agreed that he should remain a trustee of Pathway. The replacement Member Appointed Trustee, Kath Palmer, joined the Board in July 2024.

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Trustees’ report Year ended 30 June 2024

Structure, Governance and Management (continued)

Recruitment, appointment, and training of trustees (continued)

The trustees appointed Prof Graham Foster to the Board in February 2024.

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. These financial instructions were revised and agreed at the Board meeting held in July 2024.

The revised strategic plan, draft budget, and staff structure for Pathway for 2023-24 were reviewed by the Board at a special strategic meeting in June 2023, and at their normal meeting in July 2023. The detailed business plan was presented to the Board at their October meeting for approval. Progress reports were presented to the quarterly meetings of the Board. An additional strategic meeting was convened in May 2024 to review and agree Pathway’s strategic direction and its priorities for the forthcoming period (2024-25), the associated budget and also staff remuneration from 1 July.

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.

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 risks around funding to maintain services. These are addressed as follows:

1. 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.

2. Maintaining funding at the level needed to support the proposed work programme is being managed in several ways:

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Trustees’ report Year ended 30 June 2024

Structure, Governance and Management (continued)

Risk management (continued)

• @ In 2023-24 we have undertaken a comprehensive review of the Pathway Partnership Programme services including the charging policy and have started to implement the findings

• ¢ Planning will begin for negotiations with Crisis ahead of the renewal of the operating agreement

• ¢ we will continue to target funding applications to charitable foundations and other potential funder to those opportunities that support our core priority projects

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

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.

Our strategic plan 2023-2028 sets out our purpose and vision for the future as:

To improve the health and wellbeing of people experiencing homelessness and other vulnerable groups, by working closely with the NHS and other partners to create improved models of care for these people.

We strive every day for better and more equitable health and wellbeing for all patients. Inclusion health matters because homelessness is a health issue — wider social determinants impact health, not just on individuals, but the whole of society.

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Trustees’ report Year ended 30 June 2024

Objectives (continued)

Implementation of Objectives (continued)

2023-24 was the first year of Pathway’s revised strategic plan and this sets the strategic priorities over the five years to:

• ¢ drive up the quality of care for people facing homelessness in hospital, and ensure safe and effective discharges and transfers of care

• ensure everyone has somewhere safe to recover

• prevent homelessness and a deepening of the health problems faced by people experiencing homelessness, working through primary care

• ¢ Raise the profile of an make the case for homeless and inclusion health

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

1. Acute care: to drive up standards of healthcare for people facing homelessness in hospital, ensuring a safe and effective discharge

2. Asafe place to recover: intermediate and long-term accommodation and care to sustain recovery and end homelessness

3. Prevention: preventing homelessness and worsening health through primary care

4. Build mental health and place in all our work

5. Raise the profile and make the case for homeless and inclusion health

6. Maintain a strong core organisation

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. Acute care: to drive up standards of healthcare for people facing homelessness in hospital, ensuring a safe and effective discharge

2. e We supported Pathway Partnership Programme hospital teams in Leeds, Hull, St George's (Tooting), The Homerton (Hackney), East Kent and Piymouth.

3. e Wesigned an expert partner agreement with North West London Integrated Care System (ICS) to provide a bespoke package of support to hospital teams covering sites Inner and Outer North West London.

4. e Our first annual report of the Pathway Partnership Programme (PPP): ‘Breaking the Cycle: Improving Hospital Care and Discharge for Patients Experiencing Homelessness - the Pathway Partnership Programme Annual Report 2022-23 was published June 2024 with its conclusions trailed at Pathway’s annual conference in March 2024.

5. e A revised programme of bespoke training was delivered to new staff at St George’s, in East Kent, and at St Mary’s and Ealing (in West London).

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Trustees’ report Year ended 30 June 2024

Activities, Achievements and Performance (continued)

• e §=In January 2024, NHS Cardiff and Vale signed a consultancy agreement with Pathway to develop a plan to introduce a Pathway team in autumn 2024, and Pathway is supporting preliminary development work.

• e We supported teams to collect and analyse data from their work to feed into progress reports to local commissioners and to support business cases for ongoing funding.

• e Pathway Partnership Teams worked with 3377 homeless patients in the year, up from 2640 in the previous year. They reduced returns to rough sleeping by 43%.

• e Pathway’s core team carried out annual visits to London teams and to the teams in Leeds and Plymouth.

• e Prof Bola Owolabi, NHSE Director of Health Inequalities had a successful visit to the Hull team, and Emma Hardy MP also visited the Hull team prior to the General Election.

• e Staff from Partnership teams received complimentary places at the Faculty for Homeless and Inclusion Health’s annual conference and also at our annual inclusion health CPD day.

• e Pathway contracted with legal advice services to provide Tier 2 advice and some casework with our final year of funding from St Martin in the Field’s Frontline programme. This advice offer is available to Partnership and Legacy teams. The current contracts end on 31st December 2024. In the past year the legal advisors dealt responded to approximately 200 enquiries, mainly on immigration issues.

• e We used some separately fundraised donations to commission specialist housing legal advice for London hospital teams. In the past year approximately 30 housing enquiries were dealt with under this arrangement.

• e We have struggled to secure further charitable funding for legal advice and Pathway is discussing options for direct NHS funding with commissioners of London’s Partnership teams, via a newly established legal advice advisory group.

• e §6The British Medical Journal (BMJ) published a letter from Pathway about the challenges of delivering services for people experiencing homelessness and need for support for staff and expansion of provision.

• Continue to develop the Pathway model and its delivery

• e® Following an internal review, work is underway to update and refresh the ‘Pathway model’ to ensure our offer meets current challenges in the NHS; embeds lived experience and mental health throughout and is based on a financially sustainable business model.

• e We held two core PPP team awaydays to help shape the work described above.

• e The PPP programme was shortlisted for Homeless Link’s Excellence in Collaboration award

• e We delivered a programme of masterclasses for PPP teams, with expert guest speakers. We also held three ‘all teams’ meetings for Partnership and Legacy teams during the year. Masterclass topics included: the importance of empathy in inclusion healthcare; health issues relating to chemsex; Opioid Substitute Therapy & the iHost project; findings from the evaluation of the Out of Hospital Care Model Programme; and the findings from our first Homeless and Inclusion Health Barometer report & survey.

• e We established a PPP advisory group of external experts which meets quarterly.

• e Anew programme of meetings for Pathway teams’ Operational Leads and lead GP’s is planned.

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Trustees’ report Year ended 30 June 2024

Activities, Achievements and Performance (continued)

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

2. e Revised content for the PPP section of the Pathway website was developed.

3. e Promotional materials about the Partnership Programme were developed and printed for NHS Confed Expo.

4. e We carried out exit interviews to gather feedback from staff leaving Pathway teams to help us improve the programme.

5. Spread the model to areas which need it most, including psychiatric hospitals

6. e We completed our work on the Hull city-wide needs assessment for severe multiple deprivation and the final report was delivered in January 2024.

7. e Following protracted negotiations Mid and South Essex ICS confirmed a commission for a homeless health needs assessment with start date scheduled for August 2024.

8. e Discussions are underway with other areas regarding needs assessments (West Kent, and Doncaster) and also for the introduction of new Pathway teams (Devon and Exeter) funding permitting.

9. Aim 2: A safe place to recover - intermediate and long term accommodation and care to sustain recovery and end homelessness

10. Advocate for provision of intermediate care through ICSs and NHSE

11. e We completed our report on patient experiences and outcomes from the London-wide detox beds provided by Guy’s and St Thomas’ NHS Foundation Trust, funded through the Rough Sleeping Alcohol and Drug Treatment Grant. The report was submitted in September 2023.

12. e Work is underway to develop a short film, ‘Wonderland’ aimed at educating staff working with people experiencing homelessness who have addiction issues, about what an individual might be experiencing. An associated recovery handbook ‘Finding Rat Park’, for people experiencing homelessness and addiction issues, is also nearing completion. Release of the film and publication of the handbook is expected in autumn 2024.

13. e Wecompleted work in early summer 2024 on an Intermediate Care report, analysing the need for intermediate care in East Kent, funded by the DHSC/NHSE Health and Wellbeing Alliance. Following the agreement of additional funding, work is also complete on producing additional reports for ICS commissioners and national policy makers.

14. Campaign at national level for more funding for greater provision of intermediate care

15. e We have kicked off a major programme of work to build the case for greater provision in intermediate care for people experiencing homelessness. Activity includes: analysis of existing legislation and guidance relating to street discharges and intermediate care to highlight gaps in provision; instructing a KC to develop potential legal changes to close gaps in current legislation; consultation with civil servants and other stakeholders; and commissioning an economic review to support the case for more funding for intermediate care for patients experiencing homelessness The campaign is one of the joint Pathway/Crisis priorities, with Pathway leading the work.

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Trustees’ report Year ended 30 June 2024

Activities, Achievements and Performance (continued)

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• e Two of our colleagues with lived experience of homelessness, worked to co-produce an immersive conference stand to depict the reality of being discharged from hospital to the street. We displayed this at NHS Confed Expo in June 2024, where we received excellent engagement and feedback. We plan to take it to the Labour Party Conference in September 2024. The stand incorporates stories written by people with lived experience of homelessness and street discharges.

• e The All Party Parliamentary Group for Ending Homelessness (APPGEH) met in December to explore the role of public institutions in preventing homelessness. We used the opportunity to launch the joint Pathway/Crisis report ‘Beyond the Ward — Exploring the Duty to Refer in Hospital Settings’. The panel included a member of Pathway’s Lived Experience group and a GP from one of Pathway’s North West London hospital teams who spoke about the role of hospitals and presented some of the findings from the report, along with a Crisis colleague. Following the meeting the APPG Co-Chairs wrote to Government urging action to prevent vulnerable people from becoming homeless after being in the care of public services. The meeting and follow up letter garnered national media attention including from the BBC.

• Influence housing policy and spending with Crisis, to boost the provision of Housing First, specialist and supported housing and care for people with complex needs

• e Pathway contributed to Crisis’s pre-election paper to The Labour Party suggesting that, should they be elected, then any unexpected underspend could be directed at a national ‘Safe Discharge Programme’ by funding Pathway hospital teams and specialist intermediate care provision for the prevention of rough sleeping.

• e Pathway submitted a joint response, with Crisis, to an ONS consultation on data collection on deaths during homelessness. Crisis and Pathway worked together on a blog, posted on Crisis website, critiquing the proposals to withdraw the collection of homeless death statistics. Subsequently these proposals were abandoned.

• e Pathway supported Crisis’ campaigning work on Criminal Justice Bill by providing a representative for the APPG meeting and signing their joint sector-wide letter. Alex Bax co-authored an op-ed on the subject in the BMJ.

• e Pathway provided support and input into the development of Crisis’ ‘Health Equals’ project which is ongoing.

• e The first Pathway/Crisisjoint digest of homeless and inclusion health - ‘Always the Bottom of the Pile: The Homeless and Inclusion Health Barometer 2024’ — was published in March 2024. Its findings were presented at the Faculty for Homeless and Inclusion Health conference and the Frontline Network Conference, along with many meetings with officials, and will be presented at the FEANTSA conference in Budapest in late summer. An article was about it was aiso published in the BMJ.

• e The joint Pathway/Crisis report on the implementation of Duty to Refer by public services including hospitals, to intervene to help prevent homelessness according to the Homelessness Reduction Act 2017: ‘Beyond the Ward — Exploring the Duty to Refer in Hospital Settings’ was published in January 2024.

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Trustees’ report Year ended 30 June 2024

Activities, Achievements and Performance (continued)

Aim 3: Prevention: preventing homelessness and worsening health though primary

care

1. Advocate for access to primary care for people experiencing homelessness e Pathway responded to NHS England’s consultation on revisions to their national Quality and Outcomes Framework. Work on our response was led by Pathway Fellow, Dr Aaminah Verity.

2. e Pathway made a submission to Jenny Keane, NHSE discharge director, outlining how winter pressure funding could be used to support people experiencing homelessness in hospital.

Aim 4: Build mental health and place in all our work

1. Support for mental illness that can drive homelessness

2. e Membership of the Faculty for Homeless and Inclusion Health Mental Health Sub-group stands at 334 members with around 55 members attending the quarterly meetings.

3. e Contact has been made with the clinical lead of a Pathway ‘legacy team’ in a mental health trust to explore more actively supporting the spread of the model to more mental health services.

4. Work with ICS’s and PCN’s (places) — supporting local system change across the patient pathway and aligning with new Crisis centres where possible

5. e Pathway secured funding from NHS England to deliver a second phase of our successful ICS learning programme on inclusion health. Participating ICSs for this phase are: West Yorkshire, Chester and Merseyside, Black Country, Surrey, Kent and Medway, Birmingham, and Solihull. The final of six sessions with the cohort was held in July 2024 and a report on the programme is scheduled for September. The focus of the sessions is to share learning between ICSs on what they need to do to improve care for inclusion health populations drawing on Pathway’s framework and the wider evidence base for successful inclusion health interventions.

6. e We convened a joint meeting of our Phase 1 and Phase 2 ICS cohorts in early July 2024 at both cohorts’ request to share experiences and develop national recommendations for action.

7. e Our report from Phase 1 of this collaborative programme for Integrated Care Systems, ‘Beyond Pockets of Excellence: Integrated Care Systems in Inclusion Health’ was published in August 2023. It was produced in partnership with Groundswell and the King’s Fund and publicised widely on a variety of platforms.

8. e Wehave started to scope Pathway’s potential contribution to support Crisis’ planned ‘Built for Zero’ programme. The programme proposes that much better outcomes can be achieved through far more active co-ordination across relevant services (housing, health, social care, social security, and others) in a defined geographic location.

9. Maintain interest in current safeguarding and capacity issues for our hospital teams

An extended plenary session on safeguarding was well received at the 2024 Faculty for Homeless and Inclusion Health’s Conference. The session was put together by Pathway Senior Nursing Fellow Sam Dorney-Smith with presentations from Gill Taylor, Prof. Michael Preston Shoot and Melanie Williams, national ADASS lead on homelessness, with input from Khosru Miah, a community member at the People’s Recovery Project.

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Trustees’ report Year ended 30 June 2024

Activities, Achievements and Performance (continued)

Aim 5: Raise the profile and make the case for homeless and inclusion health

1. Influencing health education, so that healthcare professionals are better equipped to take care of patients experiencing homelessness

2. e We launched an online learning module, aimed at Accident and Emergency staff, and developed in partnership with Change Communication, the Royal College of Emergency Medicine, and fellow members of the VCSE Homeless Health Consortium: Groundswell and Homeless Link. It gives an overview of the challenges and opportunities when a person experiencing homelessness attends a hospital emergency department. It covers avoiding self-discharges, safeguarding in relation to concerns about self-neglect, mental capacity, and advice on how to connect people to other services.

3. e Dr Gemma Ashwell was appointed as the new Chair of the Faculty for Homeless and inclusion Health's Education Sub-Committee.

4. e Our annual Inclusion Health Continuing Professional Development (CPD) day ‘Building Evidence for Better Practice’ took place on 21 June 2024. 30 people joined a very successful day including presentations from Pathway’s Lived Experience Lead, our new Nutrition Clinical Fellow, on Machine Learning and Education in inclusion health, and the work of Pathway teams.

5. e We hosted our first CPD session for Occupational Therapists working with people experiencing homelessness in November 2023. it was attended by 20 delegates and we plan for this also to become an annual event.

6. e Our Faculty medical student group has started planning for a first Faculty Medical Students’ Conference, to be held in Sheffield in early December 2024.

7. e We appointed two new Pathway Fellows during the year bringing the total number to 23: Ghislaine Swinburn works for Bristol Inner City Primary Care Network and has over 30 experience as an NHS nutritionist working with a wide variety of services, and Hannah Style is a passionate nutritionist who works in specialist services for East London NHS Foundation Trust. In her spare time Hannah established the charity Feast with Us, providing high quality free food to destitute people in London.

8. e We established a new Faculty sub-group for ‘system leaders and managers’ - those working in ICSs, who want to benefit from the peer support and knowledge sharing the Faculty offers. It is chaired by Jonathan Pritchard, Association Director for Housing and Integration at Southern Health Foundation NHS Trust.

9. e In partnership with the University of Salford from January to March 2024 we developed and delivered a three day training package on health inequalities to 120+ delegates from services across Manchester. The group was divided into three cohorts, with both inperson and online sessions. The programme was developed and led by Pathway Fellow Sam Dorney-Smith with contributions from a wide-range of disciplines drawn from various sectors.

10. e Work continued on the project, led by Pathway Fellow Sam Dorney-Smith that aims to collate and share knowledge and experiences between specialist diabetes nurses and inclusion health nurses in order to better support patients who live with Type 2 Diabetes. The project will conclude in September 2024, and outputs will include an e-learning module, information leaflets aimed at patients living with diabetes who are experiencing homelessness, a comprehensive final report and various journal articles. In addition, Sam has already presented early findings to several different audiences.

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Trustees’ report Year ended 30 June 2024

Activities, Achievements and Performance (continued)

• e We have secured substantial multi-year grants from City Bridge Foundation and the National Lottery Community Fund - Reaching Communities in England programme to continue work over the next three years (February 2024 to end April 2027) on our Resilient Programme, The funds will support us to develop a homelessness prevention learning curriculum and materials associated with ‘The Mouse’ film and disseminate them for use with young people across NHS Child and Adolescent Mental Health Services (CAMHS). Work on the materials is progressing despite the sudden closure of Simmons House, the NHS in-patient CAMHS unit in Haringey where earlier phases of the project were hosted. Live testing of the materials with young people in CAMHS services in London is scheduled to start in autumn/winter 2024.

• e Pathway Senior Clinical Fellow Dr Caroline Shulman continues to lead a series of research and education resource development programmes on improving end-of-life and palliative care for people experiencing homelessness. Much of funding for the work is hosted by Marie Curie and the UCL Institute of Psychiatry. A new research paper published in 2023 was ‘Palliative care, homelessness, and restricted or uncertain immigration status’ in the journal Palliative Care and Social Practice.

• e Frailty— we published the results of a study that developed and tested a holistic and frailty health and care needs assessment questionnaire for use by hostel staff to complete with hostel residents. Following its success with hostel staff and residents, we undertook a further study with supplementary funding from Marie Curie, to interview mainstream health and social care professionals to ascertain how the information that hostel staff give them can be optimised to have impact. This is near to completion and is currently being written up.

• e Palliative care community of practice — i} We have continued to develop and run facilitator training to enable a range of professionals to develop localised interdisciplinary communities of practice with the aim of supporting people experiencing homelessness with multiple and complex needs or advanced ill health. The materials are all on a platform and divided into eight sessions. The platform contains a series of pre-recorded short videos from a range of professionals alongside facilitator and participant guides and resources - as well as chat fora to enable communication outside of sessions. li) With NIHR funding we have developed a national Multi-professional network for people with an interest in supporting people experiencing homelessness with palliative and end of life care needs. Sessions run monthly and there are always one or two speakers presenting at each meeting. lii) We have also been successful in obtaining funding for a three year NIHR project which will start in November 2024 to evaluate and further develop the community of practice as described above.

2. Influencing national policy to drive progress on inclusion health at system level

• e In-collaboration with Crisis and prior to the general election, Pathway worked to develop relationships with members of the opposition and to present ‘asks’ for inclusion health in Party manifestos. Pathway wrote to key MPs and invited them to visit local Pathway hospital teams. As part of this work, we will be taking our ‘end street discharges’ stand to the Labour Party Conference in September 2024.

• e We published ‘Beyond the Ward — Exploring the Duty to Refer in Hospital Settings’ in January 2024. This joint Pathway/Crisis research reported on progress with implementation of the ‘Duty to Refer’ placed on public services including hospitals, to intervene to help prevent homelessness in the Homelessness Reduction Act 2017:

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Trustees’ report Year ended 30 June 2024

Activities, Achievements and Performance (continued)

• e We played a key role influencing the first NHS England national Inclusion Health Framework. We responded to a range of Government public policy consultations, for example on statutory guidance for ICPs.

• e Following many years of work, Pathway secured improvements to the coding of inclusion health groups in key NHS data systems including the Mental Health Data Set and the Urgent and Emergency Care Data set.

• Grow a movement of change across our networks

• « In response to calls from delegates at our 2023 conference to build a movement of change, at the 2024 conference we pulled together a collective statement from Faculty members aimed at politicians, on the current state of health and care services available to inclusion health groups and calling for urgent reform. The statement was published on Pathway’s website and has been shared widely. Delegates were also invited to record short video messages to the new Secretary of State.

• e Faculty membership grew to more than 2,000 members this year.

• Connecting and supporting people working in inclusion health, through supporting and growing our Faculty and Fellows networks

• e Additional sub-groups of the Faculty for Homeless and Inciusion Health have been established including groups for: Integrated Care Systems’ Senior Leaders and Managers, Mobile and Outreach Services, Nurses, Nutrition and Dieticians. The Faculty now supports 14 specialist sub-groups.

• e The first meeting of the national Faculty subgroup for Mobile and Outreach Inclusion Health (IH) Services was attended by 40+ people and there is a strong appetite to build this network.

• e We re-launched the national Faculty group for nurses working in homeless hospital discharge settings (Pathway and non-Pathway teams).

• The Primary Care Inclusion Health Network national network, and regional primary care networks are now well established and continuing to meet regularly.

• e Anew nutrition in Inclusion Health Faculty Sub-group has just started, building on a mini evidence review completed in June by our two new nutrition Fellows.

• e Pathway continued to produce and distribute our fortnightly online newsletter to the 2,000+ members of the Faculty for Homeless and Inclusion Health.

• Delivering our 2024 Pathway conference

• e The 13 annual Faculty for Homeless and Inclusion Health’s 2024 conference: Pathways from Homelessness 2024 International Conference with the theme ‘Evidence into Action’ was held on 13% and 14 March. Two keynote speakers were: Prof Sir Michael Marmot CH, Director of the UCL Institute of Health Equity and UCL Department for Epidemiology and Public Health and Prof Kamila Hawthorne MBE, Chair of Council, Royal College of General Practitioners. They were joined by nearly 70 other speakers on a huge range of topics. The conference was attended by 400+ delegates in person and online. Eight members of Pathway’s lived experience group were supported to attend and participate in or lead sessions. Delegate feedback was once again extremely positive about the whole event.

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Trustees’ report Year ended 30 June 2024

Activities, Achievements and Performance (continued)

Aim 6: Maintain a strong core organisation

1. Maintain a standing lived experience programme and support structure as part of our core operation

2. e Anew programme manager with lived experience joined Pathway to lead work to develop and support our group of lived experience volunteers and to coordinate the programme.

3. e Members of the standing lived experience group were involved in deciding how to change ways they are involved in Pathway’s work and agreed to move towards individual project based involvement and support.

4. e Online meetings of the whole group were changed from weekly to monthly.

5. e Long standing lived experience group members participated in the planning and delivery of the Faculty for Homeless and Inclusion Health’s conference and were awarded certificates of recognition at the conference.

6. e Two members of the group were heavily involved in the design of the Campaign for Safe Discharge conference stand and they attended NHS Confed Expo as volunteers to help promote Pathway and the campaign.

7. « Anexperienced member of the group is providing one day a week input for nine months beginning in March 2024 to a Marie Curie project on creating ‘Death Cafes’ in relation to homelessness.

8. « A number of members of the group have provided lived experience expertise to our Burdett Trust for Nursing funded project on improving care for people experiencing homelessness who are living with Type 2 Diabetes, and also to an initial study on nutrition for people experiencing homelessness, led by a new Pathway Fellow.

9. e We finally launched the toolkit developed as part of our NHS England funded project to encourage the recruitment of people with lived experience of homelessness as Health Care Support Workers. NHS Employers are hosting the toolkit on their web site and are providing ongoing promotion of the resources. A session to promote the toolkit was held at Faculty for Homeless and Inclusion Health's conference, and it has also been shared at a variety of online meetings including to regional networking meetings of ICS workforce leads.

10. Develop our new lived experience programme and support structure

11. e We have recruited several new London-based volunteers to Pathway’s lived experience group and they have been attending in-person meetings monthly since October 2023.

12. e We won a small grant to support a Co-production project on a homelessness and dual diagnosis. Involving the new group members, the six month project began at the start of the year, and will culminate in a podcast scheduled to be complete by late summer.

13. e Work is ongoing to develop more formalised support structures for members of the lived experience programme.

14. Annual detailed business plan and associated budget will be approved by Pathway’s and Crisis’ boards of trustees annually

e Progress reports on the 2023-24 business plan have been produced for Pathway’s Board quarterly and shared with Crisis.

• e The business plan and budget for 2024-25 was developed and approved by Pathway’s Board and Crisis in May 2024.

15

Trustees’ report Year ended 30 June 2024

Activities, Achievements and Performance (continued)

1. Business Development: develop, build, and maintain a sustainable business and financial model for Pathway including corporate partnerships and fundraising strategy

2. e Pathway’s Business Development Manager meets monthly with Crisis’ Head of Fundraising to co-ordinate on grant applications and fundraising more generally.

3. e Apriority project for 2023-24 was the comprehensive review of the PPP model. This was concluded and reported to the Board of Trustees in April 2024. The action plan from the review will be implemented in 2024/25.

4. e We have established three corporate support partnerships, with: The Doctors’ Laboratory, Carnall Farrar and Morgan Sindall. Pathway received support from them during the year including targeted fundraising, occasional provision of rooms for external meetings and from Carnall Farrar pro-bono policy work on data issues in the NHS leading to a joint report with Pathway - ‘The Unseen Struggle: The Invisibility of Homelessness in NHS data’.

5. e A promotional postcard outlining benefits of becoming a corporate partner of Pathway was developed and trialed at NHS Confed Expo in June 2024.

6. Develop a strategic communications plan focussed on delivering our ambitions for large scale change — with Crisis support

7. e We concluded a major redesign of our website, including a new logo and brand for Pathway. The website is now more user-friendly, giving users greater ability to search our rich catalogue of inclusion health resources.

8. e Social media: We continue to use X (formerly Twitter) to promote Pathway and the Faculty for Homeless and Inclusion Health. A dedicated Pathway page was also published on Linked-In and regular posting has doubled followers.

9. e Pathway’s Communications Officer successfully applied for Pathway to join a new ‘Stronger Voices’ strategic communications and development programme for small charities. Pathway will be one of 19 organisations supported by The Media Trust and Equally Ours during this six month programme. The programme offers a wealth of targeted training and resources.

10. Regularly review the core staffing structure for Pathway

11. e An awayday of Pathway’s Senior Management Team was held to review resources including core staffing available and needed. This was used to inform the production of the 2024-25 business plan and budget.

12. e Remuneration of core staff was reviewed and benchmarked against appropriate organisations as part of our annual pay award process.

13. e Probation and half yearly performance reviews of core team staff were carried out.

16

Trustees’ report Year ended 30 June 2024

Activities, Achievements and Performance (continued)

1. Governance: adherence to best practice in charitable governance

2. e Pathway’s Financial Standing Orders were updated and approved by Pathway’s Board of Trustees in July 2024.

3. e Pathway’s details were kept up to date with the Charity Commission and Companies House.

4. e VAT returns to HMRC were submitted on time.

5. e Pathway’s Board of Trustees met quarterly, and in May we held a half-day strategy review workshop session with the board.

6. e One new trustee: Prof Graham Foster, joined the Board and received induction from the senior management team.

7. e Our Trustees’ handbook was updated and moved online.

8. Pathway brand continues to earn and maintain national recognition for improving care for homeless and other marginalised people

9. e The new Pathway and Faculty branding and website with refreshed content was launched in March 2024.

10. e Pathway staff presented at numerous external conferences and meetings, some with Pathway’s promotional materials, including:

11. International Street Medicine Symposium in London

12. Shelter’s conference: The role of Housing in health and social care

13. North East London ICS network meeting

14. Life off the Streets London network meeting

15. » New Statesman conference: Future of Healthcare

16. » Exhibited at the two day King’s Fund Annual Conference > NHS Confed Expo

17. London Network of Nurses and Midwives

18. Prof Nick Maguire's ‘Psychological approaches to homelessness’ annual one day conference, in Brighton

19. Meeting of the East of England clinical senate

20. Attended the two-day FEANTSA European Homeless Network conference in Vienna.

21. Pathway recognised as a well-run charity

22. e We successfully migrated our accounting system to Intuit Quickbooks in January 2024.

23. e Pathway met all requirements contained in our operating agreement with Crisis.

Review of financial position

Total income for the year amounted to £1,222,169 (2023 - £1,146,527). The associated expenditure for the period was £1,501 ,376 (2023 - £1,188,672). This gives a net deficit for the period of £279,207 (2023 - net deficit of £42,145). Total reserves to be carried forward to 2024/25 are £894,621 (2023 - £1,173,828).

17

Trustees’ report Year ended 30 June 2024

Activities, Achievements and Performance (continued)

The principal sources of funds in 2023/24 were:

	£
Crisis UK— a granttowards core funding forthe year ended 30 June	500,000
2024 (restricted)
City ofLondon — part ofa larger payment of£159,877 (unrestricted)	124,863
* acontract for the review of the pan-London’s Rough Sleeping Drugs
and Alcohol services run by Guy’s and StThomas’s NHS trust
e follow on work: development of education and support materials for
people experiencing homelessness who also suffer from an addiction
(unrestricted)
StMartin inThe Fields Charity’s Frontline Programme— Final payment	110,000
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)
NHSE-contracted Pathway to delivera second phase ofour ICS learning	49,583
programme on inclusion health. The focus is to share learning between
ICSs on what they need to do to improve care for inclusion health
populations drawing on Pathway’s framework and the wider evidence
base for successful inclusion health interventions (unrestricted)
Homeless Link — Final year of three year grant to be partner of the	40,542
Homeless Health Consortium, part of the VCSE Health and Weil Being
Alliance plus additional funding for additional reports
(restricted)
National Lottery Community Fund — Reaching Communities in	37,500
England programme — first halfyear payment to continue work over the
next three years (February 2024 to end April 2027) on our Resilient
Programme, (restricted)
Burdett Trust for Nursing — final payment ofa grant to share	35,222
knowledge and experiences of specialist diabetes nurses and inclusion
health nurses in better supporting homeless patients who live with Type
2 diabetes (restricted)
Hull City Council—contracted Pathway to participate in a citywide needs	30,000
assessmentonSevereMultiDeprivation(unrestricted)

Just over 88% (£1,325,334) of the expenditure can be attributed directly to Pathway’s core activities including £12,600 which relates to pro-bono consultancy from Carnall Farrar. Just under 12% (£175,617) related to support work including governance. An amount of £407 was paid for fundraising materials to support people running half marathons for Pathway (2023: Enil).

18

Trustees’ report Year ended 30 June 2024

Activities, Achievements and Performance (continued)

Reserves policy

At 30 June 2024 Pathway holds reserves of £894,621 (£296,585 restricted and £598,036 unrestricted). At their meeting in May 2024 the Trustees agreed to leave unchanged the reserves policy of retaining unrestricted reserves to cover four months basic overheads (estimated at £335,500). The unrestricted reserve of £598,036 includes: a reserve of £95,066 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 £82,494 from the final payment of the core grant from the Oak Foundation which will be used to support the 2024/25 work programme; a reserve of £32,109 from the balance of funding from City of London Rough Sleeping and Drugs and Alcohol Treatment Grant which will be used to complete and disseminate an educational film and recovery handbook in the autumn 2024: and a reserve of £26,949 from funding for the second phase of the ICS learning programme which concludes in September 2024. This leaves a residual reserve of £361,418 that provides sufficient funds to cover management, administration, and support costs and to respond to emergency situations for 2024/25. 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

2024-25 will be year two of the agreed five year strategic plan in collaboration with Crisis UK and with widespread consultation with partners and allied organisations. We will continue to work towards the aims and objectives set out in the plan, by continuing with our planned ways of working:

• e Co-production with people with lived experience

• Securing policies needed for change

• e Communicating and building relationships that bring homelessness and inclusion health into the mainstream

• e Having a research strategy that supports our priorities

• *« Connecting and supporting our networks e Growing a movement to campaign for change

• e Driving system change in places

• We will deliver our new objectives by:

• ¢ Acute Care — ending the homelessness of the most vulnerable people:

• continue to develop the Pathway hospital model and its delivery

• spread the model to areas that need it most, including in psychiatric hospitals

• implement the recommendations from the review of the Pathway Partnership Programme

19

Trustees’ report Year ended 30 June 2024

Activities, Achievements and Performance (continued)

Plans for Future Periods (continued)

Trustees agreed that this aim should continue to be a priority for 2024/25

• ¢ Asafe place to recover— intermediate and long term accommodation and care to sustain recovery and end homelessness

• advocate for provision of intermediate care through ICS’s and NHSE

• continue to campaign at national level for more funding for greater provision of intermediate care including by exhibiting at The Labour Party Conference in September

• ¢ Prevention — preventing homelessness and worsening health through primary care

• advocate for access to primary care for people experiencing homelessness

• ¢ Mental Health and Place and Making the case for homeless and inclusion healthcare ~- Support for mental illness that can drive homelessness

• ~ Work with ICS’s and PCN’s (places) — supporting local system change across the patient pathway, and aligning with new Crisis Centres where possible

• Support and develop research to make the economic case for homeless and inclusion health, and explore how to combat stigma and discrimination.

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.

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

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Trustees’ report Year ended 30 June 2024

Statement of Trustees’ Responsibilities (continued)

• ¢ 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.

Approved and authorised by the Board of Trustees on 15 October 2024 and signed on its behalf by:

==> picture [75 x 25] intentionally omitted <==

----- Start of picture text -----
Leslie Morphy
Chair of Pathway
----- End of picture text -----

21

independent auditor’s report Year ended 30 June 2024

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 2024 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 2023 and of its income and expenditure for the year then ended;

• ¢ have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice; and

• ¢ have been prepared in accordance with the requirements of the Companies Act 2006.

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 including the Trustees Report, 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 staternents. 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.

22

Independent auditor’s report Year ended 30 June 2024

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 year 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.

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.

23

Independent auditor’s report Year ended 30 June 2024

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 financialstatements.

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.

• ¢ Weunderstood 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;

• ¢ 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;

There are inherent limitations in our audit procedures described above. The more removed that laws and regulations are from financial transactions, the less likely it is that we would become aware of non-compliance. Auditing standards also limit the audit procedures required to identify non-compliance with laws and regulations to enquiry of the trustees and other management and the inspection of regulatory and legal correspondence, if any.

Material misstatements that arise due to fraud can be harder to detect than those that arise from error as they may involve deliberate concealment or collusion.

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.

24

7

Independent auditor’s report Year ended 30 June 2024

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: iS OckL et QoL +

25

Statement of financial activities Year ended 30 June 2024 (Including an Income and Expenditure Account)

		Un-			Un-
		restricted	Restricted	2024	restricted	Restricted	2023
	Notes	funds £	funds £	Total £	funds £	funds £	Total £
Income:
Donations and legacies		41,055	1,386	42,441	56,101	2,436	58,537
Investment Income: Bank
Interest		3,815	—	3,815	_	—_	—_—
Income from charitable
activities:
. Grants	2	_	798,898	798,898	_	888,756	888,756
. Research and project
income	2	377,015	—_	377,015	195,901	3,333	199,234
Total income		421,885	800,284	1,222,169	252,002	894,525	1,146,527
Expenditure:
Expenditure on charitable
activities	3	445,680	1,055,696	1,501,376	283,094	905,578	1,188,672
Total expenditure		445,680	1,055,696	1,501,376	283,094	905,578	1,188,672
Net (expenditure) /
income and net
movement in funds for theyear		(23,795)	(255,412)	(279,207)	(31,092)	= (11,053)	(42,148)
Reconciliation offunds
Total funds brought forward
at1July 2023		621,831	551,997	1,173,828	652,923	563,050	1,215,973
Total funds carried
forwardat30June2024		598,036	296,585	894,621	621,831	551,997	1,173,828

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 44 form part of these financial statements.

26

Balance sheet 30 June 2024

		30 June	30 June	30 June	30 June
		2024	2024	2023	2023
	Notes	£	£	£	£
Current assets
Debtors	9	45,693		115,093
Short term investments		353,815		—_—
Cash at bank		597,045		1,326,773
		996,553		1,441,866
Liabilities
Creditors falling due within one year	10	(101,932)		(268,038)
Net assets			894,621		1,173,828
The funds of the charity
Unrestricted funds	11		598,036		621,831
Restricted funds	12		296,585		551,997
Totalcharityfunds	13		894,621		1,173,828

The accounting policies and notes on pages 29 to 44 form part of these financial statements.

These financial statements were approved by the Board of Trustees for issue on 15 October 2024 and signed on its behalf by:

Chair — Leslie Morphy

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

27

Statement of cash flows Year ended 30 June 2024

==> picture [402 x 127] intentionally omitted <==

----- Start of picture text -----
||||||||||||| |---|---|---|---|---|---|---|---|---|---|---|---| |2024|2023| |Notes|£|£| |Cash|flow|from|operating|activities:| |Net|cash|(used|in)|/|provided|by|operating|activities|A|(375,913)|68,458| |Change|in|cash|and|cash|equivalents|in|the|period|(375,913)|68,458| |Cash|and|cash|equivalents|at|1|July|2023|B|1,326,773|1,258,315| |Cash|and|cash|equivalents|at|30|June|2024|B|950,860|1,326,773|

----- End of picture text -----

Notes to the statement of cash flows for the year ended 30 June 2024.

A Reconciliation of net movement in funds to net cash (used in ) / provided by operating activities

==> picture [412 x 101] intentionally omitted <==

----- Start of picture text -----
|||||||||||| |---|---|---|---|---|---|---|---|---|---|---| |2024|2023| |EE| |Net movement|in|funds|(as|per the|statement|of financial|activities)|(279,207)|(42,145)| |Adjustments|for:| |Decrease|/|(increase)|in|debtors|69,400|(6,388)| |(Decrease)|increase|in|creditors|(166,106)|116,991| |Net|cash|(used|in)|/|provided|by|operating|activities|(375,913)|68,458|

----- End of picture text -----

B Analysis of cash and cash equivalents

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----- Start of picture text -----
|||||||| |---|---|---|---|---|---|---| |2024|2023| |EE| |Cash|at|bank|597,045|1,326,773| |Short|term|investments|353,815|a| |Total|cash|and|cash|equivalents|950,860|1,326,773|

----- End of picture text -----

28

Principal accounting policies Year ended 30 June 2024

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 2025/27 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 for future charitable activities.

Having considered the Charity’s budget forecasts and the Charity’s cash reserves at 30 June 2024 of £950,668 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.

29

Principal accounting policies Year ended 30 June 2024

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.

30

Principal accounting policies Year ended 30 June 2024

Financial instruments

The Charity only holds basic financial instruments as defined in FRS102. Financial assets and liabilities and their recognition and measurement bases are as follows:

Debt instruments that are payable or receivable within one year, typically trade debtors and creditors are measured, initially and subsequently, at the undiscounted amount of the cash or other consideration expected to be paid or received.

At the end of each reporting period financial assets are assessed for objective evidence of impairment. If such evidence is identified, an impairment loss is recognised in the statement of financial activities. For financial assets measured at cost less impairment, the impairment loss is measured as the difference between an asset's carrying amount and a best estimate of the recoverable amount.

A financial asset is derecognised only when the contractual rights to the cash flows from the financial asset expire or are settled in cash, or when substantially all the risk and rewards of ownership of the financial asset have been transferred to another party.

A financial liability is derecognised when the contract that gives rise to it is settled, sold cancelled or expired.

Debtors

Debtors include trade debtors and certain other financial instruments, accrued income and prepayments. Prepayments are payments made for goods or services that will be received in the future. They are initially recorded as assets and amortised over time as the benefit of the prepaid expense is realised. Accrued income corresponds to income earned during the period but not yet billed or collected from the customer.

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 investments within current assets.

Creditors

Creditors include trade creditors and certain other short term financial instruments.

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.

31

Notes to the financial statements: Year ended 30 June 2024

1.	Income from charitable activities
		restricted funds	Restricted funds	Total 2024
	EE
	Grants
	Crisis UK	—	500,000	500,000
	St Martin-in-the Field Charity— Frontline Programme	—	110,000	110,000
	VCSE Alliance Homeless Health Consortium via	—	40,542	40,542
	Homeless Link
	The National Lottery Community Fund - Reaching	—	37,500	37,500
	Communities in England
	Burdett Trust for Nursing	—	35,222	35,222
	Rayne Foundation	—	30,000	30,000
	City Bridge Foundation	—	19,501	19,501
	The Co-Production Collective	—	13,264	13,264
	Other grants	—_—	12,869	12,869
	Total grants	—_	798,898	798,898
	Research and project income
	City ofLondon	124,863	—	124,863
	Pathway Partnership Fees (Hull, Leeds, Hackney, St	127,084	_	127,084
	George’s, East Kent, Plymouth, Cardiff, and Vale)
	NHSE~ ICS Learning Programme	49,583	—_—	49,583
	NHS Hull and North Yorkshire ICS	30,000	—	30,000
	Expert PartnerAgreement - Imperial and Ealing	26,250	—	26,250
	University ofSalford	16,570	—	16,570
	Other projects	2,665	_—	2,665
	Total research and project income	377,015	—	377,015
	2024Totalfundsfromcharitableactivities	377,015	798,898	1,175,913

32

Notes to the financial statements: Year ended 30 June 2024

1.	Income from charitable activities (continued)
		ce	tried funds	Restricted “s funds	Yearto30 June 2023
	aE
	Grants
	Crisis UK		—	500,000	500,000
	The FidelityFoundation		—	137,500	137,500
	StMartin-in-the Field Charity— Frontline Programme		~	110,000	110,000
	Trust forLondon		—	45,000	45,000
	Burdett Trust forNursing		_	35,222	35,222
	VCSEAlliance Homeless Health Consortium via		_	28,284	28,284
	Homeless Link
	Marie Curie		—_	24,104	24,104
	NHS England/Innovation		—	8,000	8,000
	Othergrants		_	646	646
	Totalgrants		—	888,756	888,756
	Research andprojectincome
	Pathway Partnership Fees (Hull, Salford, Leeds,
	Croydon, Hackney, St George’s. Ealing, Imperial,	143,808		—	143,808
	Plymouth, East Kent)
	City ofLondon	44,914		_
	Otherprojects	11,262		—	11,262
	Totalresearch andprojectincome	199,984		~~	199,984
	2023Totalfundsfromcharitableactivities	199,984		888,756	1,088,740

33

Notes to the financial statements: Year ended 30 June 2024

2.	Expenditure
		Unrestricted	Restricted	Year to 30
		funds	funds	June 2024
	aE
	Charitable activities
	Direct costs
	Pay costs including staff costs	270,562	491,905	762,467
	Consultants’ fees	104,920	181,278	286,198
	Consultancy— pro bono	12,600	_—	12,600
	Stafftraining	5,355	—	5,355
	Printing	333	5,209	§,542
	Patients’ costs	169	704	873
	Patients’ legal advice	17,384	138,944	156,328
	Travel and subsistence	4,552	4,082	8,634
	Catering	1,327	2,608	3,935
	Volunteer/Service User expenses	3,977	14,703	18,680
	Conference provision	—	25,987	25,987
	Marketing and design	3,900	30,275	34,175
	Stationery	179	1,764	1,943
	Telephone	—	156	156
	IT Equipment	_—	2,460	2,460
	Total directcosts	425,258	900,075	1,325,343
	Support costs
	Pay costs including staff costs	19,768	121,080	140,848
	Recruitment costs	—	—	_
	Staff training	120	5,241	5,361
	Marketing and design	~_	1,980	1,980
	Insurance	—	5,867	5,867
	Bank and payroll charges	—_	1,488	1,488
	Catering	—	—	—
	Legal advice (pro-bono)	—	—	—
	IT Equipment	135	9,504	9,639
	Stationery	23	151	174
	Total supportcosts	20,046	145,311	165,357
	Fundraising costs
	Stationery
	Marketing and Design	376	50	426
	Total fundraising costs	376	50	426
	Governance costs
	Trustees’ Expenses	—_	407	407
	Catering	_—	—_	_—
	Audit and accountancy fees	_	9,853	9,853
	Totalgovernance costs	—_	10,260	10,260
	2024Totalexpenditure	445,680	1,055,696	1,501,376

34

Notes to the financial statements: Year ended 30 June 2024

==> picture [427 x 662] intentionally omitted <==

----- Start of picture text -----
|||||||| |---|---|---|---|---|---|---| |2.|Expenditure|(continued)| |Unrestricted|Restricted|Year to|30| |funds|funds|June|2023| |EE| |Charitable|activities| |Direct costs| |Pay|costs|including|staff costs|165,618|356,871|522,489| |Consultants’|fees|36,733|190,353|227,086| |Staff training|15,465|567|16,032| |Printing|—|1,429|1,429| |Patients’|costs|625|2,528|3,153| |Patients’|legal|advice|—|128,343|128,343| |Travel|and|subsistence|2,169|4,561|6,730| |Catering|799|548|1,347| |Volunteer/Service|User expenses|1,149|10,039|11,188| |Conference|provision|15,900|19,400|35,300| |Marketing|and|design|—|6,747|6,747| |Stationery|378|4,751|5,129| |Telephone|—|69|69| |{T Equipment||—|—| |Total|direct|costs|238,836|726,206|965,042| |Support costs| |Pay|costs|including|staff costs|26,730|138,936|165,666| |Consultants’|fees|—|10,893|10,893| |Recruitment|costs|—|1,862|1,862| |Staff training|1,978|2,703|4,681| |Travel|and|subsistence|—|41|41| |Marketing|and|design|—|3,372|3,372| |Insurance|—|§,535|5,535| |Bank|and payroll charges|—|1,370|1,370| |Catering|992|2,483|3,475| |Volunteer/Service|User expenses|—|386|386| |Legal advice|(pro-bono)|15,000|—|15,000| |Bad|Debt|write|off|750|—|750| |IT|Equipment|(1,192)|3,403|2,211| |Stationery|—|922|922| |Total|support costs|44,258|171,906|216,164| |Fundraising|costs| |Stationery|~~|—|—| |Marketing|and Design|—|~~|—| |Total|fundraising|costs|—|—|—| |Governance|costs| |Catering|—|84|84| |Printing|—|5|5| |Travel|and|subsistence|—|314|314| |Audit and accountancy|fees|—|7,063|7,063| |Total governance|costs|—|7,466|7,466| |2023|Total expenditure|283,094|905,578|1,188,672|

----- End of picture text -----

35

Notes to the financial statements: Year ended 30 June 2024

3. Staff costs including key management personnel

	2024	2023
EE
Wages and salaries	795,567	610,597
Social security costs	83,212	58,805
Pension contributions	24,536	18,753
	903,315	688,155

One member of staff was seconded to the core team in 2023-24 (one in 2022-23).

One employee earned over £60,000 in year ended 30 June 2024 with their salary banding falling between £90,001 - £100,000. In the year ended 30 June 2023, the banding was £80,001 - £90,000.

The average monthly number of employees (including key management personnel) during the year to 30 June 2024 was 20 (2023 — 16).

On a full time equivalent basis, the number of employees was:

On aa full time equivalent basis, the number of employeesemployees was:
	2024	2023
NONO		NO
Key Management (CEO, Medical Director & Finance Director)	2.6	2.6
Senior Healthcare Navigator Coordinator/Healthcare Advisor	0.3	0.6
Senior Clinician	0.4	0.1
Senior Nurse and Occupational Therapist	1.8	1.4
Policy Officer	1.0	0.8
Communications Officer	1.0	0.7
Senior Project Manager	1.7	1.2
Project Manager	2.5	1.0
Research and administration	2.8	2.6
Business Development	1.0	0.4
	15.1	11.4

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, Medical Director and Policy and Programmes Director.

The number of key management personnel in the year to 30 June 2024 was four (2023 — four) (Full time equivalent basis2.6 (2023: 2.6)).

The total emoluments received by the key management personnel in the year ending 2024:

	2024	2023
ee
Salaries	225,063	214,863
Employer's NI & Pension contributions	31,444	30,525
	256,507	245,388

36

Notes to the financial statements: Year ended 30 June 2024

4. Staff costs including key management personnel (continued)

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.

1. Net movement in funds This is stated after charging:

Net movement in funds This is stated after charging:
	2024	2023
a
Auditors’ remuneration
.Statutoryauditservices	9,853	8,800

1. Trustees’ expenses

Expenses of £407 were reimbursed to two Trustees during the year (2023: £314 reimbursed to one Trustee ).

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
	2024	2023!
Trade debtors	10,625	17,250
Accrued income	5,680	17,271
Prepayments	29,388	80,572
	45,693	115,093

10. Creditors: amounts falling due within one year

	2024	2023!
Trade creditors	17,577	25,793
Other creditors	16,621	7,860
Taxes and social security	23,263	61,090
Accruals	14,200	15,265
Deferred income	30,271	158,030
	101,932	268,038

Deferred income represents Pathway Partnership income where the programme of support will be delivered in 2024/25.

37

Notes to the financial statements: Year ended 30 June 2024

11. Unrestricted funds

11.	Unrestricted funds
					At 30
		At1			June
		July 2023	Income	Expenditure	2024
	EEE
	General unrestricted funds	621,831	421,885	(445,680)	598,036
					At 30
		At 1			June
		July 2022	Income	Expenditure	2023
	EEE
	General unrestricted funds	652,923	252,002	(283,094)	621,831
12.	Restricted funds
		At 1			At 30
		July			June
		2023	Income	Expenditure	2024
	EEE
	Burdett Trust for Nursing	28,704	35,222	(59,136)	4,790
	City Bridge Foundation	_—	19,501	(6,600)	12,901
	Co-production Collective	—	13,264	(4,431)	8,833
	Crisis UK	66,169	500,000	(549,725)	16,444
	Department ofHealth	10,557	—	—	10,557
	Health Education England	2,645	—	_	2,645
	Homeless Link (forVCSE Alliance)	10,583	40,542	(47,401)	3,724
	isla Foundation	775	—	(775)	—
	London Catalyst	121	—	—	121
	King’s College — Mental Capacity NIHR grant	—	4,875	—_	4,875
	Manchester Health & Social Care
	Partnership	1,818	—	(1,818)	—
	Marie Curie	19,931	7,994	(23,099)	4,826
	National Lottery Community Fund —
	Reaching Communities in England	—	37,500	(27,022)	10,478
	NHS Devon CCG	2,576	—	(2,576)	—
	NHS England/Innovation	89,632	—_	(64,505)	25,127
	NHS NE London CCG	5,806	—	(1,840)	3,966
	Queen Mary University London	2,350	—	(2,350)	—
	Rayne Foundation	99	30,000	(26,348)	3,751
	Royal Free & Hampstead NHS Foundation		—	—_
	Trust	38,333			38,333
	St Martin in the Fields Charity	108,777	110,000	(147,059)	71,718
	Stephen Clark Charitable Settlement	3,233	—_—	—_	3,233
	Texel Foundation	14,425	—_—	(14,425)	—
	The Fidelity Foundation	107,741	—	(68,069)	39,672
	The Health Foundation	21,153	—	(1,664)	19,489
	Trust forLondon	1,813	—	(1,813)	—
	UCLH Friends	818	—	_	818
	Warwickshire County Council	5,041	—	(5,041)	—
	Donations for Faculty for Homeless &
	Inclusion Health — Faculty members	8,741	1,386	—	10,127
	Donation for Patient Dignity - OuterNW
	London	156	—	_—	156
		551,997	800,284	(1,055,696)	296,585

38

Notes to the financial statements: Year ended 30 June 2024

12. Restricted funds (continued)

		At 1			At 30
		July			June
		2022	Income	Expenditure	2023
Comparatives		£	£	£	£
Burdett TrustforNursing		—_	35,222	(6,518)	28,704
Crisis UK		32,032	500,000	(465,863)	66,169
DepartmentofHealth		10,557	_—	—	10,557
Grocers’ Company		4,500	—	(4,500)	—_
Health Education England		2,645	_	—_—	2,645
Homeless Link (forVCSEAlliance)		19,198	28,284	(36,899)	10,583
Institute ofPublic PolicyResearch		1,094	646	(1,740)	—
Isla Foundation		5,919	—	(5,144)	775
British Geriatrics Society		5,700	—	(5,700)	—
London Catalyst		323	—	(202)	121
ManchesterHealth & Social Care
Partnership		5,810	—	(3,992)	1,818
Marie Curie		6,867	24,104	(11,040)	19,931
NHS Barking &Dagenham CCG		3,975	—	(3,975)	—
NHS Devon CCG		14,284	—	(11,708)	2,576
NHS England/innovation		151,467	8,000	(69,835)	89,632
NHS KentandMedwayCCG		7,181	—	(7,181)	—
NHSNELondon CCG		7,336	—	(1,530)	5,806
NHS Plymouth CCG		3,228	—	(3,228)	—
NHS Sheffield CCG		4,604	—	(4,604)	—
Queen Mary UniversityLondon		2,350	—	—	2,350
Rayne Foundation		39,456	—	(39,357)	99
Royal Borough ofKensington	& Chelsea
(WestLondon ICS)		650	—	(650)	—_
Royal Free NHS Foundation	Trust	35,000	—	—	35,000
RoyalFree & HampsteadNHS Foundation		—
Trust			3,333	-	3,333
St Martin in the Fields Charity		86,256	110,000	(87,479)	108,777
Stephen Clark Charitable Settlement		3,233	_	—	3,233
TexelFoundation		23,552	_—	(9,127)	14,425
The Clothworkers Company		9	—_—	(9)	—
The FidelityFoundation		—	137,500	(29,759)	107,741
The Health Foundation		22,481	—	(1,328)	21,153
The OakFoundation		21,320	—	(21,320)	—
Trust forLondon		19,527	45,000	(62,714)	1,813
University College London HospitalsNHS
Foundation Trust		2	_	(2)	~_
UCLH Friends		818	—	—	818
Warwickshire County Council		10,487	—	(5,440)	5,041
Donations forpatientsphones UCLH		1,258	—	(1,258)	—
Donations forFaculty forHomeless &
Inclusion Health—Facultymembers		6,805	1,936	_—	8,741
Donation forPatient Dignity	- OuterNW
London		—	500	(344)	156
Mental Health & Rough Sleeping Donation		3,132	—	(3,132)	—
		563,050	894,525	(905,578)	551,997

39

Notes to the financial statements: Year ended 30 June 2024

12. Restricted funds (continued)

Burdett Nursing Foundation

In March 2023, a grant of £70,444 was approved for work on a year-long project that aims to share knowledge and experiences of specialist diabetes nurses and inclusion health nurses in order to better support homeless patients who live with Type 2 diabetes. The work is planned to conclude in September 2024.

City Bridge Foundation

In October 2023, a grant totalling £241,205 over three years was awarded under the ‘Bridging Divides’ Funding Programme for work to roll out the RESILIENT critical time intervention: the Mouse film and associated learning materials to early adopter sites across London. The work is to support vulnerable young people in contact with CAMHS who are at risk of homelessness.

Co-Production Collective

A grant of £13,264 was awarded in January 2024 for Pathway to work with a small group of its lived experience volunteers to produce a podcast to raise awareness of dual diagnosis across the homelessness sector. The podcast was recorded in early August, and work to finalise it and evaiuate the process continues into the autumn.

Crisis UK

Following the merger of Crisis and Pathway the core-funding grant of £500,000 was paid in four tranches.

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 has begun to campaign for the Government and NHS to ensure that no patient is discharged to the street and for the establishment of specialist intermediate care facilities. The residual funding will be used for this purpose.

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"¢ National Socially Inclusive Dentistry conference which was held in Birmingham in December 2018. The balance of funding is earmarked for the Oral Heaith subgroup of the Faculty for Homeless and Inclusion Health.

Homeless Link

Funding for the final year 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. Pathway’s project for the 2023/24 programme focussed on intermediate care. Additional priority project funding of £11,175 was awarded to extend further the work on intermediate care.

40

Notes to the financial statements: Year ended 30 June 2024

12. Restricted funds (continued)

Isla Foundation

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 was completed in 2023-24

London Catalyst

In December 2021, a grant of £1,000 towards patient dignity for use by the Pathway teams in the Royal London Hospital and UCLH.

King’s College - Mental Health Capacity (NIHR grant)

Pathway were a minor co-applicant in a bid by King’s College London for NIHR funding to explore the ‘Use of the Mental Capacity Act 2005 with people experiencing multiple exclusion homelessness in England’. The project is for two and a half years from October 2023 until end March 2026 and the total share of the award to Pathway was £4,875.

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.

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 and was complete in January 2024.

A contribution of £12,748 from a larger NIHR grant held by Marie Curie was paid to Pathway for its role in a project researching end of life care for people experiencing homelessness. Work on the project concluded in 2023-24.

In June 2023 a grant of £11,356 was made for Pathway to contribute to work on frailty in people experiencing homelessness, work concludes in September 2024.

In June 2023, a grant of £4,780 was made for Pathway to lead the lived experience contribution to a project on the provision of death cafes and their relevance to people experiencing homelessness.

The National Lottery Community Fund — Reaching Communities England Wide In September 2023 a grant totalling £225,000 over three years was awarded for work to roll out the RESILIENT critical time intervention: the Mouse film and associated learning materials across England. The work is to support vulnerable young people in contact with CAMHS who are at risk of homelessness

41

Notes to the financial statements: Year ended 30 June 2024

12 Restricted funds (continued)

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 included identifying and addressing barriers to employment in the NHS, and the development of a policy and practice toolkit for wider application and adoption of evaluated processes. The project was in partnership with Groundswell and the Royal Society for Public Health who received separate grant funding and have separate roles. An additional grant of £8,000 was paid in February 2023, Pathway’s role was for the inclusive employment strand of work including the development of an online toolkit which launched in November 2023 and is hosted and marketed by NHS Employers until end June 2026.

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’. The film retitled ‘Home-Less?’ was launched in January 2023. Some residual work to market the film is ongoing.

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 has now concluded.

NHS North East London CCG

Funding of £8,342 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 acted as the lived experience sounding board for the study. The work on the project has now concluded

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 was used for negotiations to take forward the needs assessment.

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. The third payment was delayed pending securing addition funds from other charitable foundations, but was released in October 2023.

42

Notes to the financial statements: Year ended 30 June 2024

12 Restricted funds (continued)

Royal Free and Hampstead NHS 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 £15,000 creditor could be used to explore and develop provision for homeless patients leaving the hospital. Work has begun to campaign for the Government and NHS to ensure that no patient is discharged to the street and for the establishment of specialist intermediate care facilities. The residual funding will be used for this purpose.

A small sum was paid for the provision of arts work for the International Street Medicine Symposium.

St Martin in the Fields Charity

The grant of £300,000 grant from St Martin’s Charity Frontline Fund was awarded in December 2021 is providing 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 for year 3 have been issued to legal firms in spring and early summer 2024 with end dates of 31 December 2024.

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.

Texel Foundation

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

The Fidelity Foundation

In December 2022, the first tranche of funding from the agreed grant totaling £196,000 was paid. The funding is for a business development role to support growth and to expand services to more hospitals.

The Health Foundation

Funding of £389,430 was awarded 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.

In addition, The Health Foundation provided £25,000 to fund mobile phones for homeless patients to support ongoing communication with them.

Trust for London

The grant of £135,000 grant awarded in March 2020 was 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 2022 for the third and final year.

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Notes to the financial statements: Year ended 30 June 2024

12 Restricted funds (continued)

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.

Warwickshire County Council

Funding of £20,000 was provided for the development of needs assessments and associated business cases for Pathway teams at four hospitals across the county. Four needs assessments have been completed and discussions are underway about next steps.

13. Analysis of net assets between funds

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----- Start of picture text -----
||||||| |---|---|---|---|---|---| |Unrestricted|Restricted|Total| |funds|funds|2024| |EEE| |Current|assets|654,195|342,358|996,553| |Current|liabilities|(56,159)|(45,773)|(101,932)| |2024|net|assets|598,036|296,585|894,621| |Unrestricted|—_Restricted|Total| |funds|funds|2023| |EEE| |Current assets|843,184|598,682|1,441,866| |Current|liabilities|(221,353)|(46,685)|(268,038)| |2023|net assets|621,831|551,997|1,173,828|

----- End of picture text -----

14. Related party transactions

The charitable company is a subsidiary of Crisis UK and has taken advantage of the exemption in section 33 of FRS 102, “Related Party Disclosures”, from the requirement to disclose transactions with group companies on the grounds that consolidated financial statements are prepared by its immediate parent.

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

15. Controlling party

The trustees regard Crisis UK, a charity registered in England and Wales and also in Scotland, as the ultimate and immediate parent entity. Copies of the parent’s consolidated financial statements can be obtained from Crisis UK, 50-52 Commercial Street, London, E1 6LT. This is the largest and smallest group for which group accounts are prepared...

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.

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