OpenCharities

This text was generated using OCR and may contain errors. Check the original PDF to see the document submitted to the regulator. This document is also available as Markdown.

← Action On Postpartum Psychosis

2023-12-31-accounts

REGISTERED COMPANY NUMBER: 07466643 (England and Wales) REGISTERED CHARITY NUMBER: 1139925

ACTION ON POSTPARTUM PSYCHOSIS (A COMPANY LIMITED BY GUARANTEE)

TRUSTEES' REPORT AND

UNAUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023

ACTION ON POSTPARTUM PSYCHOSIS

CONTENTS OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023

Page
Reference and Administrative Details 1 to 2
Trustees' Report 3 to 23
Independent Examiner's Report 24
Statement of Financial Activities 25
Statement of Financial Position 26
Statement of Cash Flows 27 to 28
Notes to the Financial Statements 29 to 38

ACTION ON POSTPARTUM PSYCHOSIS

REFERENCE AND ADMINISTRATIVE DETAILS FOR THE YEAR ENDED 31 DECEMBER 2023

TRUSTEES A Bauer G S Berrisford C K Cho (appointed 30.3.23) C Dolman S A Hind I R Jones A R Jones T C Robinson (appointed 20.7.23) CHIEF EXECUTIVE J Heron DIRECTOR OF FINANCE K Mullard AND OPERATIONS REGISTERED OFFICE International House 12 Constance Street London E16 2DQ REGISTERED COMPANY 07466643 (England and Wales) NUMBER REGISTERED CHARITY 1139925 NUMBER INDEPENDENT EXAMINER TCA (Shrewsbury) LLP Third Floor 21 St Mary's Street Shrewsbury Shropshire SY1 1ED SOLICITORS (PRO BONO) Howard Kennedy LLP No 1 London Bridge London SE1 9BG

Page 1

ACTION ON POSTPARTUM PSYCHOSIS

REFERENCE AND ADMINISTRATIVE DETAILS FOR THE YEAR ENDED 31 DECEMBER 2023

BANKERS

HSBC Bank PLC 18 High Street Burton on Trent Staffordshire DE14 1HU

The Cooperative Bank PLC 1 Balloon Street Manchester M60 4EP

Bath Building Society 15 Queen Square Bath BA1 2HN

Saffron Building Society Saffron House 1A Market Street Saffron Walden Essex, CB10 1HX

Page 2

ACTION ON POSTPARTUM PSYCHOSIS

TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023

The trustees who are also directors of the charity for the purposes of the Companies Act 2006, present their report with the financial statements of the charity for the year ended 31 December 2023. The trustees have adopted the provisions of Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2019).

Objectives and Activities

Postpartum Psychosis

Each year, one to two in every thousand new mums will develop hallucinations, delusions, mania, depression and unusual behaviour within days of childbirth, often out of the blue. When a mother experiences mania or psychosis following the birth of their baby it is known as postpartum psychosis (PP). The condition is frightening and can have a devastating impact, not only on the woman affected, but also on their partner and wider family. Ignorance about the illness is widespread and many women experience stigma, isolation, and a lifetime burden of guilt.

Suicide is the leading cause of death among new mothers. Prior to 2011 when our charity began, postpartum psychosis was responsible for the largest percentage of psychiatric deaths. During the last decade, PP-related maternal deaths have become rare, although maternal suicides as a whole have continued to increase. Early evidence suggests that deaths due to PP are again on the increase in the post-pandemic period. For each of these statistics, a baby loses a mother, and a family sustains an unimaginable loss, when the fact is, postpartum psychosis is a treatable illness and full recovery is possible. A shortage of Mother and Baby Units (MBUs) means that new mothers can be separated from their newborns when placed in General Adult Psychiatric Wards with the burden of care falling to other members of the family or social services - the separation compounding an already devastating situation.

Charitable Objects, Vision and Long-term Objectives

Under its Articles of Association, the charitable objects for which Action on Postpartum Psychosis (APP) is established are:

Our vision is for all women and families affected by postpartum psychosis to benefit from best-practice treatment and appropriate support through to full recovery. Our long-term objectives are:

Page 3

ACTION ON POSTPARTUM PSYCHOSIS

TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023

APP works nationally in England, Wales, Scotland and Northern Ireland, although we also look for opportunities to influence care and understanding of PP globally.

Volunteers

APP works with and is supported by several types of volunteer: peer support volunteers, media and storytelling volunteers, regional reps and fundraising volunteers. Our volunteers are women with lived experience of postpartum psychosis or their partners and family members and are passionate about making a difference for women and families affected by PP. Our volunteers enable us to draw from a wider range of postpartum psychosis experiences in our work, rather than only those of our lived experience staff team. Our peer support volunteers provide one to one and group support for women and their families who have experienced and been affected by PP. Media and storytelling volunteers raise awareness by telling their stories in the regional and national press, on social media, websites, television and radio. Regional Reps give lived experience talks at events and training sessions, often alongside APP staff, helping APP to connect with health professionals as well as disseminating information and supporting patient involvement in developing NHS services in their area. Fundraising Volunteers plan events and identify fundraising ideas and opportunities to help generate income to support APP’s work. We are very grateful for the work of all our volunteers, who enable us to reach more people and achieve more impact in all areas of our work.

Objectives and Activities in 2023

APP is an innovative collaboration between women and families who have experienced postpartum psychosis, leading academic researchers and expert health professionals. Our main objectives and activities in 2023 are described below. Our charitable activities consisted of: providing specialist support and information to affected women and families; raising awareness of postpartum psychosis amongst the public and health professionals; campaigning for improved services; and conducting research to better understand the illness. These activities are undertaken to further our charitable purposes for the public benefit. We measure the success of our work through: surveying service users, volunteers and training participants (using an online survey and feedback forms); monitoring service user data; and asking individuals to write about their experience.

Supporting affected women and families

APP’s Peer Support Service aims to create an active and engaged postpartum psychosis community, improve recovery outcomes for women and families, reduce social isolation, reduce the maternal suicide rate and decrease the long-term impact of the illness on family life.

Our Peer Support Service offers one-to-one support (via email, telephone, video call and face-to-face), café groups (face-to-face and online) and a community forum where those affected can go to ask questions, gain support and signposting. We employ Peer Support Coordinators with personal experience of postpartum psychosis to manage the service and carefully moderate to ensure that the service and forum are safe; the Coordinators are supported in turn by specialist health professionals and academic experts.

The Coordinators recruit, train and support Peer Support Volunteers and staff with experience of postpartum psychosis to provide empathy, practical information and hope for recovery. In 2023, we aimed to maintain and grow our national and regional peer support service by:

Page 4

ACTION ON POSTPARTUM PSYCHOSIS

TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023

We measure the success of our peer support work through the number of women and family members reached, through surveying service users and volunteers about the benefits and downsides of receiving or delivering support in this way, and by asking individuals to write about their experiences. Survey questions include whether service users feel more supported, less isolated, more informed, less negative about postpartum psychosis, more hopeful, and whether the peer support has aided users’ recovery. We also survey peer support volunteers about the experience of training and volunteering.

Raising awareness amongst health professionals

In 2023, we aimed to reach more health professionals with training by:

Our workforce training courses are delivered by our world leading experts in Perinatal Psychiatry, APP staff members, and APP Experts by Experience. By utilising clinical experience, cutting-edge research, and the real experiences of affected women and families, the courses aim to up-skill the workforce, developing expertise and empathetic understanding. APP’s Experts by Experience – trained volunteers and staff members with experience of postpartum psychosis - raise awareness in their local regions, by giving talks to health professionals at conferences and events, disseminating information, and sharing their personal experiences: describing their symptoms, experience of treatment and recovery, what worked well for them and what did not, and the impact on their relationship with their baby, family and friends.

We assess the success of this awareness raising work through the number and range of professionals reached, session feedback and through questionnaire feedback on the one-day training. We ask whether the training: will change their practice; has increased their knowledge of postpartum psychosis and the risks; has increased their confidence and empathy in working with affected women and families; and whether it has made them feel better equipped to help women recover.

Raising awareness amongst the general public

In 2023, we aimed to continue to raise awareness in the general public to reduce stigma and misinformation and help newly affected women and families access our lifesaving information and support by:

We measure the success of this awareness raising work through the range and reach of media pieces about PP that we are involved in, and the number of followers and level of engagement on our social media channels and website.

Page 5

ACTION ON POSTPARTUM PSYCHOSIS

TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023

Campaigning for improved services

Our goal is that all women and families in the UK have access to the services they need to get help and recover from PP. In 2023, we aimed to use our specialist expertise and lived experience voice to create change in systems, by

Research

In 2023, we aimed to continue to facilitate research studies of importance to women and families affected by postpartum psychosis, as capacity and funding allowed, by

Fundraising and strengthening our capacity

In 2023, we aimed to strengthen our capacity to fulfil our charitable objectives through strengthening our internal systems to support sustainable growth. We planned to:

Achievements and performance

Peer Support to affected women and families

In 2023, APP continued its national peer support service, expanding our work with dads and co-parents and families from diverse communities. We set up a new café group for Muslim women who have experienced psychosis in the perinatal period and promoted our dads and co-parents peer support widely, including distributing hundreds of posters to Mother and Baby Units, Perinatal Mental Health teams and community midwife teams. Overall, in 2023 APP provided peer support to more than 1,062 people, including those personally affected, partners, grandparents, wider families and friends (2022: 828). An average of 226 people used our online peer support forum every month (2022: 234) with the number of registered users increasing from 3,299 to 3518. Staff and volunteers supported 338 people via email, telephone, video call, in person meet-up and café groups, which included 275 women, 31 partners and 32 grandparents. Our NHS embedded partnership projects supported 335 individuals.

We conducted our annual peer support user survey towards the end of 2023, promoting it widely and adding new questions about whether peer support had helped with specific elements of people’s PP experience and whether users would like more support and information on legal, rights-based and financial issues as a result of PP. In 2023, our peer support survey found: 99 percent of respondents would recommend the peer support forum to others (2022: 97%), and 98 percent would recommend APP’s 1:1 support (2022: 95%). Before finding APP, 69 percent of respondents had not met anyone else with experience of PP. Since finding APP, 52 percent had met 8 or more people (in-person or virtually). Almost all respondents (99%) felt more supported since finding APP (2022: 100%); 96 percent felt less

Page 6

ACTION ON POSTPARTUM PSYCHOSIS

TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023

isolated (2022, 100%); 97 percent felt more informed about PP (2022, 93%), and 87 percent felt less negative about PP (2022, 82%). Meanwhile, 94 percent felt more hopeful about the future (2022: 92%), and 97 percent felt that APP had helped, or was helping, them to recover. Nearly half of respondents (46%) said they might not be alive if they had not found APP's peer support services this year – which is a marked increase on previous years (normally around 31-33%), demonstrating that APP’s peer support continues to change and save lives. These examples of responses from the survey show the impact of peer support:

“The support APP provides is life saving and life changing. APP’s service means community to me - from picnics, to fundraising events to cafe groups I’ve always felt included. All staff and volunteers inspire me every day - keep doing the amazing work you do APP!”

“The support I have been receiving has been tremendously amazing. I have been recovering very well and without the support I don't think I would be where I am now. I am very grateful, and I hope to help someone in the future by providing the same support.”

“Absolutely amazing charity that does a lot of work to support mothers and women at large to take control of their mental health. The support and listening ear is so valuable for recovery where sometimes we wait weeks or months for therapeutic treatment. APP is quick in response and the online community is brilliant. Peer support is so important: someone who has “been there” gives a level of empathy and close touch that professionals can’t always give and that’s why I think my access to APP was pivotal in my recovery and continual maintenance of my mental well-being.”

“I feel that all the support services APP provides are invaluable both to the mothers and their families and friends. I do not know what I would have done without the support and reassurance of APP when my daughter became ill with postpartum psychosis. I had not heard of this traumatic illness before, they were there for me and my daughter through the ups and downs of her recovery. APP has also worked to inform and educate about this shocking illness.”

The 2023 peer support survey asked more detail about people’s experiences and whether APP’s peer support had helped them with these. The questions were:

We discovered that APP’s peer support had been overwhelmingly helpful across a range of experiences during and/or following episodes of PP. The responses are in the table below:

Proportion of survey respondents who had experienced
this symptom in relation to their PP episode.		 Proportion of survey respondents who had experienced
this symptom in relation to their PP episode.		 Proportion of respondents with the
symptom who found APP peer
support had helped with this
symptom
Anxiety 98% 96%
Depression 90% 98%
Further episode(s) of psychosis 36% 94%
Ongoing bipolar illness 37% 94%
Intrusive thoughts 71% 84%
Suicidal thoughts 51% 83%

Finally, our 2023 peer support survey asked questions to explore whether our community of peer support users need more support and information on legal, rights-based and financial issues as a result of PP. Our peer supporters often discuss and signpost users to further support in this area, so we wanted to understand more about the prevalence of these issues. Survey respondents had experienced issues

Page 7

ACTION ON POSTPARTUM PSYCHOSIS

TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023

with returning to work (49%), reinstatement of their full driving licence (36%), problems at work (36%), accessing life, travel or car insurance (31%), benefits entitlements (28%), accessing the right medical treatment (28%), money worries, debt or financial difficulties (21%). In 2024, we will work to understand more about women’s experiences and what support and information APP could develop.

Café groups and wellbeing activities.

We extended our monthly regional café groups to ten (2022: 9). They now operate in Wales, Sussex & Hampshire, Yorkshire, Lancashire & Cumbria, Morpeth & the North-East, Birmingham, Manchester, London, Scotland and Northern Ireland. In total, 113 women and family members attended a regional group. Groups not linked to NHS projects mainly took place online due to funding constraints, but we are seeking funding to run these as face-to-face groups. We also extended our online café groups. We now run a monthly dads/co-parents group, a quarterly grandparents’ group (attended by 14 people in 2023), a quarterly Muslim women’s group (attended by 9 women in 2023), and a quarterly group for volunteers who manage an ongoing bipolar disorder/ psychosis diagnosis (attended by 16 people in 2023). Partners’ virtual café group meetings were held throughout the year, on the third Wednesday of each month (except December). A total of nine partners, at all stages of the PP journey, attended the groups. Feedback from our annual peer support survey shows how women and their partners value café group peer support:

“I wish I could meet up with other mums every week! In the early days, after being discharged I pushed myself to attend local mum and baby/toddler groups, but they didn't offer the same relief that APP café groups do.”

“As a partner, being able to utilise the forums and use the virtual café to chat to other dads has been brilliant and made me feel much happier and positive about the future. I think … that sometimes there isn't anyone to turn to and having the option of a dedicated service for PP where you can talk to people that have lived and breathed it could literally be a life saver during the recovery phase.”

We continued to use social media to provide peer support, running live events and activities online for volunteers and beneficiaries - for example our regular book club – and ensuring that there was always a trained peer supporter monitoring our social media to provide support and signposting to anyone needing help who commented or messaged us. We used social media to promote our online café groups, online volunteer meetups and community activities.

Training and supporting volunteers

We recruited and trained 13 new peer supporters in 2023, three of whom are now working as staff on our Manchester NHS partnership project. We have 112 active peer support volunteers (2022: 96) who provide support to women and families via our online forum, café group meet-ups, video call, one to one emails and telephone calls. In 2023 we received good feedback from new volunteers about the peer support training we provided – 100 percent would recommend the training to others (2022: 100%). Many also found it supported their own wellbeing and recovery: 100 percent felt more supported (2022: 94 %), and 100 percent felt less isolated and better connected with others with similar experiences (2022: 78 %). We received positive feedback in training evaluation forms:

“A really fabulous day, came away feeling very empowered to help others” “Very valuable training. Made me want to take the information to all pre/postnatal groups & individuals!” Attendee.

“The training gave information about how to support others, in a way that was inspiring. The training explained how giving information about my experience is beneficial and how it is important to signpost and give information, rather than advise people.” Attendee.

Our peer support volunteers were supported during 2022 with both training and social Zoom sessions, including: case discussions; an expert-led session about supporting sleep; and a Q&A with APP Trustee and world-leading expert on postpartum psychosis, Professor Ian Jones. Peer support volunteers were also invited to additional sessions which were open to our wider volunteer and staff groups or whole APP network including: a creative writing workshop with APP’s Ambassador, author Laura Dockrill; a selfcompassion session; APP’s book club; a festive meet up and quiz. We received good feedback from our peer supporters on how these sessions met their training needs, for example:

Page 8

ACTION ON POSTPARTUM PSYCHOSIS

TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023

“I thought it was a brilliant session. I really appreciate everyone’s time spent organising it and a big thank you most of all to Prof. Jones for sharing his knowledge…I thought the level of information was good and very informative. It kept my interest throughout.” APP Volunteer.

We continued with our two regular volunteer newsletters: one for peer support volunteers, and one for all volunteers, including peer supporters, storytellers and regional reps. We shared updates about the APP team, peer support project and wider work of the charity. Links to fundraising news and volunteering opportunities and information are shared, as well as upcoming events for volunteers and the wider network.

Peer support embedded in NHS perinatal mental health services

In 2023, we had four Peer Support Facilitators embedded in NHS perinatal mental health services: in the MBU in Chorley and Lancashire & South Cumbria community; in the Birmingham MBU and in the Birmingham & Solihull Community Perinatal Mental Health Teams; and in the Community Perinatal Mental Health Teams in the Black Country. We began a new partnership, working in the MBU in Manchester with a team of three sessional peer support workers. In addition, we had sessional peer support workers in the Birmingham & Solihull and, Lancashire & South Cumbria partnership projects able to provide holiday cover and additional support to women and families.

Our NHS embedded peer supporters helped 333 women (2022: 274) in 2023, in the Chorley, Birmingham and Manchester MBUs and in the community in Birmingham, Solihull, Lancashire and South Cumbria and the Black Country. Café groups remain an integral part of our NHS partnership projects to enable recovering women to meet; we held 53 café groups in 2022 (2022: 58), 11 of which were held virtually. We have continued to offer a choice of online or in person groups on our Lancashire and South Cumbria project, which covers a large geographical area. All other café groups held in NHS partnership projects are held in person. We continued to support dads, co-parents and other family members of women experiencing PP. We referred women’s partners for further support from our national dads and co-parents peer support team and women’s (or their partner’s) parents to our grandparent peer support group.

In September 2023, we began providing peer support on Andersen Ward, the MBU in Manchester, as part of a new partnership project with Greater Manchester Mental Health NHS Foundation Trust. The project also involves supporting the transition home and running a monthly café group. Our work on Andersen Ward is closely linked to our work at Ribblemere, the MBU in Chorley Lancashire, providing joined-up peer support for women and families across the northwest of England. Some APP staff work across both the Lancashire and Manchester partnership projects, and we find that women from the Manchester area may be admitted in Chorley and vice versa, before returning home and receiving support from the café group in their home area. Our contract with Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust to provide peer support in the Morpeth MBU and support the transition home ended in early 2023. However, we were able to secure funding to continue running a café group in the northeast of England, providing ongoing support for women and families recovering from PP as part of our national peer support service. In the West Midlands, we continued to provide peer support in the community in Birmingham, Solihull and the Black Country, as well as Chamomile Suite MBU in Birmingham. APP attended a "Celebrating Perinatal" event, organised by Midlands Partnership University NHS Foundation Trust and North Staffordshire Combined Healthcare NHS Trust in May. APP’s Hannah Bissett, National NHS Contracts Coordinator, gave a presentation about our NHS partnership work in peer support, coproduction and service improvement. Our Black Country Peer Support Facilitator, National Online Peer Support Coordinator also attended, whilst APP’s Chair of Trustees, Dr Giles Berrisford, gave a national update on the progress of perinatal services in his Specialty Advisor role for NHS England.

Case study

APP supports women and their families through their acute illness and beyond, as they: seek help, recover, rebuild relationships, come to terms with the illness, have concerns about parenting toddlers and teenagers, wish to campaign for change and improve the future for others, plan further pregnancies, navigate menopause, and become grandparents. Many women and family members who initially receive peer support go on to support others on our online forum and may choose to become volunteers

Page 9

ACTION ON POSTPARTUM PSYCHOSIS

TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023

themselves. Postpartum psychosis affects women’s extended families and often the baby’s grandparents provide considerable emotional and practical support when their daughter or their child’s partner is diagnosed with PP. This case study demonstrates the impact of APP’s peer support on one partner and their family’s journey to recovery:

“The first call I had was an emotional and cathartic affair, talking through our particular experience…the empathy/sympathy given (as well as the advice) was a huge comfort. This would manifest into a weekly catch-up for the next 4-5 months...I would look forward to each conversation and the support felt invaluable to my own management and recovery from what was happening. After ~12 weeks my partner returned home from the Mother and Baby Unit permanently, which was undeniably scary. The support from APP remained steadfast and truly helped me to rebuild my confidence in myself, as well as in my relationship - all whilst sleep deprived and learning to be a parent for the first time properly. I will be forever grateful for APP and the service they provide. I have a wonderfully supportive family and friends, but they cannot relate to your situation in the same way as someone that has experienced the initial shock and the saw-edge/staggered recovery from the illness.”

Raising awareness amongst health professionals

In 2023, we continued to provide training and Expert by Experience talks to health professionals across the UK. A total of 2,671 health professionals heard one of APP’s lived experience speakers in 2023 (2022: 2,287), including one-day and half-day training courses. These were across 21 different online training events (2022: 18) and 20 onsite events (2022: 17). The health professionals attending these events included midwives, health visitors, psychiatrists, mental health staff, perinatal mental health and MBU teams, psychologists, nursery nurse staff, obstetrics and gynaecology doctors, pharmacists, social workers, occupational therapists, psychology, nursing and midwifery students and mental health link workers. These events consisted of NHS training days, perinatal mental health study days, study days for health visitors, lectures to student midwives and mental health nurses, and conferences.

We continued our partnership with the Institute of Health Visiting (iHV) inputting into their two-day perinatal mental health champions training. In 2023, we delivered 8 lived experience talks on their online training courses (2022: 10), reaching 172 health visitors (2022: 250) and will continue to deliver on these courses in 2024. We also worked in collaboration with Judy Shakespeare (GPCPC (General Practitioners Championing Perinatal Mental Health)) and with the iHV to update their Good Practice resource on postpartum psychosis, which sets out what health visitors need to know about PP. The resource provides up-to-date evidence and references; it was launched during May’s Maternal Mental Health Awareness Week and shared widely.

In 2023, we input into course design for midwifery and mental health degrees (Undergraduate and Postgraduate level) at three universities (Universities of York, Hull, and Central London). These courses now include three to four hours on PP, including a lived experience talk, up to date research and case study discussions to allow the students to think about their roles as professionals in the future. Feedback on APP lived experience talks in 2023 included:

Our lived experience speakers continued to give talks and presentations in support of APP’s campaigns, in particular in relation to our antenatal campaign, where speakers presented to midwifery students, obstetricians, gynaecologists and midwifes at the Royal College of Obstetricians and Gynaecologists (RCOG) perinatal mental health conference, antenatal educators at the International Journal of Parent Educators Conference (antenatal educators) and a wide range of professionals at our suicide prevention webinar (see below).

In 2023, we delivered 4 sessions of APP’s one-day training course (2022: 2) – Managing Postpartum

Page 10

ACTION ON POSTPARTUM PSYCHOSIS

TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023

Psychosis, training 80 health professionals (2022:33) from NHS Trusts in Lancashire and South Cumbria, Shropshire, Kent and Medway, Gloucestershire, Devon, Cambridgeshire and Peterborough. 99 percent of the delegates rated the training as excellent (2022: 100 percent, 2021: 86.7 percent) and 100 percent would recommend to other health professionals working in the perinatal period. Onsite training is consistently rated slightly higher than for those delivered online. Individual feedback included: ““Really brilliant session. Balanced, informed, inspiring, emotional. So raw and real and yet very professional and contained. Best training I've attended in a very long time.” Attendee.

“Your lived experiences were so powerful and truly emotive to hear- they inspired me to continue to improve practice and continue to love what I do in perinatal care.” Attendee

We ran two new half-day online courses for health professionals in 2023:

After both workshops, 100 percent of attendees said they would recommend the training to other health professionals. Feedback included:

“The stories gave real insight into what it is like for families to go through PP.”

“The personal stories were so powerful and seeing how APP has invested in this, learning about your diverse communities and about the resources you have created was inspiring and so useful.”

The workshops were recorded and content from them is being used to develop online training modules which we plan to launch in 2024.

The phenomenal fundraising by Richard Baish, his family, colleagues and friends in memory of his wife (see p.17 below), enabled us to develop and deliver a free training webinar on suicide prevention (as well as resources to support PP antenatal education, see p14). On Wednesday 18th October, we hosted the first annual Alex Baish Memorial Lecture - Essential knowledge in preventing maternal suicide - in collaboration with the National Centre for Mental Health, General Practitioners Championing Perinatal Care, and the International Journal of Birth and Parent Education. The webinar highlighted the early symptoms of PP and the actions that should be taken to support and protect those who develop the condition. It covered the basic information all expectant families should know about PP and the information and support needs of those at higher risk. The webinar included a Q&A session with clinical, academic and lived experience speakers. We promoted the webinar widely, 2,547 health professionals, including GPs and other frontline professionals, registered to attend and many more have watched back the recording on YouTube since. Of the attendees, 92 percent rated the training as ‘excellent’; 8 percent rated it ‘good’, whilst 100 percent agreed they would change their practice because of the webinar. Feedback was excellent and will be used to plan the 2024 webinar:

“The webinar exceeded my expectations. It is not often that I will watch a webinar that has such a profound emotional impact on me and left me thinking and talking about a topic in the days after (in a positive way). Attendee.

“There are no words that can really sum up how powerful this webinar was. I watched this with a student nurse, and it created such a rich conversation. Thanks so much to all involved.” Attendee.

“This webinar was so powerful that I think this should be a mandatory training video for all working in perinatal.” Attendee.

Raising awareness amongst the general public

In 2023, our lived experience storytellers continued to help us drive engagement with thousands of people, to activate interest in APP’s work, support services, and ensure women and families with PP are

Page 11

ACTION ON POSTPARTUM PSYCHOSIS

TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023

heard regionally and nationally. As in 2022, many of our media case studies, and related social media, during the year were in support of our campaigning work (see Campaigning for Improved Services below). We continued to raise awareness of PP and the vital need for an MBU in Northern Ireland. A media consultant from Northern Ireland again helped our team with media coverage and supporting storytellers there. A quarter of the regional news pieces we worked on in 2023 were focused on Northern Ireland. We also launched our antenatal campaign toolkit in May. In response to poor media reporting of tragedies related to PP in a case in the USA and UK, we developed guidance for journalists on “Responsible reporting on suicide, infanticide and intrusive thoughts linked to postpartum psychosis” and published this on our website.

In 2023, we continued to plan social media and media work around awareness days and in support of our campaigns and regional projects, as well as reacting to events and media requests. We supported pieces in national, regional and health sector media. In May, we ran a social media campaign for Maternal Mental Health Awareness Week (MMHW), with support from Media Trust volunteers from UK advertising agency Ogilvy, global media agency Initiative and brand experience agency Sense Marketing (see Fundraising and strengthening our capacity below). During the campaign for Maternal Mental Health Awareness Week 2023, we reached 111,000 people: our social media reach increased by 262 percent week-on-week. Media highlights in 2023 included:

APP has always sought to increase the public understanding of the experience of PP in a variety of ways, from writing clinical and research findings to supporting personal stories and awareness raising pieces in the arts. In 2023, we continued to support the Good Enough Mums Club, a musical produced, written, directed and performed by mums for their UK theatre tour and supported the development of a new short film, ‘Wild Animal’, directed by Beth Park. We began working with Zah Ahmad on a film short he is developing, provisionally titled “A quiet woman”. In 2022, we promoted the UK tour of “after birth”, a play written by Zena Forster and directed by Grace Duggan. APP had supported the development of this comedy which is deeply rooted in the real-life testimonies of women within the APP network. In 2023, we participated in an afterbirth project development group with the National Perinatal Epidemiology Unit at Oxford University to explore developing the play for health professional education.

In 2023, we grew both our social media followers 27,035 (2022:24,683) and reach 1,211,858 (2022: 1,052,295). Using a digital capacity building grant from The Big Give, we explored new ways of using our

1 https://www.thesun.co.uk/fabulous/24661144/postpartum-psychosis-triplets-mums-warning/

2 https://www.theguardian.com/lifeandstyle/2023/jan/15/poverty-in-uk-could-increase-death-rates-duringor-after-pregnancy-warns-who

3 https://www.bbc.co.uk/news/articles/c7218q270q1o

4 https://www.walesonline.co.uk/news/health/my-brain-telling-baby-going-26823001

5 https://www.manchestereveningnews.co.uk/news/greater-manchester-news/thousands-women-no-idea-until27372407

6 https://www.mirror.co.uk/news/uk-news/new-mums-rushed-mental-wards-30648666

7 https://www.readersdigest.co.uk/health/everything-you-need-to-know-about-postpartum-psychosis

8 https://www.bbc.co.uk/news/uk-northern-ireland-67417664

Page 12

ACTION ON POSTPARTUM PSYCHOSIS

TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023

social media to reach existing and potential supporters, as well as developing our supporter newsletter systems to manage supporter journeys more effectively. The increase in newsletter engagement we saw in 2022 was sustained with an open rate of 39.5 per cent (December 2022: 38.9 per cent; December 2021: 30 per cent). We supported 32 national and regional media stories in 2023 (2022: 34) and shared these across our four main social media channels.

Campaigning for improved services

In 2023, we used our specialist expertise and lived experience voice influence change in systems that are important to women and families affected by postpartum psychosis, with a particular focus on campaigning for women throughout the UK to have access to a Mother and Baby Unit (MBU), and campaigning for PP to be an essential part of all antenatal class training. PP must be managed as a medical emergency for the safety of both mother and baby. APP continues to raise awareness of PP and campaign for improved services because each year, babies lose a mother and families are bereaved, when the fact is, PP is a treatable illness and full recovery is possible. Although numbers are small, consistent with other perinatal mental health and maternity charities, we continue to see an increased number of bereaved families contact us in the post pandemic period.

In 2023, we joined two networks to further our campaigning work and collaboration with other organisations. We joined the National Suicide Prevention Alliance[9] and the Pregnancy and Baby Charities Network[10] . We also continued to be an active member of the Maternal Mental Health Alliance.

Mother & Baby Unit campaign

In 2023, with support from a Rosa Women’s Voices grant, we sustained our campaign for women throughout the UK to have access to a Mother and Baby Unit (MBU). In Northern Ireland, we continued to partner with local charity Maternal Advocacy and Support and the Maternal Mental Health Alliance, and to work with our volunteers from bereaved families and from our café group to engage with MPs, support media pieces, and attend meetings to keep the need for a Mother and Baby Unit on the agenda. Media pieces included: BBC News Online[11] , The Detail[12] , UTV[13] , the Guardian[14] as well as podcast and YouTube discussions. In November 2023, it was announced that the Belfast Trust had been chosen as the site of a Northern Ireland Mother and Baby Unit. APP welcomed the news but with no funding yet allocated, no timeline given and no plans for women who develop PP before an MBU, we are committed to continuing the campaign. There are high levels of stigma around mental health issues in Northern Ireland. By supporting women to share their experiences of PP our campaign has helped to address this stigma, opening up conversations around perinatal mental health, its impact on mothers and their families. When women attending our NI café group first began to share their experiences, they did so anonymously but as the campaign has progressed, we have seen a marked increase in the number of people willing to tell their stories more openly and use their names. Volunteers and families in NI have valued being able to support APP’s campaign.

“Action on Postpartum Psychosis has helped me in so many ways. It has helped me connect with other mums who experienced PP here in N. Ireland. This has taken away how isolating it was to have gone through PP and even discuss how it felt to have experienced this here in Northern Ireland. I was privileged to be a part of the campaign to help bring about awareness of the necessity of Northern Ireland having its own Mother and Baby Unit. I imagine when I experienced PP after my fourth child was born, recovery would have been so different as I would have not been taken to a general psychiatric ward and separated from my son. I hope for the many generations to come that Northern Ireland has better resources for mums when it comes

9 https://nspa.org.uk/

10 https://www.miscarriageassociation.org.uk/pregnancy-baby-charities-network/

11 https://www.bbc.co.uk/news/uk-northern-ireland-67417664

12 https://www.thedetail.tv/articles/northern-ireland-s-first-psychiatric-mother-and-baby-unit-due-to-be-announcedwithin-days

13 https://www.itv.com/news/utv/2023-08-16/ni-mother-and-baby-unit-would-save-lives

14 https://www.theguardian.com/lifeandstyle/2023/jan/15/poverty-in-uk-could-increase-death-rates-during-or-afterpregnancy-warns-who and https://www.theguardian.com/lifeandstyle/2023/jan/15/postpartum-psychosis-new-mothersspeak-out-over-need-for-support

Page 13

ACTION ON POSTPARTUM PSYCHOSIS

TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023

to mental illness. I am now a peer volunteer with APP, and I love that I am a part of this fantastic community of women who all come from various walks in life but are united by one thing and that is to support and uplift each other.” APP volunteer.

“I wouldn’t have been brave enough to share my story without the support of the café group.” APP volunteer.

We continued to campaign for an MBU in Wales and Scotland, including: supporting a petition developed by APP volunteer, Lesley, for accessible MBU beds in the north of Scotland[15] ; and, media pieces in Wales Online[16] , BBC News Online[17] , the Courier[18] and Reader’s Digest[19] .

In May, plans for a new Mother and Baby Unit were announced by Cheshire and Wirral Partnership NHS Foundation Trust to support new and expectant parents across Cheshire, Merseyside and North Wales. The APP team is working with the Cheshire, Wirral and North Wales NHS teams to ensure the voices of lived experience are heard during the development process, as well as ensuring the unit meets the specific needs of families from North Wales. Our volunteers have input into the design, landscaping, and functionality of the MBU.

Antenatal Campaign

We continued our campaign for information about postpartum psychosis to be shared at every antenatal class in the UK. Working with families affected by PP, our volunteers and antenatal class providers, we produced a toolkit to support the delivery of information about PP in classes[20] . The toolkit, posters and downloadable social media graphics were launched as a free resource in May during Maternal Mental Health Awareness Week, shared on our social media platforms and via email to more than 700 recipients. The resources have received positive feedback:

“Just wanted to say that your awareness campaign is great. I do talk about postnatal psychosis with my antenatal class parents-to-be. I have supported one family where the mother developed PP. ” Antenatal class provider.

“Thank you so much for these downloadable resources. I'm an NCT antenatal teacher and have been spending 5 mins on PP since you encouraged us to, but these resources will help make the message clearer.” NCT antenatal teacher.

During Maternal Mental Health Awareness week, we presented an Instagram live with the Perinatal Mental Health Partnership: ‘Let's talk about postpartum psychosis’. Members of APP staff with lived experience spoke about the importance of antenatal education on PP. Also, during May, a blog post on antenatal educations was published on Tommy’s Pregnancy Hub with APP team member Zebi’s story, which resulted in increased visits to our website[21] . As detailed under ‘Raising awareness amongst health professionals’ above, APP’s staff and lived experience volunteers continued to talk about the importance of antenatal education regarding PP.

Research

APP facilitates research, supports lived experience consultancy, and helps disseminate findings, ensuring evidence-based information is accessible to women, families, and health professionals. In 2023, we used our limited research capacity to support and promote a variety of studies, and to seek funding for APP’s research support infrastructure.

Preliminary analysis of the data from our national survey on experiences of care for PP between 2010 and 2021 was completed in 2022 and has been used to inform meetings and service development. Detailed analysis and reporting of survey results was delayed due to capacity and funding. APP has

15 https://petitions.parliament.scot/petitions/PE2017 16 https://www.walesonline.co.uk/news/health/my-brain-telling-baby-going-26823001 17 https://www.bbc.co.uk/news/articles/c7218q270q1o

18 https://www.thecourier.co.uk/fp/lifestyle/health-wellbeing/4418422/perthshire-mum-postpartum-psychosis/ 19 https://www.readersdigest.co.uk/health/everything-you-need-to-know-about-postpartum-psychosis 20 https://www.app-network.org/training-on-pp/antenataltoolkit/

21 https://www.tommys.org/pregnancy-information/pregnancy-news-blogs/what-postpartum-psychosis

Page 14

ACTION ON POSTPARTUM PSYCHOSIS

TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023

been building networks to be able to support APP’s research activities. In early 2024 we were working with a team at Oxford University on the detailed analysis of our 10-year dataset and preparation for publication.

We continue to work closely with researchers at the National Centre for Mental Health (NCMH) at Cardiff University on recruitment and awareness-raising of the importance of research. In May 2023 we partnered with NCMH researchers to present a live webinar entitled Postpartum psychosis: from research to recovery; the webinar has since had more than 1,200 views on YouTube[22] . The webinar discussed recovery from postpartum psychosis and the latest research, including three projects we are collaborating on:

In 2023, publications from research we had been involved in included: our study working with NCMH examining the feasibility of cross-cultural work on PP in India and Malawi (Motherhood and Mental health (MAM-CC) study)[23] ; and a review of the role of sleep in the triggering of PP working with University of Birmingham Institute of Mental Health[24] . We also published a letter in the British Journal of Psychiatry about the importance of Mother & Baby Units to women with PP[25] .

In 2023, APP supported with recruitment or application development for over 22 research projects (2022: 42) into postpartum psychosis across a variety of UK universities. In addition to the three projects discussed in the research webinar above, our other involvement in research projects included:

22 https://www.youtube.com/watch?v=umhGWwNAqQc https://www.ncmh.info/2023/05/05/postpartum-psychosisfrom-research-to-recovery/ https://www.app-network.org/research-into-postpartum-psychosis/from-research-torecovery/

23 Yang JMK, Vaiphei K, Siliya M, Mkandawire T, Dolman C, Heron J, Wilson S, Yaresheemi S, Kitney D, Bailey L, Apsey C, Liwimbi O, Stewart R, Thippeswamy H, Jones I, Chorwe-Sungani G, Chandra P, Di Florio A. Postpartum psychosis: a public involvement perspective across three continents. Arch Womens Ment Health. 2023 Dec;26(6):831837. doi: 10.1007/s00737-023-01347-8. Epub 2023 Aug 24. PMID: 37615717; PMCID: PMC10632256. https://pubmed.ncbi.nlm.nih.gov/37615717/

24 Carr, C, Borges, D, Lewis, K, Heron, J, Wilson, S, Broome, MR, Jones, I, Di Florio, A & Morales-Muñoz, I 2023, 'Sleep and Postpartum Psychosis: A Narrative Review of the Existing Literature', Journal of Clinical Medicine, vol. 12, no. 24, 7550. https://doi.org/10.3390/jcm12247550

25 Heron, J., Berrisford, G. and Bauer, A. (2023) ‘RE: Effectiveness and cost-effectiveness of psychiatric mother and baby units: quasi-experimental study’, The British Journal of Psychiatry, 222(4), pp. 176–177. doi:10.1192/bjp.2022.196. https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/reeffectiveness-and-costeffectiveness-of-psychiatric-mother-and-baby-units-quasiexperimentalstudy/B81E23B1FC00A0C49E097BBE52934325

Page 15

ACTION ON POSTPARTUM PSYCHOSIS

TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023

Fundraising and strengthening our capacity

As in 2022, the aftermath of the coronavirus pandemic, together with the cost-of-living crisis and challenges faced by the NHS, had an impact on APP. The pandemic impacted the nation’s mental health, and this is especially true of women with a history of postpartum psychosis or bipolar disorder. Our staff, like many around the country, are experiencing increased mental health relapses, and we continue to increase our focus on wellbeing. We continued to improve our staff and volunteer training and development, particularly the sessions offered to peer support staff and volunteers, and to seek opportunities for staff to participate in training and events relevant to their roles and new areas of work we are developing.

On International Women’s Day, APP participated in the Media Trust Women’s Voices event at Google Academy in London. APP staff were teamed up with volunteers from UK advertising agency Ogilvy, global media agency Initiative and brand experience agency Sense Marketing. The team identified creative ways to increase the reach and impact of our Maternal Mental Health Awareness Week campaign (see p. 14 above for details of the campaign). Jessie, APP’s Marketing and Digital Communications Coordinator, was also given the opportunity to speak at the event about APP, raising awareness of PP and our work.[26] We are very grateful to Media Trust for the opportunity, and our volunteer team for their hard work and creativity.

APP’s new website was launched in 2023, and the team are continuing the process of reviewing older content and improving functionality and user journeys. New content was added when we launched, including information on being a parent after postpartum psychosis that would form the basis of our new insider guide published in 2024. Our data manager completed a project to simplify data recording and reporting on our NHS projects and the new system was rolled out across all of our NHS projects.

APP’s Fundraiser continued to develop our fundraising strategy and improve our systems for supporting and communicating with individual fundraisers. We were successful in a number of funding applications. We ran two Big Give match funding campaigns, in May and October, raising more than £5,000 for our dads and co-parents and diverse communities peer support work. Our community voted for us to be one of six charities supported by JoJo Maman Bébé, receiving a £10,000 Helping Hands grant.

We continued to grow our Miles for Mums and Babies fundraising campaign We had our most successful Miles for Mums and Babies campaign ever, raising nearly £33,000. Each mile reflects the journey mums, babies and families travel to be together, whilst mums receive care in Mother and Baby Units (MBUs). Many fundraisers told their own stories to help raise awareness, whilst Mother and Baby Unit and community perinatal staff teams also took part this year. Fundraisers and their chosen challenges included:

26 https://mediatrust.org/2024/01/10/womens-voices-postpartum-psychosis-campaign/

27 https://www.gofundme.com/f/action-on-postpartum-psychosis

28 https://www.gofundme.com/f/finding-becky

29 https://www.justgiving.com/page/georgina-woodcock-1680076895892

Page 16

ACTION ON POSTPARTUM PSYCHOSIS

TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023

more than £1,500.[30]

We are very grateful to all our individual fundraisers who have found many inventive ways to fundraise and increase awareness. We’d particularly like to thank:

Finally, we would like to thank Richard Baish, his family, friends and colleagues who in 2023 raised more than £70,000, and an immeasurable amount of awareness of postpartum psychosis, in memory of Richard’s wife Alex. Richard and a team of friends completed a 475-mile, 5-day bike ride from Glasgow down to Oxfordshire in May.

Katie Ball completed the Three Peaks Challenge, whilst Michael Henderson-Sowersby took on the 100km ‘Race to the Stones’ ultra-marathon. Colleagues, friends of the family and local people attended a quiz evening, disco and raffle in September, raising more than £3,300 and further awareness. Claire Willis, event organiser, told APP: "When I was asking local business for prizes for the raffle one lady in her late 60’s started to cry and went on to tell me she had PP over 40 years ago, but it wasn’t recognised, she explained to me what she went through and how the doctors thought she was crazy. This, to me, shows how important the work that you do is." The incredible fundraising by Richard Baish, his family

30 https://www.justgiving.com/page/adeline-mccann-app10k

31 https://www.justgiving.com/page/perinatalteambcuhb

32 https://www.justgiving.com/page/a-doyle-1681976901337

33 https://www.justgiving.com/page/nottsmbu-1681209781226

34 https://www.app-network.org/news/fundraising/lees-final-challenge/

35 http://www.justgiving.com/Rob-Rowe6

36 https://www.justgiving.com/page/claire-tennyson-1682358796435

37 https://www.justgiving.com/fundraising/Flora-Mollie

Page 17

ACTION ON POSTPARTUM PSYCHOSIS

TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023

and friends enabled us to deliver a free webinar on suicide prevention (see p. 11 above) and supported the development of our postpartum psychosis (PP) toolkit for antenatal educators and the associated media campaign (see p. 14 above).

Financial Review

The Statement of Financial Activities on page 25 shows APP’s income and expenditure for the year. During the year ended 31 December 2023, expenditure very slightly exceeded income by £1,949. In our Unrestricted Funds, expenditure exceeded income by £1,728. Income from charitable activities increased, reflecting a higher number of grants received and a slight increase in contract income. Income from donations was similar to 2022. Income from charitable activities increased with new grants being secured and an increase in contract income. Investment income increased significantly due to increases in the interest rate on an existing account and new interest-bearing accounts being opened to hold funds held in reserve. In our restricted funds expenditure exceeded income by £221. This reflects expenditure of funds carried forward from the prior year for dads and co-parents peer support which was offset by income from a Big Give match funding campaign in October 2023 which will be spent across the 2023 and 2024 financial years.

The Balance Sheet on page 26 shows that at 31st December 2023, APP was holding £ 116,100; of which £3,779 was restricted funds. At the start of 2023, APP’s reserves policy was to hold three months core operating costs in reserve to guard against fluctuations in income. On 1st January 2023, APP was holding £114,049 in free reserves, which was within the range then recommended by our reserves policy. (£110,000 - £120,000). During 2023, Trustees reviewed APP’s reserves policy, considering income risks, working capital requirements, future expenditure commitments and cessation risk. Trustees agreed a new reserves policy, which is to maintain reserves within the range of three to five months of core charitable expenditure. In determining this range, Trustees considered the risks to which the charity is exposed and its working capital requirements. Core charitable expenditure consists of the costs of running APP’s national peer support service, our information resources, website and social media and running the organisation effectively. It excludes the costs of operating our NHS contracts. At the end of 2023, core charitable expenditure was considered to be £37,634 per month, and the recommended reserves range was deemed to be £113,000 to £188,000. On 31st December 2023, APP was holding £110,634 in free reserves, which was slightly below the range then recommended by our reserves policy. Trustees have agreed an annual plan and budget which would bring reserves back into the recommended range. The trustees are not aware of any factors likely to impact the future financials of the Charity other than those discussed elsewhere in this report, including under risk management below.

Structure, Governance and Management

Action on Postpartum Psychosis was incorporated as a Company Limited by Guarantee on 10th December 2010. It is governed by its Articles of Association, amended by special resolution in 2012 and 2018. The charity arose from a research network within the University of Birmingham Medical School and was hosted by University of Birmingham until 31st December 2023. The University provided office space, expert time, infrastructure and resources to the charity. In January 2024, APP became independent of the University of Birmingham. APP is supported by the University of Cardiff National Centre for Mental Health, which provides expert time and resource support for the charity.

APP’s Board of Directors/Trustees is made up of women with personal experience of postpartum psychosis; world-leading clinical and academic experts in postpartum psychosis; and individuals with specific skills relevant to the management of a charity. Dr Jessica Heron is APP’s Chief Executive and manages the running of the charity. Her time for this was bought by the charity from the University of Birmingham until 31st December 2023. From 1st January 2024, Dr Heron has been employed directly by the charity. Operational plans and all major strategic decisions are discussed and agreed by the Board of Trustees.

A senior management team, consisting of the Chief Executive, Director of Finance and Operations and UK Programme Manager, run the day-to-day operations of the charity including human resources, finance, grant management, data and systems, fundraising and governance activities. National Coordinators, all of whom have lived experience of postpartum psychosis, lead on each of APP’s main workstreams. These include a: National Health Professional Training & Research Coordinator; National

Page 18

ACTION ON POSTPARTUM PSYCHOSIS

TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023

Peer Support Coordinator; Peer Support Groups Coordinator; Partners Peer Support Coordinator; National NHS Projects Coordinator; and Marketing/Digital Communications Coordinator. They line manage staff and work closely with beneficiaries and volunteers to ensure that our peer support, information, awareness raising, campaigning and research work all have lived experience at their heart.

Directors/Trustees are recruited through advertising and networking and appointed in a general meeting or by the other directors at a board meeting. New Directors/Trustees are inducted and trained through meetings with the Chair, Chief Executive, and members of staff, as appropriate to their particular area of expertise, and provided with a pack of background information about the charity. A skills audit has been undertaken and efforts are made to recruit Trustees who meet the skills requirement. In 2016, the Board agreed to aim towards a leaner Board, with all the skills necessary to the functioning of the charity. During 2023, two new board members were appointed.

APP is part of the Maternal Mental Health Alliance and seeks to support and collaborate with the Alliance in campaigning for better perinatal mental health services; this does not impact on the charity’s operating policies.

Risk management

The Trustees consider the principal risks to which the charity is exposed, and the systems in place to mitigate those risks. The Chief Executive reports the most substantial inherent risks, together with any significant emerging risks, and the control measures in place to Trustees at each Board meeting.

Financial risk: The Trustees have identified that financial sustainability is the major financial risk to the charity. The political climate for small charities is tough, demand for services and competition for grant funding are high, and capacity pressures impact on income generation. In early 2022 we recruited a dedicated fundraiser who has overhauled fundraising systems and processes. In December 2022, the board agreed a plan to increase income, control expenditure and focus staff time on income generation. Internal financial management risks are reduced by the implementation of procedures for authorisation of all transactions. Budgets are set for all major areas of expenditure, and adjustments are reviewed by the Board.

Non-financial risks: The Trustees have focussed attention on mitigating non-financial risks such as safeguarding, health and safety, lone working, operational and legal risks, with different risks assigned to members of senior staff or Board of Trustees. For each new area of operation (for example peer support contracts), the financial, legal, health and safety, operational and reputational risks are reviewed by senior staff and the Board of Trustees, to determine new policies and procedures needed, training and information needed by managers, Coordinators and volunteers, and additional external advice and support needed.

Key risks facing the organisation in 2022 were financial sustainability, management capacity and operational risks, in particular high rates of mental health relapse in staff and volunteers and the approaching end of the hosting arrangement with Birmingham University. Financial sustainability was addressed by: frequent reviews of forecast income and expenditure by the board; implementing plans for increasing income and cutting costs; securing new grant and contract funding, reviewing our fundraising strategy and stewardship of supporters; and carefully planning and budgeting for 2024. Management capacity risks were addressed through utilising the skills of new staff members to improve systems and processes, and contracting support for the website development project. We continued to actively network to seek Board members to fill identified skills gaps, with two new board members with lived experience of PP and relevant professional experience joining in 2023. Operational risks arising from mental health relapse were addressed through: continuing to agree new flexible working patterns, prioritise and reassign work; holding regular meetups with staff, contractors and volunteers to provide pastoral care and support; and reviewing staff Wellbeing Plans. Operational risks arising from the end of the hosting relationship with Birmingham University were addressed through: exploring relationships with other universities with maternal mental health or psychosis research programmes; and the board researching and agreeing appropriate terms and conditions to employ Dr Heron directly.

Page 19

ACTION ON POSTPARTUM PSYCHOSIS

TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023

Plans for Next Year

Action on Postpartum Psychosis plans for 2024 were grouped under the following objectives:

1. Supporting women and families. We plan to maintain and grow our national and regional peer support service by: 

  - Maintaining our strong peer support presence, offering online, in person, video call and café group support to all who need it nationally and via our NHS projects, and maintaining long term contact with those we support.

  - Continuing to: train new peer supporters, prioritising volunteers from diverse communities Northern Ireland, Scotland, Wales & NHS project regions, holding two training days; and continue developing the ongoing training programme and creative and wellbeing activities for volunteers, holding monthly sessions, building a strong engaged, well supported volunteer community.

  - Developing a bereavement support online group and one-to-one calls, training our first bereaved partner peer supporter and grandparent volunteer. We will work with our volunteers and a consultant to run a series of focus groups to better understand the support and information needs of bereaved partners and family members.

  - Growing our diverse communities peer support using sessional staff and volunteers, supporting staff to outreach into communities to educate about PP, using pieces in social media, and networking to identify more volunteers from Black, Asian, and other ethnic communities and LGBTQ+ backgrounds. To continue our Muslim women’s group and to set up a Black women’s café group once staff/volunteers have been identified. Funding for a diverse communities’ Coordinator and project will be sought to further develop this work.

  - Increasing attendance at café groups, building community and café group activities, developing protocols and resources for café group leaders.

  - Developing initiatives to identify more partner volunteers, increasing staff capacity and awareness of the dads and co-parents project as funding allows.

  1. Raising awareness amongst health professionals. We plan reach more health professionals

  2. with training by:

    • Continuing to offer online bookable one-day training and NHS commissioned in-person training days.

    • Arranging a second annual free Alex Baish Memorial Webinar, building our database of health professionals.

    • Continuing collaborations with the Institute of Health Visiting (iHV) and the Royal College of Psychiatrists (RCPscyh) and strengthening new collaborations with GP bodies and antenatal educators training, delivering tailored training & lived experience talks.

    • Continuing to run specialist training on supporting partners and working with women from diverse backgrounds, using recorded content to develop our first two paid online modules.

  3. Raising awareness amongst the general public . We plan to raise awareness in the general public to reduce stigma and misinformation by:

    • Developing media and communications for the main ‘moments’ across the year (for example Maternal Mental Health Awareness Week, Black Maternal Mental Health Week, World Mental Health Day, and Suicide Awareness Week); placing case studies in the media and social media to support APP campaigns, new projects, and to raise awareness of APP peer support, training and information resources.

    • Supporting APP’s relationship with: Ambassadors; Maternal Mental Health Alliance; National Suicide Prevention Alliance; Pregnancy & Baby Charities Network; NHS (influencers in perinatal mental health professionals, midwifery, health visiting, psychiatry); universities (key postpartum psychosis and PMH academics). Using the Radio 4 appeal media campaign and other opportunities to engage our community and raise awareness of PP.

    • Supporting engagement with & reporting on creative projects as staff capacity

Page 20

ACTION ON POSTPARTUM PSYCHOSIS

TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023

allows.

  1. Campaigning. Our goal is that all women and families in the UK have access to the services they need to get help and recover from PP. We plan to use our specialist expertise and lived experience voice to create change in systems, by:

  2. Continuing APP’s MBU campaign, with a particular focus on: maintaining pressure for an MBU for Northern Ireland; supporting calls for MBU beds in Northern Scotland; building good relationships with all MBUs, connecting and helping to amplify their social media; sharing positive MBU stories to demonstrate their value; engaging with the North Wales/Chester MBU build, supporting Lived Experience engagement; and monitoring NHS England bed number commitments and responding to any risk of bed closures.

  3. Continuing APP’s antenatal education class campaign: developing social media assets to convey PP information to pregnant women and partners and to raise awareness of the antenatal education toolkit to midwives, health visitors, antenatal educators and GPs; and repeat APP’s YouGov survey at the end of 2024 and social media midwife survey to determine the impact of the campaign.

5. Research. We will continue to facilitate research studies of importance to women and families affected by postpartum psychosis, if capacity and funding allows, by:

Page 21

ACTION ON POSTPARTUM PSYCHOSIS

TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023

APP’s Board

APP is governed by its Board of Directors/Trustees, which remains a mix of women with lived experience of postpartum psychosis, academic researchers, clinicians and trustees with specific skills (e.g. grant fundraising and health economics). Directors/Trustees during 2023 were as follows:

Dr Giles Berrisford Chair Annette Bauer Treasurer Catherine Cho (appointed 30[th] March 2023) Dr Clare Dolman Sarah Hind Anna Jones Vice Chair Professor Ian Jones Tracey Robinson (appointed 20[th] July 2023)

There have been no other changes to the Board of Directors/Trustees.

Public Benefit Statement

Under its Articles of Association, the objects for which Action on Postpartum Psychosis is established are: to promote and protect the physical and mental health of women who have experienced postpartum psychosis and their families through the provision of support, education and practical advice; to advance the education of the public in general (and particularly amongst health professionals) on the subject of postpartum psychosis and to promote research for the public benefit in all aspects of that subject and to publish the useful results; and to advocate for perinatal mental health services for women and their families. The Trustees confirm that they have referred to the guidance contained in the Charity Commission’s general guidance on public benefit when reviewing the organisation’s aims and objectives and in planning future activities.

The identifiable benefits of APP’s work are that women and family members affected by postpartum psychosis are able to access support and information to improve their recovery, and that healthcare professionals and the general public are better informed about, and have more understanding of, this illness. A number of examples of benefit appear earlier in the report. These benefits are achieved through peer support, patient information development, health professional training, public awareness raising, research and campaigning. The only restriction is that individuals receiving peer support have suffered from postpartum psychosis or are a partner or family member of someone who has had the illness. There are no fees for the peer support service; a fee may be charged for health professional training and lived experience speakers.

Page 22

ACTION ON POSTPARTUM PSYCHOSIS

TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023

Trustees’ Responsibility Statement

The trustees (who are also the directors of Action on Postpartum Psychosis for the purposes of company law) are responsible for preparing the Trustees' Report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice) including Financial Reporting Standard 102 "The Financial Reporting Standard applicable in the UK and Republic of Ireland".

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

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

Trustees' report, incorporating a strategic report, approved by order of the board of trustees, as the company directors, on ............................................. and signed on the board's behalf by:

................................................................. A Bauer - Trustee

Page 23

INDEPENDENT EXAMINER'S REPORT TO THE TRUSTEES OF ACTION ON POSTPARTUM PSYCHOSIS

Independent examiner's report to the trustees of Action on Postpartum Psychosis ('the Company')

I report to the charity trustees on my examination of the accounts of the Company for the year ended 31 December 2023.

Responsibilities and basis of report

As the charity's trustees of the Company (and also its directors for the purposes of company law) you are responsible for the preparation of the accounts in accordance with the requirements of the Companies Act 2006 ('the 2006 Act').

Having satisfied myself that the accounts of the Company are not required to be audited under Part 16 of the 2006 Act and are eligible for independent examination, I report in respect of my examination of your charity's accounts as carried out under Section 145 of the Charities Act 2011 ('the 2011 Act'). In carrying out my examination I have followed the Directions given by the Charity Commission under Section 145(5) (b) of the 2011 Act.

Independent examiner's statement

Since your charity's gross income exceeded £250,000 your examiner must be a member of a listed body. I can confirm that I am qualified to undertake the examination because I am a member of the Institute of Chartered Accountants in England and Wales, which is one of the listed bodies.

I have completed my examination. I confirm that no matters have come to my attention in connection with the examination giving me cause to believe:

  1. accounting records were not kept in respect of the Company as required by Section 386 of the 2006 Act; or

  2. the accounts do not accord with those records; or

  3. the accounts do not comply with the accounting requirements of Section 396 of the 2006 Act other than any requirement that the accounts give a true and fair view which is not a matter considered as part of an independent examination; or

  4. the accounts have not been prepared in accordance with the methods and principles of the Statement of Recommended Practice for accounting and reporting by charities (applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102)).

I have no concerns and have come across no other matters in connection with the examination to which attention should be drawn in this report in order to enable a proper understanding of the accounts to be reached.

C L Moelwyn-Williams BSc FCA

TCA (Shrewsbury) LLP Third Floor 21 St Mary's Street Shrewsbury Shropshire SY1 1ED

Date: .............................................

Page 24

ACTION ON POSTPARTUM PSYCHOSIS

STATEMENT OF FINANCIAL ACTIVITIES (INCORPORATING AN INCOME AND EXPENDITURE ACCOUNT) FOR THE YEAR ENDED 31 DECEMBER 2023

Unrestricted
funds
Notes
£
INCOME AND ENDOWMENTS FROM
Donations and legacies
2
252,231
Charitable activities
5
General
261,397
Other trading activities
3
-
Investment income
4
1,288
Other income
-
Total
514,916
EXPENDITURE ON
Raising funds
6
27,998
Charitable activities
7
General
488,646
Total
516,644
NET INCOME/(EXPENDITURE)
(1,728)
RECONCILIATION OF FUNDS
Total funds brought forward
114,049
TOTAL FUNDS CARRIED FORWARD
112,321		 Restricted
funds
£
5,999
24,700
-
-
-
30,699
234
30,686
30,920
(221)
4,000
3,779		 2023
Total
funds
£
258,230
286,097
-
1,288
-
545,615
28,232
519,332
547,564
(1,949)
118,049
116,100		 2022
Total
funds
£
265,463
232,996
1,212
86
25
499,782
19,494
552,701
572,195
(72,413)
190,462
118,049

CONTINUING OPERATIONS

All income and expenditure has arisen from continuing activities.

The notes form part of these financial statements

Page 25

ACTION ON POSTPARTUM PSYCHOSIS (REGISTERED NUMBER: 07466643)

STATEMENT OF FINANCIAL POSITION 31 DECEMBER 2023

Notes
FIXED ASSETS
Tangible assets
13
CURRENT ASSETS
Debtors
14
Cash at bank
CREDITORS
Amounts falling due within one year
15
NET CURRENT ASSETS
TOTAL ASSETS LESS CURRENT
LIABILITIES
NET ASSETS
FUNDS
17
Unrestricted funds:
General Fund
Restricted funds
TOTAL FUNDS		 2023
£
1,687
63,916
129,300
193,216
(78,803)
114,413
116,100
116,100
112,321
3,779
116,100		 2022
£
-
35,324
172,065
207,389
(89,340)
118,049
118,049
118,049
114,049
4,000
118,049

The charitable company is entitled to exemption from audit under Section 477 of the Companies Act 2006 for the year ended 31 December 2023.

The members have not required the company to obtain an audit of its financial statements for the year ended 31 December 2023 in accordance with Section 476 of the Companies Act 2006.

The trustees acknowledge their responsibilities for

The financial statements were approved by the Board of Trustees and authorised for issue on ............................................. and were signed on its behalf by:

............................................. A Bauer - Trustee

The notes form part of these financial statements

Page 26

ACTION ON POSTPARTUM PSYCHOSIS

STATEMENT OF CASH FLOWS
FOR THE YEAR ENDED 31 DECEMBER 2023
2023
Notes
£
Cash flows from operating activities
Cash generated from operations
1
(41,078)
Net cash (used in)/provided by operating activities
(41,078)
Cash flows from investing activities
Purchase of tangible fixed assets
(1,687)
Sale of tangible fixed assets
-
Net cash (used in)/provided by investing activities
(1,687)
Change in cash and cash equivalents
in the reporting period
(42,765)
Cash and cash equivalents at the
beginning of the reporting period
172,065
Cash and cash equivalents at the end
of the reporting period
129,300		 2022
£
30,010
30,010
-
25
25
30,035
142,030
172,065

The notes form part of these financial statements

Page 27

ACTION ON POSTPARTUM PSYCHOSIS

NOTES TO THE STATEMENT OF CASH FLOWS

FOR THE YEAR ENDED 31 DECEMBER 2023

1. RECONCILIATION OF NET EXPENDITURE TO NET CASH FLOW FROM OPERATING ACTIVITIES

Net expenditure for the reporting period (as per the Statement
of Financial Activities)
Adjustments for:
Depreciation charges
Profit on disposal of fixed assets
(Increase)/decrease in debtors
(Decrease)/increase in creditors
Net cash (used in)/provided by operations		 2023
£
(1,949)
-
-
(28,592)
(10,537)
(41,078)		 2022
£
(72,413)
280
(25)
53,760
48,408
30,010

2. ANALYSIS OF CHANGES IN NET FUNDS

At 1.1.23 Cash flow At 31.12.23
£ £ £
Net cash
Cash at bank 172,065 (42,765) 129,300
172,065 (42,765) 129,300
Total 172,065 (42,765) 129,300

The notes form part of these financial statements

Page 28

ACTION ON POSTPARTUM PSYCHOSIS

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023

1. ACCOUNTING POLICIES

Basis of preparing the financial statements

The financial statements of the charitable company, which is a public benefit entity under FRS 102, have been prepared in accordance with the Charities SORP (FRS 102) 'Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2019)', Financial Reporting Standard 102 'The Financial Reporting Standard applicable in the UK and Republic of Ireland' and the Companies Act 2006. The financial statements have been prepared under the historical cost convention.

The accounts have been prepared in pound sterling, which is the functional currency of the charity, rounded to the nearest pound.

The charitable company has taken advantage of the relevant disclosure exemptions in preparing the financial statements, as permitted by FRS 102.

Income

All income is recognised in the Statement of Financial Activities once the charity has entitlement to the funds, it is probable that the income will be received and the amount can be measured reliably.

Expenditure

Liabilities are recognised as expenditure as soon as there is a legal or constructive obligation committing the charity to that expenditure, it is probable that a transfer of economic benefits will be required in settlement and the amount of the obligation can be measured reliably. Expenditure is accounted for on an accruals basis and has been classified under headings that aggregate all cost related to the category. Where costs cannot be directly attributed to particular headings they have been allocated to activities on a basis consistent with the use of resources.

Tangible fixed assets

Depreciation is provided at the following annual rates in order to write off each asset over its estimated useful life.

Office equipment costing £1,000 or more is capitalised at cost and depreciated over it's estimated useful economic life of 3 years, on a straight line basis.

Taxation

The charity is exempt from corporation tax on its charitable activities.

Fund accounting

Unrestricted funds can be used in accordance with the charitable objectives at the discretion of the trustees.

Restricted funds can only be used for particular restricted purposes within the objects of the charity. Restrictions arise when specified by the donor or when funds are raised for particular restricted purposes.

Further explanation of the nature and purpose of each fund is included in the notes to the financial statements.

Pension costs and other post-retirement benefits

The charitable company operates a defined contribution pension scheme. Contributions payable to the charitable company's pension scheme are charged to the Statement of Financial Activities in the period to which they relate.

Debtors

Trade and other debtors are recognised at the settlement amount after any trade discount offered. Prepayments are valued at the amount prepaid net of any trade discounts due.

Page 29

continued...

ACTION ON POSTPARTUM PSYCHOSIS

NOTES TO THE FINANCIAL STATEMENTS - continued FOR THE YEAR ENDED 31 DECEMBER 2023

1. ACCOUNTING POLICIES - continued

Cash and cash equivalents

Cash at bank and in hand includes cash and short-term highly liquid investments with a short maturity of three months or less from the date of acquisition or opening of the deposit or similar account.

Creditors and provisions

Creditors and provisions are recognised where the charity has a present obligation resulting from a past event that will probably result in the transfer of funds to a third party and the amount due to settle the obligation can be measured or estimated reliably. Creditors and provisions are normally recognised at their settlement amount.

Financial instruments

The charity only has financial assets and liabilities of a kind that qualify as basic financial instruments. Basic financial instruments are initially recognised at transaction value and subsequently measured at their settlement value.

Derecognition of financial liabilities

Financial liabilities are derecognised when the company's contractual obligations expire or are discharged or cancelled.

Going concern

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

2. DONATIONS AND LEGACIES

Unrestricted
funds
£
Donations
231,688
Gift aid
20,543
252,231		 Restricted
funds
£
5,010
989
5,999		 2023
Total
funds
£
236,698
21,532
258,230		 2022
Total
funds
£
258,211
7,252
265,463

In the prior year, £242,978 of the income related to unrestricted funds and £22,485 to restricted funds.

3. OTHER TRADING ACTIVITIES


Unrestricted
Restricted
funds
funds
£
£
Sale of literature
-
-
Income from Other Trading activities
-
-
-
-		 2023

Total
funds
£
-
-
-		 2022
Total
funds
£
91
1,121
1,212

Page 30

continued...

ACTION ON POSTPARTUM PSYCHOSIS

NOTES TO THE FINANCIAL STATEMENTS - continued FOR THE YEAR ENDED 31 DECEMBER 2023

4. INVESTMENT INCOME

INVESTMENT INCOME
2023 2022
Unrestricted Restricted Total Total
funds funds funds funds
£ £ £ £
Bank interest 1,288 - 1,288 86

In the prior year, £86 of the income related to unrestricted fund and £nil to restricted funds.

5. INCOME FROM CHARITABLE ACTIVITIES

2023
General
£
Voices From The Front/Rosa
7,000
Other Trusts and Foundations
19,200
Contract Income - Lancashire and South Cumbria NHS Foundation Trust
68,665
Contract Income - Birmingham and Solihull Mental Health NHS Foundation Trust
100,823
Contract Income - Black Country Healthcare NHS Foundation Trust
50,695
Contract Income - Greater Manchester Mental Health NHS Foundation Trust
16,021
Contract Income - Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust
-
Workforce Training and Experts by Experience
17,643
Research contracts
6,050
286,097		 2022
Total
activities
£
-
4,375
67,530
96,489
11,775
-
34,429
18,398
-
232,996

In the prior year, £228,621 of the income related to unrestricted funds and £4,375 to restricted funds.

6. RAISING FUNDS

Raising donations and legacies

Unrestricted
Restricted
funds
funds
£
£
Staff costs
18,737
-
Fundraising materials and other
fundraising costs
9,261
234
27,998
234		 2023
Total
funds
£
18,737
9,495
28,232		 2022
Total
funds
£
14,393
5,101
19,494

In the prior year, £19,394 of the expenditure related to unrestricted funds and £100 to restricted funds.

Page 31

continued...

ACTION ON POSTPARTUM PSYCHOSIS

NOTES TO THE FINANCIAL STATEMENTS - continued

FOR THE YEAR ENDED 31 DECEMBER 2023

7. CHARITABLE ACTIVITIES COSTS

Direct Support
Costs (see costs (see
note 8) note 9) Totals
£ £ £
General 511,184 8,148 519,332

In the prior year, £524,503 of the expenses related to unrestricted funds and £28,198 to restricted funds.

8. DIRECT COSTS OF CHARITABLE ACTIVITIES

Staff costs
Recruitment and Health & Safety
Consultancy
Project costs
Travel
Information materials and awareness raising
Volunteer training & expenses
Office and running costs
Workforce training and experts by experience costs
Bad debts
Depreciation		 2023
£
404,279
621
55,922
918
14,837
5,673
2,179
24,309
2,446
-
-
511,184		 2022
£
397,000
32
68,993
914
18,555
30,160
1,330
27,885
32
195
280
545,376

9. SUPPORT COSTS

SUPPORT COSTS
Governance
costs
£
General 8,148
Support costs, included in the above, are as follows:
2023 2022
Total
General
activities
£ £
Independent examiners fee 2,310 2,310
Accountancy fees 5,559 4,768
Other fees 279 247
8,148 7,325

Page 32

continued...

ACTION ON POSTPARTUM PSYCHOSIS

NOTES TO THE FINANCIAL STATEMENTS - continued

FOR THE YEAR ENDED 31 DECEMBER 2023

10. NET INCOME/(EXPENDITURE)

Net income/(expenditure) is stated after charging/(crediting):

Depreciation - owned assets
Surplus on disposal of fixed assets
Independent Examination Fee		 2023
£
-
-
2,310		 2022
£
280
(25)
2,310

11. TRUSTEES' REMUNERATION AND BENEFITS

There were no trustees' remuneration or other benefits for the year ended 31 December 2023 nor for the year ended 31 December 2022.

Trustees' expenses

There were no trustees' expenses paid for the year ended 31 December 2023 nor for the year ended 31 December 2022.

12. STAFF COSTS

STAFF COSTS
Wages and salaries
Social security costs
Other pension costs		 2023
£
384,988
24,612
13,416
423,016		 2022
£
375,209
23,883
12,301
411,393

The average monthly number of employees during the year was as follows:

Core charitable activity 2023
15		 2022
17

No employees received emoluments in excess of £60,000.

The total remuneration and benefits paid to the key management personnel, to whom the Trustees delegate the day-to-day running of the charity was £55,767 (2022: £42,824).

Page 33

continued...

ACTION ON POSTPARTUM PSYCHOSIS

NOTES TO THE FINANCIAL STATEMENTS - continued FOR THE YEAR ENDED 31 DECEMBER 2023

13. TANGIBLE FIXED ASSETS

COST
At 1 January 2023
Additions
At 31 December 2023
DEPRECIATION
At 1 January 2023 and
31 December 2023
NET BOOK VALUE
At 31 December 2023
At 31 December 2022
14.
DEBTORS: AMOUNTS FALLING DUE WITHIN ONE YEAR
Trade debtors
Prepayments and accrued income
15.
CREDITORS: AMOUNTS FALLING DUE WITHIN ONE YEAR
Trade creditors
Social security and other taxes
Other creditors
Accruals and deferred income		 Office
equipment
£
1,200
1,687
2,887
1,200
1,687
-
2023
2022
£
£
52,191
23,686
11,725
11,638
63,916
35,324
2023
2022
£
£
516
4,548
-
7,228
299
543
77,988
77,021
78,803
89,340

Deferred income includes income received during the period of £38,186 (2022: £54,100) which relates to services to be provided during the financial year ended 31 December 2023.

16. ANALYSIS OF NET ASSETS BETWEEN FUNDS

Unrestricted
funds
£
Fixed assets
1,687
Current assets
189,437
Current liabilities
(78,803)
112,321		 Restricted
funds
£
-
3,779
-
3,779		 2023
Total
funds
£
1,687
193,216
(78,803)
116,100		 2022
Total
funds
£
-
207,389
(89,340)
118,049

Page 34

continued...

ACTION ON POSTPARTUM PSYCHOSIS

NOTES TO THE FINANCIAL STATEMENTS - continued FOR THE YEAR ENDED 31 DECEMBER 2023

17. MOVEMENT IN FUNDS

At 1.1.23
£
Unrestricted funds
General Fund
114,049
Restricted funds
Dad's & Co-parents Peer Support
4,000
Diverse Communities Peer Support
-
Voices From The Frontline/Rosa
-
4,000
TOTAL FUNDS
118,049
Net movement in funds, included in the above are as follows:
Incoming
resources
£
Unrestricted funds
General Fund
514,916
Restricted funds
Other Peer Support
7,500
Dad's & Co-parents Peer Support
6,959
Digital Capacity Building
700
Diverse Communities Peer Support
5,540
NE Cafe Group
3,000
Voices From The Frontline/Rosa
7,000
30,699
TOTAL FUNDS
545,615
Comparatives for movement in funds
At 1.1.22
£
Unrestricted funds
General Fund
126,494
Designated Fund
58,530
185,024
Restricted funds
Other Peer Support
5,438
Dad's & Co-parents Peer Support
-
5,438
TOTAL FUNDS
190,462		 Net
movement
At
in funds
31.12.23
£
£
(1,728)
112,321
(4,000)
-
3,393
3,393
386
386
(221)
3,779
(1,949)
116,100
Resources
Movement
expended
in funds
£
£
(516,644)
(1,728)
(7,500)
-
(10,959)
(4,000)
(700)
-
(2,147)
3,393
(3,000)
-
(6,614)
386
(30,920)
(221)
(547,564)
(1,949)
Net
movement
At
in funds
31.12.22
£
£
(12,445)
114,049
(58,530)
-
(70,975)
114,049
(5,438)
-
4,000
4,000
(1,438)
4,000
(72,413)
118,049

Page 35

continued...

ACTION ON POSTPARTUM PSYCHOSIS

NOTES TO THE FINANCIAL STATEMENTS - continued FOR THE YEAR ENDED 31 DECEMBER 2023

17. MOVEMENT IN FUNDS - continued

Comparative net movement in funds, included in the above are as follows:

Unrestricted funds
General Fund
Designated Fund
Restricted funds
Other Peer Support
Dad's & Co-parents Peer Support
Big Give Peer Support
Digital Capacity Building
Marce 2022
TOTAL FUNDS		 Incoming
resources
£
426,718
46,204
472,922
-
4,000
16,235
375
6,250
26,860
499,782		 Resources
Movement
expended
in funds
£
£
(439,163)
(12,445)
(104,734)
(58,530)
(543,897)
(70,975)
(5,438)
(5,438)
-
4,000
(16,235)
-
(375)
-
(6,250)
-
(28,298)
(1,438)
(572,195)
(72,413)

Unrestricted funds

The general reserve represents the funds of the charity which are not designated for a particular purpose.

Designated funds

Organisational Transformation Fund

In 2019, Trustees designated £60,000 for organisational transformation work in 2020. Whilst significant progress was made, the impact of the pandemic meant some planned organisational transformation work was set aside. In planning for 2021, Trustees considered the constraints under which the Charity was operating in 2020 as the organisation expanded and the pandemic impacted upon capacity and priorities. Organisational transformation priorities were included in the 2021 plan and budget including: data management and financial forecasting systems; conducting a data security review; a ten-year impact project; website structure and content review; recruiting a fundraiser; and further developing APP's project management structure. The Trustees designated a further £25,000 to complete the work initially planned in 2020 and the new priorities added for 2021.

In 2021, the coronavirus pandemic continued to have a significant impact on APP: plans for the year were adapted; staff and resources were directed to peer support, signposting and disseminating information about PP and the support available. This reprioritisation meant that some organisational transformation work was delayed, in particular the website, CRM and impact report projects were running behind their original schedules at year end.

In 2022, the remaining designated organisational transformation funds allocated to complete these projects were spent in full.

Morpeth and Black Country Peer Support Fund

In December 2021, Trustees decided to designate the funds required for APP to meet its existing commitments to peer support projects in the Black Country and Morpeth. The funding for these projects to October 2022 and April 2022 had already been paid to APP, so Trustees felt it was important to set aside the funds to complete the agreed work. In 2022, the funds allocated were spent in full.

Page 36

continued...

ACTION ON POSTPARTUM PSYCHOSIS

NOTES TO THE FINANCIAL STATEMENTS - continued FOR THE YEAR ENDED 31 DECEMBER 2023

17. MOVEMENT IN FUNDS - continued

Restricted funds

Dads & Co-parents Peer Support

In December 2022, The D'Oyly Carte Charitable Trust made a grant of £4000 to support APP's Dads and Co-parents peer support project. In addition, APP successfully applied to the Big Give's Kind2Mind Fund to run a match funding campaign in May 2023. The campaign raised more than £5,000, including match funding, for the Dads & Co-parents peer support project. We also received an unexpected £1,500 payment from the Big Give which was to match the gift aid received on our 2023 Women & Girls match funding campaign. This earlier campaign had supported the entirety of our national peer support service, including the Dads & Co-parents work, so this extra funding was used for the Dad's & Co-parents work.

The Dads & Co-parents Peer Support project connects dads and co-parents whose partner has PP with trained volunteers who have 'been there', via telephone, video call or email support. A monthly group video call for dads and co-parents provides a supportive and informal group for partners to meet others, share what has helped them and their family through the experience and provide a friendly listening ear. Our peer support staff and trained dad and co-parent volunteers also provide support on our online forum. The D'Oyly Carte Charitable Trust grant and Big Give fundraising income were spent on this project in 2023.

Digital Capacity Building

APP received a second grant for digital capacity building of £700 from The Big Give in 2023. We used this grant to continue exploring new ways using our social media to reach existing and potential new supporters, as well as developing our supporter newsletter systems and a new presentation template for our training.

National Peer Support

APP received grants from three charitable foundations - The Hospital Saturday Fund (£2,000); John Coates Charitable Trust (£3,000) and The Carmela and Ronnie Pignatelli Foundation (£2,500) - to support its national peer support project in 2023. These grants funded staff time on our national peer support work, training for our peer support staff, and online and face-to-face café groups.

NE Café Group

APP received a grant (£3,000) from the Sir James Knott Trust to continue running a peer support café group in the North East of England following the end of our NHS contract in this region.

Voices From The Frontline/Rosa

APP received a grant (£7,000) from Rosa's Voices from the Frontline fund to support our campaign to ensure all women in the UK who develop postpartum psychosis (PP) have access to a Mother and Baby Unit (MBU) from February 2023 to January 2024. The grant allowed us to make our case about the need for better MBU provision by highlighting the impact on women who aren't treated in an MBU and their families. We did this by showcasing families' voices across the year, galvanising public support through the media (digital, print, TV and radio) and bringing the human impact of inequality in service provision to life for both politicians and commissioners. We provided support for our Storytellers through café groups, particularly in Wales, Scotland and Northern Ireland. Women attending café groups were supported to place media stories, contact and influence local MPs and key decision makers, develop petitions and letters and work with other Third Sector organisations.

Page 37

continued...

ACTION ON POSTPARTUM PSYCHOSIS

NOTES TO THE FINANCIAL STATEMENTS - continued FOR THE YEAR ENDED 31 DECEMBER 2023

17. MOVEMENT IN FUNDS - continued

Marce 2022

APP received a donation to support research into postpartum psychosis, particularly through APP participating in the biennial International Marcé Society for Perinatal Mental Health Conference, which was held in London in 2022. This would promote lived experience involvement in research and develop APP's global profile and networks. APP staff and volunteers with lived experience presented in two symposiums including presenting the impact of APP's work over the last decade, exploring the ingredients for lasting impact, lessons learned, and how this learning might be used to influence care for women and families affected by PP globally. The funds were used for conference and staff travel costs.

Diverse Communities Peer Support

APP successfully applied to the Big Give's Women and Girls Match Fund to run a match funding campaign in October 2023. The campaign raised more than £5,000, including match funding, for our work supporting and improving the mental health of women from Black and Asian backgrounds who experience PP and their family members. The diverse communities peer support project connects women with trained volunteers who use their personal experiences of PP from the perspective of a Black or Asian woman to provide telephone, video call or email support. Group calls, like our online meet-up for Muslim women who’ve experienced psychosis in the perinatal period, offer safe places for women to share what helped them and their family through PP.

18. EMPLOYEE BENEFIT OBLIGATIONS

The charity operates a defined contribution pension scheme. The assets of the scheme are held separately from those of the charity in an independently administered fund. The pension cost charge represents contributions payable by the charity to the fund and amounted to £13,417 (2022: £11,913) Contributions totalling £nil (2022: £nil) were payable to the fund at the balance sheet date.

19. RELATED PARTY DISCLOSURES

Action on Postpartum Psychosis was hosted by the University of Birmingham until 31[st] December 2023. During 2023 Action on Postpartum Psychosis paid a hosting fee to the University of £42,560 (2022: £40,660) The charity receives benefits from this relationship including meeting and office space.

The charity has included an accrual of £28,496 (2022: £10,555) representing the amount outstanding to the University of Birmingham at 31 December 2023.

During the year, Trustees made donations to the charity totalling £2,493 (2022: £7,503).

Page 38