2024-03-31-accounts - Midlands Air Ambulance Charity

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MIDLANDS AIR AMBULANCE CHARITY

ANNUAL REPORT AND CONSOLIDATED FINANCIAL STATEMENTS

Year ending 31[st] March 2024

Charity Number 1143118 Company Number 07683841

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

Charity and Company Registration

Charity and Company Registration	Charity and Company Registration	Charity and Company Registration
	Midlands Air Ambulance Charity (parent charity)	Registered Office: Airbase Avenue Neachley Shifnal Shropshire TF11 8UR
	Registered Charity Number (Charity Commission): 1143118 Registered Company Number (Private company limited by guarantee, Companies House): 07683841
	Midlands Air Ambulance Trading Ltd (trading subsidiary)
	Registered Company Number (Private Limited Company, Companies House): 08256466

Our advisers

Auditor	Cooper Parry Group Limited	Sky View, Argosy Road, East Midlands Airport, Castle Donington, Derby, DE74 2SA
Bankers	Barclays Bank plc	Queen Square, Wolverhampton, WV1 1DS
Company Secretary	Nicola Rees	Hawthorn House, Dudley Road, Stourbridge, DY9 8BQ From 3 July 2023, Airbase Avenue, Neachley Shifnal, Shropshire, TF11 8UR
Solicitors	Withers LLP	16 Old Bailey, London, EC4M 7EG
Investment advisers	AFH Group	Buntsford Drive, Bromsgrove, B60 4JE

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

Content	Page
1. Chair’s report	3
2. Chief Executive’s report	4
3. Survivor case study	5
Trustee report, incorporating strategic report:	7
4. Our Charity - in brief	7
5. Delivering public benefit	8
6. Performance against objectives - FY 2023-24 ▪ Clinical excellence (13) ▪ Income generation - incorporating Financial Review (14) ▪ Organisational resilience (15) ▪ Our people (16)	13 – 16
7. Future plan - 2024 and beyond	17
8. Principal risks and uncertainties	18-19
9. Reserves policy	20
10. Structure and governance	21
11. Statement of Trustee responsibilities	27
Auditor’s report	32-35
Consolidated statement of financial activities, including income and expenditure account	36
12. Consolidated and charity balance sheet	37
13. Consolidated statement of cash flows	38
14. Notes to the financial statements	39-59

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

CHAIR’S REPORT

In my first full year as Chair for Midlands Air Ambulance Charity (MAAC), we have achieved growth in many areas, and I am proud to work with such a dedicated team of staff and volunteers, and alongside my fellow Trustees.

Keith Marriott Chair of the Board of Trustees

This document outlines the Charity’s work and achievements during the Financial Year 2023-2024. For a summary of achievements against our four strategic priorities - (i) clinical excellence; (ii) income generation; (iii) organisational resilience; and (iv) our people – please refer to section six. In this section I would like to share some highlights with you.

During the year, all three of our airbases were inspected by the Care Quality Commission (CQC). I am delighted to report that Midlands Air Ambulance Charity achieved an outstanding CQC rating at each airbase. This represents a major milestone in the organisation’s 33-year history and highlights the strength, maturity and robust governance processes across the charity.

As we evolve our operations; we remain focused on delivering the best possible pre-hospital emergency care to the patients we treat across the Midlands region. In the past year our Critical Care paramedics and Specialist Doctors have introduced a new hyper acute transfer service for patients who require time critical hospital transfers. This initiative has proved vital for stroke patients and for the neo-natal cases that our clinicians attend. We have also extended our operating hours to 24/7 as part of a trial to evaluate patient need during the dark hours and to extend our reach. Early data is showing that overnight, we are attending more complex cases requiring advanced procedures and medication.

I am also pleased to report that during the financial year 2023-2024, MAAC’s income generation held strong, and we close the year with a surplus position. However, we do not take for granted the many generous donors that support our air ambulance. Our donor base and our people are MAAC’s greatest assets, and we will continue to show our gratitude, recognition and loyalty to our supporters by providing an outstanding helicopter led emergency medical service, across the six-midlands counties that we serve. Our favourable end of year position will be utilised to build our reserves to 20 months of running costs, working towards our policy of having free reserves equal to 24 months of future operating costs, which will further safeguard our fleet of helicopters, specialist clinical staff and lifesaving operations for a sufficient period in the event that our income is impacted due to unforeseen events.

As we turn our attention to the future, I look forward to supporting and guiding the team in the delivery of the Strategic Plan. I ask you to maintain your support of our charity, so that we can continue serving the communities across the Midlands region, rapidly attending and treating critically ill and injured patients in their hour of need. Thank you.

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

CHIEF EXECUTIVE’S REPORT

The Financial Year 23/24 has been a significant period in Midlands Air Ambulance Charity’s 33-year history.

When I reflect over the last 12 months, I am proud of the organisation’s many successes, the result of the immense diligence, hard work and commitment of the team here at MAAC and the loyalty and passionate support of our many volunteers, donors and corporate partners.

Below I outline the Charity’s main achievements. In summary, we have:

✓ Completed the building programme and moved into our new Airbase and Charity Headquarters.

Hanna Sebright, Chief Executive

✓ Concluded a complex, open tender programme for an aviation partner to support our aircraft operations. We look forward to working with our colleagues at Babcock Mission Critical Services Onshore in delivering a high-quality fleet maintenance and servicing operation in the coming years.
✓ Achieved an outstanding rating with the Care Quality Commission (CQC) at all three of our airbases.
✓ Been assessed by Investors in People which has resulted in our rating moving from Silver to Gold.
✓ Launched 24/7 clinical operations as part of a trial – to extend our reach and improve equality of pre-hospital emergency care across the region, day or night.
✓ With dedicated facilities at our new airbase and HQ we have now been able to establish a comprehensive training and education function, for our clinicians internally and for external medical students as well as extending our CPR, bleed control, and defibrillation training for regional schools and businesses providing CPR skills sessions to approximately 9,000 people.
✓ We have worked hard to recruit more volunteers and bring new skill sets to the Charity. We are forever grateful for the strong levels of commitment from the community in providing voluntary support across many different areas of the charity.
✓ In line with our long-term growth plan, we have expanded our retail network to nine shops, with two new shops in Stoke on Trent and Hereford. This is part of our ongoing plan to raise funds for our charitable cause whilst supporting our sustainable shopping and recycling agenda’s.
✓ Seen our dedicated staff continuously strive for improvement with the submission of 76 innovations, which is a 50% increase from the previous year.
✓ Through hard work our highly skilled committed fundraisers have achieved strong income growth across the year in spite of increasing costs and ongoing economic uncertainty.

None of these achievements would have been possible without such a dedicated, fabulous team including our clinicians, fundraisers, retailers, critical back-office functions and our wonderful volunteers. I would like to thank everyone involved for making this happen as well as our Chairman and Board of Trustees for providing strategic direction and ongoing support throughout the year.

I look forward to the year ahead and building on recent successes whilst always putting the patient first.

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

SURVIVOR CASE STUDY

Survivor Story Denzel Nafrue

A fun Sunday afternoon at a friend’s birthday party soon took a turn for the worse for seven-year-old Denzel who lives in the Midlands.

Our service provides enhanced critical care to a child in our region every day .

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DENZEL BEING LIFTED TO A TRAUMA CENTRE
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Friends’ birthday parties are generally always a great occasion, especially if you are a child, however for seven-year-old Denzel sadly the event became a life changing moment.

In April 2023, Mary Nafrue, Denzel’s mother, dropped him off at the party at a trampoline park in Telford.

Mary explains: “I had just sat down at a nearby restaurant when I had a call to say you need to come back right away. It was the call no mother wants to receive.”

Denzel had collapsed and it was unclear as to the reasons why. His condition worsened as his heart stopped beating and went into cardiac arrest.

Mary arrived back at the trampoline park just as Midlands Air Ambulance Charity’s G-RMAA aircraft was approaching to land alongside other emergency services.

Mary continues: “I was so worried. I remember one of the clinicians reassuring me that they would do all they could for Denzel.”

Chris Brooke, critical care paramedic for Midlands Air Ambulance Charity, explains: “It wasn’t clear what caused Denzel’s collapse. On initial assessment it was looking likely he had an undiagnosed medical condition. He was suffering a hypoxic cardiac arrest meaning his body was starved of oxygen.”

Denzel also suffered trismus, a condition where the mouth clenches shut, making intubation access (getting a tube into his lungs) more difficult. Denzel had also vomited meaning his airway was further compromised and his condition was more challenging to manage.

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

Chris adds: “We shocked his heart back into a regular cardiac rhythm and worked with land ambulance crews to manage his airway using manual manoeuvres to keep oxygen flowing around his body.

“We undertook an emergency anaesthetic - an intervention that can only be undertaken by a service such as ours - as it has to be performed by a doctor and critical care paramedic. This meant we were able to put Denzel into an induced coma to protect his airway and brain from further hypoxia.”

Once stabilised, Denzel was airlifted to Royal Stoke Hospital with his mum by his side. Mary says: “He didn’t wake up from the induced coma until a week later, but he was alive and that gave us hope. We were transferred to Birmingham Children’s Hospital for further investigations. He was in hospital for six weeks.”

Patients who have suffered abnormal heart rhythms are at greater risk of experiencing further episodes. Denzel now has an Implantable Cardioverter Defibrillator (ICD) fitted to monitor his heart. The device delivers shocks if his heart rate becomes irregular.

Mary adds: “I cannot thank Midlands Air Ambulance Charity enough for what they did that day. Without being put into an induced coma to support his brain, I don’t want to think what the outcome could have been. It’s not just the clinical crew, but also the pilot who flew us to hospital. Without their lifesaving skills, Denzel would not be here.

“It still scares me when the ICD shocks Denzel’s heart, but the thought of the alternative is scarier.”

Denzel, now aged eight, has made an amazing recovery. He says: “I remember going to the trampoline park and that’s it. Then I woke up in hospital.”

After receiving the sad news, Denzel’s school teacher at Stoke-on-Tern Primary School, decided to fundraise for our lifesaving service. While Denzel was recovering in hospital, the school hosted a ‘Denzel Day’ where they held activities to raise money. When Denzel returned, the whole school ate his favourite dinner – pizza.

Denzel has the last word: “Thank you to my heroes at Midlands Air Ambulance!”

Help make our next mission possible - you can support Midlands Air Ambulance Charity in many ways, by donating, volunteering, or running an event to raise funds we would love to hear from you:

Web - midlandsairambulance.com Call - 0800 8 40 20 40

Email - info@midlandsairambulance.com

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

TRUSTEE REPORT, INCORPORATING STRATEGIC REPORT:

Our Charity - in brief

Midlands Air Ambulance Charity is an independent health care provider and is rated outstanding by the Care Quality Commissioned (CQC). We are responsible for delivering a prehospital emergency helicopter-led service across the Midlands Region – we proudly serve the diverse communities of Gloucestershire, Herefordshire, Shropshire, Staffordshire, the West Midlands, and Worcestershire.

Midlands Air Ambulance Charity (MAAC) is the largest Air Ambulance Charity in England serving a population of approximately seven million over six counties. We are an established healthcare provider with more than three decades experience. Our core organisational divisions include:

Emergency critical care service – Our three airbases play a pivotal role in delivering rapid critical pre-hospital emergency medical care, by ensuring that residents across the Midlands region have access to a network of air ambulance helicopters within 10 minutes. We provide a pre-hospital helicopter-led service, 24/7 operations, 365 days a year, to residents and visitors across the Midlands region, bringing hospital-level procedures and medicines to the patient at the scene of an accident or incident.
Charitable programme – we raise funds for our lifesaving service and play an active role within the communities of the six counties that we serve. We provide education programmes, volunteering opportunities, and social engagement activities to support with community cohesion and wellbeing.
Retail network – we have a growing portfolio of charity shops which contribute towards raising funds for helicopter and critical care car missions. This operation also supports environmental and ethical causes as part of our wider societal role.
Training provider – we deliver community life skill sessions, such as CPR, bleed control, and defibrillation usage alongside CPD accredited courses ranging from workplace first aid training to specialist pre-hospital clinical training.

Our organisation is driven by a longstanding and deep-rooted ‘One Team’ ethos:

Vision	Saving Lives by Saving Time - Today, tomorrow, and in the future.
Mission	To provide patients with outstanding pre-hospital care and life saving intervention through the operation of helicopter-led emergency medical services.
Values	Receptive, Recognition, Relevant, Respectful, and Responsible

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

Delivering public benefit

Since 1991, Midlands Air Ambulance Charity has been operating a lifesaving air ambulance service across the Midlands.

Our service has undertaken more than 75,000 missions during the last 33 years, rapidly reaching and treating the most critically unwell and injured patients.

Our service constitutes the largest operating region in England serving circa. seven million people, making us one of the UK’s busiest air ambulances.

Our lifesaving service

Our charitable activities focus on providing lifesaving pre-hospital emergency medicine 365 days a year across an operating region of 5,200 square miles. Our service enables patients to receive vitally important hospital-level critical care in situ, before being conveyed to the most appropriate hospital or major trauma centre for their individual needs, giving them the best possible chance of survival and recovery.

On average, we reach patients within ten minutes bringing the following interventions to the incident scene:

Advanced clinical care and skillset via our critical care paramedics and pre-hospital emergency medicine doctors
Enhanced medicines to further support pain relief and sedation
Hospital-level equipment to undertake surgical procedures
Blood products for patients who need transfusions

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

Our team of highly skilled clinical practitioners include both helicopter emergency medical services (HEMS) doctors and critical care paramedics. The team administers out-of-hospital advanced clinical interventions and medicines via three Airbus helicopters. Each of our three aircraft carries a crew of three: a pilot and two specialist paramedics or a single critical care paramedic and a flight doctor.

Additionally, our helicopter-led service is complemented by an ‘over land’ fleet of rapid response vehicles and specialist critical care cars. All our response platforms (air/land) are fitted with full lifesupport medical equipment and medicines.

We benefit the lives of approximately seven million people across all age groups, supporting diverse communities within our six-county region, comprising of rural and urban conurbations. We provide patient care where advanced clinical skills are needed outside the hospital environment, such as a road traffic collision, an individual who has had a cardiac arrest or fall at home, or a trauma incident in an isolated rural area. Key service outputs include:

✓ On average our advanced critical care clinicians attend over 4,300 missions per annum - 45% of our missions are in response to a medical case and 55% related to traumatic incidents.
✓ Our critical care paramedics and pre-hospital emergency medicine doctors undertake an average of 12 incidents each day and reached patients within an average of ten minutes.
✓ Over a quarter of patients required advanced procedures and drugs which is beyond the standard scope of the NHS ambulance service. Examples include sedative techniques and anaesthesia, plus interventions such as amputations and intubation, which enable the doctors and critical care paramedics to take over a patient’s breathing and stabilise their condition giving them the best possible chance of survival and recovery.

Our specialist crews rapidly bring:

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

Our delivery partners

Our strong collaborative relationship with our delivery partners is based on a mutual core principle of providing the highest quality service and care for patients.

Clinical dispatch Aviation We work in partnership with two Ambulance During FY23-24 an extensive procurement Service Trusts who coordinate responses to exercise was undertaken for this important 999 calls within our six-county operating region: function, which resulted in the announcement that Babcock Mission Critical Services Herefordshire Onshore (BMCSO) is our aviation partner for Shropshire the next 10 years. BMCSO provide our Aircraft Staffordshire Operators Certification (AOC) and the specialist West Midlands delivery team.

Herefordshire Shropshire Staffordshire West Midlands Worcestershire Gloucestershire

The pilots and engineers – are responsible for MAAC’s three Airbus helicopters (a H145 and two EC135’s) and promote safety and excellence across flight operations.

Our delivery partners task us to missions by requesting the dispatch of our fleet of helicopters and critical care cars for serious trauma cases or time critical medical emergencies.

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

Our charitable ethos

As a charity founded within the communities we serve, we are committed to building meaningful relationships and demonstrating our Charity’s lifesaving impact. Our Charity does not receive any Government funding for our daily missions. We rely on the generous support of the public, businesses, and grant giving bodies to raise the circa £16m needed each year to remain operational, as well as to assist in developing our service by purchasing new medical equipment. This is achieved by generating income from fundraising activity and our growing network of shops (refer to page 36 for more information).

Alongside our core lifesaving service, our Charity is committed to enhancing the lives of local people and businesses via the provision of education and training programmes as well as volunteering opportunities.

Training and development

We deliver a varied training programme ranging from education outreach sessions which teach life skills, such as CPR, bleed control, and defibrillation usage alongside CPD accredited courses ranging from workplace first aid training to specialist pre-hospital clinical training.

Our training in the community aims to equip adults and children with lifesaving skills, via our popular education programmes called ‘Sky Champs’ and ‘Mission Support’. These

programmes support our vision – saving lives, by saving time. During FY 23/24 we delivered skills sessions to 119 schools across our sixcounty region. A total of 8,914 children attended the sessions, which aim to equip youngsters with basic CPR skills and how to control severe bleeding wounds. We also delivered skills sessions to a total of 150 adults from community groups, businesses, and the public via drop-in sessions.

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

As part of the organisation’s commitment to continuous improvement, our new Airbase and Charity Headquarters is a key location for our training programmes. The facility includes a state-of-the-art clinical training area, complete with simulation suite, which is fundamental to delivering the advanced training programmes. Not only will this facility ensure our critical care team is equipped to treat the increasingly complex patient cases we attend, it will also provide spaces for other third parties and this is reflected in our list of courses delivered below:

✓ European Trauma Course
✓ Surgical Skills Course
✓ Transfer Course
✓ Ultrasound Course
✓ RAF Senior Leadership away day
✓ West Midlands Ambulance Service Foundation Trust (WMASFT) Mental Health Training
✓ Enhanced Critical Care Learning and Development Day (MAAC/ WMASFT collaboration)

Volunteering

Demonstrating our commitment to our expanding family of more than 250 volunteers who contribute to our charity, we are proud to have been accredited with a national Investors in Volunteers award since 2018.

Our volunteers are the backbone of Midlands Air Ambulance Charity and without such community support, our daily missions would not be possible. They play a key role from board, down to support on the ground, all complementing the work of our clinical crew, charity, and retail teams.

Following the implementation of the organisation’s rolling five-year strategy in FY22-23, a new volunteer plan was developed - year one progress shows:

✓ Volunteering numbers increased by 29%
✓ The number of hours donated by volunteers increased by 14%
✓ Overall retention levels are positive

We want our volunteering experience to be an enjoyable and hugely rewarding one. We regularly ask for feedback to check volunteers are happy as well as getting their thoughts and ideas. Additionally, feedback from the volunteer survey shows positive trends. Here are some highlights below:

✓ Strong pride in volunteering towards our cause (90%+)
✓ High levels of volunteer satisfaction (90%, up by 5%)
✓ The majority of our volunteering team would recommend MAAC (90%)

We would like to take this opportunity to thank all our volunteers

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

Performance against objectives - FY 23-24

The section below provides a summary of progress for the year April 2023 – March 2024 against the agreed four strategic priorities (i) clinical excellence; (ii) income generation; (iii) organisational resilience; and (iv) our people, in the Group’s five-year business plan:

Strategic Priority #1: Clinical Excellence

Key achievements

To deliver a patientfocused, prehospital emergency medicine,

helicopter- led service. Our team of highly skilled,

experienced critical care paramedics and doctors treat and stabilise

patients at scene

thereby providing the best outcomes for those that are critically ill or

injured.

Outstanding Care Quality Commission (CQC) rating - the team welcomed inspectors from the CQC to all three airbases, as part of their regular inspection regime. This resulted in our service being rated as ‘Outstanding’, the highest possible rating. We are very proud of achieving this rating as it demonstrates the strength of the charity and our robust governance.
Service development – we have undertaken key pilot programmes in support of enhancing patient care:
(i) Hyper acute transfer service - for patients who require time critical hospital transfers with specialist clinically trained crews. This initiative has proved vital for stroke patients and in numerous neo-natal cases.
(ii) Extended hours via critical care cars which led to 24/7 operations trial – this initiative supports the provision of equitable care for critically ill and injured patients by day and night across the six-county region that we serve.

▪ Development of our five-year clinical operations plan – aligned to delivering clinical excellence. The forward plan will guide wider organisational developments and support with understanding income requirements for enhancing our lifesaving service.

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

Strategic Priority #2: Income Generation

Key achievements

To fund our lifesaving service and enable business transformation over the next five years, income generation will embrace innovation and diversification.

▪ Achieved our fundraising total - despite the challenging economic landscape, our team of staff and volunteers were able to secure income for our 365-day a year service. Please find further details in note 2. We would like to thank all our supporters who generously contributed funds.

▪ During the 12 months we have trained over 9,000 people - we continue to provide added value to the communities we serve by engaging with local people, schools, and businesses to provide bystander support sessions, equipping them with skills to administer CPR and bleed control.

▪ We have expanded our network of shops to nine stores – with the opening of our Stoke-on-Trent and Hereford City Centre stores, this forms part of our ongoing plans to raise funds for our charitable cause whilst supporting sustainable shopping and recycling agenda’s.

▪ Established our training and education function - we are set to deliver more life skill sessions, such as CPR, bleed control, and defibrillation usage alongside CPD accredited courses ranging from workplace first aid to specialist pre-hospital clinical training.

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

Strategic Priority #3: Organisational Resilience

Key achievements

▪ The completion and occupation of our new Cosford Airbase and Charity Headquarters - has been a key project for FY23-24. This new facility will further enhance our lifesaving service by providing a training centre of excellence for pre-hospital emergency care.

To futureproof the Charity Headquarters - has been a key project for FY23-24. This new organisation by facility will further enhance our lifesaving service by providing a training centre of excellence for pre-hospital emergency care. enhancing operations to ▪ Strensham redevelopment – we have secured funding as well as planning permission. This will improve our facilities for extended ensure resilience, operating hours and staff training. sustainability, and success. ▪ Striving for continuous improvement – our innovations process encourages both staff and volunteers to submit ideas for improving and developing any part of our operations. Now in its second year, innovation proposals have grown by more than 50%, with staff submitting 76 ideas. Highlights include: (i) developing medical consumables to support with patient care whilst in transit – bespoke pillows and warming blankets; and (ii) round up appeals in our shops to support with raising funds for our service.

▪ Aviation developments - an extensive procurement exercise was undertaken in search of a supplier to provide our Aircraft Operators Certification (AOC) and the specialist delivery team. Following this exercise, we announced that Babcock Mission Critical Services Onshore will be our aviation partner for the next 10 years.

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

Strategic Priority #4: Our People

Valuing our people

Key achievements

To place collaboration

A new Health and Wellbeing programme - was created by a cross-organisational group and is based on a rolling 12-month plan of activity to engage and support staff and volunteers.

at the heart of our

working practice, by

developing our

people, growing our regional networks,

and supporting the

communities we

New employee system – was implemented to support HR administration and effective document management.
Year one delivery of volunteer plan has seen positive results with both numbers and donated hours up. We are grateful for the strong levels of commitment from the community.
We enhanced our safeguarding programme - to ensure best practice across clinical and non-clinical teams, which included a robust training programme. Governance has been strengthened with the introduction of a Trustee Safeguarding Champion who leads a specialist working group.

serve.

▪ We were assessed by Investors in People which has resulted in our rating moving from Silver to Gold – we are proud of this achievement as this is only awarded to 17% of participating organisations.

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

Future plan - 2024 and beyond

As a charity that is funded by the community it serves, our strategy aims to positively impact our sixcounty service area through our enhanced critical care service and also the wider contribution to the region.

Our strategic framework is based on four strategic priorities (i) clinical excellence; (ii) income generation; (iii) organisational resilience; and (iv) our people, which are underpinned by four enabling themes (i) innovation; (ii) leadership; (iii) environmental; and (iv) engagement.

MAAC Group five-year strategic framework

Priorities for the forthcoming financial year 2024 – 2025 include:

Implementation of our new clinical plan which focuses on completing the 24/7 trial – the aim is to enhance patient care through extending our operational hours and further development of our patient aftercare service.
Aviation programme – purchase and delivery of a new H145 D3 aircraft which replaces existing leased aircraft.
Training and education programme - roll out of a new training programme.
Redevelopment of Strensham – commence and complete the redevelopment.
Develop our new Income Generation Plan which will look at how we can further enhance fundraising activity – including our events programme and corporate sponsorship and sustainable giving programme – as well as diversifying income sources.
Further expansion of our shop network across the six counties we serve, helping the environment by recycling used goods and enabling community inclusion via the introduction of community hubs.
Introduce an employee training and talent management programme to forward plan resources and support with organisational resilience.

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

Principal risks and uncertainties

The organisation operates a comprehensive risk management process to manage and mitigate risk. Risks identified across the MAAC group are managed in accordance with The Group’s Risk Management Policy, which is underpinned with detailed risk assessments. We utilise a web-based risk management system, RADAR Healthcare, for reviewing, updating, ongoing analysis and compliance.

Our Charity’s Board of Trustees, supported by the Audit and Risk Committee, has responsibility for ensuring an effective risk management system is in place. Risks are regularly reviewed and managed by the appropriate Committee and/or Trading Subsidiary Board, and all significant risks are reported and reviewed at each Board of Trustees meeting where management and mitigation measures are discussed and agreed.

During 2023/24 MAAC has received inspections at all three airbases by the Care Quality Commission (CQC) all receiving “Outstanding” ratings. Inspection reports reference how MAAC effectively manages risk as an organisation and to patients. For example, the Strensham airbase report said: “The service controlled infection risk well using specialised equipment and vehicle adaptations. Staff assessed risks to patients, acted on them and kept good care records.”

Our risk management approach also includes monitoring and managing low likelihood but high consequence risks e.g., the low risk but high consequence of a significant helicopter incident. As with all medical interventions and helicopter/ car transportation, the nature of MAAC’s activities involves inherent risk. These inherent risks are managed closely through MAAC’s established governance and compliance framework, and experienced team.

During 2023/24 MAAC undertook a Board led review of risk, engaging with representatives from all staff across the organisation to identify potential risks for assessment and management.

One of the most significant risks MAAC continues to face is the increased competition from other charitable organisations, during the cost-of-living crisis, impacting on income generation and creating a funding gap.

Below shows the organisation’s four key strategic priorities with a summary of some of the risks that have been identified :

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

Strategic Priorities	Risks
Clinical Excellence	▪ Breach in controls, policies and/or standard operating processes, which leads to CQC action e.g., warning notice. ▪ Catastrophic event preventing full/partial service delivery ▪ Insufficient innovation impacting current and/or future capabilities. ▪ Challenges in recruiting and/or retaining quality clinical team.
Income generation	▪ Impact of external factors (e.g., adverse economic conditions or events) hampering income potential ▪ Failure to diversify financial model e.g., inability to secure commissioned services. ▪ Underperformance of a key third party income source adversely impacting on income generation. ▪ Reputational issues affecting brand perception resulting in downturn in income generation
Organisational resilience	▪ Failure to realise the long-term benefits of the capital investment programme (ABHQ). ▪ Disruption risk challenges, for example major cyber-attack. ▪ A gap within area specific strategic plans, meaning lack of focus and investment in key areas. ▪ Major incident rendering our building inoperable.
Our People	▪ Limited organisation capacity (and associated staff flight risk), restricting time available for development of individuals and/or the organisation ▪ Insufficient progress in developing MAAC group wide equality diversity and inclusion agenda. ▪ Challenges in recruiting and/or retaining quality volunteers. ▪ Failure to embed the desired organisational culture

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

Reserves Policy

The Trustees have established a reserves policy which is reviewed annually by the Audit and Risk Committee and approved by the Board. The Policy is intended to ensure the Charity can continue to accomplish its aims and to make certain that enough funds are held to fund capital projects, such as building enhancements, acquisition of a new helicopter, or the purchase of rapid response vehicles.

At the year-end, total Group funds stood at £58,083,000 (2023: £53,533,000). Of this amount, £38,805,000 (2023: £26,145,000) is made up of either restricted funds or can only be realised by disposing of tangible fixed assets and the investment portfolio, which leaves the free reserves of the Group at £19,278,000 (2023: £27,388,000), however £9,755,000 of this sits within designated funds. In line with our organisational resilience planning, £29,171,000 of this is held within the unrestricted expenditure reserve which equates to approximately twenty months of operating expenditure, which would enable maintenance of our core service should we suffer a major downturn in income generation.

Funds are categorised into three main headings:

Restricted funds - are held where funds have been received by the Charity for a specific purpose. These funds are ring-fenced and held in restricted reserves until the intended expenditure has been incurred. Restricted funds at the end of the reporting period were £2,702,000 (2023: £58,000).

Designated funds - are allocated to fund projects and initiatives agreed by the Trustees. Total designated funds at the end of the financial year were £23,121,000 (2023: £24,944,000). In prudently planning, the Trustees will endeavour to set aside designated funds to acquire assets and equipment to ensure that the Charity continues to provide the most efficient and effective service possible.

Unrestricted reserves - are those reserves which are neither restricted nor designated. This type of reserve is held in part to provide a cash safety buffer. Should the Charity’s income fall, the reserves will enable us to maintain the core service we provide to our communities, whilst allowing enough time for us to develop alternative sources of funding or to revise planned expenditure. The reserves policy states that the level of unrestricted reserves that is set aside to cover future expenditure if there is a fall in income should be up to twenty-four months of future operating costs. In addition, as we are also committed to ensuring our services are available for future generations, unrestricted reserves are used for the accumulation of funds towards the costs of significant future developments and capital purchases. Total unrestricted reserves at the end of the reporting period were £32,260,000 (2023: £28,531,000), of which £29,171,000 (2023: £25,516,000) equates to circa twenty (2023: eighteen) months future operating costs.

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

Structure and governance

Quality Assurance and Standards

As part of our commitment to quality management and continuous improvement, our Charity is a proud recipient of the following accreditations as of 31[st] March 2024:

Care Quality Commission (registration April 2022) – during FY23-24 all three airbases were inspected, and we received the highest rating of Outstanding for all three (i) Airbase and Charity HQ; (ii) Tatenhill Airbase; and (iii) Strensham Airbase.
Investors in People – we were inspected in FY23-24 and rated Gold
Investors in Volunteers
Fundraising Regulator registration

Alongside this, during FY23-24 we were recognised in the following industry accolades:

Shortlisted:

Smee & Ford – Best Free Will Service
Air Ambulances UK – Staff Member of the Year – Debbie Briden
Air Ambulances UK – Innovation of the Year – MAAC’s Innovation Process
Air Ambulances UK – Doctor of the Year – Dr Dave Cooper
Charity Film Awards – Long-form Category (Charities £5million-£20million turnover) – Nigel’s Story (Ball Case Study Film)

Won:

Air Ambulances UK – Lifetime Achievement Award – Ian Roberts
Staffordshire Chamber of Commerce Awards – Employee of the Year – Dr Mark Nash
BBC Make A Difference Awards 2023 – Gloucestershire – Steph Shaw (fundraiser)
Midlands Props Awards – The ESG Award, MAAC’s new Airbase and Charity HQ

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

Key management personnel

The Senior Leadership Team forms the key management personnel of the Charity and is responsible for directing, controlling, running, and operating the Charity’s clinical and non-clinical strategy and tactics on a day-to-day basis.

Senior Leadership Team

Senior Leadership Team	Senior Leadership Team	Senior Leadership Team
	Hanna Sebright	Chief Executive Officer
	Emma Gray	Chief OperatingOfficer
	Karen Kingham	Finance Director
	Ian Roberts	Registered Manager
	Ian Jones	Clinical Operations Director
	Mark Nash	Medical Director

Administration and finance

The charitable purpose, and fundraising to support that activity, is always at the forefront of our minds, but we also strive to ensure that we keep our administrative and financial systems and processes fit for purpose and cost effective. Our aim is to keep our administration and finance costs at less than 12 per cent of the income received, and we are pleased to be able to record that for this financial year we spent only 10.5 per cent of our income on support and governance costs.

Our Charity uses Access CRM a customer relationship management (CRM) system to assist with donor administration alongside enhancing our stewardship with donors and supporters. The Group works hard to ensure that it remains compliant with the General Data Protection Regulation (GDPR). To achieve this, we continually train our staff in areas such as customer service and data protection, and we recognise their achievements and successes in staff awards for which nominations and voting is undertaken by fellow staff members.

Our fundraising standards and promise

We are committed to upholding the highest fundraising standards:

Our Charity is registered with the Fundraising Regulator , the independent regulator of charitable fundraising in England, Wales and Northern Ireland who advocates best practice for the sector.
We are an active member of The Chartered Institute of Fundraising , the professional membership body for UK fundraising.
We strive to ensure that our fundraising adheres to Data Protection legislation as set out by the Information Commissioners Office , key Charity Commission guidance and the Code of Fundraising Practice.
As stated in Our Donor Promise , our approach to fundraising is based on the principles of responsibility, transparency, and honesty. Please refer to our website for more details - www.midlandsairambulance.com/legal/donor-promise

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

The organisation monitors all feedback received (see compliments, complaints, and feedback section) in order to assess and act on any learnings. It should be noted that for the financial year FY 23-24 the Charity received 12 complaints which were linked to fundraising. This number is low when considering the number of fundraising interactions that the organisation has with the public regarding our endeavours to raise vital funds for our lifesaving service. We are pleased that our resolution of any issues is high, with 95% being concluded upon first response.

Where appropriate, we work in partnership with reputable professional fundraisers and commercial participators to raise funds - with robust written agreements and monitoring programmes in place, and in line with our Ethical Fundraising Policy .

Important sources of sustainable income, in particular the lottery and regular giving, are delivered in partnership. All canvassers working on our behalf are committed to abiding by the guidelines laid out within Our Canvassing Code of Practice (published on our website). Arrangements for these are outlined below:

Our Lifesaving Lottery - we are a Gambling Commission licenced operator and a member of the Lotteries Council, adhering to a strict set of codes and conditions of practice, including social responsibility and the protection of vulnerable people. Our Charity’s lottery is managed under contract with an external lottery company, Tower Lotteries, who is licensed by the Gambling Commission as an External Lottery Manager.
Sustainable regular giving income - our Charity outsources some telephone fundraising to an external telephone agency, Unity4, which works to The Chartered Institute of Fundraising’s Public Fundraising Certification Programme. This activity enables committed giving, such as donations provided via direct debits, which helps our charity with achieving much needed longer-term financial support.
Our ‘Christmas Raffle’ - was delivered in partnership with CFP Lottery and Raffles Ltd who supports us with the production and governance of this fundraising activity.

We work in partnership with a range of commercial participators who generously donate to our Charity while selling their goods or services – for example, donating a percentage of every product sold – all of whom are detailed on our website: www.midlandsairambulance.com/supporterbenefits

Financial review

Each year we aim to raise sufficient funds to cover all expenditure, as well as generate additional monies to be able to invest in future projects and to purchase new medical equipment to support our daily missions. Our pre-hospital critical care service would not be possible without the fantastic contributions of both funds and time made by our supporters, volunteers, corporate partners, and grant giving bodies and trusts.

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

Our charity operates a fundamental governance principle of aiming to retain up to 24 months of operating costs, ensuring business continuity of our lifesaving service. Refer to page 20 to find out more about our Reserves Policy.

To ensure we can continue providing a lifesaving service to the public in the face of economic challenges, our governance principles ring-fence up to two years of operating costs.

A summary of our income by core stream for the FY 2023-24 is as follows:

Income stream	Description	%
Legacies and in memoriam	Gifts in wills and donations in memory of a loved one	30
Lottery	Weekly lottery draw, £1 per play, plus annual Christmas Raffle	30
Grants	Restricted and unrestricted funds received from grant making trusts and other bodies	15
Donations and fundraising events	Cash donations from the public, including monthly amounts received via direct debit or standing order, and income from fundraising events	9
Other	Other income, including investment income	8
Charity shops	Income from the sale of donated goods through our regional charity shops	6
Corporate partners	Donations and sponsorship from regional companies	2
Total		100

Compliments, complaints and feedback

The effective management of complaints is a focus for the organisation and its regulators:

Care Quality Commission – Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 16 – Receiving and acting on complaints.
Charities (Protection and Social Investment) Act 2016, Clause 13.4.e: “the annual report must include a statement of the number of complaints received by the charity or a person acting on its behalf about activities by the charity or by a person on behalf of the charity for the purpose of fund-raising”.
Fundraising Code of Practice, Standard 2.4. Complaints and concerns about fundraising.
Charity Governance Code, Recommended Practice 7.6.2: “The board makes sure that there is a transparent, well-publicised, effective and timely process for making and handling a complaint and that any internal or external complaints are handled constructively, impartially and effectively.”

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

In line with our values, we are dedicated to improving how we track and manage feedback, both positive and negative, as it helps to further develop our operations. Over the last 24 months, the organisation has expanded its existing feedback processes by introducing the tracking and managing against three categories: (i) compliments; (ii) concerns; and (iii) complaints.

Overall trends for complaints and concerns are in line with previous years and there are no adverse results – reference the summary table below. Key compliance metrics are largely positive, and satisfactory resolution of complaints is achieved first time in 95% of cases.

	TOTAL RECEIVED FY22-23	TOTAL RECEIVED FY23-24
Compliment	69	54
Concern	59 (24 werenotrelated to MAAC)	33
Complaint	25	25 (3 werenotrelated to MAAC)

Our compliments, complaints and feedback policy is published on our website, as part of our ethos to enable continuous improvement. Information can be found as follows: www.midlandsairambulance.com/contact-us/feedback

Our Group structure

Midlands Air Ambulance Charity is a charitable company - registered in England and Wales as a charity with the Charity Commission and with Companies House as a private company limited by guarantee.

MAAC has one wholly owned trading subsidiary, Midlands Air Ambulance Trading Ltd (MAATL), which is registered with Companies House as a private limited company and whose portfolio includes MAAC’s charity shops and other areas of income generation, such as merchandise. MAATL gift aids back its profits to the parent charity MAAC to help fund MAAC’s helicopter-led emergency medical services.

Our Governing Document and Charitable Objects

The organisation’s Articles of Association clearly define the following charitable objects:

To assist in relieving sickness by the operation of a helicopter-led emergency medical service within the West Midlands, Shropshire, Staffordshire, Herefordshire and Worcestershire, Gloucestershire and in such other areas as may be requested by appropriate authorities. and

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

Such other charitable purposes for the relief of sickness, including clinical research and development, substitute clinical emergency services where the provision of Helicopter Emergency Medical Services (HEMS) is impracticable and such other activities consistent with the above object as the trustees may in their absolute discretion determine.

The Articles provide for such matters as the:

number of Trustees/Directors appointed.
frequency in which Trustee/Director meetings are held, and how they are conducted.
powers available to the Trustees/Directors in decision making.

In addition, the Trustees/Directors recognise that they have a duty and responsibility to comply with requirements and guidance issued by the Charity Commission. These include, but are not limited to:

ensuring that the charitable Group complies with charity law, and prepares reports on what it has achieved, submission of annual returns and financial statements as required by law.
ensuring that the charitable Group remains true to the charitable purpose and objectives set out in its governing document.
complying with the requirements of other legislation, and any other regulators, which govern the activities of the charitable Group.
acting with integrity and avoiding any personal conflicts of interest or misuse of Charity funds or assets.
ensuring that the Charity is, and will remain, solvent.
using charitable funds and assets reasonably, and only in furtherance of the Charity’s objects.
avoiding undertaking activities that might place the Charity’s funds, assets, or reputation at undue risk.
taking special care when investing the funds of the Charity or borrowing funds for the Charity to use.

Investment powers and policy

The Articles of Association of the Charity provide the Trustees with the power to: ‘deposit or invest the Charity’s funds in any manner as may be thought fit, but only after obtaining such advice from a financial expert as the Trustees consider necessary and having regard to the sustainability of investments and the need for diversification.’ In addition, the Articles support the delegation of the management of investments to a financial expert.

Trustees recognise that they have a duty to protect the Charity’s funds and to ensure that investments are balanced and protected. They have put in place an investment policy, which sets the framework in which investments are made and managed within the Charity. In setting the policy, Trustees consider ethical matters and risk.

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

When investment decisions are made, the timing of the planned use for the reserves is considered and investments are made to ensure that funds are available when required.

Pay policy

The pay of all Charity staff, including the Senior Leadership Team, is reviewed annually by the Human Resources and Remuneration Committee, who makes recommendations to the Board of Trustees for approval. The Annual Employee Pay Review process considers inflation, salary benchmarking and the organisation’s financial performance which led to increases in salary levels.

Taxation

As a registered charity, we have charitable status with HMRC. The trading subsidiary does not have charitable status for corporation tax purposes and is registered for VAT. From 1 April 2015 air ambulance charities have been eligible for partial recovery of the VAT incurred on expenditure under Section 33 of VAT Notice 1001.

Statement of Trustee responsibilities

The Trustees are pleased to present their annual report together with the consolidated financial statements of the Charity and its subsidiary for the year ending 31 March 2024 which are also prepared to meet the requirements of a directors’ report and accounts for Companies Act 2006 purposes.

The financial statements have been prepared in accordance with Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (2019) - (Charities SORP), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Companies Act 2006.

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

select suitable accounting policies and apply them consistently.
observe the methods and principles in the Charities SORP.
make judgements and estimates that are reasonable and prudent.
state whether applicable UK accounting standards have been followed, subject to any material departures disclosed and explained in the financial statements.

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

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

The Trustees are responsible for keeping proper accounting records that disclose with reasonable accuracy, at any time, the financial position of the Charity 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 Charity and the Group and obliged to take reasonable steps for the prevention and detection of fraud and other irregularities.

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

The Board of Trustees confirm that they have complied with the duty in section 17 of the Charities Act 2011 to have regard to the Charity Commission’s general guidance on public benefit and it is satisfied that the Charity’s activities do provide public benefit. MAAC’s public benefit is demonstrated in pages 8-12 of this report.

Robust governance - our MAAC Trustees and MAATL Directors

Midlands Air Ambulance Charity’s (MAAC) Board of Trustees is responsible for ensuring the

parent charity MAAC is effectively governed and run, and that it achieves its charitable purposes for the public benefit. The Trustee structure comprises of no less than seven Trustees and no more than ten Trustees.

As MAAC is both a registered charity and a Company Limited by Guarantee, Trustees have duties and responsibilities as a charity Trustee and company director, working to both charity and company law. Trustees also have duties regarding the Charity’s trading subsidiary Midlands Air Ambulance Trading Ltd (MAATL). As part of their duties, Trustees must routinely monitor the performance of MAATL and the parent charity’s investments in MAATL, with a view to ensuring the good and proper use of the Charity’s assets. The key purpose of MAATL is to raise funds for MAAC, and its effectiveness in doing this is naturally monitored. MAATL has its own separate MAATL Board of Directors.

All of our activities and impact are underpinned by excellent governance , based on standards and guidance from the Care Quality Commission, Charity Commission, Fundraising Regulator and other key bodies. MAAC has adopted and works to the Charity Governance Code and Code of Fundraising Practice. Our robust clinical governance and charity/ corporate governance is fully documented within MAAC’s Governance Framework.

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

MAAC has a range of best-practice mechanisms in place to ensure our Trustees have the skills, knowledge, experience, and integrity that they need (both when appointed and on an ongoing basis). These include:

An open, transparent, and fair Trustee appointment process – with the charity committed to equality, diversity and inclusion. A Nominations Sub-Committee carries out the shortlisting and interview process, with candidates selected based upon the relevance of their skills and their commitment and enthusiasm for serving as a MAAC Trustee. This sub-committee then makes recommendations to the Board and candidates are appointed by a majority decision of the Trustees (in line with MAAC’s Articles of Association).
Comprehensive induction, including Induction Pack, meeting the team and site visits (clinical, non-clinical and retail).
Trustee eligibility and fit and proper person declaration.
Declaration of interests and related party transactions (as per MAAC’s Conflicts of Interests Policy).
Board skills audit and skills matrix, succession planning matrix.
Annual Board Effectiveness Review and Trustee Performance Reviews with the Board Chair, which includes discussion of any areas where a trustee needs further support, training, or development.
Board Chair 360 review exercise.

Trustee appointments are made for a term of four years, and Trustees may then be reappointed by the Board for a further term of four years. Once a Trustee has served two terms consecutively, he/she may be reappointed for a further term of four years but only after he/she has ceased to act as a Trustee for at least one year.

The table below lists the Trustees/Directors in post 01/04/2023 to 31/03/2024, all of whom volunteer their time to bring valued experience to the Charity from a range of backgrounds and sectors:

Midlands Air Ambulance Charity - Board of Trustees / Directors	Midlands Air Ambulance Charity - Board of Trustees / Directors	Midlands Air Ambulance Charity - Board of Trustees / Directors
Name	Chair roles (where held)	Any changes during year
E K Marriott	Chair of Board of Trustees Chair of Income Generation Committee
K Bailey
A Cross
G Dellenty
R Guirguis		Resigned 31/03/2024
R Douglas	Chair of Audit and Risk Committee
A Lennox	Chair of HR and Remuneration Committee
A Moss
Dr V McVey	Chair of Clinical Standards Committee
W Saleem

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

Midlands Air Ambulance Trading Ltd - Board of Directors

Midlands Air Ambulance Trading Ltd - Board of Directors	Midlands Air Ambulance Trading Ltd - Board of Directors	Midlands Air Ambulance Trading Ltd - Board of Directors
Name	Chair roles (where held)	Any changes during year
T Sehgal	Chair of Board of Directors
L Bagnall		Resigned 13/07/2023
A Cross	Appointed 30/05/2024
R Douglas		Resigned 30/05/2024
N Nicholls
H Sebright

Our Decision-Making Structure (including Scheme of Delegation and Committees)

As recommended by the Charity Governance Code, the Board makes sure that its decision-making processes are informed, rigorous and timely and that effective delegation, control and risk assessment and management systems are set up and monitored.

The Board of Trustees currently has four committees and two working groups, with Terms of References adopted by each:

Committees		Working Groups
Audit and Risk		Aviation
Human Resources and Remuneration		Safeguarding
Income Generation
Clinical Standards

Our Charity’s Scheme of Delegation clearly sets out matters specifically reserved for the Board, matters delegated to Board Committees and matters delegated to the Senior Leadership Team. Our Scheme of Delegation makes clear that the Board’s focus is on governance, oversight, strategy, performance, and assurance (not operational day-to-day matters), with the Board retaining legal responsibility and oversight where aspects are delegated to committees, advisors, staff, volunteers, or contractors.

The Board has delegated day-to-day management to the Chief Executive Officer and the Senior Leadership Team. In all respects, this only relates to matters that are within the strategic plan, the business plan and budgets that have been approved by the Board.

Disclosure of Related Party Transactions and Declarations of Interest

Under charity accounting rules, charities are required to disclose certain transactions between related parties and the charity, for example, a related party who receives payment from the charity for the provision of services. Related parties are individuals or organisations who have significant influence over the strategic and financial decisions of the charity, for example, MAAC Trustees and persons and

MIDLANDS AIR AMBULANCE CHARITY

GROUP TRUSTEE REPORT For the year ended 31 March 2024

entities closely connected to them. As part of monitoring such transactions, Trustees are required to complete a Related Party Transaction Form at the close of each financial year.

Trustees are also required to declare conflicts of interest (as per MAAC’s Conflicts of Interest Policy) both at the beginning of each Board or Committee meeting and within their Declaration of Interest form (completed annually and when conflicts of interest change).

Related party transaction and declarations of interest are recorded within MAAC’s Register of Interests. For the reporting period, Trustee transaction disclosures are as below. Fuller information on organisational related party transactions is disclosed in note 22 to the Financial Statements.

Trustee remuneration and benefits: None (£0). Our Trustees give their time freely as volunteers and receive no remuneration or other benefits from the Charity for their work.
Trustee expenses: Details of Trustee expenses (£176) are disclosed in note 11 to the Financial Statements.
Other disclosable transactions between Trustees (and persons and entities closely connected to them) and the charity: None.

Trustee indemnity insurance

The Charity holds Trustees and Directors’ indemnity insurance cover with a Limit of Liability of £5,000,000 (2023: £5,000,000), the cost is not separable from the total cost of insurance.

Exemptions from disclosure

MAAC has taken no exemptions from disclosures.

Funds held as custodian trustee on behalf of others

There are no such funds held by the charity or its subsidiary.

Statement as to disclosure to our auditors

In so far as the Trustees are aware at the time of approving our Trustees’ annual report:

there is no relevant information, being information needed by the auditor in connection with preparing their report, of which the Group’s auditor is unaware, and
the Trustees, having made the enquiries of fellow Directors and the Group’s auditor that they ought to have individually taken, have each taken all steps that he/she is obliged to take as a Director to make themselves aware of any relevant audit information, and to establish that the auditor is aware of that information.

This report was approved by trustees on 3[rd] July 2024 and is signed on their behalf by

Keith Marriott, Chair

MIDLANDS AIR AMBULANCE CHARITY

INDEPENDENT AUDITOR’S REPORT To the members and trustees of Midlands Air Ambulance Charity

Opinion

We have audited the financial statements of Midlands Air Ambulance Charity (“the Parent Charitable Company”) and its subsidiary (“the Group”) for the year ended 31 March 2024 which comprise the Consolidated Statement of Financial Activities, the Consolidated and Parent Charitable Company Balance Sheets, the Consolidated Statement of Cash Flows and the related notes including a summary of significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards including Financial Reporting Standard 102 The Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice).

In our opinion, the financial statements:

give a true and fair view of the state of the Group’s and the Parent Charitable Company’s affairs as at 31 March 2024 and of the incoming resources and application of resources, including its income and expenditure, for the year ended;
have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice;
have been prepared in accordance with the requirements of the Companies Act 2006.

Basis for Opinion

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

Conclusions relating to going concern

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

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

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

MIDLANDS AIR AMBULANCE CHARITY

INDEPENDENT AUDITOR’S REPORT To the members and trustees of Midlands Air Ambulance Charity

Other information

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

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

We have nothing to report in this regard.

Opinions on other matters prescribed by the Companies Act 2006

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

the information given in the Trustees’ Report (incorporating the Strategic Report and the Directors’ Report) for the financial year for which the financial statements are prepared is consistent with the financial statements; and
the Strategic Report and the Directors’ Report have been prepared in accordance with applicable legal requirements.

Matters on which we are required to report by exception

In the light of our knowledge and understanding of the Group and Parent Charitable Company and its environment obtained in the course of the audit, we have not identified material misstatements in the Strategic Report and the Directors’ Report.

We have nothing to report in respect of the following matters in relation to which the Companies Act 2006 requires us to report to you if, in our opinion:

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

MIDLANDS AIR AMBULANCE CHARITY

INDEPENDENT AUDITOR’S REPORT To the members and trustees of Midlands Air Ambulance Charity

Responsibilities of Trustees

As explained more fully in the Statement of Trustees’ Responsibilities set out on pages 27 and 28, the Trustees (who are also the Directors of the Parent Charitable Company for the purposes of company law) are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such internal control as the Trustees determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error.

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

Auditor’s responsibilities for the audit of the financial statements

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

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

Our assessment focussed on key laws and regulations the Group and Parent Charitable Company has to comply with and areas of the financial statements we assessed as being more susceptible to misstatement. These key laws and regulations included but were not limited to compliance with the Companies Act 2006, Charities Act 2011, Charities (Protection and Social Investment) Act 2016, Fundraising regulator, CQC, taxation legislation, data protection, anti-bribery and employment legislation.

We are not responsible for preventing irregularities, including fraud. Our approach to detecting irregularities, including fraud, included, but was not limited to, the following:

obtaining an understanding of the legal and regulatory framework applicable to the Group and Parent Charitable Company and how the Group and Parent Charitable Company is complying with that framework, including agreement of financial statement disclosures to underlying documentation and other evidence;
obtaining an understanding of the Group’s and Parent Charitable Company’s control environment and how the Group and Parent Charitable Company has applied relevant control procedures, through discussions with management and by performing walkthrough testing over key areas;
obtaining an understanding of the Group’s and Parent Charitable Company’s risk assessment process, including the risk of fraud;
reviewing meeting minutes of those charged with governance throughout the year; and

MIDLANDS AIR AMBULANCE CHARITY

INDEPENDENT AUDITOR’S REPORT

To the members and trustees of Midlands Air Ambulance Charity

performing audit testing to address the risk of management override of controls, including testing journal entries and other adjustments for appropriateness, evaluating the business rationale of significant transactions outside the normal course of business and reviewing accounting estimates for bias.

Whilst considering how our audit work addressed the detection of irregularities, we also considered the likelihood of detection of fraud based on our approach. Irregularities arising from fraud are inherently more difficult to detect than those arising from error.

Because of the inherent limitations of an audit, there is a risk that we will not detect all irregularities, including those leading to a material misstatement in the financial statements or non-compliance with regulation. This risk increases the more that compliance with a law or regulation is removed from the events and transactions reflected in the financial statements, as we will be less likely to become aware of instances of non-compliance. The risk is also greater regarding irregularities occurring due to fraud rather than error, as fraud involves intentional concealment, forgery, collusion, omission or misrepresentation.

A further description of our responsibilities for the audit of the financial statements is located on the Financial Reporting Council's website at: www.frc.org.uk/auditorsresponsibilities. This description forms part of our Auditors' report.

Use of our report

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

Glen Bott FCA Senior Statutory Auditor

For and on behalf of:

COOPER PARRY GROUP LIMITED Date: 4 July 2024 Statutory Auditor

Sky View, Argosy Road, East Midlands Airport, Castle Donington, Derby, DE74 2SA

MIDLANDS AIR AMBULANCE CHARITY

CONSOLIDATED STATEMENT	OF FINANCIAL ACTIVITIES	OF FINANCIAL ACTIVITIES	OF FINANCIAL ACTIVITIES
including consolidated		Unrestricted	Designated	Restricted	Total	Total funds
income and expenditure		funds	funds	funds	funds	2023
account for the year					2024
ending 31 March 2024	Note
		£’000	£’000	£’000	£’000	£’000
Income:
Donations and legacies	2	14,241	-	3,154	17,395	15,519
Income from charitable activities:
Hospital Transfers		6	-	-	6	-
Education and Training		10	-	-	10	-
Income from other trading
activities:
Trading activities	3	1,299	-	-	1,299	996
Fundraising events	4	198	-	-	198	178
Investment Income	5	1,345	-	-	1,345	872
Other Income		219	-	-	219	97
Total income		17,318	-	3,154	20,472	17,662
Expenditure
Costs of raising funds
Trading activities	3	1,350	-	-	1,350	875
Fundraising activities and events	4	4,159	-	-	4,159	3,524
Investment Management costs	5	35	-	-	35	47
Expenditure on charitable activities
Aircraft and base costs	6	6,120	-	371	6,491	5,686
Patient care and support	6	4,658	85	131	4,874	3,589
Total expenditure		16,322	85	502	16,909	13,721
Net Gain/(Loss) on
investments	15	987	-	-	987	(1,181)
Net income/(expenditure)		1,983	(85)	2,652	4,550	2,760
Transfers between funds	19	1,746	(1,738)	(8)	-	-
Net Movement in Funds		3,729	(1,823)	2,644	4,550	2,760
Reconciliation of funds
Total funds brought forward		28,531	24,944	58	53,533	50,773
Total funds carried forward		32,260	23,121	2,702	58,083	53,533

The statement of financial activities includes all gains and losses recognised in the year. All income and expenditure derive from continuing activities.

Detailed comparative data for 2023 is included in Note 9.

MIDLANDS AIR AMBULANCE CHARITY

CONSOLIDATED AND CHARITY BALANCE SHEETS as at 31 March 2024

Note Fixed assets: Tangible assets 13 Intangible assets 14 Investments 15 Total Fixed Assets Current assets: Stock Debtors 16 Short term deposits Cash at bank and in hand Total Current Assets Liabilities: Creditors falling due within one year 17 Net Current Assets Total Assets less Current Liabilities Net Assets The funds of the Charity: Unrestricted reserves 19 Designated fund 19 Restricted fund 19 Total Funds	Group 2024 Group 2023 Charity 2024 Charity 2023 £’000 £’000 £’000 £’000 19,424 16,747 19,404 16,722 9 12 9 12 16,670 15,187 16,670 15,187
	36,103 31,946 36,083 31,921
	78 69 - - 1,531 1,713 1,541 1,767 13,452 9,708 13,452 9,708 8,762 12,133 8,567 11,867
	23,823 23,623 23,560 23,342 1,843 2,036 1,729 1,950
	21,980 21,587 21,831 21,392 58,083 53,533 57,914 53,313
	58,083 53,533 57,914 53,313
	32,260 28,531 32,091 28,311 23,121 24,944 23,121 24,944 2,702 58 2,702 58
	58,083 53,533 57,914 53,313

The Charity has prepared group accounts in accordance with section 398 of the Companies Act 2006 and section 138 of the Charities Act 2011.

The surplus generated by the Charity for the financial year was £4,601,000 (2023: £2,639,000). The notes at pages 39 to 59 form part of these accounts.

The accounts were approved by Trustees on 3[rd] July 2024 and are signed on their behalf by

Keith Marriott, Chair

MIDLANDS AIR AMBULANCE CHARITY

CONSOLIDATED STATEMENT OF CASHFLOWS
for the year ending 31 March 2024
	Group	Group
	2024	2023
	£’000	£’000
Cash used in operating activities	3,121	3,737
Cash flows from investing activities
Dividends and Interest from investments	833	386
Purchase of fixed assets	(3,581)	(5,766)
Increase in short term deposits	(3,744)	(124)
Cash (used in) investing activities	(6,492)	(5,504)

Cash used in financing activities
(Decrease)/Increase in cash and cash equivalents in the year	(3,371)	(1,767)
Cash and cash equivalents at the beginning of the year	12,133	13,900
Total cash and cash equivalents at the end of the year	8,762	12,133
RECONCILIATION OF NET INCOME/(EXPENDITURE) TO NET CASH	FLOW FROM
OPERATING ACTIVITIES
	Group	Group
	2024	2023
	£’000	£’000
Net income for the period	4,550	2,760
Depreciation and amortisation charges	907	731
Movement on investments	(987)	1,181
Dividends, and interest from investments	(1,329)	(835)
Increase in stocks	(9)	(27)
Decrease/(Increase) in debtors	182	(419)
(Decrease)/Increase in creditors	(193)	346
Net cash in from operating activities	3,121	3,737
ANALYSIS OF CASH AND CASH EQUIVALENTS
	Group	Group
	2024	2023
	£’000	£’000
Cash in hand	8,762	12,133
Total cash and cash equivalents at the end of the year	8,762	12,133

MIDLANDS AIR AMBULANCE CHARITY

NOTES TO THE FINANCIAL STATEMENTS

1. Accounting policies

The principal accounting policies adopted, judgements and key sources of estimation uncertainty in the preparation of the financial statements are as follows:

Basis of preparation

The financial statements have been prepared in accordance with Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (2019) - (Charities SORP (FRS 102)), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Companies Act 2006.

Midlands Air Ambulance Charity meets the definition of a public benefit entity under FRS 102. Assets and liabilities are initially recognised at historical cost or transaction value unless otherwise stated in the relevant accounting policy note.

Use of estimates and judgements

When preparing the financial statements, the Trustees and management make a number of judgements, estimates and assumptions on the way in which assets, liabilities, income and expenditure is recognised and measured.

The loan to the trading company by the Charity has been recognised at the present value in recognition of the changes required by FRS 102. The loan has been issued on an interest free basis.

Going concern

These accounts have been prepared on the basis that the Charity is a going concern. The Trustees consider that there are sufficient reserves to secure the future of the Charity for at least the next 12 to 18 months from the date of signing the accounts.

Basis of consolidation

These accounts consolidate those of the Charity and its wholly owned subsidiary Midlands Air Ambulance Trading Limited. These are adjusted, where necessary, to conform to group accounting policies. The individual results of the Trading Company are included in Note 3. A separate Statement of Financial Activities and Income and Expenditure Account for the Charity have not been presented in accordance with the exemption afforded by section 408 of the Companies Act 2006. The Charity surplus before gains/losses on investments for 2024 was £3,614,000 (2023: £3,820,000). This is made up of Income £19,173,000 (2023: £16,666,000) and Expenditure £15,559,000 (2023: £12,846,000).

MIDLANDS AIR AMBULANCE CHARITY

NOTES TO THE FINANCIAL STATEMENTS

1. Accounting policies continued

Fund accounting

Unrestricted funds are available to spend on activities that further any of the purposes of the Charity. Designated funds are unrestricted funds of the Charity, which the Trustees have decided, at their discretion, to set aside to use for a specific purpose. Restricted funds are donations that the donor has specified are to be solely used for particular purposes or purchases.

Income

All income is reported gross when raised by the Charity or its agents. Any fee charged by a third party and deducted from the amount collected before it is remitted to the Charity is not offset against income but is reported as a fundraising expense.

Income is recognised in full within the Statement of Financial Activities as soon as the following three factors can be met:

Entitlement – control over the rights or other access to the economic benefit has passed to the Charity;
Probability – it is more likely than not that the economic benefits associated with the transaction or gift will flow to the Charity;
Measurement – the monetary value or amount of the income can be measured reliably, and the costs incurred for the transaction and the costs to complete the transaction can be measured reliably.
a) Legacies

Legacies are included in the Statement of Financial Activities when all the criteria for income recognition have been met. The basis is that 50% of the predicted total value is included in the Statement of Financial Activities.

b) Event income

Income received in advance of an event is deferred if the event takes place after the year-end, unless that income is non-refundable.

c) Gifts in kind

Assets donated to the Charity for its own use are included in the Statement of Financial Activities as incoming resources at the market value at the time of the gift.

Assets and gifts made for conversion into cash and subsequent application by the Charity are included in the accounting period in which the item/s are sold at the sale value.

d) Volunteers and supporters

The Charity benefits greatly from the involvement and enthusiastic support of its many volunteers and supporters, details of which are given in our annual report. In accordance with FRS 102 and the Charities SORP (FRS 102), the economic contribution of general volunteers is not recognised in the accounts.

MIDLANDS AIR AMBULANCE CHARITY

NOTES TO THE FINANCIAL STATEMENTS

1. Accounting policies continued

Expenditure

Expenditure is recognised once there is a legal or constructive obligation to make a payment to a third party, it is probable that settlement will be required, and the amount of the obligation can be measured reliably.

a) Allocation of overhead and support costs

Support costs are those functions that assist the work of the Charity but do not directly undertake charitable activities. Support costs include back-office costs, finance, personnel, facilities, payroll and governance costs which support the Charity’s air ambulance operations. These costs have been allocated between the cost of raising funds and expenditure on charitable activities. The bases on which support costs have been allocated are set out in note 7.

Costs of fundraising activities include the costs of supporting donors, volunteers, and all events, which bring in income to the Charity, as well as the costs of the Lottery, and events run by the Charity itself.

b) Operating leases

The Charity classifies the lease of premises and the helicopter as operating leases as the title to the asset remains with the lessor. Rental charges are charged according to the terms of the agreement. Full details are provided in Note 18.

c) VAT recovery

Government changes in VAT legislation in April 2015, has enabled air ambulance charities to recover a proportion of the VAT suffered on costs, in accordance with Section 33 of VAT Notice 1001. Any irrecoverable VAT is charged as a cost against the activity for which the expenditure was incurred.

Balance Sheet

The Balance Sheet reflects the resources available to the Charity, and identifies any restrictions placed on their use.

a) Tangible fixed assets

Individual fixed assets costing £1,000 or more are capitalised at cost and depreciated over their estimated useful economic lives on a straight-line basis.

Depreciation is charged in each main class of tangible asset as follows:

Freehold Buildings 2% straight line basis Leasehold Buildings straight line over the remaining term of the lease Land no depreciation Equipment and Fittings 20% straight line basis Computers 20% straight-line basis Vehicles 33% straight-line basis

MIDLANDS AIR AMBULANCE CHARITY

NOTES TO THE FINANCIAL STATEMENTS

1. Accounting policies continued

Aircraft 5% straight-line basis

Assets in the course of Construction

use

b) Intangible assets

Intangible assets e.g., software is capitalised at cost and amortised as follows:

Software 20% straight-line basis

c) Investments

Investment funds are stated at market value at the Balance Sheet date. The Statement of Financial Activities includes the net gain or loss during the financial year. Detailed analysis of the changes in investment value during the year is set out in Note 15. Investments in Group undertakings are stated at cost.

d) Financial instruments

The Charity only has financial assets and financial 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.

e) Stock

Stock is included at the lower of cost or net realisable value, on a first in, first out basis. Donated items of stock are recognised at fair value, which is the amount the Charity would have been willing to pay for the items on the open market.

f) Debtors

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

g) Short term deposits

The Charity categorises short term deposits as those funds intended to be held in accounts for five years or less.

h) 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 after allowing for any trade discounts due. Interest free intercompany loans are recognised at present value.

MIDLANDS AIR AMBULANCE CHARITY

NOTES TO THE FINANCIAL STATEMENTS

1. Accounting policies continued

Financial instruments

Basic financial instruments are initially recognised at transaction value and subsequently measured at amortised cost with the exception of investments, cash at bank and in hand, and short-term deposits which are held at fair value.

Financial assets held at amortised cost comprise trade and other debtors. A specific provision is made for debts for which recoverability is in doubt. Cash at bank and in hand is defined as all cash held in instant access bank accounts and used as working capital.

Financial liabilities held at amortised cost comprise all creditors except social security and other taxes, accruals, and provisions.

Critical accounting judgements and key sources of estimation uncertainty

In the application of the accounting policies, Trustees are required to make judgement, estimates and assumptions about the carrying value of assets and liabilities that are not readily apparent from other sources. The estimates and underlying assumptions are based on historical experience and other factors that are considered to be relevant. Actual results may differ from these estimates.

The estimates and underlying assumptions are reviewed on an on-going basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised if the revision affects only that period or in the period of the revision and future periods if the revision affected current and future periods.

Judgements made by the Trustees in the application of these accounting policies may have significant effect on the financial statements and estimates with the potential for a significant risk of material adjustment in the next year.

The areas where these judgements and estimates have been made include the following for the Group:

a) Amortisation, depreciation and residual values

The Trustees have approved the approach that the management team review the asset lives of all tangible and intangible fixed asset classes and have concluded that the length of the asset lives are appropriate.

b) Accrued income

Accrued income includes legacy income amounts. In recognising accrued legacy income, the Trustees have approved the approach that the management team take in recognising the probability of receiving each legacy based on whether the criteria for income recognition have been met. Each legacy is then carefully assessed and 50% of the predicted total value is accrued.

MIDLANDS AIR AMBULANCE CHARITY

NOTES TO THE FINANCIAL STATEMENTS

2. Income from donations and legacies

Donations Lottery and regular giving Legacies and in memorium Grants and other income	2024 2023 £’000 £’000 2,145 1,718 6,040 5,774 6,236 5,784 2,974 2,243
	17,395 15,519

Of the income received during the year £3,154,000 is restricted in its use (2023: £2,088,000). Further details of these received are set out in Note 19.

3. Trading activities

The wholly owned trading subsidiary Midlands Air Ambulance Trading Company Limited is incorporated in the United Kingdom (company number 08256466) and pays profits, which are surplus to trading requirements, to the Charity under the gift aid scheme.

The trading company operates charity shops selling clothing, furniture etc., sells merchandise and generates recycling income. The summary financial performance of the subsidiary is:

Statement of Comprehensive Income Turnover Cost of sales Gross profit Administrative expenses Operating profit Donation to Midlands Air Ambulance Charity Taxation Retained (loss)profit Balance Sheet Fixed assets Current assets Current liabilities Liabilities > 1 year Total net assets/(liabilities) Share capital and reserves	2024 2023 £’000 £’000 1,299 996 (51) (48)
	1,248 948 (1,102) (749)
	146 199 (197) (78) - - (51) 121
	2024 2023 £’000 £’000 18 26 322 375 (171) (144) - (38)
	169 219

	169 219

MIDLANDS AIR AMBULANCE CHARITY

NOTES TO THE FINANCIAL STATEMENTS

4. Fundraising events and activity

The Charity raises its income through a range of activities and initiatives, which includes but is not limited to running its own events as identified below:

Income from events Charity managed events	2024 2023 £’000 £’000 198 178
	198 178

The costs of generating all the funds, including those included in Note 2 to the accounts, for the year were:

Costs of charity fundraising Fundraising events Marketing Fundraising services General fundraising Investment income and fees Income Fixed asset investments Interest on deposit accounts Costs Investment management costs paid through investment portfolio Investment management costs paid direct	2024 2023 £’000 £’000 251 268 859 585 1,408 1,366 1,641 1,305
	4,159 3,524
	2024 2023 £’000 £’000 512 485 833 387
	1,345 872
	15 37 20 10
	35 47

5. Investment income and fees

The income and costs outlined above have been recognised in the Statement of Financial Activity in year. The fixed asset investment is held as a long-term investment. Its market value at the end of the accounting period is shown in the Balance Sheet, and the unrealised gain for the financial year has also been included on the Statement of Financial Activity. All of the Group’s investment income is held in UK bank accounts.

MIDLANDS AIR AMBULANCE CHARITY

NOTES TO THE FINANCIAL STATEMENTS

6. Charitable activities

. Charitable activities
Aircraft running costs Aircraft and airbase equipment Airbase running costs Depreciation Paramedic and clinical staff costs Medical supplies and PPE General Expenditure Tasking costs Support costs Governance Total	Aircraft & Airbase Costs Patient Welfare & Support 2024 Total 2023 Total £’000 £’000 £’000 £’000 4,476 - 4,476 3,985 52 - 52 111 115 - 115 157 610 - 610 668 - 3,265 3,265 2,688 - 160 160 103 - 269 269 101 - 251 251 213 1,191 894 2,085 1,158 47 35 82 91
	6,491 4,874 11,365 9,275

Expenditure on charitable activities was £11,365,000 (2023: £9,275,000) of which £10,778,000 was unrestricted (2023: £9,156,000) and £502,000 was restricted (2023: £119,000) and £85,000 was designated (2023: £Nil).

7. Analysis of governance and support costs

The Charity monitors expenditure on administration costs during the year against the budget which is set by the Board. At the year-end costs of the governance function are identified and are apportioned over the charitable activities. The basis of apportionment and the analysis of these costs are set out below.

Governance Business Support Total	Aircraft & Airbase Costs Patient Welfare & Support 2024 Total 2023 Total Basis of Allocation £’000 £’000 £’000 £’000 47 35 82 91 Time spent on Board matters 1,191 894 2,085 1,158 Proportional to spend 1,238 929 2,167 1,249

8. Net income/(expenditure) for the year

This is stated after charging:	2024	2023
	£’000	£’000
Operating leases	3,556	3,301
Depreciation of tangible fixed assets	904	728
Amortisation of intangible assets	3	3
Audit fees	21	15

MIDLANDS AIR AMBULANCE CHARITY

NOTES TO THE FINANCIAL STATEMENTS

9. Consolidated Statement of Financial Activities 2023

Income: Donations and legacies Income from charitable activities: Income from other trading activities: Trading activities Fundraising events Investment income Other income Total income Expenditure Costs of raising funds Trading activities Fundraising activities and events Investment management costs Expenditure on charitable activities Aircraft and base costs Patient care and support Total expenditure Net gain/(loss) on investments Net income and net movement in funds for the year Transfers between funds Net Movement in funds Reconciliation of funds Total funds brought forward Total funds carried forward	Unrestricted funds Designated funds Restricted funds Total funds 2023 £’000 £’000 £’000 £’000 13,431 - 2,088 15,519 996 - - 996 178 - - 178 872 - - 872 97 - - 97
	15,574 - 2,088 17,662
	875 - - 875 3,517 - 7 3,524 47 - - 47 5,617 - 69 5,686 3,539 - 50 3,589
	13,595 - 126 13,721
	(1,181) - - (1,181)
	798 - 1,962 2,760
	6,043 (4,016) (2,027) -
	6,841 (4,016) (65) 2,760
	21,690 28,960 123 50,773
	28,531 24,944 58 53,533

MIDLANDS AIR AMBULANCE CHARITY

NOTES TO THE FINANCIAL STATEMENTS

10. Analysis of staff costs, and the cost of key management personnel

Salaries and wages Social security costs Employer’s costs of defined contribution pension scheme Employer’s costs of defined benefit pension scheme	2024 2023 £’000 £’000 4,981 4,068 518 442 83 55 297 273
	5,879 4,838

Pension costs are allocated to activities in proportion to the related staffing costs incurred and are wholly charged to unrestricted funds. At 31 March 2024 there were thirty-five (2023: thirty-five) members of staff who are members of the NHS Pension scheme, which is a defined benefit scheme. Contribution rates are set by the pension scheme. It is not possible to identify the Charity’s share of the underlying assets or liabilities within the scheme.

The Charity offers all other employees the opportunity to join a defined contribution pension scheme. Staff are auto enrolled, but each individual can subsequently choose to opt out, in accordance with the legislation. The Charity matches employee contributions to a maximum level which has been set and reviewed by the Trustees. In addition, the Charity maintains death in service insurance cover for staff.

The number of employees receiving remuneration in excess of £60,000 for the period was as follows:

£60,000 - £70,000 £70,000 - £80,000 £80,000 - £90,000 £90,000 - £100,000 £100,000 - £110,000 £110,000 - £120,000 £130,000 - £140,000 £160,000 - £170,000	2024 2023 £’000 £’000 21 13 5 3 - 1 1 1 1 - 1 - - 1 1 -
	30 19

Contributions made in year to pension schemes for higher paid employees amounted to £250,187 (2023: £151,705).

The key management personnel comprise the Chief Executive Officer, Chief Operating Officer, Finance Director, Medical Director, Director of Operations and Registered Manager, (2023: Chief Executive Officer, Chief Operating Officer, Finance Director, Medical Director, Director of Operations and Registered Manager). The total employee benefits of the key management personnel for the year were £712,593 (2023: £609,870).

During the year no termination payments were made (2023: none).

MIDLANDS AIR AMBULANCE CHARITY

NOTES TO THE FINANCIAL STATEMENTS

10. Analysis of staff costs, and the cost of key management personnel continued

The holiday year-end is coterminous with the financial year-end. Staff can carry forward up to five days, in exceptional circumstances, approved by the Senior Leadership Team. Therefore, a provision of £2,975 (2023: £3,575) has been made in the accounts.

11. Trustee remuneration and expenses

The Charity Trustees were neither paid nor received any benefits from employment with the Charity or its subsidiary in the year (2023: £nil). Expenses amounting to £176 (2023: £150) were reimbursed to 1 (2023: 1) trustee during the year. No Charity Trustees received payment for professional or other services supplied to the Charity (2023: £nil).

The Charity holds trustees and directors Indemnity insurance cover of £5,000,000 (2023: £5,000,000), but the cost is not separable from the total cost of insurance.

12. Staff numbers

The average monthly numbers of employees (including casual and part-time staff) during the year were as follows:

Fundraising Facilities and Logistics Administration and HR Finance Clinical Trading Average head count	2024 2023 Number Number 23 19 7 5 12 9 6 5 57 59 33 21
	138 118

MIDLANDS AIR AMBULANCE CHARITY

NOTES TO THE FINANCIAL STATEMENTS

13. Tangible fixed assets

Consolidated

Aircraft Freehold Land & Buildings Leasehold Land & Buildings £’000 £’000 £’000 10,938 - 793 - - - - 11,293 -	Equipment & Fittings £’000 988 61 280	Computers £’000 111 201 121	Vehicles £’000 536 20 -	Assets in the course of construction Total £’000 £’000 9,253 22,619 3,299 3,581 (11,694) -
10,938 11,293 793	1,329	433	556	858 26,200
3,720 - 792 545 156 1	871 82	46 67	443 53	- 5,872 - 904
4,265 156 793	953	113	496	- 6,776

7,218 - 1	117	65	93	9,253 16,747

6,673 11,137 -	376	320	60	858 19,424

MIDLANDS AIR AMBULANCE CHARITY

REPORT OF THE TRUSTEES For the year ended 31 March 2024

13. Tangible fixed assets continued

Charity

Aircraft Freehold Land & Buildings Leasehold Land & Buildings £’000 £’000 £’000 10,938 - 793 - - - - 11,293 -	Equipment & Fittings £’000 914 61 280	Computers £’000 77 201 121	Vehicles £’000 536 20 -	Assets in the course of construction Total £’000 £’000 9,253 22,511 3,299 3,581 (11,694) -
10,938 11,293 793	1,255	399	556	858 26,092
3,720 - 792 545 156 1	806 80	28 64	443 53	- 5,789 - 899
4,265 156 793	886	92	496	- 6,688

7,218 - 1	108	49	93	9,253 16,722

6,673 11,137 -	369	307	60	858 19,404

MIDLANDS AIR AMBULANCE CHARITY

REPORT OF THE TRUSTEES For the year ended 31 March 2024

14. Intangible assets

Consolidated

Consolidated
Cost: As at 1 April 2023 Additions As at 31 March 2024 Amortisation: As at 1 April 2023 Charge for the year As at 31 March 2024 Net Book Value At 1 April 2023 At 31 March 2024 Charity Cost: As at 1 April 2023 and 31 March 2024 Additions As at 31 March 2024 Amortisation: As at 1 April 2023 Charge for the year As at 31 March 2024 Net Book Value At 1 April 2023 At 31 March 2024	Software Total £’000 £’000 46 46 - -
	46 46
	34 34 3 3
	37 37
	12 12
	9 9
	Software Total £’000 £’000 41 41 - -
	41 41
	29 29 3 3
	32 32
	12 12
	9 9

MIDLANDS AIR AMBULANCE CHARITY

REPORT OF THE TRUSTEES For the year ended 31 March 2024

15. Investments (Group and Charity)

The Charity’s investment policy is outlined within the Trustee’s report and is reviewed annually. The investments held at year-end were:

Market value at 1 April 2023 Additions at cost Disposal proceeds Movements in capital account Net gain/(loss) on revaluation Market value at 31 March 2024 Historical cost at period end	2024 2023 £’000 £’000 15,187 15,919 515 454 (11) (24) (8) 19 987 (1,181)
	16,670 15,187

	13,904 13,405

In addition to the above managed investment the Charity holds the following investment in subsidiary undertakings.

Midlands Air Ambulance Trading Limited	2024 2023 £ £ 1 1

The investment represents a 100% holding of the issued share capital of Midlands Air Ambulance Trading Limited, a subsidiary undertaking which was incorporated on 17 October 2012 and commenced to trade on 7 December 2012.

16. Debtors

6. Debtors
Trade debtors Prepayments Accrued income Amount due from subsidiary VAT recoverable Other debtors	Group Charity 2024 2023 2024 2023 £’000 £’000 £’000 £’000 6 16 4 15 603 581 571 557 739 977 739 977 - - 67 103 172 128 158 113 11 11 2 2
	1,531 1,713 1,541 1,767

Amounts due to the Charity from the subsidiary include an agreed loan, which at 31[st] March 2024 showed amounts due within one year £38,000 (2023: £38,000) and amounts due in more than one year of £Nil (2023: £38,000).

MIDLANDS AIR AMBULANCE CHARITY

REPORT OF THE TRUSTEES For the year ended 31 March 2024

17. Creditors: amounts falling due within one year

Trade creditors Accruals Other creditors Taxation and social security costs	Group Charity 2024 2023 2024 2023 £’000 £’000 £’000 £’000 795 1,359 762 1,348 792 464 721 398 72 72 62 63 184 141 184 141
	1,843 2,036 1,729 1,950

18. Commitments under operating leases

At 31[st] March Group companies had commitments under operating leases set out below. In accordance with FRS 102 these are stated at the minimum lease payments.

Within one year Within two to five years	Land & Buildings Helicopters 2024 2023 £’000 £’000 £’000 £’000 51 3,195 3,246 3,279 12 - 12 74
	63 3,195 3,258 3,353

19. Total Funds

Consolidated – Current Year

Restricted funds County Air Ambulance Trust Various donors Designated funds Fixed asset fund Aircraft development Capital Project fund Clinical Costs fund Unrestricted reserves Expenditure fund Development plan General fund Total funds	Balance Incoming Outgoing Transfers/ Balance 1 April Resources Resources Gains and 31 March 2023 (Losses) 2024 £’000 £’000 £’000 £’000 £’000 18 1,793 (118) (6) 1,687 40 1,361 (384) (2) 1,015
	58 3,154 (502) (8) 2,702
	13,366 - - - 13,366 1,500 - - - 1,500 7,907 - (85) (1,738) 6,084 2,171 - - - 2,171
	24,944 - (85) (1,738) 23,121
	25,516 - - 3,655 29,171 1,500 - - - 1,500 1,515 17,318 (16,322) (922) 1,589
	28,531 17,318 (16,322) 2,733 32,260

	53,533 20,472 (16,909) 987 58,083

MIDLANDS AIR AMBULANCE CHARITY

REPORT OF THE TRUSTEES For the year ended 31 March 2024

19. Total Funds continued

Consolidated – Prior Year

Restricted funds County Air Ambulance Trust Home Office Birmingham City Council The Hospital Saturday Fund Capital Funding Project Various donors Designated funds Fixed asset fund Aircraft development Capital Project fund Clinical Costs fund Unrestricted reserves Expenditure fund Development plan General fund Total funds	Balance Incoming Outgoing Transfers/ Balance 1 April Resources Resources Gains and 31 March 2022 (Losses) 2023 £’000 £’000 £’000 £’000 £’000 115 - (97) - 18 5 - (5) - - 2 - (2) - - 1 - (1) - - - 2,027 - (2,027) - - 61 (21) - 40
	123 2,088 (126) (2,027) 58
	13,366 - - 3 13,366 1,500 - - - 1,500 11,926 - - (4,019) 7,907 2,171 - - - 2,171
	28,960 - - (4,016) 24,944
	19,814 - - 5,702 25,516 1,500 - - - 1,500 376 15,574 (13,595) (840) 1,515
	21,690 15,574 (13,595) 4,862 28,531

	50,773 17,662 (13,721) (1,181) 53,533

MIDLANDS AIR AMBULANCE CHARITY

REPORT OF THE TRUSTEES For the year ended 31 March 2024

19. Total Funds continued

Charity – Current Year

	Balance	Incoming	Outgoing	Transfers/	Balance
	1 April	Resources	Resources	Gains and	31 March
	2023			(Losses)	2024
	£’000	£’000	£’000	£’000	£’000
Restricted funds
County Air Ambulance Trust	18	1,793	(118)	(6)	1,687
Various donors	40	1,361	(384)	(2)	1,015
	58	3,154	(502)	(8)	2,702
Designated funds
Fixed asset fund	13,366	-	-	-	13,366
Aircraft development	1,500	-	-	-	1,500
Capital Project fund	7,907	-	(85)	(1,738)	6,084
Clinical Costs fund	2,171	-	-	-	2,171
	24,944	-	(85)	(1,738)	23,121
Unrestricted reserves
Expenditure fund	25,516	-	-	3,655	29,171
Development plan	1,500	-	-	-	1,500
General fund	1,295	16,019	(14,972)	(922)	1,420
	28,311	16,019	(14,972)	2,733	32,091

Total funds	53,313	19,173	(15,559)	987	57,914

MIDLANDS AIR AMBULANCE CHARITY

REPORT OF THE TRUSTEES For the year ended 31 March 2024

19. Total Funds continued

Charity – Prior Year

	Balance	Incoming	Outgoing	Transfers/	Balance
	1 April	Resources	Resources	Gains and	31 March
	2022			Losses	2023
	£’000	£’000	£’000	£’000	£’000
Restricted funds
County Air Ambulance Trust	115	-	(97)	-	18
Home Office	5	-	(5)	-	-
Birmingham City Council	2	-	(2)	-	-
The Hospital Saturday Fund	1	-	(1)	-	-
Capital Funding Project	-	2,027	-	(2,027)	-
Various donors	-	61	(21)	-	40
	123	2,088	(126)	(2,027)	58
Designated funds
Fixed asset fund	13,363	-	-	3	13,366
Aircraft development	1,500	-	-	-	1,500
Capital Project fund	11,926	-	-	(4,019)	7,907
Clinical Costs fund	2,171	-	-	-	2,171
	28,960	-	-	(4,016)	24,944
Unrestricted reserves
Expenditure fund	19,814	-	-	5,702	25,516
Development plan	1,500	-	-	-	1,500
General fund	277	14,578	(12,720)	(840)	1,295
	21,591	14,578	(12,720)	4,862	28,311

Total funds	50,674	16,666	(12,846)	(1,181)	53,313

Restricted funds

The Charity is grateful to numerous organisations for their support. All the funds are restricted to the purpose for which they were given. The income from County Air Ambulance Trust has been given to refurbish our Strensham airbase. The income from the various donors has been given to assist with the funding of the purchase of the new H145 D3 helicopter. Where costs have been capitalised, the balance is transferred to unrestricted reserves once the grant has been spent.

Designated funds

The fixed asset fund is an amount set aside to cover the replacement cost of fixed assets used by the Charity for charitable purposes. This is calculated as approximately the cost value on the balance sheet of the fixed assets held at the end of the year, excluding land and buildings.

Funds have been set aside for the development of our owned aircraft G-OMAA, and G-RMAA in order to ensure these aircraft remain fit for purpose throughout their useful lives. Expenditure in this regard is not time limited.

MIDLANDS AIR AMBULANCE CHARITY

REPORT OF THE TRUSTEES For the year ended 31 March 2024

The capital project fund relates to any future costs at our Airbase and Charity Headquarters building located at Airbase Avenue, Neachley Shifnal.

The clinical costs fund is to cover any increased costs of the clinical service in line with the three-year clinical plan.

20. Analysis of net asset by fund

Current Year Tangible and intangible fixed assets Investments Cash at bank and in hand and short term deposits Other net current (liabilities)/assets Total Prior Year Tangible and intangible fixed assets Investments Cash at bank and in hand and short term deposits Other net current (liabilities)/assets Total	Restricted Designated Unrestricted 2024 Funds Funds Funds Total £’000 £’000 £’000 £’000 - 13,366 6,067 19,433 - - 16,670 16,670 2,702 9,755 9,757 22,214 - - (234) (234)
	2,702 23,121 32,260 58,083
	Restricted Designated Unrestricted 2023 Funds Funds Funds Total £’000 £’000 £’000 £’000 25 13,366 3,368 16,759 - - 15,187 15,187 33 11,578 10,230 21,841 - - (254) (254)
	58 24,944 28,531 53,533

21. Financial instruments

Financial assets Financial assets measured at fair value through profit or loss Financial assets that are debt instruments measured at amortised cost Financial liabilities Financial liabilities measured at amortised cost	2024 2023 £’000 £’000 38,884 37,028 17 27
	38,901 37,055
	867 1,431
	867 1,431

MIDLANDS AIR AMBULANCE CHARITY

REPORT OF THE TRUSTEES For the year ended 31 March 2024

21. Financial instruments (continued)

Financial assets measured at fair value through profit or loss comprise of investments, cash at bank and in hand, and short-term deposits.

Financial assets measured at amortised cost comprise trade debtors and other debtors.

Financial liabilities measured at amortised cost comprise trade creditors, and other creditors.

22. Related party transactions

Transactions occurred during the year between the Charity and trading company. For the Charity the income was £675,000 (2023: £412,637) and expenditure was £675,911 (2023: £412,286). Money owed to the Charity from the trading company at the year-end was £28,550 (2023: £27,638).

No trustee or other person related to the Charity had any personal interest in any contract or transaction entered into by the Charity during the period.

During the period, none of the MAAC Trustees, MAATL Directors or members of the key management staff, or parties related to them, has undertaken any related party transactions that require disclosure.

23. Capital Commitments

At 31 March 2024 there were capital commitments of £8,982,757 (2023: £2,005,029). £131,565 being the retention relating to the build of the Airbase and Charity Headquarters building, and £8,851,192 for the purchase of the new Airbus H145 D3 Helicopter.