DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
Registered number: 07450026 Charity number: 1143189
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED
(A company limited by guarantee)
UNAUDITED
TRUSTEES' REPORT AND FINANCIAL STATEMENTS
YEAR ENDED 30 NOVEMBER 2020
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
CONTENTS
| Page | |
|---|---|
| Reference and administrative details of the company, its Trustees and advisers | 1 |
| Trustees' report | 2 - 15 |
| Independent examiner's report | 16 - 17 |
| Statement of financial activities | 18 |
| Balance sheet | 19 - 20 |
| Notes to the financial statements | 21 - 37 |
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
REFERENCE AND ADMINISTRATIVE DETAILS OF THE COMPANY, ITS TRUSTEES AND ADVISERS FOR THE YEAR ENDED 30 NOVEMBER 2020
| Trustees | D Doughty, Chair |
|---|---|
| R Stancliffe | |
| M Smeeth | |
| G Manning | |
| J Rhys-Griffith | |
| F Daly (resigned 27 December 2019) | |
| Dr C Jessel (resigned 15 December 2019) | |
| D Mackay (appointed 6 January 2020) | |
| Dr R Hixson (appointed 6 January 2020) | |
| Company registered number 07450026 Charity registered number 1143189 Registered office 8 King Edward Street Oxford Oxfordshire OX1 4HL Principal operating office Cranbrook House 287 - 291 Banbury Road Oxford Oxfordshire OX2 7JA Chief executive officer R Stancliffe Accountants Wellers Independent Examiners 8 King Edward Street Oxford OX1 4HL |
Page 1
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
TRUSTEES' REPORT FOR THE YEAR ENDED 30 NOVEMBER 2020
The Trustees present their annual report together with the financial statements for the 1 December 2019 to 30 November 2020. The Trustees confirm that the Annual Report and financial statements of the company comply with the current statutory requirements, the requirements of the company's governing document and the provisions of the Statement of Recommended Practice (SORP), applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2015) as amended by Update Bulletin 1 (effective 1 January 2015).
Since the company qualifies as small under section 383, the strategic report required of medium and large companies under The Companies Act 2006 (Strategic Report and Director's Report) Regulations 2013 is not required.
Objectives and activities
a. Policies and objectives
The Trustees confirm that they have referred to the guidance contained in the Charity Commission’s general guidance on public benefit when reviewing the Charity’s aims and objectives, and in planning future activities and setting future policies, therefore have complied with the duty in section 17 of the Charities Act 2011. In line with Charity Commission guidance our objectives are determined by our defined charitable objectives
-
Transforming healthcare for a sustainable future.
-
Ensuring that health is safeguarded in a time of resource restraint.
-
Educating healthcare professionals and others about links between health and the environment.
b. Strategies for achieving objectives
CSH Strategies for achieving Objectives are:
-
engaging healthcare professionals, patients and the wider community in sustainability and the links between health and environment
-
engaging other industries and organisations in the healthcare sector
-
assessing current knowledge, barriers and opportunities for sustainable healthcare.
-
improving research into more sustainable options.
-
helping the NHS to reduce its carbon footprint.
Page 2
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 30 NOVEMBER 2020
Objectives and activities (continued)
c. Activities undertaken to achieve objectives
-
developing and running programmes and tools that can help to engage healthcare professionals and others.
-
sharing ideas and knowledge with other organisations to engage them with sustainable healthcare.
-
running networks to enable natural communities in healthcare to share ideas and questions.
-
working to include sustainability in medical education via curriculum development and other areas.
-
developing courses in various elements of sustainable healthcare and teaching them.
-
carrying out reviews of current research and other information on barriers and opportunities for sustainable healthcare.
-
identifying and/or carrying out research into more sustainable options for healthcare.
-
measuring the carbon footprint of services, medical products and clinical pathways.
-
developing standardised methodology for carbon footprinting and measuring the triple bottom line in healthcare.
-
promote planting trees as a mechanism to engage staff, patients and visitors with sustainability.
-
working with NHS sites to make the links between health and the environment through the NHS Forest projects.
-
improving access to green space through green health routes with the aim of improving health.
d. Volunteers
CSH continues to benefit from volunteers who have worked on central projects and tasks. During 2020 our 12 Committee members for the Sustainable Healthcare Education Programme suspended work due to the pandemic. We were joined by two GPs, (Tamsin Ellis and Mike Tomson), one medical academic (Anna Moore), and a physiotherapist (Peter May, who has since been hired by Greener NHS). In 2021 we plan an expansion of the volunteers programme, by increasing numbers, grouping them into batches, offering a standardised induction, and asking for a minimum six month commitment (4-8 hours per week), or full time for one month.
Achievements and performance
a. Review of activities
Despite some disruption to activities due to Covid-19, CSH has had an extremely busy year with both ongoing and new projects.
• Our Sustainability School training programme has proven to be a very popular way for people to share experience and to build networks and ideas in this field. The courses ran in person at the start of 2020 and then, when Covid-19 stopped physical meetings, we explored options for online platforms. After analysing several options and talking to some potential course platforms, we decided to design our own Sustainable Healthcare Learning Platform. This meant a lot of work to put the course material online, but has allowed us to continue to teach the courses and to expand their reach during the year. Altogether, 268 healthcare professionals participated in the training days this year. The feedback from the attendees has been very positive.
• In addition to the courses for individuals, we have provided bespoke training for groups such as a Public Health group in Yorkshire, The Health Foundation and Sahlgrenska Medical University, Sweden.
• In order to maximise our impact during this year we made use of many different media channels.
Staffing changes
In 2020, CSH continued growth in three ways:
Page 3
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 30 NOVEMBER 2020
Achievements and performance (continued)
-
by employing a new Fellow in anaesthesia to continue the work in that specialty, and a Fellow and staff member in Quality Improvement as part of a 2-year programme funded by Health Education England and the Health Foundation;
-
by expanding the capacity within our existing programmes. We employed a part-time person to manage the courses and other admin, and increased days for other staff to enable growth of programmes;
-
by growing the strands of work that are more within our control: Green Wards, Green Surgery Challenge and the training courses.
Green Space Programme in 2019/20
Health Routes
Programme which works in partnership with health professionals and others to support communities in accessing green space for health by creating neighbourhood maps of green space and walking routes, establishing regular health walks, running educational activities in schools, and community- based activities to celebrate local green space and nature connection. Recently funded by Postcode Lottery and Awards for All.
East Oxford: Planned and carried out school nature-based workshop for the East Oxford Health Routes project. Handed over East Oxford health walk to regular volunteer walk leader. Produced and distributed additional materials to celebrate green space. Completed work on this project and reported to funders.
-
Botley: Successfully applied for Botley health routes project. Liaised with local stakeholders, conducted consultations and started to test routes for creation of new map.
-
Wood Farm: Redeveloped Wood Farm map following earlier issues.
-
Worked with Oxford Preservation Trust to have Green Health Routes maps available online with supporting information as part of Oxford Open Doors Goes Outside in September 2020.
-
Invited to quote for health route for Bourton on the Water.
Impact of pandemic: health walks prevented through much of the year, with limited re-start of East Oxford work before second lockdown. Difficulties in access to schools in Botley project has restricted activities to providing resources. Currently planning activities in hope of being able to run them later in 2021.
FAST
A contract to carry out qualitative evaluation and reporting, including the interpretation of quantitative data, collected for the FAST programme. Led by Cherwell District Council, and funded by Sport England, FAST offers school-based activity sessions and a raft of attractively priced offers to encourage families in the district’s more disadvantaged areas to become more active.
-
Developed the FAST evaluation plan
-
Developed, organised and collected FAST preferences survey (online survey of families in the programme)
-
Developed, made arrangements with schools and carried out kid's evaluation activity (FAST)
-
Liaised with Substance on changes to the FAST portal
-
Planned, conducted and transcribed interviews with FAST participants
-
Gathered qualitative and quantitative information and wrote the FAST May 2020 report
-
Developed, organised and collected FAST lockdown survey
-
Will be producing second 2020 report before end of the year.
Impact of pandemic: core programme of school family sessions has been suspended. We were unable to run focus groups and children’s evaluation sessions as planned. Have had to replace this with electronic surveys both to gain a view of family preferences and to explore experience of lockdown. Pandemic has also made it difficult to deal with problems in collection of follow-up data required by Substance for Sport England monitoring.
Page 4
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 30 NOVEMBER 2020
Achievements and performance (continued)
Sustainability School Green Space and Health Day
A learning package aimed at health professionals, currently offered online, which focuses on the benefits of nature for health and the implications for healthcare, with a strong emphasis on practical action.
-
Held first face to face green space training day (Feb 2020)
-
Developed study package on learning platform for online version of green space training day (Summer 2020)
-
Developed and ran two online green space training days (July and September 220) and one follow-up work in progress day, and set continuing programme in place for 2021.
Impact of pandemic: face to face training not possible but online courses have made it possible to reach a wider audience and develop our approach.
Bee Healthy
A project in collaboration with the Trust for Oxfordshire’s Environment which provides advice and funding to enable GP surgeries to plant pollinator friendly borders. Our role has been primarily in surgery recruitment, project evaluation and dissemination. Funded by the Postcode Lottery.
-
Developed advertising materials to be displayed at 3 participating surgeries
-
Planned, conducted and transcribed evaluative interviews with surgery staff
-
Liaised with Bee Healthy project facilitators to gather information for the project guide
-
Developed, organised and collected a survey with patients at participating surgeries
-
Contributed to funding report by lead partner
-
Contributed to funding application for expanded project (unsuccessful).
-
Produced and disseminated Bee Healthy Project Guide. Project now completed.
Impact of pandemic: Our evaluation was limited by difficulties in surveying patients as patients no longer come into the surgery as much and as there are infection control issues around carrying out surveys at surgeries. Evaluation therefore depended on staff and patients’ responses from participation groups.
NHS Forest and site network
A network of NHS sites (around 200) with an interest in making the most of their green space. The network includes the NHS Forest tree sponsorship scheme which secures funding for trees and distributes these free of charge to NHS sites.
-
Produced four newsletters – will be 5 by the end of the year – including associated blogs and news pieces.
-
Produced and disseminated NHS Forest Conference Report
-
Attracted sponsorship for 2815 trees sponsored this year with 1630 going out to plant this tree planting season and 295 planted January- March 2020. Ran campaign with Ecosia and 2.6 challenge to attract tree sponsorship. Out of the sponsored trees 1000 were from Ecosia, 500 from a private sponsor and 700 from TGOGC.
-
Undertook work to develop tree planting plan for Nuffield site using sponsorship from Green Templeton College; liaised with Earthwatch with a view to developing this scheme as a ‘tiny forest’.
-
• Responded to a wide range of inquiries.
Impact of pandemic: We have not held our annual conference this year. We could have run this on line, though we decided to put our efforts instead into the launch for the workplace wellbeing research (see below). We also had to cancel a planned tree planting event at Nuffield Orthapaedic Hospital because of difficulties in bringing
Page 5
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 30 NOVEMBER 2020
Achievements and performance (continued)
volunteers on to site.
Workplace wellbeing and green space
A research project funded by the Health Foundation to explore staff experience of spending time in green space at work at three different NHS sites and put forward good practice recommendations.
-
Completed Space to Breathe research report on wellbeing.
-
Produced easy-read 12-page summary report on project.
-
Developed and ran launch event for Space to Breathe research (October 2020) including video and keynote from NHS Health and Wellbeing champion, attracting over 160 delegates.
-
Disseminated materials through sustainability school, IHM conference, SusQI event, Whipps Cross meeting and workplace wellbeing event (this last now postponed to Spring).
-
Ran two hot topics sessions internally on workspace wellbeing and green space.
-
Reported on project to funder. Project is now completed.
Impact of pandemic: we initially delayed publication of the research because this didn’t seem an appropriate focus at the start of the pandemic, but eventually launched materials in October. We initially planned seminar style events at individual hospitals but instead ran a large online event bringing hospitals together.
Magnificent Meadows
A project funded by the Welsh Government to encourage creation of meadow areas and engagement with meadow areas across Wales. The project is led by Plantlife and our role is to facilitate engagement activities, with a focus on health sites and health walks, and to disseminate learning from these to health sector in Wales.
-
Attended steering group meetings gave presentation on health routes concept.
-
Made progress in developing a meadows health route map, (route designed but awaiting final map). Spent time researching into local groups and engaging people in the people project - OTs, NHS staff including clinical, art therapist all engaged in the project - with an inaugural walk planned for May 2020 but postponed due to Covid. Produced and disseminated a green space questionnaire to over 50 NHS sites in Wales.
-
Publicised National Meadows Day.
Impact of pandemic: all activity on the project was suspended for several months because of concerns about encouraging people to go out. Project now resumed and our work re-scheduled.
Mount Vernon green space enhancement project
A project to enhance several green spaces at Mount Vernon Cancer Centre, funded by Heathrow Community Trust.
-
Oversaw and completed hard works (path and ramp) for redesign of sunken garden for chemo-therapy suite.
-
Some voluntary work undertaken to prepare garden for planting and schedule of plants drawn up.
-
• Furniture now on order for garden and hospital working towards Spring launch.
-
‘Fern Garden’ sign, with acknowledgement of funders, designed and ordered.
-
Volunteer restoration work on benches for Woodland Walkway.
-
Contributed to development of successful funding bid for upgraded Woodland Walkway scheme, to be put in place in 2021, including fully accessible self-binding gravel pathway.
-
Carried out research for interpretive sign for planned Woodland Walkway trail.
-
Arranged for Plantlife meadows adviser to visit the site.
Page 6
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 30 NOVEMBER 2020
Achievements and performance (continued)
-
Updated steering group and liaised with hospital architect and other staff over project operational details e.g. planning permission.
-
Reported to funders on project progress, including delays resulting from lockdown and problems in bringing volunteers on to site.
Impact of pandemic: prevention of volunteers coming on to site and redeployment of community engagement officer led to delay in development and opening of the new Fern Garden. Lack of availablity of the volunteers also prevented progress on the woodland walkway. However, project has benefited from increase in funding for hospital charities which allowed us to upgrade the scheme and attract new grant for this.
Policy work and consultancy
Ongoing contributions to policy debates.
-
Contributed to Greener NHS consultation.
-
Contributed to round-table discussion on England Tree Strategy and consultation on social prescribing, both convened by DEFRA.
-
Took part in regular National Outdoors for All Working Group, including attending a task and finish group on equality and green space.
-
Conducted evaluation for North Wales Wildlife Trust.
Development
Developing applications for new funding
- Developed several funding applications, including to Awards for All, Cadent, the Kings Fund, the Health Foundation, Green Recovery Fund x 2, Postcode Lottery, Refinitiv, JSLF Emergency, Severn Trent and Heathrow Community Trust. Successful with Postcode Lottery (commenced July 2020) and Green Recovery (Confirmed December 2020).
Impact of pandemic: funding became very focused on immediate response to covid-19. However, subsequent green recovery funding offers new opportunities, as potentially does NHS Charities Together funding.
Clinical Programme: Highlights in 2019/20
The team continued to grow with appointment of Stefi Barna as Education Director and Siobhan ParslowWilliams as QI Education Lead, as well as appointment of a second in-house QI Education Fellow, who took over from the first Fellow in August 2020. In addition, we continue to provide mentoring and supervision to Fellows and Scholars, including a new Welsh Clinical Leadership Fellowship post and fellows in Anaesthesia, Surgery and scholars in Ophthalmology.
The Covid-19 pandemic impacted our clinical programmes, which work directly with front-line staff in healthcare provision and health professions education, many of whom had to suspend work on sustainability. However, the team used the disruption to invest in developing online resources and migrate our Sustainability School online.
Sustainability in QI Education
This project was initially funded for two years (2019-21) by the Health Foundation, Health Education England and King’s College London. The aims are to:
-
pilot the inclusion of sustainable healthcare principles within undergraduate and postgraduate QI education for health professionals.
-
evaluate the impact of this inclusion on learning, including engagement with QI.
Page 7
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 30 NOVEMBER 2020
Achievements and performance (continued)
- accelerate the national adoption of successful approaches by UK universities, Foundation Schools and other providers of QI education.
Despite disruptions CSH adapted the programme in 2020. We successfully migrated the SusQI teaching programme online and recruited further pilots for the 20-21 academic year, without which the second year of pilots would not have been possible. Achievements include:
-
Creation of https://susqi.org website housing open-access resources for QI practitioners and educators.
-
Teaching at four pilot sites in 2019/20 and nine sites in 2020/21 (in undergraduate medical schools, Foundation Doctors’ training, undergraduate and postgraduate nursing and undergraduate midwifery), with further eight sites pending for 2021/22.
-
Established a research partnership with the Medical Education Research Unit, Imperial College London who helped to develop the evaluation framework. The ethics application has been approved for multi-site evaluation.
-
Delivered a first online masterclass and presented to international education conferences.
Green Ward Competitions in University Hospitals Dorset NHS Foundation Trust and Frimley Health NHS Foundation Trusts, begun in the previous year, were completed with judging events held in Autumn 2020. The new online format which allowed greater participation from the teams and much greater digital reach – we trialled a parallel live Twitter event which reached hundreds of people. Sussex Green Ward Competition postponed to 2021 and there is interest from other Trusts for commissioning a competition after the pandemic.
Connecting Q
Grant received from the Health Foundation to support the development of the Sustainable Healthcare special interest group within their Q Community for QI leaders. Remote consultations virtual event run on 25th November with three further virtual events planned in 2021.
The Sustainable Specialties programme continues to be praised as an excellent model for developing networks for change in different areas of medicine and for pioneering transformative models of care. Networks for sustainable healthcare now exist in dentistry, eye health, nursing, education, kidney care (nephrology), mental health, respiratory medicine, occupational therapy, primary care, operating theatres, commissioning, endoscopy and emergency medicine.
Anaesthetics
Dr Cathy Lawson completed the first national Sustainable Anaesthesia fellowship, a partnership between CSH, the Association of Anaesthetists of Great Britain and Ireland and Newcastle University Hospitals NHS Foundation Trust. Cathy delivered a huge number of presentations to anaesthetic audiences across the UK contributing to a growing level of awareness among anaesthetists of pro-environmental champions. Other achievements include:
-
RCoA QI recipe book - two model sustainable QI projects provided for trainees
-
Association Green Star Awards – run at Annual Congress 2019 and WSM 2020 with plans for future to embed into abstract marking process
-
Association Environmental Champions Network set up. 46 registered champions at July 2020.
-
E-learning materials developed with RCoA and housed on e-Learning for Healthcare (NHS learning platform)
Surgery
As part of a collaboration with Brighton and Sussex Medical School CSH are hosting a Sustainable Surgery Fellowship. A surgical trainee, Miss Chantelle Rizan, took up post in August 2018 and continues to work with CSH on: a literature review of carbon footprinting in surgery; research into the carbon footprint of the most
Page 8
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 30 NOVEMBER 2020
Achievements and performance (continued)
common surgical procedures and evaluation of carbon reduction approaches; development of CSH’s Sustainable Operating Theatres online network; and engagement with key organisations including the Royal College of Surgeons. She has already published a number of high quality articles and presented at many conferences.
Green Surgery Challenge
Adapting the Green Ward competition to national specialty-based leadership programme. Very good engagement and profile from partnership with Royal Colleges of Surgery. Launch planned for February 2021, followed by recruitment of six teams to receive mentoring and SusQI support.
Kidney Care
Frances Mortimer, the Medical Director, was invited and presented to the Renal Association Council on relaunching a Sustainable Kidney Care programme. The RA plans to go ahead once the Covid-19 pandemic pressures have reduced. In the meantime she contributed a chapter on sustainability to an international Primer in Nephrology textbook.
Ophthalmology
CSH in partnership with the Environmental Sustainability Working Group (ESWG) has developed a guide and call to action for supporting the International Agency of Prevention of Blindness (IAPB) members to embed environmental sustainability in their eye care provision globally which has been finalised in March 2021.
CSH’s first W.I.S.E. (Wales, Ireland, Scotland and England) scholarship in sustainable Ophthalmology in Wales has come to an end at the end of August and a new scholar has started in September, thanks to funding from Thea. While the first scholar mainly worked on rolling the Eyefficiency tool out in Wales, the second scholar is carbon footprinting a device frequently used by Ophthalmologists and carrying out a survey on the attitude toward operating theatre waste amongst cataract surgeons and nurses. A new Barts Eye Scholar will be working on sustainable QI project to streamline the cataract pathway.
Mental Health
The Green Walking Project ‘How to …” Guide was launched in 2020. The online event was attended by 180 people with excellent support from senior MH figures. In 2021 we aim to raise funds to enable us to embed this programme in every NHS Mental Health Trust.
Occupational Therapy
CSH has a programme of OT sustainability volunteers with three volunteers who are all now working on new sustainability projects.
Education
Our Sustainability School training programme made a successful transition to online provision during 2020. Building on the three 8-hour workshop titles in 2019, we commissioned a new online learning platform in March 2020, and five 8-hour blended learning courses were launched in June 2020.
Altogether, 268 healthcare professionals participated in Sus School this year. The feedback from the attendees has been very positive.
Page 9
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 30 NOVEMBER 2020
Achievements and performance (continued)
Sus School workshops Leadership – 29 SusQI – 30 Greenspace - 17 Leeds [online] - 17
Sus School Courses launched in 2020 (June-Nov): Introduction to Sustainable Healthcare 50 Greenspace and Health 28 Sustainable Quality Improvement 36 SusQI for AHSN 25 Carbon Footprinting for the Health Sector 36
We also conducted a number of very well-attended webinars in 2020: Space to Breathe: Valuing green space at NHS sites for Staff wellbeing (22 Oct);Remote Consultations: What’s their role in Sustainable healthcare? (25 Nov).
The collaboration with Sahlgrenska Medical School at Gothenburg University, Sweden, continued in 2020 with a new commission to provide 10 days consulting with department heads to help them integrate sustainability into their curriculum.
We have also begun work on developing new Sus School Courses for launch 2021: Public Health Leadership for Sustainability Sustainable Dentistry Sustainable Primary Care Sustainable Mental Healthcare Sustainability in Healthcare I: Net Zero Healthcare (for Health Education England eLearning for Health platform) Introduction to Sustainable Healthcare (self study module for Medics Academy platform)
This year our 12 Committee members for the Sustainable Healthcare Education Programme suspended work due to the pandemic. We were joined by two GPs, (Tamsin Ellis and Mike Tomson), one medical academic (Anna Moore), and a physiotherapist (Peter May, who has since been hired by Greener NHS).
Volunteers
Volunteers have been noted under several programmes above.
In 2021 we plan an expansion of the volunteers programme, by increasing numbers, grouping them into batches, offering a standardised induction, and asking for a minimum six month commitment (4-8 hours per week), or full time for one month.
NHS Sustainability priorities
Following inclusion of Sustainability in the NHS Long Term Plan, there has been a focus on both inhalers and anaesthetic gases this year. Our Medical Director participates in national groups looking at both of these issues. Our Director has been involved in the national group looking at plastic in the NHS.
Carbon Footprinting Projects
With support of the Health Foundation, CSH has developed a step-by-step guide and carbon calculator on how to calculate the carbon emissions savings of avoided patient travel due to switching from in-person outpatient or
Page 10
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 30 NOVEMBER 2020
Achievements and performance (continued)
GP appointments to remote consultations. The guide also provides an outline of how the ‘rest’ of the carbon footprint of these two ways of conducting appointments can be calculated and compared.
CSH also took part in Ufonia’s small business research and innovation (SBRI) grant funded project looking at the feasibility and environmental sustainability of an AI automated phone triage for head and neck cancer as developed by Ufonia.
b. Fundraising activities/income generation
CSH has managed to secure new funding and to diversify our income streams to take advantage of emerging opportunities, achieving a booked income of £395,012.
The six main sources of income for this period were: The Health Foundation, Health Education England, a substantial donation, Cherwell District Council, Wales Cymru and Sahlgrenska Academy Gothenburg University.
Additional smaller pots of money were secured from: Heathrow Community Fund, Postcode Local Trust, several NHS Acute Trusts, Thea Pharmaceuticals, Ufonia, Trust for Oxfordshire’s Environment, Tree Sponsorship for the NHS Forest and via delegate fees for training Workshops/ conferences.
Financial review
a. Going concern
After making appropriate enquiries, the trustees have a reasonable expectation that the company has adequate resources to continue in operational existence for the foreseeable future. For this reason, they continue to adopt the going concern basis in preparing the financial statements. Further details regarding the adoption of the going concern basis can be found in the Accounting Policies.
b. Reserves policy
We are working towards achieving a sustainable reserve, in accordance with best practice, to cover three months of operational costs.
This includes, where possible, building in a contingency to cover for costs or timings that may alter. In line with many organisations, this has been particularly relevant during 2020 given the inevitably unpredictable Covid and post-Covid working scenarios, and the knock-on effect of this for charities working closely with the NHS. In addition, we are aiming to build in elements of budget requests to cover our core costs where possible and refocusing our activities to raise core funding.
c. Surplus
This financial year (Dec 2019 – Nov 2020) the charity had an income of £399,197 and expenditure of £400,998 resulting in an operating loss for the year amounting to £1,801.
Page 11
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 30 NOVEMBER 2020
d. Principal funding
The bulk of CSH’s funding is in the form of restricted grant or contract funding which includes a contribution to the Charity’s overheads.
Grants and contracts do not always align with CSH’s financial year.
£41,206 of restricted funds were received in the year for work due to be carried out in the 2020/21 financial period.
£20,710 of unrestricted funds covers work which has already been completed but will not be invoiced until the 2020/21 financial period.
CSH is working on increasing its revenue sources through the expansion of its online CSH Sustainability School, delivering commissioned training and developing commissioned e-learning modules, expanding the Green Ward Competition programme and offering consultancy in carbon modelling.
CSH will also give closer scrutiny to new grant funding proposals to ensure that there is a proportionate contribution to the Charity’s overheads.
Structure, governance and management
a. Constitution
The company is registered as a charitable company limited by guarantee and was set up by a Memorandum of Association on 24/11/2010.
The company is constituted under a Memorandum of Association dated 24/11/2010 and is a registered charity number 1143189.The company changed its Memorandum and Articles to better reflect its work after consultation with NCVO and is currently constituted under a Memorandum of Association and Articles dated 15/07/2011.
The principal object of the company is to provide:
-
The promotion of health for the benefit of the public in any part of the world.
-
The advancement of education for the benefit of the public in any part of the world by supporting the application and implementation of research findings to improve health and healthcare.
-
The conservation, protection and enhancement of the physical and natural environment by the prudent use of natural resources for the public benefit.
b. Methods of appointment or election of Trustees
The management of the company is the responsibility of the Trustees who are elected and co opted under the terms of the Articles of Association.
Page 12
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 30 NOVEMBER 2020
Structure, governance and management (continued)
c. Organisational structure and decision-making policies
The Trustees meet once every quarter, face to face and by phone conference for alternate meetings (as permitted). The Director of CSH provides a draft agenda and financial update 2 weeks before the meetings, with opportunity for each Trustee to contribute suggested items for the agenda. Meetings are also attended by at least one other employee of CSH – usually the financial lead. Decisions are taken at the meeting unless it is deemed important to get input from anyone not present in which case a clear set of options is circulated to all and responses are collated via email.
d. Policies adopted for the induction and training of Trustees
A Skills Audit has been used, which enables the Trustees to identify their own strengths and weaknesses and helps to identify training needs for existing individuals and gaps, which might be filled by new Trustees.
e. Related party relationships
As set out in the application to the Charities Commission and accepted by them, Rachel Stancliffe is both a Trustee and the Director of CSH, receiving a regular salary as such. As governed by the Articles, she will absent herself for any meeting or any part of the meeting in which a conflict of interest may arise.
f. Risk management
The Trustees have assessed the major risks to which the company is exposed, in particular those related to the operations and finances of the company, and are satisfied that systems and procedures are in place to mitigate our exposure to the major risks.
A system of assessing risks to the programmes has been put in place with a traffic light marking (red, amber and green) to highlight projects at risk during any stage of their progress. The risk assessment for projects is reviewed quarterly and the overall risk profile of the company is reviewed annually.
Plans for future periods
Future developments
For our green space programme, the activities planned for 2021 have continued to focus on larger projects with an element of research. We have applied for a large Green Recovery Challenge Fund grant which would enable substantial growth of our Green Space programme. Working in the national arena continues to benefit the organisation and project as a whole as well as growing CSH’s impact in this increasingly prominent field. We shall continue to prioritise:
-
New research based projects including further collaboration with the Health Foundation, and opportunities to extend the work evaluating the Sport England Families Active and Sporty Together (FAST) project
-
• Developing a more extensive programme of green health routes
-
Continued engagement of sites through activities such as the annual NHS Sustainability Day and tree planting opportunities
-
In depth NHS Forest site development via renewed national interest in tree-planting campaigns
-
taking part in including green prescribing in the new social movement of social prescribing, tackling the potential for green space to address health inequalities
Page 13
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 30 NOVEMBER 2020
Plans for future periods (continued)
For our clinical work, we shall build on the emerging opportunities to:
-
Launch our Green Walking Programme nationally, ensuring that every inpatient mental health setting has the opportunity to engage in walking outdoors.
-
Influence ‘future doctors’ via our Sustainable Health Education network’s activities and set up a Sustainability School training programme for early stage medical practitioners
-
Enhance new and existing partnerships to secure Sustainability Fellowships and Scholarships
-
We will continue to promote The Green Ward Competition programme and extend this into QI programme work
-
We are developing our offer for NHS Trusts and will work closely with sustainability leads in Trusts to develop this strand of work
-
Build the international relationships that come from the ‘Eyefficiency’ app
-
Build on our international partnerships with Toronto, Gothenburg, Yale and Rome Universities
Our communications officer will help us to develop strong messaging and to design some powerful campaigns which will increase our reach and impact.
Core funding for CSH is being sought from several grant making foundations.
Funds held as custodian
We do not hold any funds as custodian.
Members' liability
The Members of the company guarantee to contribute an amount not exceeding £1 to the assets of the charity in the event of winding up.
Engagement with employees and employment of the disabled
Employees have been consulted on issues of concern to them by means of regular consultative committee and staff meetings and have been kept informed on specific matters directly by management. The company carries out exit interviews for all staff leaving the organisation and has adopted a procedure of upward feedback for senior management and the Trustees.
The company has implemented a number of detailed policies in relation to all aspects of personnel matters including:
-
Equal opportunities policy
-
Volunteers' policy
-
Health & safety policy
In accordance with the company's equal opportunities policy, the company has long-established fair employment practices in the recruitment, selection, retention and training of disabled staff.
Full details of these policies are available from the company's offices.
Page 14
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 30 NOVEMBER 2020
Engagement with employees and employment of the disabled (continued)
Statement of Trustees' responsibilities
The Trustees (who are also the directors of the company for the purposes of company law) are responsible for preparing the Trustees' report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice).
Company law requires the Trustees to prepare financial statements for each financial year. Under company law, the Trustees must not approve the financial statements unless they are satisfied that they give a true and fair view of the state of affairs of the company and of its incoming resources and application of resources, including its income and expenditure, for that period. In preparing these financial statements, the Trustees are required to:
-
select suitable accounting policies and then apply them consistently;
-
observe the methods and principles of the Charities SORP (FRS 102);
-
make judgments and accounting estimates that are reasonable and prudent;
-
state whether applicable UK Accounting Standards (FRS 102) have been followed, subject to any material departures disclosed and explained in the financial statements;
-
prepare the financial statements on the going concern basis unless it is inappropriate to presume that the company will continue in business.
The Trustees are responsible for keeping adequate accounting records that are sufficient to show and explain the company's transactions and disclose with reasonable accuracy at any time the financial position of the company and enable them to ensure that the financial statements comply with the Companies Act 2006. They are also responsible for safeguarding the assets of the company and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.
Approved by order of the members of the board of Trustees and signed on their behalf by:
_________ D Doughty
24-08-21 Date:
Page 15
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED
(A company limited by guarantee)
INDEPENDENT EXAMINER'S REPORT FOR THE YEAR ENDED 30 NOVEMBER 2020
Independent examiner's report to the Trustees of The Centre for Sustainable Healthcare Limited ('the company')
I report to the charity Trustees on my examination of the accounts of the company for the year ended 30 November 2020.
Responsibilities and basis of report
As the Trustees of the company (and its directors for the purposes of company law) you are responsible for the preparation of the accounts in accordance with the requirements of the Companies Act 2006 ('the 2006 Act').
Having satisfied myself that the accounts of the company are not required to be audited under Part 16 of the 2006 Act and are eligible for independent examination, I report in respect of my examination of the company's accounts carried out under section 145 of the Charities Act 2011 ('the 2011 Act'). In carrying out my examination I have followed the Directions given by the Charity Commission under section 145(5)(b) of the 2011 Act.
Independent examiner's statement
Since the company's gross income exceeded £250,000 your examiner must be a member of a body listed in section 145 of the 2011 Act. I confirm that I am qualified to undertake the examination because I am a member of Association of Certified Chartered Accountants, which is one of the listed bodies.
I have completed my examination. I confirm that no matters have come to my attention in connection with the examination giving me cause to believe:
-
accounting records were not kept in respect of the company as required by section 386 of the 2006 Act; or
-
the accounts do not accord with those records; or
-
the accounts do not comply with the accounting requirements of section 396 of the 2006 Act other than any requirement that the accounts give a 'true and fair' view which is not a matter considered as part of an independent examination; or
-
the accounts have not been prepared in accordance with the methods and principles of the Statement of Recommended Practice for accounting and reporting by charities [applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102)].
I have no concerns and have come across no other matters in connection with the examination to which attention should be drawn in this report in order to enable a proper understanding of the accounts to be reached.
Page 16
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
INDEPENDENT EXAMINER'S REPORT (CONTINUED) FOR THE YEAR ENDED 30 NOVEMBER 2020
This report is made solely to the company's Trustees, as a body, in accordance with Part 4 of the Charities (Accounts and Reports) Regulations 2008. My work has been undertaken so that I might state to the company's Trustees those matters I am required to state to them in an Independent examiner's report and for no other purpose. To the fullest extent permitted by law, I do not accept or assume responsibility to anyone other than the company and the company's Trustees as a body, for my work or for this report.
Signed: Dated: 24-08-21 Christina Nawrocki FCCA
Wellers
Independent Examiners 8 King Edward Street Oxford OX1 4HL
Page 17
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED
(A company limited by guarantee)
STATEMENT OF FINANCIAL ACTIVITIES (INCORPORATING INCOME AND EXPENDITURE ACCOUNT) FOR THE YEAR ENDED 30 NOVEMBER 2020
| Note Income from: Donations and legacies 3 Charitable activities 4 Total income Expenditure on: Charitable activities 5 Total expenditure Net (expenditure)/income Transfers between funds 13 Net movement in funds Reconciliation of funds: Total funds brought forward Net movement in funds Total funds carried forward |
Restricted funds 2020 £ 139,025 - 139,025 157,423 157,423 (18,398) (1,664) (20,062) 50,349 (20,062) 30,287 |
Unrestricted funds 2020 £ 64,308 195,864 260,172 243,575 243,575 16,597 1,664 18,261 (31,381) 18,261 (13,120) |
Total funds 2020 £ 203,333 195,864 399,197 400,998 400,998 (1,801) - (1,801) 18,968 (1,801) 17,167 |
Total funds 2019 £ 260,993 127,626 |
|---|---|---|---|---|
| 388,619 | ||||
| 385,761 | ||||
| 385,761 | ||||
| 2,858 - |
||||
| 2,858 | ||||
| 16,110 2,858 |
||||
| 18,968 |
The Statement of financial activities includes all gains and losses recognised in the year.
The notes on pages 21 to 37 form part of these financial statements.
Page 18
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee) REGISTERED NUMBER: 07450026
BALANCE SHEET AS AT 30 NOVEMBER 2020
| Note Fixed assets Tangible assets 10 Current assets Debtors 11 Cash at bank and in hand Creditors: amounts falling due within one year 12 Net current assets Total assets less current liabilities Net assets excluding pension asset Total net assets Charity funds Restricted funds 13 Unrestricted funds 13 Total funds |
54,039 22,489 76,528 (60,152) |
2020 £ 791 791 16,376 17,167 17,167 17,167 30,287 (13,120) 17,167 |
19,110 32,790 51,900 (32,976) |
2019 £ 44 44 18,924 18,968 18,968 18,968 50,349 (31,381) 18,968 |
|---|---|---|---|---|
Page 19
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED
(A company limited by guarantee) REGISTERED NUMBER: 07450026
BALANCE SHEET (CONTINUED) AS AT 30 NOVEMBER 2020
The company was entitled to exemption from audit under section 477 of the Companies Act 2006.
The members have not required the company to obtain an audit for the year in question in accordance with section 476 of Companies Act 2006.
The Trustees acknowledge their responsibilities for complying with the requirements of the Act with respect to accounting records and preparation of financial statements.
The financial statements have been prepared in accordance with the provisions applicable to entities subject to the small companies regime.
The financial statements were approved and authorised for issue by the Trustees and signed on their behalf by:
D Doughty
Date:
The notes on pages 21 to 37 form part of these financial statements.
Page 20
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 NOVEMBER 2020
1. General information
The Centre For Sustainable Healthcare Limited is a private company limited by guarantee, incorporated in England and Wales, registration number 07450026. The address of the companies pricipal place of business is Cranbrook House, 287 - 291 Banbury Road, Oxford, Oxfordshire, OX2 7JA.
2. Accounting policies
2.1 Basis of preparation of financial statements
The financial statements have been prepared in accordance with the Charities SORP (FRS 102) - Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2015), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Companies Act 2006.
The Centre for Sustainable Healthcare Limited 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.
2.2 Going concern
The charity's operational activities, together with the factors likely to affect its future development, performance and position are set out in the Trustees report on pages 2 to 10.
During the year, the charity made a small loss. Unfortunately, the level of unrestricted income was not sufficient to cover the unrestricted expenditure and as a result, restricted money had been used temporarily to cover ongoing unrestricted expenditure. The Trustees have since sought to secure additional funding in particular unrestricted grants and donations to ensure the unrestricted fund is not overdrawn.
2.3 Income
All income is recognised once the company has entitlement to the income, it is probable that the income will be received and the amount of income receivable can be measured reliably.
Grants are included in the Statement of financial activities on a receivable basis. The balance of income received for specific purposes but not expended during the period is shown in the relevant funds on the Balance sheet. Where income is received in advance of entitlement of receipt, its recognition is deferred and included in creditors as deferred income. Where entitlement occurs before income is received, the income is accrued.
Page 21
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 NOVEMBER 2020
2. Accounting policies (continued)
2.4 Expenditure
Expenditure is recognised once there is a legal or constructive obligation to transfer economic benefit to a third party, it is probable that a transfer of economic benefits will be required in settlement and the amount of the obligation can be measured reliably. Expenditure is classified by activity. The costs of each activity are made up of the total of direct costs and shared costs, including support costs involved in undertaking each activity. Direct costs attributable to a single activity are allocated directly to that activity. Shared costs which contribute to more than one activity and support costs which are not attributable to a single activity are apportioned between those activities on a basis consistent with the use of resources. Central staff costs are allocated on the basis of time spent, and depreciation charges allocated on the portion of the asset’s use.
Expenditure on charitable activities is incurred on directly undertaking the activities which further the company's objectives, as well as any associated support costs.
All expenditure is inclusive of irrecoverable VAT.
2.5 Government grants
Government grants relating to tangible fixed assets are treated as deferred income and released to the Statement of financial activities over the expected useful lives of the assets concerned. Other grants are credited to the Statement of financial activities as the related expenditure is incurred.
2.6 Tangible fixed assets and depreciation
Tangible fixed assets costing £200 or more are capitalised and recognised when future economic benefits are probable and the cost or value of the asset can be measured reliably.
Tangible fixed assets are initially recognised at cost. After recognition, under the cost model, tangible fixed assets are measured at cost less accumulated depreciation and any accumulated impairment losses. All costs incurred to bring a tangible fixed asset into its intended working condition should be included in the measurement of cost.
Depreciation is charged so as to allocate the cost of tangible fixed assets less their residual value over their estimated useful lives, using the straight-line method.
Depreciation is provided on the following basis:
- Computer equipment 33% Straight Line
2.7 Debtors
Trade and other debtors are recognised at the settlement amount after any trade discount offered. Prepayments are valued at the amount prepaid net of any trade discounts due.
2.8 Cash at bank and in hand
Cash at bank and in hand includes cash and short-term highly liquid investments with a short maturity of three months or less from the date of acquisition or opening of the deposit or similar account.
Page 22
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 NOVEMBER 2020
2. Accounting policies (continued)
2.9 Liabilities and provisions
Liabilities are recognised when there is an obligation at the Balance sheet date as a result of a past event, it is probable that a transfer of economic benefit will be required in settlement, and the amount of the settlement can be estimated reliably.
Liabilities are recognised at the amount that the company anticipates it will pay to settle the debt or the amount it has received as advanced payments for the goods or services it must provide.
Provisions are measured at the best estimate of the amounts required to settle the obligation. Where the effect of the time value of money is material, the provision is based on the present value of those amounts, discounted at the pre-tax discount rate that reflects the risks specific to the liability. The unwinding of the discount is recognised in the Statement of financial activities as a finance cost.
2.10 Financial instruments
The company 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 with the exception of bank loans which are subsequently measured at amortised cost using the effective interest method.
2.11 Operating leases
Rentals paid under operating leases are charged to the Statement of financial activities on a straight line basis over the lease term.
2.12 Pensions
The company contributes into a defined contribution pension scheme and the pension charge represents the amounts payable by the company to the fund in respect of the year.
2.13 Fund accounting
General funds are unrestricted funds which are available for use at the discretion of the Trustees in furtherance of the general objectives of the company and which have not been designated for other purposes.
Restricted funds are funds which are to be used in accordance with specific restrictions imposed by donors or which have been raised by the company for particular purposes. The costs of raising and administering such funds are charged against the specific fund. The aim and use of each restricted fund is set out in the notes to the financial statements.
Page 23
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 NOVEMBER 2020
3. Income from donations and legacies
| Donations Grants Government grants Total 2020 Donations Grants Total 2019 |
Restricted funds 2020 Unrestricted funds 2020 £ £ - 41,835 139,025 7,900 - 14,573 139,025 64,308 Restricted funds 2019 Unrestricted funds 2019 £ £ - 5,951 177,758 77,284 177,758 83,235 |
Total funds 2020 £ 41,835 146,925 14,573 |
|---|---|---|
| 203,333 | ||
| Total funds 2019 £ 5,951 255,042 |
||
| 260,993 |
Page 24
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 NOVEMBER 2020
4. Income from charitable activities
| Income from charitable activities - Clinical Income from charitable activities - NHS Forest Total 2020 Income from charitable activities - Clinical Income from charitable activities - NHS Forest Total 2019 |
Unrestricted funds 2020 £ 119,707 76,157 195,864 Restricted funds 2019 Unrestricted funds 2019 £ £ 15,750 86,469 - 25,407 15,750 111,876 |
Total funds 2020 £ 119,707 76,157 |
|---|---|---|
| 195,864 | ||
| Total funds 2019 £ 102,219 25,407 |
||
| 127,626 |
5. Analysis of expenditure on charitable activities Summary by fund type
| Clinical NHS Forest Total 2020 |
Restricted funds 2020 Unrestricted funds 2020 £ £ 97,870 153,615 59,553 89,960 157,423 243,575 |
Total funds 2020 £ 251,485 149,513 |
|---|---|---|
| 400,998 |
Page 25
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 NOVEMBER 2020
5. Analysis of expenditure on charitable activities (continued)
Summary by fund type (continued)
| Clinical NHS Forest Total 2019 Summary by expenditure type Clinical NHS Forest Total 2020 Clinical NHS Forest Total 2019 |
Restricted funds 2019 £ 75,356 79,441 154,797 Staff costs 2020 £ 187,242 128,923 316,165 Staff costs 2019 £ 158,101 103,192 261,293 |
Unrestricted funds 2019 £ 171,155 59,809 230,964 Other costs 2020 £ 64,245 20,588 84,833 Other costs 2019 £ 88,410 36,058 124,468 |
Total funds 2019 £ 246,511 139,250 385,761 Total funds 2020 £ 251,486 149,512 400,998 Total funds 2019 £ 246,511 139,250 385,761 |
|---|---|---|---|
Page 26
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 NOVEMBER 2020
6. Analysis of expenditure by activities
| Clinical NHS Forest Total 2020 Clinical NHS Forest Total 2019 Analysis of direct costs |
Activities undertaken directly 2020 £ 222,597 130,888 353,485 Activities undertaken directly 2019 £ 211,420 113,853 325,273 |
Support costs 2020 £ 28,889 18,624 47,513 Support costs 2019 £ 35,090 25,398 60,488 |
Total funds 2020 £ 251,486 149,512 |
|---|---|---|---|
| 400,998 | |||
| Total funds 2019 £ 246,510 139,251 |
|||
| 385,761 | |||
| Staff costs Project costs Project partner costs Project publications, leaflets and maps Professional and consultancy Conference costs Total 2020 |
Clinical 2020 £ 187,243 6,000 23,395 513 3,800 1,646 222,597 |
NHS Forest 2020 £ 128,923 - - 1,966 - - 130,889 |
Total funds 2020 £ 316,166 6,000 23,395 2,479 3,800 1,646 |
|---|---|---|---|
| 353,486 |
Page 27
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 NOVEMBER 2020
6. Analysis of expenditure by activities (continued)
Analysis of direct costs (continued)
| Staff costs Project costs Project partner costs Project publications, leaflets and maps Professional and consultancy Conference costs Total 2019 Analysis of support costs |
Clinical 2019 £ 158,100 6,147 45,455 - (1,964) 3,683 211,421 |
NHS Forest 2019 £ 103,192 3,975 4,750 1,684 87 164 113,852 |
Total funds 2019 £ 261,292 10,122 50,205 1,684 (1,877) 3,847 |
|---|---|---|---|
| 325,273 | |||
| Professional and consultancy Website and computer costs Travel and subsistence Printing, postage and stationery Office expenses Bookkeeping Entertainment Telephone Miscellaneous Bank charges Rent Insurance Payments to charitable parties Training Depreciation Governance costs Total 2020 |
Clinical 2020 £ 20 9,508 654 134 29 150 130 643 274 322 10,476 325 1,437 120 226 4,441 28,889 |
NHS Forest 2020 £ 20 5,941 441 8 78 178 - 647 277 32 6,024 - 252 55 226 4,444 18,623 |
Total funds 2020 £ 40 15,449 1,095 142 107 328 130 1,290 551 354 16,500 325 1,689 175 452 8,885 |
|---|---|---|---|
| 47,512 |
Page 28
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 NOVEMBER 2020
6. Analysis of expenditure by activities (continued)
Analysis of support costs (continued)
| Organisation 2019 £ Website and computer costs 4,580 Travel and subsistence 5,578 Printing, postage and stationery 62 Office expenses 140 Bookkeeping 2,235 Entertainment 44 Telephone 1,140 Miscellaneous 390 Repairs and maintenance 117 Bank charges 39 Rent 17,258 Insurance 481 Payments to charitable parties 109 Training 365 Depreciation 356 Governance costs 2,196 Total 2019 35,090 7. Independent examiner's remuneration Fees payable to the company's independent examiner for the independent examination of the company's annual accounts |
Clinical 2019 £ 3,365 2,819 35 72 1,826 22 831 187 108 - 12,842 437 71 16 161 2,606 25,398 2020 £ 4,800 |
Total funds 2019 £ 7,945 8,397 97 212 4,061 66 1,971 577 225 39 30,100 918 180 381 517 4,802 |
|---|---|---|
| 60,488 | ||
| 2019 £ 4,802 |
Page 29
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 NOVEMBER 2020
8. Staff costs
| Wages and salaries Social security costs Contribution to defined contribution pension schemes |
2020 £ 280,749 20,213 15,203 316,165 |
2019 £ 231,648 17,319 12,326 |
|---|---|---|
| 261,293 |
The average number of persons employed by the company during the year was as follows:
| Trustee Administration |
2020 No. 1 9 10 |
2019 No. 1 8 |
|---|---|---|
| 9 |
No employee received remuneration amounting to more than £60,000 in either year.
The total remuneration and benefits received by the key management personel totalled £69,025 (2018 - £67,100)
9. Trustees' remuneration and expenses
During the year, one or more Trustees has been paid remuneration or has received other benefits from an employment with the company. The value of Trustees' remuneration and other benefits was as follows:
| 2020 | 2019 | ||
|---|---|---|---|
| £ | £ | ||
| R Stancliffe | Remuneration | 44,000 | 44,000 |
| During the year ended 30 November 2020, | expenses were reimbursed or paid directly to 1 | Trustee_(2019_ | |
| _- to 1 Trustee)_broken down as follows: | |||
| 2020 | 2019 | ||
| £ | £ | ||
| Travel, subsistence and meeting costs | - | 1,676 |
Page 30
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 NOVEMBER 2020
10. Tangible fixed assets
| Cost or valuation At 1 December 2019 Additions At 30 November 2020 Depreciation At 1 December 2019 Charge for the year At 30 November 2020 Net book value At 30 November 2020 At 30 November 2019 |
Office equipment £ 1,766 1,199 |
|---|---|
| 2,965 | |
| 1,722 452 |
|
| 2,174 | |
| 791 | |
| 44 |
Page 31
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 NOVEMBER 2020
11. Debtors
| Due within one year Trade debtors Other debtors Prepayments and accrued income |
2020 £ 35,233 18,157 649 54,039 |
2019 £ 17,662 1,448 - |
|---|---|---|
| 19,110 |
12. Creditors: Amounts falling due within one year
| Trade creditors Other taxation and social security Pension fund loan payable Other creditors Accruals and deferred income |
2020 £ 9,196 40,374 3,938 - 6,644 60,152 |
2019 £ 7,001 16,433 1,272 1,625 6,645 |
|---|---|---|
| 32,976 |
Page 32
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 NOVEMBER 2020
13. Statement of funds
Statement of funds - current year
| Unrestricted funds General Funds Restricted funds Global Health Connecting Q Locally Postcode Local Trust Grant HF Remote Consultations Postcode Local Trust Grant SusQi Education Health Foundation Seeing Is Believing Postcode Local Trust Grant Heathrow Community Fund Green Walking Project Big Lottery - Wood Farm Total of funds |
Balance at 1 December 2019 £ (31,381) 1,664 - - - 1,747 (195) 10,553 2,712 1,939 23,594 7,535 800 50,349 18,968 |
Income £ 260,172 - 18,000 19,500 10,000 1,625 66,701 14,545 - - 8,654 - - 139,025 399,197 |
Expenditure £ (243,575) - (9,200) (6,875) (6,096) (5,311) (66,506) (25,098) (2,712) - (27,290) (7,535) (800) (157,423) (400,998) |
Transfers in/out £ 1,664 (1,664) - - - 1,939 - - - (1,939) - - - (1,664) - |
Balance at 30 November 2020 £ (13,120) - 8,800 12,625 3,904 - - - - - 4,958 - - 30,287 17,167 |
|---|---|---|---|---|---|
Page 33
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 NOVEMBER 2020
13. Statement of funds (continued)
Statement of funds - prior year
| Unrestricted funds General Funds Restricted funds Global Health Postcode Local Trust Grant SusQi Education Health Foundation Seeing Is Believing Postcode Local Trust Grant Heathrow Community Fund Green Walking Project Big Lottery - Wood Farm Total of funds |
Balance at 1 December 2018 £ 4,480 1,664 1,939 - - 8,027 - - - - 11,630 16,110 |
Income £ 195,111 - - 15,750 57,000 54,154 17,875 31,194 7,535 10,000 193,508 193,508 |
Expenditure £ (230,972) - - (15,945) (46,447) (59,469) (16,128) (7,600) - (9,200) (154,789) (385,761) |
Balance at 30 November 2019 £ (31,381) 1,664 1,939 (195) 10,553 2,712 1,747 23,594 7,535 800 50,349 18,968 |
|---|---|---|---|---|
Page 34
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 NOVEMBER 2020
14. Summary of funds
Summary of funds - current year
| General funds Restricted funds |
Balance at 1 December 2019 £ (31,381) 50,349 18,968 |
Income £ 260,172 139,025 399,197 Balance at 1 December 2018 £ 4,480 11,630 16,110 |
Expenditure £ (243,575) (157,423) (400,998) Income £ 195,111 193,508 388,619 |
Transfers in/out £ 1,664 (1,664) - Expenditure £ (230,972) (154,789) (385,761) |
Balance at 30 November 2020 £ (13,120) 30,287 17,167 Balance at 30 November 2019 £ (31,381) 50,349 18,968 |
|---|---|---|---|---|---|
| Summary of funds - prior year | |||||
| General funds Restricted funds |
Page 35
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 NOVEMBER 2020
15. Analysis of net assets between funds
Analysis of net assets between funds - current period
| Tangible fixed assets Current assets Creditors due within one year Total |
Restricted funds 2020 Unrestricted funds 2020 £ £ - 791 30,287 46,241 - (60,152) 30,287 (13,120) |
Total funds 2020 £ 791 76,528 (60,152) 17,167 |
|---|---|---|
Analysis of net assets between funds - prior period
| Tangible fixed assets Current assets Creditors due within one year Total |
Restricted funds 2019 £ - 50,349 - 50,349 |
Unrestricted funds 2019 £ 44 1,551 (32,976) (31,381) |
Total funds 2019 £ 44 51,900 (32,976) 18,968 |
|---|---|---|---|
Page 36
DocuSign Envelope ID: 74F58135-1FDD-47E3-B1F9-D36873CA0DF2
THE CENTRE FOR SUSTAINABLE HEALTHCARE LIMITED (A company limited by guarantee)
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 NOVEMBER 2020
16. Pension commitments
The company contributes into a defined contributions pension scheme. The assets of the scheme are held separately from those of the company in an independently administered fund. The pension cost charge represents contributions payable by the company to the fund and amounted to £15,203 (2019 - £12,326).
17. Operating lease commitments
At 30 November 2020 the company had commitments to make future minimum lease payments under non-cancellable operating leases as follows:
| Not later than 1 year Later than 1 year and not later than 5 years |
2020 £ 30,000 - 30,000 |
2019 £ - 60,100 |
|---|---|---|
| 60,100 |
18. Members' liability
Each member of the charitable company undertakes to contribute to the assets of the company in the event of it being wound up while he/she is a member, or within one year after he/she ceases to be a member, such amount as may be required, not exceeding £1 for the debts and liabilities contracted before he/she ceases to be a member.
19. Post balance sheet events
Following the year end of 30 November 2019 the UK has been impacted by the Coronavirus. This has resulted in all staff members being required to work from home and the charitable activities to be significantly reduced.
So far, COVID 19 has led to the pausing of one of our grant-funded projects. All other projects have been modified to allow continuation. As we work mainly with healthcare professionals some of our programmes supported by unrestricted funding, in particular the Green Ward Competition, has not had much uptake. We are in the process of re-purposing the programme to run online.
Due to the current circumstances we are turning our training courses into blended learning provided purely online. This has the potential to expand our training offer and funding in the long-term as we would be able to run it more frequently.
Page 37
Docusign En¥ÈlopÈ ID". 74F58135-1 FDtk47E&B1FWD36873CAODF2