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||
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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
1. Transforming healthcare for a sustainable future.
2. Ensuring that health is safeguarded in a time of resource restraint.
3. Educating healthcare professionals and others about links between health and the environment.
## **b. Strategies for achieving objectives**
CSH Strategies for achieving Objectives are:
1. engaging healthcare professionals, patients and the wider community in sustainability and the links between health and environment
2. engaging other industries and organisations in the healthcare sector
3. assessing current knowledge, barriers and opportunities for sustainable healthcare.
4. improving research into more sustainable options.
5. helping the NHS to reduce its carbon footprint.
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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**
1. developing and running programmes and tools that can help to engage healthcare professionals and others.
2. sharing ideas and knowledge with other organisations to engage them with sustainable healthcare.
3. running networks to enable natural communities in healthcare to share ideas and questions.
4. working to include sustainability in medical education via curriculum development and other areas.
5. developing courses in various elements of sustainable healthcare and teaching them.
6. carrying out reviews of current research and other information on barriers and opportunities for sustainable healthcare.
7. identifying and/or carrying out research into more sustainable options for healthcare.
8. measuring the carbon footprint of services, medical products and clinical pathways.
9. developing standardised methodology for carbon footprinting and measuring the triple bottom line in healthcare.
10. promote planting trees as a mechanism to engage staff, patients and visitors with sustainability.
11. working with NHS sites to make the links between health and the environment through the NHS Forest projects.
12. 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:
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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)**
1. 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;
2. 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;
3. 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.
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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
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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.
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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:
1. pilot the inclusion of sustainable healthcare principles within undergraduate and postgraduate QI education for health professionals.
2. evaluate the impact of this inclusion on learning, including engagement with QI.
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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)**
3. 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
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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.
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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
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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.
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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:
1. The promotion of health for the benefit of the public in any part of the world.
2. 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.
3. 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:
1. accounting records were not kept in respect of the company as required by section 386 of the 2006 Act; or
2. the accounts do not accord with those records; or
3. the accounts do not comply with the accounting requirements of section 396 of the 2006 Act other than any requirement that the accounts give a 'true and fair' view which is not a matter considered as part of an independent examination; or
4. the accounts have not been prepared in accordance with the methods and principles of the Statement of Recommended Practice for accounting and reporting by charities [applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102)].
I have no concerns and have come across no other matters in connection with the examination to which attention should be drawn in this report in order to enable a proper understanding of the accounts to be reached.
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