## **Outreach EMR**
## Medical Records Save Lives
## **Annual Report for 12 Months ending 31 December 2024**
Outreach EMR is a Charitable Incorporated Organisation (CIO), Registered Charity No: **1159060**
Charity Address: Fir Tree Farm, Main Street, Sutton-on-Forest, York YO61 1DP
Contact: peter.smith@outreachemr.org (+44) (0) 7712 586822
Website: www.outreachemr.org
Objective: **The relief of sickness and the preservation and protection of health by developing and making available an electronic medical records system for use in resource challenged settings.**
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## **Trustees and Governance**
Outreach EMR is governed by the Constitution of a Charitable Incorporated Organisation with voting members other than its Charity Trustees.
The policies and procedures for election of Trustees are set out in Section 13 of the Charity’s Constitution.
Trustees are:
- Dr. Peter Smith MBChB DCH MRCGP (Chairman)
- Mr. Graham Millar FCA (Treasurer)
- Mr. Mark Fowler
Dr. Peter Smith, Mr. Mark Fowler and Mr. Graham Millar have been in office for the full term of the Report: 01 January 2024 – 31 December 2024.
Ex-officio committee members are: Dr. Peter Burnett, Dr. Elizabeth Fowler, Dr. David Longworth, Mrs. Margaret Millar, Mrs. Linda Murphy, Mr. Rex Parry, Mrs. Helen Smith, Mr. Bass Stewart, Dr. Bill Tams and Mrs. Gail Tams.
## **1. Summary of Activities Undertaken**
2024 saw Outreach EMR celebrate 10 years of operation as a Charity. It has been a very productive year with much activity focused on the implementation of Project Connect in Uganda. Version 4 software has been introduced into all clinics and several former ’desktop’ clinics have enjoyed the benefits of moving onto the Cloud. A strong partnership with ‘Hope for Haiti’ has led to the development of additional ‘plug ins’, initially tailor made for that clinic, but subsequently available to all. Two successful fundraising events have taken place. We are also in receipt of several very generous donations and remain extremely grateful to everyone who has supported us.
The Charity is now approaching a critical stage. Through the completion of Project Connect, we shall soon have successfully demonstrated ‘Interoperability’ and, subject to securing additional investment, will be ready to extend
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the benefits of the Outreach EMR System to a much wider audience. To this end, a 3-year Growth Plan 2025 – 2028 has been developed for potential partners.
## **2. Financial Review**
- **Reserves policy:** The charity has total funds of £58,254. Of this £48,807 unrestricted and the remaining 9,447 is restricted. The restricted balance is made up of grants received and is to be spent on Project Connect.
## **3. System Developments**
- **Completion of Rollout of V4:** Version 4 was successfully rolled out to all clinics, ensuring users have access to the latest improvements and functionalities designed to streamline workflows.
- **‘Plug-Ins’** 2 plug ins for multiple prescriptions and cash transactions have been commercially developed and tested for a Haitian Clinic, ‘Hope for Haiti’. A third, Dentistry, is in the process of development.
- **Project Connect** to pilot Interoperability (ability to transfer real time data directly from clinics to Central Government in Uganda using the international platform DHIS2) was implemented in 6 clinic settings: 3 Government health centres and 3 run by NGOs. Project Connect is supported by UUKHA (Uganda / UK Health Alliance) with funding from Peter Sowerby Foundation (PSF).
- **Demonstration of Interoperability:** Outreach EMR showcased the interoperability between its EMR system and the Ugandan Ministry of Health's DHIS2 demo platform, enhancing ability to exchange data seamlessly and improve patient care coordination.
- **User Training and Support:** Over 50 training sessions and workshops were held in Uganda, empowering users with the knowledge and tools needed to maximize the benefits of the system.
- **Solar Power Installation:** Backup solar power was installed at Bukhaweka HC II in Uganda, ensuring that EMR usage there was no longer affected by intermittent electricity.
- **Participation in the UUKHA Symposium:** Outreach EMR actively participated in the 2nd Uganda/UK Health Alliance (UUKHA) symposium, collaborating with various stakeholders from the NHS, Uganda Ministry of Health, and other development partners, both in Kampala and virtually. Additionally, we took part in the East Africa Cross Border Digital Health Technical Working Group in Busia, Kenya, to strengthen regional EMR integration efforts.
- **Electronic HMIS 105 Reporting** was introduced on a trial basis into two Ugandan clinics.
## **4. Training and system monitoring**
- Committee members visited Uganda in both February and September to monitor progress, identify training needs and undertake initial evaluations.
- Project manager Daniel Opuch has worked tirelessly to implement Project Connect in Uganda with Project staff, Julius Okello and James Wafula, training all staff in system use. At times they have faced difficult challenges working in remote clinics, including significant weather changes, unreliable electricity, impassable roads and broken bridges.
**5. Monitoring and Evaluation** A formal evaluation by an external Consultant evaluated initial implementation and progress of Project Connect to produce a Monitoring, Evaluation and Learning Plan and a Cost benefit Analysis. This has greatly helped realign efforts towards process quality and systems improvement initiatives.
**6. Additional Clinics** For the first time, the total number of patients registered exceeded 250,000, with 21 clinics in 8 countries. During the year we added 2 clinics: one in Afghanistan (set up but not yet operational) and the second in Uganda (in fact, a re-introduction - Bumwalukani Health Centre Il, supported by the charity, Reach for Uganda).
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## **7. Governance**
- To help secure longer term sustainability, ‘at cost’ charging for Cloud storage has been implemented in all clinics, with an exception made for one without adequate funds.
- The 2023 Annual Report and Accounts secured the approval of an external examiner, as required by section 145 of the Charities Act 2011.
- All policies have been updated and displayed on the website and a new Social media Policy developed and implemented.
- Committee members attended Charity Commission Study days on Governance in January and on Social Media in March. In both cases, actions were taken as a result.
-
- Potential conflicts of interest have been declared by all Trustees and Members.
- Recruitment and appointment of new trustees: The trustees are recruited by the board of trustees on the basis of experience, competence and specialist skills.
## **8.**
## **Fundraising and Marketing**
- A successful Book and Picture sale on 01 June raised over £1,000, with a BBQ on 01 September raising more than £2,700 (including donations).
- Social media presence has been raised through the more regular use of Facebook and electronic newsletters.
Trustees and Members are extremely grateful to the many people who have continued to support Outreach EMR and donated so generously and to Zameel Amsed from Codification who has worked tirelessly on all system developments. Zameel is based in Sri-Lanka
## **9. Main Achievements**
We have:
- Completed the roll-out of V4 in all clinics
- Undertaken codebase and infrastructure upgrades to the System.
- Implemented Project Connect according to plan, with the help of a local Project Manager and supporting local project team
- Demonstrated interoperability to the Ugandan Government
- Demonstrated the use and benefits of online / offline capability (roaming) in a Ugandan Clinic
- Improved the marketing of Outreach EMR, particularly via social media.
- Developed a new 3 Year Growth Plan 2025 – 2028 to help secure new partners and funds.
- Strengthened partnerships with the Uganda UK Health Alliance (UUKHA), Foundation for International Medical Relief of Children (FIMRC), Harpenden Spotlight on Africa (HSOA), Hope for Haiti, Peter Sowerby Foundation and a number of NGOs, particularly in Hait
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**10. Future Objectives**
## **Objectives for the next 12 months are to:**
- Bring additional clinics and health care settings online
- Ensure relevant sections of electronic HMIS reports are supported in all Project Connect clinics
- Complete Project Connect by implementing fully functioning ‘Interoperability’ in designated Ugandan clinics
- Continue to building user capacity on current and new system features under development
- Demonstrate improved data security through certification of independent ‘Penetration Test’
- Raise the profile of the charity nationally and internationally
- Secure funding and/or strategic partnerships to ensure sustainability and wider roll-out.
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## **Statement of Financial Activities**
## **Year Ended 31st December 2024**
|**Unrestricted**
**Restricted**
**Funds**
**Funds**
**£**
**£**
**Income**
**Notes**
Donations
8,491
-
Grants Received
**4a**
**-**
56,800
Fund Raising
**4b**
2,106
-
Sales
5,500
-
Hosting Charges
3,225
-
**Total Income**
**19,322**
**56,800**
**Expenditure**
Project Management
-
-19,000
Software Development
-10,495
-43,667
Software and other
maintenance
-11,883
-
Equipment purchased
-354
-9,768
Project Staff in Uganda
-
-5,990
Travel - Uganda
-
-1,021
- from UK
-
-9,159
Training
-
-6,034
Hosting and Domain costs
-4,572
-1,500
Bank and professional fees
-656
-2,943
**Total Expenditure**
**-27,960**
**-99,082**
**Surplus/Deficit**
**-8,638**
**-42,282**|**Total**
**2023**
**£**
**£**
8,491
18,550
56,800
126,666
2,106
10,874
5,500
-
3,225
-
**76,122**
**156,090**
-19,000
-20,000
-54,162
-41,523
-11,883
-12,520
-10,122
-8,359
-5,990
-2,423
-1,021
-
-9,159
-8,728
-6,034
-1,482
-6,072
-3,434
-3,599
-860
**127,042**
**99,329**
**-50,920**
**-56,761**|
|---|---|
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## **Balance Sheet**
## **31st December 2024**
|**Notes**
**Reserves**
Balance brought
forward
Surplus/Deficit for
year
**Assets**
Bank
**1**
Cash in Uganda
Debtors
**Liabilities**
Creditors
**Net Assets**|**Unrestricted**
**Restricted**
**Total**
**2023**
**Funds**
**Funds**
**£**
**£**
**£**
**£**
57,445
51,729
109,174
52,413
-8,638
-42,282
-50,920
56,761
**48,807**
**9,447**
**58,254**
**109,174**
46,430
12,456
58,886
103,222
-
328
328
1,681
3,820
-
3,820
6,781
-1,443
-3,337
-4,780
-2,510
**48,807**
**9,447**
**58,254**
**109,174**|
|---|---|
## **Signed on Behalf of the Charity’s Trustees**
Peter Smith – Chairman, Trustee
Graham Millar – Treasurer, Trustee
Mark Fowler – Trustee
3 February 2025
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**OUTREACH EMR**
## **Notes To The Financial Statements**
## **1 CHARITY INFORMATION**
Outreach EMR is a Charitable Incorporated Organisation (CIO), registered with the Charity Commission in England and Wales.
The address of its registered office is Fir Tree Farm, Main Street, Sutton-on-Forest, York YO61 1DP.
## **2 ACCOUNTING POLICIES**
## **Basis of preparing the financial statements**
The financial statements of the charitable company, which is a public benefit entity under FRS 102, have been prepared in accordance with the Charities SORP (FRS 102) 'Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2019)', Financial Reporting Standard 102 'The Financial Reporting Standard applicable in the UK and Republic of Ireland' and the Companies Act 2006. The financial statements have been prepared under the historical cost convention, with the exception of investments which are included at market value.
## **Income**
All income is recognised in the Statement of Financial Activities once the charity has entitlement to the funds, it is probable that the income will be received and the amount can be measured reliably.
## **Expenditure**
All expenditure is included on an accruals basis and allocated to the activity to which it relates.
## **Taxation**
The charity is exempt from corporation tax on its charitable activities.
## **Fund accounting**
Unrestricted funds can be used in accordance with the charitable objectives at the discretion of the trustees.
- **3** Restricted Reserves can only be used for Project Connect.
## **4 INCOME**
**a** The Peter Sowerby Foundation is providing grant aid for Project Connect an interoperability project under trial in conjunction with the Ugandan Government. The project is showing how health information can be provided real time to facilitate central knowledge of health information.
- **b** Some fund-raising events are held by outside bodies and some by the Charity itself. In both cases the amount shown is the net proceeds. In 2024 the gross proceeds of events run by the Charity was £4,300 (2023 £19,100)
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**OUTREACH EMR**
## **Notes To The Financial Statements**
## **65 BANK AND PROFESSIONAL FEES**
|Accountancy - paid
Accountancy - accrued
Bank, codifcaton charges
Sundry expenses
Total|**370**
**415**
**2,677**
**137**
**2024**
**£**|200
-
660
-
2023
£|
|---|---|---|
||**3,599**|860|
## **6 NET INCOME/(EXPENDITURE)**
Net income/(expenditure) is stated after charging/(crediting):
|Net income/(expenditure) is stated afer charging/(creditng):|||||
|---|---|---|---|---|
|||**2024**||2023|
|||£||£|
|Accountant’s fees - independent examinaton|**415**||370||
## **7 TRUSTEES' REMUNERATION AND BENEFITS**
There were no trustees' remuneration or other benefits for the year ended 31 December 2024 nor for the year ended 31 December 2023.
## **Trustees' expenses**
Trustees' expenses for travelling expenditure incurred personally, totalling £5,315 (2023: £7,238) reimbursed to two trustees.
## **8 EMPLOYEES**
The average number of employees during the year was Nil (2023: Nil).
## **9 CASH AT BANK**
|**£**
Bank current account
**58,866**
Cash
**328**
Total
**59,194**|£
103,222
1,681
104,903|
|---|---|
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## **OUTREACH EMR**
## **Notes To The Financial Statements**
## **10 CREDITORS: AMOUNTS FALLING DUE WITHIN ONE YEAR**
||**2024**|2023|
|---|---|---|
||**£**|£|
|Accruals|**4,780**|2,510|
## **11 MOVEMENT IN FUNDS**
Net movement in funds, included in the above are as follows:
|Unrestricted
Funds
£
Balance at 1 January 2023
52,413
Incoming resources 2023
Resources expended 2023
Total Funds at 31 December 2023
29,424
-24,392
57,445
Incoming resources 2024
Resources expended 2024
19,322
-27,960
**TOTAL FUNDS at 31 December 2024**
**48,807**|Restricted
Funds
£
**-**
126,666
-74,937
51,729
56,800
-99,082
**9,447**|
|Total
£
52,413
156,090
-99,329
109,174
76,122
-127,042
**58,254**|
|---|---|---|---|
|||||
## **12 RELATED PARTY DISCLOSURES**
There were no related party transactions for the year ended 31 December 2024 nor the year ended 31 December 2023.
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## **OUTREACH EMR**
## **Independent Examiner’s Report to the Trustees of Outreach EMR**
**Responsibilities** I report to the trustees on my examination of the accounts of the above charity **and basis of Report** (“the Charity”) for the year ended 31 December 2024. As the charity's trustees, you are responsible for the preparation of the accounts in accordance with the requirements of the Charities Act 2011 (“the Act”). I report in respect of my examination of the Charity’s accounts carried out under section 145 of the 2011 Act and in carrying out my examination, I have followed all the applicable Directions given by the Charity Commission under section 145(5)(b) of the Act.
**Independent** I have completed my examination. I confirm that no material matters have come to my **examiner's statement** attention in connection with the examination which gives me cause to believe that in, any material respect:
- the accounting records were not kept in accordance with section 130 of the Charities Act; or
- the accounts did not accord with the accounting records; or
- the accounts did not comply with the applicable requirements concerning the form and content of accounts set out in the Charities (Accounts and Reports) Regulations 2008 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.
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.
Examiner: Harry Howley Chartered Accountant
UHY Calvert Smith Heritage House, Murton Way, York, YO19 5UW
Date: 18th September 2025
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