2022-12-31-accounts

Palliative Care Works

Annual General Meeting – Saturday 14 October 2023

Report from the Chair – Dr George Smerdon

Hello everyone and a very warm welcome to you all to our AGM.

I know that in addition to the Trustees, we have associates and other friends present. You’re most welcome.

This report, my first as Chair, is based around the past year’s organisational changes and innovations at PCW, the outcomes of our Away Day held in May and of course our ongoing work programme - all in the context of the impact the Covid pandemic has had on the core of our work, delivering palliative care training in resource limited areas, traditionally done on site, face to face.

It has been an important year so my apologies if this report is slightly longer than usual. I would like to thank the Trustees for all they do, in volunteering their time, their steadfast commitment, dedication, hard work, good humour and fellowship.

Following the resignations of both Jane Appleton and Helen Bennett, who are greatly missed - happily, though, Helen continues as an Associate - we are delighted that the Board has been strengthened by the appointment of Ruth Alderton, a nurse and Fiona Rawlinson, a doctor, both working in palliative care here in the UK. In addition to their considerable clinical expertise and experience, they both bring academic and research skills, which are already proving of benefit to our work. Thank you.

Last year, two of PCW’s founding Trustees, decided to step down from their long-held roles, Stephen Chowns, as Secretary and Karilyn Collins as Treasurer, and I’d like to echo the fulsome tribute paid to them, by my predecessor, Jane Appleton. In those roles, they made outstanding contributions to the work of PCW and happily they remain as Trustees. In considering how to manage this change, the Board took the decision to seek paid administrative support and also the professional support of an accountant. So I would like to thank our new administrator, Sue Lakie, for joining PCW, bringing her considerable experience, skills and expertise that are proving so beneficial, and to Isobel O’Connor, our Honorary Treasurer, for her valuable contribution over the year through the presentation of financial reports for Board meetings.

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My thanks also to the team of Isobel O’Connor, Karilyn Collins and Charles Campion Smith and Gordon Powell, our previous accountant adviser, for preparing PCW’s accounts for independent examination as required by the Charity Commission.

The Board continues to meet four times a year like a well-oiled machine and an action plan is generated which is managed and overseen by our Administrator.

All PCW’s Governance policies are regularly reviewed and updated and appropriate training and refreshing is undertaken by the Trustees, again overseen by our Administrator.

As part of our succession planning for the future, we continue to seek expressions of interest from not only potential new Trustees but also new Associates and have agreed a new process for doing so. We are mindful of our responsibilities around ethnicity, diversity and inclusion to which PCW remains totally committed.

We are very grateful to our small but growing number of Associates for their support and indeed to the wider circle of friends and colleagues here in UK and internationally, several of whom are here for our annual conference which follows the AGM.

Looking to the future, PCW as an organisation, really does feel stronger for these changes. So what does the future hold for PCW? To think about where we felt we were in the uncertain post lockdown world, we had an away day for the Board, entitled ‘Whither PCW?’ It was an exciting, lively, extremely thoughtful and productive day, though, not without some anxieties about our future. The Board has expressed its gratitude to Fiona Rawlinson, for so skilfully leading us through the day and to Sue Lakie for writing up the report. I don’t propose to even try and summarise that day for this report but, essentially, three key areas emerged:

• One, we really wanted to find out more about the impact of our training. Are we making a difference?

• To look at this it was decided to conduct a survey by sending out a questionnaire to all those who have received Toolkit training over the years. The results of this survey would go towards creating evidence-based material. This exciting work is already underway and the Survey Team under Fiona’s lead will shortly be reporting on it in the Conference. As it’s work in progress I don’t propose to say more in this report.

• The second was about funding the work of PCW. Funding is a serious issue - indeed across the whole sector - and without a robust income source, PCW cannot continue to offer pro bono training. The reality is that access to funds for overseas face to face trainings is severely limited these days. PCW is not a fundraising organisation and it has no plans to change this. It is reliant on funding coming from those who have asked us to deliver training courses. PCW’s current thinking is that this needs to be

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joint funding from sources, both in country, say from a ministry or a faith-based organisation or both and out of country, from donor groups. Promoting partnerships with shared responsibilities and accountability.

Applying for grants on our own behalf is another option and Ruth Wooldridge remains PCW’s ‘go to’ Trustee for grant applications, having secured a number of important grants over the years without which much of what has been achieved would not have been possible. I welcome this opportunity to formally acknowledge this outstanding contribution. Thank you, Ruth.

• The third area was how to increase PCW’s visibility so more people were aware of what we had to offer. Visibility overseas is very important and much of PCW’s work has come from personal recommendation. An action plan was drawn up and we will be implementing elements over the next few months, including the distribution, throughout the palliative care community at home and abroad, of PCW’s beautiful new poster designed by Sue Lakie. It says all that needs to be said about what PCW is.

We are not slaves to social media, so our website is becoming increasingly important in increasing our visibility. It is visited regularly but as part of our visibility campaign, we feel it needs refreshing. This is now in hand in collaboration with our webmaster Mark Ewins to whom we are very grateful.

What of our current work programme?

Tanzania

Jane reported a year ago on the completion of the DFID/FCDO funded 4 hospital project in SE Tanzania. It was the biggest piece of work PCW has undertaken bringing, as it has, proven improvements to the quality of life of patients and their families and care givers through training and mentoring. Karilyn’s impressive report is available on our website as indeed are all the reports on this project.

Ongoing mentorship of these teams, by in country colleagues, collaborating with PCW trustees, is in place through a number of initiatives, and these have led to establishing strong links with teams there as they seek to integrate and strengthen PC there. This includes developing a series of information sheets about various aspects of palliative care to be sent out to the teams on a regular basis. The PCW Palliative Care Toolkit and its companion Trainer’s manual remain the bedrock on which trainings are delivered and we were pleased to hear the films we had made in lockdown are also in use, helping in cascading learning and experience.

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An important spin off from the FCDO project is that PCW supported seven early career nurses from 2 project sites (Nyangao and Ndanda) to apply successfully for Nursing Now Challenge Fund fellowships focussed on Leadership and Improvement. All these Fellows completed the on-line learning from the University of Global Health Equity. Feedback praised the commitment and enthusiasm of the nurses; one being given the Exemplary Leader award.

In January Karilyn and Richard Collins (who had been one of the original mentors) had the opportunity to meet four of the Fellows. All were very positive about the course and the relevance of what they had learnt to their daily work. All seemed to have taken on stronger leadership roles in palliative care in three of the four hospitals, with participation in educational initiatives for hospital and community colleagues. Karilyn’s report of her whole trip is available on PCW website. It notes, amongst many other positives, regular access to morphine. As this NNCF project nears its end, the challenge will be to continue to support the Fellows who will have so many competing demands on their time and attention.

Nepal

Palliative Care Works has been delighted to work with the International Nepal Fellowship (INF) over the past five years to enhance the development of palliative care in Nepal. Ruth Wooldridge has been the key link here working closely with Dr Dan Munday, a specialist in palliative care who has been developing palliative care services in Nepal for many years. He is part of the Primary Palliative Care Research Group at Edinburgh University. PCW is also delighted to have collaborated with the Nepalese Association of Palliative Care (NAPCare) and the Gurkha Welfare Trust (GWT) who have also been partners involved in the project. PCW, through Ruth Wooldridge, was successful in a grant application with INF securing £15,000 from a Trust for the Toolkit to be translated and contextualised into Nepali for local training and use at health posts and we are delighted to announce these Toolkits are now in regular use in Nepal. We wish those teams well as they cascade this learning and experience and I’m also delighted to say Dr Dan Munday is presenting on this work at this year’s Conference.

Lesotho and Liberia

Before finally reporting on our two other projects, Lesotho and Liberia, I want to comment on the challenges to delivering training as we come out of lockdown. Not having been able to undertake overseas travel and face to face teaching and the rapid rise in online teaching and learning courses and webinars, it has been important for us to review where we see ourselves in the world of palliative care training. Our Palliative Care Toolkit and its companion Trainer’s Manual have been freely available online for years in several languages and are regularly accessed as indeed are the films, along with their scripts and teaching suggestions. We’re absolutely committed to grassroots training in LMIC through using those resources and this inevitably means trying to reach communities where resources and

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access to appropriate technology is limited. We are now in the world of online and blended teaching and earlier this year PCW was invited to participate in the iECHO teaching programme delivering online basic palliative care training to multi professional teams in Lesotho. Project ECHO® (Extension for Community Healthcare Outcomes) is a collaborative medical education model that aims to build workforce capacity in rural and underserved areas. The teaching for this particular project is being delivered by an international multi professional panel being led by staff from PallCHASE (Palliative Care in Humanitarian Aid Situations and Emergencies) and the Starlight Oasis of Hope Hospice in Lesotho, the whole venture being sponsored by APCA. Gillian, Ruth and I are participating on the Faculty. This is a first for PCW and we will be reporting on the experience at a later date. It should be noted that plans for PCW to deliver face to face teaching in Lesotho - the original proposal - are going ahead as a collaboration between Dr Paul Myres under the auspices of the Wales and Africa Health Links Network https://www.wfahln.org/, Mme Tebello Lephearne, the founder of the Starlight Oasis of Hospice in Lesotho. The delay in being able to fix a date centres around accessing sufficient funding and internal tensions within Lesotho, both of which are beyond PCW’s control. It is hoped these will be resolved in the next few weeks, enabling the training to go ahead in March 2024.

Both the Lesotho and our other projects in Liberia are to deliver face-to-face teaching and both are delayed by the same problems of funding and a reluctance at administrative levels to see palliative care as a priority. In Liberia there are the forthcoming elections creating added uncertainty. Gillian Chowns, PCW’s project leader is working closely with the incountry partner, whom she knows well, but funding remains the stumbling block as the Liberian team have not been able, as yet, to secure funding.

So in conclusion, whilst we wrestle with the challenges of adapting to new ways of delivering on our mission statement, it’s clear that looking at ways of funding our work, preferably through partnerships here and abroad is the priority for the coming year. Thank you.

George Smerdon Chair Palliative Care Works 14 October 2023

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PALLIAnVE CARE WORKS A CHARITABLE INCORPORATED ORGANISATION RECEIPTSAND PAYMENTS ACCOUNTS FOR THE YEAR ENDED 31ST DECEMBER 2022 UNRESTRICTED RESTRICTED FUND FUND RESTRicfED NNF PROJE HS PROJEcr TOTAL YE31 12 2021 RECEIPTS THET DFID HS Trust Training/Consultation Fees NPAC ITZ Project) Donations Refunds 64CX).00 64CQ.00 0.00 10525.49 51K)O.00 75.00 1064.94 500.00 2887.37 3423.31 / 125.98 / So.￿ 3423.31 125.98 So.￿) TOTAL RECEIPTS 3599.29 / 0.00 6400.00 9999.29 4 2c￿52.80 PAYMENTS Nursing Project Tanzania Projett HS Project Nepal Expenses Members Conferenceltravel & APCA Expenses Printing & IT Sundry S049.50 5049.50 22028.51 1383.93 1410.30 1410.30 2274.89 1133.52 365.80 445.90 2274.89 1133.52 365.80 445.90 73.07 38.99 TOTAL PAYMENTS 1945.22 2274.89 / 1410.30 / 5049.50 10679.91 23524.50 1654.07 -2274.89 -1410.30 1350.50 -680.62 / -3471.70 SURPLUS DEFICIT FOR THE YEAR BANK BALANCE @ l Jan 2022 9150.37 2263.07 3633.29 15046.73 18518.43 TRANSFER BETWEEN FUNDS 2211.17 11.82 -2222.99

BANK BALANCE @ 31 Dec 2022 £13 015.61 £0.00 £o.oD £1 350.50 £14 366.11 £15 046.73 STATEMENT OF ASSETS & IIABILITIES 31 Dec 2022 BANK BAL4NCE 31 Dec 2022 13015.61 0.00 1350.50 14366.11 15046.73 Other Moneta Assets DFID Balance of NPAC Bethlehem Training Course 125.98 2073.31 Llabllltles Mr S. Bass- Expenses Dr.C. Campion - SmithlBoard Members Expenses) Mr5 S. Lakie-secretarial SeNices -£90.00 -£105.30 -£331.50 .£90.00 -£105.30 331.50 ASSETS 31 Dec 2022 £12 488.81 £0.00 £0.00 £1 350.5 £13 839.31 £17 246.02 Note: A stock of toolkits. Manuals & leaflets was held at 310e¢ember 2022 whlch are usually dlstrlbuted free of charge. -tL L'A C¢tsJ¢ t. LL er recorjs. eve q ¢coLI tts J. nrt 4CLo.itt'. 4Vt gf2cuGH 2LIl,,113