# ANNUAL REPORT 2020/21
REPORT OF THE TRUSTEES AND FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 MARCH 2021 FOR THE DAVID NOTT FOUNDATION
Registered charity number: 1162537
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## CONTENTS
- 3 WELCOME FROM THE CHAIR OF THE BOARD OF TRUSTEES
- 5 STATEMENT ON THE IMPACT OF COVID-19
- 6 OBJECTIVES AND ACTIVITIES
- 7 ACHIEVEMENT AND PERFORMANCE
- 8 PUBLIC BENEFIT
- 12 FUTURE PLANS
## WELCOME FROM THE CHAIR OF THE BOARD OF TRUSTEES
- 12 PLANS FOR FUTURE PERIODS, SUBJECT TO COVID-19 RESTRICTIONS CONTINUING TO EASE
- 13 FINANCIAL REVIEW
- 15 STRUCTURE, GOVERNANCE AND MANAGEMENT
- 16 LEGAL AND ADMINISTRATIVE DETAILS
- 17 TRUSTEES’ RESPONSIBILITIES STATEMENT
- 20 INDEPENDENT EXAMINER’S REPORT TO THE TRUSTEES
- 21 STATEMENT OF FINANCIAL ACTIVITIES
IT IS A GENUINE PRIVILEGE FOR ME TO ADDRESS YOU ONCE AGAIN AS CHAIR OF THE BOARD OF TRUSTEES OF THE DAVID NOTT FOUNDATION. SIMPLY PUT, IT IS A COMPELLING CAUSE, DELIVERED BY DEDICATED AND SKILLED PROFESSIONALS AND IN SOME OF THE MOST AUSTERE ENVIRONMENTS IN THE WORLD.
- 22 BALANCE SHEET
- 23 STATEMENT OF CASH FLOWS
Our ambition remains to positively impact national surgical systems through sustained training delivery in the countries and regions that need it most. Notwithstanding the disruption we have experienced as a result of the COVID-19 pandemic, we remain committed to the following strategic themes:
Acknowledging the operating theatre as our focus and area of expertise, and to drive clinical enhancements across the spectrum of whole-theatre activities.
To concentrate our work in austere environments across the Middle East & Africa.
To evolve and grow our training faculty.
The Foundation benefits from an experienced and committed board of trustees, who offer a wide range of skills and perspectives and who continue to be wholly invested in ensuring the highest quality training, protection of individuals and data, and effective and appropriate deployment of donor funds.
The team and clinical faculty are all highly experienced and capable and are each committed to furthering David’s work, in a way that is authentic and true to his vision.
Despite the impact of Covid, we are fortunate enough to have maintained a strong financial position and we remain determined to create a sustainable future so that we can confidently plan and deliver training wherever it is needed, within an enduring system of clinical excellence and evolution.
I would like to take this opportunity to express my gratitude to all our supporters, who have so generously and selflessly championed our work up until this point and for the support you have continued to offer us, despite the limited training courses we have been able to run during the pandemic. In this latest review, we reflect on what challenges our doctors have faced and how, through your generosity, we’ve been able to continue delivering training and invest in stateof-the-art equipment to ensure we can offer the very best in future surgical training courses.
The Foundation’s strengths remain consistent, and we are looking forward to leveraging them once more, for our beneficiaries, as we hopefully emerge from the pandemic and recommence with our overseas operations.
With many thanks to Andrew Rees at Westco Communications (westcocommunications.com) for so generously supporting the production of our annual report and War Doctor Heroes booklet.
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This last year has been like no other, for all of us. But for our family of war doctors, we are acutely aware of the additional challenges they have had to navigate since the start of the pandemic: conflict sadly continues around the world, with indiscriminate attacks on civilians and even direct attacks on hospitals, which remain a grim reality.
As a key supporter you will appreciate that for small charities, like the David Nott Foundation, every donation has a disproportionately large and lasting impact – on both war doctors and their patients in conflict zones. Every donation produces tangible results and keeps us on the road, training war doctors. From all of us at the Foundation, we thank you for a year of incredible generosity. We hope that you will continue to stay at the heart of the David Nott Foundation family and come with us on our journey into the post-COVID world.
The David Nott Foundation is so much more than an NGO. It is a family – of supporters selflessly donating and offering support; skilled medical professionals who offer their services in pursuit of our mission; the clinical faculty that deliver our training courses; partner organisations that ensure our safety abroad and, of course, the war doctors themselves who rely on this all coming together in concert for our ultimate beneficiaries.
We are now in the process of restating our three-year strategic plan and this gives us tremendous sense of hope and optimism for our future growth and impact, which we can only achieve in partnership with all of you.
## GRAHAM HODGKIN
CHAIR OF THE BOARD OF TRUSTEES
## STATEMENT ON THE IMPACT OF COVID-19
FOR AN ORGANISATION WHOSE PRIMARY MODE OF OPERATION IS IN-PERSON TEACHING, THE COVID-19 PANDEMIC NECESSITATED A RADICAL CHANGE IN HOW THE DAVID NOTT FOUNDATION (DNF OR FOUNDATION) PURSUED OUR MISSION. THANKS TO THE HARD WORK OF THE STAFF TEAM AND SOME CREATIVE THINKING, WE WERE ABLE TO MAINTAIN OUR CONTACT WITH THE COMMUNITY OF DOCTORS WE HAVE TRAINED.
## ACTIVITIES
In January 2020, when we ran a Hostile Environment Surgical Training (HEST) mission to Hajjah in Yemen, little did we realise this would be our last face-to-face course for more than 18 months. At the moment of first lockdown, DNF had courses planned in Syria, Iraq, Somaliland, Democratic Republic of Congo (DRC) and Uzbekistan (for Afghan surgeons). By the end of April 2020, all of these, bar the DRC course scheduled for December 2020, had been postponed. In November 2020, we took the difficult decision to postpone the DRC course as well.
Like many other educational organisations, with in-person courses cancelled or postponed, the Foundation found other means to deliver training. Whilst nothing replaces face-to-face teaching, we found other ways of connecting with students and experimented with new formats, some of which we will continue. In December 2020 we ran a livestreamed, digital Hostile Environment Surgical Training (DigiHEST) course which condensed the five-day HEST programme into three days. The HEST course when run abroad contains a large portion of practical work. Whilst participants were not able to partake in the practical work, we used the DNF teaching models including whole-body simulator HESTON to demonstrate various procedures. We were delighted to have over one hundred participants attend from some 29 countries including Ethiopia, Thailand, Syria, Nepal, Somalia and Sri Lanka.
We also commenced a programme of webinars where doctors could gather on Zoom and share their experiences, sometimes related to COVID-19 and other times cases they had encountered in the operating theatre. The conversations continued on the DNF WhatsApp group which now numbers over 130 people and is a lively forum for sharing information and knowledge.
## FINANCES
The Foundation has been fortunate to largely maintain its fundraising income in this pandemic period. We have been significantly helped by the continued generous support of the Syncona Foundation and were humbled to be selected by staff at the Wellcome Trust as their charity of the year for 2020. Furthermore, we are grateful to continue to benefit from the loyal support of many longstanding individual donors. This has enabled us to continue to build long-term capacity in the Foundation and to trial new delivery methods. Thanks to the generosity of our supporters, we are in a position to be ready to re-commence face-to-face training as soon as it is possible.
The Board of Trustees has been prudent this year in taking the opportunity to reduce overheads by terminating the office lease and managing annual salary costs. It was decided that an office space was not necessary whilst the UK Government advice was clear to stay at home. Together with the generosity of our donors, the financial year 2020-21 ended with a net positive impact on the Foundation’s finances.
## EMPLOYEES
David Nott Foundation team members began working from home in March 2020 during the first national lockdown in the UK. The office lease was terminated to reduce outgoings and a new office was sought in October 2021. The CEO left the Foundation during August 2020 and, given the circumstances of the pandemic, the Trustees chose not to immediately rehire. The duties were temporarily absorbed by other team members, supported by the Board of Trustees and a new Chief Executive, Eleanor Nott, appointed following a recruitment process and interview in November 2021. During the year in review, plans were also developed to expand the Board of Trustees and we are delighted to announce that Kamila Kingstone was appointed in September 2021. Kamila brings a wealth of experience from her work as a civil servant at the Cabinet Office and previously as a freelance journalist with the Guardian and Independent newspapers.
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## OBJECTIVES AND ACTIVITIES
THE DAVID NOTT FOUNDATION HAS A MISSION TO DELIVER THE BEST SURGICAL TRAINING TO MEDICAL PROFESSIONALS OPERATING IN AUSTERE AND HOSTILE ENVIRONMENTS WORLDWIDE; ENABLING THEM TO IMPROVE SURGICAL OUTCOMES AND SAVE MORE LIVES. OUR PURPOSE REMAINS:
“The advancement of health and the saving of lives by funding and/or delivering or facilitating training (either alone or in partnership with other organisations) for surgeons and medical professionals, to enable them to address the needs of medical patients in conflict and disaster zones and other austere environments.”
different is our focus on improving the skills of the local healthcare workers in their home countries. Through this, we believe we can improve surgical outcomes for patients and support health systems.
We are a humanitarian organisation motivated to help patients suffering from the effects of conflict and catastrophe and empower local healthcare workers. The most powerful way we believe we can do that is by equipping healthcare workers with the specialist skills and knowledge they need to make the right choices for their patients and improve the health systems within which they operate.
## WE GO BEYOND BORDERS
Our training improves the skills of healthcare workers and helps them improve the quality of life of their patients.
Our vision is a global network of healthcare workers, trained to the highest standards, providing the best care to patients in austere or hostile environments.
## WE WORK LOCALLY, TO DELIVER GLOBAL IMPACT
We are the only UK registered charity dedicated solely to training healthcare workers living and working in areas of conflict and austere environments.
## THE NEED FOR WHAT WE DO
There is an unfortunate certainty in the enduring occurrence of conflicts and natural disasters. Wherever these occur, experienced and well-trained healthcare workers are required to help patients and preserve life. We are the only UK charity dedicated solely to teaching specialist surgical skills to healthcare workers operating in areas affected by conflict and catastrophe. There are other charities that provide medical teams and vital infrastructure but what makes the David Nott Foundation
## WE TRANSFORM COMMUNITIES – NOW AND FOR THE FUTURE
Our legacy remains long after our courses come to an end. Through our global skillssharing network, we contribute to improved healthcare, knowledge, and confidence that continues to benefit entire communities.
## ACHIEVEMENT AND PERFORMANCE
Up to 100 doctors from 29 countries attended the pilot livestream of our DigiHEST course.
Travelled to Somalia to discuss a series of courses for Somali surgeons with the World Health Organisation (WHO).
Trained 24 new faculty members from a variety of surgical specialisms.
Launched a global digital network of alumni and faculty for doctors to connect, collaborate and share information with each other and the faculty.
Established regular series of online webinars for HEST and STAE alumni to share information on COVID-19 and complex surgical cases.
Expanded the Friends of David Nott Foundation societies to eleven universities throughout the UK.
Developed two new surgical models, a kidney and a beating heart, with a 3D printing company for the HEST course.
## **All time total 848** Surgeons trained
**30** STAE & hest courses in Palestine lebanon syria UK libya iraq yemen cameroon Argentina kenya chile
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## PUBLIC BENEFIT
TRUSTEES HAVE HAD REGARD TO THE GUIDANCE ISSUED BY THE CHARITY COMMISSION ON PUBLIC BENEFIT. THE FOUNDATION PROVIDES MEDICAL EDUCATION, TRAINING AND EXPERTISE. IT DOES SO WITH THE FOLLOWING PRINCIPAL PRODUCTS:
## HOSTILE ENVIRONMENT SURGICAL TRAINING (HEST)
The HEST course is unique to the Foundation and is delivered around the world, wherever medical professionals are dealing with complex surgical cases and would benefit from better training
HEST is taken abroad at the invitation of host countries, charitable organisations and international NGOs. Since our training began in 2015, a total of 650 surgeons have been trained in surgical techniques that, in conflict and disaster zones, often mean that the difference between life or death.
The settings where HEST is taught rule out cadaveric teaching so a combination of lectures, videos and discussions with practical exercises including the suturing of prosthetic organs and blood vessels and demonstrations on a bespoke simulator model, HESTON, is used instead. The Foundation’s faculty are experts in austere environment surgery and deliver tailored training to a globally recognised standard.
We are continuously appreciative of our strong links with other organisations in the humanitarian sector. It is through our partnerships with these organisations that we are able to reach the surgeons who most benefit from our training. Through allowing us to use their in-country logistics, risk-analysis, security and transport networks we are able to reduce our costs compared to those courses we undertake alone.
Whilst the course syllabus is consistent, each course differs in scale, timing and logistics. The average cost per surgeon trained is approximately £1,000. We aim to train up to 30 surgeons per HEST course, giving an average total cost per course of £30,000.
COVID-19 has impacted the ability of the Foundation to deliver our training in the usual way. With this in mind the Foundation has innovated by offering a number of various alternatives to reach doctors in conflict zones and austere environments.
A series of closed webinars on Zoom were organised for all the doctors in the Foundation network. During these webinars, doctors presented complex cases that were difficult to solve, or that they had solved with techniques learned on a David Nott Foundation course. Their peers could either advise on the complex case or learn from the modified technique but most importantly, during this time of global lockdown, doctors got to discuss cases or simply engage with their peers across the globe. Now they present and discuss cases on a WhatsApp group, which is hosted and managed by the Foundation. The original webinar series resumed in September 2021 with a larger audience than ever sharing more complex cases for discussion.
In December 2020 the Foundation ran a pilot livestreamed course, called DigiHEST. This was streamed over two days from a COVID-secure location in London to up to 100 doctors from 29 countries. DigiHEST introduced doctors to many of the skills taught on our flagship HEST course and ensured that course delivery could continue in some form while international travel was not possible.
Almost a year to the day from the HEST course in Hajjah, Yemen, a two-person team from the DNF travelled to Mogadishu to discuss a series of HEST courses with the World Health Organisation’s (WHO) Somalia country office to be based in the green zone at Mogadishu airport. An initial course was agreed for early March 2021 but unfortunately, Somalia was moved to the UK Government COVID-19 Red list of countries so travel was rendered impossible. The DNF has always been conscious that its faculty comes from the active cadre of NHS surgeons and therefore has a responsibility to ensure that the surgeons are away from their NHS responsibilities for as short a time as possible and avoid a 10-day hotel quarantine.
In July 2021, the Foundation delivered its first ‘Train the trainers’ workshop to dramatically expand the number of DNF teaching faculty available to teach future HEST courses. A total of 23 surgeons and nine faculty members spent three intensive days at the Wellcome Collection, learning and practicing the HEST material. Feedback from the event by participants was very positive and all expressed an interest in joining the faculty on future overseas courses. The next steps will be to introduce one or two new faculty members on each course, alongside experienced faculty, to provide them with in-country experience of teaching the course.
## THE STAE SCHOLARSHIP PROGRAMME
The Foundation also awards scholarships to surgeons to be trained by David Nott on the course he directs at the Royal College of Surgeons of England, Surgical Training for Austere Environments (STAE). The STAE course provides theoretical and technical training specific to surgical challenges faced in regions of conflict. David Nott Foundation
Scholarships are awarded to surgeons who show promise in the field of humanitarian surgery and would either struggle or not be able to meet the cost of course fees or have demonstrated a commitment to undertaking humanitarian missions.
The cost of their tuition, return travel to the UK, accommodation, visas and subsistence is met as part of the scholarship and amounts to approximately £5,000 per scholar. Each course costs us £70,000 to run.
In 2020-2021, the Foundation carried forward 14 scholarships that had been awarded for a March 2020 course, but which was ultimately postponed due to the travel restrictions brought about by the pandemic. At this time the Foundation additionally decided to award 15 more scholarships for courses in 2022. Scholars will travel to the UK from inter alia Nepal, Ethiopia, D.R. Congo, Burundi and Cameroon. The scholarship programme continues to widen outreach and reduce barriers to access to world-class training that would not be possible otherwise. The next STAE course will take place in December 2021, travel restrictions permitting.
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2020/21
DAVID NOTT FOUNDATION ANNUAL REPORT
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## GRANTS
The Foundation awards grants to faculty members and other training bodies to deliver surgical training true to the Foundation’s aims and values. The Foundation has a detailed grant making policy to ensure that any grants given are in line with the overall aims and goals of the Foundation. Grants provided by the Foundation will support individuals, other charities, and organisations which promote objects which are charitable under the law of England and Wales, particularly in the delivery of training and mentoring to improve the quality of surgery and patient outcomes in austere environments. On receipt of a grant application form, should it meet the criteria, the form and a written recommendation from Foundation staff will be sent to the Board of Trustees for approval. Grants may be given to individuals, private organisations and other charities and the policy covers the different parameters for making these awards.
During this reporting period, no grants were awarded.
## TEACHING MATERIALS AND AIDS
Critical to the successful learning of surgical procedures is the ability to touch, feel and observe the anatomy of the patient. There are practical and ethical restrictions on using cadavers for teaching in many countries, so the Foundation uses creative, innovative ways to ensure the doctors we teach experience the most effective training.
The Foundation’s bespoke simulator model (known as Heston) enables the demonstration of anatomy and a variety of injuries and surgical procedures. The model is anatomically identical to a human and made from materials that replicate the look and feel of human skin, flesh, bone and organs. Once complete, all the procedures which are taught in the various modules will be supported with discussions and demonstrations using the simulator. Heston has been developed and built with use of a restricted grant from the Open Society Foundations awarded in late 2016.
During the reporting period, more work was commissioned on Heston to expand the number of procedures visible on the manikin. Additionally, the Foundation worked with 3D Life Prints to produce a pneumatic beating heart model and a highly realistic kidney with full internal structure. Both can be operated on during courses. These models, which use a combination of silicone moulding and 3D printing, will enhance the Foundation’s training offering in the field.
Supporting the training models are new technologies including a virtual reality headset placing surgeons in a mass-casualty triage scenario to test their decision-making and new, portable ultrasound systems to demonstrate scanning techniques for rapid injury assessments.
## COLLABORATIVE LEARNING PLATFORM – APP
With the generous support of the Vodafone Foundation the DNF developed video material to serve as a resource for doctors seeking advice, originally envisaged to be delivered through an app. With the successful trial of a WhatsApp group and online webinars, and in consultation with the Vodafone Foundation, these video materials will be incorporated directly in the HEST courses instead.
## FUNDRAISING POLICY
The Foundation maintains robust fundraising practices in line with our Fundraising Policy and does not solicit for donations through the use of professional fundraisers, telemarketing or involve commercial participators. The Foundation takes its responsibility to protect vulnerable people seriously and abides by its Safeguarding and Welfare Policy to ensure strict procedures and practices are in place. The Foundation has ensured its privacy notice complies with data protection laws, GDPR, and has a proactive complaint handling procedure that is published on our website. We have not received any complaints to date.
Our fundraising objective during the year was to strengthen our relationships with our longstanding and committed donors. Like most charities, our income in 20/21 was significantly impacted by the COVID-19 pandemic with a fall in income of 17%. However, the trustees consider that our income has remained strong despite the challenging circumstances thanks to the generous support of our donors.
The Foundation is a member of the Chartered Institute of Fundraising and is bound by and accordingly complies with the Fundraising Regulator’s revised Code of Fundraising Practice.
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## FUTURE PLANS
PLANS FOR FUTURE PERIODS, SUBJECT TO COVID-19 RESTRICTIONS CONTINUING TO EASE
GOALS FOR 2021-22:
Return to in-person training.
Amplify the Foundation’s reach by increasing the number of healthcare workers trained in areas of greatest need:
Further growth of our training faculty to increase HEST course delivery and reach;
Further develop the Foundation’s webinar series and community groups;
Invest in the best value training equipment to maximise our effect;
Commission a research project to evaluate training effectiveness over time and identify areas for development and improvement;
Support healthcare workers in hostile environments with:
Training reference manuals and handbooks;
An expanded collaboration network.
Diversify our income sources through identification of charitable foundations and trusts, corporate partnerships, and reduce costs with gifts in kind.
Increase the diversity of our scholars through promoting the programme and encouraging applications from around the world.
Strengthen and consolidate our partnerships; recognising we achieve more when we work together.
## FINANCIAL REVIEW
## FINANCIAL POSITION
consistently gave outstanding effort to the cause from completing challenges to auctioning lunches with Director Sir Jeremy Farrar. This partnership with the Wellcome Trust will have a profound and lasting impact on both war doctors and their patients in conflict zones for many years to come.
THIS WAS THE FIFTH FULL YEAR OF OPERATIONS FOR THE FOUNDATION. WE CONTINUE TO DEVELOP OUR DONOR STRATEGY TO DIVERSIFY SOURCES OF REVENUE AND RAISE AWARENESS OF OUR ACTIVITIES TO A BROADER BASE OF POTENTIAL DONORS. WE ARE EXTREMELY GRATEFUL FOR OUR DONORS’ CONTINUED SUPPORT PARTICULARLY DURING THE CHALLENGING PERIOD SINCE MARCH 2020.
Expenditure was £330,009, down 52% from £690,404 in the prior year, due to cost savings being realised by not replacing the CEO immediately and terminating the office lease. In addition course costs were much-reduced due to travel restrictions imposed by the pandemic.
£831,282 of income was unrestricted with the restricted remainder being £nil.
The Foundation raised donations of £830,804 in the period to 31 March 2021, down 17% from £1,000,380 in the prior year. Like most charities, our income was impacted by the COVID-19 pandemic. While we were unable to fundraise through events, our income has remained strong through the continued and generous support of long-standing and committed donors, the increased fundraising capacity of the team, continued publicity from David’s book ‘War Doctor’ and an increased number of online interviews and talks.
The ability for the Foundation to deliver cost-effective training through partnerships and efficiencies continues to be an important factor in the control of its expenditure. As we continue to invest in improving the training value of our equipment, the quality of our teaching aids and volume of training these costs are expected to increase. We aim to deliver best-in-class training wherever we are.
We benefitted from the continued generous support from the Syncona Foundation, making a significant contribution to the Foundation’s ability to grow. We were humbled to be selected as the Wellcome Trust’s ‘staff charity of the year’ for 2020. During this time their employees
As reported in the previous year’s accounts, the beneficial finances of the five full years to period-end have now enabled the Foundation to transfer £570,000 into investments in line with its investment policy.
AS OF MARCH 31ST 2021, THE VALUE OF THE FOUNDATION’S INVESTMENT WAS AS FOLLOWS:
|COIF CHARITIES DEPOSIT FUND|£404,085|
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|COIF CHARITIES INVESTMENT FUND||
|ACCUMULATION UNITS|£695,377|
|Fund Summaries:|£1,099,462|
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## INVESTMENT POLICY AND OBJECTIVES
The Foundation has developed a formal investment policy to protect cash assets against inflation and grow capital in real terms.
The Foundation’s investment objective is to achieve an average annual total return of inflation of CPI plus 4% over a rolling five-year period. Investments are managed by a third party on a discretionary basis reporting to the Board each quarter. The Foundation’s investments are well diversified, cost effective, and offer at least monthly liquidity. The portfolio performance for the year was 14.2% compared to a comparator index of 0.5%.
The Foundation’s ethical policy is applied to these investments in regard to companies involved in the manufacture of controversial weapons, strategic military weapons, non-military firearms, tobacco, pornography, and online gambling. The Foundation also prefers investment partners who integrate Environmental, Social and Governance factors into the investment process and engage in active ownership to improve company performance and change behaviour.
## OPERATING RESERVE POLICY
The Operating Reserve refers to ringfenced cash set aside by the Board of Trustees to guarantee the stability of the programmes, employment, and ongoing operations of the organisation. As is best practice, the Operating Reserve provides an internal source of funds for unforeseen situations such as a sudden increase in expenses, one-time unbudgeted expenses, unanticipated loss in funding, or uninsured losses.
Operating Reserves are not intended to replace a permanent loss of funds or eliminate an ongoing budget gap and, if the funds are used, it is the intention of the Foundation to replenish the reserve within a reasonably short period of time.
The Operating Reserve in 2020-21 was set for four months of average budgeted operating costs, a relatively conservative provision for an organisation of this kind. The calculation of average monthly operating costs includes all recurring, predictable expenses such as programme related expenses, salaries and occupancy, but excludes depreciation, in-kind, and other non-cash expenses. Four months of budgeted operating costs equates to £179,000
After taking into account our reserves policy as summarised above, the Foundation is above the Board’s target for the year. The level of free reserves at the year-end is £1,804,613. This is calculated as the total funds of the charity less restricted funds and less fixed assets held for charity use. This leaves £1,519,613 available for contingencies. The restricted funds at 31 March 2021 were £155,160 and are not available for the general purposes of the charity. The Trustees are cognisant of the size of the reserve which has accrued largely due to the inability to carry out teaching abroad. There are substantial plans for the years ahead however with plans to increase the number of HEST courses by 35% and also conduct two specialist obstetric and neonatal resuscitation training courses. We also continue to modestly expand our staff to be able to manage the increased training load. New equipment is also needed, as existing simulation models begin to experience wear and tear and the single-use models are again used to train abroad. The reserve is therefore not anticipated to be anything approaching this size by the time of the next Trustees Annual Report.
The amount of the Operating Reserve Fund will be calculated each year after approval of the annual budget, reported to the Board of Trustees, and included in the regular financial reports.
## STRUCTURE, GOVERNANCE AND MANAGEMENT
## GOVERNING DOCUMENT
other trustees. Trustees are encouraged to attend appropriate external training events where these will facilitate the undertaking of their role.
The charity is controlled by its governing document (the Constitution dated 9 June 2015) and is registered as a charitable incorporated organisation. The Constitution was amended on 2 July 2021 to protect the role of our CoFounders, David and Elly Nott, in determining the strategic direction of the charity despite not being Trustees or management themselves.
## ORGANISATION
The Board of Trustees, which must have at least three members, administers the charity. The board normally meets at least quarterly but also informally on a very regular basis. In the absence of a CEO during part of the year in review, delegated authority was provided to the incumbent Operations Director and Head of Donor and Supporter Relations, with terms of delegation approved by the trustees, for operational matters including finance and employment.
## RECRUITMENT AND APPOINTMENT OF NEW TRUSTEES
Appointments to the Foundation are made following an appraisal of current needs, in terms of expertise, by the Board in conjunction with the Co-Founders.
## RISK MANAGEMENT
## REMUNERATION POLICY
The trustees have a risk management strategy which comprises:
All trustees give of their time freely and in a voluntary capacity and no trustee received remuneration in the year. Details of trustees’ expenses and related party transactions are disclosed in notes 15 and 26 respectively to the accounts. Compensation levels for all Foundation employees all is reviewed annually and normally increased in accordance with average earnings. The trustees also endeavour to benchmark roles against pay levels in other similar organisations.
an annual review of the principal risks and uncertainties that the charity faces
the establishment of policies, systems and procedures to mitigate those risks identified in the annual review and
the implementation of procedures designed to minimise or manage any potential impact on the charity should those risks materialise.
## TRUSTEE INDUCTION AND TRAINING
This work has identified that overseas work and travel to conflict and disaster areas is an area of major risk. Key mitigants to these risks are security assessments, security procedures, security training and insurance.
New trustees undergo an orientation period to brief them on their legal obligations under charity law, the Charity Commission guidance on public benefit, and inform them of the content of the Constitution, the committee and decisionmaking processes, the business plan and recent financial performance of the charity. During the induction period they meet key employees and
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## LEGAL AND ADMINISTRATIVE DETAILS
## REGISTERED CHARITY NAME
## INDEPENDENT EXAMINERS
The David Nott Foundation
Shipleys LLP
Chartered Accountants & Statutory Auditor 10 Orange Street, Haymarket London, WC2H 7DQ
## CHARITY REGISTRATION NUMBER
1162537
## BANKERS
## PRINCIPAL OFFICE
The Co-operative Bank Business Direct PO Box 250 Skelmersdale WN8 6WT
1 Lyric Square Hammersmith London W6 0NB
## INVESTMENT MANAGERS
## TRUSTEES
Mr G J Hodgkin Ms C Hughes Mr R R Hoare Mr S J Armitage Ms K E L Kingstone (appointed 6 September 2021)
CCLA Investment Management Limited Senator House 85 Queen Victoria Street London, EC4V 4ET
## TRUSTEES’ RESPONSIBILITIES STATEMENT
## THE TRUSTEES ARE RESPONSIBLE
FOR PREPARING THE TRUSTEES’ ANNUAL REPORT AND THE FINANCIAL STATEMENTS IN ACCORDANCE WITH APPLICABLE LAW AND UNITED KINGDOM ACCOUNTING STANDARDS INCLUDING FINANCIAL REPORTING STANDARD 102: THE FINANCIAL REPORTING STANDARD APPLICABLE IN THE UK AND REPUBLIC OF IRELAND (UNITED KINGDOM GENERALLY ACCEPTED ACCOUNTING PRACTICE).
The law applicable to charities in England and Wales requires the trustees to prepare financial statements for each financial year which give a true and fair view of the state of affairs of the charity and the income and expenditure of the charity 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 in the Charities SORP;
make judgments and accounting estimates that are reasonable and prudent;
state whether applicable UK Accounting Standards have been followed, subject to any material departures disclosed and explained in the financial statements; and
prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charity will continue in business.
The trustees are responsible for maintaining proper accounting records which disclose with reasonable accuracy at any time the financial position of the charity and enable them to ensure that the financial statements comply with the Charities Act 2011, the Charity (Accounts and Reports) Regulations 2008 and the provisions of the trust deed/constitution. They are also responsible for safeguarding the assets of the charity and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.
The trustees are responsible for the maintenance and integrity of the charity and financial information included on the charity’s website. Legislation in the United Kingdom governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions.
The trustees’ annual report was approved on 10 January 2022 and signed on behalf of the trustees by:
MS C HUGHES TRUSTEE
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## INDEPENDENT EXAMINER’S REPORT TO THE TRUSTEES
I have completed my examination. I confirm that no material matters have come to my attention in connection with the examination giving me cause to believe that in any material respect:
I report to the trustees on my examination of the accounts of the David Nott Foundation for the year ended 31 March 2021 which are set out on pages 21 to 42.
1. Accounting records were not kept in respect of the charity as required by section 130 of the Act; or
## RESPONSIBILITIES AND BASIS FOR REPORT
2. The accounts do not accord with those records; or
As the charity trustees of the charity you are responsible for the preparation of accounts in accordance with the requirements of the Charities Act 2011 (‘the Act’).
3. The accounts do 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 report in respect of my examination of the Trustees’ accounts carried out under section 145 of the 2011 Act and in carrying out my examination I have followed the applicable Directions given by the Charity Commission under section 145(5)(b) of the 2011 Act.
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.
## INDEPENDENT EXAMINER’S STATEMENT
Since the charity’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 the Institute of Chartered Accountants in England and Wales (ICAEW), which is one of the listed bodies.
## SIMON ROBINSON FCA
Shipleys LLP Independent Examiner 10 Orange Street Haymarket London WC2H 7DQ
## STATEMENT OF FINANCIAL ACTIVITIES
FOR THE YEAR ENDED 31 MARCH 2021
## 2021 2020
|||||2021|2020|
|---|---|---|---|---|---|
|||Unrestricted|Restricted|||
|||funds|funds|Total funds|Total funds|
||Notes|£|£|£|£|
|Income and endowments||||||
|Donations and legacies|5|830,804|–|830,804|1,000,380|
|Investment income|6|478|–|478|2,458|
|Total income||831,282|–|831,282|1,002,838|
|Expenditure on:||||||
|Raising funds|7|(74,714)|–|(74,714)|(165,250)|
|Charitable activities|8|(223,103)|(32,192)|(255,295)|(525,154)|
|Total expenditure||(297,817)|(32,192)|(330,009)|(690,404)|
|Net income before net gains||||||
|/ (losses) on investments||533,465|(32,192)|501,273|312,434|
|Net gains / (losses) on investments|12|136,210|–|136,210|(17,033)|
|Net income / (expenditure ) and||||||
|net movement in funds||669,675|(32,192)|637,483|295,401|
|Reconciliation of funds||||||
|Total funds brought forward||1,211,763|187,352|1,399,115|1,103,714|
|Total funds carried forward||1,881,438|155,160|2,036,598|1,399,115|
10 January 2022
The notes form part of these financial statements
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## BALANCE SHEET
## FOR THE YEAR ENDED 31 MARCH 2021
|||2021||2020||
|---|---|---|---|---|---|
||Notes|£|£|£|£|
|Fixed assets||||||
|Tangible fxed assets|16||192,496||143,216|
|Investments|17||695,377||559,167|
||||887,873||702,383|
|Current assets||||||
|Debtors|18|10,681||1,247||
|Cash at bank and in hand||1,157,289||720,950||
|||1,167,970||722,197||
|Creditors: amounts falling||||||
|due within one year|19|(19,245)||(25,465)||
|Net current assets|||1,148,725||696,732|
|Total assets less current liabilities|||2,036,598||1,399,115|
|Net assets|||2,036,598||1,399,115|
|Funds of the charity||||||
|Unrestricted funds|23||1,881,438||1,211,763|
|Restricted funds|24||155,160||187,352|
|Total charity funds|||2,036,598||1,399,115|
These financial statements were approved by the board of trustees on 10 January 2022, and are signed on behalf of the board by
## STATEMENT OF CASH FLOWS
## FOR THE YEAR ENDED 31 MARCH 2021
|||2021|2020|
|---|---|---|---|
||Notes|£|£|
|Cash fows from operating activities||||
|Net income||637,483|295,401|
|Adjustments for:||||
|Depreciation of tangible fxed assets||45,820|47,740|
|Net (losses)/gains on investments||(136,210)|17,033|
|Dividends and interest from investments||(478)|(2,458)|
|Changes in:||||
|Trade and other debtors||(9,434)|59,999|
|Trade and other creditors||(6,220)|(3,794)|
|Cash generated from operations||530,961|413,921|
|Net cash from/(used in) operating activities||530,961|413,921|
|Cash fows from investing activities||||
|Dividends and interest from investments||478|2,458|
|Purchase of tangible assets||(95,100)|(20,245)|
|Purchases of other investments||–|(200,000)|
|Net cash used in investing activities||(94,622)|(217,787)|
|Net increase/(decrease) in cash and cash equivalents|27|436,339|196,134|
|Cash and cash equivalents at beginning of year||720,950|524,816|
|Cash and cash equivalents at end of year||1,157,289|720,950|
MS C HUGHES TRUSTEE
The notes form part of these financial statements
The notes form part of these financial statements
24
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## NOTES TO THE FINANCIAL STATEMENTS
## FOR THE YEAR ENDED 31 MARCH 2021
## 1. General information
The David Nott Foundation meets the definition of a public benefit entity under FRS 102.
The charity is a Charitable Incorporation Organisation, registered in England and Wales. The address of the principal office is The Office Group, 1 Lyric Square, Hammersmith, London W6 0NB. The objectives of the charity are set out on page 6.
The functional currency of the charity is considered to be pounds sterling because that is the currency of the primary economic environment in which the charity operates. The financial statements are also presented in pounds sterling.
The amounts in the financial statements are prepared to the nearest £, unless otherwise stated.
## 2. Statement of compliance
These financial statements have been prepared in compliance with FRS 102, ‘The Financial Reporting Standard applicable in the UK and the Republic of Ireland’, the 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) (Charities SORP (FRS 102)) and the Charities Act 2011.
## GOING CONCERN
The financial statements of the charity have been prepared on the going concern basis.
The charity’s ability to deliver overseas training has been significantly restricted by the impact of the COVID-19 pandemic, with most physical training courses deferred or cancelled. We have maintained contact with our beneficiaries through online webinars and ran a Digital HEST course in December 2020. Additionally, the potential DNF teaching faculty has been expanded via a UK based ‘Train the Trainers’ workshop, readying us for the recommencement of overseas courses in Q3 2021 . More of these sessions are envisaged in order to develop trainers to resource future international programmes. The charity has sufficient funds in place to resource all anticipated programmes in the foreseeable future. There are no material uncertainties about the charity’s ability to continue as a going concern.
The financial statements have been prepared to give a ‘true and fair’ view and have departed from the Charities (Accounts and Reports) Regulations 2008 only to the extent required to provide a ‘true and fair view’. This departure has involved following Accounting and Reporting by Charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) issued on 16 July 2014 rather than the Accounting and Reporting by Charities: Statement of Recommended Practice effective from 1 April 2005 which has since been withdrawn.
## 3. Accounting policies
## JUDGEMENTS AND KEY SOURCES OF ESTIMATION UNCERTAINTY
## BASIS OF PREPARATION
There are no judgements or key sources of estimation uncertainty that would have a significant effect on the carrying amounts of assets and liabilities recognised in the financial statements.
The financial statements have been prepared on the historical cost basis, as modified by the revaluation of certain financial assets and liabilities measured at fair value through income or expenditure.
## NOTES TO THE FINANCIAL STATEMENTS
## FOR THE YEAR ENDED 31 MARCH 2021
## FUND ACCOUNTING
Interest on funds held on deposits is included when receivable and the amount can be reliably measured by the charity. This is normally upon notification of the interest paid or payable by the bank.
Unrestricted funds are available for use at the discretion of the trustees to further any of the charity’s purposes.
## EXPENDITURE
Restricted funds are funds that can only be used for particular restricted purposes within the objects of the charity. They are subjected to restrictions on their expenditure declared by the donor or through the terms of an appeal.
Liabilities are recognised as expenditure as soon as there is a legal or constructive obligation committing the charity to that expenditure, 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 recognised on an accruals basis and is classified under headings of the statement of financial activities to which it relates:
## INCOME
All income is included in the statement of financial activities when entitlement has passed to the charity; it is probable that the economic benefits associated with the transaction will flow to the charity and the amount can be reliably measured.
expenditure on raising funds includes the costs of all fundraising activities, events and non-charitable trading activities
Income from donations or grants is recognised when there is evidence of entitlement to the gift, receipt is probable and its amount can be measured reliably.
expenditure on charitable activities includes all costs incurred by a charity in undertaking activities that further its charitable aims for the benefit of its beneficiaries, including those support costs and costs relating to the governance of the charity apportioned to charitable activities.
Donated professional services and donated facilities are recognised as income when the charity has control over the item, any conditions associated with the donated item have been met, the receipt of economic benefit from the use by the charity of the item is probable and that economic benefit can be measured reliably. On receipt, donated professional services and donated facilities are recognised on the basis of the value of the gift to the charity which is the amount the charity would have been willing to pay to obtain services or facilities of equivalent economic benefit on the open market; a corresponding amount is then recognised in expenditure in the period of receipt. In accordance with the Charities SORP (FRS 102), the contribution of volunteers is not recognised in the accounts.
All costs are allocated to expenditure categories reflecting the use of the resource. Direct costs attributable to a single activity are allocated directly to that activity.
Support costs are those functions that assist the work of the charity but do not directly undertake charitable activities. Support costs include staff, premises, finance and governance costs. These costs have been allocated between expenditure on raising funds and expenditure on charitable activities on the basis of an estimate of the proportion of time spent by staff on those activities.
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## NOTES TO THE FINANCIAL STATEMENTS
## FOR THE YEAR ENDED 31 MARCH 2021
## INVESTMENTS
Governance costs comprise all costs involving the public accountability of the charity and its compliance with regulation and good practice.
Investments are a form of basic financial instrument and are initially recognised at their transaction value and subsequently measured at their fair value as at the balance sheet date using the closing quoted market price.
Irrecoverable VAT is charged as a cost against the activity for which the expenditure was incurred.
Grants payable are payments made to third parties in the furtherance of the charitable objects of the charity. In the case of an unconditional grant offer this is accrued once the recipient has been notified of the grant award. The notification gives the recipient a reasonable expectation that they will receive the grant. Grants awarded that are subject to the recipient fulfilling performance conditions are only accrued when the recipient has been notified of the grant and any remaining unfulfilled condition attaching to the grant is outside of the control of the charity. Provisions for grants are made when the intention to make a grant has been communicated to the recipient but there is uncertainty as to the timing of the grant or the amount of grant payable.
All gains and losses are taken to the statement of financial activities as they arise. Realised gains and losses on investments are calculated as the difference between sales proceeds and their opening carrying value or their purchase value if acquired subsequent to the first day of the financial year. Unrealised gains and losses are calculated as the difference between the fair value at the year-end and their carrying value. Realised and unrealised investment gains and losses are combined in the Statement of Financial Activities.
## FINANCIAL INSTRUMENTS
The charity only has financial assets and financial liabilities of a kind that qualify as basic financial instruments. Basic financial instruments are initially recognised at transaction value and subsequently measured at their settlement value unless otherwise stated in the accounting policies.
## TANGIBLE ASSETS
Tangible assets are initially recorded at cost, and subsequently stated at cost less any accumulated depreciation and impairment losses.
## DEBTORS
## DEPRECIATION
Trade and other debtors are recognised at the settlement amount due after any trade discounts offered. Prepayments are valued at the amount prepaid net of any trade discounts due.
Depreciation is calculated so as to write off the cost of an asset, less its residual value, over the useful economic life of that asset as follows:
Teaching equipment – 25% reducing balance Computer equipment – 25% reducing balance Office equipment – 25% reducing balance
## CASH AT BANK AND IN HAND
Cash at bank and cash 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.
## NOTES TO THE FINANCIAL STATEMENTS
## FOR THE YEAR ENDED 31 MARCH 2021
## CREDITORS AND PROVISION
## DEFINED CONTRIBUTION PLANS
Contributions to defined contribution plans are recognised as an expense in the period in which the related service is provided. Differences between contributions payable in the year and the contributions actually paid are shown either in accruals or prepayments on the balance sheet.
Creditors and provision are recognised where the charity has a present obligation resulting in the transfer of funds to a third party and the amount due to settle the obligation can be measured or estimated reliably. Creditors and provisions are normally recognised at their settlement amount after allowing for any trade discounts due.
## OPERATING LEASE COMMITMENTS
Rentals paid under operating leases are charged to the Statement of Financial Activities on a straight line basis over the term of the lease.
## 4. Taxation
The charity is exempt from tax on income and gains to the extent that these are applied to its charitable objectives.
## 5. Donations and legacies
||Unrestricted|||
|---|---|---|---|
||fund|Restricted fund|Total funds 2021|
||£|£|£|
|Donations|830,804|–|830,804|
||Unrestricted|||
||fund|Restricted fund|Total funds 2020|
||£|£|£|
|Donations|965,013|35,367|1,000,380|
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## NOTES TO THE FINANCIAL STATEMENTS
## FOR THE YEAR ENDED 31 MARCH 2021
## NOTES TO THE FINANCIAL STATEMENTS
## FOR THE YEAR ENDED 31 MARCH 2021
## 6. Investment income
|6. Investment income|6. Investment income||||
|---|---|---|---|---|
|Unrestricted||Total Funds|Unrestricted|Total Funds|
||Funds|2021|Funds|2020|
||£|£|£|£|
|Deposit account interest|478|478|2,458|2,458|
|7. Costs of raising donations and legacies|||||
|Unrestricted||Total Funds|Unrestricted|Total Funds|
||Funds|2021|Funds|2020|
||£|£|£|£|
|Cost of raising funds|57,163|57,163|117,248|117,248|
|Support costs|17,551|17,551|48,002|48,002|
||74,714|74,714|165,250|165,250|
|8. Expenditure on charitable activities|||||
|||Unrestricted|Restricted|Total Funds|
|||Funds|Funds|2021|
|||£|£|£|
|Hostile Environment Surgical Training (HEST)||160,113|32,192|192,305|
|Surgical Training for Austere Environments (STAE)||10,404|–|10,404|
|Other training projects||52,586|–|52,586|
|||223,103|32,192|255,295|
||||Restricted|Total Funds|
|---|---|---|---|---|
||Unrestricted Funds||Funds|2020|
|||£|£|£|
|Hostile Environment Surgical Training (HEST)||280,351|41,190|321,541|
|Surgical Training for Austere Environments (STAE)||174,986|–|174,986|
|Other training projects||28,627|–|28,627|
|||483,964|41,190|525,154|
|Analysis of expenditure on charitable activities|||||
||Grant funding||Support|Total funds|
||of activities|Direct costs|costs|2021|
||£|£|£|£|
|Hostile Environment Surgical Training (HEST)|–|160,249|32,056|192,305|
|Surgical Training for Austere Environments (STAE)|(28,000)|27,185|11,219|10,404|
|Other training projects|–|35,502|17,084|52,586|
||(28,000)|222,936|60,359|255,295|
||Grant funding||Support|Total Funds|
||of activities|Direct costs|costs|2020|
||£|£|£|£|
|Hostile Environment Surgical Training (HEST)|–|258,447|63,094|321,541|
|Surgical Training for Austere Environments (STAE)|56,000|103,976|15,010|174,986|
|Other training projects|7,409|12,755|8,463|28,627|
||63,409|375,178|86,567|525,154|
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## NOTES TO THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 31 MARCH 2021
## 9. Analysis of support costs
|||||Other||
|---|---|---|---|---|---|
||Fundraising|HEST|STAE|projects|Total 2021|
||£|£|£|£|£|
|Premises costs|3,569|6,518|2,281|3,474|15,842|
|IT costs|573|1,047|366|558|2,544|
|Insurance|3,491|6,377|2,232|3,399|15,499|
|Depreciation|295|538|189|287|1,309|
|Bank charges|28|51|18|26|123|
|Governance costs|9,595|17,525|6,133|9,340|42,593|
||17,551|32,056|11,219|17,084|77,910|
Support costs are allocated to the activities of the charity based on the estimated time spent on those activities by the charity’s employees.
|||||Other||
|---|---|---|---|---|---|
||Fundraising|HEST|STAE|projects|Total 2020|
||£|£|£|£|£|
|Premises costs|13,594|17,868|4,251|2,397|38,110|
|IT costs|530|697|166|93|1,486|
|Insurance|12,873|16,921|4,025|2,270|36,089|
|Depreciation|564|742|176|100|1,582|
|Bank charges|79|104|25|13|221|
|Governance costs|20,362|26,762|6,367|3,590|57,081|
||48,002|63,094|15,010|8,463|134,569|
## NOTES TO THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 31 MARCH 2021
## 10. Governance
|10. Governance|||||
|---|---|---|---|---|
||Unrestricted|Total Funds|Unrestricted|Total Funds|
||Funds|2021|Funds|2020|
||£|£|£|£|
|Accountancy|11,935|11,935|450|450|
|Audit|–|–|7,500|7,500|
|Independent examination|3,300|3,300|–|–|
|Staf costs|26,948|26,634|21,938|21,938|
|Legal fees|410|410|13,072|13,072|
|Recruitment|–|–|12,954|12,954|
|Trustee meetings|–|–|1,167|1,167|
||42,593|42,279|57,081|57,081|
## 11. Analysis of grants
|11. Analysis of grants|||
|---|---|---|
||2021|2020|
|Grants to institutions|£|£|
|Syria Relief|–|6,000|
|Grants to institutions|–|6,000|
|Scholarships at Royal College of Surgeons|(28,000)|56,000|
|Visit to Edna Adan Hospital, Somaliland|–|1,409|
|Total grants|(28,000)|63,409|
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## NOTES TO THE FINANCIAL STATEMENTS
## FOR THE YEAR ENDED 31 MARCH 2021
## 12. Net (losses)/gains on investments
||Unrestricted|Total Funds|Unrestricted|Total Funds|
|---|---|---|---|---|
||Funds|2021|Funds|2020|
||£|£|£|£|
|Gains/(losses) on listed investments|136,210|136,210|(17,033)|(17,033)|
## 13. Net income
Net income is stated after charging/(crediting):
|Net income is stated after charging/(crediting):|||
|---|---|---|
||2021|2020|
||£|£|
|Auditor’s remuneration|–|7,500|
|Independent examiners fee:|||
|– independent examination|3,300|–|
|– accountancy|8,250|–|
|– corporation tax|1,140|–|
|– payroll|1,440|–|
|Depreciation of tangible fxed assets|45,820|47,740|
|Operating lease expense – land and building|9,450|32,400|
## NOTES TO THE FINANCIAL STATEMENTS
## FOR THE YEAR ENDED 31 MARCH 2021
## 14. Staff costs
The total staff costs and employee benefits for the reporting period are analysed as follows:
||2021|2020|
|---|---|---|
||£|£|
|Wages and salaries|170,531|155,737|
|Social security costs|13,682|14,083|
|Employer contributions to pension plans|3,242|2,818|
|Other employee benefts|555|1,569|
||188,010|174,207|
|Pension costs are allocated to activities on the basis of time spent by each|||
|employee and are wholly allocated to unrestricted funds.|||
|The average head count of employees during the year was 4 (2020: 4). The|average||
|number of full-time equivalent employees during the year is analysed as follows:|||
||2021|2020|
||No.|No.|
|Charitable activities|2|2|
|Fundraising|1|1|
||3|3|
One employee received employee benefits of more than £60,000 during the year (2020: one employee received employee benefits of more than £70,000). Pension contributions of £1,313 (2020: £1,316) were paid on behalf of higher paid employees during the year. The number of higher paid employees accruing benefits under defined contribution pension schemes were 1 (2020: 1).
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## NOTES TO THE FINANCIAL STATEMENTS
## FOR THE YEAR ENDED 31 MARCH 2021
## 15. Trustee remuneration and expenses
The trustees have not received any remuneration during the year (2020: £nil). No out of pocket expenses were reimbursed to trustees during the year (2020: £nil). No charity trustee received payment for professional or other services supplied to the charity (2020: £nil).
## 16. Tangible fixed assets
||Teaching|Computer|Ofce||
|---|---|---|---|---|
||equipment|equipment|equipment|Total|
||£|£|£|£|
|Cost|||||
|At 1 April 2020|322,306|9,750|–|332,056|
|Additions|94,056|–|1,044|95,100|
|At 31 March 2021|416,362|9,750|1,044|427,156|
|Depreciation|||||
|At 1 April 2020|183,835|5,005|–|188,840|
|Charge for the year|44,511|1,186|123|45,820|
|At 31 March 2021|228,346|6,191|123|234,660|
|Carrying amount|||||
|At 31 March 2021|188,016|3,559|921|192,496|
|At 31 March 2020|138,471|4,745|–|143,216|
## NOTES TO THE FINANCIAL STATEMENTS
## FOR THE YEAR ENDED 31 MARCH 2021
## 17. Investments
|17. Investments|||
|---|---|---|
||2021|2020|
||£|£|
|Fair value|||
|At 1 April 2020|559,167|376,200|
|Additions|–|200,000|
|Net gain / (loss) on revaluation|136,210|(17,033)|
|At 31 March 2021|695,377|559,167|
|Historical cost|570,000|570,000|
|Analysis of investments at 31 March 2021:|||
|UK listed investments|695,377|559,167|
All investments are carried at their fair value. Holdings in investment funds, unit trusts and open-ended investment companies are at the bid price. Asset sales and purchases are recognised at the date of trade at cost (that is their transaction value).
The following investments were material in the context of the investment portfolio:
COIF Charities Investment Fund – £695,377 (2020: £559,167).
The main form of financial risk faced by the charity is the volatility in investment markets due to wider economic conditions and variability of investment returns. This risk is mitigated by obtaining advice from a financial expert on the charity’s investment portfolio.
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## NOTES TO THE FINANCIAL STATEMENTS
## FOR THE YEAR ENDED 31 MARCH 2021
## 18. Debtors
|18. Debtors|||
|---|---|---|
||2021|2020|
||£|£|
|Prepayments and accrued income|9,882|1,247|
|Other debtors|799|–|
||10,681|1,247|
## NOTES TO THE FINANCIAL STATEMENTS
## FOR THE YEAR ENDED 31 MARCH 2021
## 20. Deferred income
|20. Deferred income|||
|---|---|---|
||2021|2020|
||£|£|
|Balance at 1 April 2020|10,210|21,896|
|Amount released to income|(210)|(21,896)|
|Amount deferred in the year|280|10,210|
|Balance at 31 March 2021|10,280|10,210|
## 19. Creditors: amounts falling due within one year
Deferred income comprises income received in advance in respect of training courses and fundraising events.
||2021|2020|
|---|---|---|
||£|£|
|Trade creditors|20|–|
|Accruals and deferred income|18,670|18,610|
|Social security and other taxes|–|6,167|
|Other creditors|555|688|
||19,245|25,465|
## 21. Pensions and other post retirement benefits
## DEFINED CONTRIBUTION PLANS
The amount recognised in income or expenditure as an expense in relation to defined contribution plans was £3,242 (2020: £2,818).
## 22. Commitments under operating leases
At 31 March 2021, the charity had total minimum lease payments under non-cancellable operating leases as set out below.
Land and Buildings
||2021|2020|
|---|---|---|
||£|£|
|Operating leases which expire:|||
|Within 1 year|–|8,100|
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## NOTES TO THE FINANCIAL STATEMENTS
## FOR THE YEAR ENDED 31 MARCH 2021
## 23. Unrestricted funds
|||||Gains and|At 31 March|
|---|---|---|---|---|---|
||At 1 April 2020|Income|Expenditure|losses|2021|
||£|£|£|£|£|
|General funds|1,222,596|831,282|(297,817)|–|1,756,061|
|Unrealised gain||||||
|on investment|(10,833)|–|–|136,210|125,377|
||1,211,763|831,282|(297,817)|136,210|1,881,438|
||At 1 April 2019|Income|Expenditure|Gains and losses At 31 March 2020||
||£|£|£|£|£|
|General funds|904,339|967,471|(649,214)|–|1,222,596|
|Unrealised gain||||||
|on investment|6,200|–|–|(17,033)|(10,833)|
||910,539|967,471|(649,214)|(17,033)|1,211,763|
The unrealised gain on investment is the difference between the historical cost of the investment and the fair value recognised in these financial statements.
## NOTES TO THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 31 MARCH 2021
## 24. Restricted funds
||At 1 April 2020|Income|Expenditure|Gains and losses|At 31 March 2021|
|---|---|---|---|---|---|
||£|£|£|£|£|
|Simulator|147,863|–|(32,192)|–|115,671|
|Digital project|4,122|–|–|–|4,122|
|Surgeons in Syria|25,000|–||–|25,000|
|Manikins|10,367|–|–|–|10,367|
||187,352|–|(32,192)|–|155,160|
||At 1 April 2019|Income|Expenditure|Gains and losses|At 31 March 2020|
||£|£|£|£|£|
|Simulator|184,292|–|(36,429)|–|147,863|
|Digital project|8,883|–|(4,761)|–|4,122|
|Surgeons in Syria|–|25,000||–|25,000|
|Manikins|–|10,367|–|–|10,367|
||193,175|35,367|(41,190)|–|187,352|
Restricted funds can only be used for particular restricted purposes within the objects of the charity as specified by the donor or when funds are raised for particular restricted purposes:
Simulator – Open Society Institute grant for teaching materials for war surgery training.
Digital project – Vodafone Foundation grant to support the costs used for the development and ongoing support of the charity’s learning platform for sharing videos and information related to the work of the charity.
Surgeons in Syria – CHK Foundation grant to support surgeons who are working in Syria to attend the specialist training course in the UK, or to attend a locally delivered HEST course.
Manikins – Festival Medical Services grant for the purchase of single use manikins.
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## NOTES TO THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 31 MARCH 2021
## 25. Analysis of net assets between funds
||Unrestricted Funds|Restricted Funds|Total Funds 2021|
|---|---|---|---|
||£|£|£|
|Tangible fxed assets|76,825|115,671|192,496|
|Investments|695,377|–|695,377|
|Current assets|1,118,481|49,489|1,167,970|
|Creditors less than 1 year|(9,245)|(10,000)|(19,245)|
|Net assets|1,881,438|155,160|2,036,598|
||Unrestricted Funds|Restricted Funds|Total Funds 2020|
||£|£|£|
|Tangible fxed assets|33,929|109,287|143,216|
|Investments|559,167|–|559,167|
|Current assets|634,132|88,065|722,197|
|Creditors less than 1 year|(15,465)|(10,000)|(25,465)|
|Net assets|1,211,763|187,352|1,399,115|
## NOTES TO THE FINANCIAL STATEMENTS
## FOR THE YEAR ENDED 31 MARCH 2021
## 27. Analysis of changes in net debt
||At 1 April 2020|Cash fows|At 31 March 2021|
|---|---|---|---|
||£|£|£|
|Net cash||||
|Cash at bank and in hand|720,950|436,339|1,157,289|
||At 1 April 2019|Cash fows|At 31 March 2020|
||£|£|£|
|Net cash||||
|Cash at bank and in hand|524,816|196,134|720,950|
## 26. Related Party Transactions
The key management personnel of the charity comprise the trustees, the chief executive, the operations director and the head of supporter & donor relations. The total employee benefits of the key management personnel of the charity was £148,722 (2020: £139,573).
There were no other related party transactions for the years ended 31 March 2021 or 31 March 2020.
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## NOTES TO THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 31 MARCH 2021
## 28. Comparatives for the Statement of Financial Activities
||Unrestricted|Restricted|Total Funds|
|---|---|---|---|
||Funds|Funds|2020|
||£|£|£|
|Income and endowments||||
|Donations and legacies|965,013|35,367|1,000,380|
|Investment income|2,458|–|2,458|
|Total income|967,471|35,367|1,002,838|
|Expenditure on:||||
|Raising funds|(165,250)|–|(165,250)|
|Charitable activities|(483,964)|(41,190)|(525,154)|
|Total expenditure|(649,214)|(41,190)|(690,404)|
|Net income / (expenditure) before net losses on investments|318,257|(5,823)|312,434|
|Net losses on investments|(17,033)|–|(17,033)|
|Net income / (expenditure) and net movement in funds|301,224|(5,823)|295,401|
|Reconciliation of funds||||
|Total funds brought forward|910,539|193,175|1,103,714|
|Total funds carried forward|1,211,763|187,352|1,399,115|
FOUNDATION