2021-03-31-accounts - Action4Diabetes

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CHARITY REGISTRATION NUMBER: 1166447

Action4Diabetes Unaudited Financial Statements

31 March 2021

CHEDZOY BUTTERWORTH

Accountants & business advisors

2 Chartfield House Castle Street Taunton Somerset TA1 4AS

Action4Diabetes

Financial Statements

Year ended 31 March 2021

	Page
Trustees' annual report	1
Independent examiner's report to the trustees	6
Statement of financial activities	7
Statement of financial position	8
Notes to the financial statements	9
The following pages do not form part of the financial statements
Detailed statement of financial activities	15
Notes to the detailed statement of financial activities	17

Action4Diabetes

Trustees' Annual Report

Year ended 31 March 2021

The trustees present their report and the unaudited financial statements of the charity for the year ended 31 March 2021.

Reference and administrative details

Registered charity name Action4Diabetes Charity registration number 1166447 Principal office 9 Parkfield Road Taunton Somerset TA1 4RL The trustees

Mr R H D Toomey Mr C E Toomey Mr J M O'Brien-Gore

Reference and Administrative Details:

Charity Name:

Action4Diabetes, also known as A4D, registered as a charity with the Charity Commission (England and Wales) as Charity Number 1166447.

Trustees: Mr Richard Toomey (Chair) Mr Charles Toomey Mr Jeremy Gore

There are no exemptions from trustee disclosures.

Independent examiner Chedzoy Butterworth 2 Chartfield House Castle Street Taunton Somerset TA1 4AS

Structure, governance and management

Action4Diabetetes is a Charitable Incorporated Organisation (CIO) and has a 'Foundation' model constitution in accordance with Charity Commission regulations.

New Trustees are appointed by election from existing trustees.

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Action4Diabetes

Trustees' Annual Report (continued)

Year ended 31 March 2021

Objectives and activities

Purposes of the Charity

The Charity was established in 2016 as Action for Diabetics. During the year, the trustees decided to change the Charity's name to Action4Diabetes with effect April 2021. In every other respect the Charity remains the same, including its purpose: to preserve and protect the health of children and young adults suffering from Type 1 Diabetes in Myanmar, Thailand, Laos, Vietnam, Cambodia and Malaysia and such other locations in South East Asia as the Trustees think fit, particularly but not exclusively, through the provision of financial assistance, support, and the organisation of training.

Main Activities

Type 1 Diabetes (T1D) is an incurable condition that strikes indiscriminately. Action4Diabetes (A4D) has identified that thousands of young people with T1D in developing countries such as in South East Asia are dying annually due to lack of diagnosis and access to essential medical supplies. In these countries, there is limited or indeed no universal healthcare coverage as we know it in the United Kingdom. In addition to lack of access to essential medical supplies, there are significant gaps in the required knowledge in the healthcare profession, amongst close family members and the individuals who are diagnosed with T1D. The mission of A4D is to 'Save and Empower young people with T1D in South East Asia.

In the fifth full year of operation until March 2021, we were faced with the unique challenge of Covid, which has had an impact on our ability to execute some of our programmes and limited planned fund raising activities. Despite this we are delighted to report that we have continued to grow our cornerstone programme, the Clinic Support Programme, where we provide on an ongoing basis free medical supplies to over 530 young people suffering from T1D in Myanmar, Thailand, Laos, Vietnam, Cambodia and Malaysia. This is a 17% increase over last year, and is a clear sign of the resilience and sustainability of the model we have adopted. The healthcare systems in these countries suffer from limited funding and capacity, and lack universal healthcare coverage. The majority of the young people with T1D supported by A4D programmes are from low income families, so are unable to afford the essential medical supplies critical to their survival. A significant number of the patients live hundreds of miles from the nearest hospital where expert medical capability is available. In either case, patients cannot access the kind of lifesaving care and medical support that would be considered standard in the United Kingdom or Europe. Consequently, individual T1Ds, parents and guardians often suffer physical and psychological issues. A4D's Clinic Support Programme is an absolute lifeline, without which the children's prospects of survival would be extremely limited. We are delighted that through the tremendous commitment and efforts of our dedicated staff, volunteers and partners, these young people can look forward to continued support from A4D throughout their young lives up to the age of 25.

The very specific expertise of key individuals in A4D enables us to operate in a highly cost-effective manner. We purchase high quality medical supplies directly from reputable suppliers, rather than from hospitals or pharmacies, which would be considerably more costly. We then provide the medical supplies directly and free of charge to the T1Ds on our programme. At the same time, this approach ensures the provision of high-quality products, while keeping our spending transparent and efficient. At present 93% of our annual expenditure is spent on activities that impact directly on T1Ds on our programme. A4D's management and administrative costs are kept to the absolute minimum to ensure that our operations are well controlled and sustainable. We believe this is one of the most cost-effective economic models available. A4D's approach ensures that funds raised are spent in an extremely targeted and cost-effective manner, directly saving lives and delivering positive, measurable clinical outcomes.

The Trustees have acted in accordance with the Charity Commission's guidance on Public benefit.

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Action4Diabetes

Trustees' Annual Report (continued)

Year ended 31 March 2021

Achievements and performance

The following is a summary of the main achievements of the Charity in this last year, explaining how our work is making a difference to our beneficiaries.

Clinic Support Programme - CSP

A4D provides free essential medical supplies to beneficiaries, including insulin, pens, needles, blood glucose meters, lancets, testing strips and HBA1C tests. As of March 2021, we partner directly with 23 government clinics, up from 20 in 2019-20: ten in Thailand, two in Myanmar, one in Vietnam, two in Laos, four in Cambodia and four in Malaysia. Through A4D, overall 530 young people with T1D continuously receive free medical supplies, up from 450 in 2019-20. In addition, we fund three junior support doctors to work in the Diabetes Clinics in Yangon and Mandalay Children's Hospitals, and in Cambodia. As part of the ongoing control and tracking of the Clinic Support Programme, A4D monitor and track over 20 data points of relevant data for each individual T1D, and each individual clinic, so we are able to assess the resource utilisation and outcomes associated with the delivery of the programme.

A total of 70 of the T1D supported through the CSP are individually supported through the Sponsor a Child Programme. This enables individuals or organisations to support a specific child with T1D for a year, at a cost of £450. There is no direct contact between the donor and the child or family. However, the donor receives a twice yearly update on the child's progress from A4D.

The outlook for 2021 is that we will expand CSP to provide ongoing support to 700 young people with T1D and are exploring entering Indonesia with a partner organisation.

ASPIRE - Scholarship and Development

We realise that young adults with T1D need support, which goes beyond the provision of essential medical supplies. As a result of their condition, they can become marginalised in society. This leads to a lack of self-confidence and they often struggle to establish a purpose and direction in life and achieve economic independence. We presently support five young adults on university courses in Thailand, and have supported vocational training in Cambodia. The outlook for 2021 is that we will expand this programme to support up to ten young adults in Thailand and possibly Malaysia and Cambodia.

Healthcare Professional Capacity Building.

According to the World Bank the global average percentage of national wealth (GDP) spent on healthcare is about 10%. In OECD countries, this is 12%. However, the average across the countries where A4D operates is less than 5% and as low as 2.9% in Laos. As a result of the lack of medical infrastructure in the region, we have identified the need to provide additional educational support for doctors and other healthcare professionals (HCP) directly involved in caring for young people with T1D. This has a a direct and positive impact on the survival and quality of life of the patients enrolled on our programmes, with indirect benefits for other T1Ds who these HCP also care for. This year we were unable to run any of the planned programmes due to Covid.

The outlook for 2021-22 is that we anticipate moving away from face to face training and are in the process of developing an online training syllabus for HCPs. This will be delivered though a range of webinars both live and pre recorded and will be tailored specifically to topics relating to young T1Ds.

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Action4Diabetes

Trustees' Annual Report (continued)

Year ended 31 March 2021

Achievements and performance (continued)

HelloType1 - Digital Platform for T1D and Family Members

We realised that in the countries in which we operate there is limited availability of information for patients and family members about living with T1D. The traditional approach of publishing leaflets and distributing through clinics, although done with the best of intentions, is of limited impact, as the information tends not to reach or engage the audience. With so many people interacting online in our target countries, we believe there is scope to provide access to carefully designed content online in local languages, for T1D, caregivers and local HCPs. This year we successfully launched HelloType1 in the Khmer language in Cambodia to address this opportunity.

The outlook for 2021-22 is that we will roll out the platform in Vietnam and Malaysia, provided we can identify a partner organisation to fund it. HelloType1 is a ground-breaking initiative, and there is no other organisation in South East Asia that has created anything like this either for T1Ds or any other medical-related conditions. We see the platform as the first step towards developing a digital ecosystem for T1Ds, caregivers and HCPs, which could truly revolutionise the delivery of care and support to save and empower people with T1D across South East Asia.

Diabetes Family Camps - DFC.

During the reporting period, A4D did not organise any Diabetes Family Camps as this proved to be impossible due to Covid restrictions. We will look for start these again as and when Covid restrictions on arranging meetings and travel make this possible.

The outlook for 2021 is that it is unlikely we will organise and DFC, however we are piloting some online interventions at specific clinics with a motivational webinar fronted by A4D Co-Founder, Jerry Gore.

Challenges in Myanmar

From early 2021, the civil unrest in Myanmar is having an impact on our operations there. The HCPs who work in our partner hospitals have been unable to function as normal, communications and travel is also severely disrupted. In future, there may be delays in the import of foreign products - including medical supplies - into the country. We are making best efforts to ensure the ongoing provision of medical supplies to all T1Ds on our programmes, and will continue to adapt to the situation as it evolves.

The outlook for 2021 for A4D activities in Myanmar is extremely uncertain due to the turmoil in the country. It can be assumed that there will be challenges in maintaining support as usual for all T1Ds, supported by A4D. We will however continuously strive to overcome the challenges in order to provide ongoing support for all enrolled T1Ds in Myanmar.

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Action4Diabetes

Trustees' Annual Report (continued)

Year ended 31 March 2021

Financial review

At the end of its fifth year of operations, A4D is in a sound financial position. In 2020-21 we received £236,733 in income and donations and spent £162,603, which resulted in a surplus for the year of £74,130. Charitable expenditure on our programmes was £151,230 (2019: £188,466), a reduction of £37,236. This was due to significant savings on the cost of diabetes consumables and the temporary cancellations of certain activities due to the pandemic. At the end of the financial year we had total funds available to spend of £211,386, an increase of £74,130 on 2019, but as we are expanding, we continue to fundraise energetically to meet our expanding programmes. The Trustees judge that this is an excellent financial position to be in and that the Charity is a going concern.

Reserves

The funds held at the end of the year of £211,386 will be retained for expenditure on the Charity's activity in the year ahead. The Trustees' policy at this stage is:

(1) to build a limited buffer so that we can resource the needs of T1D children and young people on a continuing basis with as little risk as possible; and (2) to have the resources to expand our operations in the region.

Funds held as custodian trustee

There are no funds held by the Charity on behalf of others.

The trustees' annual report was approved on 27 May 2021 and signed on behalf of the board of trustees by:

Mr R H D Toomey Trustee

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Action4Diabetes

Independent Examiner's Report to the Trustees of Action4Diabetes

Year ended 31 March 2021

I report to the trustees on my examination of the financial statements of Action4Diabetes ('the charity') for the year ended 31 March 2021.

Responsibilities and basis of report

As the trustees of the charity you are responsible for the preparation of the financial statements in accordance with the requirements of the Charities Act 2011 (‘the Act’).

I report in respect of my examination of the charity's financial statements 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 examiner's statement

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:

accounting records were not kept in respect of the charity as required by section 130 of the Act; or
the financial statements do not accord with those records; or
the financial statements 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 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.

Chedzoy Butterworth Independent Examiner

2 Chartfield House Castle Street Taunton Somerset TA1 4AS

24 June 2021

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Action4Diabetes

Statement of Financial Activities

Year ended 31 March 2021

		2021		2020
		Unrestricted
		fundsTotal funds		Total funds
	Note	£	£	£
Income and endowments
Donations and legacies	4	236,260	236,260	197,030
Investment income	5	473	473	263
		`─────────`	`─────────`	`─────────`
Total income		236,733	236,733	197,293
		`═════════`	`═════════`	`═════════`
Expenditure
Expenditure on raising funds:
Costs of raising donations and legacies	6	1,657	1,657	3,753
Expenditure on charitable activities	7	151,230	151,230	188,466
Other expenditure	8	9,716	9,716	2,660
		`─────────`	`─────────`	`─────────`
Total expenditure		162,603	162,603	194,879
		`═════════`	`═════════`	`═════════`
		`─────────`	`─────────`	`─────────`
Net income and net movement in funds		74,130	74,130	2,414
		`═════════`	`═════════`	`═════════`
Reconciliation of funds
Total funds brought forward		137,256	137,256	134,842
		`─────────`	`─────────`	`─────────`
Total funds carried forward		211,386	211,386	137,256
		`═════════`	`═════════`	`═════════`

The statement of financial activities includes all gains and losses recognised in the year. All income and expenditure derive from continuing activities.

The notes on pages 9 to 13 form part of these financial statements.

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Action4Diabetes

Statement of Financial Position

31 March 2021

		2021		2020
	Note	£	£	£
Current assets
Debtors	11	–		2,684
Cash at bank and in hand		227,459		152,025
		`─────────`		`─────────`
		227,459		154,709
Creditors: amounts falling due within one year	12	16,073		17,453
		`─────────`		`─────────`
Net current assets			211,386	137,256
			`─────────`	`─────────`
Total assets less current liabilities			211,386	137,256
			`─────────`	`─────────`
Net assets			211,386	137,256
			`═════════`	`═════════`
Funds of the charity
Unrestricted funds			211,386	137,256
			`─────────`	`─────────`
Total charity funds	13		211,386 `═════════`	137,256 `═════════`

These financial statements were approved by the board of trustees and authorised for issue on 27 May 2021, and are signed on behalf of the board by:

Mr R H D Toomey Trustee

The notes on pages 9 to 13 form part of these financial statements.

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Action4Diabetes

Notes to the Financial Statements

Year ended 31 March 2021

1. General information

The charity is a public benefit entity and a registered charity in England and Wales and is unincorporated. The address of the principal office is 9 Parkfield Road, Taunton, Somerset, TA1 4RL.

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.

3. Accounting policies

Basis of preparation

The financial statements have been prepared on the historical cost basis, as modified by the revaluation of certain financial assets and liabilities and investment properties measured at fair value through income or expenditure.

The financial statements are prepared in sterling, which is the functional currency of the entity.

Going concern

There are no material uncertainties about the charity's ability to continue.

Judgements and key sources of estimation uncertainty

The preparation of the financial statements in the current period have not required management to make judgements, estimates or assumptions that affect the amounts reported. This policy is continually reviewed decisions are based on experience and other factors, including expectations of future events that are believed to be reasonable under the circumstances.

Fund accounting

Unrestricted funds are available for use at the discretion of the trustees to further any of the charity's purposes.

Designated funds are unrestricted funds earmarked by the trustees for particular future project or commitment.

Restricted funds are subjected to restrictions on their expenditure declared by the donor or through the terms of an appeal, and fall into one of two sub-classes: restricted income funds or endowment funds.

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Action4Diabetes

Notes to the Financial Statements (continued)

Year ended 31 March 2021

3. Accounting policies (continued)

Incoming resources

All incoming resources are 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. The following specific policies are applied to particular categories of income:

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.
legacy income is recognised when receipt is probable and entitlement is established.
income from donated goods is measured at the fair value of the goods unless this is impractical to measure reliably, in which case the value is derived from the cost to the donor or the estimated resale value. Donated facilities and services are recognised in the accounts when received if the value can be reliably measured. No amounts are included for the contribution of general volunteers.
income from contracts for the supply of services is recognised with the delivery of the contracted service. This is classified as unrestricted funds unless there is a contractual requirement for it to be spent on a particular purpose and returned if unspent, in which case it may be regarded as restricted.

Resources expended

Expenditure is recognised on an accruals basis as a liability is incurred. Expenditure includes any VAT which cannot be fully recovered, and is classified under headings of the statement of financial activities to which it relates:

expenditure on raising funds includes the costs of all fundraising activities, events, non-charitable trading activities, and the sale of donated goods.
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.
other expenditure includes all expenditure that is neither related to raising funds for the charity nor part of its expenditure on charitable activities.

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. Shared costs are apportioned between the activities they contribute to on a reasonable, justifiable and consistent basis.

Financial instruments

A financial asset or a financial liability is recognised only when the charity becomes a party to the contractual provisions of the instrument.

Basic financial instruments are initially recognised at the amount receivable or payable including any related transaction costs.

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Action4Diabetes

Notes to the Financial Statements (continued)

Year ended 31 March 2021

3. Accounting policies (continued)

Financial instruments (continued)

Current assets and current liabilities are subsequently measured at the cash or other consideration expected to be paid or received and not discounted.

Debt instruments are subsequently measured at amortised cost.

Where investments in shares are publicly traded or their fair value can otherwise be measured reliably, the investment is subsequently measured at fair value with changes in fair value recognised in income and expenditure. All other such investments are subsequently measured at cost less impairment.

Other financial instruments, including derivatives, are initially recognised at fair value, unless payment for an asset is deferred beyond normal business terms or financed at a rate of interest that is not a market rate, in which case the asset is measured at the present value of the future payments discounted at a market rate of interest for a similar debt instrument.

Other financial instruments are subsequently measured at fair value, with any changes recognised in the statement of financial activities, with the exception of hedging instruments in a designated hedging relationship.

Financial assets that are measured at cost or amortised cost are reviewed for objective evidence of impairment at the end of each reporting date. If there is objective evidence of impairment, an impairment loss is recognised under the appropriate heading in the statement of financial activities in which the initial gain was recognised.

For all equity instruments regardless of significance, and other financial assets that are individually significant, these are assessed individually for impairment. Other financial assets are either assessed individually or grouped on the basis of similar credit risk characteristics.

Any reversals of impairment are recognised immediately, to the extent that the reversal does not result in a carrying amount of the financial asset that exceeds what the carrying amount would have been had the impairment not previously been recognised.

4. Donations and legacies

	Unrestricted	Total Funds	Unrestricted	Total Funds
	Funds	2021	Funds	2020
	£	£	£	£
Donations
Donations - direct	226,617	226,617	164,321	164,321
Donations - just giving	3,471	3,471	17,844	17,844
Donations - gift aid tax credit	225	225	25	25
Donations - my donate	–	–	2,138	2,138
Donations - Virgin money giving	5,947	5,947	12,702	12,702
	`─────────`	`─────────`	`─────────`	`─────────`
	236,260	236,260	197,030	197,030
	`═════════`	`═════════`	`═════════`	`═════════`

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Action4Diabetes

Notes to the Financial Statements (continued)

Year ended 31 March 2021

5. Investment income

	Unrestricted	Total Funds	Unrestricted	Total Funds
	Funds	2021	Funds	2020
	£	£	£	£
Bank interest receivable - Non UK	473	473	263	263
	`════`	`════`	`════`	`════`
Costs of raising donations and legacies
	Unrestricted	Total Funds	Unrestricted	Total Funds
	Funds	2021	Funds	2020
	£	£	£	£
Costs of raising donations and legacies
- Donations	1,657	1,657	3,753	3,753
	`═══════`	`═══════`	`═══════`	`═══════`
Expenditure on charitable activities by fund type
	Unrestricted	Total Funds	Unrestricted	Total Funds
	Funds	2021	Funds	2020
	£	£	£	£
Laos	10,711	10,711	23,852	23,852
Myanmar	28,872	28,872	33,418	33,418
Thailand	22,852	22,852	34,069	34,069
Vietnam	8,353	8,353	11,754	11,754
Malaysia	4,575	4,575	19,607	19,607
Cambodia	31,693	31,693	36,045	36,045
Support costs	44,490	44,490	29,721	29,721
	`─────────`	`─────────`	`─────────`	`─────────`
	151,230	143,788	188,466	188,466
	`═════════`	`═════════`	`═════════`	`═════════`
Other expenditure
	Unrestricted	Total Funds	Unrestricted	Total Funds
	Funds	2021	Funds	2020
	£	£	£	£
Other expenditure - bank fees	720	720	208	208
Other expenditure - exchange rate
variance	8,996	8,996	2,452	2,452
	`───────`	`───────`	`───────`	`───────`
	9,716	9,716	2,660	2,660
	`═══════`	`═══════`	`═══════`	`═══════`
Independent examination fees
			2021	2020
			£	£
Fees payable to the independent examiner for:
Independent examination of the financial	statements		2,440 `═══════`	1,770 `═══════`

6. Costs of raising donations and legacies

7. Expenditure on charitable activities by fund type

8. Other expenditure

9. Independent examination fees

10. Trustee remuneration and expenses

No remuneration or other benefits from employment with the charity or a related entity were received by the trustees;

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Action4Diabetes

Notes to the Financial Statements (continued)

Year ended 31 March 2021

11. Debtors

		2021	2020
		£	£
	Prepayments and accrued income	–	2,684
		`════`	`═══════`
12.	Creditors: amounts falling due within one year
		2021	2020
		£	£
	Bank loans and overdrafts	85	1,926
	Accruals and deferred income	2,000	1,540
	Trustee loan	13,988	13,987
		`────────`	`────────`
		16,073	17,453
		`════════`	`════════`

13. Analysis of charitable funds

Unrestricted funds

					At
	At 1 April 2020	Income	Expenditure	31 March 2021
	£	£	£		£
General funds	137,256	236,733	(162,603)		211,386
	`═════════`	`═════════`	`═════════`		`═════════`
					At
	At 1 April 2019	Income	Expenditure		31 March 2020
	£	£	£		£
General funds	134,842	197,293	(194,879)		137,256
	`═════════`	`═════════`	`═════════`		`═════════`
Analysis of net assets between	funds
			Unrestricted		Total Funds
			Funds		2021
			£		£
Current assets			227,459		227,459
Creditors less than 1 year			(16,073)		(16,073)
			`─────────`		`─────────`
Net assets			211,386		211,386
			`═════════`		`═════════`
			Unrestricted		Total Funds
			Funds		2020
			£		£
Current assets			154,709		154,709
Creditors less than 1 year			(17,453)		(17,453)
			`─────────`		`─────────`
Net assets			137,256		137,256
			`═════════`		`═════════`

14. Analysis of net assets between funds

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Action4Diabetes

Management Information

Year ended 31 March 2021

	2021	2020
	£	£
Brought forward	4,575	19,607
	`───────`	`────────`
	4,575	19,607
	`───────`	`────────`
Cambodia
*Activities undertaken directly*
Cambodia medical services	3,257	2,454
Cambodia clinic support	18,893	32,598
Cambodia patient subsistence	1,534	–
Cambodia travel expenses	567	129
Cambodia diabetes website	7,442	-
Cambodia diabetes camp	–	864
	`────────`	`────────`
	31,693	36,045
	`────────`	`────────`
Governance costs
Accountancy fees	2,439	1,770
	`───────`	`───────`
	`─────────`	`─────────`
Expenditure on charitable activities	151,230	188,466
	`═════════`	`═════════`

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