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2020-12-31-accounts

Charity number: 1167785

British Association for Performing Arts Medicine (BAPAM)

Trustees’ Annual Report and Financial Statements

For the year ended 31 December 2020

British Association for Performing Arts Medicine (BAPAM) Charity 1167785

Chairman’s Introduction

2020 has been an extraordinarily challenging year for everyone as we deal with the COVID-19 pandemic, and | am very proud of the way in which BAPAM has responded to the crisis. The performing arts industry has been particularly hard hit with live performances cancelled and many freelancers not eligible for government funding. Unable to practise their art, and without access to usual support networks, many performers have struggled with their mental health.

BAPAM was able to transform our health service to online delivery from 17 March 2020, the very start of the lockdown, and this has meant we could continue to deliver our service remotely to performers. By the end of the year, a total of 1224 appointments had been delivered this way, the highest number yet recorded. We have seen a decrease in the overall number of patients contacting BAPAM in 2020. This was caused by a drop in numbers in the second quarter of the year when lockdown started. Many performance professionals were, at that point, most concerned with makinga living as their livelihood had been wiped out and health matters were lower on the agenda. Some assumed that BAPAM was closed along with many other services. Demand picked up from the summer onwards and, by the end of the year we had supported over 1400 patients. We have continued to maintain our objective of ensuring that services are available to performers across the UK and | am pleased to say that 50% of performers are from outside London, compared to 40% in 2019. Despite this difficult time, we were delighted to have increased our Directory of Practitioners to just under 230 clinicians, all experienced in working with performers. We are sad to say good-bye to Dr Frances Carter (GP) and Carol Chapman (Counselling Psychologist) who have given many years’ service both as assessing clinicians and on the Medical Committee. We thank them for all their work over the years and wish them well in retirement.

We have seen a decrease in the number of people coming to us with musculoskeletal problems, usually linked with intense performance schedules, but a significant increase in people with mental health problems. We also picked up a number of patients who would have otherwise been seen by the NHS but where clinics were either closed temporarily or had long waiting lists. Over the summer we offered some interim support for patients with vocal health problems who could not get a diagnosis and we are grateful to our Vocal Rehabilitation Coaches for delivering this service online. Our partnership with Equity to provide counselling for Equity members, has been very successful with measurable improvements at the end of counselling sessions, and patients expressing their gratitude for the service. We were very pleased that the Equity Charitable Trust was also able to support this programme.

Feedback from our patients continues to show a high level of satisfaction, however our annual survey of patients seen between May 2019 and April 2020 shows that only 80% of patients are back to performing within 6-12 months, compared to 90% the previous year. This is partly due to the timing of the survey when very few people were performing anyway, but also highlights a concern with BAPAM’s capacity to follow up patients in 2019 when we had a significant increase in demand, but no additional resources. A review of activity over the years showed us that in busy times, BAPAM has to refer patients on to other services because of a lack of capacity to provide appointments. We were delighted this year when Help Musicians agreed to not only renew their contract with BAPAM, but also to increase funding in line with demand. 2020 also strengthened our relationship with the Royal Society of Musicians. BAPAM has provided clinical advice on applications for decision-making, and on policy development as the Royal Society increases the number of applicants they support. Towards the end of the year, we also collaborated on delivery health training with the RSM. The initial sessions sold out and were repeated and this success led to a full programme of events planned for 2021.

During this year, we have significantly expanded our health education programme -— training over 2000 performing arts professionals through running online sessions. In addition to running general sessions on preventing physical injury, mental and vocal health, we have also offered weekly Community Drop-in

British Association for Performing Arts Medicine (BAPAM) Charity 1167785

Sessions to support attendees to develop and maintain health goals, thanks to funding from Help Musicians. We have also provided one-to-one and group mentorship sessions for winners of Help Musicians’ “Doing it Differently” and MOBO awards. We are very grateful to the clinicians and trainers who have worked with us on these programmes. To manage the increase in activity, Phoebe Butler has joined the team to provide administrative support and has enabled us to deliver a very successful, well evaluated scheme.

Special thanks are due to Dan Hayhurst, Senior Manager, Special Projects for his work on IT systems and communications. We were able to provide online systems to clinicians and staff within a day or two of locking down asa result of his foresight in the design of our database and online document system. He also produced a new website as a result of PPL’s introduction and support of a new working partner, Preview. This has enabled us to communicate more effectively with performers and the industry about our service.

The accounts for BAPAM for the year to 31 December 2020 ended the year with a healthy surplus on unrestricted funds of £48,940. This was achieved despite a significant increase in activity which increased spend on clinical services. Our year end unrestricted reserves are £148,418.

On behalf of our trustees | would like to pay a special tribute to our staff and clinicians who have adapted to home working and remote clinical services, and worked through some of the inevitable teething problems to ensure that we can continue to provide BAPAM’s important services. It has been a difficult time for everyone, but our commitment and hard work this year will stand us in good stead as we further develop health services for performers. Dr Penny Wright, Honorary Medical Director deserves special thanks for her ongoing clinical guidance to the team, as she has helpfully steered them through this time of change.

Thanks too, to our key funders, Help Musicians, Musicians’ Union, Equity, Equity Charitable Trust, PPL, PRS Member’s Fund and the Royal Society of Musicians as well as everyone who has given their time and resource to ensure that BAPAM continues its mission to help performers stay healthy.

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PETER LEATHEM, Chairman

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attish Association for Performing Arts Medicine (BAPAM) Charity 1167785

Contents

Page

Legal and administrative information 1-2
Trustees’ Annual Report 3-9
Structure, governance and management
Objectives and activities
Strategic report
Achievements and performance
Financial review
Plans forfuture periods
Principal risks and uncertainties
Statement ofTrustees’ responsibilities 10
Auditor’s report to the Trustees 11-13
Statement offinancial activities 14
Balance sheet 15
Cash flow statement 16
Notestothefinancialstatements 17-21

British Association for Performing Arts Medicine (BAPAM) Charity 1167785

Legal and administrative information

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|||||||||| |---|---|---|---|---|---|---|---|---| |Charity|number|1167785| |Registered|Office|7-9,|Bream’s|Buildings| |London|EC4A|1DT| |Patrons|Imogen|Cooper| |Sir|Mark|Elder| |Dame|Evelyn|Glennie| |Sir|Simon|Rattle| |Sheila|Reid| |Zeb|Soanes| |Dame|Janet|Suzman| |Sir|Willard|White| |Julian|Lloyd-Webber| |Trustees|Peter|Leathem|(Chairman)| |John|Turner|(Honorary Treasurer)| |Penny Wright|(Honorary|Medical|Director)| |Charles|Easmon|(appointed|5|February|2020)| |Matthew|Hood| |Jonathan|Morrish| |Mark|Phillips|(appointed|5|February|2020)| |Mike|Shipley|(retired|5|February|2020)| |Hara|Trouli|(appointed|5|February|2020)| |Chris|Waters|(appointed|20 January|2021)| |Jonathan|White|(retired|20 January|2021)| |Diane|Widdison| |lan|Winspur|(retired|S|February|2020)| |Aaron|Williamon| |Pat Woo|(appointed|5|February|2020)| |Medical|Committee|Penny Wright|(Chair) MA MBBS MRCGP| |Frances|Carter BSc MBBS FRCP FRCGP|(retired|Dec|2020)| |Hara|Trouli|MBBS,|MSc PAM| |David|Fielding BM|BCh|MRCS LCRP DRCOG MRCP| |Tamara|Karni|Cohen|MBChB|BSc|(appointed|5|Feb|2020)| |Christine|Hunter MBChB|BSc|(appointed|5|February|2020)| |Peter|Newman|BSc,|MBBS,|DRCOG,|JCPTGP,|Dip|Occ Med| |(appointed|5|February|2020)| |Anita|Nathan|MB|ChB|MRCGP| |Declan|Costello|MA,|MBBS,|FRCS (ORL-HNS)| |Carol|Chapman|BA|(Hons) MSc DPsych|CPsychol| |{retired|Dec|2020)| |Sarah|Upjohn|EdD MA|MSCP|

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British Association for Performing Arts Medicine (BAPAM) Charity 1167785

Legal and administrative information

Anthony Ordman MBBS, LRCPMRCS, FFARCS,
FRCP, FFPMRCA (appointed 5 February 2020)
Michael Mehta BSc (hons)Osteopathy Pilates
Rehabilitation
Jonathan White MB ChB (retired 5 February 2020)
Mike Shipley MA MD FRCP (retired 5 February 2020)
Paul Checkley MSc Audiology RHAD,MSHAA
Chief Executive Claire Cordeaux
Administrative Team Dan Hayhurst, Information Officer
Ruth Zadi, Clinics Manager
PareisJean-Marie, Office Manager
Tulika Pandey, Assistant Information Officer
Phoebe Butler, Heath Promotion Officer
Auditors CompassAccountants
Venture House, The Tanners
East Street, Titchfield
Hampshire PO14 4AR
Bankers UnityTrust Bank
Four Brindley Place
Birmingham B1 2JB
CCLA - COIF Charities Deposit Account
StAlphage House, 2 Fore Street
LondonEC2Y5AQ

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British Association for Performing Arts Medicine (BAPAM) Charity No 1167785

Report of the Trustees for the year ended 31*t December 2020

The Trustees present their report and the financial statements for the year ended 31 December 2020. The Trustees who served during the year and up to the date of this report are set out on page 1. The Trustees have had due regard to the guidance issued by the Charity Commission on Public Benefit.

Structure, governance and management

Board of Trustees

In January 2020 the BAPAM Board comprised ten Trustees: Peter Leathem, who holds a number of music industry Directorships including the role of CEO of Phonographic Performance Ltd (PPL) as chair, four medical doctors (with expertise in performing arts medicine), a chartered accountant, an academic, a music industry communications expert and two representatives from funder organisations (Musicians’ Union (MU), Equity).

We were sorry to say good-bye to two long standing medical trustees, Dr. Mike Shipley and Mr. lan Winspur who had both given enormous support to BAPAM over the years, both as Trustees, clinicians and in the establishment of the UCL MSc in Performing Arts Medicine.

During 2019, we advertised for and successfully appointed in February 2020 four new Medical Trustees, all of whom have worked as clinicians at BAPAM. We were delighted that Dr. Charlie Easmon (public and occupational health), Mr. Mark Phillips (hand surgery), Dr. Hara Trouli (orthopaedics and lead of UCL MSc in Performing Arts Medicine), Professor Pat Woo (rheumatology) all accepted the role of Trustee and we have been grateful for their support and guidance during 2020

Trustees are appointed and chosen by existing members. Newly appointed Trustees receive written and verbal guidance from the Chief Executive about the responsibilities of their role and the objectives, structure and activities of the organisation and are invited to all BAPAM’s educational events. The Chief Executive also ensures that Trustees regularly receive relevant information from the Charity Commission, Auditors and Solicitors, Care Quality Commission, as well as expert advice and support from colleagues such as the Honorary Medical Chief Executive.

Chief Executive and administrative team

During 2020, the role of Director was renamed Chief Executive in recognition of the breadth of responsibility of this role. Trustees delegate much of the charity’s business to the paid Chief Executive, who is appointed and supervised by the Board. The Chief Executive is responsible for the day to day management of the organisation including appointing and managing administrative staff, financial transactions, performance reporting, fundraising and organising events. The Chief Executive also advises the Board on operational and strategic development and risk management issues.

The Chief Executive is supported by a small administrative team. This year the team has comprised a fulltime Clinics Manager, Ruth Zadi, and a full time Office Manager, Pareis Jean Marie. Tulika Pandey has assisted communications as well as supporting clinical work. Our Senior Manager, Dan Hayhurst, has overseen the information and communications function of BAPAM, including clinician recruitment and has been responsible for successfully implementing our new online CRM and developing our new website. During 2020, Phoebe Butler joined us on a temporary, part-time basis to manage the increase in health education work. As contracts were renewed, her job was extended and she successfully applied to take on this role on a permanent basis at the end of 2020.

At the end of 2020, the team consisted of 5 full time equivalents with three full time staff (The Chief Executive, Clinics and Office Manager) and three part-time staff.

Volunteers

We are very grateful to all our volunteers, particularly to those clinicians who give their time for free in Medical Committees and their working groups to develop clinical guidance for the organisation and to distribute across the sector. We held 13 of these meetings over 2020, involving 35 clinicians who gave an estimated 250 hours in meetings, and have taken forward work to follow up meeting actions of a further 200

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British Association for Performing Arts Medicine (BAPAM) Charity No 1167785

hours. For our internal purposes we value this at approximately £22,500 which in accordance with accounting principles is not recognised in the Financial Statements.

Committees

The BAPAM Board is supported by one standing committee — the Medical Committee — and delegates responsibility for BAPAM’s clinical governance (including statutory compliance) and operations to the Committee. The Medical Committee is chaired by the Honorary Medical Director (a Trustee) and is supported operationally by the Chief Executive and team.

The Committee operates in accordance with Terms of Reference developed by the Medical Director and Chief Executive. Members are volunteer healthcare practitioners appointed through a formal application process. Key Committee responsibilities include: the appointment and monitoring of BAPAM’s clinical workforce (sessional workers and volunteers); overseeing membership ofthe Directory of Practitioners; monitoring the safety and quality of BAPAM’s clinical and advisory services; overseeing BAPAM’s health education and training activities.

Working groups

Finance and Annual Audit are overseen by the Chairman and Treasurer. Staff appraisals are conducted annually by the Chief Executive, and formal salary reviews are conducted every three years by nominated Trustees (a review took place in 2017, and is now due in 2021). Additional corporate responsibilities are delegated by the Board to working groups of Trustees as required (and similarly, the Medical Committee delegates specific clinical governance issues to individual expert members). At present the following Working Groups are in place:

Networks and other relationships

BAPAM is proud of its lengthy association with many national performing arts organisations. Throughout 2020, we have maintained strong links with our principal funders, Help Musicians UK, and with unions representing performers - particularly the Musicians’ Union (MU) and Equity who also provide us with funding. Our new counselling service was launched with Equity in 2020 and we have seen over 70 Equity members who have accessed 6 sessions of counselling. This has had an overwhelmingly positive impact with measurable reduction in depression and anxiety. Equity members have expressed their gratitude for the

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British Association for Performing Arts Medicine (BAPAM) Charity No 1167785

service. Our relationship with PPL has again been a great source of strength this year thanks to the CEO (and BAPAM Chair), Peter Leathem, who as well as providing us with much needed funding, has also given generous support by enabling BAPAM to access legal, HR, IT and Communications expertise from the PPL senior team. We are also grateful to PRS for their ongoing financial support.

Our relationship with the Royal Society of Musician (RSM) has developed significantly this year. Dr Anthony Ordman and Claire Cordeaux have provided monthly support to review applications from a clinical perspective and have been helping the RSM to review internal process to enable the organisation to deal with the increase in applications for funding. Towards the end of the year, we also started to work collaboratively on health training for musicians which has proved extremely popular and has led to further sessions in 2021.

We also have ties with educational institutions, both in the performing arts sector (e.g. performance courses at conservatoires and colleges) and in healthcare science and medicine (e.g. performance science and performing arts medicine courses at the Centre for Performance Science at the Royal College of Music and at University College London). We are very grateful to the Royal College of Music for inviting us to collaborate on a PhD project. Michael Durrant has started his PhD on health promotion. Our Chief Executive, Claire Cordeaux, and two of our BAPAM Medical Committee members (Sarah Upjohn and Hara Trouli) are members of the Healthy Conservatoires Network Steering Group. Our clinicians regularly provide expert input into teaching on the Masters in Performing Arts Medicine at UCL.

Objectives and activities

The purpose of BAPAM is: the advancement of education by the promotion of medical research in the field of physical and mental stress and its effects on performance; the protection and preservation of health by the improvement of medical care for actors, musicians, dancers and those involved in the performing arts; by the provision of treatment and preventative care; by encouraging research in this field; and by disseminating the useful results of such research.

BAPAM achieves this through direct provision of information, clinical assessment and referral for student and professional members of the performing arts community, and through broader education, training, research and dissemination of knowledge about best practice in performing arts medicine

At the start of 2018, we agreed a three year strategy with our Board and funders with five key aims which are reviewed each year. In 2020, we agreed the following update, adding a fundraising aim.

  1. Uphold the standard for clinical practice in Performing Arts Medicine, providing approval for practitioners and branding for BAPAM approved services

  2. Expand clinical services to reach more performers in all regions and all relevant specialties by: a. maintaining and developing our own our high quality, performer-centred service b. supporting the expansion of quality clinical services through the NHS and independent providers.

c. Improving online resources

  1. Work as a clinical partner with HMUK to develop relevant services and provide clinical support 4. Promote evidence-based practice in performer's health, wellbeing and performance excellence to the wider performance-related and health communities through training, education and resource development

  2. Facilitate development of research in performing arts medicine, using our database to improve reporting and act as a resource for research.

  3. Improve fundraising and increase level of funding

In establishing and delivering BAPAM’s mission and Strategic Plan the Trustees confirm that they have considered the Charity Commission’s guidance on public benefit. BAPAM’s work directly benefits the health and wellbeing of those sections of the community comprising performing arts students and professional performers, many of whom experience distress and hardship due to health issues and injuries. Details are provided quarterly to our Board, Medical Committee and funders.

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British Association for Performing Arts Medicine (BAPAM) Charity No 1167785

Achievements and performance

Clinical Governance

The Care Quality Commission cancelled onsite inspections as a result of COVID-19 and will be changing their inspection regime going forward. Nevertheless, we have continued to maintain scrutiny of our clinical governance processes through the Medical Committee.

Clinics

Our free assessment services remained a core service throughout 2020. We continued to provide regular, confidential clinics in London, Birmingham, Cardiff, Glasgow, Belfast, Manchester, Liverpool and Leeds (until mid-March when all subsequent clinics were delivered online, by telephone or Zoom). Musculoskeletal clinics are usually by video conference. This has actually increased the number of patients from outside London to 50% from 40% in 2019. We had planned to run at clinic at the Sage in Gateshead in 2020, but these clinics have been cobranded with the Sage and are running online. A summary of activity is provided in the table below. We are most grateful to all our clinicians for their work, not just in providing clinics but also in adapting to an online service.

Clinical workforce

Twenty-eight clinicians, nationally, delivered our free BAPAM clinical assessment services during 2020, providing their services for an honorarium below the market rate. Our clinicians’ areas of expertise included general practice, rheumatology, orthopaedic surgery (upper limb), physiotherapy, osteopathy and clinical psychology.

Thirty clinical practitioners joined the Directory in 2020 taking our total number to 226. We also gained two new assessing clinicians.

Clinical Activity

During 2020, we registered 984 new patients, worked with 425 existing patients and provided 1,224 free appointments (assessments and follow-ups). This is the highest number of clinics recorded in the last 5 years and thanks go to Ruth Zadi for managing this significant workload. 1577 clinical enquiries were handled. In the summer of 2020 as professional vocal health clinics closed at the start of lockdown, we offered , interim sessions with BAPAM vocal rehabilitation coaches to singers with voice problems who were unable to get help elsewhere. More patients with complex conditions have called for support, possibly because NHS services have been unavailable. This caused us to review our practice both at helpline level and in clinical consultations and we have developed further guidance on referral pathways for patients presenting with chronic pain.

Free appointments 1224 1212 987 702
(assessment and
follow-up)
Subsidised follow-up 148 120
appointments

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British Association for Performing Arts Medicine {BAPAM) Charity No 1167785

Over half of our patients were from London (50%), We are pleased that our service to patients from other regions has increased this year by 10%. Musculoskeletal problems presented as the main problem (55% of cases), although this is a 8% drop, 23% of patients were concerned about psychosocial health, an increase of 8% and 13% presented with vocal problems and 3% with hearing problems. It should be noted that this is based on information taken at registration and after assessment many patients are found to have more than one diagnosis. 35% of patients were at the start of their career (either students or “emerging practitioners”). This year for the first time, we have again seen a drop in the number of patients identifying as male — 44% vs 55% female patients. 64% of our patients are aged between 18 and 35, with 33% 18-25 years. 75% of patients are instrumentalists or singers and songwriters, and the remaining 25% actors and dancers/circus performers. Many of our patients do more than one performing art.

Clinical services - evaluation and impact

We have continued to collect extensive anonymous patient satisfaction and survey data throughout 2020. This data enables us to monitor and improve our services, and to assess impact. They also provide evidence of performers’ broader healthcare experiences and needs which we share with our partners in the field.

We undertook an assessment of the feedback collected from 365 performers attending their first BAPAM assessment during 2020. 72% reported being seen within 2 weeks of contacting BAPAM and 87% within 3 weeks. Only 6% waited more than 4 weeks. However, 98% of patients were satisfied with waiting times. Clinical advice and manner was rated as ‘good’ or ‘excellent’ by 98% of performers, 98% rated clinician knowledge as excellent or good. 99% said they would recommend BAPAM toa colleague. The most common appointment outcomes were information about health condition (69%) and advice about healthy performance practice (55%).

Our annual survey which collects feedback from patients 6 -12 months or more after their appointment was sent out in October and received 135 responses. It covered patients seen between May 2019 and April 2020. 80% of patients said that BAPAM had helped with their problem compared to 89% in 2018/9. Of the 20% who said BAPAM had not helped, some had long standing complex problems that we could not help with, some could not get financial support for private healthcare and some had not been able to access further help. We have been able to implement an offer of routine follow ups for patients after 3 months so that we can pick up people who have not been able to access the support recommended and provide further help. Patients told us that 79% were back to performance, 45% partially and 34% full time.

Developing remote services

One of our strategies for increasing capacity efficiently was to update our IT systems to enable secure online access with a view to enabling more clinics to be delivered remotely if clinically appropriate. These systems have provided immediate benefit and enabled us to continue to deliver a service online during the COVID-19 lockdown through telephone assessments and online training. Thanks are due to Dan Hayhurst for his work in developing, adapting and maintaining these systems, enabling us to continue to offer a service over the pandemic.

Mental health

Our mental health work increased over 2020, partly due to the Equity counselling project, and also the increase in mental health support required over the pandemic. Our experience with the mental health project, ably supported by Pareis Jean Marie, enabled us to successfully propose a similar, more complex project as part of Help Musicians’ Music Mind Matter. We were delighted that this was approved in 2020 to start in 2021. We were well aware that in general, there is a lack of counsellors and psychotherapists from Black, Asian and Minority Ethnic backgrounds. We were delighted that PPL and Help Musicians agreed to cofund a project to fund bursaries for music professionals from this background to provide an opportunity to develop a career in therapy. We successfully advertised and were able to award bursaries. Practitioners will undertake their clinical placement at BAPAM with performing artist clients.

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British Association for Performing Arts Medicine (BAPAM) Charity No 1167785

Performer health education

Our health promotion training programme, supported by Help Musicians and Equity, went online from midMarch and has attracted over 2000 attendees from across the UK — over double the number in the previous year. We have been offering monthly sessions on mental wellbeing, injury prevention and vocal health as well as weekly sessions — the “Community Drop-in” from June to support performers to set and maintain health goals. These have been very well evaluated, and as a result, we have been approached by other organisations to co-run further training events. The Royal Society of Musician workshops sold out and were repeated and have led to a further full programme in 2021, more sessions were requested by PRS Members Fund and the Royal Variety Charity. We have continued to work with the winners of the Help Musician “Doing it Differently” and MOBO awards to provide health mentorship sessions. Our Healthy Practice Diary has been valued as a useful resource to help performers identify their own heaith risks and to develop healthy practices to mitigate them. Phoebe Butler joined us to help with the administration work required to manage the training programme and has beena large factor in its success.

Professional development

As our usual continuing professional development days could not be run as a face to face event, we have been running a monthly 2-hour evening session online, starting from October 2020. Attendance was 56 in 2020 as we considered health issues for performers in lockdown and best practice in remote consultations. The programme continues until June 2021. It has been well received and is more accessible to clinicians across the UK than our face to face events, although practitioners are missing the social interactions with colleagues.

Research and academic liaison

We continued our partnership with the UCL MSc in Performing Arts Medicine during 2020, with contributions to the course from our trustees and volunteer medical practitioners.

Michael Durrant, PhD student from the Centre of Performance Science at the Royal College of Music is continuing to work with us on health promotion.

Communications

With the support of Trustee, Jonathan Morrish and PPL who kindly allowed Lynne Best, their Communications Lead, to work with BAPAM, we have made significant progress in this area. We launched our new website in early summer with the help of Preview who did an excellent job of bringing together all of BAPAM’s services and resources in an accessible format. With this foundation, we have been able to update our resources and create new content, knowing that it is more likely to be seen by a wider audience. We also produced our first promotional annual report for some years. The Communications Working Group, supported by Dan Hayhurst and Tulika Pandey is really helping to provide a focus on how we can ensure that important health messages are shared with the performing arts community.

Finance and Fundraising

Fundraising activities

We are extremely grateful to performers, patients, organisations and supporters who raised funds for BAPAM through donations and events during 2020. It is pleasing to note that our partnership working with industry organisations has resulted in increased funding. BAPAM has been recompensed for our CEO’s time in advising the Royal Society of Musicians, and we were grateful for additional funding from the Equity Charitable Trust to support counselling for creative practitioners. Our increased training activity is also funding the administration of training programmes. As a result we are starting 2021 in a healthier financial position.

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British Association for Performing Arts Medicine

(BAPAM) Charity No 1167785

Financial review

Unrestricted income for the year, including donations in kind (legal services generously funded by PPL - £8,346) was £409,723, a substantial increase of 22% over 2019, largely attributable to the additional funding for specific projects undertaken for Help Musicians, Equity and the Royal Society of Musicians. We are also grateful for the receipt of £10,000 as an exceptional grant from the Greater London Authority. Expenditure increased but to a lesser extent (7%) from £338,405 to £360,783; the additional costs incurred in delivering the additional projects being to some extent offset by the lower costs of travel, and being obliged to conduct consultations remotely for a large part of the year due to the Covid pandemic. The annual surplus on unrestricted funds was £48,940 (versus a deficit in the prior year of £5,375).

We benefit from grants from Help Musicians UK, MU, PPL, [and] Equity [and the Grand Order of Water Rats]; these are key to BAPAM’s sustainability.

Reserves

BAPAM hasa reserves policy designed to maintain reserves at a level to ensure that, in a period of unforeseen difficulty, its activities can be continued for a minimum period of three months. In the event that the organisation can no longer function, this would allow a strategic run down of activities and full compliance with outstanding personnel and operational obligations.

We ensure the calculation at the required level of reserves is an integral part of annual planning, budget and forecasting and takes into account planned activity levels, all financial commitments and the risks associated with different income streams.

We ensure that such reserves are held in readily realisable form and cover: statutory redundancy, contractual obligations to staff, professional fees, three months utilities and other property costs, equipment costs and write downs.

BAPAM’s Reserves Policy sets a target of £100k in accessible funds. At the end of 2020, our unrestricted reserves were £148,418.

Principal risks and uncertainties and plans for the future

The board of Trustees regularly reviews the principal risks to the charity. Those risks include our reliance on grant funding, the burdens placed on our relatively small staff numbers, and reputational and other risks associated with our professional work. We continue to seek wider and more secure sources of finance and are heartened by the renewed and increased support we are receiving from our funders. We have recently strengthened our staff team. Our professional standards are key; both the board of Trustees and our Medical Committee give continuing and careful attention to the way in which we offer clinical services and advice. We review our insurance requirements annually.

Working closely with our funders we plan to increase the volume of the clinical services we offer in London and to widen our reach to more cities outside the capital.

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PETER LEATHEM, Chairman

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British Association for Performing Arts Medicine (BAPAM) Charity No 1167785

Statement of Trustees Responsibilities

The Trustees are responsible for preparing the Trustees’ Annual Report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice).

The {aw applicable to charities in England & 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 of the incoming resources and application of resources of the charity for that period. In preparing these financial statements, the trustees are required to:

The Trustees are responsible for keeping proper accounting records that 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. 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

Trustee Declaration

So far as the Trustees are aware, there is no relevant audit information of which the charity’s auditors are unaware. Trustees have taken all the steps necessary to make themselves aware of any relevant audit information and to establish that the charity's auditors are aware of that information.

This report was approved by the BAPAM Board of Trustees on 14 April 2021 and signed on its behalf by

PETER LEATHEM, Chairman

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British Association for Performing Arts Medicine (BAPAM) Charity No 1167785

Independent Auditor’s Report to the Trustees of the British Association for Performing Arts Medicine

Opinion

We have audited the financial statements of the British Association for Performing Arts Medicine (the ‘charity’) for the year ended 31 December 2020 which comprise the Statement of Financial Activities, the Balance Sheet, the Cash Flow Statement and notes to the financial statements, including a summary of significant accounting policies. The financial reporting framework that has been applied in their preparation is 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).

In our opinion the financial statements:

Basis for opinion

We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under those standards are further described in the Auditor's responsibilities for the audit of the financial statements section of our report. We are independent of the charity in accordance with the ethical requirements that are relevant to our audit of[the][financial][statements] in the UK, including the FRC’s Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.

Conclusions relating to going concern

In auditing the financial statements, we have concluded that the trustees’ use of the going concern basis of accounting in the preparation of the financial statements is appropriate.

Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the charity's ability to continue as a going concern for a period of at least twelve months from when the financial statements are authorised for issue.

Our responsibilities and the responsibilities of the trustees with respect to going concern are described in the relevant sections of this report.

Other information

The other information comprises the information included in the Report of the Trustees, other than the financial statements and our auditor’s report thereon. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon.

Our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the audit or otherwise

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British Association for Performing Arts Medicine (BAPAM) Charity No 1167785

appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether this gives rise to a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact.

We have nothing to report in this regard.

Matters on which we are required to report by exception

We have nothing to report in respect of the following matters in relation to which the Charities (Accounts and Reports) Regulations 2008 require us to report to you if, in our opinion:

Responsibilities of trustees

As explained more fully in the trustees’ responsibilities statement [set out on page 10], the trustees are responsible for the preparation of financial statements and for being satisfied that they give a true and fair view, and for such internal control as the trustees determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error.

In preparing the financial statements, the trustees are responsible for assessing the charity’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the trustees either intend to liquidate the charity or to cease operations, or have no realistic alternative but to do so.

Auditor’s responsibilities for the audit of the financial statements

We have been appointed as auditor under section 145 of the Charities Act 2011 and report in accordance with regulations made under section 154 of that Act.

Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements.

Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud. The specific procedures for this engagement and the extent to which these are capable of detecting irregularities, including fraud is detailed below:

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British Association for Performing Arts Medicine (BAPAM) Charity No 1167785

Because of the inherent limitations of an audit, there is a risk that we will not detect all irregularities, including those leading to a material misstatement in the financial statements or non-compliance with regulation. This risk increases the more that compliance with a law or regulation is removed from the events and transactions reflected in the financial statements, as we will be less likely to become aware of instances of non-compliance. The risk is also greater regarding irregularities occurring due to fraud rather than error, as fraud involves intentional concealment, forgery, collusion, omission or misrepresentation.

A further description of our responsibilities is available on the Financial Reporting Council’s website at: httos://www.frc.org.uk/Our-Work/Audit/Audit-and-assurance/Standards-and-guidance/Standards-andguidance-for-auditors/Auditors-responsibilities-for-audit/Description-of-auditors-responsibilities-foraudit.aspx. This description forms part of our auditor’s report.

Use of our report

This report is made solely to the charity’s trustees, as a body, in accordance with Part 4 of the Charities (Accounts and Reports) Regulations 2008. Our audit work has been undertaken so that we might state to the charity’s trustees those matters we are required to state to them in an auditor’s report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the charity and the charity’s trustees as a body, for our audit work, for this report, or for the opinions we haye-farmed. Mae

pass Accountants Limited, Statutory Auditor

Venture House, The Tanneries East Street, Titchfield Hampshire, PO14 4AR

Date 2 AP2IL Jo2\

Compass Accountants Limited is eligible to act as an auditor in terms of section 1212 of the Companies Act 2006.

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British Association for Performing Arts Medicine (BAPAM) Charity No 1167785

Statement of Financial Activities

For the year ended 31 December 2020

Unrestricted Restricted * 2020 Unrestricted Restricted * 2019
Funds Funds Funds Funds Total
£ £ £ £ £ £
Income
Grants 377,535 0 377,535 317,850 0 317,850
Donations in kind 8,346 0 8,346 6,100 ) 6,100
Otherdonations 23,758 0 23,758 8,805 2,000 10,805
Investment income 84 0 84 275 0 275
Total Incoming
Resources 409,723 0 409,723 333,030 2,000 335,030
Expenditure
etna!8OS15-
general		 67,150 0 67,150 54,037 0 54,037
Health Promotion 0 ¢) 0 2,885 0 2,885
Staffing costs 189,564 ) 189,564 167,809 0 167,809
Marketihgar
services		 4,780 0 4,780 51 0 51
fundraising
expenditure		 0 0 0 950 0 950
Premises costs 56,473 0 56,473 61,166 0 61,166
Office costs 28,529 0 28,529 40,879 0 40,879
‘marae ianins: Sali
bank charges		 2,290 0 2,290 1,312 0 1,312
Legal expenditure 8,346 ) 8,346 4,900 0 4,900
Governance costs:
trustee meetings 51 0 51 416 0 416
GONEIMETIORGASES!
audit		 3,600 0 3,600 4,000 0 4,000
Awards from
Research and
Education Fund		 ) 250 0 ) 1,212 1,212
TotalChanttable
expenditure		 360,783 250 361,033 338,405 1,212 339,617
N
:
ine
funds		 48,940 (250) 48,690 (5,375) 788 (4,587)
Transfersbetween
funds		 0 0 0 0 0 0
Reserves brought
forward 99,478 2,946 102,424 104,853 2,158 107,011
Tealhanesari
forward		 148,418 2,696 151,114 99,478 2,946 102,424

All transactions are derived from continuing activities.

All recognised gains and losses are included in the Statement of Financial Activities

*The restricted fund represents sums set aside for research and education in performing arts medicine

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British Association for Performing Arts Medicine (BAPAM) Charity No 1167785

Balance Sheet

As at 31 December 2020

2020 2019
Notes £ £ £ £
Fixed Assets
Tangible assets 3 5,898 8,217
Current Assets
Debtors 4 18,179 15,961
Cash at bankand in hand 143,431 90,993
161,610 106,954
Creditors: amounts fallingdue within one
year 5 (16,394) (12,747)
Net CurrentAssets 145,216 94,207
NetAssets 151,114 102,424
Funds
Unrestricted Funds 6 148,418 99,478
Restricted Funds 7 2,696 2,946
as 8 102,424

The accounts have been prepared in accordance with the Financial Reporting Standard 102 and the Charities Act 2011.

|

The financial statements were approved and authorised for issue by the Trustees on 14 April 2021 and signed on its behalf by

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Ade. lee
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PETER LEATHEM, Chairman

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JOHN TURNER, Honorary Treasurer

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British Association for Performing Arts Medicine (BAPAM) Charity No 1167785

Cash Flow Statement

For the year ended 31 December 2020

2020 2019
£ £
Cash Flowsfrom Operating Activities:
Net Cash Used in Operating Activities 55,369 9,561
Cash Flowsfrom Investing Activities:
Purchase ofproperty, plantand equipment (2,931) (2,671)
Change in Cash and Cash Equivalents in theyear 52,438 6,890
Cash and cash equivalents at 1 January2020 90,993 84,103
Cash at31 December2020 143,431 90,993
Reconciliation ofnet income/expenditure to net cash flowfrom from operating activities
£ £
Net income/(deficit) SOFA 48,690 (4,587)
Depreciation 5,250 6,135
Reduction/(Increase) in prepayments/debtors (2,218) 6,137
Increase/(Reduction) in accruals/creditors 3,647 1,876
NetCashGenerated/(Used)inOperatingActivities 55,369 9,561

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British Association for Performing Arts Medicine (BAPAM) Charity No 1167785

Notes to the financial statements

for the year ended 31 December 2020

The principal accounting policies are summarised below. The accounting policies have been applied consistently throughout the year.

1.1. Charity information

The British Association for Performing Arts Medicine is a registered charity, number 1167785. The business address is shown in the information page.

The British Association for Performing Arts Medicine meets the definition of a public benefit entity under section 34 of FRS 102. Assets and liabilities are initially recognised at historical cost or transaction value, unless otherwise stated in the relevant accounting policy.

The principal objectives of the charity are detailed in the Trustees report.

1.2. Basis of accounting

The financial statements have been prepared under the historical cost convention and in accordance with Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective October 2019) - (Charities SORP (FRS 102)), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102), the Charities Act 2011 and UK Generally Accepted Practice.

1.3. Fund accounting

Unrestricted funds are grants, donations and other incoming resources received or generated for general purposes.

Restricted funds are to be used for specified purposes as laid down by the donor. Expenditure which meets these criteria is identified to the fund.

1.4. Income

Voluntary income is received by way of donations and gifts and is included in full in the Statement of Financial Activities when receivable. Donated assets are included at the value to the charity where this can be quantified and a third party is bearing the cost. The value of services provided by volunteers has not been included.

Grants, including grants for the purchase of fixed assets, are recognised in full in the Statement of Financial Activities in the year to which they relate.

Income from investments is included in the year in which it is receivable,

1.5. Resources expended

Expenditure is recognised on an accruals basis as a liability is incurred. Charitable expenditure comprises those costs incurred by the charity in the delivery of its activities and services for its beneficiaries. It includes both costs that can be allocated directly to such activities and those costs of an indirect nature necessary to support them. Support costs are those costs incurred directly in support of expenditure on the objects of the charity and include project management. Governance costs include those costs incurred in the governance of the charity and its assets and are primarily associated with constitutional and statutory requirements.

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British Association for Performing Arts Medicine (BAPAM) Charity No 1167785

Notes to the financial statements

for the year ended 31 December 2020

1.6. Financial instruments

The charity’s financial assets and liabilities consist of cash and cash equivalents, other debtors and creditors, and accrued expenses. The fair value of these items approximates their carrying value due to their short-term nature. Unless otherwise noted, the charity is not exposed to significant interest, foreign exchange or credit risks arising from these investments.

1.7. Tangible fixed assets

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||||||||||||||||| |---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---| |Depreciation|is|provided|at|rates|calculated|to|write|off the|cost|less|residual|value|of each|asset|over| |its|expected|useful|life,|as|follows:| |Computer|Equipment|-|33|1/3%|per annum| |Office|Equipment|-|20%|per annum| |Fixtures|and|Fittings|-|20%|per annum| |Medical|Equipment|-|20%|per annum|

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1.8. Going concern

There are no material uncertainties related to events or conditions that may cast significant doubt upon the charity's ability to continue as a going concern.

  1. Employees

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||||||||| |---|---|---|---|---|---|---|---| |Number|of Employees|2020|2019| |The|average|monthly|number|of employees|during|the|year| |were:|6|5| |Employment|Costs|2020|2019| |(All|employment|Costs|for both|years| |are|charged|to|unrestricted|funds)|£|£| |Salaries|164,612|146,923| |Social|Security|Costs|11,659|11,138| |Pension|Costs|12,659|11,272| |Other|staff|costs|-|-| |189,195|169,333|

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During 2020 one staff member earned emoluments in between £70,000 and £80,000 per annum (2019: 1 £60,000 - £70,000). No trustees received any remuneration. During the year, 1 Trustee was paid a total amount of £51 expenses (2019: 1 Trustee, £376) to reimburse costs of travel to trustee and other meetings.

Senior management Remuneration costs (including benefits) were £71,604 (2020: £63,036)

The charity operates a defined contribution pension scheme in respect of the employees. The scheme and its assets are held by independent managers. The pension charge represents contributions due from the charity.

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British Association for Performing Arts Medicine (BAPAM) Charity No 1167785

Notes to the financial statements

for the year ended 31 December 2020

3. Fixed assets

Computer Medical
equipment Furniture equipment Total
£ £ £ £
Cost/vatuation
At 1 January 2020 16,816 1,229 1,773 19,818
Additions 2,931 0 0 2,931
Disposals 0 0 0 0
At 31 December 2020 19,747 1,229 1,773 22,749
Amortisation
At 1January 2020 (10,100) (741) (760) (11,601)
Charge fortheyear (4,650) (245) (355) (5,250)
Disposals 0 0 0 0
At 31 December 2020 (14,750) (986) (1,115) (16,851)
Net BookValue
At 31 December 2020 4,997 243 658 5,898
At 31 december2019 6,716 488 1,013 8,217
4. Debtors
2020 2019
£ £
Otherdebtors 10,764 11,430
Prepayments 7,415 4,531
18,179 15,961
5. Creditors
2020 2019
£ £
Accruals 16,394 12,747
16,394 12,747

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British Association for Performing Arts Medicine (BAPAM) Charity No 1167785

Notes to the financial statements

for the year ended 31 December 2020

6. Net assets between funds

Analysis ofNetAssets
between Funds Unrestricted Restricted 2020 Unrestricted Restricted 2019
Funds Funds Funds Funds
£ £ £ £ £ £
Fund Balances at 31
December as
represented by:
Tangible Fixed Assets 5,898 0 5,898 8,217 0 8,217
Current Assets 158,914 2,696 161,610 104,008 2,946 106,954
Current Liabilities (16,394) 0 (16,394) (12,747) QO (12,747)
148,418 2,696 151,114 99,478 2,946 102,424

7 Restricted funds

Restricted funds are available for prizes and grants in the field of research and education.

2020 2019
£ £
Balance as at 31 December prioryear 2,946 2,158
Donations received during the year 0 2,000
Awards made during the year (250) (1,212)
Balancecarriedforwardat31December 2,696 2,946

8. Lease commitments

At 31 December 2020 the Charity outstanding commitments for future minimum lease payments under non-cancellable operating leases as follows:

Land and Buildings Land and Buildings
2020 2019
£ £
Expiry Date:
Within one year - 53,500
Between two and five years 95,000 -
Overfiveyears - -

9. Related party transactions

One of the trustees received £2,525 in payments relating to conducting clinics [and presenting Health Promotion workshops] (2019: one Trustee, £875).

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British Association for Performing Arts Medicine (BAPAM) Charity No 1167785

Notes to the financial statements

for the year ended 31 December 2020

10. Financial instruments

The carrying amounts of the charity’s financial instruments are as follows:

2020 2019
£ £
Financial assets
Debt instruments measured at amortised cost:
-Otherdebtors (note 4) 10,764 11,430
10,764 11,430

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British Association for Performing Arts Medicine (BAPAM) Charity No 1167785

Unrestricted Income and Expenditure for the year to 31 December 2020

(This and the following page are for management information only and do notform part of the statutory financial statements)

2020 2020 2020 2019
£ £ £ £
Grants
HMUK 200,000 200,000
MU 50,000 50,000
Equity 30,000 30,000
PPL 30,000 30,000
PRS for Music 7,500 6,750
Grand Order ofthe Water Rats (5,000) -
312,500 316,750
Other income
Income ona per capita basis 65,035 1,100
Othervoluntary income, including donations and fundraisers 23,758 8,805
Bank interest 84 275
Donations legal advice 8,346 4,900
Donation ofRoom Occupancy 0 1,200
Total otherincome 97,223 16,280
Total Income 409,723 333,030
Clinic costs
Honoraria paid to clinicians (76,321) (44,696)
Other clinic costs including medical committee (6,013) (9,745)
Clinicians training courses surplus/(deficit) - 403
(82,334) (54,038)
Education and Training net surplus/(deficit) 15,184 (2,885)
Premises
Premises rent and rates (56,473) (59,966)
Donated Occupancy (Meeting Rooms made available) - (1,200)
Premises fit out - -
(56,473) (61,166)
Staffcosts
Salaries including NI and pensions (189,564) (167,809)
Temporary staffand recruitment costs - -
Total staffcosts (189,564) (167,809)
Marketing and fundraising
Advertising/ marketing ofservices (4,780) (51)
Fundraising expenditure - (950)
(4,780) (1,001)

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British Association for Performing Arts Medicine (BAPAM) Charity No 1167785

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||||||||| |---|---|---|---|---|---|---|---| |£|£|£|£| |Office|expenditure| |Donated|legal|advice|(8,346)|(4,900)| |Software|and|IT support|(7,951)|(5,044)| |Trustee|meeting|expenses|(51)|(416)| |Sundry|office|expenditure|(8,509)|(24,394)| |Insurances|(6,819)|(5,305)| |Equipment|depreciation|(5,250)|(6,135)| |(36,926)|(46,195)| |Finance|costs| |Audit|(3,600)|(4,115)| |Accountancy|(1,979)|(856)| |Bank charges &|bad|debts|(311)|(341)| |Finance|costs|(5,890)|(5,311)| |Awards|from|Research|and|Education|Fund|:|-| |Total|expenditure|(360,783)|(338,405)| |(Deficit)/ Surplus|48,940|(5,375)|

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