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2021-03-31-accounts

Trustees’ Annual Report and Accounts 1 April 2020 - 31 March 2021

CWPLUS Company limited by guarantee registered in England and Wales No.10410134

Contents

Foreword 3-4
About CW+ 5
Achievements, Performance and Impact 5-16
The Year Ahead 17-19
Financial Review 20
Policies and Procedures 21-24
Structure, Governance and Management 25-26
Reference and Administrative Details 27
Statement of Trustees’ Responsibilities 28
Independent Auditor’s Report 29-33
Statement of Financial Activities 34
Balance Sheet 35
Statement of Cash Flows 36
Notes to the Accounts 37-52

Cover Image: Donation of silk flowers from Wildabout Flowers in 2020, installed at the entrance of West Middlesex University Hospital

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Foreword

Welcome to our 2020/21 Annual Report and Accounts. It’s been a year like no other, with the COVID-19 outbreak across our communities impacting every aspect of life for our patients, supporters and staff.

In Spring 2020, the Charity’s strategy, priorities and working practices were radically redirected as we responded to the local and national emergency. It is a testament to the strength and dedication of our local community that we were able to support our staff and patients throughout the pandemic, during the initial first wave and throughout the subsequent outbreaks, variants and setbacks we have faced. We have been overwhelmed by the generosity of individuals, families and organisations who have gone above and beyond to donate to our COVID-19 Rapid Response Fund, set up in March 2020. They have enabled us to respond to, and address, the emerging and pressing needs of our patients and staff, including helping us to provide new equipment, the latest technologies and importantly, support for their mental and physical wellbeing in this taxing time.

While responding to the pandemic was a core focus of our work throughout 2020-21, we were still able to continue with elements of our broader charitable aims as planned, and to utilise the necessity to change as an opportunity to rapidly innovate and rethink how we can support our hospitals.

Our CW Innovation programme, which celebrated its first birthday in September 2020, enabled us to advance at pace to introduce a range of innovations into our day-to-day services, such as digital consultation and remote monitoring tools so patients could still access care without the need to visit our hospitals.

Our position as a leading national and international centre for research has also been strengthened with our support of important COVID-19 clinical trials such as PIONEER, which aims to prevent patients with mild to moderate COVID-19 from becoming seriously ill.

There’s no doubt that the pandemic has challenged us to act quickly and decisively. In March 2020, our Adult Intensive Care Unit was fast-tracked to open in time to treat the increased number of patients being cared for with COVID-19. Construction across both the Adult and Neonatal Intensive Care Units is now complete, and we are greatly indebted to our supporters who enabled us to achieve our three-year fundraising goal in just two years. These world-class facilities bring together our core strengths in digital innovation, environment and design, while testing and scaling the latest clinical technologies.

Despite restrictions, our work to refurbish and enhance our wards, and to transform both clinical and non-clinical areas into healing environments continued this year. Our participatory arts programme Arts For All, which was adapted into a digital programme called Virtual Connections, also continued to provide patients with the opportunity to engage with our artists, whether in hospital or isolating at home in the community.

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Finally, we were also proud to celebrate West Middlesex University Hospital’s centenary, beginning with virtual celebrations in September 2020, which we are continuing throughout the hospital’s centenary year. With a physical and online exhibition planned to explore West Middlesex’s rich history, we are looking forward to uncovering the extraordinary heritage of our hospital, honouring its staff and their ongoing dedication to caring for patients and families.

As we emerge from the pandemic and turn to our recovery phase, we look forward to seeing how the incredible support from our communities will continue to enable our staff to innovate, advancing care and setting a benchmark of excellence across the NHS. We are extremely grateful for the continued generosity of our supporters, and the dedication of our staff, which have allowed CW+ to go from strength to strength, even in this challenging year.

Tony Bourne Chairman

Chris Chaney Chief Executive

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About CW+

Our Vision

To be seen as leaders in the delivery of innovation in patient care, patient experience and the hospital environment.

Our Mission

CW+ is the official charity of Chelsea and Westminster Hospital NHS Foundation Trust including its hospitals and clinics. Our generous supporters and partners enable us to:

Our work would not be possible without the wonderful generosity of our supporters, to whom we are immensely grateful.

Achievements, Performance and Impact

The report section to follow provides commentary on the year’s performance against the 2020-23 objectives. The strategy sets out clear goals for delivery over three years. The Charity employs a balanced scorecard approach to ensure we consider all aspects necessary for its success.

This encompasses:

This report sets out our goals under these headings and provides a commentary on achievements, performance and impact.

Delivering Impact for our Beneficiaries

There were three key areas of focus for our activities:

  1. Fundraising and the COVID-19 Rapid Response Fund

  2. Patient environment and experience

  3. Grants and innovation

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  1. Fundraising and the COVID-19 Rapid Response Fund

The Charity aims to be the principal provider and coordinator of capital and revenue fundraising for the Trust. Our goal is to be generating a minimum £6 million per annum in fundraised income at a 4:1 income/cost ratio.

The Charity came close to achieving this goal in this, the first year of our three-year strategy, having raised a total of £5.3m. We are pleased to report that the income was delivered at an income-to-cost ratio of 5:1.

A further £1.1m has been committed by way of pledges of financial support from donors which will be receivable over the next three years.

The year 2020-21-was focused on responding to the COVID-19 pandemic and to the changing needs of the Trust. We raised a further £2.5m for our COVID-19 Rapid Response Fund, including £858,000 for the PIONEER research programme.

We were the grateful beneficiaries of £1.6m in legacy income, including a bequest of £1m from John Karadzas for Medical Equipment at West Middlesex University Hospital.

We have also raised funds to support our arts in health, innovation and grants programmes, as well as a focus of activity around HIV and sexual health projects.

We would like to extend our thanks to all those who have supported us throughout the past year, without whom none of our work would be possible.

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2. Patient environment and experience

Our award-winning arts in health programme combines visual and performing arts with live music and dance; participatory music, art and craft workshops; film screenings at the CW+ MediCinema; innovative design and green spaces; as well as our collection of over 2,000 works of art and digital installations to transform the hospital environment for patients, families, volunteers and staff.

Some of our projects from 2020/21 are explained below:

Arts for All and Virtual Connections

Our participatory arts programme Arts for All brings together our Care of Older People, Performing Arts and Paediatric Participation programmes to be delivered to the entire hospital community.

Launched in May 2020, Virtual Connections was created in response to the COVID-19 pandemic as a digital version of our Arts for All programme. The online arts programme allowed us to support the health and wellbeing of our patients, staff, and those selfisolating in the wider community, with new videos from many of our resident artists and local partners.

Over 30 artists and partner organisations have shared with us original and specially commissioned content for the platform, including Chelsea FC Foundation, the National Portrait Gallery and English National Ballet School, as well as our long-term Arts for All resident artists including harpist Mark Levin, Akademi South Asian Dance, and violinist Adrian Garratt.

In 2020, we also launched a new campaign, Scarf Up, to encourage volunteer knitters to make and donate scarves to our hospitals. The scarves would then be given out to patients suffering from asthma, chronic obstructive pulmonary disease (COPD), and those recovering from COVID-19. We commissioned several renowned artists to design unique scarf patterns for this project, including Denzil Forrester and Michael Landy.

The CW+ MediCinema at Chelsea and Westminster Hospital was temporarily closed during the COVID-19 pandemic in accordance with restrictions, but thanks to Hospedia, patients were able to watch new films on their bedside screens. Since March 2021, the CW+ MediCinema has been open to inpatients at Chelsea and Westminster for socially distanced screenings in addition to the Hospedia programme.

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CW+ Studio and Community Bridge

Our Community Bridge programme is expected to reach more than 24,000 local residents, consisting of both inpatients and outpatients, and around 7,000 carers. Community Bridge aims to:

The CW+ Studio was created as a base for the Community Bridge programme, specially designed as a bespoke, dementia and disability friendly space that would become a hub of cultural activity. As the COVID-19 outbreak hit, the Community Bridge programme was paused and the CW+ Studio temporarily transformed into a staff wellbeing hub. At the peak of the pandemic, the CW+ Studio was open 24 hours a day providing a welcoming environment for staff to relax, reflect and refuel.

In April 2021, we officially welcomed patients to the CW+ Studio for the first time as COVID-19 restrictions relaxed. The CW+ Studio will initially launch with a hybrid programme of online activities and events alongside small-scale ‘live’ participatory events, programming, and workshops. Through a co-designed community approach, the CW+ Studio and arts programme expect to reach 24,360 residents (inpatients and outpatients), over 7,000 carers, through 1,128 activities over three years.

Design and Environment

Throughout the year, we have been working to refurbish and enhance our wards, and to transform both clinical and non-clinical areas into healing environments for patients, staff, and visitors.

In June 2020, we started a major project to refurbish six wards across both sites, including five wards specialising in care of older people at both hospitals. Using our Design Standards, we have created patientcentred environments which reflect current

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practice in dementia care. Across all wards, we are installing adaptable lighting, signage, sound systems, and colour-coding to help patients navigate the wards. Many of these works have now been completed, while we continue to renovate and plan others.

Other significant improvements to the design and environment across our hospitals include:

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Exhibitions and Events

With in-person events on hold due to the COVID-19 pandemic, we are celebrating West Middlesex University Hospital’s centenary online throughout the year, sharing the fascinating stories of the hospital and its staff. A physical exhibition onsite is also in progress, with our Heritage Officer working to explore West Middlesex’s rich history thanks to a grant from the National Lottery Heritage Fund. Celebrations began on 17 September 2020, West Middlesex’s 100th birthday, and will culminate with an in-person event in September 2021.

Over the last four years, London-based photographer Lewis Khan spent time at both our hospitals as our Photographer-in-Residence. His new book, Theatre, was released in May 2020 and is a result of Lewis’s time with us, containing a new body of work that looks at the intimate realities of the NHS.

In January 2021, we launched CW+ Conversations, our arts in health webinar series, with our inaugural event entitled ‘Arts in Hospitals during COVID-19: Time to Reflect’. CW+ Conversations aims to bring together people from different disciplines and settings in a conversational space to explore the work we are all doing, to share experiences and ideas, and – as a result – to find ways to improve and further innovate. Our inaugural event was organised in association with the Arts, Heritage and Design in Healthcare Network with participation from over 65 attendees with expertise and interest in the arts in health field.

Future Hospital

Working with a range of health technology partners, as well as renowned and emerging artists, architects and designers, we are aiming to elevate patient care and empower our staff with our Future Hospital studies.

One example is our research on sleep in intensive care, which is informing how we can best create an environment for optimal sleep and healing in our new, state-of-the-art Adult Intensive Care Unit (ICU) at Chelsea and Westminster Hospital. As part of our redevelopment of the ICU, we have collaborated with Sensyne Health, Sonitus and Airthings to measure data recorded from individual patients’ beds in ICU in real-time.

These innovative sensors track temperature, air quality, CO2 levels, virus risk and lighting, and will all help to improve patient experience in critical care and provide our staff with key information on patient wellbeing and progress. Our innovative research

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explores the reasons for sleep deprivation in ICU, including major contributing factors such as the patient’s illness or injury, pain from surgical procedures, anxiety and, importantly, the ICU environment itself. We are working with the ICU team at Chelsea and Westminster Hospital on a Sleep Study to review using Virtual Reality (VR) in an ICU environment and how this can impact sleep quality and, in-turn, psychological and physical symptoms. We have also facilitated further VR studies in the Cardiac Catheter Labs and in the Paediatric Emergency Department.

We installed the Immersive Healing Art System in the Level 5 Sky Garden at Chelsea and Westminster, an innovative, interactive digital artwork developed by Genesis Arts.

The unique installation uses sensors and facial scanning software to identify and interpret an individual’s emotions and then aims to influence a positive reaction by creating a unique audio-visual art piece that calms, relaxes and improves mood.

3. Grants and Innovation

Grants

The Charity met its strategic goal to deliver a discretionary grants programme of at least £500,000 per annum, aligned to Trust priorities. It targeted the following areas:

Grants totalling £3.1m were awarded during the 2020–2021 period. A breakdown of these is shown in note 3.1 to the accounts.

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CW Innovation, led jointly by CW+ and the Trust, tests and scales high-impact innovations that improve patient care, patient experience, and the way we run our hospitals. Together, we look for new and innovative solutions that address the most fundamental challenges healthcare organisations face today. As a founding partner of the DigitalHealth.London Accelerator (DH.LA), CW Innovation expedites the adoption of digital health innovation in the NHS, ensuring that patients benefit faster from new technologies.

The overall objectives of CW Innovation are:

Our CW Innovation programme manages a portfolio of over 80 projects, ranging from testing remote monitoring tools and applying Artificial Intelligence (AI) analytics, to real-time clinical data to improve patient management, through to evaluating the impact on patient outcomes and experience of novel technologies; including robots, Virtual Reality (VR)/Augmented Reality (AR) and sensor arrays across a range of clinical settings.

Our clinical staff have been central to the development of new technologies, including the DNA-Nudge testing system, the SYNE-OPS-1 AI algorithm which helps assess patients and their need for ventilated breathing support, and novel eye-tracking technology which helps us identify the early onset of delirium.

Our digital team has designed and launched a real-time command and control centre linked to our Cerner Electronic Patient Record system, which helps us track patients across our organisation, manage our clinical assets in real-time, and utilise predictive data analytics to improve our understanding of the demands on our services.

The CW Innovation programme aligns its activities with Trust priorities at an organisational and divisional level working closely with Trust leadership to deliver it. We have established an expert Innovation team in the Trust and an influential external Advisory Group, and we continue to seed fund a range of projects across our hospitals.

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Some specific projects supported through our grants and innovation programmes are outlined here:

Chronic Hepatitis C treatment for homeless people

Chronic liver disease is the third highest cause of death in persons experiencing homelessness. We agreed funding for the Hepatitis C Virus infection testing in the Westminster homeless population. The purchase of a Cepheid machine was agreed to provide testing in a GP surgery in Westminster. This will enable the identification and treatment of patients in a single visit to the surgery. The aim is to completely eradicate the disease in the patient cohort.

Remote diabetes management with DBm-Health

Optimising diabetes treatment relies on adjusting medication based on patients’ home glucose results (SBGM). Many patients need support from the diabetes team alongside self-management. Improved diabetes control is vital to prevent the longterm complications of diabetes (such as blindness and renal failure). Clinicians contact multiple patients by phone or email to review their data, frequently relying on patients reading out their results over the phone. This does not allow proactive identification of patients in need of extra support.

The DBm-Health app has been co-designed by diabetes clinicians at the Trust and Sensyne Health, based on a system used in pregnancy. It offers two significant benefits: a) remote monitoring, allowing clinicians to see patients’ SBGM results without visiting the hospital and b) identification of those whose glucose readings are out of range, allowing targeted support.

National Neonatal Palliative Care Project

In partnership with the Trust and the True Colours Trust, we launched the national rollout of our pioneering regional Lead Nurse for Neonatal Palliative Care Project after a successful five-year London pilot at Chelsea and Westminster Hospital NHS Foundation Trust. The work will continue to be spearheaded by Alex Mancini, who will become the country’s first National Lead Nurse in Neonatal Palliative Care.

Eye-tracking in intensive care

A feasibility trial in ICU using a state-of-theart eye-tracking system that is non-invasive, continuous and provides results in near real-time. The trial will cover finalisation and optimisation of equipment, recruitment of patients, analysis of data and dissemination of findings. The project aims to produce evidence-based novel insights into delirium and the gaze of patients in adult ICU who are at risk of developing delirium.

We also agreed funding for several small-scale, innovative projects including:

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Supporting Trust staff

We continue to focus on awards that value and support Trust staff and volunteers. This has been especially important during the COVID-19 pandemic.

The Trustees made a major commitment of £202,000 to support the annual cost of the volunteering programme for the Trust. The programme supported over 900 volunteers in the Trust in 2020-21.

In 2019-20, we launched a new Staff Wellbeing and Amenities Grant (SWAG) to support staff. In 2020-21, we invested circa £700,000

in staff health and wellbeing. Of this, £580,000 was focused around supporting staff during their delivery and recovery phases of the COVID-19 pandemic.

In 2020-21, we approved 15 applications to our Training, Education and Development Fund. Due to the pandemic, we saw a reduction in the number of training awards and funding was often used for online training.

We also fund the Trust’s monthly Proud Awards, other celebratory events and ‘thank you’ events for staff during the year.

Small Grants

In 2020-21, we spent a total of £25,000 on over 30 Small Change Big Impact (SCBI) projects for ward enhancements, recreational projects, non-essential equipment, and others, including:

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Special Funds

In addition to specific appeals and projects, CW+ also holds special purpose funds to support a range of activities across the Trust. These are detailed in notes 10.1 and 10.3. CW+ awarded £272,000 from these funds in 2020-21. These supported a wide range of activities, including staff and patient welfare, medical equipment, education and training. Fund advisers, who are hospital specialists in the relevant fields, advise CW+ on the best use of the funds.

COVID-19 Rapid Response Fund

In response to the COVID-19 outbreak, we launched our dedicated COVID-19 Rapid Response Fund in March 2020, to help our staff provide the best possible care to those in need. We raised a further £2.5m in the year ended 31 March 2021 (year ended 31 March 2020: £1.2m) .

Our hospitals prepared for a significant increase in patients needing support in intensive care, with the Trust playing a key role in responding to the virus in London. We accelerated the opening of 10 new intensive care beds in the new adult ICU at Chelsea and Westminster Hospital, embedded new digital solutions to monitor and communicate with patients and carers, provided enhanced training for staff and deployed a skilled volunteer workforce to support the needs of both patients and staff.

The COVID-19 Rapid Response Fund supported our hospitals with grants and funding of £1.8m in the following key areas:

Ensuring we have resources to meet our aims

Our goal is to have maintained our asset base represented by our long-term capital fund to support CW+ programmes and its workforce.

The financial strategy and investment policy continue to deliver a sound asset base to generate the resources to enable the delivery of our key strategic workstreams:

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Development and investment in resources

Constitution and governance

Key to our success is the goal to develop and embed new governance procedures for CW+ in our partnership with the Trust. Since 1 January 2017, when CW+ became a newly-constituted charity independent of the Department of Health, our constitution, Trustee Board representation and positioning as the Trust’s official charity have helped to successfully coordinate our objectives, outputs and communications in true partnership with the Trust.

Investment in new and existing staff

During the year, we have invested in new staff members to deliver our ambitions, including a Head of Development for Clinical Programmes.

We have recruited a Head of Major Projects to lead on the project management of the Best For You Programme and other major projects directly delivered by CW+. We have also recruited a Digital Innovation Fellow to lead on the digital innovation strand in Best For You and support digital innovation generally.

We have signed up to a new ten-year lease of the offices at Verney House and refurbished them to provide for an improved working environment and better meeting facilities.

During the COVID-19 pandemic, staff were supported in working from home arrangements.

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The Year Ahead

Best For You

Best For You, our new transformative patient-centred model of care in child and adolescent mental health, is planned to be based initially in North West London and aims to address variation and capacity constraints to provide rapid, personalised, compassionate and long-term support focused on the needs of individual young people and their families.

Over the next year, we will plan the delivery of the programme with the development of a Child and Adolescent Unit in the Trust and a Day Centre located nearby. The capital development plan will include enhancements from the CW+ arts team. The programme will integrate digital innovations with the new physical units alongside a portfolio of relevant patient-facing apps to support clinical delivery.

We aim to raise £3m towards the programme in 2021-22.

Ideas Hub

We want to create a space which combines national leading operational performance, our award-winning arts in health programme and a culture of innovation and improvement to continue to advance the care delivered to the population we serve. This will be a bespoke space that meets the needs of clinical teams to deliver innovations and improvements to the care that they deliver to the population.

Aligned to the existing and established programmes, the space should accelerate existing work and provide an opportunity to bring in and trial new proof of concepts, innovations and improvements that position the Trust and CW+ as leaders in this field. This programme will bring together the art and design and innovation workstreams of the charity, and will be a core fundraising target of the Horizon Initiative (see below).

Arts, Environment and Patient Experience

We will continue to bring original artwork, innovative arts programming, and excellent design into our hospitals, transforming the experience and environment for patients, their families and the staff who care for them.

We aim to extend the participatory offer to all inpatients under the umbrella of ‘Arts for All’. We hope to deliver activities in CW+ Studio and as part of our wider Community Bridge programme. Whilst COVID-19 restrictions operate, we will continue to develop and deliver Virtual Connections. Our Future Hospital programme will combine arts in health with innovation by testing concepts utilising digital, robotics, VR and AI to enhance patient experience.

We will support the overall programme through core funding, the Horizon Initiative and focused project fundraising.

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In alignment with the Trust’s strategic objectives, we will continue to deliver an exciting ‘test and scale’ portfolio of successful innovation projects at the Trust.

We will move to further integrate with the Research, Innovation and Quality Improvement (RIQI) team to deliver the CW Innovation programme.

In doing so, we aim to further develop the culture of innovation at the Trust through the Horizon Initiative, including the delivery of the Ideas Hub.

CW Innovation will be delivered through synergies and overlap with Best For You, the grants programme, the NHS Charities Together digital recovery programme and the Future Hospital programme.

Grants

We will review the priorities and structure of the programme, shifting the priority to the delivery of focused calls for applications. We have identified themes for the following calls:

We will supplement core funding of £500,000 with funding from the Rosetrees Trust, the Kusuma Trust and the Karadzas legacy to support these funding calls.

Our small grants programmes, which include Small Change Big Impact grants, Staff Welfare and Amenities Grants, and Training and Education grants, will continue. We will also support staff recruitment and retention and the Trust volunteering programme.

Horizon Initiative

The Horizon Initiative is designed to capture and realise the surge in new thinking brought about by the COVID-19 pandemic.

Our vision is to utilise the real-world setting potential of our hospitals and clinics, our entrepreneurial staff base, our national and international network of public and private sector organisations and our community of like-minded partners and supporters to identify, seed, test and implement a new generation of healthcare innovations and research programmes, including activity to support initiatives in HIV and sexual health, with the

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potential to make a step-change in the way we deliver care to patients.

We believe the Horizon Initiative now has the potential to catalyse a new chapter for the Trust, and to support the wider NHS as the country recovers and evolves from the impact of COVID-19.

We aim to raise £2.5m next year, with an ambition to raise £10m over the next four years.

NHS Charities Together – North West London Digital Inclusion Programme

We have been designated as the lead charity within North West London for supporting COVID-19 recovery activities. As part of this work, with a proposed funding pot of over £1 million, we are working with partners from across the region to deliver three digital inclusion and innovation projects for the population. These projects were identified through a competitive process held in early 2021, led by CW+.

We are now working with NHS Charities Together and the successful bidders to develop and deliver a programme and associated evaluation on ‘Supporting shielding and vulnerable people effected by COVID-19 through digital access to health, care and community resources’ over the next two years, with a view to successes being scaled on a wider level. As part of this process, we have also agreed to work with NHS Charities Together to share our process, materials and support with other regions work should it be required.

Other Activities

Additional fundraising - we will continue a programme of fundraising for the volunteering programme, arts commissions and residencies and phase two of the Sun and Stars Appeal.

Celebratory Events - we aim to make 2021-22 a year of celebration. We will celebrate the 100th anniversary of West Middlesex University Hospital and we hope to be able to hold an in-person celebration as the COVID-19 pandemic recedes. We will stage events to celebrate the completion of Critical Care and if possible, the Ideas Hub.

Communications - the aims and outcomes of our whole programme will be promoted and widely shared online, on social media and with the press with the support of our dedicated communications team.

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Financial Review

Total income for year ended 31 March 2021 at £6.0m represented an increase of 24% on the previous year. A further £2.5m was raised for the COVID-19 Rapid Response Fund and the PIONEER COVID-19 Research project to add to the £1.2m received in the Fund in the previous year. We also benefitted from £1.6m from generous gifts in legacies. These support a variety of areas including burns, the heart department and, most notably, £1m bequeathed by John Karadzas for medical equipment at West Middlesex.

Investment income for the year ended 31 March 2021 was £425,000 (year ended 31 March 2020: £507,000). Net gains on investment assets amounted to £5.4m reversing losses of £1.7m in the year ended 31 March 2020.

Fundraising costs were £1.1m for the year ended 31 March 2021 (year ended 31 March 2020: £1.0m).

Charitable activities are divided between our Grants and Innovation programmes and our Art and Design programmes. In the year ended 31 March 2021 expenditure on Grants Payable including support costs was £3.4m (year ended 31 March 2020: £1.3m). The increase was buoyed by £1.9m of grants in support of the Trust’s response to the COVID-19 pandemic. There was also a £202,000 grant for the Trust’s volunteer programme. Art and Design was £1.7m (£7.3m in 2020). The 2020 results included £6.0m towards the works on the Critical Care Campaign. Funding for this project reduced to £425,000 in the year ended 31 March 2021 as the project drew to a successful conclusion.

Support costs, including governance, for the year ended 31 March 2021 at £525,000 (year ended 31 March 2020: £557,000), showed a fall of circa 6% on the previous year. These costs are apportioned against the area of activity to which they related and are therefore included in the figures quoted above. CW+ continues to be satisfied that such costs are being appropriately controlled.

Total charity funds increased to £43.0m at 31 March 2021 from £37.9m at 31 March 2020. £3.5m (2020: £3.8m) is held in restricted funds. This includes funds held in the COVID-19 Rapid Response Fund.

After designations, Free Reserves stood at £103,000 at 31 March 2021 (31 March 2020: £16,000).

Investment Performance

The return in the portfolio (ex-property) for the year ended 31 March 2021 was 18.2%. The five-year annualised return to 31 March 2021 of the total portfolio was 7.1% matching the long-term target of 7.1% (a target of 4.5% plus inflation).

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Policies and Procedures

Fundraising Policy

Our approach to fundraising rests on positive supporter engagement in order to attract, steward and maintain support, whilst respecting the wishes of our donors. To help us achieve this, we store and segment supporter information using the Harlequin Customer Relationship Management database.

The Charity is registered with the Fundraising Regulator and contributes to the Fundraising Regulator Levy on fundraising charities. We adhere to the Fundraising Regulator’s Code of Practice and to Charity Commission guidelines. Trustees are aware of the Commission’s six fundraising principles and ensure adherence by charity staff:

  1. Effective planning

  2. Supervision of fundraisers

  3. Protection of charity reputation

  4. Money and other assets

  5. Ensuring compliance with laws and regulations

  6. Following recognised standards; openness and accountability

Trustees and staff are aware of the need to protect the public, and especially vulnerable people; hence no cold calls, telephone or street fundraising is carried out, and no inducements are made to staff or volunteers. No professional fundraisers or commercial participators carried out any fundraising activities on behalf of the Charity.

The Charity has a Fundraising Governance Committee which reports directly to the Board of Trustees. The Committee meets quarterly and its remit includes (but is not limited to) considering, approving, recommending, deferring or declining fundraising applications of £100,000 or above. The Committee will ensure all fundraising activity complies with the Charities fundraising policies and wider aforementioned legislation.

Failures to comply with Fundraising Standards will be reported to the Fundraising Regulator if they occur, as will complaints, for which there is guidance for the public on our website and an internal process to follow if any are received. There have been no complaints nor any recorded failures to comply with fundraising standards in the last financial year nor since the Fundraising Regulator was introduced.

Our privacy policy covers how we use our donors’ data and provides opportunities for all donors to opt out of contact with us or make a complaint at any point.

We provide website links to our privacy policy on fundraising materials, including: our general charity leaflet, ward donation forms and electronic newsletters, which are sent using MailChimp®.

Risk Management Policy

In order to meet their obligations for risk management in relation to the Charity, the Trustees have adopted a framework under which they identify and monitor risks. The

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Charity carries out a formal risk assessment, resulting in the preparation of a detailed risk register. The procedures consist of the following:

Using this process, the Trustees have carefully examined the major strategic and operational risks faced by the Charity.

These are as follows:

There is a risk that the CW+ strategy will no longer be deliverable during the pandemic. The Senior Management Team have reviewed the strategy and presented updated key performance indicators (KPIs) to the Trustee Board. The Charity is confident that it can continue to deliver its charitable objectives focused on its core strategic themes. There is a change in emphasis in some areas in order to coordinate a highly supportive response to the Trust’s delivery of healthcare during the COVID-19 outbreak.

Investment values have been closely monitored by the Finance and Investment Committee with the support of its adviser, Cambridge Associates. The portfolio is structured to withstand economic and market shocks by incorporating significant asset allocations to absolute return strategies and bonds. This strategy has proved highly successful in delivering excellent returns during the COVID-19 pandemic.

CW+ has carefully monitored and followed government and NHS advice on business operations during the outbreak, with a special focus on risks relating to staff health and wellbeing. Staff have worked from home whenever possible, with meetings and events conducted online via platforms such as Zoom. Support has been given to staff to avoid using public transport, and guidance has been issued on how to behave should they need to attend the office or hospitals.

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Grants and Distribution Policy

Grant applications and other awards are considered at the Grants Committee and recommendations made to the Board of Trustees. The Trustees have agreed to proactively focus on the initiatives described in this report. These are in the long-term interests of the hospital’s beneficiaries – the patients.

Reserves Policy

The Charity normally plans the distribution or designation of all its free reserves through its charitable activities. It therefore does not plan the long-term retention of undesignated free reserves. Free reserves stand at £103,000 at 31 March 2021 (31 March 2020: £16,000).

Unrestricted Funds:

The Charity holds £39.5m in unrestricted funds. It has designated the majority of these for different purposes. The breakdown and projected timescales for application of these funds is shown in notes 10.2 to the accounts.

Designated Funds:

Long-Term Capital

The Long-Term Capital Fund has been established over many years to provide for both current and future needs of patients and communities served by the Trust and the Charity. The £34.0m Long-Term Capital Fund is invested to provide stability and liquidity for the Charity’s activities in the long term.

Arts Assets:

This £3.2m fund represents the art on display and other fixtures and fittings in and around the Trust’s property. It is not readily realisable and therefore does not constitute free reserves.

Other designated funds:

The Charity holds 138 funds totalling £2.4m which are designated to support activity at different parts of the Trust. A full list of the funds is available from the Charity on request.

Restricted Funds:

Restricted funds are reserved for specific purposes. Details of the funds are shown in note 10.1.

Investment Policy

Our Long-Term Capital Fund delivers the resources to enable the Charity to increase considerably its impact and fundraising capacity. This allows voluntary income to be delivered directly to support our charitable priorities in art and design, research and clinical innovations. The Charity invests its Long-Term Capital Fund in accordance with its Investment Policy Statement (IPS). This is summarised below.

The financial objectives of the overall portfolio are to:

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The long-term investment objectives of the portfolio are to:

CW+ recognises the importance of environmental, social and governance (ESG) investing as part of investment strategy. The policy acknowledges the Charity’s ethical responsibilities and aligns with its ethical approach to accepting donations. The Charity will ensure that a consideration of ESG factors is a standard part of the selection process when appointing new fund managers. In applying this approach, the Charity will aim to avoid increasing portfolio risk or compromising investment returns. The Charity will review the ESG strategy of its existing managers at least annually.

Diversity Policy

CW+ is committed to the principles of the Equality Act 2010. Our workforce is diverse across many spectrums including gender mix, culture, religion, sexuality, race and disability.

We have taken active steps over the past few years to ensure our Trustee Board is more diverse and now have six females and five males on our Board. Whilst we have diversity in terms of gender, nationality and work experience, we are working towards more inclusion across other spectrums and will continue to proactively focus on this over the next few years as and when new Trustee positions become available.

We also support the Trust in its commitment to being a diverse and inclusive employer. The Trust is a Stonewall Diversity Champion, Disability Confident Employer and Timewise accredited flexible employer. We have helped fund the Trust’s Black Asian Ethnic Minority (BAME) Network and we recently supported the Trust’s Equity Diversity and Inclusion (EDI) vision with a grant for Virtual Bodyworks, which uses virtual reality to expand on EDI training for staff by using the VR environment to replicate real-life situations.

Spending Policy

The Charity will target a spending rate of 3.0% of long-term capital. To preserve the portfolio’s long-term value, the target spend rate is smoothed over a three-year period to ensure that spending volatility is managed within an acceptable range. The Trustees have discretion to increase this spending rate in any one year. 4.25% was allocated to spending in 2020-2021 to allow the Charity to sustain its fundraising capacity for the future.

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Structure, Governance and Management

Objects

The objects of the Charity are set out in its governing document, the Articles of Association of the company, dated 4 October 2016. The objects of the Charity are for any charitable purposes relating to the general or specific purpose or purposes of the Trust or the purposes of the health service (as described in Section 1 of the NHS Act 2006 or any statutory modification of that section).

The Trustees also held other charitable funds on trust for specific purposes connected with the Trust and the wider NHS, a number of which are registered with the Charity Commission as part of the Trustees’ group.

Governance

The Charity has an independent Board (currently eleven Trustees). The Chairman is elected from amongst the Trustees by the Trustees. The Trustees are appointed by a Nominations Committee established under its Articles of Association. Trustees can be reappointed for a second four-year term. The Trustees shall normally consist of the following:

The Trust shall identify candidates to constitute one-half of the Trustees (not counting the Chairman) at any time. The Trust shall give details of its proposed candidates for Trusteeship to the Nominations Committee, and such candidates shall then (if, after review, they are recommended for appointment by the Nominations Committee) be appointed as Trustees, by the Trustees. If the Nominations Committee declines to recommend a candidate of the Trust as Trustee, the Trust shall propose further candidates until the post is filled.

Apart from candidates proposed by the Trust, all other Trustees shall be appointed by the Trustees via the operation of a Nominations Committee. The Nominations Committee will review potential candidates against the Trustees’ criteria and make recommendations for appointment, subject always to the Trustees’ final approval.

The Chairman must be appointed by the Trustees from the independent Trustees.

New Trustees receive an induction pack and have a series of induction meetings. All Trustees are updated on current issues and are invited to attend relevant seminars and conferences.

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In addition to attending quarterly meetings of the Board of Trustees, each Trustee is a member of at least one of these Committees:

The Committees meet at least four times a year and make decisions under delegated authority and make recommendations to the Board of Trustees. Each Committee must include at least two Trustees. The minutes of the Committees are formally recorded and submitted to the Board of Trustees.

Pay and Remuneration Arrangements

The Board of Trustees has specific responsibility for remuneration matters. It will agree final recommendations on annual increases to the salary budget at its March meetings through the budget-setting process for the forthcoming financial year.

The Chief Executive and Senior Management Team will make recommendations on starting salaries for new staff. They will make recommendations on increases and performance-related bonuses for existing staff, subject to approval by the Board. The Board of Trustees will agree remuneration matters for the Chief Executive.

The Charity has a flexible salary structure. Each individual’s remuneration will be fair and appropriate with reference to prevailing market rates for similar roles and responsibilities. There are no salary scales or set incremental rises.

There will be an annual review of salaries each year. The annual review will not guarantee an increase in salary. The review will take into consideration changes in the cost of living and prevailing market rates for comparable work and performance in the year under review.

Management

Day-to-day operations of the Charity are managed by the Chief Executive, who reports to the Board of Trustees. The heads of the Charity’s functional departments all report to the Chief Executive. These individuals form the Senior Management Team.

Related Parties

None of the Trustees receive remuneration or any other benefit from their work with the Charity. Any connection between a Trustee or senior management of the Charity with providers of services to the Charity must be disclosed to the full Board of Trustees. There were no such connections reported in the period ended 31 March 2021.

Volunteers

The Trustees would like to pay tribute to the role of volunteers who have played a key role in delivering our art and design programme. We would also like to thank our committee and advisory panel members who volunteer their time to provide the Charity with valuable advice, guidance and fundraising support.

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Reference and Administrative Details

Name

The official name of the Charity is CWPLUS. CW+, Chelsea and Westminster Health Charity and CWHC are also working names on the Charity Commission’s register.

Registered Office

4 Verney House, 1B Hollywood Road, London SW10 9HS

Members of the Board of Trustees Tony Bourne, Chairman Jonathan Callaway Fiona D’Silva Marina Lobanov Rostovsky Sarah Waller CBE Edwin Wulfsohn Roger Chinn (from 16 March 2021) Nicholas Gash Angela Henderson Zoe Penn (until 30 April 2020) Elizabeth Shanahan Lesley Watts

*Trustees appointed from candidates proposed by the Trust.

Chief Executive Chris Chaney

Senior Management Team Trystan Hawkins, Director of Patient Environment Sarah Holland, Head of Communications (maternity leave) Kerry Huntington, Fundraising Director James Porter, Head of Major Projects James Varley, Finance Director Rachel Vrettos, Interim Head of Communications

Bankers

CAF Bank Limited, 25 Kings Hill Avenue, Kings Hill, West Malling, Kent ME19 4JQ

Auditor

Moore Kingston Smith LLP, Devonshire House, 60 Goswell Road, London EC1M 7AD

Solicitors

Withers LLP, 20 Old Bailey, London EC4M 7AN

Investment Consultants

Cambridge Associates Limited, 80 Victoria Street, Cardinal Place, London SW1E 5JL

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Statement of Trustees’ Responsibilities

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

Company law requires the Trustees to prepare financial statements for each financial period that give a true and fair view of the state of affairs of the charitable company and of the incoming resources and application of resources, including the income and expenditure, of the charitable company for that period. In preparing those financial statements, the Trustees are required to:

The Trustees are responsible for keeping proper accounting records which disclose with reasonable accuracy at any time the financial position of the charitable company and to enable them to ensure that the financial statements comply with the Companies Act 2006.

They are also responsible for safeguarding the assets of the charitable company and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

In so far as the Trustees are aware:

The Trustees’ Annual Report is approved by the Trustees of the Charity.

Signed on behalf of the Trustees on: 15 September 2021

Tony Bourne, Chairman

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Independent Auditor’s Report to the Members of CWPLUS

Opinion

We have audited the financial statements of CWPLUS (‘the company’) for the year ended 31 March 2021 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 FRS 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 charitable company 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 charitable company’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.

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Other information

The other information comprises the information included in the annual report, other than the financial statements and our auditor’s report thereon. The trustees are responsible for the other information. 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.

In connection with our audit of the financial statements, 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 appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether there is a material misstatement in the financial statements or a material misstatement of the other information. 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.

Opinions on other matters prescribed by the Companies Act 2006

In our opinion, based on the work undertaken in the course of the audit:

The information given in the trustees’ annual report for the financial year for which the financial statements are prepared is consistent with the financial statements; and the trustees’ annual report has been prepared in accordance with applicable legal requirements.

Matters on which we are required to report by exception

In the light of the knowledge and understanding of the company and its environment obtained in the course of the audit, we have not identified material misstatements in the trustees’ annual report.

We have nothing to report in respect of the following matters where the Companies Act 2006 requires us to report to you if, in our opinion:

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Responsibilities of trustees

As explained more fully in the trustees’ responsibilities statement set out on page 27, the trustees (who are also the directors of the charitable company for the purposes of company law) are responsible for the preparation of the 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 charitable company’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 charitable company or to cease operations, or have no realistic alternative but to do so.

Auditor’s responsibilities for the audit of the financial statements

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 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 extent to which our procedures are capable of detecting irregularities, including fraud is detailed below.

Explanation as to what extent the audit was considered capable of detecting irregularities, including fraud

The objectives of our audit in respect of fraud, are; to identify and assess the risks of material misstatement of the financial statements due to fraud; to obtain sufficient appropriate audit evidence regarding the assessed risks of material misstatement due to fraud, through designing and implementing appropriate responses to those assessed risks; and to respond appropriately to instances of fraud or suspected fraud identified during the audit. However, the primary responsibility for the prevention and detection of fraud rests with both management and those charged with governance of the charitable company.

Our approach was as follows:

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As part of an audit in accordance with ISAs (UK) we exercise professional judgement and maintain professional scepticism throughout the audit. We also:

We communicate with those charged with governance regarding, among other matters, the planned scope and timing of the audit and significant audit findings, including any significant deficiencies in internal control that we identify during our audit.

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Use of our report

This report is made solely to the charitable company’s members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our audit work has been undertaken so that we might state to the company’s members 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 any party other than the charitable company and charitable company’s members as a body, for our audit work, for this report, or for the opinions we have formed.

Luke Holt (Senior Statutory Auditor) for and on behalf of Moore Kingston Smith LLP, Statutory Auditor

Devonshire House

60 Goswell Road, London EC1M 7AD

Date: 16 September.

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020 3315 6600 charity@cwplus.org.uk www.cwplus.org.uk @cwpluscharity

CW+ is the charity of Chelsea and Westminster Hospital NHS Foundation Trust