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2022-03-31-accounts

Trustees’ Annual Report and Accounts 1 April 2021 - 31 March 2022

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 17-18
Financial Review 19
Policies and Procedures 20-23
Structure, Governance and Management 24-25
Reference and Administrative Details 26
Statement of Trustees’ Responsibilities 27
Independent Auditor’s Report 28-32
Statement of Financial Activities 33
Balance Sheet 34
Statement of Cash Flows 35
Notes to the Accounts 36-51

Cover Image: Visitor enjoying our arts in health exhibition ‘Journeys: The Healing Arts’ at Saatchi Gallery, London.

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Foreword

Welcome to our 2021/22 Annual Report and Accounts. Despite the past financial year being another difficult time for everyone, we have continued to be overwhelmed by the generosity of our community to support our patients, families and staff. This generosity has enabled us to deliver a number of new and exciting projects and we were also delighted to be able to reinstate many of our previous activities in our hospitals as COVID-19 restrictions lifted.

We have enjoyed some landmark achievements over the past year including winning awards for our Arts in Health, HIV and Sexual Health and CW Innovation programmes.

It has also been a busy year for events. In June 2021, we officially opened our Adult and Neonatal Intensive Care Units. Two former patients opened the units which was also streamed live online so our supporters could be part of this significant moment. These world-class units are now able to treat 2,000 critically ill adults and babies every year in optimum, and patient-centred environments.

In September 2021, we concluded a year of celebrating West Middlesex University Hospital’s centenary. We hosted an intimate church service of thanksgiving with hospital staff followed by a garden BBQ celebration event, where we were delighted to welcome Sir David Sloman, NHS Regional Director for London.

September also saw us celebrate the two-year anniversary of CW Innovation. This exciting programme continues to identify, test and scale the latest health innovations to improve patient care. The latest programme as part of CW Innovation is our Horizon Fellowship, in partnership with DigitalHealth.London Accelerator which will nurture the next generation of innovative Trust staff.

We officially launched Best For You in November 2021, which is our new model of mental health care and support for young people and their families. Best For You is a partnership between CW+, Central and North West London NHS Foundation Trust, Chelsea and Westminster Hospital NHS Foundation Trust and West London NHS Trust. Together, we are also working with a range of local community, digital and voluntary sector organisations to provide the best possible clinical and holistic care for young people and their families.

We partnered with Saatchi Gallery in November 2021 to deliver the gallery’s first Arts in Health exhibition which ran until January 2022. Journeys: The Healing Arts showcased a selection of bespoke artworks from our collection exploring the different communities and stories that make up Chelsea and Westminster Hospital. This unique exhibition explored the journey from traditional drawn artworks through to innovative digital and screen-based artworks, including a new commission created by musician and artist Brian Eno.

Our grants programme continued to support and fund project ideas from Trust staff identified to improve patient care and experience. We held our first dedicated funding call for rapid, digital innovations called RADICAL which received a number of superb

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applications. Our annual Nurse, Midwife and Allied Health Professional funding call remained popular with a variety of applications submitted and we were delighted to welcome Ruth May, Chief Nursing Officer for NHS England, to be part of the judging panel.

Our colleagues at the Trust have continued to work tirelessly to care for patients and their loved ones and to run our hospitals and clinics during the challenging times we have faced. We remain one of the leading Trusts in the country and this is testament to the workforce who we are so proud to work alongside and support. We have a busy and exciting year ahead with many more innovative and transformational projects to provide our patients with the best care possible.

We would like to extend our sincere thanks to all of our supporters, partners and friends who make our work possible.

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 four key areas of focus for our activities:

  1. Fundraising

  2. Best For You

  3. Patient environment and experience

  4. Grants and innovation

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1. Fundraising

The Charity aims to be the principal provider and coordinator of capital and revenue fundraising for the Trust. Our goal is to be generating £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 second year of our three-year strategy, having raised a total of £5.7m. We are pleased to report that the income was delivered at an income-to-cost ratio of 5:1.

The year 2021-22-was focused on launching our £8 million fundraising campaign for our Best For You programme. We were incredibly grateful to receive a multi-year transformative pledge from the Reuben Foundation towards this programme.

We were also delighted to receive a gift of a property in Fulham which has been valued at £1.8 million.

We received a grant of £1.1 million from NHS Charities Together to lead a number of digital inclusion projects to enable vulnerable and digitally excluded groups to have access to digital health care and support.

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. Best For You

The number of young people in the UK needing urgent mental health support has reached crisis point. In response to this, CW+, Chelsea and Westminster Hospital NHS Foundation Trust, Central and North West London NHS Foundation Trust, and West London NHS Trust have partnered to launch ‘Best For You’. Best For You is a new model of mental health care and support for young people and their families.

Best For You is designed to provide immediate help for those in crisis as well as ongoing, personalised care for as long as needed. The unique model of care combines the rapid assessment, transfer and treatment of young people requiring inpatient care with day, digital and community services that provide consistent and comprehensive care.

Best For You aims to transform mental health services for young people and their families delivering:

The Best For You first-of-its-kind model of care will include:

CW+ is engaging a network of partners and supporters to raise £8 million to deliver each element of the Best For You Programme. Thanks to an incredible initial response from our community, CW+ has already secured over £3.5 million since the launch in November 2021.

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3. 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 2021/22 are highlighted below:

Opening of Critical Care Units

In June 2021, CW+ officially opened the state-of-the-art expansion and redevelopment of the Adult and Neonatal Intensive Care Units at Chelsea and Westminster Hospital, enabling the treatment of more than 2,000 critically ill adults and babies every year. These new critical care facilities were made possible through the charity’s £12.5 million Critical Care Campaign. Both units were officially opened by previous patients who received incredible care on these new units.

The new Adult Intensive Care Unit has increased in capacity by 45%, allowing the Trust to care for an additional 500 patients per year and has world-class facilities with a first-of-its-kind patient-led approach to care. The new unit aims to significantly improve critically ill patients’ recovery and wellbeing by creating optimal healing environments and incorporating the latest innovations and digital solutions that can be personalised to reduce anxiety, pain and stress. The new Adult Intensive Care Unit won Best Interior Design Project at the Building Better Healthcare awards in 2021.

The new Neonatal Intensive Care Unit has expanded by 40% providing specialist care to 150 more babies every year, as well as providing better clinical space and family facilities. The unit, designed to offer a ‘home from home’ environment, is equipped with the latest technology to facilitate improved healing conditions for babies.

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Sky Garden

Adjacent to the new ICU, we have installed a bespoke indoor botanical Sky Garden, created to bring the outdoors in, support the cognitive function, wellbeing, and rehabilitation of patients in intensive care. The Sky Garden is one of only two green spaces in the UK designed specifically to incorporate the physical and psychological needs of intensive care patients and their families.

The Sky Garden won an NHS Forest Award as an innovative green space in 2021.

Arts for All

CW+ also offer their participatory arts programme Arts For All via in-person sessions in wards at both hospitals, and through their online platform Virtual Connections. In-person activities resumed in March 2021 and the Virtual Connections programme now has over 200 on-demand videos, and new content from partners including the National Portrait Gallery, English National Ballet School, London Art Studies and Chelsea FC Foundation.

We were thrilled to win Best Collaborative Arts Project / Performance at the Building Better Healthcare Awards in November, for our pioneering Virtual Connections programme.

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Ward enhancements and installations

Across all clinical and non-clinical spaces, CW+ strive to enhance our hospitals to provide an outstanding healing environment, reducing stress and anxiety for patients and staff to improve wellbeing and outcomes. Significant improvements to the design and environment across both hospitals have been made this year, ranging from complete ward refurbishments to new artwork commissions and installations.

We undertook extensive renovations of the Cheyne Child Development Service at Chelsea and Westminster Hospital including redecorating, purchasing sensory equipment, and installing new electrics, furniture and artworks. We also commissioned artist Lottie Hall to create a bespoke artwork for the reception area which featured mark-making by local school children.

We installed four large, bespoke backlit images by artist Charlie Waite in the newly redeveloped Adult Intensive Care Unit.

We were also kindly donated a series of colourful banners by British artist and Royal Academician Joe Tilson, which are on display in the main atrium at Chelsea and Westminster Hospital.

Exhibition at Saatchi Gallery

In November 2021, CW+ was delighted to partner with Saatchi Gallery to present Journeys: The Healing Arts, the first Arts in Health exhibition at the gallery, which ran until January 2022. The unique exhibition explored the journey from traditional drawn artworks through to innovative digital and screen-based artworks, including a new commission created by musician and artist Brian Eno. Many of the drawn artworks captured life in the hospital during the pandemic and are a visual representation of the way the hospital and its communities changed so dramatically during this challenging time. Over 25,000 people visited the show which generated interest in our work from around the globe.

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Celebrating our history

Throughout 2021, CW+ showcased elements of West Middlesex’s fascinating history on their website and social media, including old photos and stories as well as accounts from current West Middlesex staff on their experiences working at the hospital during the pandemic.

Thanks to funding from the National Lottery Heritage Fund, CW+ is also leading on the

creation and installation of an onsite heritage exhibition, uncovering details from our archive photos and documents to share with staff and visitors.

On 17 September 2021, we marked the end of West Middlesex’s extraordinary 100th year with a special service at All Saints Church in Isleworth and a celebration BBQ for past and present staff. We were delighted to be joined by Sir David Sloman, NHS Regional Director for London at this event.

4. 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:

This budget is supplemented by legacies, gifts and donations received either in the year or held in specific restricted or designated funds from previous years.

The result is that grants and charitable programme funding totaling £3.5m was made during the 2021–2022 period. A breakdown of funding is shown in note 3.1 to the accounts.

The charity has hosted several special funding call events throughout the year with dedicated funding awarded to specific areas of work.

The annual Nurse, Midwife and Allied Health Professionals funding call winners were from the Obs & Gynae team who proposed Project Eirene, providing women with an alternative pain relief in the form of a VR headset when having gynaecological

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procedures to lower pain and decrease stress. All shortlisted finalists for the call received funding for their ideas.

RADICAL was our first ‘Rapid Adoption Innovation Call’ open to all Trust staff. The winner was announced as FibriCheck, a smartphone atrial fibrillation testing app proposed by cardiology staff. All the finalists were awarded funding including trialing the use of Microsoft’s Hololens glasses across our hospitals, enabling medical students to remotely stream into clinics.

Funding has been provided in previous years to develop the burns laser service in 2017. Due to the success of the service, £135,000 of funding was used for a new laser for the burns scars team to meet demand.

As one of the largest providers of Neonatal Care within London, it is imperative that we provide a high quality of support for parents which extends to the accommodation we offer during their stay. Thanks to a generous gift of £75,000 we will be able to fully refurbish four overnight parents rooms so that parents can stay close to the Unit.

We funded several grants to support sexual health services. We awarded £39,000 towards the pilot of an improved testing programme for Trichomonas Vaginalis (TV), including testing for men who may pass on the infection. We piloted the LARC contraceptive service with the aim to offer contraception to all women having a baby, with the aim to solve inequity of access to contraception and put women in control of their reproductive health. We also modernised the space used by young people accessing Twickenham House sexual health clinic.

Grants to support staff and volunteers

We provided £179,000 to fund the team that delivers the Trust volunteer programme, which provides invaluable support every day to our staff and patients.

In 2021-22, we approved 31 applications to our Training, Education and Development Fund and granted nearly £44,000 on top of a further £41,000 from special funds to support training and conference attendance. We also launched the Horizon Fellowship programme which you can read more about on page 14.

We provided £75,000 to support a programme to support the refurbishment of staff rest rooms.

Our Innovation programme also delivers projects to support staff, such as Peppy and Virtual Bodyworks. Peppy is an innovative app to help women manage the menopause, which will be provided to support staff at the Trust as part of its health and wellbeing programme. Virtual Bodyworks aims to introduce an innovative form of EDI training for staff to expand on the current mandatory training requirements by using virtual embodiment. This allows participants to become embodied as a person from a different race, gender, physical ability, or sexual orientation in a virtual reality (VR) environment.

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

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Small Grants

In 2021-22, we spent £31,000 on over 30 Small Change Big Impact (SCBI) projects for ward enhancements, recreational projects, non-essential equipment, and others, including:

NHS Charities Together Stage 2 Community Partnership Grants

CW+ is the lead partner for the NHS Charities Together Programme in NW London delivering three interconnected projects to enable the vulnerable and digitally excluded groups to have access to digital health care and support. The three programmes are:

The projects are being evaluated by a specialist team at Imperial College Health Partners.

CW Innovation

The second anniversary of CW Innovation (led jointly by CW+ and the Trust) was celebrated with a series of virtual events to showcase the exciting and diverse portfolio of transformative projects. The Rt. Hon Sajid Javid MP, the then Secretary of State for Health and Social Care, and Professor Tony Young, National Clinical Lead for Innovation,

NHS England, participated in one of the virtual events endorsing the programme.

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This year, the CW Innovation programme has gone from strength to strength, with a growing portfolio of innovative solutions and models of care and we are delighted that the Trust was the only London Trust selected to host the NHS Clinical Entrepreneur Programme.

CW+ is a founding partner of the DigitalHealth. London Accelerator (DH.LA). Now in its sixth consecutive year, the programme has supported some of the biggest and most effective digital innovations now being used by the NHS, which were all trialled at Chelsea and Westminster.

CW Innovation has also launched its 12-month Horizon Fellowship programme in partnership with DigitalHealth.London, which will nurture 20 Trust staff to develop their innovative ideas for projects to improve patient care and experience.

CW Innovation supported the winner of the 2021 Digital Health Rewired Pitchfest event, ‘Peppy Menopause’. We also supported the third Pitchfest event in 2022, where the winner was announced as CardMedic - an innovative app to reduce health inequalities, which will be tested and scaled at Chelsea and Westminster.

The Trust continues to build a portfolio of remote monitoring solutions. During the previous 12-months, the CW Innovation Programme cemented its partnership with GE Healthcare to conduct a world first deployment of GE Healthcare’s new Portrait Mobile remote vital signs monitoring solution for patients on general medical wards. Supported by funding of £140,297, our partnership demonstrated the benefits to patients of in hospital remote monitoring. This partnership is leading to further research into this exciting new area.

We also secured £500K from the NHSx Digital Health Partnership programme, on behalf of the sector to work with our partner acute trusts in North West London to: (1) establish a remote

monitoring hub to manage multi-specialty virtual wards from all acute trusts in a single command centre and (2) to set up new virtual wards for patients with heart failure, chronic obstructive pulmonary disease, and atrial fibrillation. These virtual wards have been established and are contributing towards the management of patients in their own homes.

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Highlights of the CW Innovation programme this year include:

We have also continued to strengthen the CW Innovation team to support the programme and new innovation initiatives within the Trust.

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 £202,000 from these funds in 2021-22. 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.

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 2007, 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. We have recruited a new Database Officer to manage the migration over to our new fundraising database. We have also recruited an Engagement and Digital Content Manager for Best For You to establish and manage our digital and online content. We have recruited an Administration Assistant to look after the Charity’s administrative requirements and support with charitable operations. We have now adopted a hybrid model of working in the office and remotely.

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The Year Ahead

Best For You

We look forward to expanding our community partnerships to offer mental health support for young people in more locations which they frequent.

Our brand new Day Service will be opening and will provide a specially designed environment for young people and their families to access support following inpatient treatment.

We will develop the digital platform further to offer young people, their families and professionals advice, support, signposting and information about mental health. The platform will also provide young people with a resource of engaging, relatable and supportive content to offer support and reassurance about mental health and challenges young people face today.

We will continue developing our plans, and raising funds for the creation of a Young People’s Rapid Assessment Unit at Chelsea and Westminster Hospital which will integrate, for the first time, medical care with mental health care to quickly and seamlessly assess, transfer and treat young people.

Following the initial success of two of our videos being featured on the YouTube homepage during Mental Health Awareness Week in May 2022, we have been formally commissioned by YouTube to produce further material for them as part of their new health shelf programme. We know from working with young people that YouTube remains a valuable source of information and being commissioned to produce 40 videos will ensure we are providing the best possible information on a platform that remains relevant to our core audience.

Arts in Health

We will be expanding our award-winning Arts in Health programme further into our local communitites by providing a variety of inclusive and creative workshops in the CW+ Studio.

We are supporting Zheyuan Zhang with a PhD, in partnership with Imperial College London, which will explore the impact of digital artwork interventions on patient wellbeing in a hospital environment. This research builds on a number of years of establishing a programme of digital artworks and creative technology interventions throughout our hospitals, which aim to improve the patient environment and experience.

We will recruit an Arts Coordinator to expand and deliver our Arts in Health programme at West Middlesex University Hospital.

We look forward to installing our permanent heritage exhibition at West Middlesex, celebrating the hospital’s fascinating history and celebrating the staff who are, and have been, so integral to the hospital’s achievements. We will also be creating two garden

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spaces at the hospital to provide areas of rest and relaxation for patients and staff.

CW Innovation

In our third year of CW Innovation we will continue to identify, test and scale the latest health innovations, technologies and new ways of working to transform and improve patient care and experience. We will look to build on the success of the programme and expand the team to deliver more innovative projects and partnerships, both at our Trust and throughout North West London.

We will also look to expand the programme infrastructure by creating an Ideas Hub at Chelsea and Westminster Hospital, which will be a dedicated space for the expanded team and clinicians to develop innovative projects, further establishing the Trust as a leader in health innovation.

We look forward to supporting and nurturing our Horizon Fellows throughout the rest of their 12-month programme and developing their project ideas to be able to test in a real-world setting at our hospitals.

We will also continue to work in partnership with DigitalHealth.London Accelerator to deliver the sixth cohort of applications from health tech SMEs (small and medium-sized enterprises).

Our portfolio of virtual wards will continue to expand with the launch of a new virtual ward to support patients suffering from inflammatory bowel diseases (IBD). Virtual wards are increasingly being used to support earlier discharge of patients from an inpatient bed, or to prevent the avoidable admission of patients who may have attended A&E.

Working in partnership with Kensington Wing (private maternity), we will launch a fundraising campaign aiming to fund vital, innovative research into preterm birth and its complications.

Grants

Our grants programme will continue to support Trust staff with a range of funding opportunities. We will deliver our second Rapid Adoption Digital Innovation Call (RADICAL) to identify digital solutions as well as our annual Nurse, Midwife and Allied Health Professional Funding Call. We will launch our first Green Funding Call which will specifically identify and support staff ideas which support the Trust’s Sustainability Plan.

We will recruit a dedicated Head of Impact and Evaluation to establish and deliver a process to measure, evaluate and disseminate the outcomes from our grants programme.

We will continue to roll out the NHS Charities Together Stage 2 Community Partnership Grants programme.

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Financial Review

Total income for year ended 31 March 2022 at £6.2m represented an increase of 4% on the previous year. £5.7m of this income was from donors including £386,000 from legacies. CW+ was also gifted a freehold property worth £1.8m which is held in donated assets for resale. Investment income for the year ended 31 March 2022 was £436,000 (year ended 31 March 2021: £425,000). Net gains on investment assets amounted to £1.7m (£5.4m in the year ended 31 March 2021).

Fundraising costs were £1.0m for the year ended 31 March 2022 (year ended 31 March 2021: £1.1m).

Charitable activities are divided among Best For You, our Grants and Innovation programme and our Art and Design programme. In the year ended 31 March 2022 expenditure on Grants Payable including support costs was £3.5m (year ended 31 March 2020: £3.4m). The figure included a £1.1m Covid-19 Digital Recovery programme funded by NHS Charities Together which is locally led by CW+. There was also a £179,000 grant for the Trust’s volunteer programme.

Included in the above are Best For You delivery costs of £307,000 and CW Innovation delivery costs were £304,000.

Art and Design funding totalled £1.3m (£1.7m in 2021).

Support costs, including governance, for the year ended 31 March 2022 at £564,000 (year ended 31 March 2021: £525,000), showed a rise of circa 7% 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 £44.9m at 31 March 2022 from £43.0m at 31 March 2021. £3.4m (2021: £3.5m) is held in restricted funds.

After designations, Free Reserves stood at £1.6m at 31 March 2022 (31 March 2021: £103,000).

Investment Performance

The return in the portfolio for the year ended 31 March 2022 was 7.0%. The five-year annualised return to 31 March 2022 of the total portfolio was 4.4% behind the long-term target of 8.2% (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 Donorfy 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:

A major appeal of this nature will rely on the careful identification of financial supporters and their generosity. The capital elements of the appeal are still in the planning stage and there is a risk that the increasing inflation and construction costs will put financial pressure on the programme. In order to control the risk the Charity has a dedicated executive team in place to manage the programme and a governance structure incorporating all partners with review committees managing different project strands. The Trustees have established funding ‘Gateways’ which must be reached before major project elements of the programme commence to ensure sufficient funds will be available.

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

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through its charitable activities. It therefore does not plan the long-term retention of undesignated free reserves. Free reserves stand at £1.6m at 31 March 2022 (31 March 2020: £103,000). This reflects the receipt of an unrestricted £1.8m gift shortly before the year end.

Unrestricted Funds:

The Charity holds £41.5m 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 £34.3m Long-Term Capital Fund is invested to provide stability and liquidity for the Charity’s activities in the long term.

Arts Assets:

This £3.1m 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 111 funds totalling £2.5m 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:

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

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Over the long term, it is expected that portfolio risk (volatility), as measured by the standard deviation of annual returns, will be in the range of 10-13%.

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.

Equality Diversity and Inclusion 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 are reviewing our policies to ensure they reflect the most recent Charity Commission guidance.

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 2021-2022 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.

In addition to attending quarterly meetings of the Board of Trustees, each Trustee is a

24

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 2022.

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.

25

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 Nicholas Gash Angela Henderson 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 Kerry Huntington, Fundraising Director James Porter, Director of Major Projects James Varley, Finance Director

Bankers

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

Auditor

Moore Kingston Smith LLP, 9 Appold Street, London, EC2A 2AP

Solicitors

Withers LLP, 20 Old Bailey, London EC4M 7AN

Investment Consultants

Cambridge Associates Limited, 62 Buckingham Gate, London SW1E 4QW

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: 7 December 2022

Tony Bourne, Chairman

27

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 2022 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.

Emphasis of Matter – Investment properties

We draw attention to Note 7.1 to the financial statements which describes a material uncertainty in respect of the valuation of one of the investment properties, valued at £9.94m, as a result of ongoing negotiations regarding the rent review and lease renewal. Our opinion is not modified in respect of this matter.

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.

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:

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:

29

Responsibilities of trustees

As explained more fully in the trustees’ responsibilities statement set out on page [x], 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.

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

30

on the charitable company’s ability to continue as a going concern. If we conclude that a material uncertainty exists, we are required to draw attention in our auditor’s report to the related disclosures in the financial statements or, if such disclosures are inadequate, to modify our opinion. Our conclusions are based on the audit evidence obtained up to the date of our auditor’s report. However, future events or conditions may cause the charitable company to cease to continue as a going concern.

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.

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

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.

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:

31

to identify instances of non-compliance with laws and regulations. This included making enquiries of management and those charged with governance and obtaining additional corroborative evidence as required.

There are inherent limitations in the audit procedures described above. We are less likely to become aware of instances of non-compliance with laws and regulations that are not closely related to events and transactions reflected in the financial statements. Also, the risk of not detecting a material misstatement due to fraud is higher than the risk of not detecting one resulting from error, as fraud may involve deliberate concealment by, for example, forgery or intentional misrepresentations, or through collusion.

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

6th Floor 9 Appold Street London EC2A 2AP

Date: 8 December 2022

Statement of Financial Activities for the Year ended 31 March 2022

Note
Income and endowments from:
Donations and legacies
2.1
Charitable activities
2.2
Trading activities
2.3
Investment income
7.3
Total income and endowments
Expenditure on:
Raising funds
Fundraising
Investment management costs
Charitable activities
Grants payable
3.1
Arts and Design
3.1
Total expenditure
4
Net gains on revaluation of functional assets
5,6
Net gains on investment assets
7.1
Net income/(expenditure)
Transfers between funds
10
Net movement in funds
Reconciliation of funds
Total funds brought forward at 1 April 2022
Total funds carried forward at 31 March 2022
Net income/(expenditure) before net gains on
investment assets
Unrestricted
Funds
£000
2,897
92
17
436
3,442
964
117
1,303
1,032
3,416
26
-
1,658
1,684
285
1,969
39,530
41,499
Year
Restricted
Total
Funds
Funds
£000
£000
2,764
5,661
-
92
-
17
-
436
2,764
6,206
14
978
-
117
2,190
3,493
309
1,341
2,512
5,929
252
278
-
-
-
1,658
252
1,936
(285)
-
(33)
1,936
3,474
43,004
3,441
44,940
ending 31 March 2022
Unrestricted
Funds
£000
1,731
133
22
425
2,311
1,060
118
935
564
2,677
(366)
13
5,358
5,005
428
5,433
34,097
39,530
Year
Restricted
Total
Funds
Funds
£000
£000
3,603
5,334
67
200
-
22
-
425
3,670
5,981
17
1,077
-
118
2,496
3,431
1,096
1,660
3,609
6,286
61
(305)
-
13
-
5,358
61
5,066
(428)
-
(367)
5,066
3,841
37,938
3,474
43,004
ending 31 March 2021

The notes at pages 36-51 form part of these accounts. All activities derive from continuing operations.

33

Balance Sheet as at 31 March 2022

Note
Unrestricted
Funds
£000
Fixed assets
Intangible assets
5
67
Tangible assets
6
3,280
Investments
7.2
36,204
Total fixed assets
39,551
Current assets
Stock: Donated assets held for resale
1,802
Debtors
8
643
Cash at bank and in hand
415
Total current assets
2,860
Liabilities
Creditors: Amounts falling due within one year
9
(911)
Net current assets (liabilities)
1,949
Creditors: Amounts falling due
within more than one year
9.2
-
Total net assets
41,500
Funds of the Charity
Restricted funds
10.1
-
Unrestricted funds
Designated funds
39,935
Free reserves
1,564
Total Charity funds
41,499
Signed: Anthony Bourne
Date: 7 December 2022
Chairman
Restricted
Funds
£000
-
-
4,528
4,528
-
710
-
710
(1,263)
(553)
(535)
3,440
3,441
-
-
3,441
Total Funds
31 March 2022
£000
67
3,280
40,732
44,079
1,802
1,353
415
3,570
(2,174)
1,396
(535)
44,940
3,441
39,935
1,564
44,940
Unrestricted
Funds
£000
50
3,142
35,638
38,830
2
362
1,289
1,653
(925)
728
(28)
39,530
-
38,427
103
39,530
Restricted
Funds
£000
-
-
2,826
2,826
-
1,396
-
1,396
(748)
648
-
3,474
3,474
-
-
3,474
Total Funds
31 March 2021
£000
50
3,142
38,464
41,656
2
1,758
1,289
3,049
(1,673)
1,376
(28)
43,004
3,474
39,427
103
43,004

The notes at pages 36-51 form part of these accounts. All activities derive from continuing operations.

Company registration number 10410134

34

Statement of cash flows for the Year ended 31 March 2022

Cash flows from operating activities:
Net cash used by operating activities (i)
Cash flows from investing activities:
Dividends, interest and rents from investments
Purchase of fixed assets: fixtures, fittings and equipment
Proceeds from the sale of investments
Proceeds from the sale of fixed assets
Purchase of investments
Net cash inflows from investing activities:
Change in cash and cash equivalents in the reporting period
Cash and cash equivalents at the beginning of the reporting period (ii)
Change in cash and cash equivalents in the reporting period
Cash and cash equivalents at the end of the reporting period (ii)
(i)
Adjustments for:
Depreciation and amortisation charges
(Gains)/losses on revaluation of functional assets
Gains on investments
Dividends, interest and rents from investments
Increase in donated assets held for resale
Decrease/(increase) in debtors
Increase in creditors
Net cash used by operating activities
(ii)
Analysis of cash and cash equivalents
Cash in hand
Total cash and cash equivalents
Net income (expenditure) for the reporting period (as per the
Statement of Financial Activities)
Total Funds
£000
(446)
436
(254)
4,140
-
(4,750)
(428)
(874)
1,289
(874)
415
1,936
99
-
(1,658)
(436)
(1,800)
405
1,008
(446)
415
415
Year ending 31 March 2022
Total Funds
£000
(522)
425
(348)
1,000
1
(513)
565
43
1,246
43
1,289
5,066
71
(13)
(5,354)
(425)
-
(325)
458
(522)
1,289
1,289
Year ending 31 March 2021

The charity has no net debt and therefore no net debt note is presented.

35

Notes to the Accounts

1 Accounting policies

1.1 Basis of preparation

These financial statements are prepared on a going concern basis, under the historical cost convention, as modified by the revaluation of investments and some tangible and intangible assets, being measured at fair value through income and expenditure within the Statement of Financial Activities.

The financial statements have been prepared in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102). The Charity is a public benefit entity for the purposes of FRS 102 and therefore the Charity also prepared its financial statements in accordance with the Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (The FRS 102 Charities SORP), the Charities Act 2011 and the Companies Act 2006.

The financial statements are prepared in sterling, which is the functional currency of the Charity. Monetary amounts in these financial statements are rounded to the nearest one thousand pounds.

The principal accounting policies adopted in the preparation of the financial statements are set out below.

1.2 Income

All income is included in full in the Statement of Financial Activities as soon as the following three factors can be met:

Legacies

Legacies are accounted for as income once the receipt of the legacy becomes measurable, receipt is probable and the charity has entitlement to income.

Donated goods for resale

Donated goods for resale are recognised on receipt.

1.3 Expenditure

The financial statements are prepared in accordance with the accruals concept. All expenditure is recognised once there is a legal or constructive obligation to make a payment to a third party. Costs are inclusive of irrecoverable VAT.

Expenditure on raising funds

The cost of raising funds are the costs associated with generating income for the charity's funds. This will include the costs associated with investment actions.

Charitable activities

Grants payable are payments, made to third parties in the furtherance of the charitable objectives. They are accounted for on an accruals basis where the conditions for their payment have been met or where the grants have been communicated to the recipient and the third party has a reasonable expectation that they will receive the grant. This includes grants paid to NHS bodies.

Operating lease costs

Rentals under operating leases are charged on a straight-line basis over the term of the lease.

36

Notes to the Accounts (continued)

Pension costs

The amount charged to the Statement of Financial Activities in respect of pension costs to the defined contribution schemes is the total of the contributions payable in the year.

1.4 Structure of funds

The Charity's funds are classified under Unrestricted funds (including designated funds) and restricted funds. The major funds held within these categories are disclosed in note 10.

Unrestricted funds and the designated funds

Unrestricted funds earmarked by the Trustees for particular purposes in the future are classified as designated funds.

Restricted funds

Where there is a restriction on the purpose to which a fund may be put, the fund is classified in the accounts as a restricted fund.

1.5 Fixed assets

Intangible and tangible arts assets are held as functional assets to provide a service to its beneficiaries. The works of art, selected for display, are sited in public areas where they can be enjoyed by the patients, visitors, staff and the general public.

No depreciation is charged as the residual value of arts assets is considered to be comparable with the book value and therefore any depreciation charge to the assets is considered to be immaterial.

Computer software and fixtures and fittings and equipment are capitalised at cost and depreciated on a straight line basis at 20% per annum.

The cost of refurbishment of the leasehold premises at 4 Verney House, 1b Hollywood Road SW10 9HS is written off over the expected lifetime of the lease.

At the end of each reporting period, the residual values and useful lives of assets are reviewed and adjusted if necessary. In addition, if events or change in circumstances indicate that the carrying value may not be recoverable then the carrying values of tangible fixed assets are reviewed for impairment.

The Trustees have reviewed the valuation of the functional assets in 2021-2022 and do not consider there to have been a material change and therefore no adjustment to the valuation has been made.

The Charity only capitalises items costing more than £5,000. However, if components or equipment, such as computers and furniture, are acquired with unit costs below £5,000, then these groups of assets are collectively capitalised at the time of purchase.

1.6 Investment fixed assets

Investment fixed assets are shown at market value.

Property assets are not depreciated but are shown at market valuation.

The Trustees revalued their properties at 31 March 2022. This valuation was carried out by Gerald Eve LLP, Chartered Surveyors, see note 7.1.

Other investments are included in the balance sheet at market price.

1.7 Stock: donated assets for resale

Stock represents freehold property and art assets held with the intention of reselling within one year. The freehold property was donated to the charity in the year and is held at fair value. The property was valued by JCF Property Management Ltd on 20 January 2022. The Trustees do not consider the valuation at 31 March 2022 to be materially different.

37

Notes to the Accounts (continued)

1.8 Realised gains and losses

All gains and losses are taken to the Statement of Financial Activities as they arise. Realised gains and losses on investments are calculated as the difference between sales proceeds and opening market value (or value on date of purchase if later). Unrealised gains and losses are calculated as the difference between market value at each period end and opening market value (or value on date of purchase if later).

1.9 Employee benefits

The costs of short-term employee benefits are recognised as a liability and an expense.

1.10 Allocation of support costs

Support costs have been allocated between expenditure on raising funds, the charitable activities. The support costs are allocated to the relevant activity cost category they support on the bases detailed in note 4.1.

1.11 Going concern

The Trustees have assessed whether the use of the going concern basis is appropriate and have considered possible events or conditions that might cast significant doubt on the ability of the Charity to continue as a going concern. The Trustees have made this assessment for a period of at least one year from the date of approval of the financial statements. In particular the Trustees have considered the Charity’s forecasts and projections and have taken account of pressures on income. After making enquiries the Trustees have concluded that there is a reasonable expectation that the Charity has adequate resources to continue in operational existence for the foreseeable future. The Charity therefore continues to adopt the going concern basis in preparing its financial statements.

1.12 Financial instruments

The Charity has elected to apply the provisions of Section 11 ‘Basic Financial Instruments’ and Section 12 ‘Other Financial Instruments Issues’ of FRS 102 to all of its financial instruments. Financial instruments are recognised in the company's balance sheet when the company becomes party to the contractual provisions of the instrument. Financial assets and liabilities are offset, with the net amounts presented in the financial statements, when there is a legally enforceable right to set off the recognised amounts and there is an intention to settle on a net basis or to realise the asset and settle the liability simultaneously.

With the exceptions of prepayments and deferred income all other debtor and creditor balances are considered to be basic financial instruments under FRS 102. See notes 8 and 9 for the debtor and creditor notes.

1.13 Cash and cash equivalents

Cash and cash equivalents include cash in hand, deposits held at call with banks, other short-term liquid investments with original maturities of three months or less.

1.14 Critical accounting areas and the use of judgements

In preparing financial statements it is necessary to make certain judgements, estimates and assumptions that affect the amounts recognised in the financial statements. The following judgement is considered by the trustees to have most significant effect on amounts recognised in the financial statements.

Artwork as per note 6 is included at a valuation based on reports provided by third party valuers. The latest valuation was provided by Christie's as at 10 February 2020 and the Trustees believe there has been no material change in values since that date. Subsequent additions have been included at cost which is deemed to also be their market value.

1.15 Key estimate policy

The Charity’s investment property is included in the financial statements at valuation as described in note 7.1 to the financial statements. This is considered to be a critical accounting estimate in view of the amounts involved and the judgements applied in their valuation, particularly in light of uncertainties described in note 7.1.

38

Notes to the Accounts (continued)

2 Income

2.1 Donations and Legacies

Donations from individuals and community
Trusts and foundations
Corporate donations and sponsorship
Legacies
Government grants
Unrestricted
Restricted
Total
£000
£000
£000
2,117
315
2,432
243
2,329
2,572
141
120
261
386
-
386
10
-
10
2,897
2,764
5,661
Year ending 31 March 2022
Unrestricted
£000
1,211
318
117
85
-
1,731
Year
Restricted
Total
£000
£000
66
1,277
899
1,217
1,148
1,265
1,490
1,575
-
-
3,603
5,334
ending 31 March 2021

2.2 Charitable Activities

Courses
Other income from charitable activities
Unrestricted
Restricted
Total
£000
£000
£000
6
-
6
86
-
86
92
-
92
Year ending 31 March 2022
Unrestricted
£000
1
132
133
Year
Restricted
Total
£000
£000
-
1
67
199
67
200
ending 31 March 2021

2.3 Other Trading Activities

Profit on sale of art work
Other
Unrestricted
Restricted
Total
£000
£000
£000
6
-
6
11
-
11
17
-
17
Year ending 31 March 2022
Unrestricted
£000
16
6
22
Year
Restricted
Total
£000
£000
-
16
-
6
-
22
ending 31 March 2021

39

Notes to the Accounts (continued)

Grants payable:
Delivering patient centred care
Covid -19 Innovation, equipment and support for patient care
NHS Charities Together Digital Recovery Programme.
Innovation and service improvement
Small Change Big Impact
Burns initiatives
Supporting the Trust's volunteering programme
Chelsea Children's Hospital (including MediCinema)
Research
Covid 19 Research
Other research grants
Staff retention and recruitment
Covid -19 Supporting staff wellbeing
Other support for staff
Support costs
Total grants payable
CW+ charitable programmes
Best for You (Child and Adolescent Mental Health)
CW Innovation programme delivery
Total grants and charitable programmes including support costs
Arts and Design
Programme delivery
Collection management
Design and environment
Critical Care
Sky Garden
Sun & Stars
Reuben Maternity Centre
CW+ Studio
Other Design and environment
Arts for All
Future Hospital
Other
Support costs
Other special fund grants
Unrestricted
Restricted
Total
£000
£000
£000
2
72
74
-
1,069
1,069
342
204
546
31
-
31
-
135
135
79
100
179
74
10
84
-
20
20
220
52
272
-
71
71
61
10
71
115
88
202
124
4
128
1,047
1,835
2,882
10
297
307
246
58
304
1,303
2,190
3,493
334
-
334
49
-
49
195
114
309
-
104
104
-
-
-
-
(16)
(16)
23
49
71
32
5
37
187
-
187
24
-
24
46
46
91
143
7
150
1,032
309
1,341
2,335
2,499
4,834
Year ending 31 March 2022
Unrestricted
£000
-
-
133
25
-
102
-
-
94
-
104
228
59
744
-
190
935
292
34
-
-
-
-
-
10
44
-
38
146
564
1,499
Year
Restricted
Total
£000
£000
1,061
1,061
-
-
61
194
-
25
-
-
100
202
30
30
322
322
254
348
580
580
2
106
44
272
1
60
2,455
3,199
41
41
-
190
2,496
3,431
-
292
-
34
425
425
326
326
33
33
190
190
71
71
43
53
-
44
-
-
-
38
8
154
1,096
1,660
3,592
5,090
ending 31 March 2021

40

Notes to the Accounts (continued)

3.2 Grants made to Institutions and Individuals

Institution
Chelsea and Westminster Hospital NHS Foundation Trust
West London NHS Trust
Open Age
Hiyos Practice
MediCinema
Support costs
Year ending 31
March 2022
Total
£000
1,601
333
368
369
84
2,754
128
2,882
Year ending 31
March 2021
Total
£000
3,110
-
-
-
30
3,141
60
3,201

4 Total expenditure

4.1 Support costs

Unrestricted
Staffing costs
Other office costs
Governance costs (note 4.2)
Total support costs
Restricted
General administration
Expenditure on
raising funds
Charitable
expenditure
Total
£000
£000
£000
153
171
324
107
86
193
12
10
22
272
267
539
14
11
25
Year ending 31 March 2022
Expenditure on
raising funds
£000
157
110
28
295
17
Year
Charitable
expenditure
Total
£000
£000
130
287
60
170
15
43
205
500
9
25
ending 31 March 2021

41

Notes to the Accounts (continued)

4.2 Governance costs

Audit fees
Trustees' liability insurance
Legal fees
Year ending 31
March 2022
Total
£000
18
3
2
22
Year ending 31
March 2021
Total
£000
17
3
24
44

The allocation of support costs has been made in line with the charity's strategic objectives. Where appropriate, expenditure has been directly attributed to a cost category. Where this has not been possible expenditure has been allocated on an estimated time basis.

4.3 Salary and pension entitlements of senior managers

Salary and pension entitlements of senior managers
Year ending 31 Year ending 31
March 2022 March 2021
No. of employees No. of employees
Band
£120,000-£130,000 1 1
£90,000-£100,000 1 -
£80,000- £90,000 - 1
£70,000- £80,000 2 1
£60,000 - £70,000 1 1

Contributions for the provision of retirement benefits under defined contribution schemes in respect of the above amounted to £34,889 in the year ended 31 March 2022 (year ended 31 March 2021 £32,991).

42

Notes to the Accounts (continued)

4.4 Analysis of employment costs

Costs
Year ending 31
March 2022
£000
Salary costs
1,136
National insurance costs
127
Pensions costs (defined contribution schemes)
90
1,353
Numbers (based on the average number of employees during the respective periods)
Year ending 31
March 2022
No. of employees
Charitable activities
7.5
Fundraising
9.5
Administration and finance
5.0
22.0
Year ending 31
March 2021
£000
1,025
113
81
1,219
Year ending 31
March 2021
No. of employees
6.0
10.0
4.0
20.0

The six senior management team members are the charity's key management personnel. Their total remuneration and employee benefits for the year ended 31 March 2022 was £556,598 (year ended 31 March 2021 £500.019).

5 Fixed Assets: Intangible Assets

Asset cost or valuation
Balance brought forward at 1 April 2021
Additions in the year
Disposals
Balance carried forward at 31 March 2022
Accumulated depreciation
Balance brought forward at 1 April 2021
Released on disposal
Charge for the year
Balance carried forward at 31 March 2022
Balance carried forward at 31 March 2022
Balance carried forward at 31 March 2021
Art assets
£000
50
-
-
50
-
-
-
-
50
50
Computer
software
£000
15
21
(15)
21
(15)
15
(4)
(4)
17
-
Total
£000
65
21
(15)
71
(15)
15
(4)
(4)
67
50

The art asset is a digital work, Stones against Diamonds’, by Isaac Julien. Filmed deep within the remote glacial caves of Iceland, Isaac Julien has created a unique five screen work for our hospital.

43

Notes to the Accounts (continued)

6 Fixed Assets: Tangible Assets

Asset cost or valuation
Balance brought forward at 1 April 2021
Additions in the year
Balance carried forward at 31 March 2022
Accumulated depreciation
Balance brought forward at 1 April 2021
Charge for the year
Balance carried forward at 31 March 2022
Balance carried forward at 31 March 2022
Balance carried forward at 31 March 2021
Art assets
£000
2,863
5
2,868
-
-
-
2,868
2,863
Fixtures,
fittings and
equipment
£000
383
-
383
(103)
(72)
(175)
208
280
Leasehold
premises
improvements
£000
-
227
227
-
(23)
(23)
204
-
Total
£000
3,246
232
3,478
(103)
(95)
(198)
3,280
3,143

The art assets were revalued as at 10 February 2020 by Christie's, 8 King Street, London SW1Y 6QT and the trustees are satisfied that the valuation at 31 March 2022 is not materially different.

7 Analysis of investments

Investment movements
As at 1 April 2021:
Less: Disposals at carrying value
Add: Acquisitions at cost
Net gain/loss on revaluation
31 March 2022
£000
38,464
(4,140)
4,750
1,658
40,732
31 March 2021
£000
33,596
(1,000)
513
5,355
38,464

7.1 Investment movements

44

Notes to the Accounts (continued)

----- Start of picture text -----
£000 £000
Investment properties - held in the UK 12,240 11,175
Investments listed on Stock Exchange - held in the UK 1,843 1,725
Investments in investment funds - held overseas 23,853 24,505
Cash held as part of the investment portfolio 2,796 1,054
40,732 38,459
----- End of picture text -----

The investment property was re-valued by Gerald Eve LLP on 31 March 2022 in accordance with the Practice Statements and Guidance Notes contained in the Valuation Standards of the Royal Institution of Chartered Surveyors (RICS) 6th Edition. These valuations were based on the market value of the Charity's interests subject to the existing tenancies as at 31 March 2022. As at the valuation date, one of the investment properties, valued at £9.94m, is subject to ongoing negotiations regarding a rent review and renewal of the lease. As the value of the investment property is determined based on the future rental income stream this valuation is currently uncertain. It will not be certain until the proposed new lease is completed or the dispute is resolved with a different outcome. As a result, this valuation is reported with a higher degree of valuation uncertainty than other property investments where there is no dispute on the provisions of an existing lease.

7.2
Programme related investments
Unlisted Health innovation investments in RetVas Ltd retinal imaging digital solutions (held in UK)
7.3
Analysis of gross income from investments
Unrestricted
Restricted
Total
£000
£000
£000
Investment properties
436
-
436
Cash held as part of the investment portfolio
-
-
-
436
-
436
Year ending 31 March 2022
31 March 2022
£000
-
31 March 2021
£000
5
Unrestricted
£000
450
57
507
Year
Restricted
Total
£000
£000
-
450
-
57
-
507
ending 31 March 2021

8 Analysis of debtors

8.1
Amounts falling due within one year:
Prepayments and accrued income
Other debtors
Total debtors falling due within one year
31 March 2022
£000
1,105
248
1,353
31 March 2021
£000
1,599
159
1,758

45

Notes to the Accounts (continued)

9
Analysis of creditors
9.1
Amounts falling due within one year:
Trade creditors
Accruals and deferred income
Other creditors
Total creditors falling due within one year
Includes £nil in respect of pension liabilities at 31 March 2022 (31 March 2021:£5,534)
9.2
Amounts falling due within more than one year:
Other creditors
31 March 2022
£000
106
33
2,035
2,174
535
31 March 2021
£000
103
88
1,482
1,673
28

10 Analysis of funds

10.1 Restricted funds
PIONEER Fund
Best for You
A K Sullivan Fund
Taylor Eales (Restricted)
ViiV Clinical Observation
Horizon Fellowships
The Burdett Trust
Patient Support Fund
Jenner Cardiac Fund
Jean Evelyn Baldwin Legacy
NHS Charities Together Stage 3 funding
Maternity Innovation Fund
Wynne-Thomas Oncology
Sun and Stars Appeal
Others (48 funds at 31 March 2022)
Total
1 April
31 March
2021
Income
Expenditure
Transfers
2022
£000
£000
£000
£000
£000
675
-
-
-
675
2
753
(270)
(103)
382
176
-
(2)
-
174
224
-
(56)
-
168
137
-
(2)
-
135
-
83
-
50
133
91
96
(60)
-
127
126
-
(1)
-
125
125
-
(1)
-
124
125
-
(1)
-
124
-
103
-
-
103
148
-
(52)
-
96
91
-
(1)
-
90
78
2
(1)
-
79
1,476
1,727
(2,066)
(232)
905
3,474
2,764
(2,513)
(285)
3,440

46

Notes to the Accounts (continued)

10.1 Restricted funds
PIONEER Fund
COVID-19 Rapid Response Fund
Taylor Eales (Restricted)
A K Sullivan Fund
Maternity Innovation Fund
Burns Unit Legacy
ViiV Clinical Observation
Patient Support Fund
Jenner Cardiac Fund
Jean Evelyn Baldwin Legacy
Critical Care
Eagles & Sparrows
The Burdett Trust
Wynne-Thomas Oncology
Others (56 funds at 31 March 2021)
Total
1 April
31 March
2020
Income
Expenditure
Transfers
2021
£000
£000
£000
£000
£000
-
858
(183)
-
675
1,148
1,669
(1,949)
(422)
446
226
-
(2)
-
224
178
-
(2)
-
176
99
100
(51)
-
148
-
152
(1)
-
151
137
-
5
(5)
137
127
-
(1)
-
126
126
-
(1)
-
125
-
125
-
-
125
508
258
(702)
(4)
60
29
67
(1)
-
95
-
92
(1)
-
91
66
25
(1)
-
90
1,197
324
(720)
3
804
3,841
3,670
(3,609)
(428)
3,474

Name of fund

PIONEER Fund Best for You A K Sullivan Fund Taylor Eales (Restricted) ViiV Clinical Observation Horizon Fellowships The Burdett Trust Patient Support Fund Jenner Cardiac Fund Jean Evelyn Baldwin Legacy NHS Charities Together Maternity Innovation Fund Wynne-Thomas Oncology Sun and Stars Appeal Burns Unit Legacy Eagles & Sparrows COVID-19 Rapid Response Fund

Description

To support COVID-19 research To support Child and adolescent mental Health

For research on HIV and staff development at sexual health services. For medical equipment at West Middlesex University Hospital.

To support fellowships in digital innovation To support HIV Clinical Observation Programme To fund a Nursing Innovation Fellow

For the relief and assistance of patients. To support the heart unit. For cancer equipment and treatment at Funds to support NHS staff wellbeing To support innovative projects in maternity services. To support the work of the oncology unit. For Children's services at West Middlesex University Hospital To support Burns Unit To fund clinical leadership training To provide the best possible care during the Covid 19 outbreak across our communities.

47

Notes to the Accounts (continued)

10.2 Unrestricted funds

Designated funds
Long Term Capital
Art: Assets
Other designated funds (note 10.3)
Free reserves
Total Unrestricted funds
Designated funds
Long Term Capital
Art: Assets
Other designated funds (note 10.4)
Free reserves
Total Unrestricted funds
Balance
1 April
2021
£000
33,979
3,192
2,256
39,427
103
39,530
Balance
1 April
2020
£000
29,912
2,904
1,265
34,081
16
34,097
Income
£000
-
-
522
522
2,920
3,442
Income
£000
-
-
1,348
1,348
963
2,311
Expenditure
£000
(117)
-
(241)
(358)
(3,058)
(3,416)
Expenditure
£000
(118)
-
(268)
(386)
(2,291)
(2,677)
Transfers
£000
(1,237)
(66)
(11)
(1,314)
1,599
285
Transfers
£000
(1,173)
275
(89)
(987)
1,415
428
Gains
£000
1,658
-
-
1,658
-
1,658
Gains
£000
5,358
13
-
5,371
-
5,371
Balance
31 March
2022
£000
34,283
3,126
2,526
39,935
1,564
41,499
Balance
31 March
2021
£000
33,979
3,192
2,256
39,427
103
39,530

Name of fund

Long Term Capital Art Assets

Description of the nature and purpose of each fund

Assets invested to provide stability and liquidity for the charity’s activities in the long-term (more than ten years).

Represented by art on display in and around the hospital. It is not readily realisable and therefore does not constitute free reserves. It is also held for the long term (more than ten years).

48

Notes to the Accounts (continued)

10.3 Other designated funds
John Karadzas legacy
The Burns Unit
Ron Johnson Ward Fund
Mum and Baby app
C&W Hospital Postgraduate Centre
Chelsea INfectious DisEases Research fund (CINDER)
North West Thames Histopathology Fund
West Middlesex Genito Urinary Medicine (GUM fund)
Kensington Wing Ward Fund
56 Dean Street
Trauma and Orthopaedic fund
Burns Research Fellowship
W. London Centre for Sexual Health
Haematology Fund
Day Care Kobler Centre Fund
Others (96 funds at 31 March 2022)
Total
John Karadzas legacy
Mum and Baby app
Chelsea INfectious DisEases Research fund (CINDER)
C&W Hospital Postgraduate Centre
Ron Johnson Ward Fund
North West Thames Histopathology Fund
Kensington Wing Ward Fund
Burns Research Fellowship
W. London Centre for Sexual Health
Haematology Fund
Day Care Kobler Centre Fund
Obstetric Anaesthesia Fund
Burns Bursary fund
Medical Library
The Burns Unit
56 Dean Street
Others (122 funds at 31 March 2021)
Total
Balance
Balance
1 April
31 March
2021
Income
Expenditure
Transfers
2022
£000
£000
£000
£000
900
38
-
-
938
24
135
(5)
-
154
82
46
(2)
(11)
115
123
50
(58)
-
115
84
-
(1)
-
83
86
-
(2)
-
84
79
-
(6)
-
73
10
61
(17)
-
54
47
-
(1)
-
46
23
54
(25)
(5)
47
9
38
(3)
-
44
42
-
-
-
42
38
-
(2)
-
36
30
-
-
-
30
30
-
(1)
-
29
649
100
(118)
5
636
2,256
522
(241)
(11)
2,526
Balance
Balance
1 April
31 March
2020
Income
Expenditure
Transfers
2021
£000
£000
£000
£000
£000
-
1,000
-
(100)
900
70
78
(25)
-
123
-
105
(19)
-
86
85
-
(1)
-
84
67
16
(2)
-
81
91
-
(12)
-
79
48
-
(1)
-
47
58
-
(1)
(15)
42
38
1
(1)
-
38
30
-
-
-
30
28
3
(1)
-
30
29
-
-
-
29
30
-
(3)
-
27
26
-
-
-
26
18
6
-
-
24
50
49
(80)
4
23
597
90
(122)
22
587
1,265
1,348
(268)
(89)
2,256

49

Notes to the Accounts (continued)

Name of fund

Description of the nature and purpose of each fund

John Karadzas legacy For medical equipment at West Middlesex University Hospital. The Burns Unit To support the Burns Unit Ron Johnson Ward Fund To support Ron Johnson Ward. Mum and Baby app To support the Mum and Baby app. C&W Hospital Postgraduate Centre Staff educational activities including purchase of equipment. Chelsea INfectious DisEases Research fund (CINDER) To support infection based research & development North West Thames Histopathology Fund Histopathology services. West Middlesex Genito Urinary Medicine (GUM fund) To support the genito-urinary medicine at West Middlesex University Hospital. Kensington Wing Ward Fund To support the Kensington Wing. 56 Dean Street To support the operation of the 56 Dean St sexual health clinic. Trauma and Orthopaedic fund To support Trauma and Orthopaedic care. Burns Research Fellowship To support burns research. W. London Centre for Sexual Health To support training and education and equipment purchase. Haematology Fund To support haematology staff and patients. Day Care Kobler Centre Fund To support the Kobler Centre. Obstetric Anaesthesia Fund To support research, education and staff welfare related to obstetric anaesthesia. Burns Bursary fund To support staff training and cost of conferences. Medical Library To support the West Middlesex medical library. Maternity Unit Fund To support the West Middlesex maternity unit.

It is not possible to predict the exact timing of expenditure, but we would anticipate that funds would be spent up in under five years.

11 Commitments and liabilities

With the exception of lease commitments stated in note 15, the charity has no commitments this year ended 31 March 2022 (year ended 31 March 2021- None). All of the current grant liabilities have been included in the balance sheet. Liabilities for commitments budgeted but not confirmed will be recognised in the balance sheet when grants are notified to recipients.

12 Trustee and connected persons transactions

12.1

No trustee remuneration was paid in the year ending 31 March 2022 (year ending 31 March 2021 - £Nil). No expenses were reimbursed in the year ended 31 March 2022 (year ended 31 March 2021 - £35).

13 Related party transactions

Under CW+’s Articles of Association, a number Trustees are nominated by the Chelsea and Westminster Hospital NHS Foundation Trust and include three Trust Board Directors: Lesley Watts, Nick Gash and Liz Shanahan. As the principal object of the charity is to benefit the Trust, the bulk of transactions in the accounts either indirectly or directly support that organisation (see note 3.2 for total grants awarded to the Trust).

50

Notes to the Accounts (continued)

14 Taxation

As a registered charity, CW+ is potentially exempt from taxation of income and gains falling within s505 Income and Corporation Taxes Act 1988 and s256 Taxation of Chargeable Gains Act 1992. No tax charge has arisen in either of the year ended 31 March 2022 or the year ended 31 March 2021.

15 Lease commitments

Within one year - for land and buildings and office equipment
Within two to five years - for land and buildings and office equipment
At the balance sheet date the charity had the following annual lease commitments which fall
due as follows:
31 March 2022
31 March 2021
£000
£000
139
87
416
555
555
642
Property
31 March 2022
31 March 2021
£000
£000
1
1
1
2
2
3
Office equipment

16 Contingent Liability

The charity is in negotiations with the tenant regarding the interpretation of the lease at its property at 82 Vincent Square, London, SW1. At present it is not possible to determine if any amount might be payable by either party as a result of these negotiations and accordingly no provision has been made.

17 Members' liability

The company is limited by guarantee, not having a share capital and consequently the liability of the members is limited, subject to an undertaking by each member to contribute to the net assets or liabilities of the company on winding up such as amounts as may be required not exceeding £1.

51

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

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