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← Picturing Health

2023-12-31-accounts

PICTURING HEALTH

Charity Number 1171738

Trustee Annual Report and accounts for year ending 31 Dec 2023

Charity Objectives

Picturing Health's goal as a charity is to use film and art to improve public health. We make films to disseminate research and turn evidence into practice. working with leading medical and research institutions including the World Health Organisation (WHO), the Medical Research Council (MRC) and the London School of Hygiene and Tropical Medicine (LSHTM). We make films to train health workers. We make films to inform patients and to promote discussion in communities. Films cover topics from HIV and emergency paediatric medicine to diabetes, dementia and mental health. We use Art in our films, and also support using art and art therapy in public health. We have worked mostly in Africa, but also have projects in Asia, Latin America and the UK.

Our core objectives are

Public benefit

All our films made are available for free use under creative commons licenses and can be viewed or downloaded from: www.picturinghealth.org. We have more than 300 films currently on our website. We work in partnership with leading research institutions and medical experts to make sure that our films are evidence based and in line with current guidelines.

Charity structure

At present the charity has no salaried staff, rented office or other major overheads. Rather, we put together film teams on a project-by-project basis. Where possible we work with local filmmakers, editors, health staff and others in the countries where films are made, providing training and direction, because capacity building is an important objective. We work closely with research teams and other health organisations providing treatment on the ground, including Ministries of Health.

Income and financial policy

We have a policy of not spending more than our income. This is, however, worked out on a project-byproject basis rather than annually. Because our projects often span over more than a year, it means that on some years it may appear in the annual accounts that spending is higher than income. However, all spending is matched by future contracted funding. Picturing Health had neither contracts nor grant funding in 2023 from central government. In 2020 Picturing Health registered with the UK government's Gift Aid Scheme and we received income through this in 2023.

Income from commissions: Most of our film projects are commissions where we are contracted to create films as part of wider projects to research or implement medical programs. This means being part of projects with multiple partners. Normally there is a set budget, so financially we work on a project by project basis, making sure that our filming and other activities fit within the contracted budget. Ten percent of projects is set aside for administration of the charity, running the website, financial management and other core costs. Ninety percent goes to the charitable activity directly. We keep at least one year of core costs in reserve. In practice core costs have until now been below this ten percent threshold. This has allowed us to build up over time a working fund of around £10,000 which allows us to move projects forward before contracted funds have been paid.

Income from donations: In addition to contracts we also have a number of donations. We do not however spend money on fundraising. This allows us to spend 90% of donations on charitable activities, retaining only 10% for core running costs. The aim is to use these funds to make additional films, related to those we are commissioned to make, but aimed at different audiences. So if we are commissioned to make training films for a program, we can expand this and at the same time gather material to make films aimed at patients or communities.

ACHIEVEMENT AND PERFORMANCE Charitable activities

Picturing Health's main focus was once again this year on the creation of films. Most of the projects we have been working on have come from commissions.

NEST 360 – Essential Technology for Neonatal Intensive Care Units

Link to films: https://www.picturinghealth.org/nest360-training/

iKMC Training Films

Link to films: https://www.picturinghealth.org/ikmc-trial/

In 2022 we completed a set of two films about the Immediate Kangaroo Mother Care (iKMC) study - a major Randomized Controlled Clinical Trial carried out by WHO in India, Nigeria, Tanzania, Malawi and Ghana. This showed a 25% reduction in deaths of underweight, preterm and sick babies through using KMC in intensive care units - whilst babies are also receiving oxygen, CPAP, or other respiratory support. This led to a change in WHO guidelines, which now recommend that almost all babies received KMC as soon after birth as possible and for as many hours a day as possible. This is for both high and low income settings. In 2023 we started a long-term project, commissioned by the American Academy of Paediatrics (AAP) to make films for online training modules to introduce the new guidelines. We will produce between 4 and 6 modules – totaling about

80 minutes of film for use in both high and low income settings. The first filming for the project was carried out in Chile and Burkina Faso. We will film in Uganda, Nigeria, Colombia and somewhere in Europe in 2024.

NeoiPC

We have been commissioned to produce a set of seven short films for a Horizon-funded Europewide research project looking at ways to implement Kangaroo Care in Neonatal Intensive Care Units (NICUs) and then measuring the impact on infection prevention. This has been commissioned by PENTA (Paediatric Network for the Treatment of Aids). This year we produced the first of these films, aimed at families, to explain what Kangaroo Care is and the potential benefits. The next set if films will be produced as the project unfolds.

Lumbar Punctures

We have been asked by the London School of Hygiene and Tropical Medicine to produce a film with multiple language versions aimed at adults in Africa with suspected meningitis, to encourage uptake of lumbar punctures – which are vital for the correct treatment. Without a quick diagnosis, people with meningitis are at high risk of death, as they may not receive the correct treatment. Lumbar punctures are also used to reduce the pressure around the brain and relieve symptoms. This year we produced a draft of the film. We will complete the project in 2024.

CurArte and Art Therapy.

CurArte is a project we have partnered with and sponsored to use art in public health. This has in the past included giving workshops to HIV positive teens, struggling with adherence in Africa; and a three year collaboration with the mental health unit of a large public hospital in El Salvador. Following this, we received a donation to support two Salvadoran artists, one of them working in El Salvador’s ministry of health, to do a two-year Masters in Art Therapy at an institute based in Barcelona. Both have now successfully completed their masters. As a continuation of this project CurArte in 2023 started a group therapy for former political prisoners in El Salvador. This project will continue through 2024 and we hope expand in collaboration with the Salvadoran Ministry of Health.

Capacity building

Most of our training and capacity building is through on the job training, where we hire local film makers. All the filming for NEST projects in Malawi has been done by a local film maker trained over many years by Picturing Health. For the iKMC project, where we are filming in multiple countries, we are using a very experienced (ex-BBC and others) Brazilian Film Maker as two of the locations are in South America. He will work with a local film maker in each country who will provide a second camera allowing us to provide training, and also build new film making contacts. This allows us to gradually train up and build relationships with freelance film makers in many countries.

Financial Review and Management

Core Spending: Through 2023 we continued to work to improve our website, which is key for distribution of films; build partnerships to allow better evaluation of films within health programmes; looked for funding opportunities and used our film making activities to build capacity in our film making; used opportunities to build organisational capacity. We were part of several unsuccessful funding bids as part of wider research programs.

Countries where Picturing Health operates: In most of the places we make films, we are not operating on a permanent basis. We therefore do not have a legal presence, permanent representative, or offices. In 2023 we worked in Malawi, Uganda, Zimbabwe, Nigeria, El Salvador, Chile and the UK. Spending was entirely related to film production, which was coordinated from the UK. Money was

transferred through the banking system. Receipts were collected for expenditure and accounting done on a project by project basis to fit within the budgets agreed with partners and commissioners.

Financial position: The accounts show activities for the year and are prepared on a receipts and payments basis. Total receipts for Picturing Health were £88,659. Total payments for filmmaking activity were £75,258. The balance at the year-end was £21,065 of which £23,193 was unrestricted offset by an excess of payments over receipts for projects of £2,128. Our overheads in 2023 were £3,686.

The accounts for the previous year were prepared on the accruals basis but have now been restated onto a receipts and payments basis.

Reserves policy: Our reserves policy states that we will maintain a year of core overhead costs in reserve and then work on a project-by-project basis, balancing budgets within projects.

Projected activities for 2024: Projected turnover from commissioned work in 2024 is expected to continue at roughly the same level as 2023 between £50,000 and £100,000.

Governing document: The charity is controlled by its governing document, Charitable Incorporated Organisation - Foundation constitution registered on 22nd February 2017.

Management: Trustees continued to meet at least three times a year. The risk register identified similar risks to 2022. The main risk continues to be the possibility of accidents involving contractors and freelancers, working with Picturing Health. This has been addressed until now by ensuring that all those we work with have their own insurance. However we will look into the possibility of getting a filming indemnity policy for the Charity, covering those who film for us. Another risk as that we do not have sufficient working capital to carry out filming when it needs to happen, often before we have received grant or other funding. We have addressed this by building up a working capital fund of around £10,000 which allows us to start projects more quickly. We have written a safe-guarding policy, an ethical filming policy, a privacy policy for the website and other social media. We are developing an ethical fund-raising policy. The charity does not have any trading subsidiaries. None of the trustees received remuneration, benefits, or expenses. The charity has no employees, but instead works contractually. The charity had no UK volunteers, although a number of UK based contractors gave time at reduced rates for charity work.

REPORT OF THE TRUSTEES for the year to 31 December 2023

Approved by order of the board of trustees on 6[th] October 2024 and signed on its behalf by:

Hon Prof E M Molyneux - Trustee

26[th] October 2024

INDEPENDENTEXAMINER'S REPORTTOTHETRUSTEES OF PICTURING HEALTH Charity number: 1171738 Indepgnclent 8xamln9r'8 report to tho tru8tea8 of Pi¢turing Haallh I report to the charSty trustees on my examlnatlon of the accounts of Plcturing Health Ithg Trust) for the year ended 31 December 2028. Responsibilities and ba#1# of roport As the charlty trustees of the Trustyou sre responslblF> for the pr8parBtion otthe accounts in 8ccord8nc8 whh tha r8qulr8m6nt$ of thè Ch8rltl8s Aet 2011 I'thè Aet'}. I report in respect of my examin8tion of the Trust's accounts carried out under Sectlon 145 of tho Act and Sn carrying out my examination I have followed all appllcablè Dlrectlons giv8n by th8 Charoty Commlsslon under Sectlon 14515llbl of th6 Aot. Ind&pend6nl examlner'g $talem6nt I have completed my examlnatlon. l ¢onflrm that no materlal matters have come to my 8ttention in connection with the examination glving me caus8 to b81iev8 thgt in any mgterial r88PgCt: 1. 8ccounting records wère not kèpt In r•sp8Ct of th8 Trust as r8quir8d by Section 130 of the Act,. or 2. Ihe accounts do not accord with those records. I have no concerns and have come across no other matter8 in connection with the examlnatlon to whlch Éttentlon should be drawn i ort In order to engblg a proper undgrstandlng of th8 accounts to be reached. lan Barrètt F Barretts CharteredAccountants &Chartered TaxAdv18ers 22 Unlon Street Newton Abbot Dfjvon TQ12 2JS 25 Octobor 2024

Receipts and Payments Account for the year ending 31st December 2023

2023 2022
Unrestricted Restricted Total Total
Funds Funds
Receipts
Project income 8,725 73,621 82,346 59,783
Donations 6,313 6,313 1,032
Total Receipts 15,038 73,621 88,659 60,815
Payments
Project costs 71,572 71,572 55,942
Social media 565 565 485
Information technology 1,356 1,356 1,099
Administration 2,766 2,766 3,036
- - -
Advances 1,121 1,121 1,861
Other expenses 120 120 -
Total Payments 3,686 71,572 75,258 58701
Deficit/Surplus for the Year 11,352 2,049 13,401 2,114
-
Bank and cash balances at start of year 11,841 4,177 7,664 5,550
-
Bank and cash balances at end of year 23,193 2,128 21,065 7,664

Statement of Assets and Liabilities as at 31st December 2023

2023

2022

Unrestricted Restricted Total Total
Assets
-
Cash at bank 23,193 2,128 21,065 7,664
-
23,193 2,128 21,065 7,664
Debtors - - - -
-
Total Assets 23,193 2,128 21,065 7,664
Liabilities
- - - -
- - - -

Note

The trustees confirm, in accordance with the Charitable Incorporated Organisations (General) Regulations 2012, that at the year end the CIO did not have any outstanding guarantees to third parties nor any debts secured on the assets of the CIO.

REFERENCE AND ADMINISTRATIVE DETAILS Registered Charity number 1171738

Principal address Flat 3 Springfield Jubilee Road Totnes Devon TQ9 5BW

Trustees

The trustees who served throughout the year and to the date of this report are: Hon Prof E M Molyneux Prof A L Kinmonth Prof Sir I Weller Dr A E South Mr R Wilson Mr N Lewis

Independent Examiner Ian Barrett FCA FCIE Barretts Chartered Accountants & Chartered Tax Advisers 22 Union Street Newton Abbot Devon TQ12 2JS

Approved by order of the board of trustees on 6[th] October 2024 and signed on its behalf by:

Hon Prof E M Molyneux - Trustee 26[th] October 2024