## _Global Anaesthesia Development Partnerships_ **Report and Financial statements for year ended 31[st] March 2021**
A Charitable Incorporated Organisation
Registered as a charity in England and Wales: 1175791
# **Global Anaesthesia Development Partnerships for the year ended 31 March 2021**
|**Page**|**Contents**|
|---|---|
|3 - 9|Trustees’ annual report|
|10|Independent examiner’s report|
|11|Receipts & payments account|
|12|Statement of assets & liabilities|
|13-14|Notes to the accounts|
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## **Global Anaesthesia Development Partnerships Trustees’ annual report for the year ended 31 March 2021**
## **Introduction**
Global Anaesthesia Development Partnerships (GADP) is pleased to provide its annual and financial report for 2020/2021. From its conception in July 2017 and registration in November 2017, it has rapidly achieved its business aim of supporting the development of anaesthesia provision in low-and middle-income countries. Notably, to date all of its activity has been conducted through voluntary activity by its operational staff, with none of its budget required for salary or wage support. Income generation (from donations and grant applications) and mentoring and support for incountry programmes will continue to form the core of its business. The GADP trustees took the decision to change the last word of its name from “Project” to “Partnerships” in December 2020; this was felt to better represent the work of the charity, which is to support local country partnerships.
**Full name** Global Anaesthesia Development Partnerships
**Other names by which the charity is known** Global Anaesthesia Development Project
**Organisation type** Charitable incorporated organisation
**Registered charity number** 1175791
## **Principal address**
The Coach House, Fambridge Road, Roachford, SS4 3LY
## **Trustees**
Dylan Bould, Chair Lesley Crichton, Vice Chair David Snell, Treasurer Sonia Akrimi, Fundraising Lowri Bowen Christine Msadabwe Hazel Mumphansha Abel Mwale Nathan Oates Emma Coley Naomi Shamambo Emma Lillie Jayne Sutherland Masuzyo Zyambo
## **Independent examiner**
John O’Brien, employee of Community Accounting Plus, Units 1 & 2 North West, 41 Talbot Street, Nottingham, NG1 5GL
## **Governance and management**
The charity is operated under the rules of its Foundation adopted 17 November 2017 and most recently amended 13 November 2020.
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## **Global Anaesthesia Development Partnerships Trustees’ annual report for the year ended 31 March 2021**
Trustees are appointed for a term of three years by a resolution passed at a meeting of the board of trustees. Nominees are proposed by any sitting trustee, with support required by two further trustees. Trustees are eligible for re-election and may serve for three consecutive terms of office. Some foundation trustees were appointed for a term of 2 years to ensure that the entire board are not due for re-election at the same time.
Decisions are made jointly by the Trust Board and need to be agreed by a simple majority of all the trustees, with the Chair having the casting vote in the event of no clear majority.
If the current board of trustees identifies a vacancy or an area of need, a brief “job description” and person specification is agreed, after which the position is advertised. Interviews are conducted by a small group of trustees, the successful candidate(s) are vetted and welcomed. All new trustees receive a formal letter of welcome, and the core charity documents, as well as an informal induction.
## **Objectives and activities**
The formal purpose of Global Anaesthesia Development Partnerships (hereafter referred to as GADP) is:
“The advancement of health and saving of lives for people undergoing surgery in underdeveloped countries by training providers in anaesthesia practice”.
## **Summary of the main activities undertaken for the public benefit**
The activities of the GADP during the reporting period were through its two country partnerships:
- Zambia Anaesthesia Development Program (ZADP) and
- Ethiopia Anaesthesia Development Program (EADP)
The specific methods by which these partnerships deliver GADP’s objectives are by supporting:
1. Travel and subsistence costs of individual volunteers to undertake visits to LMICs to provide anaesthesia training.
2. In-country short-course education programmes.
3. Research activity.
4. Travelling fellowships of the LMIC anaesthesia providers.
5. Educational activities aimed at improving the training of anaesthesia providers.
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## **Global Anaesthesia Development Partnerships**
The work of GADP benefits the public of Zambia and Ethiopia by contributing to health systems strengthening by increasing the capacity for physician-led anaesthetic care. This means a greater number of patients benefit from being directly cared for by a physician, and in addition non-physician anaesthesia providers receive greater support in their practice and professional development. Available resources, drugs and equipment needed for safe practice also increase by having staff confident in advocating to policymakers, and improved governance practice that also benefits safe patient care.
## **Public benefit statement**
The Trustees confirm that they have complied with the duty in section 17 of the Charities Act 2011 to have due regard to the Charity Commission's general guidance on public benefit, 'Charities and Public Benefit'.
## **Summary of the main achievements during the period**
Broadly speaking, the ZADP partnership has been developing and evolving over several years, whereas the EADP partnership is newer, and has benefitted from our learning over the years.
A significant proportion of the charity’s activities over this financial year had to be altered in view of the COVID-19 pandemic and increased risk associated with international volunteering. Immediate actions initially focused on getting UK volunteers home safely and subsequently finding ways to adapt and continue our support of in-country partners. This involved conducting repeated needs assessments of local priorities including those resulting from the COVID-19 pandemic.
The highlight achievements of each partnership over the reporting year were:
## **ZADP**
- Adapting to support the physician anaesthesia training programme remotely through facilitated tutorials, journal clubs, case discussions and examination practice. 24 volunteers provided remote training programme support.
- Supporting Zambian partners with COVID-19 training and mentorship whilst they developed their local practices.
- Collaborating with the World Federation of Societies of Anaesthesiologists to build a framework of COVID-19 resources for anaesthesia providers globally.
- Running remote training with physician anaesthetists across eight countries, enabling sharing of learning and examples of practice.
- Developing Personal Protective Equipment (PPE) packs, guidelines and training resources. These were distributed to all 247 anaesthesia providers in Zambia across 83 hospitals, in addition to further PPE resources being provided to multiple critical care, operating theatre and emergency departments supporting other multidisciplinary staff.
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## **Global Anaesthesia Development Partnership**
- Starting refurbishments of anaesthesia training rooms at University Teaching Hospital and Ndola Teaching Hospital, enabling learning to take place in more a comfortable, better resourced environment.
- Running a buddy system providing additional psychological support for Zambian partners and UK volunteers alike.
- Developing wellbeing resources and sharing these with other organisations supporting anaesthesia providers globally.
- Running the #LondonToLusaka challenge- an international combined exercise challenge to raise awareness of the vital role of international partnerships during the pandemic, and to raise funds to enable the charity to conduct its partnership work. In total 118 volunteers contributed to the challenge, exercising a total distance of 23,575.74km!
## **EADP**
- Completed a needs assessment to map our local priorities and how the GADP charity and our experience in Zambia, can be best utilised to support these needs.
- Using the experience gained in Zambia, our EADP partnership also supported development of PPE resources in Ethiopia for anaesthesia providers.
- We also supported the Ethiopian Society of Anaesthesiologist’s annual conference with volunteer panel support, discussing issues relating to COVID-19.
## **Other**
- We held our annual GADP conference in January 2021 hosted remotely, enabling participants from multiple countries to join. This conference, entitled “Continuing to Build Essential Surgical Services During a Pandemic” had multiple eminent speakers as well as contributions from both our EADP and ZADP partnerships. The event included a panel discussion sharing our learning of COVID-19 management and how anaesthetists in our partner countries have been able to continue to provide care despite severely constrained resources. The event was very well attended including by multiple other charities and groups working within international global health development.
## **Governance & Risk Management**
## **Governance**
The organisation is proactive in developing its governance structures. During this year, trustees attended a two-day charity governance training event led by the National Council for Voluntary Organisations (NCVO).
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## **Global Anaesthesia Development Partnership**
## **Risk Management**
The Trustees have developed a Risk Management Policy which follows Charity Commission guidance and has adopted a Risk Register. Major risks are reviewed at each Trustee meeting. All risks, regardless of risk rating, are presented to the Trustee committee and reviewed annually.
During this period, risk assessments have been conducted more frequently due to rapidly changing risks associated with the COVID-19 pandemic. Where appropriate, systems or procedures have been established to mitigate the risks the charity faces.
## **Trustee training**
The board of trustees has spent a considerable amount of time working on professional development. The activities undertaken during the reporting period included:
- A two-day fundraising course for one trustee;
- A one-day finance course for four trustees;
- Trustees attended several conferences and meetings concerning global surgery/anaesthesia and international development.
## **Financial review**
The GADP is a charity whose purpose is “to contribute to the provision of safe anaesthesia worldwide, but particularly in under-resourced environments”. As such the mainstay of its charitable income/funding is from healthcare project grants from a variety of sources with some supplementation from individual donations and events.
Our net expenditure during the financial year was significantly smaller than planned. This was wholly because of the pandemic. Not only did the COVID-19 pandemic completely inhibit volunteers travelling to our partner countries but many of the planned in-country projects were put on hold given the changing and dangerous work environment within Ethiopia and Zambia (and globally). Those that were continued were moved to remote platforms which reduced running costs, although had some limitations.
## **Brief statement of the charity’s policy on reserves**
The GADP has always deemed reserves necessary in case of unanticipated repatriation of volunteer staff (that may not be covered by insurance policies), unforeseen or ancillary requirements of project activities, delays in grant instalments and any other extenuating circumstances.
Fundraising and charitable donations provide the main income for our reserves as well as the occasional un-restricted grant.
GADP agreed to increase the reserve, if possible, to a minimum of £5000. Where possible, the charity will increase our reserve further, depending on available funds.
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## **Global Anaesthesia Development Partnership**
## **Financial risks**
The main financial risk faced by GADP over the financial year were cuts made to international aid by the Foreign, Commonwealth and Development Office (FCDO). This had a massive impact on our FCDO grant, resulting in a loss of £43,000. Projects had to be restricted and other grants re-purposed to cover these losses.
These cuts to international aid will, inevitably result in an ongoing reduction in available grants.
## **Further financial review details**
The principal sources of funding that GADP received over the period 1[st] April 2020 to 31[st] March 2021 are detailed below.
## **AAGBI IRC 2021 Grant**
£5538 received on 26/1/2021
The purpose of this grant was to help expand training to the Copperbelt region of Zambia through increased training capacity and medical education training for local faculty.
## **Canadian Anesthesiologists’ Society International Education Foundation (CASIEF)**
£2,988.78 was donated by CASIEF during this financial year. . We have valued their ongoing support of the charity’s activities in our partner countries.
## **Mannion Daniels (FCDO) grant**
£7955.46 was received by Mannion Daniels on 15/5/2020
The purpose of this grant was in supporting the expansion of physician anaesthetist training to the Copperbelt Province of Zambia.
## **INSPIRE (International Network for Simulation-based Pediatric Innovation,**
## **Research & Education)**
£22,413.69 was received from the International Network for Simulation-based Pediatric Innovation, Research, & Education (INSPIRE) group. This is in support of a research project using sequential paediatric simulation in Zambia to develop paediatric perioperative patient safety. The project has been hampered by the COVID-19 pandemic and, as such, has not yet been spent.
## **THET Africa Grants Project 4.73**
£24, 740.23 was received on 11/12/2020. This was the first instalment of a £60,800 grant to develop regional anaesthesia in Zambia. During this finical year, many of the planned expenditure was not concluded because of Zambian staff focusing on COVID-19.
## **THET Health Worker Action Fund**
£5000 was received on 19/6/2020. This grant was fully spent and contributed to the dispensation of personal protective equipment to staff within Zambia healthcare facilities.
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## **Global Anaesthesia Development Partnership**
## **Online Fundraising and petty cash donations**
Ian Burnell Trust £1000 Easy Fundraising £96.26 Just Giving £16,438.33
## Signed on behalf of the charity’s trustees:
Signed _____________________________________________ Date 24.1.2022
Dylan Bould, Trustee
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## **Independent examiner’s report to the trustees of Global Anaesthesia Development Partnerships for the year ended 31 March 2021**
I report to the trustees on my examination of the accounts of Global Anaesthesia Development Partnerships for the year ended 31 March 2021
## **Responsibilities and basis of report**
As the trustees of the charity you are responsible for the preparation of the accounts in accordance with the requirements of the Charities Act 2011 (‘the Act’). I report in respect of my examination of the charity’s accounts carried out under section 145 of the 2011 Act and in carrying out my examination I have followed all the applicable Directions given by the Charity Commission under section 145(5)(b) of the Act.
## **Independent examiner’s statement**
I have completed my examination. I confirm that no matters have come to my attention in connection with the examination giving me cause to believe that in any material respect:
1. accounting records were not kept in respect of the charity as required by section 130 of the Act; or
2. the accounts do not accord with those records.
I have no concerns and have come across no other matters in connection with the examination to which attention should be drawn in this report in order to enable a proper understanding of the accounts to be reached.
Signed _________________________ Date ______________________ 25/1/2022 John O’Brien MSc, FCCA, FCIE Employee of Community Accounting Plus
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## **Global Anaesthesia Development Partnerships Receipts & payments account for the year ended 31 March 2021**
|_2020_
Total
**Unrestricted**
Funds
**Funds**
£
**Note**
**£**
**Receipts**
48855
Grants & donations
**2**
10695
5963
Fundraising
-
329
Bank compensation
-
55147
**Total receipts**
**10695**
**Payments**
11791
Consultant expenditure
27361
Training and conference
1198
11512
Project activities
5749
3084
Insurance
318
418
IT and computing
1084
-
Administration
1423
-
Legal & professional
1300
156
Bank charges
170
54322
**Total payments**
**11242**
825
**Net receipts/(payments)**
(547)
9693
Cash funds at start of this period
572
10518
**Cash funds at end of this period**
**25**|**_2021_**
**Restricted**
**Total**
**Funds**
**Funds**
**£**
**£**
75811
86506
-
-
-
-
**75811**
**86506**
-
-
2369
3567
14605
20354
-
318
-
1084
1518
2941
-
1300
400
570
**18892**
**30134**
56919
56372
9946
10518
**66865**
**66890**|
|---|---|
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## **Global Anaesthesia Development Partnerships Statement of assets and liabilities at 31 March 2021**
_2020_ _**2021**_ £ **Cash assets £** 10518 Bank accounts 66890 10518 **66890 Assets retained for the charity’s own use** General equipment. **Liabilities** (840) Creditors:Independent examination (840) (840) **(840)**
These financial statements are accepted on behalf of the charity by:
Signed David Snell, Trustee
Dated 24.1.2022
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## **Global Anaesthesia Development Partnerships Notes to the accounts for the year ended 31 March 2021**
## **1. Receipts & payments accounts**
Receipts and payments accounts contain a summary of money received and money spent during the period and a list of assets and liabilities at the end of the period. Usually, cash received and cash spent will include transactions through bank accounts and cash in hand.
## **2. Grants & donations**
|DFID UK AID
Association of Anaesthesia
Covid PPE
Health Worker Action Fund
CASIEF
INSPIRE (Paediatric Simulation)
THET AGP
Ian Burnell Trust
Sundry
**Funds analysis**
**Restricted funds**
EADP development
Obsterics
Copperbelt training
Paediatric Simulation
COVID-19
**Unrestricted funds**
General|**Unrestricted**
**£**
-
-
-
-
-
-
-
10695
**10695**
**Opening**
**balance**
**£**
9351
595
-
-
-
**-**
572
**572**|**Unrestricted**
**£**
-
-
-
-
-
-
-
10695
**10695**
**Opening**
**balance**
**£**
9351
595
-
-
-
**-**
572
**572**|**Restricted**
**Total**
**£**
**£**
7955
7955
5538
5538
1688
1688
5000
5000
1000
1000
22414
22414
24740
24740
1000
1000
6476
17171
**75811**
**86506**
**Receipts (Payments)**
**£**
**£**
24740
(967)
-
(595)
13493
(2166)
22414
-
15164
(15164)
**75811**
**(18892)**
10695
(11242)
**10695**
**(11242)**|**Closing**
**balance**
**£**
33124
-
11327
22414
-|
|---|---|---|---|---|
||||||
||||||
|||**-**||**66865**|
|||572||25|
|||**572**||**25**|
## **3. Funds analysis**
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## **Global Anaesthesia Development Partnerships Notes to the accounts for the year ended 31 March 2021**
EADP development: The purpose of this is to perform a needs assessment and initial development of the Ethiopian Anaesthesia Development Programme (EADP). This is to run alongside the Zambian Anaesthesia Development Programme and support anaesthesia trainees in training, mentorship and professional development. Although the project did enable the first steps in an in-country needs assessment as well as development of EADP teaching fellow roles, the emergence of the COVID-19 global pandemic stalled any further development. THET have kindly allowed re-purposing of the budget and an extension of the grant. This is ongoing.
Obstetrics fund is a programme for improving obstetric anaesthetic care in Zambia through multidisciplinary simulation training, mentoring, and increased professional support for anaesthesia providers. Only a proportion of the grant was spent during this financial year.
Copperbelt training funds specialist training.
Paediatric Simulation This is in support of a research project using sequential paediatric simulation in Zambia to develop paediatric perioperative patient safety. The project has been hampered by the COVID-19 pandemic and, as such, has not yet been spent.
COVID-19 To cover additional costs during the pandemic.
## **4. Trustees’ remuneration**
Trustees received no expenses, remuneration or benefits in this period.
## **5. Related party transactions**
- There were no related party transactions
## **6. Glossary of terms**
**Creditors:** These are amounts owed by the charity, but not paid during the accounting period.
**Restricted funds:** These are funds given to the charity, subject to specific restrictions set by the donor, but still within the general objects of the charity.
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