## _Global Anaesthesia Development Partnerships_ **Report and Financial statements for year ended 31[st ] March 2024** A Charitable Incorporated Organisation Registered as a charity in England and Wales: 1175791 Global Anaesthesia Development Partnerships (Registered charity. number 1175791 } Financial statements for the year ended 31 March 2024 Page Contents Trustees, annual report Independent examiner's report Receipts & payments account Statemenl of assets & liabilities Notes lo Ihe accounts capLUS COMMUNITY ACCOUNTING Global Anaesthesia Development Partnerships Trustees, annual report for the year ended 31 March 2024 Full name Global Anaesthesia Development Partnerships Organisation type Charitable incorporated organisation Registered charity number 1175791 Principal address Global Anaesthesia Development Partnerships, Office North 2774, 182-184 High Street, East Ham, London, E6 2JA Trustees Dylan Bould. Chair Lesley Crichton, Vice chair Evelyn Marshall, Treasurer Abel Mwale Emma Lillie Naomi Shamambo Manisha Patel, from 0710112024 Notulu Lungu, Deputy Treasurer Jayne Sutherland, Secretary Hazel Mumphansha Emma Coley Nathan Oates Tom Gray Atikiltie Baraki. from 2610212024 Independent examiner John O'Brien, employee of Community Accounting Plus, Units 1 & 2 North West, 41 Talbot Street, Nottingham. NG15GL Governance and management The charily is operated under the rules of its constitution adopted 1711112017 and most recently amended 1311112020. Methods adopted for the recruitment and appointment of new trustees Truslees 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 Iwo 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 board of trustees 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 identrfies 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. Global Anaesthesia Development Partnerships Objectives and activities The formal purpose of Global Anaesthesia Development Partnerships is.. "The advan￿ment of health and saving of lives for people undergoing surgery in underdeveloped countries by training providers in anaesthesia practice.. 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.. 1. Supporting local training. quality improvement. research and other capacity building priorities working towards safer anaesthetic and critical care in Zambia and Ethiopia 2. Travel and subsistence costs of individual volunteers to undertake visits to LMICS to provide anaesthesia training. Following the COVID pandemic volunteers continue to deliver remote learning from abroad using teleconference facilities reducing classroom teaching pressures on our in country volunteers 3. In-country short-course education programmes 4. Travelling fellowships of the LMIC anaesthesia providers 5. Other educational activities aimed at improving the training of anaesthesia providers 6. Advocacy for safer surgical and critical care. Summary of the main activities undertaken for the public benefit This work 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 practi￿ 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 This year we have continued to promote our hybrid working model in both Ethiopia and Zambia, utilising the skills of remote and in country fellows to support the training needs of our partner projects. Both roles have been extremely popular both amongst volunteers and trainees, and we intend to continue this hybrid model for the foreseeable future. The ZADP and GADP board have worked closely together to ensure continuity of funding and ongoing leadership during a period of personnel change for the ZADP committee. Substantial grants have been sought and secured to allow the current training model to continue for the coming year. International aid funding is becoming increasingly challenging to secure and so a new fundraising group has been fomied to diversify our fundraising streams. The highlight achievements of each partnership over the reporting year were: ZADP: All activities are developed and led in collaboration, ensuring that we work in unison, that our efforts are directed at the areas of greatest need, and that we conduct our work ethically and with a mind to sustainability. Predominantly Ihis is done through.. -support for SAZ and training programme leads, sub- speciality leads and Zambian members. -supporting priority activities identified by Zambian partner members - 5 areas of need were identified through an in depth needs assessment of 41 Zambian anaesthesia providers and this will inform the work supported by both remote and in country volunleers. -zambian Anaesthesia Training programme support: In-country and remote trainee and consultant volunteers support the training of anaesthetists through a number of clinical and non-clinical activities. This year 11 in country fellows undertook short to midterm placements during which they rotated through theatres and support around 2-3 trainees every day. Alongside mentoring anaesthetists and teaching perioperative care of patients they have been developing the team's non-technical skills relating to leadership and management. These aspects of the job make the in- country role so invaluable, with Zambian trainees able to observe behaviours and skills in the fellows that cannot be taught remotely. They also supported the training of regional anaesthesia (local anaesthetic blocks} which offers significant improvements in patient care by reducing risk of anaesthetic for sick patient and reducing post- operative pain where other forms of analgesia are difficult to access. This is part of an ongoing programme of work since 2020 to develop regional anaesthesia services in Zambia. Whilst ZADP focuses on training physician anaesthetists they have frequently collaborated with others to provide training support to non- physician anaesthetists. -Teaching'. Classroom teaching has been undertaken by remole and in country fellows. As well as lecture based leaching there is regular simulation training of critical incidents and advanced airway management training. Critical care is an identified area of need and has been addressed by combining bedside teaching with lectures and simulation-based leaching on critical care topics and skill-based training. Novice anaesthetist training has been formalised through creation of a four-day introductory course for new starter anaesthetist trainees has been established to cover basic anaesthesia principles and covered areas such as pre- operative assessment, documentation, expectations and program structure. Remote fellows have provided 332 hours of remote and hybrid teaching across 3 different hospital sites and supported many of the lecture and discussion based components of the above listed activities as well as supporting morbidity and mortality meetings and joumal clubs. -wellbeing support.. ZADP fellows have run difficult case debriefs for individual trainees and as groups, welfare checks, and social events to increase team cohesion and allow for time to wind down. -Pan African fellows.. ZADP has been working to build links between anaesthetists across sub-saharan Africa, igniting a vibrant exchange of experiences and resources. There have been 2 projects focussing on Ihis.. the pan-African ZADP fellows and the Ghana- Zambia-Ethiopia training programme leads collaboration. Across these, we have shared experiences and resources, targeted common problems, and aided multi-directional learning and developmenl. -supporting advocacy activities for safer anaeslhetic care.. this has been achieved through the long term partnership with Society of Anaesthetists of Zambia and mentoring and support of Zambian graduated anaesthetists. EADP alongside with its collaborators in Tikur Anbessa hospital and CASIEF has had an active year. There has been continuous in country fellow presence. The focus of activities for in country fellows has been the consistent delivery of the VAST foundation training program. The fellows have also been involved in various training and Quality improvement initiatives. Quality improvement initiatives.. The most inventive was "block and bhuna (coffee)" where they used a series of phantom limbs and fruit to help the residents learn ultrasound guided local anaesthetic blocks. The residents enjoyed this, as it gave them space to learn while decompressing from clinical pressures. Other fellows have been focussing on critical care teaching, developing educational skills amongst residents, and starting conversations about wellbeing and burn out. Ethiopian Training Lead.. We worked with in country partners to create a post for an Ethiopian anaesthetic consultant to oversee the delivery of the VAST training program. This post allows teaching a greater focus, training to be better protected and the quality delivered higher. Our aim is to continue to support the expansion of this role until training needs can be managed exclusively by Ethiopian faculty. Remote fellows.. Over the last year a remote program was established and we have recruited staffing to allow us to expand this next year. Our weekly sessions are almost entirely run by remote fellows, reducing the pressure of finding faculty meaning less sessions are postponed. Other remote activities are around advocacy, and research support. We have supported residents to present at an intemational journal club and others to secure international grants, prizes and submit papers to journals. The charity's policy on reserves The reseNes policy aims to maintain £5,000 in the unrestricted funds where possible. Signed on behalf of the charity's trustees.. Signed Dylan Bould, Chair Date 11th Jan 2025 Independent examiner's report to the trustees of Global Anaesthesia Development Partnerships for the year ended 31 March 2024 I report lo the trustees on my examination of the accounts of Global Anaesthesia Developmenl Partnerships (the charity) for the year ended 31 March 2024. 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 ststement 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.. 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 examinalion to which attention should be drawn in this report in order to enable a proper understanding of the accounts to be reached. Signed John O'B c, FnCA, FnlE Employee of Community Accounting Plus Date 1310112025 Global Anaesthesia Development Partnerships Receipts & payments account for the year ended 31 March 2024 2023 2024 Total Funds Unrestricted Restricted Funds Funds Total Funds Note Receipts Grants & donations Total receipts 21119 21119 1890 1890 48036 48036 49927 49927 Payments Administrative Advertisinglpromotional Bank charges Conference & meetings Consultant expenditure Insurance IT and computing costs Legal & professional fees Officelgeneral administrative expenditures Printing, postage and stationery Project actimties Trainee expenditure Training courses Total payments 10979 719 360 895 11688 12582 242 1553 550 4128 112 1661 792 5681 112 2073 511 1122 1871 662 1882 175 413 511 1122 5996 21785 1685 2938 17423 4623 17423 203 45123 203 6624 44436 38499 (23318) 48568 Net receiptsl(payments) Cash funds at start of this period Transfers between fur)ds Cash funds at end of this period (4734) 5523 3739 4528 9537 19728 3739 25527 4804 25251 25251 30055 Global Anaesthesia Development Partnerships Statement of assets and liabilities at 31 March 2024 2023 2024 Cash assets Bank accounts 25251 25251 30055 30055 other monetary assets Prepayrnent- Insuran 704 704 Liabilities Creditors- Independent examination 906 {906) 1002 1002 These financial statements are accepted on behalf of the charity by: Signed Evelyn Marshall, I reasurer Dated Global Anaesthesia Development Partnerships Notes to the accounts for the year ended 31 March 2024 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 Unrestrictsd Restricted Total Sundry grants & donations Just Giving Global Health Partnerships Association of Anaesthetists International Relations Committe Obstetric Anaesthetists Association The Royal College of Anaesthetists Tropical Health Education Trust 1890 1890 3913 250 5537 15000 5000 18336 49926 3913 250 5537 15000 5000 18336 48036 1890 3. Funds analysis Opening balance Receipts (Payments} Transfers Closing balance Restricted funds Copperbelt training Critical care Obstetrics Paediatric Simulation Regional Anaesthesia Scholars fund ZADP Anaesthesia & training Zambia Anaesthesia CapacityAssessment EADP Development 5537 2500 15000 (1798) (3739) 2500 5672 5837 2500 (9328) (129) 5966 2500 3913 (4201) 250 (23042) 18336 288 13370 (9422) 18336 105 48036 25527 38499 3739 105 19728 Unrestricted funds General 5523 5523 1890 6624 3739 6624 1890 ￿ 3739 4528 4528 The transfer from the Copperbelt training fund to the General fund reflects the release of any restrictions on the use of these funds. The ZADP Anaesthesia & training fund was in deficit of £9,422 on 31 March due to a late receipt from a donor which was received on 30 April. 4. Trustees, remuneration Trustees received no expenses, remuneration or benefits in this period. 5. Related party transactions There were no related party transactions in this period 6. Glossary of tenns Creditors: These are amounts owed by the charity, but not paid during the accounting period. Prepayments: These are services that the charity has paid for in advance, but not used 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.