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2021-09-30-accounts

Charity no. 1178152

Maternal Mental Health Alliance Report and Unaudited Financial Statements

30 September 2021

Maternal Mental Health Alliance

Reference and administrative details

For the year ended 30 September 2021

Charity number 1178152
Registered office and International House
operational address 12 Constance Street
London
E16 2DQ
Trustees The trustees are who served during the year and up to the date of this
report were as follows:
Sarah Arnold
Iulia Avramescu (Treasurer, appointed 1 August 2021)
Kate Billingham (Vice-Chair)
Dr Clare Dolman
Dr Henry Fay
Luciana Goldsmith (Chair)
(née Berger)
Alain Gregoire
Christel Hawkins
Ian Jones
Shapira Papain (Resigned 9 October 2020)
Olga Vysotska (Resigned 13 July 2021)
Bankers CAF Bank Ltd
25 Kings Hill Avenue
West Malling
Kent
ME19 4JQ
Independent examiner Godfrey Wilson Limited
Chartered accountants and statutory auditors
5th Floor Mariner House
62 Prince Street
Bristol
BS1 4QD

1

Maternal Mental Health Alliance

Report of the trustees

For the year ended 30 September 2021________

Reference and administrative information set out on page 1 forms part of this report. The financial statements comply with current statutory requirements, the Constitution and the Statement of Recommended Practice - Accounting and Reporting by Charities (effective from January 2019).

The trustees are pleased to present their annual report together with the financial statements of the charity for the year ended 30 September 2021.

Foreword by our chair – Luciana Berger

After a very challenging year for us all, I am pleased to share with you the Maternal Mental Health Alliance's (MMHA) Annual Report and Accounts for 2020/21.

The year has been framed by the pandemic. Coronavirus has continued to be a shock to our health and social care system, impacting the women and families we advocate for and all those we rely on to achieve our vision. Throughout the pandemic the voluntary sector has stepped up to fill some of the gaps in perinatal mental health (PMH) support which existed prior to Coronavirus and widened in the face of it. In a relatively short space of time, the impact of Covid on maternal mental health has been significant; in order to recover, successive governments will need to invest in the entire system of care and provide comprehensive support to all women and families across the spectrum of need.

Against this backdrop, the MMHA's role as a central voice on the issue of maternal mental health has never been so crucial. Despite funding pressures for many of our members, and increasing demands on their services, we have kept up our regular schedule of members’ meetings, albeit virtually. One benefit has been that colleagues from further afield have been able to join us for UK-wide, rich conversations and have fed into our plans for all four nations.

Despite difficult conditions, the Alliance has been steadfast in our resolve to ensure women and families affected by PMH problems have access to high quality, comprehensive PMH care. This year, we were proud to deliver on our commitment to provide the PMH community with robust evidence of the impact of COVID-19 on maternal mental health and PMH services, through commissioned research. We launched ‘Make all care count’, our new Big Lottery-funded campaign phase which sees the MMHA expanding our focus for the first time beyond specialist services to the wider PMH ecosystem.

We have also been able to expand our team this year and with it our capacity to diversify our income and provide more opportunities to the mums, dads, grandparents, and other family members who make up our lived experience ‘Champions’ network. And we have invested in a robust programme of equality, diversity and inclusion work, the outcomes of which will become more visible during 2021/22.

Inevitable adjustments needed to be made this year, including postponing our plans to publicly mark and celebrate the charity’s 10th anniversary. However, the Alliance was able to reflect on our collective impact during this time and remember how far we’ve come.

I want to thank our generous funders and supporters, and acknowledge the extraordinary efforts made by all our staff, volunteers, members and trustees despite the personal and professional challenges everyone has faced this year. In particular we said goodbye to our founder and CEO Emily Slater, after a decade of dedicated and skilled work.

The passion and dedication of all involved to improve the lives of women and families impacted by perinatal mental health problems has been nothing short of inspiring. My first full year as Chair of the MMHA has been a remarkable one and I look forward to the ambitious one ahead.

2

Maternal Mental Health Alliance

Report of the trustees

For the year ended 30 September 2021________

Objectives and activities for the public benefit

The trustees confirm that in compiling this report they have had due regard to guidance on public benefit issued by the Charity Commission in compliance with the duty set out in section 17(5) of the Charities Act 2011.

The MMHA is a UK-wide charity and network of more than 100 organisations, dedicated to ensuring women and families affected by perinatal mental health (PMH) problems have access to high quality comprehensive PMH care and support. We bring the maternal mental health community together and make change happen by combining the power of real-life experience with clinical and professional expertise.

The MMHA exists to ensure:

The need:

More than one in ten women develop a mental illness during pregnancy or within the first year after having a baby. If untreated, PMH problems can have a devastating impact on the women affected and their families. In the UK, mental illness in pregnant and postnatal women too often goes unrecognised, undiagnosed, and untreated.

The outcomes we expect from MMHA activities are:

Whilst the primary target of our activities is to benefit women and their families with PMH problems, the above outcomes also serve to foster greater efficiency and effectiveness in health and social care services, more culturally appropriate care, and greater health equality overall.

How the MMHA is trying to achieve change:

There are five core areas of work that we undertake:

3

Maternal Mental Health Alliance

Report of the trustees

For the year ended 30 September 2021________

Achievements and performance

During a globally tumultuous 12 months, the MMHA has managed to successfully deliver on 2020-21 plans and activities, including:

Our activities 2020-2021

Campaign successes

This year, the Everyone’s Business campaign welcomed new maternal mental health hubs that opened in England, moving the country a step closer to achieving the ambitious plans for PMH laid out in the NHS Long-Term Plan. These hubs will help around 6,000 more new, expectant, or bereaved mothers a year, many of whom won’t meet the current threshold for specialist support.

Funding promised for specialist PMH community services in Northern Ireland last year came to fruition and some excellent progress has been made, with services expected to be operational in all five Trusts by early 2022.

We celebrated the opening of an interim Mother and Baby Unit (MBU) in Wales, with talks of a permanent solution and an additional joint England/North Wales MBU ongoing.

The Scottish Government launched PMH Care Pathways, which define the ideal routes for a woman to get the care she needs.

With Covid-19 dominating national policy conversations, the political landscape has been challenging. However, the MMHA has continued to engage with key stakeholders to ensure PMH stays on the agenda, including:

4

Maternal Mental Health Alliance

Report of the trustees

For the year ended 30 September 2021________

Make all care count: a new phase of the MMHA’s work

In June 2021, we launched the next phase of the Everyone’s Business campaign. For almost 10 years, the MMHA has focussed primarily on securing specialist PMH services across the UK. This year, thanks to progress in this area and new funding from the National Lottery Community Fund, we were able to expand our focus to ‘Make all care count’.

Working closely with members, we identified eight key service areas, including specialist PMH, that can play a crucial role in improving outcomes for all women with or at risk of poor maternal mental health.

The MMHA’s ‘Make all care count’ campaign phase calls for:

All women and families across the UK to have equitable access to comprehensive, high-quality PMH care, including and beyond specialist PMH services.

This includes:

We have a challenge ahead to close gaps in specialist PMH services and balance calls for other essential PMH care to be available for all new and expectant mothers.

Maternal mental health during a pandemic: A rapid evidence review of Covid-19’s impact

From early in the pandemic, the MMHA was concerned about the increased mental health challenges that new and expectant mothers might be facing and widening inequalities affecting families in the UK. Thanks to Comic Relief funding, we were able to commission MMHA member organisation Centre for Mental Health to examine what the evidence was saying on Covid-19’s true impact on PMH and the services that support women, babies, and families during the perinatal period.

The three main activities were:

In addition, the Centre looked at public source national data on PMH services and conducted a survey of voluntary and community service providers.

We are very grateful to the organisations who conducted and shared their research with us and would like to say a particular thank you to the parents who spoke about their experiences, and all those working in perinatal services who have provided care and support to women and families despite challenges.

5

Maternal Mental Health Alliance

Report of the trustees

For the year ended 30 September 2021________

The Centre’s report drew together all available data collected during the pandemic for the first time. Together, we developed eight urgent recommendations for action, which were unveiled at an event in March 2021, a year since the first national lockdown. Hundreds of people joined us for the launch, which was comprised of research presentations, an expert panel discussion and powerful testimony from women and families with lived experience.

Press interest around the report was significant, with high-profile coverage across print, radio, and TV. It has since been cited by peers and stakeholders making a case for more PMH support for families in the wake of the pandemic.

Working with members

Key to the MMHA’s success is a strong collaborative relationship with our growing membership. As well as our well-attended quarterly meetings, this year we consulted with members throughout the brand update project and ahead of the Make all care count launch to develop the look, substance, and purpose of this new campaign phase.

As ever, we also continued to lend our expertise to member initiatives. We are proud that our staff spend considerable time working out of the public view with member organisations to discuss and agree responses – for example to government consultations - and assist with members’ reports, research, media opportunities, and campaigns.

Highlights of our work with members over the last year include:

Current members:

  1. Aberlour

  2. Acacia Family Support

  3. Action Mental Health

  4. Action on Postpartum Psychosis

  5. Action Trauma

  6. Anna Freud National Centre for Children and Families

  7. Approachable Parenting

  8. Association for Infant Mental Health (AiMH UK)

  9. Association for Postnatal Illness

  10. AWARE

  11. BASIS

  12. Barnardo’s Cymru

  13. Best Beginnings

  14. Bipolar Scotland

  15. Mental Health Foundation

  16. Mind

  17. MIND Cymru

  18. MindWise

  19. Motherdom

  20. Mothers at Home Matter

  21. Mothers for Mothers

  22. Mummy's Star

  23. Mums Aid

  24. Muslim Women’s Network UK

  25. National Centre for Mental Health (NCMH)

  26. National Childbirth Trust

  27. National Children’s Bureau

  28. Netmums

6

Maternal Mental Health Alliance

Report of the trustees

For the year ended 30 September 2021________

15. Bipolar UK 69. NSPCC
16. Birth Companions 70. PANDAS Foundation
17. Birthrights 71. Parents 1st
18. Bluebell Care 72. The Parent-Infant Foundation
19. Brazelton Centre 73. Perinatal Mental Health Partnership UK
20. Breastfeeding Network 74. Person Shaped Support
21. British Association for Counselling and 75. Petals
Psychotherapy
22. British Medical Association 76. Postpartum Support International
23. British Psychological Society (BPS) 77. Prosperitys
24. British Society of Psychosomatic Obstetrics, 78. Quarriers
Gynaecology & Andrology
25. Centre For Mental Health 79. Refugee Women Connect
26. Centre for Research on Families and 80. Relate
Relationships
27. Centred Soul 81. Relate NI
28. Children and Young People’s Mental Health 82. Rethink
Coalition
29. City Pregnancy Counselling and 83. Royal College of General Practitioners
Psychotherapy
30. Community Practitioners and Health Visitors 84. Royal College of Midwives
Association (CPHVA)
31. Crossreach Counselling 85. Royal College of Nursing
32. Doula UK 86. Royal College of Obstetricians &
Gynaecologists
33. Early Intervention Foundation 87. Royal College of Occupational Therapists
34. Family Action 88. Royal College of Paediatrics and Child
Health
35. Family Links 89. Royal College of Psychiatrists
36. Family Nurse Partnership 90. Samaritans
37. Fatherhood Institute 91. Sands
38. Fertility Network UK 92. Society for Reproductive and Infant
Psychology
39. For Baby's Sake 93. Support 2Gether
40. Have You Seen That Girl 94. The Birth Trauma Association
41. The Hearts and Minds Partnership 95. The Daisy Foundation
42. Homestart 96. The Motherhood Group
43. Institute of Health Visiting 97. The Parent Rooms (formerly We Are
Pangs)

  1. National Maternity Support Foundation (Jake’s Charity)

  2. The Pelvic Partnership

  3. Tommy’s

  4. Joanne Bingley Memorial Foundation 99. Tommy’s 46. La Leche League of Ireland 100. Twins Trust (previously TAMBA) 47. Lactation Consultants of Great Britain 101. Unite the union 48. Local Government Association 102. Wave Trust

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Maternal Mental Health Alliance

Report of the trustees

For the year ended 30 September 2021________ the year ended 30 September 2021________
49. Make Birth Better 103. Wellbeing of Women
50. Marce Society 104. Women’s Institute (WI)
51. Maternal Mental Health Scotland 105. Women’s Resource and Development
Agency
52. Maternal OCD 106. Young Mums Support Network
53. Maternity Action 107. YoungMinds
54. Mellow Parenting

Lived Experience Champion Network and Communications

Lived experience remains at the heart of our charity.

The MMHA has a network of experts by experience (‘Champions’) across the UK who share their personal PMH journeys to help raise awareness and improve services. This year, we welcomed new members to our network and introduced policies and plans to help us amplify their voices powerfully yet safely.

Champions engage with our work in several ways, and we aim to ensure the voice of lived experience is present across the breadth of MMHA channels and outputs, for example through:

Specifically, this year we have:

We are delighted to have secured champion representation on the Royal College of Psychiatrists’ PMH Faculty and conference, and regular speaking opportunities with the Institute of Health Visiting’s Perinatal and Infant Mental Health training programme. Champions have also been able to influence policies via Health Education England’s training audit and inform service delivery through research conducted by Manchester Metropolitan and Hertfordshire universities.

In a new direction for the MMHA and our Champions, we supported Comic Relief’s corporate partnership with Maltesers by offering expert feedback on their joint maternal mental health campaign. This resulted in an influx of traffic to the MMHA website thanks to Comic Relief signposting to our support pages.

8

Maternal Mental Health Alliance

Report of the trustees

For the year ended 30 September 2021________

We are seeing a steady number of direct enquiries from NHS England, Public Health England and other key stakeholders seeking the experiences of those with lived experience to inform plans. These proactive approaches are relatively new, and a testament to the exemplary work and emotional commitment of our Champions raising the profile of PMH in the UK and the MMHA.

To support the safety of our Champions, and the staff members who support them, this year we introduced clinical wellbeing supervision, and committed to two topical wellbeing workshops per year. This is in addition to wellbeing check-ins and follow-ups for each individual involvement opportunity and a dedicated member of staff who co-ordinates the network. We ensure there is an appropriate distance between the experience of a PMH journey and sharing them, and our priority in any decisionmaking about our work with our Champions is their wellbeing.

Learning and Evaluation

This year, we commissioned and laid the foundations for a major external evaluation report, covering the past five years of Comic Relief funding for the Everyone’s Business campaign. Available from early 2022, this report will confirm the activities and approaches which have made the biggest impact on PMH service development and, ultimately, the lives of women and families in the UK.

Evaluation learnings combined with findings from our forthcoming commissioned economic research, should set a clear direction of travel for the MMHA’s campaigning efforts over the next five years. The aim for these complimentary reports is to show us what women and families need now and how to best achieve this.

Alongside our regular and ongoing reporting, we also released a separate piece of work capturing the - impact of Covid 19 on the MMHA and our response. The review process was comprised of focus groups and interviews with a selection of member organisations representing the Voluntary and Charitable Sector, Professional Bodies, Champions, national stakeholders, MMHA staff and trustees.

Our independent evaluators found that the context of the pandemic served to reinforce the importance of collaborative working and a unified voice, whist staying focused on the needs of women and families and them having access to good-quality PMH care.

Equality, diversity and inclusion

The main words on the lips of staff and Board members this year have been “equality”, “diversity” and “inclusion” (EDI), as we seek to make our organisation, including its work and component parts, more representative of the UK landscape.

It was important to staff and Board members that we shared a joint understanding of what our organisation was currently achieving, what needed to change, and, crucially, what we, individually and as a team, needed to learn. To achieve this, the team undertook an externally facilitated EDI programme with New Ways Academy, which helps business leaders create inclusive, anti-racist work cultures.

The programme ran over several months, completing after year end in November 2021, with a commitment to publish our overall vision and aims, and develop and implement an EDI plan during 2021-22.

Alongside the learning programme, during the year we strived to be part of an expanded, more diverse network, with the intention of being better placed to further highlight health inequalities within PMH, and to campaign for equity within service provision.

9

Maternal Mental Health Alliance

Report of the trustees

For the year ended 30 September 2021________

We successfully proactively sought new MMHA members and Champions representing or specifically working on behalf of LGBTQ+ communities, teenage parents, and a wider range of ethnic and faith groups – new members included the Young Mums Support Network, Refugee Women Connect, Prosperitys, The Motherhood Group, and Muslim Women’s Network UK. We also developed two workstreams specifically linked to our EDI aims:

We recognise that the MMHA is at the start of its journey towards achieving our vision for all women to have equitable access to quality services that fit their needs, and we have some way to go to become a credible voice on the specific needs of marginalised groups. Our aim is to be a role model for how to do better as an inclusive, anti-racist organisation that holds itself accountable to the change it knows our sector needs.

Organisational development

As reported in the Annual Report for 2019-20, the beginning of 2020-21 saw Luciana Berger join the MMHA as our new Chair. During the year, our Treasurer Olga Vysotskaya came to the end of her term and we successfully recruited Iulia Avramescu, who started a 3-year term in July 2021.

At the end of July, the MMHA said goodbye to co-founder and CEO Emily Slater, who moved on to a new role. Having been with the Alliance since its very first meeting in 2011, Emily left behind an enormous body of work and an impressive legacy, for which the Board extends its heartfelt thanks. We were fortunate to recruit experienced interim CEO, Justin Irwin, who joined us for the remaining two months of this financial year. Justin will continue to lead the charity during this period of transition, armed with his knowledge of the mental health and early years’ sectors, into 2022 when we will be joined by our newly appointed permanent CEO, Laura Seebohm.

In January 2021 a new post of Development and Programmes Manager was appointed to the MMHA to work towards diversifying our income and developing a fundraising strategy.

A management review from 2020 has continued to be implemented to strengthen governance and management of the charity. The role and function of sub-committee structures have been further improved, with absolute clarity about decision-making authority in place, building on an existing schedule of delegation.

Fundraising and income generation

This year, we began our relationship with new funders, the National Lottery Community Fund and Esmée Fairbairn Foundation.

We delivered on commitments to Comic Relief following our successful Covid-19 Recovery Grant bid, which allowed us to commission the rapid review of research into the impact of the pandemic on maternal mental health.

With our new post of Development and Programmes Manager in place, we were able to begin the process of developing a clearer plan for fundraising from trusts and foundations and set in place early thinking for a new income generation strategy. This included developing a clear case for supporting the MMHA, as well as an Ethical Fundraising Policy.

We received a small but growing number of unsolicited donations from individuals keen to support our work, including healthcare professionals wanting to carry out fundraising activities on our behalf.

10

Maternal Mental Health Alliance

Report of the trustees

For the year ended 30 September 2021________

We are extremely grateful for this support and remain particularly conscious of ensuring that we use our funds responsibly and appropriately, maintaining a clear focus on spending money that will best help us to achieve our mission.

Everyone involved at the MMHA would like to say thank you to all our donors and supporters.

Plans for the future

We are conscious that, as an Alliance, it is sometimes tricky to clearly explain what we do and how successful we are. We have therefore decided to publish details of our key operational planning document for 2021-22, with the intention of reporting on our successes and failures in our subsequent Annual Report.

Campaign, lobby, and influence to make the case for quality PMH care:

Convene as an alliance to amplify the collective influence, voice and resources of members and others committed to the provision of PMH care:

Ensure decisions made are influenced by the voices of experts by experience:

Reduce stigma around and raise awareness of PMH to ensure that there is parity of care for women’s mental health with care for women’s physical health during pregnancy and after birth:

Run our organisation efficiently and effectively, maximising our impact and making best use of our funds:

We note that our successes in many of these work areas are difficult to evidence, although our achievements as an Alliance will continue to be monitored through newly commissioned external evaluators. We also plan to reconsider how we monitor, measure and describe our impact – both of the work carried out by our team, and that undertaken by our members.

11

Maternal Mental Health Alliance

Report of the trustees

For the year ended 30 September 2021________

Structure, governance, and management

The MMHA was founded in 2011 by women with lived experience, coming together with clinicians and voluntary sector organisations, with a shared determination to improve care and support for women in the perinatal period. It operated as an informal alliance of membership organisations and, in 2017, it was agreed that the MMHA would be established as a charity in its own right to ensure a sustainable future.

Our charitable incorporated organisation (CIO) was registered in April 2018 and is governed by our constitution.

The trustees serving during the 2020/21 financial year and since year end are as follows:

Sarah Arnold Iulia Avramescu (Treasurer, appointed 1 August 2021) Kate Billingham (Vice-Chair) Dr Clare Dolman Luciana Goldsmith (née Berger) (Chair) Alain Gregoire Dr Henry Fay Christel Hawkins Ian Jones Shapira Papain (Resigned 9 October 2020) Olga Vysotska (Resigned 13 July 2021)

Trustee selection process

The MMHA’s constitution requires a majority of trustees to be elected by members. At the time of elections, the MMHA had more than 100 member organisations. Six of the eight current trustees were elected by members, including the chair and vice-chair.

Trustees are appointed for a term of three years and may stand for re-election, with a limit of three terms. At each AGM, one third of trustees must stand down, although they can then stand for re-election if desired. There is a trustee induction and training programme in place. The board consider what skills are needed from new trustees, and recruit on that basis, typically through a public recruitment process.

Meeting and sub-committees

The trustees meet together formally four times a year and communicate frequently throughout the year.

The board of trustees has a finance and governance sub-committee, and certain decisions are delegated by the rest of the board to this sub-committee, which also meets four times a year.

Charity management

Day-to-day management of the MMHA is delegated to the CEO, and their team of seven part-time staff. Justin Irwin took over from Emily Slater as CEO on an interim basis from 1 August 2021, pending recruitment of a permanent CEO.

Although the MMHA has a registered address in London, staff are all home-based, ensuring office costs are minimal. This has had some benefits during the Covid-19 pandemic as staff were already set up for home-working and its challenges.

12

Maternal Mental Health Alliance

Report of the trustees

For the year ended 30 September 2021________

Arrangements for setting key management personnel remuneration

Remuneration is discussed annually by the remuneration sub-committee or the full board of trustees.

Salaries of senior MMHA staff are benchmarked against similar roles in the voluntary sector, with regular reviews. The salary of the CEO is discussed annually by the board.

Financial review

These accounts show activity for the year October 2020 – September 2021.

The MMHA considers itself to be in a healthy financial situation. Total income for 2020/21 was £411,118 and total expenditure was £443,939, details of which are set out in the attached accounts.

As evident from the accounts, this year saw the last full year of income from a three-year Comic Relief grant overlap with the first year of a four-year grant from Big Lottery. In addition, funding was received from the Esmée Fairbairn Foundation.

Restricted funds at 30 September 2021 were £138,754 (2020: £125,944). Unrestricted funds at 30 September 2021 were £88,943 (2020: £134,574). The charity has no debt or guarantee.

Risk management

Responsibility for risk management lies with trustees, with day-to-day responsibility delegated to the CEO. The risk register is regularly reviewed by the trustees and the finance and governance subcommittee. The senior leadership team typically considers risk on at least a monthly basis. Controls are in place to minimise risks, and to manage risks that occur.

Reserves policy

The MMHA needs reserves to provide security to MMHA operations. An abrupt ceasing of MMHA operations would impact indirectly on women with maternal mental health problems and the MMHA’s work to improve services.

The MMHA is heavily reliant on grant income. The MMHA reserves policy is therefore designed to cover shortfalls in income and periods when income does not reach expected levels or to ‘buy some time’ in the event of reduced income, for example a grant not coming through or being delayed.

The trustees have agreed a reserves policy of maintaining 3 to 6 months running costs. One month’s running costs in the financial year 2020 - 2021 is forecast at around £45,000. Reserves at year end 2020-21 are £227,697, equivalent to just over 6 months running costs based on 2020-21 expenditure, and 4.7 months based on budgeted 2021-22 expenditure.

Statement of responsibilities of the trustees

The trustees are responsible for preparing the trustees' report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102: The Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice).

The law applicable to charities in England and Wales requires the trustees to prepare financial statements for each financial year, which give a true and fair view of the state of affairs of the charity and the incoming resources and application of resources, including the net income or expenditure, of the charity for the year.

13

Maternal Mental Health Alliance

Report of the trustees

For the year ended 30 September 2021________

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 charity and which enable them to ensure that the financial statements comply with the Charities Act 2011, the Charity (Accounts and Reports) Regulations 2008 and the provisions of the constitution. The trustees are also responsible for safeguarding the assets of the charity and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

The trustees are responsible for the maintenance and integrity of the corporate and financial information included on the charity's website. Legislation in the United Kingdom governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions.

The trustees are members of the charity but this entitles them only to voting rights. The trustees have no beneficial interest in the charity.

Independent examiners

Godfrey Wilson were re-appointed as independent examiners to the charitable organisation during the year and have expressed their willingness to continue in that capacity.

Approved by the trustees on 2 March 2022 and signed on their behalf by

Luciana Goldsmith (née Berger) - Chair

14

Independent examiner's report

To the trustees of

Maternal Mental Health Alliance

I report to the trustees on my examination of the accounts of Maternal Mental Health Alliance (the CIO) for the period to 30 September 2021, which are set out on pages 16 to 27.

Responsibilities and basis of report

As the charity trustees of the CIO 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 CIO’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

Since the CIO’s gross income exceeded £250,000 your examiner must be a member of a body listed in section 145 of the 2011 Act. I confirm that I am qualified to undertake the examination because I am a member of the Institute of Chartered Accountants in England and Wales (ICAEW), which is one of the listed bodies.

Godfrey Wilson Limited also provides payroll services to the CIO. I confirm that as a member of the ICAEW I am subject to the FRC’s Revised Ethical Standard 2016, which I have applied with respect to this engagement.

I have completed my examination. I confirm that no material matters have come to my attention in connection with the examination giving me cause to believe that in any material respect:

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.

Date: 2 March 2022

Laura Richards ACA Member of the ICAEW

For and on behalf of: Godfrey Wilson Limited Chartered accountants and statutory auditors 5th Floor Mariner House 62 Prince Street Bristol BS1 4QD

15

Maternal Mental Health Alliance

Statement of financial activities

For the year ended 30 September 2021

Note
Income from:
Donations
3
Charitable activities
4
Total income
Expenditure on:
Raising funds
Charitable activities
Total expenditure
6
7
Total funds brought forward
Total funds carried forward
Net income / (expenditure) and net
movement in funds		 Restricted
£
-
352,173
352,173
23,955
315,408
339,363
12,810
125,944
138,754		 Unrestricted
£
8,945
50,000
58,945
10,836
93,740
104,576
(45,631)
134,574
88,943		 2021
Total
£
8,945
402,173
411,118
34,791
409,148
443,939
(32,821)
260,518
227,697		 2020
Total
£
3,138
423,807
426,945
19,130
352,025
371,155
55,790
204,728
260,518

All of the above results are derived from continuing activities. There were no other recognised gains or losses other than those stated above. Movements in funds are disclosed in note 13 to the accounts.

16

Maternal Mental Health Alliance

Balance sheet

As at 30 September 2021

Note
Current assets
Debtors
10
Cash at bank and in hand
Liabilities
Creditors: amounts falling due within 1 year
11
Net current assets and net assets
12
Funds
13
Restricted funds
Unrestricted funds
General funds
Total charity funds		 2021
£
5,442
259,886
265,328
37,631
227,697
138,754
88,943
227,697		 2020
£
4,576
273,856
278,432
17,915
260,518
125,944
134,574
260,518

Approved by the trustees on 2 March 2022 and signed on their behalf by

Luciana Goldsmith (née Berger) - Chair

17

Maternal Mental Health Alliance

Statement of cash flows

For the year ended 30 September 2021

Cash used in operating activities:
Net movement in funds
Adjustments for:
Decrease / (increase) in debtors
Increase / (decrease) in creditors
Net cash provided by operating activities
Increase in cash and cash equivalents in the year
Cash and cash equivalents at the beginning of the year
Cash and cash equivalents at the end of the year		 2021
£
(32,821)
(865)
19,716
(13,970)
(13,970)
273,856
259,886		 2020
£
55,790
(127)
(3,990)
51,672
51,672
222,184
273,856

The charity has not provided an analysis of changes in net debt as it does not have any long term financing arrangements.

18

Maternal Mental Health Alliance

Notes to the financial statements

For the year ended 30 September 2021

1. Accounting policies

a) Basis of preparation

The financial statements have been prepared in accordance with Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities in preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2019) - (Charities SORP (FRS 102)), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102).

Maternal Mental Health Alliance meets the definition of a public benefit entity under FRS 102. Assets and liabilities are initially recognised at historical cost or transaction value unless otherwise stated in the relevant accounting policy note.

b) Going concern basis of accounting

The accounts have been prepared on the assumption that the charity is able to continue as a going concern, which the trustees consider appropriate having regard to the current level of unrestricted reserves. There are no material uncertainties about the charity's ability to continue as a going concern.

c) Income

Income is recognised when the charity has entitlement to the funds, any performance conditions attached to the item of income have been met, it is probable that the income will be received and the amount can be measured reliably.

Income from the government and other grants, whether 'capital' grants or 'revenue' grants, is recognised when the charity has entitlement to the funds, any performance conditions attached to the grants have been met, it is probable that the income will be received and the amount can be measured reliably and is not deferred.

d) Donated services and facilities

Donated professional services and donated facilities are recognised as income when the charity has control over the item, any conditions associated with the donated item have been met, the receipt of economic benefit from the use by the charity of the item, is probable and the economic benefit can be measured reliably. In accordance with the Charities SORP (FRS 102), general volunteer time is not recognised.

On receipt, donated professional services and donated facilities are recognised on the basis of the value of the gift to the charity which is the amount the charity would have been willing to pay to obtain services or facilities of equivalent economic benefit on the open market; a corresponding amount is then recognised in expenditure in the period of receipt.

e) Interest receivable

Interest on funds held on deposit is included when receivable and the amount can be measured reliably by the charity: this is normally upon notification of the interest paid or payable by the bank.

19

Maternal Mental Health Alliance

Notes to the financial statements

For the year ended 30 September 2021

1. Accounting policies (continued)

f) Funds accounting

g) Expenditure and irrecoverable VAT

Expenditure is recognised once there is a legal or constructive obligation to make a payment to a third party, it is probable that settlement will be required and the amount of the obligation can be measured reliably.

Irrecoverable VAT is charged as a cost against the activity for which the expenditure was incurred.

h) Allocation of support and governance costs

Support costs are those functions that assist the work of the charity but do not directly undertake charitable activities. Governance costs are the costs associated with the governance arrangements of the charity, including the costs of complying with constitutional and statutory requirements and any costs associated with the strategic management of the charity’s activities. These costs have been allocated between cost of raising funds and expenditure on charitable activities on the basis of staff costs as follows:

2021 2020
Raising funds 11.0% 7.3%
Charitable activities 89.0% 92.7%

i) Debtors

Trade and other debtors are recognised at the settlement amount due after any trade discount offered. Prepayments are valued at the amount prepaid net of any trade discounts due.

j) Cash at bank and in hand

Cash at bank and cash in hand includes cash and short term highly liquid investments with a short maturity of three months or less from the date of acquisition or opening of the deposit or similar account.

k) Creditors

Creditors and provisions are recognised where the charity has a present obligation resulting from a past event that will probably result in the transfer of funds to a third party and the amount due to settle the obligation can be measured or estimated reliably. Creditors and provisions are normally recognised at their settlement amount after allowing for any trade discounts due.

l) Financial instruments

The charity only has financial assets and financial liabilities of a kind that qualify as basic financial instruments. Basic financial instruments are initially recognised at transaction value and subsequently measured at their settlement value with the exception of bank loans which are subsequently recognised at amortised cost using the effective interest method.

20

Maternal Mental Health Alliance

Notes to the financial statements

For the year ended 30 September 2021

1. Accounting policies (continued)

m) Pension costs

The charity operates a defined contribution pension scheme for its employees. There are no further liabilities other than that already recognised in the SOFA.

n) Functional currency

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 £1.

o) Accounting estimates and key judgements

In the application of the charity's accounting policies, the trustees are required to make judgements, estimates and assumptions about the carrying values of assets and liabilities that are not readily apparent from other sources. The estimates and underlying assumptions are based on historical experience and other factors that are considered to be relevant. Actual results may differ from these estimates.

The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised if the revision affects only that period, or in the period of the revision and future periods if the revision affects both current and future periods.

There are no sources of estimation uncertainty that have a significant effect on the amounts recognised in the financial statements.

2. Prior period comparatives: statement of financial activities

Income from:
Donations
Charitable activities
Total income
Expenditure on:
Raising funds
Charitable activities
Total expenditure
Net income and net movement in funds		 Restricted
£
£
-
3,138
373,807
50,000
373,807
53,138
19,000
130
338,643
13,382
357,643
13,512
16,164
39,626
Unrestricted		 2020
Total
£
3,138
423,807
426,945
19,130
352,025
371,155
55,790

21

Maternal Mental Health Alliance

Notes to the financial statements

For the year ended 30 September 2021

3. Income from donations

Donations
Membership fees
Coronavirus Job Retention Scheme
Total income from donations
Prior period comparative:
Donations
Donations of time for legal expertise
Total income from donations
Income from charitable activities
Grants:
Comic Relief
National Lottery Community Fund
Comic Relief Covid
Esmee Fairbairn
NI Public Health
Total income from charitable activities
Prior period comparative:
Grants:
Comic Relief
National Lottery Community Fund
Comic Relief Covid
Esmee Fairbairn
NI Public Health
Total income from charitable activities		 Restricted Unrestricted
£
£
-
6,205
-
200
-
2,540
-
8,945
Restricted
£
£
-
978
-
2,160
-
3,138
Restricted
£
£
120,000
-
216,805
-
8,000
-
-
50,000
7,368
-
352,173
50,000
Restricted
£
£
300,000
-
34,439
-
32,000
-
-
50,000
7,368
-
373,807
50,000
Unrestricted
Unrestricted
Unrestricted		 2021
Total
£
6,205
200
2,540
8,945
2020
Total
£
978
2,160
3,138
2021
Total
£
120,000
216,805
8,000
50,000
7,368
402,173
2020
Total
£
300,000
34,439
32,000
50,000
7,368
423,807

4. Income from charitable activities

22

Maternal Mental Health Alliance

Notes to the financial statements

For the year ended 30 September 2021

5. Government grants

The charity receives government grants, defined as funding from NI Public Health and National Lottery Community Fund to fund charitable activities. The total value of such grants in the period ending 30 September 2021 was £224,173 (2020: £41,807). This year the charity also received a furlough grant, totalling £2,540 (2020: £Nil). There are no unfulfilled conditions or contingencies attaching to these grants in 2020/21.

6. Total expenditure

Total expenditure
£
Staff costs (note 8)
23,597
Direct project costs
-
Monitoring and evaluation
-
Organisational / capacity development
-
Overheads
-
Sub-total
23,597
Allocation of support and governance costs
11,194
Total expenditure
34,791
Total governance costs were £2,737 (2020: £1,876).
Raising
funds		 £
£
194,864
71,444
63,658
-
32,520
-
25,668
-
-
32,188
316,710
103,632
92,438
(103,632)
409,148
-
Charitable
activities
Support and
governance
costs		 2021
Total
£
289,905
63,658
32,520
25,668
32,188
443,939
-
443,939

Prior period comparative:

Staff costs (note 8)
Direct project costs
Monitoring and evaluation
Organisational / capacity development
Overheads
Sub-total
Allocation of support and governance costs
Total expenditure		 £
14,519
-
-
-
-
14,519
4,611
19,130
Raising
funds		 £
£
184,772
39,690
77,798
-
15,870
-
14,909
-
-
23,597
293,349
63,287
58,676
(63,287)
352,025
-
Charitable
activities
Support and
governance
costs		 2020
Total
£
238,981
77,798
15,870
14,909
23,597
371,155
-
371,155

23

Maternal Mental Health Alliance

Notes to the financial statements

For the year ended 30 September 2021

7. Net movement in funds

This is stated after charging:

Trustees' remuneration
Trustees' reimbursed expenses
Independent examiners' remuneration (including VAT)
▪
Independent examination (including VAT)
▪
Other services (including VAT)		 2021
£
Nil
Nil
1,380
1,115		 2020
£
Nil
318
1,320
1,042

In 2020 two trustees were reimbursed £318 for travel and subsistence expenses.

8. Staff costs and numbers

Staff costs were as follows:

Salaries and wages
Social security costs
Pension costs
Freelance staff		 2021
£
225,965
16,294
20,334
27,312
289,905		 2020
£
184,626
13,170
15,032
26,153
238,981

No employee earned more than £60,000 during the year.

The key management personnel of the charity comprise the Trustees, the CEO, the HR and Governance Advisor and the Development and Programmes Manager. The total employee benefits of the key management personnel were £104,239 (2020: £85,668).

Average head count
Full time equivalents		 2021
No.
9
6		 2020
No.
7
5

9. Taxation

The charity is exempt from corporation tax as all its income is charitable and is applied for charitable purposes.

24

Maternal Mental Health Alliance

Notes to the financial statements

For the year ended 30 September 2021

10. Debtors

10. Debtors
Trade debtors
Prepayments
11. Creditors: amounts due within 1 year
Trade creditors
Accruals
Other creditors
12. Analysis of net assets between funds
Current assets
Current liabilities
Net assets at 30 September 2021
Prior period comparative:
Current assets
Current liabilities
Net assets at 30 September 2020		 £
148,856
(10,102)
138,754
£
132,859
(6,915)
125,944
Restricted
funds
Restricted
funds		 2021
£
5,000
442
5,442
2021
£
10,194
23,784
3,653
37,631
£
116,472
(27,529)
88,943
£
145,574
(11,000)
134,574
Unrestricted
funds
Unrestricted
funds		 2020
£
-
4,576
4,576
2020
£
2,277
15,068
569
17,915
Total
funds
£
265,328
(37,631)
227,697
Total funds
£
278,433
(17,915)
260,518

25

Maternal Mental Health Alliance

Notes to the financial statements

For the year ended 30 September 2021

13. Movements in funds

Movements in funds
Restricted funds
Comic Relief
National Lottery Community Fund
Comic Relief - COVID report
Devolved co-ordinators NI
Total restricted funds
General funds
Total unrestricted funds
Total funds
Unrestricted funds		 At 1
October
2020
£
126,107
(1,911)
1,748
-
125,944
134,574
134,574
260,518		 Income
£
120,000
216,805
8,000
7,368
352,173
58,945
58,945
411,118		 £
143,729
178,518
9,748
7,368
339,363
104,576
104,576
443,939
Expenditure		 £
102,378
36,376
-
-
At 30
September
2021
138,754
88,943
88,943
227,697

Purposes of restricted funds

Comic Relief

This grant is to continue the work of the Everyone's Business campaign. The Everyone’s Business campaign aims to end the postcode lottery in specialist perinatal mental health services, and address the damaging gaps in prevention and non-specialist care.

National Lottery Community Fund

This grant is to extend the work of the Everyone's Business campaign, into Everyone's Business - at Every Contact. This builds on our experience and the current interest in perinatal mental health to ensure all women receive the right support and care, whatever their mental health needs, background and whichever part of the system they are in contact with.

Comic Relief - Covid report

Working with the Centre for Mental Health to conduct a rapid evidence review of the impact of Covid-19 on maternal mental health and perinatal mental health services, including voluntary & community sector, working across all 4 UK nations in order to influence policy.

Devolved Coordinator NI Funding for the NI devolved coordinator role granted for 18 months from Public Health NI.

26

Maternal Mental Health Alliance

Notes to the financial statements

For the year ended 30 September 2021

13. Movements in funds (continued) Prior period comparative:

Restricted funds
Comic Relief
National Lottery Community Fund
Comic Relief - COVID report
Devolved co-ordinators NI
Total restricted funds
General funds
Total unrestricted funds
Total funds
Unrestricted funds		 At 1
October
2019
£
109,780
-
-
-
125,944
94,948
134,574
204,728		 Income
£
300,000
34,439
32,000
7,368
373,807
53,138
53,138
426,945		 £
283,673
36,350
30,252
7,368
357,643
13,512
13,512
371,155
Expenditure		 £
126,107
(1,911)
1,748
-
At 30
September
2020
125,944
134,574
134,574
260,518

14. Related party transactions

There were no related parties in the current or prior period.

27