**REGISTERED CHARITY NUMBER: 1182182** ## REPORT OF THE TRUSTEES AND UNAUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2022 ## FOR ## FUTURE HEALTH AFRICA Barretts Chartered Accountants & Chartered Tax Advisers 22 Union Street Newton Abbot Devon TQ12 2JS ## **CONTENTS OF THE FINANCIAL STATEMENTS for the year ended 31[st] December 2022** ||**Pages**| |---|---| |**Report of the Trustees**|**3-16**| |**Independent Examiner’s report**|**17**| |**Statement of Financial Activities**|**18**| |**Balance Sheet**|**19**| |**Notes to Financial Statement**|**20-23**| |**Detailed Statement of Financial Activities**|**24-25**| 2 **Trustees’ Annual Report for the period** **From 1st January 2022 to 31[st] December 2022** **Charity name: Future Health Africa (FHA)** **Charity registration number: 1182182** |**Objectives and Activities**|**Objectives and Activities**| |---|---| |The purposes of the
charity as set out in
its governing
document|The objects of the CIO are, for the public benefit, particularly, but not exclusively, in Africa and
other low/middle income countries (LMICs):
(1)
the relief of sickness and the preservation of health, particularly but not exclusively by
promoting the sharing of healthcare knowledge and skills and assisting in the provision of
medical treatment;
(2)
the advancement of education in healthcare, in particular by the delivery of quality
improvement and leadership training in a healthcare context and other health- related
education and training to those involved in health and care delivery at all levels and to the
wider public, and by raising awareness of global health issues;
(3)
to develop the capacity & skills of members of socially and economically disadvantaged
communities in LMICs in which the CIO is working, in such a way that they are better able to
identify and help meet their needs and to participate more in society.| |The main activities
in relation to those
purposes for the
public benefit, in
particular, the
activities, projects
or services
identified in the
accounts.|In 2022, the charity had 8 workstreams (with a 9thin development) directed at achieving our
objectives. Not all are active every year. Each is described below along with the activities conducted
during the period of this report. All of the work was conducted in Kenya. Further detail can be seen
atwww.futurehealthafrica.org
All of our work aligns with the Sustainable Development Goals and in particular goals
1,**3**,4,5,10,17| 3 ## **WORKSTREAM 1: TRAUMA TEAM** **Leads: Mr Christoph McAllen (Consultant Orthopaedic Surgeon, Plymouth, UK) Dr Samuel Ndanya (Consultant Orthopaedic Surgeon, Nanyuki, Kenya) Mr Darren Munn (Surgical Practitioner, Torbay Hospital, UK) Dr Will Jewell (Consultant in Anaesthetics, Truro, UK) Dr Mary Nduta (Medical Doctor, Nairobi, Kenya) Description:** This is a clinical & training project in which a joint UK and Kenyan team of skilled professionals of different cadres undertake orthopaedic trauma activities in Kenyan health facilities. Trauma Team activities are categorised into Bronze, Silver and Gold. All services are delivered at the highest standard, with improving quality as a central aim. **Bronze** : immediate & direct patient care through - high quality consultations, advice and where appropriate, both operative and non-operative treatment to alleviate pain, suffering and disability - **Silver** : learning opportunities/ new skills - side-by-side working with exchange of knowledge & skills in relevant disciplines (surgery, anaesthesia, nursing, operating department practice, radiography, physiotherapy) - • developing a safer surgical environment • exchanging knowledge on safe general and regional anaesthesia and pain management **Gold** : sustaining improvement/ development • identifying areas to develop a stepwise pathway • supporting local need and wishes to change • developing non-operative treatment options for local patients • providing ongoing support and communication outside of projects • inclusion of Kenyan orthopaedic trainees in the team promotes better future practice • presentations at national academic meetings to share challenges and best practice ## **Activities undertaken:** Following an approach for potential partnership from St Joseph’s Mission Hospital & Trauma Centre in Nyabondo, Kisumu County, a number of on-line meetings were held followed by a visit in person in April 2022 by the Chair of Trustees (Kerri Jones). Following this positive visit, Darren Munn (Trauma Team Lead) applied for and gained a THET (Tropical Health & Education Trust) grant of £5,000 to establish a new health partnership. A one-week visit took place in November/December 2022 following which an MoU was signed and provisional plans were made for a project to be held there in November 2023. It is hoped that the brand new government-funded Trauma Centre built in St Joseph’s grounds will be open and functioning by then. 4 ||A visit was also made to Kisii County & Referral Hospital to explore opportunities there raised during
a visit/talk from Kerri Jones at a Kenya-UK Health Alliance (KUKHA) Summit meeting earlier in the
year.
Planning and fundraising took place for a Trauma Team visit to be held in Nanyuki Teaching and
Referral Hospital in Jan/Feb 2023.
The UK Lead orthopaedic surgeon, Mr Christoph McAllen was appointed as a Visiting Lecturer to the
University of Nairobi.| |---|---| ||**WORKSTREAM 2: GRASPIT**
**Leads: Dr Matt Halkes (Consultant in Anaesthetics/Critical Care, Torbay Hospital, UK)**
**Kiruja Gitonga Jason (Senior Nurse, Kenyatta National Hospital, Kenya)**
**Christine Musee (Director of Nursing for Surgery, Kenyatta National Hospital**
**Dr Mike Swart (Consultant in Anaesthetics/Critical Care, Torbay Hospital, UK)**
**Description:**GRASPIT (Global Recognition & Assessment of the Sick Patient & Initial Treatment) is a
one-day course which equips clinicians with a structured systematic approach to the management
of the deteriorating acutely ill patient. GRASPIT has been shown to increase a clinician’s confidence
in the management of these challenging patients. The four key principles of GRASPIT are:
1.
Early recognition of deteriorating acutely ill patients
2.
Systematic approach to the assessment of patients
3.
Early initial treatment
4.
Team working through effective communication
When introduced to a new health facility, an introductory 3-day course is run which includes a
‘training of trainers’ course. Following this, local trainers are able to continue to deliver the course
to more healthworkers. Initial training is conducted by Kenyan trainers with support from the UK
faculty. The UK lead (Dr Matt Halkes) holds oversight of standards of delivery, strategy and grant
applications within his remit.| ||**Activities undertaken:**
The GRASPIT team started planning for restarting its work and lead, Dr Matt Halkes, made a one-
week visit to Nairobi, St Joseph’s Hospital and Kisii Hospital and University in November/December.
Professor Raymond Oigara, the Dean of the Health Faculty at Kisii University is particularly keen on
experiencing a GRASPIT course and planning started for this to take place in 2023.
For part of the year, GRASPIT had the benefit of 2 ‘Improving Global Health (IGH)’ fellows funded
by Health Education England (HEE), one of whom (Dr Rosie Lyus) accompanied the team visit to
Nairobi in Nov/Dec 2022. She scoped, along with Dr Mike Swart, the potential for re-establishing
the course at Kenyatta National Hospital. Dr Damaris Adebambo is concentrating on the work with
Kisii. The Fellows are both junior doctors who are paid by HEE a day a week for a 6-12 month period
to support GRASPIT.
In June 2022 Dr Kerri Jones met with Dr John Wanyungu, Deputy Director of Community Health for
Kenya, and he is keen for a version of GRASPIT, suitable for Community Health Volunteers and
Community Health Assistants, to be developed. Discussions are now underway to try and develop
this along with a review of the current materials for delivery to trained healthworkers.| ||**WORKSTREAM 3: QUALITY IMPROVEMENT & LEADERSHIP (q4a)**
**Lead: Dr Kerri Jones**| 5 ||**Description:**This workstream recognises that ‘sick systems’ prevent better patient outcomes. Our
q4a (quality for all) faculty has designed the SPRINGBOARD course to empower frontline healthcare
workers to improve quality of care by learning and applying ‘The Science of Improvement’ and the
‘Art of Leadership’. The course normally runs for 10 days and imparts knowledge of improvement
methodology, team working, leadership, patient-centred care and an understanding of how to
create a positive culture for change. The skills are learned through**doing**real live quality
improvement(QI) projects.| |---|---| ||**Activities undertaken:**
2022 was the 2ndyear of our FCDO (formerly DFID) grant which was directed at testing if teaching QI
and leadership skills to people running Community Health Units (CHUs). These people were
Community Health Volunteers, Community Health Assistants, and subcounty/county community
focal people. The aim was to help them to impact positively on maternal and newborn mortality
and morbidity. In 2021 the project had run in Migori County but moved to Laikipia County in late
2021 and continued until 30thNovember 2022.
Because of the travel restrictions imposed by COVID-19, activity and grant monies were delegated
to a downstream partner to deliver on our behalf. Our chosen partner was LVCT Health, a Kenyan
NGO with longstanding links to the Liverpool School of Tropical Medicine. They successfully
delivered, in 2 CHUs,
•
a 3-day training in QI at CHU level with the formation of QI teams
•
a 3-day training in leadership
•
a further 3-day training in QI
•
a mid-term Learning event (2 days) April 2022
•
a final Learning Event (one day) November 2022
•
coaching and mentoring of QI teams focussing on maternal outcomes
Workstream lead Kerri Jones retained overall management of the project along with reporting
responsibilities. She was able to attend the mid-term Learning Event in April 2022.
The training materials used were LVCT QI Community framework complemented by FHA’s
Leadership course. This proved to be a successful blend.
Grant management was delegated by the FCDO to Mannion Daniels with whom there were regular
communications.
Findings (brief summary) were
•
CHVs were unclear about their role and had received insufficient training
•
Data collection was not happening
•
CHAs were not supervising CHVs
•
Sub-county staff were not adequately supervising CHAs
•
County staff were not focussing on Community HEalth
•
CHVs were lacking motivation due to lack of remuneration
The Learning Events created the opportunity to share the work and produce Action Plans and the
county has indicated ongoing commitment to continue and spread the work.
Impact:
•
CHVs increased household visits
•
Pregnant women attended ante-natal clinics more frequently
•
More women sought a skilled birth attendant
All grant targets were met. Clearly QI and Leadership training impacts positively at Community
level. A follow-up visit to Migori County, where we had worked in 2021, took place.
The findings from this project will be used to inform further grant applications to identify and test
further facilitatice strategies to help CHVs in their work.| 6 ||**q4a**was fortunate to be allocated an HEE IGH Fellow (as for GRASPIT – see above) for one day per
week. The focus of their work has been to develop accessible QI course materials where
SPRINGBOARD cannot be delivered in person. UPBEAT is now available at
https://open.plymouth.ac.uk/course/view.php?id=210 . A testing site in a LMIC is being sought.
Communication continued with the Society for Quality Healthcare Kenya (SQHK).
Kerri Jones visited St Joseph’s, Nyabondo and Kisii hospital/University where strong interest was
expressed in QI and leadership training. Resources need to be found to enable this to happen.| |---|---| ||**WORKSTREAM 4: COMMUNITY**
**Leads: Dr Lucy Obolensky**
**Dr Kerri Jones (for QI work)**
**Description:**This project aims to improve health outcomes in rural areas of Kenya. It includes
working with conservation NGOs (such as Northern Rangelands Trust and Lewa Wildlife
Conservancy) and the Ministry of Health.
There is a new focus on teaching QI skills at community level.| ||**Activities undertaken:**
Community work continued through the QI & Leadership work described in the q4a section above.
An FCDO grant of £48,841 allowed us to work (through LVCT Health) with two Community Health
Units in Laikipia County (Naibor & Powys) to improve perinatal care of pregnant mothers.
The Technical Assistance work with the Northern Rangelands Trust is no longer undertaken under
the FHA banner.| ||**WORKSTREAM 5: TEAM TALK**
**Lead: James Lyon-Taylor**
**Description:**Team Talk seeks to directly improve the lives of Kenyan girls, enabling them to be
aspirational and play a fuller role in the family and the wider community. It encourages boys to
develop a greater level of respect for the girls. It uses TAG rugby in rural primary schools alongside
classroom sessions to address gender inequality. Boys and girls to play together, developing
teamwork and mutual understanding.| ||**Activities undertaken:**
Projects were run in
•
February 2022
`o`
Borana hosted its 7th Team Talk project. Volunteers from Kenya and Future
Health Africa spent 5 days working with Sangaa school and community delivering

Education sessions

Tag rugby tournament
•
July 2022
`o`
Activities inGundua - Kisima, Ereri - Ol Pejeta, Leparua – Lewa, Enaikashoma &
Ethi – Borana delivering

Education sessions

Tag rugby tournament
This activity was funded courtesy of the ATLAS FOUNDATION to whom we are very grateful.
Team Talk activity will move to become part of this Foundation and ceased to be a FHA workstream
on 31stDecember 2022.| ||**WORKSTREAM 6: MATERNITY**| 7 ## **Lead: Jacq Crow** **Description:** The overarching objective of the 3 midwife members of the Maternity team is to reduce maternal mortality & morbidity through education of healthworkers, traditional birth attendants and mothers in safer childbirth practices. They have delivered training in - Nyahururu (Laikipia County) - Communities around Lewa Conservancy (Laikipia/Meru/Isiolo counties) - • Marsabit County • Pumwani (major maternity centre in Nairobi) • Kenyatta National Hospital (KNH) - The focus of the teaching is management of the most common emergencies in maternity/obstetric care ie haemorrhage, sepsis, pre-eclampsia/eclampsia, complications of labour (eg obstructed labour). **Activities undertaken:** ||**Lead: Jacq Crow**
**Description:**The overarching objective of the 3 midwife members of the Maternity team is to
reduce maternal mortality & morbidity through education of healthworkers, traditional birth
attendants and mothers in safer childbirth practices. They have delivered training in
•
Nyahururu (Laikipia County)
•
Communities around Lewa Conservancy (Laikipia/Meru/Isiolo counties)
•
Marsabit County
•
Pumwani (major maternity centre in Nairobi)
•
Kenyatta National Hospital (KNH)
The focus of the teaching is management of the most common emergencies in maternity/obstetric
care ie haemorrhage, sepsis, pre-eclampsia/eclampsia, complications of labour (eg obstructed
labour).|**Lead: Jacq Crow**
**Description:**The overarching objective of the 3 midwife members of the Maternity team is to
reduce maternal mortality & morbidity through education of healthworkers, traditional birth
attendants and mothers in safer childbirth practices. They have delivered training in
•
Nyahururu (Laikipia County)
•
Communities around Lewa Conservancy (Laikipia/Meru/Isiolo counties)
•
Marsabit County
•
Pumwani (major maternity centre in Nairobi)
•
Kenyatta National Hospital (KNH)
The focus of the teaching is management of the most common emergencies in maternity/obstetric
care ie haemorrhage, sepsis, pre-eclampsia/eclampsia, complications of labour (eg obstructed
labour).| |---|---|---| |||**Activities undertaken:**
A scoping exercise was undertaken in St Joseph’s Hospital, Nyabondo. Ongoing work is taking place
to understand if FHA can meet any of their needs.
No other activity took place.| |||**WORKSTREAM 7: EMERGENCY MEDICINE**
**Description:**The purpose of the Emergency Medicine (EM) stream is to improve patient outcomes
in Emergency Departments (EDs).| |||**Activities undertaken:**
Most of this work was taking place as part of the South West UK EM training programme. This
workstream has now moved to a charity with a specific focus on Emergency Medicine.| |||**WORKSTREAM 8: BURSARIES**
**Description:**
When our charity resources allow, we support courses and study visits for
LMIC individuals. These maytakeplace in either Kenya or the UK.| |||**Activities undertaken:**
None.| |||**WORKSTREAM 9 (emergent): STORYTELLING/THEATRE ARTS**
**Description:**A new project is under consideration/development to use storytelling and theatre arts
to improve health & wellbeing in adolescents.| |||**Activities undertaken:**
No activity took place.
It was decided by the workstream lead that this work would not progress and it ceased to become
part of FHA’sportfolio on 31stDecember 2022.| |Public Benefit||We confirm that trustees have regard to the guidance issued by the Charity Commission on public
benefit and have consideredhttps://www.gov.uk/government/publications/public-benefit-the-
public-benefit-requirement-pb1 .Theyconclude that FHA metpublic benefit requirements in 2022.| |**Additional information**|| |---|---| |Policy on grant making|FHA has not to date awarded any grants. Bursaries are decided upon using
the charity’s agreedpolicy‘Bursaries’.| |Policy on social investment including
program related investment|The charity has not utilised social investment finance.| 8 |Contribution made by volunteers|All of the activities of the charity, apart from book-keeping, accountancy,
web support and some administrative tasks are done on a voluntary_pro bono_
basis.
Many project leads’ visits to Kenya are self-funded.
All Trauma Team volunteers and some other volunteers raise money
themselves to be able to take part.
Trustees contribute their time voluntarily.| |---|---| |**Achievements and Performance**|**Achievements and Performance**| |---|---| |Summary of the main achievements of
the charity, identifying the difference the
charity’s work has made to the
circumstances of its beneficiaries and
wider benefits to society as a whole.|The charity was able to take positive steps to re-establish its work following
the restrictions of the COVID-19 pandemic.
**Achievements:**The charity’s achievements in brief were:
Trauma Team: New partnerships were fostered - worked with St Joseph’s
Nyabondo to establish a project in late 2023. Planning for Nanyuki Jan/Feb
2023.
GRASPIT: A successful scoping visit took place in November/December
building relationships with Kenyatta National Hospital and Kisii Hospital /
University. Training for healthworkers will result.
q4a: successfully completed FCDO grant delivery and opened discussions
with Kisii/Nyabondo re potential work. Developed on-line training materials
now hosted on the University of Plymouth website. These will enable
remote teaching of QI & Leadership skills.
Community: FCDO grant has enabled improvements in peri-natal care in
Migori and Laikipia counties.
TeamTalk: 2 successful projects – moved outside FHA to be a project under
its major funder, the Atlas Foundation.
Maternity: scoping work in SW Kenya.
Emergency Medicine: moved out of FHA.
Bursary: No funds allocated.
**Public benefit:**
All projects have complied with the requirement for public benefit.
The TRAUMA clinical projects have sought to alleviate pain, disability and
suffering through direct patient care. Treatment has been open to any
member of the public in Kenya and is particularly directed at those who
cannot otherwise access care because of geography or poverty.
GRASPIT and q4a taught healthworkers the skills they need to enhance care
of the public who they serve.
Community projects enhance medical services available to communities and
individuals.| 9 TeamTalk is directed at improving the life-chances of young rural children and is available to all. Maternity and Emergency Medicine projects improve education in these specialties for the benefit of any patient receiving services from those trained. The charity trustees believe that the projects deliver the requirement for public benefit and volunteers also gained personal and professional development that they will apply for further public benefit in their individual environments in both the UK and Kenya. FHA Trustees are pleased to consolidate its workstreams and projects around well-being and healthcare. From end 2022, FHA workstreams will be 1. Trauma Team 2. GRASPIT 3. QI & Leadership training (SPRINGBOARD) 4. Community a. QI b. Maternity 5. Bursaries will be supported when funds allow. |**Additional information**|| |---|---| |Achievements against objectives set|All major objectives from the agreed FHA ActivityPlan for 2022 were met.| |Performance of fundraising activities
against objectives set|All necessary funds were raised from volunteer contributions, donations and
grants.| |Investment performance against
objectives|The charity has no investments.| |Other|**Trustees:**
Judy Ravenscroft and Isabelle Risso-Gill resigned due to work pressures.
Carrie Piper was appointed with expertise in finance.
Dr Caroline Dimond was appointed (start 2023) with expertise in Public
Health.
**Volunteers:**
FHA continued to be led and run by volunteers.
Paid work was for bookkeeping, accounting, web support and insurance
purposes only.| |**Financial Review**|| |---|---| |Review of the charity’s financial position
at the end of the period|At the end of the financial year on 31.12.2022, the charity had assets of
**£55,126**, £35,466 of which was restricted. Funds are held to cover future
activity, including planned trips to Kenya.
The charity reserves £10,000 as contingency in any one year to cover any
unanticipated events or incidents.| |Statement explaining the policy for
holding reserves stating why they are
held|Trustees allocate a reserve figure when agreeing the activity plan for the
forthcoming year. It is based on the nature of the projects planned for that
year and is to cover anyunexpected events.| 10 |Amount of reserves held|As at 31.12.2022, the charity held free reserves of £19,660. Although this
was in excess of the stated policy, plans are in place to upgrade processes in
2023,includingemployment of administrative/management assistance.| |---|---| |Reasons for holdingzero reserves|n/a| |Details of fund materiallyin deficit|n/a| |Explanation of any uncertainties about
the charitycontinuingas agoingconcern|n/a| |**Additional information**|| |---|---| |The charity’s principal sources of funds
(including any fundraising)|•
volunteer contributions
•
donations
•
grants
•
fundraising events
•
significant project leads’ personal contributions
•
major contribution fromproject leads,trustees and volunteers ‘in kind’| |Investment policy & objectives including
anysocial investmentpolicyadopted|The charity has no investments.| |A description of the principal risks facing
the charity|The charity has developed a risk register.
Principal risks identified
•
safeguarding
•
travel associated risks
•
local societal conflict
•
sickness of volunteers
•
non-engagement of participants in LMIC
•
healthworker strikes in LMIC
•
availability of project leads
•
misuse of finances for projects (though minimal amounts are delegated
so risk is verylow)| |Research|Abstract submitted to ISQuA Feb 2022
QUALITY IMPROVEMENT AND LEADERSHIP SKILLS FOR THE IMPROVEMENT
OF PATIENT CARE IN KENYA
Xavier Frisch*,TimothyPanga,Kerri Jones,David Barkwill| |**Structure, Governance and Management**|**Structure, Governance and Management**| |---|---| |Description of charity’s trusts:|None| |Type ofgoverningdocument|CIO Constitutionpluspolicies listed below| |How is the charityconstituted?|CIO| |Trustee selection methods|There is an agreed Trustee Management Policy which includes the appointment
process| 11 |**Additional information**|| |---|---| |Policies and procedures
adopted for the induction and
training of trustees|1.
Bursaries
2.
Code of Conduct & Human Rights
3.
Complaints & Whistleblowing
4.
Conflict of Interest
5.
Financial management including Procurement and Gifts & Hospitality
6.
Anti-fraud, bribery, corruption & money-laundering
7.
Grant Management
8.
Human Resources
9.
Needlestick (Sharps) Injury
10. Risk Management (and RAID - risk register)
11. Safeguarding
12. Trustee management
13. Volunteer management
14. Monitoring,Evaluation & Learning| |Organisational structure|**See attached organogram**| |Relationship with any related
parties|**Partnerships/Associations:**FHA believes in working with and through local
organisations and in building relationships with academics in both countries. These
relationships continue to help us to maintain alignment with Kenyan needs, strategy
& policy and therefore maximise our efforts.
Society for Quality Healthcare Kenya (SQHK)
National Resuscitation Council for Kenya (NRCK)
LVCT Health (Kenya)
Kenya Orthopaedic Association (KOA)
St Joseph’s Mission Hospital (Nyabondo, Kisumu County, Kenya)
Laikipia Health Services
University of Nairobi (Kenya)
University of Plymouth (UK) through its Global Health Collaborative
Tropical Health & Education Trust (THET)
South West International Development Network (SWIDN)
Kenya-UK Health Alliance:
The charity became a member of the Kenya -UK Health Alliance (KUKHA). Kerri Jones
gave presentations at its inaugural summit meetings in Kenya (June 2022) and in the
UK(July2022). She is now a member of the KUKHA SteeringCommittee| |**Reference and Administrative details**|**Reference and Administrative details**| |---|---| |Charityname|Future Health Africa| |Other name the charity uses|n/a but its predecessor charity was the unincorporated Exploring Global Health
Opportunities(now closed)| |Registered charitynumber|1182182| |Charity’s principal address|15 Platway Lane
Shaldon
Teignmouth
Devon
TQ14 0AR| 12 |**Names of the trustees who manage the charity**|**Names of the trustees who manage the charity**|**Names of the trustees who manage the charity**|**Names of the trustees who manage the charity**|**Names of the trustees who manage the charity**| |---|---|---|---|---| ||**Trustee name**|**Office (if any)**|**Dates acted if not**
**for whole year**|**Name of person (or body) entitled to**
**appoint trustee (if any)**| |1|Kerri Jones|Chair||Board of Trustees| |2|Nicholas Roberts|Vice-Chair||| |3|Michael Wake|||| |4|Judy Ravenscroft||01.01.22 – 05.11.22|| |5|Lydia Okutoyi|||| |6|Isabelle Risso-Gill||01.01.22 – 30.06.22|| |7|Carrie Piper||05.04.22 – 31.12.22|| |8|Caroline Dimond||Appointed 01.03 23|| |**Corporate trustees – names of the directors at the date the report was approved**|**Corporate trustees – names of the directors at the date the report was approved**| |---|---| |**Director name**|**n/a**| ||| |**Name of trustees holding**|**title toproperty belonging to the charity**| |**Trustee name**|**n/a**| ## **Funds held as custodian trustees on behalf of others** |**Funds held as custodian trustees on behalf of others**|**Funds held as custodian trustees on behalf of others**| |---|---| |Description of the assets held in this capacity|Nil| |Name and objects of the charityon whose behalf the assets are held|Nil| |Arrangements for safe custody & segregation of such assets from the charity’s
own assets|Nil| ## **Names and addresses of advisers** |**Names and addresses of advisers**|**Names and addresses of advisers**|**Names and addresses of advisers**| |---|---|---| |**Type of adviser**|**Name**|**Address**| |**Bookkeeping**|Anita Harper|Devon Square Charity Accounting Ltd
14 Torquay Road
Newton Abbot
Devon TQ12 1AJ| |**Independent**
**Examiner**|Barrett’s Accountants|22 Union St
Newton Abbot
Devon
TQ12 2JS| |**In-country**
**(Kenya)**|Dr Samuel Ndanya
Dr Tim Panga
Dr Mary Nduta|c/o Nanyuki Hospital, Laikipia County, Kenya| 13 ## **Exemptions from disclosure** n/a ## **Declarations** ## **The trustees declare that they have approved the trustees’ report above.** **Signed on behalf of the charity’s trustees** |**on behalf of**|**the charity’s trustees**|| |---|---|---| |**Signature(s)**
**Full name(s)**
**Position**
**Date**||| ||Dr Kerri Jones|Dr Nick Roberts| ||Chair of Trustees|Vice Chair of Trustees| ||17thApril 2023|| ||17thApril 2023|| 14 ## **Organisational Structure (Organogram) & Advisers** **Up to 31.12.2022** 15 From 01.01.2023 Future Health Africa lfvomOI.01.231 Kerrt JoThes lthalrlNlckRobertsNCI MIP*Wike L￿1{ 0￿10￿ C4wrleP*r TrLtstees *knyErn5EttltudifiguproiErtmU5tdcclureGnrnEerat ond5fepo5idefforEknt￿Cffl£￿t01thE￿￿VSteE￿Work overn3nce Inance Programrne ¢JperatlOn5 Project leids** Trauma Tearn GRASP Mateml Bursar￿¥ Volunteers from UK and LMICS *** Kenyan Advisory Team to Future Health Africa Name Role in Kenya Consu￿3￿1 Surgeon Nanyuki Role for Future Health Afri(a DrS3muel Ndanya Trauma Tedn) Ken￿ft Lead, Future Health Africa advisor DrTimothy Pèn8 Dr Lydia Okutoyi Dr Mary Nduta A8 Chlef Olflcer of Heèlth. LalkSplè CDuntyGDvernment Kenyatta National Hospitsl Medical Doctor, St p&ers Hospitsl, Kikuyu, Nairobi SPRINGBOARDlo4a Kenyan Lead Pre51d2nt SQHK Trauma TÈÈM Ke￿￿￿ Lead, F￿￿re Health Afrlta advisor GRASPIT Edutstion Lead Christine Musee GRASP￿ M&E lead. SPRING8OARDfaculty Drvlnce￿t Muiiso Oept ol Orrhopaedics, Universlty of Nairobi 16 JVDEPENDEYfEXAMJNER' FUTURE HEALTH AFRICA REPORTTO 171E IRUSTEES OF Independent eA8mlllees re￿rt to Ihe tn*tee5 of Fuhtre Health Afri0• I r¢yirt to the charity truste¢s ott my exwnination of the a(%ounts of Future Health Afri￿ (the Tnjst) for the year ended 31 Dec¢m]Kr2tr22. R￿pOnsibIlI¢l¢S 8nd b￿9 of Yo￿rt As the ch&tity trU8teea of the you Irv rwible for ik of the ￿0￿nts in ￿e0rdance with the quirements of the Ch￿1t1t￿ Act 2011 Cthe ACVI. I r¢tvrt in ￿pect of my examination of the Trth WXXXJDts carrid out ￿￿er 145 of the and in Carrying out my exami[￿l0￿ I have followed all appli¢Jbk DireL%•)n8 given by thc Charity Commiuion Stclititt 145(5)(b) of the ACL l￿dept￿￿e￿ examlner's yt*tttDtnt I haye Co￿p]eted my &Kamination. I that rtiaterial rngttEts hav¢ wn¢ to my attention in rtN]thwt￿￿ with the ¢xamination ￿ving￿t Cause ts) IKliev¢ that in anyJDthia] respe¢tr aca)w)ting tt£onts Th)t kept in rwtofthe Tnwt aswutird by 130 ofthe Ac¢ or the ￿COUnts do wtac¢onl wilh th0￿ [￿rth.. OT the acu)unts (k> not comply with the appIl￿b]e r4uiretnutts c<)nLEmiDg the forn and o)nt¢nt of accounts set out in the Charities {A￿Ullts athl Reports) Regulations 2008 other any ffquiranent that the ￿)Unts giv¢ a trueat¥J fatr virwwbith 15 ￿>￿Id￿l ￿*￿tof an i￿￿￿teX9MIllatio I have no wncerns hav¢ wm¢ 8cr¢)ss other mattets cO]]neCtK￿ With the examination to which attention shollld be dr4v¢ll in this rep￿ in othto Enable aprnper ￿￿k[s￿ng of the w)unts to IK r￿Ghed. laUBa￿Ett Chartwd T&K Advisers 22 Union Street Newton AEknt TQ12 US 18 April 2023 PJg¢ 17 FUTURE HEALTH AFRICA ## STATEMENT OF FINANCIAL ACTIVITIES for the Year Ended 31 December 2022 |Unrestricted
Restricted
fund
funds
Notes
£
£
**INCOME AND ENDOWMENTS FROM**
Donations and legacies
**194**
**42,671**
**EXPENDITURE ON**
**Charitable activities**
Chartitable expenditure
**1,313**
**52,670**
**NET INCOME/(EXPENDITURE)**
**(1,119)**
**(9,999)**
**Transfers between funds**
8
**2,575**
**(2,575)**
**Net movement in funds**
**1,456**
**(12,574)**
**RECONCILIATION OF FUNDS**
Total funds brought forward
**18,204**
**48,040**
**TOTAL FUNDS CARRIED FORWARD**
**19,660**
**35,466**|**2022**
**Total**
**funds**
**£**
**42,865**
**53,983**
**(11,118)**
**-**
**(11,118)**
**66,244**
**55,126**|2021
Total
funds
£
25,103| |---|---|---| |||| |||41,833| |||(16,730)| |||-| |||(16,730)| |||82,974| |||| |||66,244| The notes form part of these financial statements Page 18 FUTURE HEALTH AFRICA ## BALANCE SHEET ## 31 December 2022 |Unrestricted
Restricted
fund
funds
Notes
£
£
**CURRENT ASSETS**
Debtors
5
**3,636**
**-**
Cash at bank and in hand
**22,009**
**35,466**
**25,645**
**35,466**
**CREDITORS**
Amounts falling due within one year
6
**(5,985)**
**-**
**NET CURRENT ASSETS**
**19,660**
**35,466**
**TOTAL ASSETS LESS CURRENT**
**LIABILITIES**
**19,660**
**35,466**
**NET ASSETS**
**19,660**
**35,466**
**FUNDS**
8
Unrestricted funds
Restricted funds
**TOTAL FUNDS**|**2022**
**Total**
**funds**
**£**
**3,636**
**57,475**
**61,111**
**(5,985)**
**55,126**
**55,126**
**55,126**
**19,660**
**35,466**
**55,126**|2021
Total
funds
£
3,170
85,878| |---|---|---| |||89,048| |||(22,804)
66,244
66,244| |||66,244| |||18,204
48,040
66,244| The financial statements were approved by the Board of Trustees and authorised for issue on 17 April 2023 and were signed on its behalf by: K Jones - Trustee The notes form part of these financial statements Page 19 FUTURE HEALTH AFRICA NOTES TO THE FINANCIAL STATEMENTS for the Year Ended 31 December 2022 ## **1. ACCOUNTING POLICIES** ## **Basis of preparing the financial statements** The financial statements of the charity, which is a public benefit entity under FRS 102, have been prepared in accordance with the Charities SORP (FRS 102) 'Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2019)', Financial Reporting Standard 102 'The Financial Reporting Standard applicable in the UK and Republic of Ireland' and the Charities Act 2011. The financial statements have been prepared under the historical cost convention. ## **Income** All income is recognised in the Statement of Financial Activities once the charity has entitlement to the funds, it is probable that the income will be received and the amount can be measured reliably. ## **Expenditure** Liabilities are recognised as expenditure as soon as there is a legal or constructive obligation committing the charity to that expenditure, it is probable that a transfer of economic benefits will be required in settlement and the amount of the obligation can be measured reliably. Expenditure is accounted for on an accruals basis and has been classified under headings that aggregate all cost related to the category. Where costs cannot be directly attributed to particular headings they have been allocated to activities on a basis consistent with the use of resources. ## **Taxation** The charity is exempt from tax on its charitable activities. ## **Fund accounting** Unrestricted funds can be used in accordance with the charitable objectives at the discretion of the trustees. Restricted funds can only be used for particular restricted purposes within the objects of the charity. Restrictions arise when specified by the donor or when funds are raised for particular restricted purposes. Further explanation of the nature and purpose of each fund is included in the notes to the financial statements. ## **2. TRUSTEES' REMUNERATION AND BENEFITS** There were no trustees' remuneration or other benefits for the year ended 31 December 2022 nor for the year ended 31 December 2021. ## **Trustees' expenses** There were no trustees' expenses paid for the year ended 31 December 2022 nor for the year ended 31 December 2021. ## **3. COMPARATIVES FOR THE STATEMENT OF FINANCIAL ACTIVITIES** |Unrestricted
Restricted
fund
funds
£
£
**INCOME AND ENDOWMENTS FROM**
Donations and legacies
548
24,555
**EXPENDITURE ON**
**Charitable activities**
Chartitable expenditure
1,098
40,735
**NET INCOME/(EXPENDITURE)**
(550)
(16,180)|Total
funds
£
25,103
41,833
(16,730)| |---|---| continued... Page 20 FUTURE HEALTH AFRICA ## NOTES TO THE FINANCIAL STATEMENTS - continued for the Year Ended 31 December 2022 |**3.**
**COMPARATIVES FOR THE STATEMENT OF FINANCIAL ACTIVITIES - continued**
Unrestricted
Restricted
fund
funds
£
£
**RECONCILIATION OF FUNDS**
Total funds brought forward
18,755
64,219
**TOTAL FUNDS CARRIED FORWARD**
18,205
48,039
**4.**
**INDEPENDENT EXAMINER'S FEE**
The fee for the independent examination is £360.
**5.**
**DEBTORS: AMOUNTS FALLING DUE WITHIN ONE YEAR**
**2022**
**£**
Trade debtors
**600**
Prepayments and accrued income
**1,110**
Prepayments
**1,926**
**3,636**
**6.**
**CREDITORS: AMOUNTS FALLING DUE WITHIN ONE YEAR**
**2022**
**£**
Bank loans and overdrafts (see note 7)
**-**
Trade creditors
**1,043**
Other creditors
**4,942**
**5,985**
**7.**
**LOANS**
An analysis of the maturity of loans is given below:
**2022**
**£**
Amounts falling due within one year on demand:
Bank overdrafts
**-**||Total
funds
£
82,974| |---|---|---| |||66,244| |||| |||2021
£| |||600| |||-
2,570| |||3,170| |||| |||2021
£| |||3,714| ||23
19,067
22,804|| |||| |||| |||2021
£| |||3,714| continued... Page 21 FUTURE HEALTH AFRICA ## NOTES TO THE FINANCIAL STATEMENTS - continued for the Year Ended 31 December 2022 ## **8. MOVEMENT IN FUNDS** |**MOVEMENT IN FUNDS**||||| |---|---|---|---|---| |||Net|Transfers|| |||movement|between|At| |At 1.1.22||in funds|funds|31.12.22| ||£|£|£|£| |**Unrestricted funds**||||| |General fund|**18,204**|**(1,119)**|**2,575**|**19,660**| |**Restricted funds**||||| |Maternity|**448**|**-**|**-**|**448**| |Team Talk|**15,039**|**(15,385)**|**346**|**-**| |Trauma Team|**24,796**|**5,542**|**-**|**30,338**| |F C D O|**(3,714)**|**3,714**|**-**|**-**| |Community|**797**|**(451)**|**(346)**|**-**| |Springboard|**2,364**|**-**|**-**|**2,364**| |Emergency Medicine|**2,575**|**-**|**(2,575)**|**-**| |Graspit|**5,735**|**(3,419)**|**-**|**2,316**| ||**48,040**|**(9,999)**|**(2,575)**|**35,466**| |**TOTAL FUNDS**|**66,244**|**(11,118)**|**-**|**55,126**| |Net movement in funds, included in the above are as follows:||||| |||Incoming|Resources|Movement| |||resources|expended|in funds| |||£|£|£| |**Unrestricted funds**||||| |General fund||**194**|**(1,313)**|**(1,119)**| |**Restricted funds**||||| |Team Talk||**9,660**|**(25,045)**|**(15,385)**| |Trauma Team||**7,729**|**(2,187)**|**5,542**| |F C D O||**20,282**|**(16,568)**|**3,714**| |Community||**-**|**(451)**|**(451)**| |Graspit||**-**|**(3,419)**|**(3,419)**| |St Joseph's||**5,000**|**(5,000)**|**-**| |||**42,671**|**(52,670)**|**(9,999)**| |**TOTAL FUNDS**||**42,865**|**(53,983)**|**(11,118)**| continued... Page 22 FUTURE HEALTH AFRICA NOTES TO THE FINANCIAL STATEMENTS - continued for the Year Ended 31 December 2022 ## **8. MOVEMENT IN FUNDS - continued** ## **Comparatives for movement in funds** |||Net|| |---|---|---|---| |||movement|At| ||At 1.1.21|in funds|31.12.21| ||£|£|£| |**Unrestricted funds**|||| |General fund|18,755|(551)|18,204| |**Restricted funds**|||| |Maternity|3,531|(3,083)|448| |Team Talk|20,070|(5,031)|15,039| |Trauma Team|20,822|3,974|24,796| |F C D O|7,298|(11,012)|(3,714)| |Community|2,324|(1,527)|797| |Springboard|1,839|525|2,364| |Emergency Medicine|2,575|-|2,575| |Graspit|5,760|(25)|5,735| ||64,219|(16,179)|48,040| |**TOTAL FUNDS**|82,974|(16,730)|66,244| |Comparative net movement in funds, included|in the above are as follows:||| ||Incoming|Resources|Movement| |---|---|---|---| ||resources|expended|in funds| ||£|£|£| |**Unrestricted funds**|||| |General fund|548|(1,099)|(551)| |**Restricted funds**|||| |Maternity|-|(3,083)|(3,083)| |Team Talk|81|(5,112)|(5,031)| |Trauma Team|5,696|(1,722)|3,974| |F C D O|18,178|(29,190)|(11,012)| |Community|-|(1,527)|(1,527)| |Springboard|600|(75)|525| |Graspit|-|(25)|(25)| ||24,555|(40,734)|(16,179)| |**TOTAL FUNDS**|25,103|(41,833)|(16,730)| continued... Page 23 FUTURE HEALTH AFRICA NOTES TO THE FINANCIAL STATEMENTS - continued for the Year Ended 31 December 2022 ## **9. RELATED PARTY DISCLOSURES** There were no related party transactions for the year ended 31 December 2022. Page 24 FUTURE HEALTH AFRICA ## DETAILED STATEMENT OF FINANCIAL ACTIVITIES for the Year Ended 31 December 2022 |DETAILED STATEMENT OF FINANCIAL ACTIVITIES
for the Year Ended 31 December 2022||| |---|---|---| ||2022|2021| ||£|£| |**INCOME AND ENDOWMENTS**||| |**Donations and legacies**||| |Donations|**6,483**|6,261| |Gift aid|**-**|64| |Grants|**36,282**|18,178| |Other revenue|**100**|600| ||**42,865**|25,103| |**Total incoming resources**|**42,865**|25,103| |**EXPENDITURE**||| |**Charitable activities**||| |Direct costs|**13,832**|9,030| |Flights & transport|**14,352**|2,240| |Accommodation & subsistence|**5,125**|1,346| |Equipment and supplies|**2,006**|3,066| |Sub-contracted Project Delivery|**10,302**|20,332| |Project health insurance|**2,372**|1,882| |IT software & consumables|**548**|328| |Website|**302**|324| |Subscriptions|**320**|13| |General expenses|**20**|-| |Charitable donations|**2,270**|1,528| ||**51,449**|40,089| |**Support costs**||| |**Finance**||| |Sundries|**-**|1| |Bank charges|**84**|83| ||**84**|84| |**Governance costs**||| |Accountancy and legal fees|**2,450**|1,660| |Total resources expended|**53,983**|41,833| |**Net expenditure**|**(11,118)**|(16,730)| |||| This page does not form part of the statutory financial statements Page 25