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2024-12-31-accounts

Reg No:1182182

REPORT OF THE TRUSTEES AND UNAUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED 31[ST] DECEMBER 2024

FOR FUTURE HEALTH AFRICA (CC REG: 1182182)

Ian Barrett

Chartered Accountant and Chartered Tax Adviser

Newton Abbot

Devon TQ12 2JS

ian@check-book.co.uk

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Reg No:1182182
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CONTENTS

Pages
Report of the Trustees 3-15
Financial Accounts 17
Independent Examiner’s report 18

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Reg No:1182182

Trustees’ Annual Report: 1st January 2024 to 31[st] December 2024 Charity name: Future Health Africa (FHA) Charity type: Charitable Incorporated Organisation (CIO)

Charity registration number: 1182182

Objectives and Activities

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.
Alignments All of our work aligns with the Sustainable Development Goals and in particular goals
1,3,4,5,10,17
Future Health Africais an active member of theKenya-UK Health Alliance (KUKHA),a government
to government agreement made between the two countries in 2021. The purpose of the Alliance is
to improve alignment of the efforts of the many UK health sector actors and health workers (NGOs,
Universities, NHS Institutions, Academia, health-care companies) involved in working towards better
healthcare for Kenyans.
The main
activities
in relation
to public
benefit		 Trustees confirm adherence 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 .They conclude that FHA met public benefit requirements in 2024.
In 2024, the charity had4 workstreamsdirected at achieving our objectives. 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

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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

Silver : learning opportunities/ new skills

Gold : sustaining improvement/ development

Activities undertaken:

The Trauma Team was invited to run 3 Orthopaedic camps in 2024;

These were at the invitation of the Laikipia County Government and the Diocese of Kisumu respectively.

Reports from these projects are summarised below;

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EALTH AFRICA Reg No..1182182 FUTURE HEALTH AFRICA NANYUKI TEACHING & REFERRAL HOSPITAL- 26 Jan to 9 Feb 2024 STJOSEPH'S NYABONDO MISSION HOSPITALANDTrAUMA CENTrE-2 Febto9 Feb2024 Summary of achfjeyements Acrtsss 2 wÈÈks and 2 Sites, our team of 35 UK voluntèèr hèalth wtsrkÈrsjoined Nanyuki Teachln8 & RÈfeffal Htsspltal and Stloseph's Nyabondo Mission Hosplt31 and Trauma cent￿ colleagues to collaboratively revleyé. advise, and treat & trautna patient5, while workin8 tO8etherand learnin8 togethEr to share knowledle and skills to transform IkrfÈS. This was th Trauma Tèam's first Yisit In thè nw partnÈrship wlth Stjosèph's, to hÈlp build and £ratè thè trauma KENYA Our activ1tiesare6xq4o￿￿IS.' Bronie.. Providin8 irnrnedi41e 3nd dire¢1 patient ¢?re fjold.. Trauma Service sustainable improvernenildevelopment Over 1.400 patlentsassttsed across b¢th srt•S 80 patknts underwent complexsur8eryor mlnor prL¥cedures Nurnerous patlents partlclpated In back paln educatlon cl355es delfvered at both skns Slfv•r lolnt 51de by slde worklng between the multl-d55clpllnaryteam5 wlthln outpatTrentdlnlc. ward rounds. phy51otherapv. workingto4eihÈr, learning together. Introductlon to back wln management classes at Sljoseph's and provlslon of patlent Inlorrnatlon rnaterlal to support sÈlf-mana$ÈmÈnt,. chan8in$ deliveryat Nanyuki Teachin8 & Referral Hospital INRTHI tts an upperand lower limb needs. Informal tachln8 On ostèoarthrltls mana8ÈmÈntand gait r-èduCatlon betwèèn Physiothèraplsts atStJosÈph's. Introductlon of bedslde chalrs for post-op patlents at NTRH to Support recovery throuih Increased ￿)ll$￿and ran8e of movernent through patiEnts bein8 able to Sit out more often. Introduditsn of an in-patieht bottk forth phyS￿thèr3pVtéaM at NTRH tts kÈp up tts datÈ with all patlent detalls, including which post-op day they are. and their phy510 need5. to 5UPPQrt workload p14nnin8. Theatre prartice shared b￿tween tearns. including pre and pD5t op theatre team briefingi Use af sharp5, Count paperwork. and'stop Before You Block, In 4D0 Teachin8 se5s1on5 held on upper4nd lower limb local nerve block5 In theJtre Jt NTRH. usin8 the inventlVE Oemonstratinz a55es5rnent and decision-makin8ski115 in the operatin8 theatre. with focu5 Qn tearn dynamic5 to ensure patient 5afety- Increaslng awareness of sood pain manaiement In improvlni outcornes Whole hospital continuin8 medical educatlon 5ession5 delNered at NTRH in Osreomyelitis. Spinal Injurie5 As5essrnent and Managemen¢ and Tlbla Plateau Fractures longstanding bony malformations and standing knee51aDkle5' adaptine servKe provision durin8 power outages. rEBarding best prattic tethniquÈ5, Patient triagE, empathÈiit patient care tÈthnique5, and Effective totnmunltation Gold ContSnued back paln pathway servlce support at NTRH. Developlng lower Ilmb support servlce through physiotherapy at NRTH. da5s•s plann•d.

EALTH AFRICA Reg No..1182182 FUTURE HEALTH AFRICA TrAUMA TEAM: sr JOSEPHS NYABONDO MISSION HOSPITALAM> TRAUMACENTRE- 15th Novto 22nd Nov2024 5ummJry of ifhlewerneTrtsl Acros5 the week. ourteam of 15 UK volunteer heatth workersjoSned St 105eph's Nyabondo Mlssion Hospital and Trauma KENYA new partnershlp with Stjoseph's, to help build and treate the trauma servlce they are pufsuini, with project dÈllvtry.

rtsnzè.. Prtsvidin8 Immèdiatè and dlrrt patint tar

Gold.. Trauma service sustèlnèble Improvementldevelopment ronie 131 pa1ntsAsSss￿ In tsutytlnt tllnlc 23 patknts underwent complex sur8ery 10 pat￿nts seen In cllnlc wf(h a plan to reylew In February 2025 Numerous patlents were gP4en back palnlMSK paln educathin 511ver Jaint side by side working between the multi41￿1p1Inary tearn5 Within tsutPabÈnttlinit, ward rounds, physiDtheraPy. r4diolo8y and theatre- workin8 tO8ether. le¥rnin8 tQ8ether. a Kenyan Orthopaedic sur8eons joined the team a5 well a5 2 Kenyan Theatre nurses frorn Laikipia. Nursin8 and Clinlcal OffltrsiudÈnts 8aind Èxpèrlnt watching opèrations in thÈairÈ. Theatre practlce shared between teams, Includlng pre and post operaiive theatre team brlefln& use of 'sharpscount paper4vork', and'stop Before YOU Blotk. in anaesthesia. ensure patient Safety. In£￿aS1Th1 awareness of 8ood paln mana8emtnt In Improvln8outctsmes, dally paln ward rounds With Pain scorès cornpleted by the team. DÈveltrpin8 procèsss ¥vithln thè radiolo8ydÈpartmÈnt usln8 adaptlvè techrtlouès to achlèv Optlmal ptsst-opÈrntwÈ imaglni. lrttrèasin8 awarÈnèss tsf radiation protèttion tÈchni4ues wlthln thè thÈatr ÈrtvirtshmÈrtt. fjold Continuin{ Medical Education with 5 mornin¥ ses510n5 delivered by UK ¥olunteer5'. Management cf bone infection AnJesihesia for adYan¢ed airway & breathin8 a55es5ment and rnana8ernent Paln management Theatre Infra-strutture development.. The trauma centre has recently been opened by HIS Excellency Hon. Wllllam Samuel Ruto on 3118124. The UK team tollaboratÈd with the Kènyan team th develop safety* efflclÈncy and Quality for patients. Asummary of recommendations was 5ubmti@d to the hospital rnanagem￿nt t@am atthe end of the visit.

Reg No:1182182

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) Dr Matt Halkes holds oversight of standards of delivery, strategy and grant applications. Description : GRASPIT is a one day training course aimed at improving healthcare workers confidence and ability to recognise and manage sick patients (both adults and children). Its key tenets are - recognition of abnormal vital signs - systematic approach to assessment - prompt treatment of identified issues using simple and context-appropriate resources - promotion of teamwork through effective communication The course format is a combination of lectures and scenario based sessions. It is supported by learning materials and website. Faculty development is supported by a Train the Trainers course plus associated Course Organisers Handbook and ToT (Training of Trainers) Manual. The course is accredited by the National Resuscitation Council of Kenya. Through a combination of support from Future Health Africa and THET grants, it has been disseminated to 10 institutions in 6 Counties in Kenya with over 2000 health care workers and 120 trainers trained. 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 independently to more healthworkers. Initial training is conducted by Kenyan trainers with support from the UK faculty. Activities undertaken:

GRASPIT Faculty Development Programme Nairobi County Roadmap for the development of GRASPIT faculty and County wide training programme that would also include expansion of GRASPIT Master Trainer Faculty. This would create capacity to deliver GRASPIT training / faculty development in KNH and meet the TNA needs identified in 2022.

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All the above activities and aspirations align to the strategic objectives of the Kenya UK Health Alliance(KUKHA) which include the potential for GRASPIT to be part of the HEE SCALE programme (critical care / emergency medicine / maternity and neonatal medicine).

We were delighted to support Dr Christine Musee, one of our Kenyan GRASPIT leads to deliver her paper ‘Impact of GRASPIT training in five Kenyan hospitals’ at the 16th ECSACONM* Biennial Scientific Conference, 11-13th September 2024 held in Lesotho with 17 African countries represented.

*ECSACONM is the East, Central and Southern Africa College of Nursing and Midwifery.

WORKSTREAM 3: QUALITY IMPROVEMENT (QI) & LEADERSHIP (q4a)

Lead: Dr Kerri Jones

Description: This workstream recognises that ‘sick systems’ may account for at least 50% of all avoidable deaths worldwide, with the majority occurring in the global south. Our q4a (quality for all) faculty 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:

We were delighted to support Dr Christine Musee, one of our Kenyan SPRINGBOARD leads to deliver her paper ‘ Evaluation of impact of springboard quality improvement and leadership training: a case study of Nyahururu, Nanyuki and Kwale health facilities’ at the 16th ECSACONM* Biennial Scientific Conference, 11-13th September 2024 held in Lesotho with 17 African countries represented. ECSACONM is the East, Central and Southern Africa College of Nursing and Midwifery.

Musee is a tireless advocate for our work and we are extremely grateful to her.

Further development of online QI materials occurred which are available on the University if Plymouth website at https://open.plymouth.ac.uk/course/view.php?id=210 . Discussions are ongoing with the University with regard to incorporating elements within the new online Masters in Global Health due to start in September 2025.

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q4a (through Dr Kerri Jones) continues to work with the Society for Quality Healthcare Kenya (SQHK) in an advisory capacity.

Discussions regarding applications for NIHR grants are ongoing.

WORKSTREAM 4: MATERNITY

Lead: Jacq Crow

Description: The overarching objective of the Maternity work is to reduce maternal mortality & morbidity through education of healthworkers, traditional birth attendants and mothers in safer childbirth practices. Training has now been delivered in the following locations

The teaching focusses on 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 needs assessment undertaken in Nyabondo in 2023 highlighted a stark need for basic neonatal resuscitation training. It concluded that

No single professional in any of the seven clinics or hospitals visited could correctly demonstrate how to hold and position a bag and mask to undertake resuscitation. Many staff lamented the fact that they were never successful in neonatal resuscitation.

A course was designed and in March 2024, despite having been unable to secure additional resources to do this, lead Jacq Crow, who designed the course, delivered four one-day courses in both hospital and community. She was supported throughout by Darren Munn. A mannequin was purchased to support delivery of the course.

While visiting Kilifi, Jacq was invited to deliver training there also, which she did.

In total, 54 clinicians were trained and five Trainers were established to continue and spread the training. Staff who attended came from 15 separate facilities.

At a total cost of £1,267 to our charity, this represented extraordinary value. However, for more sustainable impact, an infrastructure to support ongoing delivery of the courses is required.

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Additional information
Policy on grant making FHA has not to date awarded any grants. Bursaries may be given in
accordance with the charity’s agreedpolicy‘Bursaries’.
Policy on social investment including
program related investment		 The charity has not utilised social investment finance.
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.		 Achievements:The charity’s achievements in brief were:
Trauma Team: Successful projects took place in Nanyuki and
Nyabondo
GRASPIT: GRASPIT was successful in attracting a further grant to
introduce GRASPIT to Kilifi Hospital in 2025.
q4a: On-line training materials are now hosted on the University of
Plymouth website. These will enable remote teaching of QI &
Leadership skills.https://open.plymouth.ac.uk/enrol/index.php?id=210
Maternity: Exceptional value courses in neonatal resuscitation were
conducted in Nyabondo and Kilifi.
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.
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.

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Additional information
Achievements against objectives set All major objectives from the agreed FHA Activity Plan for 2024 were
met.
Performance of fundraising activities
against objectives set		 All necessary funds were raised from volunteer contributions,
donations andgrants.
Investment performance against
objectives		 The charity has no investments.
Other Trustees:
Carrie Piper continues to lead on all finance matters.
Workstream support from Trustees is as follows
Trauma T
Mike Wake
GRASPIT
Caroline Dimond
q4a
Carrie Piper
Maternity
Lydia Okutoyi
Volunteers:
FHA continued to be led and run by volunteers.
Paid work was for bookkeeping, accounting, web support and
insurancepurposes only. The charityhas no employees.
Financial Review
Review of the charity’s financial
position at the end of the period		 At the end of the financial year on 31.12.2024, the charity had assets
of£35,155, £29,117 of which was restricted. Funds are held to cover
future activity, including planned trips to Kenya.
The charity reserves up to £10,000 as contingency in any one year to
cover anyunanticipated 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 thatyear and is to cover anyunexpected events.
Amount of reserves held As at 31.12.2024,the charityheld unrestricted funds of £6,038
Reasons for holdingzero reserves n/a
Details of fund materially in deficit Equipment with a value of approximately £8000 was held in a locked
store room at Torbay Hospital. During the year this was cleared and
disposed of by the Trust’s Estates Department without FHA’s
knowledge and without any consultation. We continue to pursue
recoveryof the value of thisproperty.
Explanation of any uncertainties
about the charity continuing as a
goingconcern		 n/a

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Additional information ~~Re No:1182182~~
The charity’s principal sources of
funds (including any fundraising)		 ~~g~~
•
volunteer contributions
•
donations
•
grants
•
fundraising events
•
significant project leads’ personal contributions
•
major contribution from project leads, trustees and volunteers ‘in
kind’
Investment policy & objectives
including any social investment
policyadopted		 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 very low)
None of these was realised in 2023.
Research,Monitoring& Evaluation Allprojects undertake evaluations of theirprojects.
Structure, Governance and Management Structure, Governance and Management
Description of charity’s trusts: None
Type ofgoverningdocument CIO Constitutionpluspolicies listed below
How is the charity
constituted?		 CIO
Trustee selection methods There is an agreed Trustee Management Policy which includes the appointment
process

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Additional information 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
15. Malaria(Guidelines)
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.
These include:
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 (co-chaired by FHA’s Chair of
Trustees, Dr Kerri Jones)
Tropical Health & Education Trust (THET)
South West International Development Network (SWIDN)
Kenya-UK Health Alliance:
The charity has been a member of the Kenya -UK Health Alliance (KUKHA) since 2022.
Dr Kerri Jones(Chair of Trustees)and Dr Will Jewell(Project Lead)are activelyinvolved.
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 charity Exploring Global
Health Opportunities(now closed)
Registered charitynumber 1182182
Charity’s principal address 15 Platway Lane
Shaldon
Teignmouth
Devon
TQ14 0AR
info@futurehealthafrica.org
www.futurehealthafrica.org

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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 Names of the trustees who manage the charity
Trustee name Office (if any) Dates acted if not
for wholeyear		 Name of person (or body) entitled to
appoint trustee(if any)
1 Kerri Jones Chair Board of Trustees
2 Nicholas Roberts Vice-Chair 01.01.24 - 22.03.24
3 Michael Wake
4 Lydia Okutoyi
5 Carrie Piper
6 Caroline Dimond

Corporate trustees – names of the directors at the date the report was approved

Director name n/a

Name of trustees holding title to property 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 Reuben Evans
Maceva Bookkeeping		 4 Orchard Court
Station Road
Norton Fitzwarren
Taunton TA2 6BF
Independent
Examiner		 Barrett’s Accountants
(CheckBook)		 22 Union St
Newton Abbot
Devon TQ12 2JS
In-country
(Kenya)		 Dr Samuel Ndanya
Dr Tim Panga
Dr MaryNduta		 c/o Nanyuki Hospital, Laikipia County, Kenya

Exemptions from disclosure

n/a

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Declarations

The trustees declare that they have approved the trustees’ report above.

Signed on behalf of the charity’s trustees

Signature(s)
Full name(s)
Position
Date
Dr Kerri Jones Michael Wake
Chair of Trustees Finance Trustee
8thJune 2025
8thJune 2025

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Organisational Structure (Organogram) & Advisers From 01.01.2024

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Financial Accounts 1[st] January 2024 – 31[st] December 2024

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Independent Examiner’s Report to the Trustees of Future Health Africa Charity no. 1182182

I report to the trustees on my examination of the accounts of Future Health Africa(the Charity) for the year ended 31[st] December 2024.

Responsibilities and basis of the report

As the charity trustees of the charity you are responsible for the preparation of the accounts in accordance with the requirements of the Charities Act 2011 (the Act).

I report in respect of my examination of the charity’s accounts carried out under section 145 of the 2011 Act and in carrying out my examination I have followed all the applicable Directions given by the Charity Commission under section 145(5)(b) of the Act.

Independent examiner’s statement

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

  1. Accounting records were not kept in respect of the charity as required by section 130 of the Act; or

  2. The accounts do not accord with those records.

I have no concerns and have come across no other matters in connection with the examination to which attention should be drawn in this report in order to enable a proper understanding of the accounts to be reached.

Ian Barrett FCA FCIE Barretts 22 Union Street Newton Abbot TQ12 2JS

8[th] October 2025

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