## **Sleep Apnoea Trust AGM 15[th] Oct 2022** ## **Annual report from the Chair for the period of 24[th] Oct 2021 to 15[th] of October 2022.** Covid has caused the world to change forever as it affects every aspect of our lives - the NHS is in the forefront of its successful treatment. Covid is, however, so infectious, that the NHS has had to initiate major changes, to eliminate the possibility of cross infection of NHS staff. This involves every diagnostic pathway, from primary care to successful treatment of almost every illness and injury. A major increase in the use of technology to minimise unnecessary patient contact, plus a modernisation programme that is both huge and rapid, is underway. The objective is to make the NHS resilient enough to cope with any foreseeable similar threat in the future. SATA was established on September 29[th] 1993, so every year we very sadly suffer some membership loss of older members, around 10 per year in recent times. However, Covid resulted in 50 more deaths than we previously experienced. Thankfully, the death rate has almost returned to normal. We wish to express our deepest sympathy to the families of members who lost their lives. May they rest in peace. The pioneering efforts of all those who supported SATA from its early days helped us to achieve our first great goal of free CPAP treatment on the NHS and more recently, a new NICE Guideline that will help save many others. ## **Trustee & Committee** The past year has been very difficult for the Committee, with the resignations of Chris Wade in January, and then Graham Hill in June. This meant that we lost our interim Chairman and also the planned long-term Chairman in less than a year. On countless occasions we have identified the need for succession and, just as important, finding volunteers to meet the skill shortages we face, such as fundraising, social media, IT and website. We now add Chairmanship to those skills. We advertised these roles in the August edition of Sleep Matters. Sadly, at this moment, no one with the specific skills required has come forward. There is a real threat to the continuation of the Charity since, if we are not successful, we will have to buy in these services, which means a revolution in the way we are funded. The Trustees have discussed the issue and decided that we should follow the Charity Commission guidance on how a COI should operate to adapt to a more efficient business regime. Our current structure is out of date and cumbersome, with three committees; the Trustees, the Executive (Trustees plus some Committee members) and the Committee. From now on we will have a Trustee Board with the active engagement of Trustees in every aspect of the Charity’s business. So, with immediate effect, the Trustees have decided to offer all current Committee Members a Trustee position and have concentrated all activities with a SATA Trustee Board, with clear roles and responsibilities. ## **New SATA Trustee Board** : |**New SATA Trustee Board**:|| |---|---| |Chairman:|Vacant| |Vice-Chairman:|Rob Holt| |Managing Secretary:|Chris Rogers (Part voluntary/part paid)| |Treasurer:|Rob Holt| |Medical Advisor:|Dr Annabel NIckol| |Travel Officer:|David Graddon| |Sleep Matters Team:|Dr Tim Healing plus David Graddon & Chris Rogers| |Sleep Clinic Liaison Officer:|Louise Mather| |Local Fundraising Officer:|Keith Nadin| |National Fundraiser Officer:|Vacant| |IT Officer:|Vacant| |Social Media/Website Officer:|Vacant| When the new CIO charity started operation on 1[st] July 2021, the previous organisation was actually dissolved in terms of running the charity, but the Association of the paying members still exists. However, the impractical arrangements for establishing officers has been terminated, as it conflicted with the modernisation that is so vital for our future success. We have had no nominations from the AGM for the Committee in the past 10 years. In future, any member, so long as they have the proven skill set required, can apply for the vacant positions and the Trustee Board will consider all applications. ## **Progress report.** Our advocacy is now as high as it can be. SATA has a unique position in terms of influencing those that make decisions about sleep apnoea and its treatment. This applies to the NHS as a whole but also at a local level in Sleep Clinics. The new NICE Guideline was supposed to stimulate another major increase in Sleep Clinic referrals. It also provides for an alternative to those intolerant of CPAP with moderate or mild OSA, the Mandibular Advancement Splint. However, two major factors have muted these effects. The global shortage of CPAP machines is due to the Philips issue. The company is having to replace and or repair millions of machines, so very few new patients are getting a Philips product. The other manufacturers of high-quality machines (ARTP standard) are unable to increase production owing to the global shortage of micro-processors. In addition, DeVilbiss decided to stop production in Dec 2021. The remaining usual NHS suppliers, ResMed and Fisher & Paykal, have been joined by France’s Sefam and Germany’s Lowenstein, but the numbers supplied are still not meeting the demand. Therefore, waiting lists will continue to grow for perhaps the next year and then gradually return to normal. The second is the current fragmentation of dental services and clinical services in the NHS. This is inhibiting the development of the Mandibular Advancement Splints (MAS) treatment for moderate and mild obstructive sleep apnoea for those intolerant to CPAP. Clear treatment pathways are not emerging other than in places like Bristol, as clearly outlined in the August 2022 edition of Sleep Matters. We are working with the OSA Alliance to address this issue. ## **Activity Report** It is important to stress that there is a “below the line” activity where we have been particularly influential in both raising awareness of sleep apnoea and improving the efficiency of the referral and diagnostic process. Health Education England have established a learning hub for clinicians and SATA was invited by the NHS to contribute the section on sleep apnoea. Graham Hill completed that job before he left the committee, and David Graddon is now in charge of editing any changes that might be necessary or updating any information as required. In another area of what is known as Future NHS collaboration, which came out of the NHS “Get It Right First Time” initiative, we have been involved in helping to formulate a new pathway to sleep disorder referral and diagnosis, considering the new technologies that are available and using electronic communication in the virtual world. In addition, we have assisted in PIFU, Patient Initiated Follow Up, to give patients and their carers the flexibility to arrange their follow-up appointments as and when they need them. This means that after an appointment with a specialist, it is often the need to arrange follow-up outpatient appointments for ongoing care. This will tailor a patient's follow-up care to their individual clinical needs, circumstances and preferences. This will bring many efficiencies and significantly reduce unnecessary administration. ## **Outlook** As identified in the Imperial College study on SATA three years ago **,** we needed to make major improvements to our website. This has taken place but we still have one area to address, that being the readability of the website text. As the smart phone is now the predominant tool for viewing websites, we have to adapt the text to make it easier to read on this smaller screen. This is going to be a routine but major job for the new Trustee Board ## **Graham Hill** Our Chairman, Graham Hill, decided to resign as Chairman and also leave the Committee. He will be greatly missed with his years of experience, not only as a SATA Committee member, but also for his external work. During his time on the Committee and as Chair, he attended many conferences and exhibitions on our behalf. His early work on the Committee involved a survey of Primary Care Trusts and he identified that low GP referrals was limiting the of growth of patients being diagnosed and treated. His tenacity in dealing with the Royal College of General Practitioners to try and get them to recognise this issue was outstanding even if it was not as successful as we had hoped. But it has led to other organisations becoming involved and they are also exerting pressure. On the important issue of driving, his liaison with the DVLA was continuous and his guideline for patients on our website is regarded as the best and most accurate guide in the UK. We are most grateful to him for his years of service to SATA and the organisation has lost an excellent ambassador, someone who could stand up in front of any audience and get them to understand what Sleep Apnoea is, how it affects people and what they need to do about it be they a patient, a politician or a civil servant. ## **Conclusion** The Committee as a whole must be congratulated in the way it has coped with the unexpected challenges it has faced this year. As a Trustee Board it will be better equipped to work as an integrated team and harness the creativity and innovation of all its members. Signed, ## _Rob Holt_ Vice Chairman Sleep Apnoea Trust Charity No. 1186235 Sleep Apnoea Trust R&gi$terod Charity No. 1186235 Accounts for the year ended 31 March 2022 Seymour Taylor Limited 57 London Road High Wycombe Buckinghamshire HP1118S INDEPENDENT EXAMINER'S REPORTTOTHE TRUSTEES OF SLEEPAPNOEA TRUST CHARITY NO. 1186235 FOR THE YEAR ENDED 31 MARCH 2022 INDEPENDENT EXAMINER'S REPORT I report lo th¢ charily trustees on my èxamination of the accounts ol the charity for the year ended 31 March 2022 which comprise the Receipts and Payment5 AILounl and the Slatemenl ol Ass&ts and Liabilities RESPONSIBILITIES AND BASIS OF REPORT As the charity's Iruslees you are ￿SponSible for the preparation af the actx)unts in accordance vlith the roquii¢mgnts ol the Charitie5 Act 20111'lhe Ael'l. l ￿port in respect of my examinatlon of the charity's accounts carr*ed out under section 145 ol the Act and in carrying out my examination I have followed all the applicable C)irections given by the Charity commission under section 14515llbl of the ACL INDEPENDENT EXAMINER'S STATEMENT I have completed rny examination. l eonlim that no materkil matlers have come lo my attention in conneetlon Mrith the examinat￿n giving me cause to beliave th* in any material respect.. 1. accounling records were not kepl in rèspect of the ¢harily as ￿qUired by sodion 130 01 theAct' or 2. the accwnls do not accord wth those records I have no concerns and have come across no other matters in connedion with the exafflinabon lo which attention should bo drawn in this repurt I￿ Drder lo ellable a proper understanding of the accounts lo be reached. /• Tim Fulker BSclEo)nl FCA Seymour Taylor Limited 57 Londori Road High Wycombe Buckinghamshire HP111BS 12 Octobor2022 CHARITY COMMISSION FOR ENGLIND ANO WAtES Sluop Apn&￿T￿$t 1186235 Recelpts and payments accounts CC16a For perlod from 01.04.2Q21 31.03.2022 Section A Receipts and payments ilnrestritto runds R￿trIcted I￿nd Endownwnl lund8 Total funds Last year neartsi£ nvare&t tothj n￿r•S1£ Al Ra¢el I Metnkr8hi -unrestrlc Ba S- Unw¥lriGled Public Awerengss- unteslrictgd GirtAld unre5Vlcled Inrttsmrt-iinreslriated E>onallon- unr¢%lrfcled Funs18 Public aw$rfjness Travel and subslslencg Bank fee8 940 674 16,430 2,903 510 513 17 1,204 940 fjY4 2.903 510 513 171 1,204 Accowtanc feqs Sub talBI A4 Asset And Investment urLhaso9, S•0 18blo Sub tolal Tolalpaymènls 28.D94 Nel of reQ￿pt81{payMonrs) AS Transfers b8tW8f*n fund8 Transfer of funds from prevlous unlMcorpor&tad tharlty Ae Cash funds last year end 26.522 Cash funds Ihls yaar end CCXXR3 {SSI 0411Q12Q2 Section B Statenieiit of assets and liabilities at the eiid of tlie period Unre$trl¢ted f￿ndS Re$lrf¢tgd funds EndoMThént fund torLouuI£ ¢ategorlos 81 Ca5hlunds Natwest CunEnlAEcountl11 WalWe5t CutrentAccount NalWfAt RegcwoAwA)LrtI11 COIFDwhAc())unt 13J01 1S3 1,128 Totaloashlunits 18,017 Unre8trJ¢tsd funds R88ltkted End0Y￿￿￿t ton•aMBt£ B2 O¢h0rmonetarya5sots Dptails B3 Invostm&ntH¥59ts CwBntwau B4A¥s&ts retalned fortho chaTIty's u8• Fur￿¢0*111[b Aniountdu• DFtsII B5 Ltabllltlès Bnedbyone orlwolNst•e$on tr¢h*fot?IllhfjlN*w5 gnaiu PMtN¥me Dateof A- Holk