## **Health Care 4 All International** ## **- Trustees Annual Report for Period 2022 2023** The Chairman and Board of Trustees of Health Care 4 All International present their annual report and audited accounts for the period 2021-2022, and confirm they comply with the requirements of the Charities Act 2011, the trust deed and the Charities SORP (FRS 102). - This report was agreed and accepted at the HC4AI AGM on Thursday 26 October 2023. ## **Aims:** ## **The aims of Health Care 4 All remain the same as before** _**AIM; Providing Good Quality, Easily Accessible and Cost-Effective Primary Health Care to Rural and Remote Communities using Hybrid system of Conventional and Telemedicine.**_ We aim to provide good quality, cost effective and easily accessible healthcare to the rural and remote communities who either have none or have very difficult access to healthcare. The aim is achieved by using a combination of conventional medical practice through a well-equipped **Community Health & Tele-Medicine Centre** and a modified and unique Telemedicine system we developed and call it the **Novel Hybrid System of Telemedicine (NHST).** Formed in 2014 Health Care 4 All International (HC4AI) is a ‘not for profit’ charity organization registered with the charity commission UK and interior ministry and PCP in Pakistan as well as with the Kashmir Council and Societies. It is a small organization that has no corporate backing and is funded solely by personal funding and individual supporters. Our services, including consultation, treatment, medicines, and transport are all completely free to all deserving patients in the rural and remote communities we serve. **HC4AI was registered as a charity on 8[th] September 2014 (REGISTERED CHARITY NO. UK 1158474). On 31[st] January 2020 the status of the charity was changed to Charity Incorporated Organization (CIO) with the registered charity number 1187677** **For Background of the organization and Services offered see previous reports or visit our website: www.healthcare4all.org.uk** ## _**- Our Achievements and Experience during 2022 2023**_ ## **HC4AI Activities are elucidated under the following headings:** - Services through our Community Health and Telemedicine Centre (CHTMC) - Health Awareness and Disease Prevention Programme - Academic Activities - Management, Administration - Governance and - Audit - ## **CHTMC:** This Centre is located on the main road connecting Mirpur to Dudial and Kotli and hence provides access to many populations scattered in several villages and small isolated and remote dwellings. It functions as a central nidus for all our activities. Through this centre we continue to provide services which are updated and improved year upon year. Following is brief report about our services during 2022-2023: - **Primary Health Care** through outpatient clinics and services. As always these are open 24/7, 365days of the year and are operated by our qualified Doctors (One female with Obs. & Gyn. Qualifications and two male Resident Medical Officers) and eight Community Medical Assistants. It is walk in service open for all. - **Specialist Care:** We have engaged several specialists from nearby city hospitals who visit the CHTMC on a weekly basis to do clinics. Currently the Centre is visited by a Physician, paediatrician, General Surgeon, and a Rheumatologist. - **Emergency Services** : We continue to provide both medical and surgical emergency care with appropriate treatment options, including transfer to nearest secondary care facility if required. As other services this continues to show increasing use, mainly because of our proximity to a busy main road, hilly terrain of our catchment area and no quick access to any other medical centre with 24hour emergency service. - **Telemedicine** : From our inception we introduced our own designed Novel Hybrid System this continues to provide service in patients homes coordinated through the CHTMC. The use of the service remains stable for acute illnesses and longterm home care. - **Laboratory Services** : Our well-equipped laboratory at the Centre, continues to provide most of the essential biochemistry and haematology investigations, with increasing number of requests including outside referrals. - **Pharmacy:** The inventory of this licensed pharmacy has further expanded and continues to remain open all hours. - **Day Care and Observation Ward:** Four beds with patient monitoring and resuscitation facilities, now equipped with continuous patient monitoring. These are used for short term observation and treatment and for patients waiting for transfer. - **Minor Operation and Procedure room:** This service is increasingly used. We have now improved operating lights and new instrument sterilizing and cleaning facility. - **Antenatal, maternal, and childcare:** This continues to be a major part of our activity. We continue to register pregnant ladies on our Electronic Medical Records (EMR). As in the previous years they are followed up regularly throughout their pregnancy with necessary lab tests and Ultrasound scans. Information and assistance after delivery for both mother and baby are provided. All antenatal records are maintained on EMR with internationally accepted antenatal cards. If a complication is anticipated in delivery during the antenatal check the patient is, then referred to our designated secondary care hospitals for follow-up and delivery. For details of patient record of 2022-2023 see table 1 appended at the end ## **Health Awareness and Disease Prevention:** ‘Prevention is better than cure’ remains our guiding principle. Because of COVID-19 restrictions these activities were significantly curtailed until the beginning of 2022 when we resumed. This year has seen the Community Coordination Committee (local representatives from villages- see below and previous reports for details) taking very active part in organizing the **Community and Women Health Awareness** seminars/meetings. Our female lead CMA had to leave because of family reasons and the male lead CMA went off for health reasons which has severely hampered this programme. ## **Academic Activities** : Continues as in previous years. To keep our staff updated in current clinical practice we have weekly educational meetings which is obligatory for all clinical staff. These meetings include Topical presentations and discussion, journal club, case presentations and updates on emergency care and resuscitation. All CMA’s keep a log of CME (Continuing Medical Education) credits that is used for their annual appraisals. This has continued as in previous years, however this year we introduced a new regular feature of on-line video conferences from UK. A UK doctor from Leeds Dr Haseeb Basit Khan is the lead and coordinator. Not only our staff but medical and clinical staff from other district hospitals are invited to join into these seminars on-line. It has been a great success. ## **Management, Administration:** There has not been any significant change in the management and administration structure and personnel since its revamp three years ago and introduction of Hospital Management System with Electronic Health Records. **Community Coordination Committee (CCC):** The CCC was restructured at the end of 2021 and continues in 2022-23 with the inclusion of several new members (all volunteers) representing increasing number of villages. This committee has been increasingly active with main agenda of promoting HC4AI services in their villages, registering of people on HC4AI database, identifying and recommending deserving households as eligible for free treatment with issuance of HC4AI free treatment family cards, arranging Health Awareness seminars in their villages and meeting up with the management on monthly basis to discuss local issues and requirements. **Governance:** The Governance structure in 2022-23 has remained the same as in 2021-22 HC4AI UK Board of Trustees remains the overall guardian of the charity and provides strategic directions to the HC4AI AJK Board and management which continues as the operational arm of the organization. Dr A Q Akhter (SVP of AJK Board and ex-DG Health) continues as the Medical Director (MD), an honorary post. He continues to oversee all the operational matters and reports to the HC4AI Chair and BoT AJK. The three new directorates which were created to manage the operations remain in place and are functioning smoothly 1. Management including accounts; headed by the project manager (PM) 2. Clinical; headed by Clinical Director (CD) the senior clinician 3. Community: Coordination Committee (CCC) comprised of community representatives Roles and duties and of each are described in our governing documents. ## **Audit:** All patients, services, assets, and financial data is recorded on our electronic database **:** Details of financial audit for AJK appended separately as attachment - Data of all patient activities and services provided are recorded and audited monthly by the chairman. And HC4AI management - Data of all staff activity is recorded and checked monthly by the chairman and HC4AI management - Comprehensive details of all services, donations (income) and expenses are audited monthly by the chairman and by our volunteer accountant in UK (Ms Lynne Roberts). - Audit of the pharmacy, stores and the inventory are undertaken six monthly and randomly checked by a qualified accounting firm in Mirpur AJK funded by our supporter Mr Rafay Saleem. - Yearly financial audit in AJK is carried out by our appointed accounting firm in Mirpur who are on our payroll and in UK voluntarily by own Treasurer & Trustee, Mr Arif Khan (Arif Khan & Sons LTD). Both the accounts are then verified by registered auditors. - All financial accounts are submitted yearly to the Charity Commission UK. ## **Board of Trustees UK** At the last BoT meeting two new trustees were appointed and one trustee has retired: - 1 **Chair:** Mr. Syed Tariq Kazim Shah: MBBS. MRCS. LRCP. MMEd. FRCS. Consultant Urological Surgeon, The Yorkshire Clinic, Bingley Road, Bradford BD16 1TW. West Yorkshire UK - 2 **Vice Chair:** Dr (Mrs) Tasneem A Tariq. FRCOG Rtd. Consultant Obstetrician Gynecologist. - 3 **Secretary:** Dr Akram Khan. MBBS. MRCGP. GP (Rtd.) Ex-Clinical Chair Bradford City Clinical Commissioning Group. Principal, Avicenna Med Practice Bluebell Building, Barkerend Health Clinic, Barkerend Road Bradford BD3 9QH UK - 4 **Trustee:** Mr. Dilshad Khan. CQSW. MBA. MIHSM. JP Ex-Director Equality & Diversity Bradford Teaching Hospital Trust. - 5 **Trustee:** Mr Mohammad Ajeeb. CBE Ex Chairman City Primary Care Trust Bradford. Ex Lord Mayor Bradford - 6 **Trustee:** Mr. Asif Saleem Managing Director Nafees Bakers Ltd Bradford. - 7 **Trustee & Treasurer:** Mr Arif Khan: Member AAT & AAIA Accountancy. BPP University law School Leeds Director Arif Khan accountants - 8 **Trustee:** Mr. Younis Choudhry. Local businessman and MD Regal Food Industries Bradford - 9 **Trustee:** Mr. Luqman Rashid. Professional Financial Advisor at Hillcrest Wealth Management partner practice of St. James’s Place Wealth Management. - 10 **Trustee & Secretary of the Board:** Ms Kosar Hussain. Secretary of the Board. Solicitor - 11 **Trustee:** Mohammad Haroon. Philanthropist, writer, and retired trustee of Uspar Trust ## **Thank You** HC4AI is extremely grateful to the large number of our supporters, well-wishers, and benefactors. We have no doubt that without their help this project would never have the success it has achieved. I am specially obligated to the several individuals for their support and guidance, their contributions with names are detailed in previous reports. Several individuals wish to remain anonymous we respect their wishes: ## **Special Thank You** As previous a huge thank you to all the members of the **HC4AI Board of Trustees UK (Strategic Board) and HC4AI Board of Trustees AJK (Operational Board)** for their time and complete support in guiding the policies and operations of the project. Thanks go to Mr Rafay Saleem and Mr Steve Davidson for invaluable support and help And Dr A Quddus for providing the medical lead as Clinical Director of the project To Ms Lynne Roberts for reviewing monthly account and activity sheet from our project To Arif Khan for preparing our yearly accounts and audit Members of Community Coordination committee for providing the essential missing link with the charity and the beneficiary community My final thank you goes to my wife **Dr** ( **Mrs) Tasneem Aslam Tariq** for her patience, unconditional and relentless support and guidance and for her endurance during the difficult times of the project. She remains a member of the BoT UK **Dr. Tariq Shah Chairman For Board of Trustees Health Care 4 All International** ## **Table 1. Patient record July 2022-June 2023** |||||||**Patient Record for the Year June 2022-July 2023**|**Patient Record for the Year June 2022-July 2023**|**Patient Record for the Year June 2022-July 2023**|**Patient Record for the Year June 2022-July 2023**|**Patient Record for the Year June 2022-July 2023**|**Patient Record for the Year June 2022-July 2023**|**Patient Record for the Year June 2022-July 2023**|**Patient Record for the Year June 2022-July 2023**|||| |---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---| |||||||||||||||||| |**Year**|**Total Pts**||**Male Pts**||||**Female Pts**|**Under age**
**16**||**OPD**|**Out-**
**Reach**|**Free**
**Pts.**||**Subsidized**||**Donor**
**Pts.**| |**2022-**
**2023**|13322||5580||||7742|3502||11464|657|5371||2519||5021| ||||||||||**Antenatal**|||||||| |**2022-**
**2023**|||||||**Ladies Registered for antenatal care = 138**|||||||||| |||||||||||||||||| ||||||||**Patients seen in PKR and £ sterling**|||||||||| |**2022-**
**2023**|**Medicines**
**Free**||**Lab. Free**||**Lab.**
**Subsidy**||**Consulta-**
**tion Free**|**Subsidy**||**Total Free +**
**Subsidy**||||||| |**PKR**|3,106,078||404,200||210,480||1,342,750|287,050||6,228,178||||||| |**£**
**1=**
**PKR**
**305**|10,160||1322||688||4,392|939||20,372||||||| |||||||||||||||||| Table 3. HC4AI UK Account Audit 2021-2022 ce.ve a •ll ITrtom¥llonBI Recelpts and pa ments accounts ?11DI1?0?I CC16a Forth• p•rfpd n1wran?? Section A Receipts and payineiit5 Unrostrlti8d R•￿rIal•d End(swm•nl nd• nd• fvnd Tow funds La•t>wr A1 RK• lJ1.715 117.91 4Q4ri 4U71 HMRCP•fUr￿l Sub fotalfGft￿ Incorn fDrAR) 741 (•M tal)l•). Subts 220.746 270.746 BNnkch•rG FL In4 i)• unl•r¢i Trov•l E¥fiWII • •TrJWnlpMrn• A4 A•••l •nd Inw•tmwrt • t•bl• Sub to 1fè.18J 170,31 C•th lund• Imt ￿raffld 170.1 R1 aco>Jn* Is81 Section B Stateinent of assets and liabilities Llt tlie cnd of the period Unr•¥trlctBd fundi R••trt¢thd Endowm•nt fund fund• C•t•qorl•• D•tall• B1 Cmh fvndl Tol•l cuh lI￿d• fvnd• to rMrB•t£ lund• D•l411• B3 kM•lm•nt u••ts D•t•ll• B4 A•••t• r•l•ln•d for th• ¢￿rIty,$ liwn u FU￿10￿1 Tkn du• D•l•ll• B5 U•bllltl ShJn8iu CQXX R2 aovJnts1&g1 CHARITY COMMISSION FOR ENGLAND AND WALES Independent examlnorfs report on the accounts Scrtioii A Iiidei)ciident Exiiniiiier's Rcport •mb•r• H8ath Caro 4 all Intematlonal On aceaunl8 forlh• ymr 31* January 2023 Charlty no (If •ny) 1158474 8•t out on pog I roport to the tru8toès on my •xamln8tion of the accounts of the above chorlty Trust.) for thg yo8r ended Ro•pon•lbllltl•8 and A8 the charlty tru818es of tha TrusL you are re8pon81ble for the prepar8llon bJ•kn af Mp￿1 of the accounts In accordance wllh tho requlrement8 of the Charltlos Act 2011 Acr). I rwrt In re8pect of my examinatlon of tho Tru8t'8 accounts carrlod out undèr 8ectlon 145 of the 2011 Act and In earrylng OLrt my examlnatlon, I followed the appllcablo Dlrectlons g￿n by tho Charlty CommlB61on undér $8Ctlon 145(5Xb) of the Act. I hav8 completed my examlnatlon. I conflmi tkot rnatarlal matterB hava cx)m8 to my attenUon {cther than that d18do8ed bolow.) In COnn￿lI0n th8 WAamlnalon whlch g￿6 me cau80 to belleve that In, 8ry materlal re8pect: a￿¢untIng record8 were not kept In a(xordance wlth ¥ecWon 130 of the Act or tho accounts do not accoFd wlth the acmuntlng record8 Ind?pondont oxamln•rfs stst•mont I have no conc•m8 arKI have corne acro88 no olher m8tt8rs In connectl¢Jn wlth the examlnalion to whlch attentlon Should bo drawn In ordar to onable a propèr underntsndlrvJ of tha accounts to be ro8ched. ' Pba88 dalete the In th& bracknt8 Kthey do not apply. 81gn•d: 281912023 N•m•: MR K HUSSAIN Rolovant prof•8•loMI qu•llftcatlon(•) or body (ir any): FMAAT, AAIA AddrM•: 21 DUCKWOFtrH LANE BRADFORD BD9 SER IER O¢tob•r 2018 Section B Disclosure Onty complets If the examiner needs to hlghlight matter8 of concem (Bee CC32, IndeperKlerrt gYAmIna￿on of charity accounts: dlrectlDn8 and gukdanc8 for examlner8). Glv• h•rn brlef detall8 of NONE any It￿n• that th• •x•mln•r wl•hM to dl•clow. IER October 2018