## **2020-21:** _**Resilience**_ Health Exchange Trustees’ Annual Report & Accounts Company Reg No: 06445689 Charity Reg No: 1188838 2 ## **Resilience** The teams at Health Exchange have demonstrated that regardless of the challenge, they exceed expectations in what has been a period of uncertainty across the world. On the 17th March 2020 we entered into lockdown. Our first response was to implement our robust Business Continuity Plan and quickly mobilise all staff to work from home. Some of my teams had never worked from home before and, with the prospect of getting COVID-19 heavily on everyone’s mind, staff transitioned to being a remote-only service within a matter of days. Whilst many organisations were having to close completely, our teams, and our IT support teams made it possible to continue to offer an excellent service to all those who needed to use our services. Our Type 2 team, moved from 100% face to face to 100% remote within a week. This led to the team not only being able to meet the annual target, which is often a challenge, but actually led to an increase of 23% more individuals accessing our Type 2 Structured Education programme. We had our teething problems, as everyone did, but with the help and support of our Data teams and the Type 2 team we were able to ensure there was no interruption to our service for our service users with the additional telephone support provided where necessary. Our social prescribing team, including Lorraine Crampton, who is pictured on the front cover of this report, were instrumental in supporting the vaccine roll out in their Primary Care Networks throughout the pandemic and also provided telephone support and assurances for those who were shielding and often very fearful. Our team members also provided support by accompanying PCN colleagues on home visits when the world began to open up, ensuring that those who needed the most support got it. Never in my time as COO has the need for mental health and wellbeing services been highlighted in such a unique and dramatic way, however our teams answered the call and were instrumental in not only supporting and responding remotely to clients who were accessing mental health interventions but also providing mindfulness sessions and vital wellbeing interventions for the staff and wider team here at Health Exchange. These sessions have since been described as “invaluable” by colleagues who accessed them. A few months into the pandemic, when we had no guidance or timeline of when things may begin to improve, I had to take the difficult decision to put some staff on furloughed leave. During this time it was essential that we kept those staff in the loop and supported so regular check-ins from their Line Managers and SMT members was crucial to them remaining part of our network of teams, even if not physically involved at the time in the day-to-day operations. Thankfully, I was able to successfully bring back all staff that were on furlough with no redundancies having to be made. That makes me so proud of how we, as a medium sized charity, handled the challenges of the pandemic. Our teams across all of our services including our amazing support staff including; Finance, HR and Office Administration, Marketing and Data, have managed to keep the organisation going. The goal for this coming year is to keep supporting staff as the world opens up and new contracts and opportunities come on stream, to continue to be the amazing values-based, mission-led organisation that we are, so that we can help individuals to choose positive lifestyles and wellbeing for themselves, their families and their communities. I would like to extend a huge thank you to all of our teams on behalf of the Senior Management Team, **keep up the great work.** Jennifer Jones-Rigby Chief Operating Officer 3 ## **Contents** ## **Trustees’ Annual Report** 4-5: Our Mission 6: What Our Service Users Say 7: The Chair’s Report 8: Meet The Chief Executive 9: An Example Of Our Work 10: Our Headline Stats 11: Our Covid Response 12: Our Impact 13: Going Above And Beyond 14: Public Benefit 14-15: Priority Areas 16-17: Financial Review 18: What’s Next For Us? 19: How Can You Help Us? 20: Administrative Information 21: Risk Management 22-23: Structure & Governance 23: Living Well Taking Control 24: Thank you to staff + Trustees 25: Statement of Trustee Responsibilities 26+: Financial Accounts 4 ## **Our Mission** _“To shape the design and development of health and wellbeing services that will enable everyone to have the capacity and confidence to choose positive health and wellbeing.”_ 5 ## **Our Mission** To achieve our mission, we rely on our core values: _**• Investing:**_ in our people by recruiting local people and helping them to develop their skills and knowledge. _**• Being The Best:**_ at providing services that meet the needs of every individual, commissioner, or buyer of our services. _**• Social Value:**_ by spending money in a way that benefits our local communities. _**• Innovation:**_ by creating new ways of working which continue to make our services more efficient and engaging. _**• Empowerment:**_ support patients to develop the knowledge, skill and confidence to become active participants in achieving their health and wellbeing goals. **----- Start of picture text -----**
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## **What Do Our Service Users Say About Us?** _I was given a lot of advice, motivation and material to help me._ ## **Saleem** - _I felt Kalbinder really cared about me as a person, I_ - _wasn’t just someone with Diabtes to her. I think I_ - _would have slipped into depression without her support._ ## **Tina** _I would have been lost without the support I’ve received, I’ve learned so much._ _I’m just sad I won’t get to see Kim now!_ **June (Pseudonym)** 7 ## **The Chair’s Report** **This is the first full year that Health Exchange has operated as a charity and on behalf of the other Non-Executive Directors, I would like to start my report by thanking all the organisation’s staff and volunteers in ensuring that the transition from a community interest company to a fullyfledged charity has been successful.** **All organisations have continued to feel the impact of the pandemic and I am pleased to see how Health Exchange has continued to manage the challenges which it faces while still implementing future growth plans. Supported by the Board, and under the leadership of the Chief Executive, Ron Owttrim, the future direction of the organisation has been set and designed to ensure the organisation is able to deliver its core objectives while remaining in a healthy position financially.** **As I reported last year, I continue to believe that with our current Trustees and Executive we have a nicely balanced spread of experience and skills around the table to take the organisation forward and meet the challenges ahead. However, as the business grows, we will be undertaking a skills-mix review of our Non-Executive Directors to identify any additional requirements we may need as we move forward. This will enable us to recruit additional talent to our Board as necessary, and further ensure we are able to move ahead and grow the organisation safely.** **Continuing to operate and deliver high-quality cost-effective services has been, as it was last year, a major achievement; home working has continued for many staff, as has other impacts caused by the continuing pandemic.** **However, despite the continuing challenges, we have continued to provide the quality of service to our users that they expect and deserve.** **Professor Chris Langley Chair of the Board of Trustees** 8 ## **Meet The Chief Executive** It has been another busy year, dealing with the effects of the pandemic and operating as a newly formed charity. The Annual review highlights some of the work we undertake and cannot really capture the commitment of our staff and volunteers and the fantastic work they have continued to provide over the past year. We continue to see the impact our staff and volunteers have on the health and wellbeing of our clients especially during this most challenging year. Our staff have continued to provide services remotely and have gone above and beyond to ensure services continued. I have enjoyed seeing so much of the inspiring work the organisation does within the communities we serve. I wish to personally thank all our staff and volunteers within Health Exchange and our partner organisation Living Well Taking Control for all their hard work and commitment. Overall, it has been another good year and we continue to be in a strong financial position to continue to grow but, more importantly, our services continued to evolve, improve, and change. During the coming year we will continue to look at ways to deliver the vision and values of the Charity and look at areas where we can make a difference by providing people focused quality services. We will continue to provide services that meet the needs of the population we serve and look forward to the future in terms of the commitment, enthusiasm and skills of our staff and volunteers. It is an honour to continue to lead a dedicated team at Health Exchange during this exciting time and I believe we will continue to meet the challenges ahead and the organisation has a bright future ahead. **Ron Owttrim Chief Executive** 9 ## **An Example Of Our Work** A young client in their 20s accessed the Mental Health & Wellbeing service where they met with a therapist for 12, weekly sessions. This referral was made by the weekly clinic that Health Exchange holds with the client’s GP practice. The client was seeking support for symptoms of depression which included feeling sad, crying, lack of motivation which meant they were no longer doing things they used to do. Initially the client felt apprehensive about accessing the service, as they described a poor experience with previous therapy. However, as treatment progressed, having the therapeutic relationship at core, the therapist and client were able to identify the source of the symptoms and explore historic traumatic experiences, complex/familial environment, and a recent bereavement. In addition, the client was able to identify what maintained these symptoms which included beliefs such as not being ‘good enough’ which they were able to work through during the therapy. By the end of treatment, the client had more self-awareness and felt able to cope with their feelings of Depression. Client’s feedback included thanking for the support which they said had proved invaluable and reported that they had been this experience of therapy had been more positive than their first. The client completed weekly questionnaires which assessed the severity of their symptoms, and at the beginning of therapy they scored in the ‘moderate’ range for symptoms of Depression, and by the end of the therapy this had moved into ‘mild’ and were sub-clinical, indicating the therapy had successfully helped the client manage their symptoms. 10 ## **Our Headline Stats** ## **91%** Of surveyed service users said that social prescribing support made them feel less isolated and better connected to others during 2020-21. ## **73%** The percentage of service users who completed one of our support services after starting a programme ## **3,280** The number of service users who accessed our support across all of our contracts and services 11 ## **Our Covid Response** **Our year has been defined by our ability to adapt to the restrictions of COVID, constantly facing ever-changing challenges in order to continue the delivery of our contracts and ensure support was available to those who needed it in our community. We did this through:** - Moving our deliver to online zoom group meetings, offered at different times during the day, evening and weekend to make them accessible - Telephone support, for those who preferred it and those who didn’t have access to the internet **We actually found that this way of delivering worked really well for our service users as:** - Taking part in group sessions and meetings felt more relaxed in a home environment - Clients working from home could fit sessions in more easily rather than missing work - Clients saved money in travel expenses - Individuals with visual or mobility impairments felt it was easier to join in and contribute through audio interactions on remote sessions rather than trying to attend and participate in an in-person group. - Non-English speaking patients found it easier to take part due to ease in having a translator/family member alongside them in a digital meeting 12 ## **Impact Assessment** The Charity continues to grow through contracts for services with primary care trusts, clinical commissioning groups, local authorities and other public bodies thereby increasing our footprint across the country. Throughout 2020-21, Health Exchange has impacted the lives of thousands of individuals across the West Midlands and beyond. Our key services such as our Mental Health and Wellbeing Services moved more people to recovery than the national average with over 51% moving to recovery after intervention from one of our trained and accredited practitioners. - In 2020-21 over 1654 patients were referred to the social prescribing service through VCSE work with Our Health Partnership and Primary Care Networks. - On average 1,000 contacts with patients made every month. - Through VCSE grant we have received 1250 referrals from Our Health Partnership practices with support adjusted in light of COVID 19 in March 2020 - Quote – “Overall this was an excellent result, social prescribing supported me through a difficult time financially and helped me talk to the DWP about my needs so I can get the support I need for me and my family.” ## **Community Health and Wellbeing services** This involves the Type 2 Diabetes and Social Prescribing. Our Type 2 Service has been providing Support in Communities for over 10 years helping individuals management their long-term condition. Each year over 1000 individuals are provided with information about how to better manage their condition, with over 850 completing a structured Diabetes Education programme in their area. Our Social Prescribing service has highlighted the wide variety of support required throughout Birmingham, supporting a wider social prescribing steering group with newer partners to ensure consistency of support across the city. Referrals continue to increase for social prescribing support to enable people to live healthier and wealthier lives. ## **Primary Care Support services** Health Exchange is an established provider of Social Prescribing and behaviour change services, with over 10 years’ experience delivering for people, not profit. We are 1 of 23 organisations within the country selected by the Department of Health to deliver Social Prescribing under the Voluntary, Community and Social Enterprise Fund, and currently work in partnership with Primary Care Networks (PCNs) across the West Midlands to provide Link Workers to their local populations. This has allowed us to support over 6000 individuals to access the support they require and reduce their dependency on primary care services. For the past 3 years this support has been delivered in Birmingham and Sandwell, however 2020 has opened up opportunities to support individuals in Coventry, Rugby and Warwickshire. We continue to develop our reporting mechanisms, enabling us to monitor and evaluate our performance and ensure that we remain accountable and transparent in our delivery. 13 ## **Going Above And Beyond** ## **Volunteering across services and organisations** We are proud to say that Health Exchange employees have formed an integral part of our local vaccination rollout programmes, donating their time and support to the cause which took national priority following the approval of the vaccines in December 2020. Following a press release celebrating the Health Exchange volunteers who helped Portway Vaccination Centre in Oldbury surpass 20,000 vaccines delivered in just 3 months, we received a wealth of enquiries from new volunteers who have stayed on and intend to volunteer with us into the 21-22 financial year. 14 ## **Public Benefit** **Health Exchange’s charitable objects are enshrined within its Articles of Association, and as such, the Trustees ensure that the objectives are achieved through our priority areas.** **Quarterly and annual reviews of our work evaluate our activities against our set aims, targets and outcomes. A structured model of evaluation enables us to identify if we are achieving our outcomes to allow us to tailor our service delivery to match local needs more closely.** **In setting plans and priorities for areas of work, the Trustees of Health Exchange have had regard to the guidance from the Charity Commission on the provision of public benefit and Health Exchange meets the definition of a public benefit entity under FRS 102.** **In particular, the Trustees consider how planned activities contribute to meeting charitable objectives – as set out in the Articles of Association.** ## **Priority Areas** **Each year Health Exchange supports thousands of clients with both information and person centred one to one support or group support. In the 12 months between April 2020 and March 2021, 3801 clients were assessed, supported and contacted, with 3280 customers having more in-depth support based on their needs which are often quite complex with many having co-morbidities needing specific support. Health Exchange offers services built around key pillars.** - **Primary Care** - **Mental Health and Wellbeing** - **Social Prescribing** - **Type 2 Diabetes support** **In 2020-21 delivery focused on these primary areas, detailed on the next page.** 15 ## **Priority Areas** ## **Mental Health and Wellbeing services** Our Mental health and Wellbeing Support that includes Increased Access to Psychological Therapy (IAPT) and Forward Thinking Birmingham (FTB) aimed at young people up to the age of 25. ## **Community Health and Wellbeing services** This involves the Type 2 Diabetes and Social Prescribing. Our Type 2 Service has been providing Support in Communities for over 10 years helping individuals management their long-term condition. Each year over 1000 individuals are provided with information about how to better manage their condition with over 850 completing a structured Diabetes Education programme in their area. ## **Primary Care Support services** Health Exchange is an established provider of Social Prescribing and behaviour change services, with over 10 years’ experience delivering for people, not profit. We currently work in partnership with Primary Care Networks (PCNs) across the West Midlands to provide Link Workers to their local populations. **----- Start of picture text -----**
Service Name Referrals Contacted/Triaged/ Completed Intervention/
Accessed Service Discharged
IAPT 830 723 371
FBG 815 477 439
SP 786 765 538
MANAGING TYPE 2
1370 1315 1036
DIABETES
TOTAL 3801 3280 2384
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**Service Performance** That’s a cross-service completion rate of: 73% 16 ## **Financial Review** ## **Our income sources** The charity’s income streams for the year can be divided into three categories: - Fixed income contracts - Payment by result contract - Grants & Awards The first two categories are classified as unrestricted/designated to deliver on the service and the last category is restricted as it is subject to specific restrictions imposed by the terms of the grant. Our total income for the year 2020/21 was £1.467m, - Our GE grant ended in August 2020. - The VCSE grant ended in March 2021. - We were awarded new contracts covering social prescribing and link workers provision in Coventry, Warwickshire, - and Rugby - Face to Face and group delivery of Mental Health and Community support was significantly affected by the lock- - down. - The Community health and Wellbeing support including the type 2 education program was able to exceed target - for the year through digital delivery. ## **How our money was spent** Our total expenditure in the year including impairment losses for our investment in Living Well Taking Control LLP was £1.413m. 75% of staffing cost covers staff delivering services withing the community, 25% is in relation to support function required for governance, compliance and to implement appropriate controls. During the lockdown we invested in supporting our staff to work efficiently from home, cost of equipment required was capitalised in line with accounting conventions. We had savings against prior year in some areas (despite the 10month period of the previous financial years account) mainly due to the impact of COVID-19, e.g., lower spend on - Travel and subsistence - Office and premise expenses - Bank staff required - Reducing recruitment to only new contracts where roles were funded. - Room hire and rent for teams working in the community 17 ## **Financial Review Cont...** ## **Funds** The charity’s total funds increased by £54k to £1,113m on 31 March 2021. £370k is designated to finance: - Existing asset portfolio: Leasehold property revaluation reserve and investment (derived from initial value and revaluation and impairment adjustments) or - Charity’s commitments and anticipated future commitments and reserves - Other redevelopment projects After allowing for these existing plans, general funds (that is, funds not restricted, or designated in respect of use) amount to £743k, reflecting the rise in income due to the additional contracts but also the reduced expenditure on raising funds explained above. ## **Restricted Funds** The charity held a two grant funds to support specific activities as determined by the terms of the grant and falls within the objectives of the charity. The £41k deficit in restricted funds relates to expenditure in the year for which income was received in the previous year. ## **Unrestricted** Unrestricted funds are expendable at the discretion of the Trustees to further the charity’s objectives. The charity’s unrestricted funds at 31 March 2021 were £1.113k ( 31st March 2020: £1,059k). Each year, the Trustees review the need to designate unrestricted funds, the redevelopment of the web-based applications and specific projects to be committed and spent in future years. This helps to provide financial stability and confidence in the charity’s ability to fund vital areas of work within communities. ## **Reserves and liquidity policy** The Trustees are keen to ensure that funds raised by the charity are not only used to achieve the objectives of the charity but deliver substantial impact. The Trustees need to balance this objective with the need to maintain financial prudence and ensure the long-term financial sustainability of the charity. The Trustees introduced guidelines for minimum liquidity levels which require the charity to be confident it can meet at least three months future liabilities, when they fall due, in circumstances where income would be significantly reduced. This level was set at £300k for 2019/20 and sustained in 2020/21. ## **Living Well Taking Control LLP** Living Well Taking Control LLP(LWTC) is a partnership between Health Exchange and Westbank Community Health and Care. The partnership made losses in 2021/22 that significantly impaired investment in the partnership (£190k in 2019/20 to £634 2020/21) 18 ## **What’s Next For Us?** The Charity’s plan is to further develop services over the 12 to 24 months to set the foundation for the organisation for the next 5 years. Our strategy is to continue to deliver services in areas of deprivation that provide an additional safety net where we have identified health inequality and gaps in statutory and community provision. The areas we identify will form the basis for our continued growth and success whilst ensuring our core commitment to provide safe high-quality care services through developing strong relationships with our partners, commissioners, staff, and clients. Utilising our skills gained providing Social Prescribing, Mental Health and Diabetes Prevention we will work with partners to improve the overall wellbeing of individuals ensuring they have improved accessibility to services. We will aim to work in three main areas to develop innovative services to support: Support families in hard to reach areas with high levels of deprivation to improve there overall mental health wellbeing especially post covid. Support groups of elderly clients to retain their independence and reduce levels of loneliness and isolation. Work with families to help support a healthy lifestyle by providing and monitoring factors to improve lifestyle choices being overweight. To support our ambition Hex will develop a digital application, this digital hub will provide clients real time access to their information plus supporting materials through the form of digital asset service. Clients and Link Workers and Coaches will be able to communicate directly within the application through push notifications and instant communication channels. The application will be fully secure and will be able to integrate into a variety of external systems via an API to allow for functionality such as SMS, email & social communication. The application will be readily available across multiple devices allowing users to access their data at home from their computers or their smartphones. As we continue to grow and deliver more complex projects, we will ensure our Board and Senior Team have the skills experience to deliver the range of services. Key Executives will meet the challenges of the future and ensure we have the skills and competencies in our staff to meet the challenges ahead. 19 ## **How Can You Help Us?** ## **Referral** Health Exchange (HEX) carries out communications campaigns and multi-channel marketing throughout the year, however there is no better way to ensure the right people hear about this support than word of mouth. So if you know someone who you think would benefit from support or regularly find yourself working with members of the community, then please do get in contact with our team to find out more about how to refer a service user. ## **Volunteering** Whether it’s with HEX or one of the many organisations the charity partners with in the community, particularly through its social prescribing work, volunteering opportunities are permanently available and the help is so gratefully received. ## **Awareness Raising** To support the charity in raising awareness of it’s services, any offer to share information, put up posters, write about this work in the press etc would go such a long way towards helping to spread the word amongst relevant communities. ## **Event Hosting/Invitations** Finally, Health Exchange staff are on hand and available to attend any information or community events that would be beneficial for getting the brand and the services offered in front of relevant members of the community or well-placed healthcare professionals. So if you are hosting an information event or would be in a position to put Health Exchange in front of the public or healthcare professions then the team would be very grateful for the opportunity to attend. 20 ## **Administrative Information** **Charity Name:** Health Exchange **Charity Registration Number:** 1188838 **Company Registration Number:** 06445689 **Website:** www.healthexchange.org.uk **Registered Office:** Avoca Court, 27 Moseley Road, Digbeth, B12 0HJ **Bankers:** Santander UK **Auditors:** Cooper Parry Group Limited, Chartered Accountants and Statutory Auditors, Sky View, Argosy Road, East Midlands Airport, Castle Donington, Derby, DE74 2SA ## **The Board Of Trustees** Prof. Christopher Andrew Langley - _Chairman_ Sir David Ross Winkley Dr Jacky Chambers Dr Russell Muirhead Ronald Patrick Owttrim Obaid Mahmood Choudry David Melbourne **Senior Management Team** Ronald Patrick Owttrim Jennifer Jones-Rigby Olabimpe Odubanjo Rachel Georgiou Parminder Sandhu Stuart Brown 21 ## **Risk Management** Strategic management of risk is an integral part of Health Exchange’s decision-making quality and assurance processes and culture, supporting effective planning and evaluation of activities. By following the ISO 9001:2015 model for which we have been accredited for almost 10 years, we identify review and track all risks on our live Risk Tracker. The trustees review the charity’s main risks on a regular basis. They are responsible for approving and then overseeing the implementation of any changes to procedures, training or other actions to mitigate the risks. The Trustees have in place a risk register which is reviewed quarterly and updated annually. These risks coverall aspects of the operations of the organisation, including, but not limited to: ## **Risk** ## **Primary Mitigations** - Implementing strong safeguarding plans, with external review of our compliance with safeguarding requirements ## **Safeguarding, regulatory and operating risk** - - Ensuring all Health Exchange staff/volunteers and those we work with have received appropriate training in safeguarding. - We are Working with our internal auditors and other providers of external assurance in ensuring recommendations are implemented promptly. ## **Finance** Risk of unanticipated falls in voluntary income, reducing liquidity and capacity to effectively deliver against plans ## **People** People are a critical part of our delivery at Health Exchange, we therefore face risk of an inability to find, and keep, people with the right skills to deliver our plans. - Our reserves policy protects us against the impact of short-term volatility in cash flow. - • We closely monitor our key performance indicators, against budgets and perform regular reforecasting. - In the past year specific consideration of finance risk has included the end/loss of key contracts/grants and sourcing new funding opportunites. - We map the capability of our teams against requirements and continually refine communications to ensure staff engagement. - To remain competitive as a potential employer and retain current staff, with incentives including flexible working and bolstering reward and recognition policy amongst existing staff. - - - Continue to receive regular reports on our IT estates and review the security of systems. ## **Cyber security and IT risk** - Implementation of a Digital Transformation Plan to ensure all internal systems are fit for purpose, and support efficiency across the business. - Continue to rationalise the technical estate, leveraging software to improve efficiency. - Invest in Health Technology and in return negotiate shared IP - • Continue to invest in the database team. **Key Partners and partnerships** Overreliance on key partners and partnership ## **Change in Commissioners strategy and intentions** ## **Strategic plan** The risk that our strategy is not sufficiently clear and innovative to deliver against our ambitions. - Offer consortia opportunities, collaboration of local reach with national reaching organisations, buying the right expertise and impliment robust diligence process to ensure parterns work to the same standard. - Flex and change to new demands, adjust service offer accordingly - • Ensure we are at the right briefings, service planning, listening events so that we can steer service provision around our evidence-based practice. - Our future plans expands Health Exchange geographical reach in each of our priority areas. We will continually test our strategy to ensure maximum impact for the communities we support. We constantly scan the internal and external environment for opportunities and threats. - We are focusing efforts on our digital delivery and our ability to demonstrate impact and efficiency. ## **Operational risk of Covid-19** The impact of Covid-19 on the Charity’s operations. - Hybrid working is in place and our office has COVID safe systems designed to ensure a safe working environment whilst adhering to external environment and Government guidellnes. - All key risks including strategic and clinical are reviewed at monthly integrated governance and mitigating actions recommended and implemented. 22 ## **Structure & Governance** **TRUSTEES** **CEO** **COO** **----- Start of picture text -----**
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**Living Well Taking Control** **Mental Health Primary Care Support and Wellbeing** **Community Health and Wellbeing** The members of the Board of Trustees present their report together with the financial statements of Health Exchange for the 11-month period ended 31 March 2021. The report has been prepared in accordance with Part 8 of the Charities Act 2011 and constitutes a directors’ report for the purposes of company legislation. The financial statements have been prepared in accordance with the accounting policies outlined in the attached financial statements and comply with the charitable company’s memorandum and articles of association, applicable laws and the requirements of the Statement of Recommended Practice on “Accounting and Reporting by Charities” (FRS102) issued in 2019. Health Exchange is a charitable company limited by guarantee, incorporated on the 5 December 2007 and registered as a charity on the 31st of March 2020. The company was established under a Memorandum of Association which established the objects and powers of the charitable company and is governed under its Articles of Association. A scheme of delegation is in place and day to day responsibility for the provision of the services, which rests with the Chief Executive along with the Senior management team. The Chief Executive is responsible for ensuring that the charity delivers the services specified and that key performance indicators are met. The COO has responsibility for the day to day operational management of the teams, the service leads are responsible for the individual supervision of staff within the team and also ensuring cohesiveness with the overall charity objectives. 23 ## **Structure & Governance** ## **Trustees responsibilities** The Trustees have control of the Charity, its property and funds. Trustees are appointed by the Members or co-opted by the Trustees. The number of Trustees shall be at least three but not more than twelve persons, all of whom must support the Objects. The Trustees must hold at least two meetings each year. A quorum at a meeting of the Trustees is at least three or one third of the total number of Trustees for the time being, whichever is greater. ## **Finance Sub-committee** The Finance Sub-Committee provides expert advice to the board and trustees on the financial health of the charity and any remedial action necessary. It holds the professional finance staff accountable for discharge of their responsibilities, including compliance with external regulation. The Finance Subcommittee is also responsible for preparing and submitting to the Board a proposed budget for each financial year, for monitoring income and spending against budget profile, and for progressing matters related to the finances of the Society. ## **Objectives and activities** The Charity’s objectives are to further such charitable purposes relating to: 1) the advancement of health, including public health and well-being. 2) to promote social inclusion amongst marginalised and minority groups who are excluded from society, or parts of society, due to their social and economic position by providing education, training, information, and opportunities for social interaction. 3) the promotion of urban regeneration in areas of social and economic deprivation (in particular, but not exclusively in, the West Midlands) by all or any of the following means: (a) the relief of poverty. (b) the relief of unemployment. (c) the advancement of education, training or retraining, particularly among unemployed people, and providing unemployed people with work experience; and (d) the provision of public health facilities. 4) the advancement of education, including the provision of training, particularly in relation to matters of health. 5) to develop the capacity and skills of members of the public in such a way that they are better able to identify, and help meet, their needs and to participate more fully in society. 24 ## **Living Well Taking Control** After a number of successful contract tenders in 2020, Living Well Taking Control delivers the **NHS Healthier You Type 2 Diabetes Prevention Programme** in 6 geographies across the UK: - Derby & Derbyshire - Dorset - Herefordshire & Worcestershire - Northamptonshire - Nottingham & Nottinghamshire - Shropshire, Telford & Wrekin ## **Adapting To Covid** When COVID lockdowns prevented LWTC from delivering face-to-face group sessions, the entire service was digitised with an online self-referral pathway built for at-risk members of the community who couldn’t attend a GP appointment. Online sessions are now the norm with thousands of residents accessing the NDPP remotely across England. ## **Some Key Stats** - 95% of completers in the pandemic said they “found it easy to access remotely” - 93% of participants surveyed said they felt more positive for having attended the programme - 88% stated that the Healthier You programme had helped them become more active - Service users who achieved milestone 4 lost an average of 5.61% of their body weight _**“I’ve lost 2 stone in the first 4 months of the programme and expect to get at least another stone off before it ends!”**_ - _**Nick, Kidderminster**_ _**“Since taking part in the programme, I get my 10,000 steps every day now” - Paul, Shropshire (pictured)**_ _**“I don’t feel 69 anymore!” - Chris, Nottingham**_ 25 ## **Thank You** **As an organisation, we would like to thank the incredible people who make up our team, delivering vital support across England and ensuring we go from strength to strength as a charity.** **Without each and every member of the Health Exchange family, vital care and support simply wouldn’t be avalable to those who need it most.** **In this truly unique year, our people have met every challenge with enthusiasm, positivity and resilience.** **So from all of the Board and Senior Management Team, we would like to say a heartfelt thank you to all of our staff, volunteers, partner organisations and referral partners, past and present, who have all made such a huge contribution to our work and their communities.** **Here’s to the future!** 26 ## **Statement of Trustee Responsibilities** The Trustees, who are also the directors of Health Exchange or the purpose of company law, are responsible for preparing the Trustees’ Report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice). Company law requires the Trustees to prepare financial statements for each financial period which give a true and fair view of the state of affairs of the charitable company and of the incoming resources and application of resources, including the income and expenditure, of the charitable company for that period. In preparing these financial statements, the Trustees are required to: - select suitable accounting policies and then apply them consistently; - observe the methods and principles in the Charities SORP 2019 (FRS102); - make judgments and estimates that are reasonable and prudent; - state whether applicable UK Accounting Standards have been followed, subject to any material departures disclosed and explained in the financial statements; and - prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charity will continue in operation. The Trustees are responsible for keeping adequate accounting records that disclose with reasonable accuracy at any time the financial position of the charitable company and enable them to ensure that the financial statements comply with the Companies Act 2006. They are also responsible for safeguarding the assets of the charitable company and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities. In so far as the Trustees are aware: - there is no relevant audit information of which the charitable company’s auditor is unaware; and - the Trustees have taken all steps that they ought to have taken to make themselves aware of any relevant audit information and to establish that the auditor is aware of that information. The Trustees are responsible for the maintenance and integrity of the corporate and financial information included on the charitable company’s website. Legislation in the United Kingdom governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions. ## **AUDITORS** Cooper Parry Group Limited has expressed their willingness to continue in office and will be proposed for re-appointment at the Annual General Meeting. Approved by the Trustees on 31/01/2022 and signed on their behalf by **Professor Chris Langley Chairman** 27 Registered number: 06445689 Charity number: 1188838 ## HEALTH EXCHANGE (A company limited by guarantee) TRUSTEE’S REPORT AND FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 MARCH 2021 28 ## **Contents** 29-32: Independent auditor’s report on the financial statements 33: Statement of financial activities ## 34: Balance sheet 35: Statement of cash flows 36-55: Notes to the financial statements 29 ## INDEPENDENT AUDITOR’S REPORT TO THE MEMBERS OF HEALTH EXCHANGE ## Opinion We have audited the financial statements of Health Exchange (the ‘charitable company’) for the year ended 31 March 2021 which comprise the Statement of Financial Activities, the Balance sheet, the Statement of cash flows and the related notes, including a summary of significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102 ‘The Financial Reporting Standard applicable in the UK and Republic of Ireland’ (United Kingdom Generally Accepted Accounting Practice). In our opinion the financial statements: • give a true and fair view of the state of the charitable company’s affairs as at 31 March 2021 and of its incoming resources and application of resources, including its income and expenditure for the year then ended; - have been properly prepared in accordance with United Kingdom Generally Accepted Accounting - Practice; and - have been prepared in accordance with the requirements of the Companies Act 2006. ## Basis for opinion We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under those standards are further described in the Auditor’s responsibilities for the audit of the financial statements section of our report. We are independent of the charitable company in accordance with the ethical requirements that are relevant to our audit of the financial statements in the United Kingdom, including the Financial Reporting Council’s Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion. ## Conclusions relating to going concern In auditing the financial statements, we have concluded that the Trustee’s use of the going concern basis of accounting in the preparation of the financial statements is appropriate. Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the charitable company’s ability to continue as a going concern for a period of at least twelve months from when the financial statements are authorised for issue. Our responsibilities and the responsibilities of the Trustees with respect to going concern are described in the relevant sections of this report. 30 ## Other information The other information comprises the information included in the Annual report other than the financial statements and our Auditor’s report thereon. The Trustee are responsible for the other information contained within the Annual report. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon. Our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the course of the audit, or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether this gives rise to a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact. We have nothing to report in this regard. Opinion on other matters prescribed by the Companies Act 2006 In our opinion, based on the work undertaken in the course of the audit: • the information given in the Trustee’s Report for the financial year for which the financial statements are prepared is consistent with the financial statements. - the Trustee’s Report has been prepared in accordance with applicable legal requirements. ## Matters on which we are required to report by exception In the light of our knowledge and understanding of the charitable company and its environment obtained in the course of the audit, we have not identified material misstatements in the Trustee’s Report. We have nothing to report in respect of the following matters in relation to which Companies Act 2006 requires us to report to you if, in our opinion: - adequate accounting records have not been kept, or returns adequate for our audit have not been - received from branches not visited by us; or - the financial statements are not in agreement with the accounting records and returns; or - certain disclosures of Trustee’s remuneration specified by law are not made; or - we have not received all the information and explanations we require for our audit; or • the Trustee were not entitled to prepare the financial statements in accordance with the small companies regime and take advantage of the small companies’ exemptions in preparing the Trustee’s Report and from the requirement to prepare a Strategic Report. ## Responsibilities of trustees As explained more fully in the Trustee’s responsibilities statement, the Trustees (who are also the directors of the charitable company for the purposes of company law) are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such internal control as the Trustees determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error. In preparing the financial statements, the Trustees are responsible for assessing the charitable company’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the Trustees either intend to liquidate the charitable company or to cease operations, or have no realistic alternative but to do so. 31 ## Auditor’s responsibilities for the audit of the financial statements Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an Auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements. Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud. The extent to which our procedures are capable of detecting irregularities, including fraud is detailed below: Our assessment focussed on key laws and regulations the Charitable Company has to comply with and areas of the financial statements we assessed as being more susceptible to misstatement. These key laws and regulations included but were not limited to compliance with the Companies Act 2006, Charities Act 2011, Charities (Protection and Social Investment) Act 2016, taxation legislation, data protection, anti-bribery and employment legislation. We are not responsible for preventing irregularities. Our approach to detecting irregularities included, but was not limited to, the following: • obtaining an understanding of the legal and regulatory framework applicable to the Charitable Company and how the Charitable Company is complying with that framework, including agreement of financial statement disclosures to underlying documentation and other evidence; • obtaining an understanding of the Charitable Company’s control environment and how the Charitable Company has applied relevant control procedures, through discussions with Trustees and other management and by performing walkthrough testing over key areas; - obtaining an understanding of the Charitable Company’s risk assessment process, including the risk of fraud; - reviewing meeting minutes of those charged with governance throughout the year; and - performing audit testing to address the risk of management override of controls, including testing journal en- - tries and other adjustments for appropriateness, evaluating the business rationale of significant transactions outside the normal course of business and reviewing accounting estimates for bias. Whilst considering how our audit work addressed the detection of irregularities, we also considered the likelihood of detection based on our approach. Irregularities arising from fraud are inherently more difficult to detect than those arising from error. Because of the inherent limitations of an audit, there is a risk that we will not detect all irregularities, including those leading to a material misstatement in the financial statements or non-compliance with regulation. This risk increases the more that compliance with a law or regulation is removed from the events and transactions reflected in the financial statements, as we will be less likely to become aware of instances of non-compliance. The risk is also greater regarding irregularities occurring due to fraud rather than error, as fraud involves intentional concealment, forgery, collusion, omission or misrepresentation. A further description of our responsibilities for the audit of the financial statements is located on the Financial Reporting Council’s website at: www.frc.org.uk/auditorsresponsibilities. This description forms part of our Auditor’s report. 32 ## Use of our report This report is made solely to the charitable company’s members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our audit work has been undertaken so that we might state to the charitable company’s members those matters we are required to state to them in an Auditor’s report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the charitable company and its members, as a body, for our audit work, for this report, or for the opinions we have formed. Glen Bott FCA (Senior statutory auditor) for and on behalf of Cooper Parry Group Limited Chartered Accountants Statutory Auditor Sky View, Argosy Road, East Midlands Airport, Castle Donington, Derby, DE74 2SA Date: 11 February 2022 healt exc ange 33 STATEMENT OF FINANCIAL ACTMTIES IINCORPORATING INCOME AND EXPENDITURE ACCOUNTI FOR THE YEAR ENDED 31 MARCH 2021 Total funds 10 months ended 31 March 2020 Unrostrict•d funds R•strict• fvnds Total funds 31 March 2021 31 March 2021 31 March 2021 Note Income from: Donation5 and legacies Charitable activit185 313,533 313,533 1,152,935 535 367,732 609,125 542 1,152,935 507 Investments 28 Total Income 1.153.442 313.561 1,467.003 977.399 Expènditure on- Charitable activit185 1,041,123 372,258 1,413,381 1,005,051 Totsl expenditure 1.041.123 372.258 1,413.381 1,005.051 N•t in¢om•ll•xp•nditur•l Transfers belween funds 112,319 141,6511 158,6971 41,651 53,622 127,6521 18 Net movement in funds 70,668 117,0461 53,622 127,6521 Re¢on¢llla¢lon of funds: Total funds brought fotward Net movement in funds 1.042,200 70,668 17,046 117,0461 1.059,246 53,622 1,086.898 127,6521 Total funds ¢arried forward 1,112,868 1,112,868 1,059,246 The Statement of Financial Activities includes all gains and losses recognised in the year. 34 **Professor Chris Langley Chairman** **Ron Owttrim Chief Executive** healt exc ange 35 STATEMENT OF CASH FLOWS FOR THE YEAR ENDED 31 MARCH 2021 10 months ended 31 March 2020 31 March 2021 Cash flow5 from operating activities Net cash used in operating activities 70,132 118,797 Cash flow5 from investing activit105 Dividends, interests and rents from investments Proceeds from the sale ol tangible fixed assets Purchase of tangible fixed assets 535 542 17.500 117,8331 11,1701 Net cash provlded byllused Inl Investlng actlvltles 202 16281 Cash flow5 from financing activit185 Repayments of borrowing 19.6481 15.7961 Net cash used in financing activities 19.6481 15,7961 Changè in eash and eash •quival•nts in tho yèar Cash and cash equivalents at the beginniro of the year 60,686 112,373 435.445 323.072 Cash and cash equivalents at the end of the year 496,131 435,445 healt exc iange 36 Gpnoral information Heath Exthary is a registered ethnp8ny ￿ThIed by gvarBntee with reBi5tered charitsbk 5tabJs. in the Unrted Kingdom. The addre55 of the regIs￿d office 15 giverh in tho chanty informobon on poge 20 of these financi￿ Stat￿ents. The nature of the charity's operatiorva and principal 8Ctmt￿ are kn pr•vent or relieve poverty. suffwing. distre55 or financial hbrdship amongst the benefieiaries by Fffjviding fmncial us15tanr* and support as **ll ￿ bth'ng hc4id8y properties to the be￿￿e4*r1e3. Accounting polici•5 2.1 8a515 01 pw•paration ot rThncial 5tst•m•nts The financial ststements have ￿en prepared in aCCordaTh￿ *ith the char￿e5 SORP {FRS 1021- Accc4Jntinp and Rèportir¥ by Charitiès.. St8temeni of Reeommènded P￿￿Ice SP￿•￿&ble to Charit￿ preparing Ihw 8ccourrt5 ￿ accordan￿ wth ihe Fmoncial Reporfiry Stsndard opplicable in the UK and Reputlc.otJ[e￿I IFRS 102) leffethe 1 January 2019). ts Financ481 Reporkn9 standard •pph'c4ble ￿ Ihe UK 8nd Republic of IrelaTrJ (FRS 102) arKI the Coffynie5 Act 2OJ6. Health Exc*anoe mÈets IhÈ definilion af a public bènefft entity under FRS 102. Assels and liabilitiès are In￿.￿1￿ rècognised at historical cost ￿ trsnsaekion Wa￿e unless Othe￿ stated in thé relévgrt •r￿unti￿ pc4iBy. 2.2 Going concern At the yew eTrJ the oonliNed ou1b￿* af c(￿ne¥￿U$ h85 develcyd irto a gbb81 pendemio. At thts s¢&Je ts Trusiees ao assessino what impacl Ihi% may have on the Charity. though there r•mains a high level of uncertwnty •bout extent and lh• lim•frwno of the viru5 ￿ th* gknbqj •conomy. they boliove the Charty 15 strongty pl•cod to handle any downlum that m•y oC￿r in any of the sedors the Charity Op￿t•S in. The Truslees believe Ihe Ch¥lty is well pl8¢ed thrtyJ￿ Ihe U￿erta￿ b.mes coused by the CtyMa¥irus pondem¢ Oue lo its strcffjg cash balance and >Jnffiw)t net *)fftnt a￿ts Fwbon •mounkng to £744k 45 8131 March 2021. Trnstee5 h￿e revlaw￿ the fmarbc*al posknon of thè tharbty. inthdiw its forecast cash flow5, 1tr4uidty posibon and exisl•ig and pOt￿tial ffijndiry ec*mmth)Ènts for the next 12 monlhs And range of scenari05 that consider PDtential fvture implic4¢ion5 of the COVIO-19 viru5 on the charity. The Twstees are also con5ittering 8 new fvtryear 5tr8tegy. knyih amt￿t￿u9 fuTrJraising targets so that we can do even more to Slwrt the communilie5 We serve. Con5equenty. Trusteès believe that Ih¥e are adequate resources fc4 fv ¢hgrity to meet its liablities as they fall due and cmtinue in oper)tiM for the fcosee&ble thJture thet it is appropriate to ¢onunue to *Jcpl the poiry concem basis 018ccowitir4 h prep8ring this Amrwal Repcrft and Fine4ioal Ststements. 2.3 Income Incclrry ￿OurCeS a￿ ￿¢0￿nISed In perifyJ in ththlch Ihe th¥rity s enbtled to r￿10 and the Int cen be measured wlh re¥son8ble certalrty. Income is deferred onty when the ¢h8rty to fvffil corKlibon5 before becorrung entitkni to it or Yth•ro th• don￿ or funder h45 sP￿d that the Incoiii• is to be w•nd8d in a luturo Kuuntir¥J pwiod. ND amount IS fbc4￿JQd in the finaneial ststements lof volunteer time in line with the SORP {FRS 102). ants are inC￿ded in the Statement ol finBnci81 on a rec*iv8ble basis. The bal8nce of income received for S￿￿4￿C purpose5 blrt not ￿pended duriryJ the sh(1￿ in the relevant lunds the Balance sheet. Whwe incomè is feeeived in advar+Cè Gf ertitlement ol receipt its recognihon is deferred inC4L￿d ￿ rnditcig 85 defwred in¢cthe. ￿ere enlthment o¢w before in¢on* is re¢wed, the in¢¢4ne is 8￿r￿. healt exc ange 37 2.4 Expendilure Expenthture is recc•Jnised once there is a legal or Cc￿StruCtive o￿lgati£￿ to transfer ecoTrJrric benefft to a third party. rt i8 probable that a trarth of ecowmic beneffts knryll be required in setuement arKI the armunt of the Ob1￿a￿.0n can be rr￿uled reliak*. Expendiiure is classffj￿ by activty. The cfjsts of each actrvty are m&Je up of the to￿￿ of direct costs and shared costs, ind￿dir￿j suppc4t costs invcAved in undertakitYJ each actsty. tlirecl costs attributaNe to a siThJle acts'vty are allocated directty to Ihat actiwty. Shared costs vthich ccffitiibute to m¢ye than oThe acbvty J supwrt costs whith a￿ Th)t attributable to a sir* activty ￿ apF#Jt'Med between Ihose activit*s ￿ a basts Cor￿lStent with tr* use of resources. Central staff costs are allocated on the ba%'s of ts.me spen( and depreciat￿ charges allocated ￿ the wrbon of the asset's use. Expenditure on charitable actrvities is incurred on directy urmdertaking trbe actsvit￿ *t#ch t￿ther trbe Chanys Ctythes. as *EII as any 8&80¢iated support costs. 2.5 Supwt cost allocation costs are tIK*e that assist the work of the Ixrt th+ r*)1 directy rewes￿￿ chwiL¥)le actshrytbes and include office costs. govemance costs, •Jmini8tratsve ¢08ts. Tly we incurred i*recty in SUPFQrt of expenditure on the 04.ects of trle chanty. The analrn of Ihese cc*ts is inthded 7. 2.6 lrtere81 receivable Ir￿e￿$t M I￿19 held on deF#)Sit 18 includ&J vthen receiv*Ae ￿ the can te meagured relably by ts Charity., this is rrtty Ur#￿ nobficalK*n of tr+e interest paMI or payable ty the 2.7 Tangible fixed assels and depreciation Tangible fixed assets we nitialty rets)￿￿8ed at cost. After recc*Jnition: wthr the cosl I￿NJIble fixed assets are ￿￿*Ured at cost less accumulated depreu"ats.C￿ and accunwlated impaimEnt h￿e$. AJI ¢08ts inwrred to ￿"rrfj a taTh*)le fixed a&8et lito rt8 iIMd&J rwation is charged so as to allo&*e the cost of tangible fixed 852ets less Iher repAdual v over th￿"r estin*ted useful lives, usry the straight4ine methoj. - 0.83% Oder 120 - 2S.￿ strwgm line - 33.33% straKJht line - 33.33% str&ght line &)tor vehides Fixtures and fthings Office equipment The assets, res*Jual values: usefvl Ibves aTrJ derreciation method5 are reMe*td. and adjusted XDspectwely rf app￿pnate. or rf there is an indicats)n of a s￿n[ficant chaTwJe %nce the rep)rbrbo 2.8 A88ociated loint veiAure8 Associates and Joint VentLTes ￿ held al cost les8 iry>aimw)L The iwestswrt has been accwnted for as a F*owme related InveStr￿ll. healt exciiange 38 2.9 D•btors Trade ana olher debtors are recognised at the settlement amounl after any trade discounl offere(l. Prepayments are valued at Ihe aff￿unt prepaid net ol any tra¢Je dlscounts due. 2.10 Cash al bank and In hand Cash al bank and in hand indudes cash and short-temi huhty IhiuKI inveslmenls wtth a short maturtty of three months or less from the date of acquisitKJn or OFening of the dep)srt or similar account_ 2.11 Liabilities and provisions Liabiifties are recognised when there is an obiig*ion at the Balance sheel dale as a result of a past evenl. r( Is probatle mat a transfer of economic benefit will be required in settlement, and the anK)unt of the settlement can be estimated reliabty. abililies are recognised at the amount that the Chanty anticipates rt will pay to settle the debt or the amount rt has received as ao*anced paymenls for the goods or ServI￿S it must prowde. 2.12 Flnanclal Instruments The Chanty onty has financrdl assets and financial liabilities of a klnd that qualtty as basic financrdl instruments. Basic financial instruments are initially recognised at transacts.on value and subsequent measured at their settlement value wrth Ihe exception of bank loans which are subsequent measured at amortised cost using Ihe ellective interest melho¢Y. 2.13 operatlng leases Rentals paid under operating leases are charged to the Statement of financial activities on a straMJht line basis over the lease terrn. 2.14 P•nsions The Chanty operates a ¢Jefined contributic￿ plan for rts employees. A deflned contthbulbn Plan is a pension Plan undef which the Chanty pays fixed contributions into a separate entrty. Once the conln"buti(￿s have been paKI. the Charity has no further obl¥Jations. The contribukn'ons are recognised as an expense in the Stalemenl of Financial Activities when they fall due. Amounts not paid are shown in accruals as a liaDilty in the Balance sheet_ The assets of the plan are heKI separatety from the Charty in in¢JepeniJenty adminislere(I funds. Certaln past and present empwes are covered ty the provislons of the Iwo NHS Pensk)n Schemes. Details of the benefits payable and rules of the Schemes can be found on the NHS Pensions website at www.nhsbsa.nhs.uklFensions. Both are unfunded defined benefft schemes that cover NHS employers. GP practices and other bodies. allowed under the direction of Ihe Secretary of state for Heatth and Soual Care in England and Wales_ They are not designed to De run in a way that would enable NHS bodies lo identity their share of the under￿"ng scheme assets an¢J liabilities. Therefore, each scheme is accounteij for as il il were a defined conlribution scheme.. Ihe cost to Ihe NHS body ol parncipating in each scheme is laken as equal to Ihe Contribut￿nS paYa￿e to Ihat scheme for the accounts.ng period. healt exc ange 39 2.15 Fund accountlng Unrestricted lunds are available for use at the di$￿tron of the trustees in furth￿anCe of the general ci)jectives of the charty and whKh have r￿t been designated for other purp)ses. DesMJnated fijnds comprise unreslncted funds that have been set asioe ty the truslees for particular wrwses. The alm and use ol each desMJnated lund is set out In the mtes to the financial statements. Resth'cted funds a￿ funds which are lo be used in accordance wth specffjc Teslrid￿ns imposed by th)nors or which have been raised by the chanty for particular purposes. The cost of raising and ajminislenng such funds are charged against the speafic fund. The aim and use of each restn.cled lund is set out In the notes to the financial statements_ Crilieal aceounting estimates and areas of judgemènt Estimates aTrJ judgements are corrtinuaty evahjated and are based ￿ hislorical expenence and other lactors. including expectations or fvture evenls thal are believed to be reasonable under the arcumstances. Cribcal accounkng estsmates and a$s￿MpIKInS". The Charty makes eslimales and aswmptions conceming the future. The resurting accounling estimates and assumptions will, by Oeflnitic￿, seldom equal the related actual resulis. The estimates and assumpts.ons that have a sNJnificanl risk of causing a material adjustment lo the carrying amounts or assets and IlabiliWes within1he next Inandal year are discussed below. Cribcal areas of judgement". DepreCia￿n and residual value_. The truslees have revÈwed the asset Ilves and assoclaled resldual values of all tanglble fixed assets dasses. and have concluded that asset INes and residual values a￿ appropriate_ Incom• from donations and l•gaci•s Total funds 10 months •nd•d 31 March 2020 Restricted funds Total funds 31 March 2021 31 March 2021 Grants VCSE Health and Wellbeing Big Lottery 313.533 313.533 250,000 117.732 313.533 313.533 367,732 healt exc ange 40 Income from charitable activities Unrestricted funds Total funds 31 March 2021 31 March 2021 Bham CCG-Type2 Diabetes Education Service Mental Health & Wellbeing Triage for EWH Thrive Project Primary Care Ne￿ork Other Income Profil on disposal of fixed assets Coronavirus job rentention scheme income 151,610 279,763 84,755 16,655 575,789 362 17,500 25,212 151.610 279,763 84,755 16.655 575,789 362 17,500 25.212 1,151,646 1,151,646 Unrestrlcted funds 10 months ended 31 March 2020 Total funds 10 months ended 31 March 2020 USE IT Project Bham CCG-Type2 Diabetes Education Service Modaility (Connected Care Partnership Vanguard Programmel Mental Health & Wellbeing Triage for EWH Thrive Project Primary Care Ne￿Ork Other Income Pharmacy Voijcher NRT- Pharmacy- Patches NRT- Pharmacy- Oral 25,628 99,905 6,625 325,392 68,333 27,185 38,065 7,512 1,257 4,078 5,145 25,628 99,905 6,625 325,392 68,333 27,185 38,065 7,512 1,257 4,078 5,145 609,125 609,125 healt exc ange 41 Investment income Unrestricted Restricted funds funds Total funds 31 March 2021 31 March 2021 31 March 2021 Bank interest receivable 507 28 535 Unrestricted funds 10 months ended 31 March 2020 Total funds 10 months ended 31 March 2020 Investment income- local cash 542 542 healt exc ange 42 Expendlture on ¢harftsble a¢t1¥k￿$ Mental Community Health & Health & Social Wellbelng WellbeSng Pers¢rlblng Blg Lottery Head Olfi¢e Total 2020 110 Month Perfodl Other Il¥ltle$ Totsl 2021 Direct Costs Staff costs 157,001 3,646 35,499 368,029 3.667 23.501 186,363 3,234 5,400 10,153 282 144,8031 12,6791 674,064 10,832 76,760 5.544 509,576 5,889 97.442 Telephone, inlemet & SMS Supporters Mobile unrt and van costs 12.360 5,464 Travel and subsisten 271 879 158 10.195 8,825 21,837 7.257 24.747 Adv8rti5ing, promoti(￿5 and m8rk81ing Othèr direct ￿sts Recwilmenl costs RcN)m hire and ￿nI 4,800 450 5,764 550 20,964 3,909 377 7.198 189,366 2,545 364 3TI 714 5,584 560 Impaimenl loss- LWTC 189.366 Totsl direct costs 204,546 587.4TI 2(￿,405 20.675 120.0921 12.6791 .332 691.750 healt exc ange 43 ial Communlty H•￿￿h & H•alth & Sotlal Wellbelng Wellbelng P•rs¢rlblng Lottery Head omc• Total 2020 110 Month Peroodl otMr tlvltfjèu Totsl 2021 Support¢o$t$ Staff costs Renl, raies and 51ora98 Heac Light ond P(wgr Trgvèl and subsL4t8ncè 38B 91 134 17.244 209.178 21.7fj7 4.214 226.944 21.858 4.238 169,739 19,644 24 7,279 Tdephone. Inlemet and SMS Te Offi<￿ expenses L￿¥1 and prOfe￿On￿l Equipmem And I￿nCES Premises expenses Bank Cfvarg8s and Intere Depretyatl Subscripbons and donations ITlw£bsite ￿St& Ropalrs 8rKJ renewals Insuran Other Gosis 287 162 31 13.204 8.376 36.981 17.215 6.901 13.674 9.975 90.306 26.004 7.116 25 10.891 3.281 290 530 449 7,335 3,191 28,785 28,191 7,626 660 4,800 1,802 120 3.796 95 2.599 125 587 3B5 232 0.689 2.TT1 6.607 2,409 6,473 475 18,493 3,863 327 25.274 6.436 1337.3771 327 25.664 23.077 10.275 112.268 1,128 100,359 5,238 9,811 Haad offi¢p r*harges 114,939 Tolal supwrt rrtsts 1x1.988 113,855 37,297 21.858 423.049 313,301 healt exc ange Auditorfs remuneration 10 months ended 31 March 2020 31 March 2021 Fees payable to the Charity's auditor for the audit of the Charity's annual accounts 9,600 9.500 Stsff costs 10 months ended 31 March 2020 31 March 2021 Wages and salaries Social security costs Contribution lo defined contribution pension schemes 810,431 67,314 26,515 566.160 46,003 17,242 904,260 629,405 The average number of persons employed by the Charity during the year was as follows= 10 months ended 31 March 2020 No. 31 March 2021 No. Adminislralion Frontline Operats'onal Management 29 31 45 47 healt exc ange 45 Stsff costs Icontinuedl The number of employees whose employee benefits (excluding employer pension costs) exceeded £60,000 was.. 10 months ended 31 March 2020 No. 31 March 2021 No. In the band £60,001 £70,000 The trustees consider ils key management personnel comprise the management team. The total employment benefits including employers national insurance and employer pension contributions of the key management personnel were £147,65812020.' £147,165). 10. Trustee's remuneration and expgnses During the year, one Trustee has been paid remuneration or has received other benefits from an employment with the Charity as permitted under the Charitys goveming document. The value of Trustee's remuneration and other benefits was as follows.. 10 months ended 31 March 2020 31 March 2021 Ronald Owitrim Remuneration 70,000 2.100 65,233 2,100 Pension contributions paid During the year ended 31 March 2021. no Trustee expenses have been incurred12020 - £NILI- healt exc ange 46 11. Tangible fixed a88et8 Lontrlemi leasehokl property Motor Fixtsre8 and Vehicle fittings ewipnxnt Total Cost or valualion At 1 Awl 2020 33,675 109,427 526,154 Additio 3.082 10,546 17,833 DiBpMalB (33,67S) 133,675) At31 Mwch X121 36,134 119.973 510,312 Depreciation At1￿2020 2,917 33,675 27,174 101,020 164,786 Ch¥ge ft* the 2.102 7,549 10,689 (33,675) 133,675) At31 3)21 5,019 28.212 108,569 141,8LK) Nel book value At 31 Mwch 3J21 At31 3)20 ThE wbtere8t in the kx￿4￿rn ka8eh(Ad FXI>p￿ty wa8 revalu￿1 on 30 Auyt 2019 Twhith deem￿1 the leasefK4d interesl in the propety to be £350.c￿ The valuatp)n was pro￿￿ed by a qualffied vakwwh) Re￿￿ed ¥alRr as ￿er¥￿d the RICS vdUat￿ Regatr&K￿ Scheme. The directors twe considered thts valuth'on as at the date of sgning these accounts arKI deem this ValUa￿n to represent current market conditicr6 as at that date. thwetse feel rt is apprwte to carry this at revalued a)Kunt su*'ect to dewttiaticfi. healt exc ange 47 12. Fixed asset investments Investment In lolnt ventures Cost or valuation At 1 April 2020 190,000 At 31 March 2021 190,000 Impaimignt Charge for the year 189,366 Al 31 March 2021 189,366 Al 31 March 2021 634 At 31 March 2020 190,000 The company participates in 8 joint venture 8rr8ngement in Living Well Taking Control LLP, an LLP incorporated in England and Wales. with one other party. In March 2013 Health Exchange joined forces with Exeler-based charity Weslbank Community Health and Care lo deliver the programme. called Living Well Taking Control, to people in Birmingham and Exeter identified as being al risk of developing, or recently diagnosed with, Type 2 diabetes. Keen to ensure effective evaluation of this education and support programme. this partnership also worked with a number of Universities including Exeler, Bristol and Birmingham lo evidence the value and benefits of the service to service-users. The company owns 50% of the LLP and its share of trading results and assets and liabilities are shown in note 13. healt exc-,ange 48 13 Joint venture trading result 2021 2020 Turnover 526,234 1,058,266 Cost of sales 1550,1341 {781,4851 Gross profit 123,9001 276,781 Administrative expenses 1169,6191 {321,3461 Operatlng (lossiiproflt 1193,5191 {44,S651 Fixed assets 5,253 2,443 Currgnt Assgts 373,592 642,765 Credrtors 1378,2111 1430,8091 Net assets 634 214,399 Members other Interests Members capital classified as equity 190,000 190,000 Other reserves 1189,3661 24,399 1￿ Debtors 2021 2020 Due wlthin one year Trade debtors 372,729 130,405 Other debtors 3,149 50,319 Prepayments and accrued income 14,101 42,603 healt exc ange 49 15. Crgditors: Amounts falling dug Within ong ygar 2021 2020 Bank overdrafts 1,459 7,569 16,275 83,474 23,168 10,443 Bank loans 7,719 34,841 65.023 8.241 25,572 Trade creditors Other t8X81ion and social security Other creditors Accruals 142,388 141,396 16. Creditors: Amounts falling due after more than one year 2021 2020 Bank loans 9,498 17. Financial instruments 2021 2020 Financial assets Financial assets measured at fair value through income and expenditure 496,131 435.445 Financial assets measured at fair value through income and expenditure comprise cash in bank. healt exc ange 50 18. Statement offunds Staternent of funds - current year Balance at 31 March 2021 Balance at 1 April 2020 Transfers inlout Income Expenditure Unrestrlcted funds Designatgd funds Tangible fixed asset fund Leasehold property Revaluation reserve Investments 116,497 98.833 146,037 190,000 17,7711 12,102) 17,834 126,560 96,731 146,037 634 1189,3661 551,367 1199,2391 17,834 369,962 General funds General 490,833 1,153,442 1841,8841 159,4851 742,906 Total Unrestricted funds 1,042.200 1,153,442 {1,041,1231 141,6511 1,112,868 Restricted funds Big Lottery Fund VCSE Health and Wellbeing 17,046 28 313,533 {57,9991 1314,2591 40,925 726 17,046 313,561 1372,2581 41,651 Total of funds 1,059,246 1,467,003 {1,413,3811 1,112,868 healt exc ange 51 18. Statement of funds {contlnuedl Statement of funds - prior year Balance at 31 March 2020 Balance at 1 June 2019 Transfers inlout Income Expenditure Unrestrlcted funds Flxed Asset funds Tangible fixed asset fund Leasehold property Revaluation reserve Investments 121,832 101,750 146,037 190.000 16,505} 12,917} 1.170 116,497 98,833 146,037 190,000 559,619 19,4221 1,170 551,367 General funds General Funds - all funds 527,279 609,667 1644,9431 11.170) 490,833 Total Unrastrict8d funds 1,086,898 609,667 1654,365} 1.042,200 Restrlcted funds Big Lottery Fund VCSE Health and well being 117,732 250,000 1100,686} 1250,000} 17,046 367.732 1350,686} 17,046 Total of funds 1.086.898 977,399 11,005,0511 1,059,246 Tangible fixed asset fund and leasehold property fund The purpose of these funds are lo recognise the value of operational assets which are not freely convertible into cash. Revaluation Fund This represents the revaluation of the leasehold property. The trustees believe that it is inappropriate lo consider that this unrealised valuation surplus is available for the ongoing work of the Charity. VCSE Health and wellbeing This fund represents grant income lo be used on the social prescribing project. Big Lottery Fund This fund represents grant income lo be used on the wellbeing asset building project. healt exc ange 52 19. Summary of funds Summary of funds - current year Balance at 31 March 2021 Balance at 1 April 2020 Transfers inlout Income Expenditure Designated funds General funds Reslricled funds 551,367 490,833 17,046 1199,2391 1841,8841 1372,2581 17,834 159,4851 41,651 369.962 742,906 1,153,442 313,561 1,059,246 1,467,003 11,413,381) 1,112,868 Summary of funds- prioryear Balance at 31 March 2020 Balance at 1 June 2019 Transfers inlout Income Expenditure Designated funds General funds Reslricled funds 559,619 527,279 19,4221 1644,9431 1350,6861 1,170 {1,170) 551,367 490,833 17,046 609,667 367,732 1.086,898 977,399 11,005,051) 1,059,246 20. Analysls of net assets between funds Analysls of net assets between funds - current year Unrestrlcted funds 2021 Total funds 2021 Tangible fixed assets Fixed asset inveslrnents 368,512 634 368,512 634 Current assets Creditors due within one year 886,110 1142,3881 886,110 1142,3881 Total 1,112,868 1,112,868 healt exc ange 53 20. Analysis of net assets between funds lcontinuedl Analysis of net assets between funds - prior year Unrestricted Restricted funds funds 2020 2020 Total funds 2020 Tangible fixed assets Fixed asset investments Current assets Creditors due within one year Creditors due in more than one year 361,368 190,000 641,726 1141,3951 19,4981 361,368 190,000 658.772 1141,3951 19,4981 17,046 Total 1,042,201 17,046 1,059,247 21. Reconci1Satlon of net movement Sn funds to net cash flow from operatlng actlvities 10 months ended 2020 2021 Net ineomelexpendilure for the year las per Statement of Financial Aclivitiesl 53,622 (27,6521 Adjustments for: Depreciation charges Impairment of joint venture Dividends, interests and rents from investments Lossllprofill on the sale of fixed assets Decreasel{increasel in debtors Increaselldecreasel in creditors 10,689 189,366 15351 117,5001 1166,6521 1,142 9,422 {5421 316,945 1179,3761 Net cash provlded by operatlng actlvltles 70,132 118,797 22. Analysis of Cash and cash gquivalent$ 2021 2020 Cash in hand 496,131 435,445 healt exc ange 23. Analysis of changes in ngt debt At 1 April 2020 Cash flows At 31 March 2021 Cash al bank and in hand Bank overdrafts repayable on demand Debt due within 1 year Debt due after 1 year 435,445 60,686 {1,4591 150 9,498 496.131 11,4591 17,5691 17.7191 19,4981 418,228 68,875 487,103 Pension commitments The company operates a defined contribution stakeholder pension scheme. The assets of the scheme are held separately from those of the company in an independently administered fund. A proportion of the pension cost charge represents contributions payable by the company to this fund and amounted 10 £26,51512020.' £17,242) in the year. Contributions lolalling £1,70212020'. £3,819) were payable to the fund at the balance sheet date and are induded in other creditors. NHS Penslon Scheme Past and present employees are covered by the provisions of the ￿ NHS Pension Schemes. Detsils of the benefits payable and rules of the Schemes can be found on the NHS Pensions website al www.nhsbsa.nhs.ukJpensions. Both are unfunded defined benefit schemes that cover NHS employers, GP practices and other bodies, allowed under the direction of the Secretary of Slate for Health and Social Care in England and Wales. They are not designed to be run in a way that would enable NHS bodies lo identify their share of the underlying scheme assets and liabilities. Therefore, each scheme is accounted for as if il were a defined contribution scheme.. the cost to the NHS body of participating in each scheme is taken as equal to the contributions payable to that scheme for the accounting period. In order that the defined benefit obligations recognised in the financial slalemenls do not differ materially from those that would be detemined al the reporting dale by a fomial actuarial valuation, the FReM requires that "the period between fomial valuats'ons shall be four years, with approximate assessments in intervening years" An outline of these follows.. Accounting valuation A valuation of scheme liability is carried out annually by the scheme actuary (currently the Government Actuary's Department) as al the end of the reporting period. This ulilises an actuarial assessment for the previous accounting period in conjunction wth updated membership and financial data for the current reporting period, and is accepted as providing suitably robust figures for financial reporting purposes. The valuation of the scheme liability as at 31 March 2021, is based on valuation data as al 31 March 2019, updated to 31 March 2021 with summary global member and accounting data. In undertaking this actuarial assessment, the methodology prescribed in IAS 19, relevant FReM interpretations. and the discount rale prescribed by HM Treasury have also been used. The latest assessment of the liabilities of the scheme is contained in the report of the scheme actuary. which forms part of the annual NHS Pension Scheme Accounts. These accounts can be viewed on the NHS Pensions website and are published annually. Copies can also be obtained from The Stationery Office. healt exc ange 55 24. P•nslon eommiim•nis Iconiinu•dl Full a¢tuarlal Ifundingi valuati¢n The purpose of this valuatson is to assess the level of liability in respect of the benefits due under the schemes Ilaking into account recent demogratthic exFenencel. to recommend conlnLMJlhJn rates payable ty emph)yees and employers. The lalesl actuarial valuatson undertaken for the NHS PenS￿Tr Scheme was completed as al 31 March 2019. The results ol this valuatson sel the empkjyer contributiC￿ rate payable from Apnl 2019 10 20.6%. and the Scheme Regulations were amended acc¢Ndingly. 25. Operatlng lease ¢ommltm*nts At 31 March 2021 the Chanty had commitmerts to make lulure minimum lease payTnents under non- cancellable operatirbg leases as follows- 2021 2020 Not later 1 year Later Ihan 1 year and not later Ihan 5 years 1.596 3.591 1,596 5,187 5,187 6,783 26. Members. liability Each membei of the chantable company undertakes lo contribute lo the assets of the company in the event of it belrKJ wound up whlle helshe is a member. or wthin one year after helshe ceases lo be a member. such amount as may be requred. not exceedlng £1 lor the debts and liabl11t￿S contracted belore helshe ceases to be a member. 27. R•lai•d party transa¢tl¢ns As stated in mle 12 Heallh Exchange participates in a joint venture arrangement with LivirKJ Well Taking Ccffltrol LLP an LLP incorporated in Englan¢Y and Wales Icompany number.. OC407449}. During the pefK)d Health Exchange made payments behalf ol the Living Well Taking Control LLP amountsng to £305.21612020.' £456,8401 ol whlch £nil12020" £nlll reflects the capltal conlmbulkin baThJ thelr share of the joint venture arrangement. Included within trade debtors due wlhin one year is £75,13412020= £63,974) due from Living Well Taking Control LLP. Al year end there is an amount of £83,824 in deferre(l income which relates to redundancy costs incurred behalf of LNing Well Taking Control LLP. All of the Truslees, In Heallh Exchange are also Trustees ol Heallh Exchange UK a company regL8tered in EnglaThY and Wales {Company number.. 095958391. Health Exchange provide¢ a h)an during year ending 2017 for £5,000 lo the chanlable company and the balance outstanding in respect of Ihis loan at the year end was.. £Nil12020 ". £201 this is included wrthin other debtors due within one year. Dufing the year Scotdct Consultancy Ltd. a company where CEO aThJ Trustee Russell Muknead is a directci. provmyed clinical supervision services lo staff. The cost of these services totalled £13,61212020'. £6.0631. At the year end an amount of £1,252 was owed to12020." £Nill Scotdoc Consultancy Ltd.