# **Annual Report** _**2020**_
**1**
Bravo Medics is a registered charity in England & Wales (1189780).
2020
84 incidents attended
1,731
53% •18/
miles
trauma
emergency anaesthesia
60% at
night
18% W10/
cardiac arrests
children
Jarns one of ourvolunteer dottor5, wa5 woken at
night by arnbulance control asking hitn to attend an
Incident where a car had been hit by a lorry. The car
had been rolled over and the young tnale orcupant
was irapped Inside wrth 5evwe and very painful
Injunes.
90%
mes was able io adrninisrer strong pain killing
medicabtsns. not available to ambulance creY+s, to keep
him comfortable whilst he wa5 freed frorn the
wreckage. Once he wa5 released it was noticed h15
fÈmur (the long bone at the top of the leg) was béd
broken salaFries sedated hitn (8ave him a light general
anaestheticl. allong his leg to be straightened and
splinted for the onwardjourney to the MajorTrautna
Centre in Southrnead. Bristol. wherelarne5 handed
him ¢)ver for expert ongoing trauma care.
of people we treated survived to
h05Pltal
"Detai changed to proiect patient confidenDality.
Glouie5rershire
10 s Gloucesterthire
Br15t 24
N. Somer5et 23
6 BANES
12 w Itshiie
mer5et 3
## **Contents**
What We Offer Patients 8 Objectives & Activities 11 Structure, Governance & Management 12 Meet The Team 15 Financial Review 16 Accounts 17
To serve the local community and support the local ambulance service in caring for the sickest patients, wherever they become ill or injured.
We do this by providing volunteer doctors, highly trained in critical care and equipped with specialist medical equipment - ‘bringing the Emergency Department to their side.’
## **Our Mission**
**4**
**5**
## **Bravo Medics**
## **Report of the Trustees for the year ended 31 December 2020**
The trustees of Bravo Medics present the annual report, including accounts, of the charity’s activities between 1 January and 31 December 2012. They additionally confirm that they comply with the Charities Act 1993, as amended by the Charities act 2006 and the Charities SORP applicable to charities preparing their accounts in accordance with the Financial Reporting Standard for Smaller Entities.
_**“Bravo Medics were there for us when our family needed them.”**_
## **Charity name**
## **Charity registration number**
## **Registered address**
## **Board of trustees**
## **Clinical Lead**
## **Responding Doctors**
## **Accounts reviewed by**
## **Registered bank**
## Bravo Medics
## 1189780
(Charity Commission of England & Wales)
Garden Cottage
Long Lane
Wrington, Bristol BS40 5SA
Dr Andrew Heavyside (Chair of Trustees) Dr James Tooley Mr Blair Sasada Dr Frederick Stourton
Dr James Tooley
Dr Andrew Heavyside Dr James Tooley
Mrs Jackie Taylor
## HSBC
10 Colliers Walk Nailsea, Avon BS48 1RL
**6**
**7**
## **What We Offer Patients**
## **Pre-Hospital Emergency Anaesthesia**
Often the very sickest patients need to be put into a medically induced coma to allow a tube to be placed in their windpipe so that a machine can take over their breathing. This is done to return their blood oxygen levels to safe limits and to protect their lungs from aspirating vomit, something which can happen to patients who are unconscious.
In patients who are unconscious because of a head injury or brain haemorrhage the anaesthetic itself can reduce any ongoing damage to the brain. It does this by reducing the brain’s demand for oxygen and controlling blood flow to reduce swelling and pressure inside the skull.
Traditionally this procedure was only performed by anaesthetists and intensive care doctors in hospital, and despite the best efforts of the ambulance service some patients would sadly die en-route to the Emergency Department.
Every doctor volunteering for Bravo Medics is trained to be able to administer an anaesthetic on the roadside, or at a patient’s home, optimising their care and reducing the risks of ongoing transfer to hospital.
## **Life Saving Surgical Procedures including Open Heart Surgery**
A very small number of our patients have conditions which if left untreated would kill them before they get to hospital and thus require us to intervene on the road side with surgical procedures to save their lives.
All of our clinicians can carry out procedures to relieve a pneumothorax (air that is trapped in the patient’s chest outside of their lung) and to surgically place a breathing tube via a tracheostomy type incision in a patient’s neck if they are unable to breath.
Our volunteer doctors are also trained to perform open heart surgery, in the event of a patient’s heart having stopped beating after being stabbed in the chest/abdomen, or other penetrating injury, to the chest.
## **Sedation**
Sometimes it is necessary to perform unpleasant procedures in the pre-hospital environment that cannot, or should not, wait until the patient gets to hospital but that will cause them significant pain. These are procedures such as straightening and splinting badly broken bones or freeing patients that are trapped in car wreckage.
To facilitate these procedures Bravo Medics would be called and are able to administer strong sedative medications, which work in a similar way to a short general anaesthetic, and reduce the pain and distress associated with these procedures. Whilst a patient is under sedation we use our high-tech monitors to ensure the patient stays safe.
## **Advanced Pain Relief**
One area in which the ambulance service can find themselves limited is in the provision of pain relief to patients, particularly children.
Bravo Medics clinicians are happy to support crews on scene and increase patient comfort by administering stronger pain relief.
In rare cases we might use ultrasound to block nerves to an injured part of the body thus numbing it completely, this is known as regional anaesthesia and is usually performed in the operating theatre by highly trained anaesthetists.
## **Drugs & Treatments Normally Only Available in Hospital**
We carry medications that are not available on standard ambulances, these are used to treat the following conditions:
- Seizures resistant to initial treatment
- Eclampsia (seizures which can occur in late pregnancy)
Our team practice these skills regularly so they can be reliably performed in an emergency.
## **Consultant Level Decision Making**
- Asthma
- Severe sepsis
- Life threatening cardiac arrhythmias (the electrical activity driving the heart)
- Cardiac arrest
A harder to quantify attribute that Bravo Medics volunteer clinicians bring to every scene is experience, and the ability to work outside of guidelines in order to ensure that every patient receives care tailor made to their specific circumstances.
This experience has been gained through many years of training and working both in hospital and within the pre-hospital environment. We also learn from every case we attend as they are reviewed as part of our clinical governance and case review process, which ensures that we deliver safe and consistent care to every patient.
**8**
**9**
## **Objectives & Activities**
## **Objectives**
Bravo Medics’ main objective is to save lives in the community by providing equipment, training and financial support to Critical Care doctors who respond to emergencies in their area at the request of the local ambulance service.
Our main activity in our first 10 months of operating has been to fully equip two responding doctors who have undertaken a large number of life-saving missions. We have also established ourselves as a charity, including a website. Finally, we have been able to provide ongoing financial support to the two doctors by funding the fuel required for their response driving.
Bravo Medics is built on the ethos of providing a life-saving service to the local communities of its responders. The charity’s activities are designed to further that goal. All decisions made by the trustees are done so with due regard to the Charity Commission’s guidance on public benefit.
## **Achievements and performance**
Ultimately, our performance is measured by the number of people we treat and the lives we save. Every incident to which we are dispatched is critical and the people involved are at an immediate risk of losing their lives. Our critical care is gold standard. In 2019, the BMJ stated that pre-hospital care provided by critical care teams was associated with an increased chance of survival at 30 days when compared with care provided by ambulance clinicians (Maddock et al, 2020).
Our work is also cost effective: We can provide hospital level critical care, potentially including anaesthesia and emergency surgery, to a patient for less than the cost of a GP appointment to the NHS.
Our support after treatment is not only informative but can aid people’s recovery. Providing information - in some cases when people have no memory - can help people understand what happened so they can focus on their recovery.
## **References**
Maddock A, Corfield AR, Donald MJ, et al Prehospital critical care is associated with increased survival in adult trauma patients in ScotlandEmergency Medicine Journal 2020;37:141-145.
**10**
**11**
## **Structure, Governance & Management**
## **Governing document**
Bravo Medics is a Charitable Incorporated Organisation (CIO), registered with the Charity Commission under number 1189780. The first meeting of the trustees was on 12 February 2020. The CIO is governed by a constitution dated 12 February 2020.
## **Organisational structure**
The overall responsibility for the control and management of the charity lies with the trustees in accordance with the duties of trustees as laid out below. The trustees give their time freely and receive no remuneration or other financial benefits. The trustees meet at least 3 times a year, either virtually or in person.
Bravo Medics responds on behalf of South West Ambulance Service Trust, and under the umbrella of BASICS South West, and complies with the organisational requirements of both organisations.
Oversight of clinical activities is delegated to the Clinical Lead, who is a member of the board of trustees. For the recorded period, this role was filled by Dr James Tooley. Review of clinical activities is performed on a regular basis in conjunction with other BASICS schemes in the BASICS South West umbrella in order to ensure high quality care. Appointment of responding doctors is performed by the clinical lead, subject to approval by BASICS South West.
## **Appointment of new trustees**
Trustees are selected and appointed by the current trustees. Every trustee must be appointed for a term of three years by a resolution passed at a properly convened meeting of the charity trustees. In selecting individuals for appointment as charity trustees, the charity trustees must have regard to the skills, knowledge and experience needed for the effective administration of the CIO.
The holder of the Clinical Lead role is also invited to become a trustee. The Clinical Lead must be a full clinical member of Bravo Medics and is usually at consultant level (or equivalent post CCT) level. The Clinical Lead shall be appointed by the charity trustees following advice from the clinical members of the organisation and the outgoing Clinical Lead as to who, in their considered opinion, would be best suited to fulfil the position.
## **Duties of Trustees**
The Trustees shall perform their duties in accordance with the constitution of the CIO and the law, in particular the preparation of an annual report and financial statements.
The Charity trustees shall manage the affairs of the CIO and may for that purpose exercise all the powers of the CIO. It is the duty of each Charity trustee:
- To exercise his or her powers and to perform his or her functions in his or her capacity as a trustee of the CIO in the way he or she decides in good faith would be most likely to further the purposes of the CIO.
- To exercise, in the performance of those functions, such care and skill as is reasonable in the circumstances having regard in particular to:
- any special knowledge or experience that he or she has or holds himself or herself out as having; and,
- if he or she acts as a Charity trustee of the CIO in the course of a business or profession, to any special knowledge or experience that it is reasonable to expect of a person acting in the course of that kind of business or profession.
**12**
**13**
## **Dr Andrew Heavyside** _**Chair of Trustees & Clinical Responder**_
Andrew is a senior registrar in Anaesthesia and Pre-Hospital Emergency Medicine currently in the final year of his anaesthetics training in the Wessex Deanery. He developed his interest in pre-hospital care whilst at university in Aberdeen and completed his training in Pre-Hospital Emergency Medicine with Great Western Air Ambulance Charity over 2019-20. In a varied career to date, to complement his base specialty training, Andrew has completed additional posts in Paediatric and Neurosciences Intensive Care, Emergency Medicine and Major Trauma. He has also served as an officer in the Royal Navy.
Andrew has been involved in BASICS since 2008. He passionately believes that critical care should be available to patients 24 hours a day wherever they are injured or become ill and that voluntary schemes play a key part in this.
From a fairly junior stage he took an interest in clinical governance and service development; sitting on a hospital trust clinical governance committee, playing a key role in improving the pre-hospital capability of the medical teams on a large military airbase and later expanding and rebranding another BASICS scheme.
He is keenly involved in the charity sector, where he has volunteered as a doctor to facilitate holidays and activity camps for those with serious illnesses and disabilities as well as planning several large-scale fundraising activities.
He is relishing the challenge of being the founding Chairman of Bravo Medics and looking forward to how this will impact positively on patient’s lives in the local area.
Outside of work Andrew enjoys scuba diving and walking in the countryside.
## **Dr Frederick Stourton** _**Treasurer & Trustee**_
Freddie qualified as a doctor in 2019 and works in Sussex. He has had an interest in pre-hospital care from an early stage in his career, including a stint as a voluntary Emergency Responder for London Ambulance Service.
He has previously been involved in a number of charity and community organisations. He spent 4 years on the committee of a youth volunteering charity, which included the organisation and management of a yearly trip for over 250 people. He is used to managing money, including the accounts of community organisations with a significant annual budget.
He is keen to develop a sustainably funded service that provides round the clock critical care.
## **Blair Sasada**
## _**Trustee**_
Blair has a long-term commitment to the charity sector. He has been volunteering with a charity helping people with disabilities since his final years at school. This has involved the organisation of activities in the UK, across Europe and the Middle East as well as several years on the charity’s committee.
Blair's professional background is in marketing and fundraising. He has worked for a number of healthcare organisations, including a pancreatic cancer charity where his role was to raise awareness of the disease.
He is passionate about the world-class service that the NHS provides; so is delighted to be founding trustee of Bravo Medics.
## **Dr James Tooley** _**Clinical Leand & Trustee**_
James has been a Consultant in Paediatrics and Neonatal Intensive Care for more than ten years and works full time as a Paediatric and Neonatal Retrieval Medicine Consultant based out of Bristol. He is also a Critical Care Doctor for Great Western Air Ambulance.
James has a proven track record in developing clinical services in the South West of England. He is the founder and clinical lead of a world class Neonatal Transfer Team based in Bristol. Involved in BASICS since 2015, James took over as Chairman of BASICS South West in 2018. He firmly believes that pre-hospital critical care should be available to the most seriously ill and injured patients at all times of day and night. He is therefore very keen to help develop Bravo Medics as a robustly governed critical care scheme to assist his local community.
Blair and his wife enjoy travelling and they have just returned from 3 years exploring New Zealand.
## **Meet The Team**
When James isn't in the back of an ambulance he likes to spend time at home with his wife and two children.
**14**
**15**
## **Financial Review**
## **Liabilities**
In this first year of the charity’s operation, the main financial aim was to equip our two responders with equipment, including vehicle warning lights and uniforms. It was also the intention of the trustees to ensure that the charity had a reasonable public presence online to assist with fundraising. Grant applications were therefore mainly targeted at these two objectives.
At the end of the period, the Charity held £4,864 (net of liabilities), the majority in restricted funds to be used for further core and operational costs as delineated by the restrictions including;
- Further warning equipment for response driving
As of the 31st of December 2020, the charity had two outstanding liabilities:
- Equipment servicing (Zoll monitors, payment due in January 2021) - £840
- Loan repayments. Of the initial £5,000 loans, the charity successfully repaid £3,000 over the course of 2020. In the next accounting period, the charity will pay off the remainder of these loans.
## **Managing the impact of the Covid-19 pandemic**
- Critical Care medications and accessories
- Professional development costs for clinical members
- Fuel for response driving and winter tyres
- Servicing of equipment
As a charity that started operating in the early stages of the COVID-19 pandemic, Bravo Medics struggled with building certain traditional income streams. Instead the charity focused on COVID-19 specific grants, with some success. We expect that the number of callouts for our responders will increase as normal patterns of life are re-established into 2021.
## **Principal funding sources**
## **Plans for future periods**
The charity’s main source of income is grant applications. £20,755 was raised through grants last year. The remaining income was from 2 private ‘start-up’ loans from two trustees, totalling £5,000, and a small amount of online fundraising through the Amazon Smile and Easyfundraising platforms. All grant income was in the form of restricted grants, although this included both capital purchase grants and ongoing operational income.
## **Significant financial events**
There are no current concerns over the charity’s ability to operate as a going concern. The financial aims for the next period are as follows:
- Equipping a third medical responder once they have been approved by BASICS South West
- Building our income streams by working with a professional fundraiser
- Repay the remainder of the start-up loans.
During the period, one significant event occurred which resulted in the loss of a full set of warning equipment due to the vehicle being written off. The incident occurred outside the activities of the charity, and was reported to the Charity Commission in line with the guidance on reporting serious incidents. The cost of replacing the equipment was covered by an additional grant.
## **Reserves policy**
As stated above the charity held just under £5,000 at the end of the period, the majority to be used for future equipment purchases and operational costs. It is the charity’s intention to build a small unrestricted financial reserve over the next accounting period that is not committed to any future liability to account for future contingencies.
## **Preparation of accounts**
As a CIO with an income of under £250,000, the accounts were prepared on a receipts and payments basis in accordance with the Charities SORP. These were then checked by Mrs Jackie Taylor
## **Accounts**
## **Exemptions from disclosure**
The Charity reports no exemptions from disclosure.
## **Investment policy and objectives**
## **Funds held as custodian trustee on behalf of others.**
The charity has no long term investments at present.
The Charity does not act as a custodian trustee, nor do any of its individual trustees.
**16**
**17**
||**Bravo Medics**|**1189780**||
|---|---|---|---|
||**Garden Cottage, Long lane, Wrington, BS40 5SA**|||
||**Receipts and payments accounts**||**CC16a**|
||**For the period**
**from**
1/1/2020
**To**|31/12/2020||
|||||
## **Section A Receipts and payments**
||||**Unrestricted**
**funds**|**Unrestricted**
**funds**||||**Restricted**
**funds**||||**Endowment**
**funds**|||||**Total funds**||||**Last year**|||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|||**to the nearest**||||||**to the nearest £**||||**to the nearest £**|||||**to the nearest £**||||**to the nearest**|**£**||
|**A1 Receipts**|||**£**|||||||||||||||||||||
|HELP Grant 1||**-**||**--**|||**-**|**8,414-**|||**-**|**--**||||**-**|**8,414-**|||**-**|**--**|||
|HELP Grant 2||**-**||**--**|||**-**|**2,529-**|||**-**|**--**||||**-**|**2,529-**|||**-**|**--**|||
|Wiltshire Community Foundation grant||**-**||**--**|||**-**|**4,308-**|||**-**|**--**||||**-**|**4,308-**|||**-**|**--**|||
|Groundwork Grant||**-**||**--**|||**-**|**500-**|||**-**|**--**||||**-**|**500-**|||**-**|**--**|||
|BASICS start-up grant||**-**||**--**|||**-**|**5,000-**|||**-**|**--**||||**-**|**5,000-**|||**-**|**--**|||
|Online Fundraising||**-**||**103-**||||||||||||**-**|**103-**|||||||
|||**-**||**--**|||**-**|**--**|||**-**|**--**||||**-**|**--**|||**-**|**--**|||
|**_Sub total_**_(Gross income for_||**-**||**103-**|||**-**|**20,751-**|||**-**|**--**||||**-**|**20,854-**|||**-**|**--**|||
|_AR)_
**A2 Asset and investment sales,**||||||||||||||||||||||||
|**(see table).**||||||||||||||||||||||||
|Private start-up loans||**-**|**5,000-**||||**-**|**--**|||**-**||**--**|||**-**|**5,000-**|||||||
|||**-**||**--**|||**-**|**--**|||**-**||**--**|||**-**|**--**|||**-**||**--**||
|**_Sub total_**||**-**|**5,000-**||||**-**|**--**|||**-**||**--**|||**-**|**5,000-**|||**-**||**--**||
|||||||||||||||||||||||||
|**_Total receipts_ **||**-**|**5,103-**||||**-**|**20,751-**|||**-**||**--**|||**-**|**25,854-**|||**-**||**--**||
|**_Total receipts_ **||**-**|**5,103-**|||**-**|**20,751-**|||**-**|**--**|||**-**|**25,854-**|||**-**|**--**||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|**A3 Payments**|||||||||||||||||||||
|Core - accounting||**-**|**84-**|||||||**-**|**--**|||**-**|**84-**|||**-**|**--**||
|Core - Legal expenses||||||**-**|**1,200-**|||**-**|**--**|||**-**|**1,200-**|||**-**|**--**||
|Core - Publicity and Fundraising||||||**-**|**355-**|||**-**|**--**|||**-**|**355-**|||**-**|**--**||
|Operational - Critical Care Drugs||**-**|**380-**|||**-**|**432-**|||**-**|**--**|||**-**|**812-**|||**-**|**--**||
|Operational - Equipment maintenance||**-**|**503-**|||**-**|**293-**|||**-**|**--**|||**-**|**796-**|||**-**|**--**||
|Operational - Insurance Uplifts||||||**-**|**325-**|||**-**|**--**|||**-**|**325-**|||**-**|**--**||
|Operational - Mileage||||||**-**|**768-**|||||||**-**|**768-**||||||
|Operational - Vehicle fitting||**-**|**36-**|||**-**|**8,916-**|||||||**-**|**8,952-**||||||
|Operational - Equipment purchase||**-**|**176-**|||**-**|**898-**|||||||**-**|**1,074-**||||||
|Operational - Uniforms and PPE||**-**|**--**|||**-**|**785-**|||**-**|**--**|||**-**|**785-**|||**-**|**--**||
|**_Sub total_ **||**-**|**1,178-**|||**-**|**13,972-**|||**-**|**--**|||**-**|**15,150-**|||**-**|**--**||
|**_Sub total_ **||**-**|**1,178-**|||**-**|**13,972-**|||**-**|**--**|||**-**|**15,150-**|||**-**|**--**||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
||||||||||||||||||||||
|**A4 Asset and investment**|||||||||||||||||||||
|**purchases, (see table)**|||||||||||||||||||||
|Loan Repayments||**-**|**3,000-**|||**-**|**--**|||**-**|**--**|||**-**|**3,000-**||||||
|**_Sub total_ **||**-**|**3,000-**|||**-**|**--**|||**-**|**--**|||**-**|**3,000-**||||||
||||||||||||||||||||||
|**_Total payments_ **||**-**|**4,178-**|||**-**|**13,972-**|||**-**|**--**|||**-**|**18,150-**|||**-**|**--**||
||||||||||||||||||||||
|**_Net of receipts/(payments)_ **||**-**|**925-**|||**-**|**6,779-**|||**-**|**--**|||**-**|**7,704-**|||**-**|**--**||
|**A5 Transfers between funds**||**-**|**--**|||**-**|**--**|||**-**|**--**|||**-**|**--**|||**-**|**--**||
|**A6 Cash funds last year end**||**-**|**--**|||**-**|**--**|||**-**|**--**|||**-**|**--**|||**-**|**--**||
|**_Cash funds this year end_ **||**-**|**925-**|||**-**|**6,779-**|||**-**|**--**|||**-**|**7,704-**|||**-**|**--**||
||||||||||||||||||||||
|||||**-**
**--**||**-**
**--**||**-**
**--**|
|---|---|---|---|---|---|---|---|---|
|**B2 Other monetary assets**
**B3 Investment assets**
**B4 Assets retained for the**
**charity’s own use**
**B5 Liabilities**
Signed by one or two trustees on
behalf of all the trustees|**_Total cash funds_**
(agree balances with receipts and payments
account(s))
**Details**
**Details**
**Details**
**Details**
Core - Loan Repayments
Operational - equipment mainenance
Signature
|||**-**
**925-**||**-**
**6,779-**||**-**
**--**|
|||||||||OK|
|||||**Unrestricted**
**funds**
**Restricted**
**funds**
**to nearest £**
**to nearest £**
**-**
**--**
**-**
**--**
**Fund to which**
**asset belongs**
**Cost (optional)**
**-**
**--**
**Fund to which**
**asset belongs**
**Cost (optional)**
**-**
**--**
**-**
**--**
**Fund to which**
**liability relates**
**Amount due**
**(optional)**
Unrestricted
**-**
**2,000-**
Restricted -
Groundwork and
WCF
**-**
**840-**
Print Name
Frederick Stourton
Treasurer and Trustee
Andrew Heavyside
Chair of Trustees||||**Endowment**
**funds**
**to nearest £**|
|||||||||**-**
**--**|
|||||||||**Current value**
**(optional)**|
|||||||||**-**
**--**|
|||||||||**Current value**
**(optional)**|
|||||||||**-**
**--**|
|||||||||**-**
**--**|
|||||||||**When due**
**(optional)**|
||||||||||
|||||||||**31 January 2021**|
|||||||||Date of
approval|
|||||Frederick Stourton
Treasurer and Trustee||||22/10/2021|
|||||Andrew Heavyside
Chair of Trustees||||25/10/2021|
## **Section B Statement of assets and liabilities at the end of the period**
|||||||**Unrestricted**|||**Restricted**|||**Endowment**|
|---|---|---|---|---|---|---|---|---|---|---|---|---|
|||**Categories**|**Details**|||**funds**|||**funds**|||**funds**|
|||||||**to nearest £**|||**to nearest £**|||**to nearest £**|
|**B1**|**Cash**|**funds**|Unrestricted funds||**-**|**925-**||**-**|**--**||**-**|**--**|
||||Restricted grants||**-**|**--**||**-**|**6,779-**||**-**|**--**|
**18**
**19**
CCXX R1 accounts (SS)
28/10/2021
1
CCXX R2 accounts (SS)
28/10/2021
2
## bravomedics.org
**bravomedics BravoMedicsUK**
Garden Cottage Long Lane Bristol BS40 5SA 0117 287 0199
Bravo Medics is a registered charity in England & Wales (1189780).
**20**
**21**