Annual Report 2024
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Chairman’s Welcome
It’s great to welcome you to Bravo Medics’ annual report, covering our activities of 2024, our fifth year of operation. Our first four years of operation saw Bravo Medics evolve from a small organisation, operating with two responders and second-hand equipment, to an established life-saving organisation for the Bristol and Avon area. Five volunteer consultant responders, each carrying the equivalent of a state-of-the-art Emergency Department to our patients’ side – able to provide a whole range of interventions from emergency surgery, to anaesthesia and blood product transfusion.
On founding the organisation, I could never have dreamed of the success it has turned out to be, and this is in no small part due to the grant givers and supporters who have tirelessly helped us along the way – from individuals, to our charity partner BrisDoc Healthcare Services, each and every donation has been carefully targeted at improving patient care, guided by our wonderful Trustees who are now joined by longstanding responder Dr Glyn Thomas.
From a volunteer responder perspective, Dr Matt Thomas has settled into his role and has supported patients both in our operational area, as well as further afield across the South West – due to the travel involved in his professional role. Unfortunately, Dr Mark Tehan, left the team to pursue other professional challenges – we wish him all the best.
Our volunteers continue to strive to improve the 24/7 availability of critical care across our region, and whilst slow progress, we will continue to engage with all local partners to one day make this a reality.
As we move into the new year, 2025 will see big changes in both the charity and clinical side of Bravo Medics. Two of our trustees, Blair Sasada and Freddie Stourton, who have supported us since our foundation are stepping down due to other professional commitments. We wouldn’t be where we are without them, and owe them a huge debt of gratitude – thank you. Clinically, we are hoping that 2025 will see us take on our first nonphysician responder, a Critical Care Paramedic – he will respond both solo, providing a high-level enhanced care capability, as well as alongside our consultants to form a Critical Care Team.
Thank you for your time reading the report and your ongoing support of our charity.
Andrew Heavyside Chair of Trustees
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Contents
Bravo Medics
Report of the Trustees for the year ended 31 December 2024
| Chairman’s Welcome | 2 |
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| Mission Map | 8 |
| Clinical Lead Report | 10 |
| Objectives & Activities | 11 |
| What We Offer Patients | 12 |
| Structure, Governance & Management | 14 |
| Fundraising | 16 |
| Financial Review | 18 |
| Accounts | 20 |
| Indepnedent examiners report on the accounts | 22 |
The trustees of Bravo Medics present the annual report, including accounts, of the charity’s activities between 1 January and 31 December 2024. 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.
Charity name
Bravo Medics
Charity registration number
1189780 (Charity Commission of England & Wales)
Registered address
Garden Cottage Long Lane Wrington, Bristol BS40 5SA
Board of trustees
Dr Andrew Heavyside (Chair of Trustees) Dr James Tooley Mr Blair Sasada
Dr Frederick Stourton Dr Glyn Thomas
Our Mission
To serve the local community and support the local ambulance service in caring for the sickest wherever become ill or patients, they injured.
Clinical Lead
Responding Doctors
Dr James Tooley
Dr Andrew Heavyside
Dr James Tooley Dr Glyn Thomas Dr Matt Thomas
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.’
Accounts reviewed by
Registered bank
Mrs Jackie Taylor
HSBC
10 Colliers Walk Nailsea, Avon BS48 1RL
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BRAVO MEDICS
2024 IMPACT
Saving lives
We estimate one in every four people
we treat could suffer life-changing
injuries or die without our intervention
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Saving lives
We estimate one in every four people
we treat could suffer life-changing
injuries or die without our intervention
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Local demand
Bristol City 30% of responses
North Somerset 24% of responses
South Gloucestershire 20% of responses
61%
We remain the only increase
road based voluntary critical care in responses to cardiac
service to carry powdered blood arrests since 2023, with an
making transfusions in average patient age of 33
communities more available years
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Conditions and emergencies
2022-2024 responses
2022 2023 2024
120 26%
26%
100
80
In 2024 we saw a
60 110% increase in 15%
stabbings
40 4% 5% 1%
20 1% 3% 2% 1% 1% 2% 1% 1% 1% 1% 4% 4% 1% 3% 1% 1%
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Limb injury/amputation/impaledAcute mental healthBreathing/chokingCardiac arrestCardiac otherDrowningFire/explosionFallHead injuryMajor incidentsHoaxNeurological & seizuresNeonatalPoisoning/chemicalReport of corpse/deathOverdosesRoad Traffic CollisionsStabbing/shooting/violenceSelf-immolation SuicideTrappedOther
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Mission Map 2022-2024 Locations Bath and North East Somerset BristoL Gloucestershire North Somerset Somerset South Gloucestershire Wiltshire 20 40 60 80 100 120 2022 2023 2024 I10 11+
Clinical Lead’s Report
Our Volunteer Doctors and Their Impact
Our doctors generously volunteer their time during their free hours. As a result, every time we increase the number of responders, our capacity to respond improves—especially overnight when other critical care resources are scarce in our region.
Comprehensive Patient Care
Throughout the year, we have successfully treated a diverse range of patients across an extensive area, particularly during night-time hours. The critical care expertise and multidisciplinary nature of our team make us a highly valued resource for the ambulance service.
Maintaining Response Rates
In addition to providing essential critical care services for the broader region, I am thrilled that we continue to achieve a high first-on-scene rate. This success is largely due to our ability to respond directly from our homes in the areas we serve, equipped with emergency supplies and medications stored in our own vehicles.
Future Plans for Improvement
Looking ahead to 2025, we aim to reassess our kit bags and the deployment of equipment at the scene. As the volume of gear we carry has increased, managing it all effectively with our current bag system has become more challenging. In addition, in we hope to recruit a specialist paramedic trained in critical care. This addition will enhance our ability to offer a full spectrum of critical care treatments, which often necessitate more than a solo responder.
Objectives & Activities
Objectives
Bravo Medics’ main objective is to save lives in the community by providing equipment, training, and financial support to Critical Care Healthcare Professionals who respond to emergencies in their area at the request of the local ambulance service.
In our fourth year, we increased our resilience as a charity, and this has continued through our fifth year of operations. We are now a reliable and constant form of support to our local ambulance service and the local population it serves, and a financially secure organisation prepared for the future in an ever more financially uncertain world.
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. We deliver gold standard critical care. 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 emergency surgery, to a patient for a similar anaesthesia and cost to an NHS GP appointment.
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 inadult trauma patients in ScotlandEmergency Medicine Journal 2020;37:141-145.
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What We Offer Patients
Life Saving Surgical Procedures including Open Heart Surgery
A limited number of our patients have conditions that necessitate immediate surgical intervention on-site to preserve their lives. All our clinicians are trained to perform procedures to alleviate a pneumothorax (collapsed lung) or to place a tracheostomy to aid in breathing. Additionally, our volunteer doctors are equipped to carry out open-heart surgery if a patient's heart has ceased beating due to a penetrating chest injury, such as stab wounds. Our team regularly practices these skills to ensure they can be executed reliably during emergencies.
Sedation
Occasionally, it becomes essential to carry out uncomfortable procedures that must be done immediately, rather than waiting for the patient to reach a hospital. These procedures can cause considerable pain, such as realigning and splinting severely fractured bones or rescuing individuals trapped in vehicle wreckage. Bravo Medics are equipped to administer powerful sedative medications that alleviate pain and anxiety during these interventions, while ensuring patient safety with our advanced monitoring technology.
Consultant Level Decision Making
Bravo Medics' volunteer clinicians possess extensive experience gained from years of training and practice in both hospital settings and pre-hospital environments. This expertise enables them to operate beyond standard guidelines, ensuring that each patient receives care customized to their unique situation. We continually learn from each case we encounter, as they are assessed through our clinical governance and case review process, which guarantees that we provide safe and consistent care.
Pre-Hospital Emergency Anaesthesia
The most critically ill patients sometimes require a medically induced coma to protect their lungs from the aspiration of vomit, ensure adequate blood oxygen levels or minimise further brain damage following a head injury or stroke. Traditionally, this procedure was only performed by anaesthetists and intensive care doctors within a hospital setting. However, every Bravo Medics doctor is trained to administer anaesthesia in emergency situations, whether on the roadside or at a patient's home. This training optimizes patient care and mitigates risks during transport to the hospital.
Advanced Pain Relief
One limitation the ambulance service often faces is the ability to provide effective pain relief to patients, especially children. Bravo Medics clinicians can enhance patient comfort on the scene by administering more potent pain relief options. This may involve employing ultrasound techniques to numb the nerves connected to an injured area, a procedure known as regional anaesthesia. Typically, this is conducted in the operating theatre by skilled anaesthetists.
Drugs & Treatments Normally Only Available in Hospital
We provide medications that are not typically found on standard ambulances, which are utilized to address the following conditions:
Seizures resistant to initial treatment
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Eclampsia (seizures that may occur during late pregnancy) Asthma
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Severe sepsis
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Life-threatening cardiac arrhythmias (irregular electrical activity affecting the heart) Cardiac arrest
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Structure, Governance & Management
Governance and Management
Appointment of new trustees
Every trustee shall be appointed by the current trustees for a term of three years, following a resolution passed at a properly convened meeting of the charity trustees.
The trustees hold the primary responsibility for overseeing and managing the charity, in alignment with the duties outlined below. They volunteer their time without receiving any financial compensation or benefits. The trustees convene at least three times a year, either virtually or in person.
In the appointment of charity trustees, they must consider the necessary skills and experience required for the effective administration of the CIO.
Bravo Medics acts on behalf of the South West Ambulance Service Trust and operates under the umbrella of BASICS South West, adhering to the organizational requirements of both entities.
The Clinical Lead is also invited to serve as a trustee. This individual must be a full clinical member of Bravo Medics and typically holds a consultant level position (or an equivalent post-CCT level). The charity trustees will appoint the Clinical Lead based on recommendations from the clinical members of the organization and the outgoing Clinical Lead, who will advise on the most suitable candidate for the role.
Oversight of clinical activities is entrusted to the Clinical Lead, who is a member of the board of trustees. During the recorded period, this position was held by Dr. James Tooley. Clinical activities are regularly reviewed in collaboration with other BASICS schemes within the BASICS South West framework to ensure the delivery of highquality care. The appointment of responding doctors is managed by the Clinical Lead, pending approval from BASICS South West.
Responsibilities of the Trustees
The Trustees are required to carry out their roles in alignment with the constitution of the CIO and applicable laws, particularly focusing on the preparation of an annual report and financial statements.
The Charity trustees are responsible for managing the affairs of the CIO and may exercise all powers necessary for that purpose. Each Charity trustee has the following duties:
To exercise their powers and fulfill their functions as a trustee of the CIO in a manner they reasonably believe will most effectively advance the purposes of the CIO.
To perform those functions with appropriate care and skill under the circumstances, particularly considering: Any special knowledge or experience they possess or claim to have; and if acting as a Charity trustee of the CIO within a business or professional context, any specific knowledge or experience that would be expected of a person in that line of work.
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Fundraising
Events and Challenges
A number of people embarked on challenges to raise funds for Bravo Medics, some in memory of loved ones and others to celebrate the work we do. We extend our most sincere thanks to everyone who supported our work in this way.
Businesses
We would like to thank BrisDoc Healthcare Services for their ongoing partnership with Bravo Medics and provided gifts in kind which further enabled us to achieve our mission. Donations
In 2024, we received several donations from individuals towards our work. We would like to thank each and every donor for their generosity.
We receive no government funding and continue to rely on donations to fund our lifesaving work, so we are very appreciative of any gift, no matter the size.
Trusts and Foundations
We received a variety of grants from trusts and foundations towards our work and would like to thank everyone who awarded Bravo Medics a grant.
How We Spent Donations
Fundraising Regulator
Approximately 70p in £1 donated was spent on supporting people in the community.
Bravo Medics is registered with the Fundraising Regulator. We are pleased to report that the charity received no complaints in 2024.
Looking Forward
Bravo Medics is currently developing its fundraising strategy to ensure a balanced, sustainable income portfolio. The charity welcomes support from the community and potential partnership approaches.
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Significant financial events
No significant financial events occurred over the accounting period
Reserves policy
Treasurer’s comments
2024 was a good year for Bravo, as we moved from a year of capital spending and growth to a period of stability. Grant income was again a large source of income but this was directed more towards operational and running costs rather than expanding. We were able to expand our reserve fund and acquire some replacement LUCAS compression devices as well, setting us up well for the future.
This will be my last annual report as treasurer and as a trustee of Bravo medics as I hand over in 2025. I am hugely proud of the work we have done in setting up the charity and getting it to the state that we have. I would like to take this opportunity to thank everyone who has been instrumental in this process.
Dr Frederick Stourton
Summary of year aims
The charity’s financial aims over the fifth year of operation, as laid out in our annual report for 2023, were as follows:
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Maintain current stability,
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Build reserves to prepare for any further expansion
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Plan for future expenditure including renewing equipment.
At the end of the period, the Charity held £53,573, split between restricted and unrestricted funds. This includes an operational reserve fund of £10,000 to deal with unexpected costs.
The reserve was expanded to £10,000 over the course of 2024. This means that the charity could comfortably absorb unexpected costs, and could also contribute to setup for a new responder and be replenished in due course.
Investment policy and objectives
The charity has no long term investments at present.
Liabilities
As of the 31st of December 2024, the charity had no outstanding liabilities.
Plans for future periods
There are no current concerns over the charity’s ability to operate as a going concern. Over the next year, the charity will aim to maintain its current stability and expand the number of responders, as well as handing over to a new trustee team.
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 reviewed by Mrs Jackie Taylor.
Exemptions from disclosure
The Charity reports no exemptions from disclosure.
Funds held as custodian trustee on behalf of others .
The Charity does not act as a custodian trustee, nor do any of its individual trustees.
Principal funding sources
The charity’s main source of income was grant applications, raising £85,215 over the period. Other income came through online fundraising via various means. Total income for the year was £85,661.
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CHARITY COMMISSION FOR ENGIANO ANO WALES Section B Statent of assets and liabilth.es at the end of the period Recei ts and ments accounts CC16a Unrestricted Re5tricied En(k>wTnent LtsliS For the period from t• nMr••te Bl Ca•h fumlb 15.SQ2 X.•71 Section A Receipts and payments 10.0 Unreslricted lunds Restricted funds Endownienl Total caslj funds 25.)2 Toial funds Lasi year 28.071 t• the nearost tts tho noarSt e to th narst E A1 Recel Fundr4ising . E•snr•I$l Fundraisifi - Or)Iii r75 315 29.772 315 15.215 GrnT In¢¢me 55.443 AR) 30.218 55,U3 seta see table . Investment sa ttailS 15.661 Cvr•- Acrnunthi Cor•- Fvndr•wr Cort- PuNieiry Cor*-R ulito d Finw¢• 6.317 343 663 2.106 711 1.423 1.054 862 J.136 1.993 2$.%1 Op•raional- Insurane• Op•raional- Equipm•nt m•irf•DJno• Op•r4tion41- Egilipm•nt pyrch•J• Op•r•¥on•l- thryJ •TrJ 3.136 163 2.999 [tailS 1.130 22.569 436 4J6 Sub lotal 13.699 27.852 41 341 A4 A8set and InvestnnI Sub total Ltill5 13.689 2T.652 BS LI41t Net ofrtteipW(paymentsJ A5 Transfers between funds A6 Cash funds last end Cash fvnds this year end 280 9.253 53.573 550 T1202$
CHARITY COMMISSION FOR ENGLAND AND WALES Independent examinorfs report on the accounts Section A Independent Examiner's Report R•port to the tru•tso&1 m•mb•rn of Bravo Modi On •¢counts for th• ymr •nd•d Ch•rlty no 1189780 111 ny) 31 D•caml)w 2024 S•t out on pag 20 and 21 I to the truthes on my examnation of tho KCJnts d th• 4bMI chanty Ilh• Tru> lor tho year ended 31112r2024. R••pon•lbllltb•• and A8 tharty oltho Tru8t. yw ar• re•pmbl• fty the Ixepya b••l• of r•port of the accounts in acCud with tha r•quir•nI1 of Charits8 A(a 2011 rt I roport in rospect of my ex8rninab.on ol the Trusl'i xcounts camed otrt undar Mdion 145 01 the 2011 A¢t and in cafrying out my oxaminatKn, I h•ve follo¥wd the appli¢&ble gr4en by Chanty C(xnmMon undèr •ectson 145(51{bl of thè Ad. Ind•p•nd•nt I have fxnpleled my •xmination. l ¢onfThi that no m•1Wi m•tt•rn h• •MmlMrf• •tatsm•nt (¥Th to my 8ttenb.on in ccrt)nection V•ith the examatl which gNO8 mo cauBe to believe that in, any material respe(I accnn9 rKord8 wwe not kept in 8¢wOarKo with M(on 130 ot tho A¢ or I have no concems •rKI have come ac*o¥• no other m•ttor¥ in connec wth the examination lo whith alIe.()n 8houk1 be drwffl In ¢yd•r lo enoblo Yopor understanding of the account• lo reacw. 81gn•d: N•m•: Jacquéline Taylor R•l•vant prof•••lon•l qlI¢tIon(lI or body (If any): FCA Addrnm: Hdly Tr•e Lodg8, Hocw L• Stoke Po BuckirKJh¥mshir•, SL2 4QE
“Without your attendance that night, I wouldn’t be - here thank you.”
The first patient given LyoPlas by Bravo Medics.
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