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2023-03-31-accounts

Plus++ Inform. Support. Empower. Improve health .org.uk Trustees, Annual Report 2023 for the year ended 31 st March 2023 Plushealth the online peer support charity Registered charity in England & Wales (Reg.no 1191316)

Report contents

Pages
Statement from our Chair 3
Trustees’ report 4 - 5
Our charitable activities 6 – 10
Financial review 11 – 13
Charity structure, governance 14 – 15
and management
Independent Examiner’s report 16
Financial statements 17
Thank you 18
Reference and administrative details 18
Declarations 18

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Statement from our Chair

I would like to thank our past Chair, Vicky Lomas who stepped down as Chair at the end of March 2023. Through her leadership, commitment and energy Vicky has made a significant contribution to the growth and success of the charity.

Since becoming Chair in April 2023, I have been impressed with the drive and vision from everyone involved in Plushealth. Making a real difference to those living with and affected by HIV is central to our work and our leadership as a Board of Trustees.

This report highlights work of Plushealth during 2023/24 and our collaboration with other organisations to ensure the HIV community was represented in a range of areas including the Thrive LDN and Fast-Track Cities London Participatory Research and the Gilead Find Your Four health campaign.

Sitting alongside our national peer support work the one-to-one peer support as part of Fast Track Cities London project enabled us to work with a range of partner organisations within the charity sector and NHS. We have seen an increase in the number of people accessing our national service as well as the one-to-one support provided through the Fast Track Cities project.

The number of visitors to our website who are seeking information continued to increase during the year and in 2024/25 we will be looking at how our website is developed to ensure that it is fit for purpose and meets the needs of people who use it.

Our fundraising and income generation work continues to evolve and grow with the appointment of a fundraising consultant. This role is enabling us to apply for a range of funding opportunities to develop our national peer support service. Thank you to all our supporters who donate and fundraise money for us.

Over the next year we intend to build on our strengths and successes to develop as a charity, further develop our services and continue to grow our national online peer support.

Jason Warriner Chair, Board of Trustees

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Trustees’ report

The board of trustees are pleased to present their annual report together with the financial statements covering the period 4[th] April 2022 to 31[st] March 2023.

The financial statements comply with Charities Act 2011, CIO foundation governing document and guidance set out by the Charity Commission for England & Wales on the preparation of receipts and payments accounts. We have engaged ATS Accountants to provide the independent examination of our annual accounts as our income for the period is above the £25,000.

During the period we adjusted to our year end reporting date with the Charity Commission for England & Wales to fall into line with accepted practice. Our next reporting period will be from 1[st] April 2023 to 31[st] March 2024.

Our purpose and activities

Our objects as set out in our constitution document dated 14[th] August 2020 are to address the needs of people living with HIV for the public benefit by:

Our vision is to promote emotional and physical wellbeing by providing practical help and support so everyone living with HIV can live healthy active lives, free from stigma and prejudice.

Our actions are to inform, support, empower and improve the lives of people living with or affected by HIV.

Our approach is to provide information that is relevant, practical, and easy to understand which is based upon up-to-date science, research and guidelines relating to HIV care and treatment.

Our delivery is via a low cost, high value model, which embraces the use of digital technology. This enables our work to have national coverage so we can reach more people living with or affected by HIV.

The role and contribution of volunteers

As a small charity we are reliant on volunteers to undertake a variety of roles which include volunteering as a trustee, peer mentor, social media officer, finance, and general administrative volunteer roles. We highly value the contribution volunteers bring to our charity, as without their commitment we could not continue our valuable work.

We encourage our volunteers to contribute to the development of our charity and in return we are committed to providing role specific training and other opportunities for our volunteers to develop their knowledge and skills.

During the period covered by this report our volunteers (including trustees) donated 1270 hours. We estimate the monetary value to be £20,000.

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In kind donations

Whilst our charity has not received any in kind donations for the period covered by this report, we wish to acknowledge the support received from those who have provided informal advice and support.

We would also like to acknowledge the support given to some of our most vulnerable service participants from other charitable organisations which include Migrant Help, Positively UK (benefit advice), Riverhouse Trust, Terrence Higgins Trust (community forum, online counselling) The Foodchain (nutritional support), Trussell Trust (nutritional support) YMCA Positive Health.

Public benefit statement

HIV remains a highly stigmatised and misunderstood health condition, despite major advances in treatment, care, and advocacy. Whilst our services are specifically aimed at supporting people living with or affected by HIV there are wider public health benefits which include the following:

Physical health benefits – by providing up to date information on our website we can inform the general population about current HIV developments. We provide information on the prevention of onward transmission of HIV using treatment as a form of prevention, sometimes referred to as TasP.

By providing one-to-one peer support we inform, support, and empower people living with HIV to improve their overall health, including viral suppression, linkage to care, and physical wellbeing.

Emotional health benefits – reducing the burden of internalised and perceived stigma has a significant benefit to wider society. Empowering people living with HIV to challenge misinformation and negative attitudes towards HIV can change beliefs and reduce stigma. Providing good quality information increases the knowledge and confidence of people who consider themselves at risk of contracting HIV. This in turn helps them make healthy choices in reducing their likelihood of acquiring HIV.

Health costs – there is evidence that where people living with HIV are supported at the point of diagnosis and beyond, their retention in care and adherence to treatment is improved when compared to those who do not receive peer support. There are additional health costs when people living with HIV are unable to continuously engage with their care and treatment. Inpatient care is particularly expensive with some estimates suggesting an average stay in a specialist HIV inpatient service costing up to £150,000 per average stay.

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Our charitable activities & achievements

Our charitable activities are focused in four areas:

Supporting and empowering peer participants

Our low cost, high value model of delivering peer support remotely using digital technology has been shown to be popular with the participants we work with. The service provides a seamless online experience where people living with or affected by HIV can register and book appointments online and get to ‘meet’ someone else living with HIV by their chosen means, typically within 2 to 3 days of registering for the service.

We provide one-to-one peer support through our national service, which is freely available across the UK, regardless of location. This is delivered remotely using digital platforms to include video, voice, and text chat support. As part of our national service, we provide peer support using email and other secure electronic means such as WhatsApp and other messaging platforms. We fund our national services through individual voluntary donations and unrestricted grant income.

In addition to our national peer support service, we provide one-to-one peer support as part of Fast Track Cities London project working alongside our partners Chelsea and Westminster NHS Foundation Trust, Positively UK, and Naz Project London. This service is funded via a restricted grant from Healthy London Partnership and paid through the grant from our partner Positively UK.

For the period 4th April 2022 to 31[st] March 2023 (all peer participant services) we engaged with 149 individual peer support participants (up from 77 the previous year) and delivered the following:

National peer support service

Providing peer support throughout the four nations of the UK is one of our long held primary objectives and has been developed by people living with HIV. The service was completely funded by unrestricted funds and charitable donations for the period. This service is delivered and managed by Chris Williams, who has led this service since it was founded in 2018.

For the period 4th April 2022 to 31[st] March 2023 our national service engaged with 40 individual peer support participants (up 30% on the previous year) and delivered the following:

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Fast Track Cities, London, peer support improvement project

This project is a collaboration with Positively UK, Naz Project and Chelsea and Westminster NHS Foundation Trust HIV Services, including 56 Dean Street, 10 Hammersmith Broadway, Kobler Clinic, HIV services at West Middlesex Hospital and inpatient services at the Chelsea & Westminster Hospital site.

This report covers the third year of this project, and the quality improvement approach has enabled us to improve the way we engage with those accessing the service and deliver timely intervention for those people receiving a new HIV diagnosis.

These individuals were referred to us by their clinical team because they met one or more of the following criteria:

For the period 4th April 2022 to 31[st] March 2023 this service engaged with 85 peer support participants (up from 46 the previous year) and delivered the following:

409 individual interventions
4.8 interventions per participant
341 hours of peer support
£42 is the average cost per intervention
£200 is the average cost per peer support participant

Informing people living with or affected by HIV

Our website provides practical information written by people living with HIV. We’ve arranged the information to mirror the experiences of people living with HIV from initial diagnosis to living well with HIV and beyond. The website pages are regularly reviewed to include new and relevant information available in the public domain. Our approach is to provide information that is relevant, practical, and easy to understand and based upon up-to-date science, research and guidelines relating to HIV care and treatment.

Visitors to our website

The following statistics provide a snapshot of visitors to our website for the period covered by the report. Visitor numbers and other metrics shown below have increased significantly, up by over 200% on the same period last year. This is attributed to our use of Google Ads Grant for Charities which has helped to drive traffic to our website.

Total visitors 4005
New visitors 3995
Returning visitors 418
Total sessions 5055
Total page views 8243
Average time on page 1 minute 32 seconds
Bounce rate 60.60%

Website development and content

Our website is currently managed and updated by volunteers and is of bespoke design, which brings with it advantages in that it can be further developed to our exacting requirements. The challenge of this design is content management can be more complex and requires expert knowledge of the website to provide any updates or additions.

Our website was launched in July 2018 and is therefore in need of redevelopment and renewal and we will seek to obtain funding to support the development of a new website.

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Our social media channels

As a digital organisation we use social media to engage with the communities we serve. Facebook, Instagram, and Twitter are the main channels we currently use to reach out to and engage with our target audiences.

Providing a voice for people living with HIV

During the year we collaborated with other organisations to ensure the HIV community perspective was represented in the following project areas:

Thrive LDN & Fast-Track Cities London Participatory Research

We were invited to contribute to this project which took place during 2022 with the aim to develop a deeper understanding of the intersectionality of Londoner’s living with HIV, their mental health and overall wellbeing.

We held 2 in-person roundtable discussions with 10 peer participants during August & early September 2022. We also circulated an online questionnaire to those peer participants who were unable to attend the roundtable events. The questionnaire was designed to explore the intersection between HIV, mental health, and ageing. Here are some of the headline results:

Peer support - 73% of the questionnaire respondents have accessed peer support through a variety of formats including one-to-one and group in person services, individual phone and video calls and online chat only services.

94% agreeing or strongly agreeing with the statement that ‘peer support has helped me better manage my HIV treatment and care’

87% agreeing or strongly agreeing with the statement ‘peer support has helped me to better manage my mental health’

94% agreeing or strongly agreeing with the statement ‘Peer support has helped to reduce the stigma I feel around HIV’

HIV treatment and care - 95% of the questionnaire respondents were taking HIV medication. We asked a question about un-planned treatment breaks. 32% of respondents reported having a break in their treatment, with 71% of this group having a break for several months to over 1 year. Peer support plays an important role to ensure people remain linked to their HIV care and taking treatment. 63% of our respondents strongly agreed that peer support helped them to better manage their treatment and care.

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Mental Health & HIV - people living with HIV are twice as likely than the general population to experience depression and anxiety which not only impacts of their quality of life but also their ability to manage their HIV treatment and care. 75% of our questionnaire respondents said that their mental health had an impact on how well they were able to manage their HIV treatment and care. When we asked the question what the MAIN reason was you stopped taking your medication, 73% said this was because of their mental health.

As shown below, 56% of our questionnaire respondents strongly agreed that peer support helped them better manage their mental health.

Whilst this questionnaire has several limitations, including sample size, it provides an insight into the intersections between mental health, HIV treatment and care and the positive impact peer support has for people living with HIV.

Gilead Find Your Four health campaign

Find Your Four is a campaign developed and funded by Gilead Sciences, in collaboration with the HIV community. During the year along with other community organisations we contributed to the development of 2 new resources For A Healthy Mind and For A Healthy Body .

Each resource was co-produced with the HIV Community to ensure the experiences and voices of people living with HIV are at the heart of their development. A new resource starts out in life as a health literacy project where a steering group comprising of community organisations, clinicians and the Gilead team come together to scope out the development of a new resource. High on the agenda is the importance of providing practical information in a format that is easily accessible and uses phrases and wording that reflects a people first approach.

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The Find Your Four campaign fits well with our aim to provide support and information for people living with HIV using online platforms and technology. It's vital that information is easily accessible and in a format which provides effective messaging that supports the individual experiences of living well with HIV. We have been able to share our experiences of delivering peer support which has informed the development of some of the Find Your Four resources.

Income Generation

To execute our vision for our national peer support service and to ensure long-term sustainability we employed an income generation consultant during February 2023. This post will be funded through the unrestricted reserves we have at our disposal for the coming financial year. We intend to develop and submit several grant applications to secure funding for the national peer support service and re-develop our website which is now in its 5[th] year and requires a complete review. We want to continue to diversify our funding streams to ensure our charity can be sustained in the longer term.

Community Fundraising Activities

As a small charity we are reliant on the generosity of our supporters to ensure Plushealth can continue its vital work. Community fundraising is a key area of focus as we continue to diversify our income streams. Against the backdrop of the cost-ofliving crisis income from our community fundraising and individual giving activities was significantly impacted when compared to the previous year.

Main sources of income were as follows:

The combined income from these community events was £4,300, which represents 16% of our total income for the period. We will continue to build upon our community fundraising activities as this will ensure the security of our national peer support service, which doesn’t receive any funding from grants or statutory contracts.

We set up a designated fund for donations received from a fundraising page set up by our trustee Lee Forster-Kirkham, following the untimely death of his husband in November 2022. The fund attracted donations of £1,650. The board of trustees wanted to ensure this fund provided a legacy to the memory of Craig and we are currently developing a small grants policy around support for peer participants who would otherwise struggle to access our online peer support service.

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Financial review

Our financial review covers the period 4th April 2022 to 31[st] March 2023

Principle receipts 2022-23

Principle Receipts This Year Last Year £ £ Voluntary donations 4,267 5,447 Other Income 850 400 Unrestricted grants 10,218 3,100 Restricted Grants 11,246 12,200 Totals 26,581 21,147

Principle payments 2022-23

Principle Payments This Year Last Year
£ £
Generating receipts 1,296 60
Unrestricted spending 3,650 3,700
Restricted spending 16,987 11,622
Governance 761 556
Totals 22,694 15,938

Net Surplus/deficit for the year £3,887

The year-end cash balance 31[st] March 2023 stood at £19,529 which is represented by the following:

This Year Last Year Movement
£ £ £
Unrestricted funds 15,891 7,914 7,977
Designated funds 1,650 - 1,650
Restricted funds 1,988 7,728 (5,740)
Total 19,529
 15,642 3,887

General charity activities, unrestricted fund – we used our charitable donations and unrestricted funds to deliver our National Peer Support Service, maintain our website and hold roundtable engagements with a group of peer participants. Total cost of delivering these services for the period was £3,650. We spent £1,296 on activities to generate charitable donations and a further £761 on governance.

Total payments on core charity activities were £5,707. Income for core charity activities was £13,685 with charity reserves increasing by £7,977 for the period. We received unrestricted grants from Thrive London, Fast-Track Cities London, and Local Giving to support our core charity activities.

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Forster-Kirkham designated fund - this fund attracted donations of £1,650 and is designated to provide specific support for peer participants who would otherwise struggle to access our online peer support service or experience financial hardship which may prevent them accessing clinical care and remaining well. The year-end position shows a balance carried forward of £1,650.

The charity general fund reserves stood at £15,891 at the end of the period 31[st] March 2023.

Projects and restricted fund services – we received a total of £11,246 in restricted funds with payments totalling £16,986 all of which was attributed to Fast Track Cities peer support project. At the end of the period reserves for restricted funds stood at £1,988.

Fast Track Cities Peer Support – income for the period totalled £10,296 with total spending for the period being £16,986. Most of the spending was on staffing costs to provide online and some in-clinic peer support across all the HIV service provided by Chelsea and Westminster NHS Foundation Trust. £1,328 of these payments were used to support peer participants with travel assistance, mainly for those who have no recourse to public funds and those who had a disposable income of less than £100 after accommodation costs were considered. As expected, there was an in-year deficit of £6,690. The year-end position shows a balance carried forward of £377.

Saving Lives Grant – there was no income or payments made during the year, and therefore there is a positive balance of £661 carried forward to the next financial year.

NSUN Project – we received £950 from National Survivor User Network, sustaining safe spaces grant and were authorised to carry this funding over into the new financial year. This funding is designated to provide mental health first aid training to our peer support volunteers. There were no payments made for this project during the period ended 31[st] March 2023, therefore, as agreed with the funding organisation the £950 positive balance has been carried forward to the new financial year 2023/24

Summary of movement in funds for the year ended 31st March 2023

Loans, investments & property

We currently do not have any loans, investments or own any properties. Our constitution provides powers to the board of trustees to take out loans, make investment decisions and to buy or lease property to further the objects of our charity for public benefit. At this current time, we do not envisage the need to use these powers.

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Reserves policy

The board of trustees have agreed a policy of keeping a working cash balance to ensure Plushealth can continue its charitable activities for a period of 3 months. In case of a decision being taken to dissolve the charity this would provide adequate financing to meet our contractual commitments and ensure the charity was closed in an orderly manner to reduce the impact on our beneficiaries and to ensure all financial agreements can be met.

Future charitable activities

Our vision is to develop the reach of our national peer support service across the UK to ensure people living with or affected by HIV can access one-to-one peer support free of charge regardless of where they live within the UK. This was the principle aim of our Founder Chris Williams which has been adopted by the board of trustees as our vision for the future of our charitable activities.

Our experience of delivering peer support online (remotely) served the charity well during the coronavirus pandemic and beyond, offering choice to peer participants, which has been an important factor in the delivery of services post pandemic. We believe we have a strong operational model which will enable the charity to grow its presence to compliment other service providers in the post coronavirus pandemic.

Our involvement in the Fast Track Cities Improvement Programme (London) has enabled us to develop an online service model which can be integrated with NHS specialist HIV services. The experience gained to date by working with the HIV clinic teams at Chelsea and Westminster NHS Foundation Trust provides our charity with opportunities to work closely with other NHS Trusts to further develop the support available to people living with or affected by HIV.

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Charity structure, governance, and management

Plushealth is a Charitable Incorporated Organisation (CIO) where the only voting members are the charity trustees (foundation model). We have a total of six trustees:

Names of the charity trustees

Date appointed Date resigned

Ms Victoria Anne Lomas (Chair) 16[th] September 2020 Mr Gerard Creamer (Treasurer) 16[th] September 2020 Mr Harun Tulunay 16[th] September 2020 Mr Sean Hourigan 1[st] February 2021 Mr Lee Forster-Kirkham 1[st] February 2021 Mr Shiraaz Chaim Sidat 1[st] February 2021

Names of Senior Staff

Names of Senior Staff Date appointed Date resigned Mr Christopher Williams 1[st] July 2020 (Service Lead – Fast Track Cities Initiative, London)

Trustee recruitment

We are committed to expanding the diversity and representation of all communities to our board of trustees. We welcome applications from under-represented individuals, particularly people from minority ethnicities, people who identify as trans and/or non-binary, and heterosexual men. We believe it is important our board of trustees includes people from all communities. Such a policy will be extended to our recruitment of employees and volunteers. Peer support roles are naturally occupied by people living with HIV.

Policies and procedures adopted for the induction and training of trustees

As a small charity our resources are somewhat limited to carry out what might be considered as a formal induction of new trustees. We are therefore reliant on the information available via the Charity Commission website and in addition provided our trustees with ‘in-role’ training.

Organisational structure

The structure of our charity is shown in the organogram shown below:

We employ one part-time member of staff who is the Service Lead for Fast Track Cities Initiative London peer support service. This post is currently funded until June 2023.

The day-to-day management of our charity is a voluntary role at this stage in the development of our charity. The board of trustees have delegated this role to Chris Williams who is supported by a small team of volunteers.

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Charitable and political donations

During the report period our charity made no donations to other charitable or political party organisations.

Risk management

The trustees have overall responsibility for setting the direction of the charity and to deliver the public benefits as stated in our governing document. Trustee responsibilities include the leadership, governance, and financial oversight of the charity to ensure it carries out its statutory obligations and always remains financially secure. The trustees review the risk register at each quarterly board meeting and take action to mitigate any potential risks to the financial viability and legal obligations as set out by the Charity Commission.

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Independent Examiner’s Report 31st March 2023

Independent examiner’s report to the trustees of PLUSHEALTH (charity number 1191316)

I report to the trustees on my examination of the accounts of the above charity for the year ended 31 March 2023.

Respective responsibilities of trustees and examiner

The trustees are responsible for the preparation of the accounts. The trustees consider that an audit is not required for this year under section 144 (2) of the Charities Act 2011 (the 2011 Act) or under Regulation 10 (1) (a) to (c) of The Charities Accounts (Scotland) Regulations 2006 (the 2006 Accounts Regulations) and that an independent examination is needed. The charity is required by company law to prepare accrued accounts and I am qualified to undertake the examination by being a qualified member of the Chartered Institute of Public Finance and Accountancy.

Having satisfied myself that the charity is not subject to audit under company law and is eligible for independent examination, it is my responsibility to:

Basis of independent examiner's report

My examination was carried out in accordance with the general directions given by the Charity Commission. An examination includes a review of the accounting records kept by the charity and a comparison of the accounts presented with those records. It also includes consideration of any unusual items or disclosures in the accounts and seeking explanations from you as trustees concerning any such matters. The procedures undertaken do not provide all the evidence that would be required in an audit and consequently no opinion is given as to whether the accounts present a 'true and fair view' and the report is limited to those matters set out in the statement below.

Independent examiner's statement

In connection with my examination, no matter has come to my attention:

(1) Which gives me reasonable cause to believe that in any material respect the requirements

(2) to which, in my opinion, attention should be drawn in order to enable a proper understanding of the accounts to be reached.

Shahedul Alam BSc (Hons) CPFA On behalf of ATS Accountants

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Financial statements 2022-23

Statement of financial activities for the year ended 31st March 2023

Statement of assets and liabilities the year ended 31st March 2023

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Thankyou

We should like to take this opportunity to thank all our supporters and volunteers without whom we would not be able to continue our valuable work. As a small charity we are extremely appreciative of the generosity shown by so many individuals and their belief in our vision to promote emotional and physical wellbeing by providing practical help and support so everyone living with HIV can live healthy active lives, free from stigma and prejudice.

Working collaboratively with other organisations is vital for any charity and is particularly important for small charities. We would like to give special thanks to:

Reference and administrative details

Charity name: Plushealth Registered charity number 1191316 Charity’s principal address 250 Longford Court, Emlyn Gardens, London W12 9UW Accountants ATS Accountants Ltd, 8 Rochdale Road, Royton OL2 6QJ Bankers Barclays, Leicester, LE87 2BB

Declaration

The trustees declare that they have approved the trustees’ report and financial statements. Signed on behalf of the charity’s trustees.

Signature: Full name: Jason Warriner Position: Chair of the board of trustees Date: 11[th] January 2024

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