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2024-03-31-accounts

The Spirit Health Foundation Trustee Report and Financial Statements For the Year Ended 31st March 2024 Charity number: 1204694

Spirit Health Foundation is an independent, global non-profit organisation that was founded and registered on 13th September 2023. As its trustees, we present this report along with the financial statements for the charity for the year ended 31st March 2024.

The financial statements have been prepared based on the accounting policies set out in the notes supporting the financial statements. Spirit Health Foundation is registered with the Charity Commission for England and Wales, under registered number 1204694.

Contents

The Challenge

Despite the progress over the last two decades, more than half of people in countries in the SubSaharan Africa region are unable to get the essential health services they need to protect themselves and their families. This is over 600 million people, typically living in underserved communities, who face multiple barriers – long walking distances or unaffordable transport to health facilities, lack of healthcare workers (with a predicted 6.1 million shortage in the region by 2030), and lack of access to education, screening, treatment and monitoring. Current systems don’t work.

As a result, many people don’t get the essential care they need until it’s too late, if at all, leading to a high burden of disease and far too many lost lives – deaths that are often preventable. Sadly, many of these lost lives are mothers, newborns and children. In the Sub-Saharan Africa region, the Maternal Mortality Rate is 545 deaths per 100,000 live births (more than one hundred times higher than in high income countries) and neonatal conditions remain the leading cause of death. Underserved communities in many countries also face the dual challenge of infectious diseases such as HIV/AIDS and TB (Tuberculosis) whilst combatting the growing threat from Non-communicable Diseases, such as heart diseases, cancers, and diabetes.

+600 100x million people maternal deaths lack essential vs High Income health services Countries

Our purpose and approach

Current health systems aren’t working and won’t protect the lives of mothers, newborns, children, and the millions of people living with or at risk from different diseases. But simpler, smarter health systems will, enabled by the best technologies and led by the communities themselves. That’s why Spirit Health Foundation was founded as a fully independent global health charity in September 2023.

Our purpose is to make it simple for underserved communities to get the essential healthcare they need, and we have set an initial goal to enable 30 million people in underserved communities to get essential healthcare by 2030.

Enable 30 million people in underserved communities to get essential healthcare by 2030

10 million 20 million 50 million 100% 3 million 20,000 Mothers, babies Community Screening and screened and lives improved or health workers and children members monitoring monitored saved as a result digitised and protected screened for sessions individuals with of interventions trained through ANC, Non-communicable delivered in total their clinical risk PNC and Under-5 or infectious score identified monitoring diseases

Our novel approach

Spirit Health Group is an international healthcare organisation in over 20 countries and trusted NHS partner. They provide us their market-leading Clinitouch platform, services and people for free.

We provide these as millions of pounds of in-kind funding to in-country non-profits, and work with them to build simpler, smarter health systems that improve and save lives in underserved communities. This novel approach makes world leading health services accessible in communities they normally aren’t.

We generate external fundraising to catalyse the new health system services alongside our country partners, which can then be sustained and scaled over the long term through our in-kind funded support. This includes unlimited licenses, user support and clinical library access for Clinitouch, integration with existing country health systems, and building the capacities of country partners to deliver themselves.

In-kind funding support provided to our country non-profit partners

Unlimited licenses, user support and library access

Clinitouch platform unlimited user licenses for clinicians, community health teams, Clinitouch platform and administrators for community health worker delivered services and licenses Ongoing user technical support for Clinitouch via Global Support Desk Ongoing access to question sets and tools for MNCH, NCDs, and Infectious Access to Clinitouch Diseases via Clinitouch portal library - partners trained to customise and deploy in clinical library Clinitouch

Catalytic support (typically 2 years)

Bespoke clinical pathway question sets for screening and monitoring (up to 4) New Clinical Pathways Bespoke education videos and visual aids (up to 4) Co-creation of solution design for pilot and scale up Solution Design and Development Community engagement guidance and materials Guidance on developing FHIR into health information management systems FHIR interoperability Support integration work of FHIR systems with Clinitouch for interoperability Measurement and evaluation framework Monitoring and evaluation Development of 1 peer-reviewed study In-person training events and virtual training sessions for users Capacity and capability building Train the trainer for all relevant partner staff to sustain and scale

How we work

Clinitouch is a smart platform that enables community health teams and healthcare facilities to work together to educate, screen and monitor any health condition in even the hardest-to-reach communities, generating a risk score so early action can be taken to save lives.

Community Health Workers (CHWs) are equipped with the Clinitouch app on a smart phone or tablet to provide education, screening or monitoring using clinical questionnaires, alongside supporting tools. This can all be conducted offline and synced when back online, enabling usage in the many rural communities still lacking mobile connectivity.

Staff at remote health clinics or hospitals use the Clinitouch clinician portal where they can review every community member screened or monitored. The smart algorithm based system generates a Red, Amber, or Green risk score based on the data captured in Clinitouch by the Community Health Workers, so staff can take preventative or early action to refer community members for care at a clinic, hospital or via a telemedicine consultation through the Clinitouch platform.

Why our solution protects and saves lives

1. PROVEN TO ADDRESS RISKS - Not just symptoms, enabling early action

2. CUSTOMISABLE - Any health area, protocol or language

3. INTEROPERABLE - With existing HIMS and tools via HL7 FHIR

4. SUSTAINABLE - Unlimited licenses and £ millions in-kind funding

5. EVIDENCE-BASED - Reducing unscheduled admissions by 67.5%

6. SIMPLE TO USE - Enabling CHW efficiency and effectiveness

Community-based teams Smart educate, screen and Alogorithms monitor on offline app

Remote health facilities get risk score on portal so can take preventative or early action

What we achieved… our first 6 months

Spirit Health Foundation was founded on 13th September 2023, so only operated for six months of the year ended 31st March 2024. We prioritised three focus areas for our first six months:

  1. Building and deploying an effective strategy and plan to deliver our charitable goals – across programmes, fundraising, operations and human resources

  2. Establishing our first two country partnership initiatives in Sub-Saharan Africa to deploy in our first eighteen months

  3. Embedding robust processes and policies, aligned to our governing document and charity commission guidelines

“The response of our first partners in South Africa and Eswatini validates our initial assumptions, the learnings from this work will help us fine-tune our strategy going forward”

Philippe Jacon, Chairman of the Board of Trustees.

1. Building and deploying an effective strategy and plan

Together as a Board with our CEO, we built a clear and focused strategy to deliver for the communities we support in the most effective and sustainable way.

We prioritised underserved communities in countries in Sub-Saharan Africa where we’ll make the biggest difference:

We focused our services in two key areas:

1.1. Maternal, newborn and under-5 child health care

70% of maternal deaths occur in the Sub-Saharan Africa region, whilst neonatal conditions remain the leading cause of death. Community Health Teams are equipped with Clinitouch on a smart phone or tablet to provide Antenatal Care (ANC), Postnatal Care (PNC) or Under-5 child health monitoring using clinical questionnaires, and supporting tools. Based on the risk scores, Midwives or Nurses at remote health facilities use Clinitouch to take action to protect the lives of the mothers and children.

1.2. Early screening and care for priority diseases

Poor access to education and screening is major gap in the underserved communities we support, meaning life-threatening conditions don’t get spotted until too late, if at all. For example, 73% people have undiagnosed hypertension or over 80% of cancers are not diagnosed until the advanced stage in the Sub-Saharan Africa region.

Community Health Teams are equipped with Clinitouch to educate, screen and refer community members for priority diseases at households and in the communities.

Unlike most programmes, our Clinitouch solution is customisable to any health condition or priority disease. Remote staff can see risk scores for everyone screened, and get them to the care they need before conditions get worse.

We focus on amplifying impact through partnerships

Spirit Health Foundation’s approach is driven by partnerships and collaboration. In order to deliver our charitable purpose and goals, we focus on establishing two kinds of partnerships to deploy and scale impact for the underserved communities we support (please note – these partners can sometimes be the same organisation).

Strategic funding partners:

Global health organisations with common mission and goals, who can provide external funds (as well as capabilities) for the catalytic deployment of the new health system solutions in the underserved communities and countries where we work.

In-country implementing partners:

Non-profits and social enterprises already delivering services in the communities, often working in tandem with public health providers, whom we can support through the in-kind funding and external funding to amplify impact for people in need.

2. Establishing our first two country partnerships in Sub-Saharan Africa

UNJANI CLINICS NPC (SOUTH AFRICA)

Having launched in September 2023, we were delighted to formally sign our first country partnership with Unjani Clinics Not-For-Profit (NPC) company by the end of 2023.

Since 2014, Unjani Clinics NPC has provided funding and support to professional nurses to set up, own and sustainably run clinics providing quality primary healthcare in low-income communities across South Africa. There are now over 178 Unjani Clinics (as well as 12 mobile health pods), providing over 90,000 consultations per month for infectious diseases, non-communicable diseases and maternal and child health.

During 2024, Spirit Health Foundation will support a 6-month pilot with an initial group of Unjani Clinics in Gauteng province, equipping community-based Health Promotion Officers with Clinitouch to provide essential screening for both Non-Communicable and Infectious diseases, as well as under-5 child health monitoring. The goal is to identify at risk adults and children, so they can be referred to Unjani Clinics or government clinics to get the care they need.

ELIZABETH GLASER PEDIATRIC AIDS FOUNDATION (ESWATINI)

We also developed a major new partnership with leading global health non-profit Elizabeth Glaser Pediatric AIDS Foundation to help save the lives of mothers, newborns and children in Eswatini, with contracts then formally signed later in July 2024.

The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) is a proven leader in the global fight to end HIV and AIDS, and an advocate for every child to live a full and healthy life into adulthood. EGPAF began supporting the Kingdom of Eswatini in 2003 in the provision of PMTCT (Prevention of Mother To Child Transmission) and later, comprehensive quality HIV and TB prevention, care and treatment services. Currently EGPAF is leading the ASPIRE Project (funded by USAID) and its implementation in Hhohho and Shiselweni regions across 78 health facilities.

Through this partnership and Spirit Health Foundation’s support, Rural Health Motivators and Rural Health Clinics will be equipped with Clinitouch to enable mothers to get the essential eight Antenatal Care and four Postnatal Care contacts needed, identifying potential risks or complications early so action can be taken to protect the lives of mothers and newborns. This initiative will roll out from early 2025, with the second phase then focused on under-5 child health monitoring.

NEW PARTNERSHIPS

We chose to take a focused approach to country partnerships for our first eighteen months to ensure Spirit Health Foundation’s first initiatives were delivered effectively and efficiently for our communities. We will be expanding our portfolio of country partnerships in 2025 onwards to deliver impact in more communities, supported by external fundraising.

3-Embedding robust processes and policies

Our third priority was establishing the processes, policies and governance to ensure the Spirit Health Foundation operates effectively, efficiency and responsibly at all times.

Governance

CIO Governing Document

Governance ensuring independence from Spirit Health Group

Policies

Essential charity policies

Essential insurance policies

Processes

Financial systems and processes

Ways of working and processes for volunteers from Spirit Health Group

HR processes for employees, contractors and volunteers

Plans for the future

We have set the initial goal of enabling 30 million people to get essential healthcare, but with the right funding and country partners, we can go much further to support many more people and communities in need.

Spirit Health Group’s funding of its market-leading platforms, products and services has enabled us to establish Spirit Health Foundation as an independent global health charity. But in order to deliver our goals, it’s vital we bring in sustainable external fundraising and this will be a key focus for us during 2025 and beyond.

We have identified the countries and country non-profit partners that we can work with, external fundraising partners will provide the vital funding to catalyse the essential health services urgently needed in the communities we support.

Objects, Structure, and Governance

Legal Objects

Spirit Health Foundation’s date of constitution was 13th September 2023.

The governing document defines Spirit Health Foundation’s objects as:

“For the public benefit the relief of sickness and the preservation and protection of good health of people anywhere in the world by building the capacities and capabilities of healthcare providers and workers in underserved communities across low and middle income countries to provide equitable, accessible healthcare for their populations”.

Trustees and Organisational Structure

The charity trustees manage the affairs of the CIO and may for that purpose exercise all the powers of the CIO. All trustees, except where otherwise stated, served for the whole financial period.

There must be at least three charity trustees. If the number falls below this minimum, the remaining trustee or trustees may act only to call a meeting of the charity trustees, or appoint a new charity trustee. The maximum number of charity trustees is 12. The charity trustees may not appoint any charity trustee if as a result the number of charity trustees would exceed the maximum.

The Chair of the Board at constitution, Mr Anthony Lowther, resigned from Board in December 2023 due to the requirements of a new commercial role he was recruited for. The board unanimously voted for Mr Philippe Jacon to be the new Chair of the Board at the board meeting on 14th December 2023.

Chief Executive Officer

Our Chief Executive Officer (CEO) is responsible for the day to day operations of the charity, overseeing, driving and delivering the strategy, operations, and programmes of Spirit Health Foundation. Our CEO Rich Bryson brings extensive expertise and experience in global health and technology, both from the private and philanthropic sectors. He has previously held other senior C-suite leadership roles and was a co-founder of the Spirit Health Foundation.

Governance and Management

Spirit Health Foundation is governed in line with our CIO’s Governing Document, and a set of robust policies to ensure responsible and effective management. Trustees meet quarterly for board meetings, which includes assessment and agreement on key organisational decisions, informed by our governing document and policies.

Financial review

Statements of Financial Activities

Income and Expenditure Statement

For the period ended 31st March 2024

Income
Grants
Donations in kind
Donations
Bank Interest
Expenditure
Salaries and Wages
Programme Expenses
Accounting and Legal Fees
Fundraising and Marketing
General Administrative Cost
Offce
Donations in kind
Net Income/(Expenditure)
Reconciliation of Funds
Total funds brought forward
Net Income/Expenditure
Total Funds Carried forward		 Unrestricted
Funds (£)
Total (£)
128,000
128,000
100,650
100,650
6,595
6,595
450
450
235,695
235,695
(57,980)
(57,980)
(6,978)
(6,978)
(2,160)
(2,160)
(5,047)
(5,047)
(1,018)
(1,018)
(620)
(620)
(100,650)
(100,650)
(174,453)
(174,453)
61,242
61,242
-
-
61.242
61,242
61,242
61,242

Balance Sheet

Current Assets
Cash at bank and in hand
Prepayments
Creditors: amounts falling due within one year
Trade Creditors
Other Creditors
Net Current Assets
Net Assets
Reconciliation of Funds
Total funds brought forward
Net Income/Expenditure
Total Funds		 As at 31st March 2024
(£)
62,058
7,443
69,501
(2,690)
(5,569)
(8,259)
61,242
61,242
-
61,242
61,242

Approved by the Trustee and signed on behalf by:

Philippe Jacon (Chair of the Board of Trustees)

Notes forming part of the Financial Statements for the year ended 31st March 2024

1. Basis of preparation

1.1 Basis of accounting

These accounts have been prepared under the historical cost convention with items recognised at cost or transaction value unless otherwise stated in the relevant notes to these accounts. These accounts have been prepared in accordance with the Financial Reporting Standard applicable in the United Kingdom and Republic of Ireland (FRS 102).

1.2 Fund accounting

Unrestricted funds are general funds that are available for use at the trustees’ discretion in furtherance of any of the objectives of the charity.

1.3 Incoming resources

All incoming resources are included in the statement of financial activities in the period to which they relate.

1.4 Resources expended

Expenditure is accounted for on an accruals basis and has been included under expense categories that aggregate all costs.

1.5 Donated services and facilities

Donated services and facilities that are consumed immediately are recognised as income with an equivalent amount recognised as an expense under the appropriate heading in the Income and Expenditure Statement.

1.6 Tangible Fixed Assets

These are capitalised if they can be used for more than one year, and cost at least £750. They are valued at cost.

Computer equipment is depreciated at 33% straight line.

2. Analysis of Income

Income
Grants
Donations in kind
Donations
Bank Interest		 Unrestricted
Funds (£)
Total (£)
128,000
128,000
100,650
100,650
6,595
6,595
450
450
235,695
235,695

3. Staff numbers

The average number of employees during the period was 1.

4. Staff costs

Salaries and wages
Social security costs
Pension costs (defned contribution scheme)
Total staff costs		 2024 (£)
50,208
6,272
1,500
57,980

The charity operates a defined contribution pension scheme.

5. Trustees expenses

None of the trustees have been paid any remuneration or received any other benefits from an employment with their charity or a related entity. During the period the charity did not incur any trustees expenses for fulfilling their duties.

6. In-kind funded products and services

Spirit Health Foundation’s model is based on receiving in-kind funded products and services from Spirit Health Group, which are provided to its country non-profit partners to deliver its charitable mission and goals.

The products and services donated by Spirit Health Group are provided directly onward to Spirit Health Foundation’s non-profit partners to deliver our charitable projects.

Below details the estimated normal market value of these products and services for the three-month period where this was applicable for the year ended 31st March 2024. The value of Clinitouch platform licenses are accounted for in the financial periods once projects are actually launched and the licenses are used.

The value of other volunteer time to support the charity is not included in these statements.

In-kind funded products & services from Spirit Health Group to Spirit Health Foundation

----- Start of picture text -----
January February March Total
Clinitouch platform licenses
Clinitouch clinical pathways £20,000 £10,000 £10,000 £40,000
System solution deployment £10,000 £10,000 £10,000 £30,000
Capacity building £10,000 £10,000
Monitoring and evaluation £10,000 £5,000 £5,000 £20,000
£100,00
----- End of picture text -----

Products & services provided as in-kind funding by Spirit Health Foundation to country non-profit partners

----- Start of picture text -----
January February March Total
Clinitouch platform licenses
Clinitouch clinical pathways £20,000 £10,000 £10,000 £40,000
System solution deployment £10,000 £10,000 £10,000 £30,000
Capacity building £10,000 £10,000
Monitoring and evaluation £10,000 £5,000 £5,000 £20,000
£100,00
----- End of picture text -----

Additionally to support the core operations of the charity, Spirit Health Group donated Spirit Health Foundation the following equipment : 1 x laptop and software licenses, estimated value of £650.

Independent examiner’s report to the trustees of Spirit Health Foundation

I report to the trustees on my examination of the accounts of Spirit Health Foundation for the year ended 31 March 2024.

Responsibilities and basis of report

As the charity trustees of the Trust you are responsible for the preparation of the accounts in accordance with the requirements of the Charities Act 2011 (‘the Act’).

I report in respect of my examination of the Trust’s accounts carried out under section 145 of the 2011 Act and in carrying out my examination I have followed all the applicable Directions given by the Charity Commission under section 145(5)(b) of the Act.

Independent examiner’s statement

I have completed my examination. I confirm that no material matters have come to my attention in connection with the examination giving me cause to believe that in any material respect:

  1. accounting records were not kept in respect of the Trust as required by section 130 of the Act;

or

  1. the accounts do not accord with those records; or

  2. the accounts do not comply with the applicable requirements concerning the form and content of accounts set out in the Charities (Accounts and Reports) Regulations 2008 other than any requirement that the accounts give a ‘true and fair view which is not a matter considered as part of an independent examination.

I have no concerns and have come across no other matters in connection with the examination to which attention should be drawn in this report in order to enable a proper understanding of the accounts to be reached.

Signed:

Name: Daniel Johnson FCCA Relevant professional qualification or membership of professional bodies (if any): FCCA Address: 7 Faraday Court First Avenue, Centrum 100 Burton Upon Trent DE14 2W

Date: 23/01/2025