# 

St Christopher’s Hospice annual report and accounts 2022-23 **www.stchristophers.org.uk** 


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## **Contents** 

|**Contents**||
|---|---|
|About St Christopher’s|**2**|
|Meeting increased need during tough times|**3**|
|What we do with your money|**4**|
|What people say about us|**5**|
|Maintaining and improving our high||
|standards of care|**6**|
|Talking and learning about death and grief|**12**|
|How we’ve worked|**20**|
|Structure, governance and management|**25**|
|Financial review|**32**|
|Independent auditor’s report to the<br>Members and Trustees of St Christopher’s||
|Hospice|**36**|
|Financial statements|**40**|
|Notes to the fnancial statements|**44**|
|What we are going to do next<br>A huge thank you to all our supporters|**58**<br>**60**|
|Who’s who at St Christopher’s|**62**|



**At St Christopher’s Hospice, we have a vision of a world in which all dying people, and those close to them, have access to care and support, whenever and wherever they need it. That means everyone should have access to the best care at the end of their lives.** 

Operating from two locations, one in Sydenham and one in Orpington, our efforts are focused on meeting the goals of people with a life-shortening condition and supporting their families and carers wherever we can.  Our reach spans a diverse population of approximately 1.6 million people within the five London boroughs of Bromley, Croydon, Lambeth, Lewisham and Southwark. 

Our ambition is to help people live well until they die, and support those affected by the death of a friend or relative. Each person is unique, so we ask “What matters most?” and then tailor our care to meet social, emotional and spiritual needs, as well as manage physical symptoms. 

Everyone should have access to the best care at the end of their lives. We provide this through a mix of expert clinical care, support at home, research and education, and strategic partnerships with other organisations that have the same aspiration. We are proud that last year we provided care and support to 5,785 patients, 1,358 carers and 445 children across south east London. 

It costs over £25m to run St Christopher’s each year. We receive £9m of funding from the NHS and we need to raise over £16 million every year to continue to care for people when it matters most. This would not be possible without the support of our local communities, our donors, our staff and our volunteers, so a huge thank you for your support, from us all. 


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A family share a moment<br>together in our Sydenham cafe<br>2 St Christopher’s Hospice annual report and accounts 2022-23<br>**----- End of picture text -----**<br>




## 

## **Welcome to the Annual Report and Accounts of St Christopher’s Hospice (referred to as ‘St Christopher’s’ in this document).** 

Not everyone who dies in the five boroughs we serve will need access to our support, but the demand for our services continues to grow. Referrals for our inpatient unit (IPU) and community services increased by 4% during 2022-23 compared to the prior year, and these were also 23% higher compared to four years ago. 

Our services are free at the point of need, which means no one, irrespective of background, will pay for the care and support offered by our multi-disciplinary team to ensure they’re able to live well until they die. 

Meeting this increased need comes at a cost. On top of this, St Christopher’s has experienced the effects of the rising cost of living over the last year. This means an increase to our running costs, such as staff costs and energy costs to keep our hospice open 24/7; we are expecting further cost increases in the future too. The pressures on cost of living also means that it’s harder for St Christopher’s to fundraise, as donors in our community have less money to give. All of this gives St Christopher’s additional financial challenges as we go into 2023-24. 

However, the rising cost of living has hit some of our patients, their carers and families much harder. We have seen a 13% increase in referrals to our Welfare Team specifically – this includes many people who previously may not have been anxious about their finances, but have concerns about the rising costs of their energy bills. This is at a time when it would already have been a particularly difficult period in their lives. 

Helen Simmons joined as our Chief Executive in May 2022. To help ensure that we address this increased need fairly during these tough times, Helen has been taking a fresh look to ensure we’re at the forefront of breaking down inequalities in end of life care. Alongside this important 

work, she has also been encouraging us to review the ethical challenges facing palliative care, and to support our aspirational vision for St Christopher’s position on a global stage. You can read more about our new organisational strategy and what we’re going to do next on pages 58-59. We’d also like to extend a heartfelt thank you to Heather Richardson, who held the position of interim Chief Executive from December 2021 until Helen joined, when Heather then moved to our Professional Learning Team and to support with research and policy. 

We have continued to make excellent progress with our recently opened centre, St Christopher’s Centre for Awareness and Response to End of Life (CARE). In 202223, just over 10,000 learners from 56 countries engaged with CARE, compared with 4,366 in the previous year. From this centre, we have increased the skills, capabilities and insights of palliative care workers in the UK and beyond. We have also encouraged new ways of thinking in relation to palliative and end of life care in both the community and the wider health system. 

We appreciate times are very difficult for many at the moment with money being tight. We would therefore like to extend a huge thank you to all those who support us financially: alongside the NHS, this includes our donors, our fundraisers, our charity shop customers and those people who remember us in their Wills. 

We would also like to thank those who help us deliver high-quality care: from our staff and volunteers to our delivery partners in the health system and the local community; we could not help those people who need us most without your unwavering dedication and support. 


## **Neil Goulden** 

Chair of the Board of Trustees 

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St Christopher’s Hospice annual report and accounts 2022-23 



## 

**People are often surprised to see we have a gym at the hospice but our focus is helping people to live well and maintain independence** 

**It is thanks to the incredible generosity of our supporters that we are here. Your kindness means we are able to continue to provide vital services for people in south east London and beyond.** 

## **Where our money comes from** 

An incredible £17.2m (63%) of our income is from people in our community, donated through fundraising activities, leaving gifts in Wills or buying goods in our shops. We are so very grateful for the money you donate, and we are careful to spend and invest it wisely in ways that will best serve the people who need our support. 

We are also very thankful for the money we have received from the NHS which comprised £9.0m (33%) of our total income. 

Our remaining income comprised £1.0m (4%) that we generated from education, fees and investments, and other income. 

The total income of £27.2m raised this year enabled us to continue providing care to people who live in the boroughs we serve – Bromley, Croydon, Lewisham, Lambeth and Southwark – as well as shaping care for people across the globe through education, research and innovation. 

## **Where our money goes** 

It cost £25.3m to run St Christopher’s in 2022-23. Here’s a breakdown of how we spent the money you gave us. Our full financial review starts on page 32. 


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Education, fees and   Investments  Education, research  Bereavement services  £0.7m<br>other income  £0.7m £0.4m and policy  £1.2m<br>Community<br>Donations to  NHS  Raising   action<br>fund our  income voluntary   £0.7m<br>hospice   £9.0m income<br>services   £1.5m Commu-<br>£4.5m Income   Expenditure   nity care<br>£27.2m £25.3m £10.0m<br>Shops  £5.0m Gifts in Wills  £7.6m Shops  £3.4m Inpatient care  £7.8m<br>**----- End of picture text -----**<br>


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St Christopher’s Hospice annual report and accounts 2022-23 



## 

In December 2022, we asked people using our services for feedback, helping us to understand what we’re doing well and where we need to improve. 

## **At St Christopher’s, we’re committed to continually improving and developing the support and services we offer, ensuring they meet the changing and diverse needs of the communities we serve.** 

The results were overwhelmingly positive: 

To make sure we’re doing this effectively, we regularly measure and report on the impact we have both to the health and wellbeing of people receiving our support and their experience of our care. Over the last year we continued to invest in learning about and use of patient and other user reported outcome measures, working closely with the academic team at Hull and York Medical School and University. Our Quality Account 2022-23 also explores this work and we were heartened to see a reduction in physical and psychological concerns whilst people were supported by our teams. 

- **88%** of patients said they were very satisfied or 

- satisfied with our care 

- **89%** of carers were very satisfied or satisfied with 

- our care 

- **93%** of patients and carers felt we had listened to their needs always or most of the time 

- **97%** of people who used our service felt they were treated with respect and helped to feel dignified always or most of the time. 

“We feel we can trust you and not be judged by our thoughts and feelings of going forward without mum” 

“I feel I always have someone to turn to and talk as I have some bad days; I know they are there for me” 

**Our team are committed to providing the best individualised care and support** 

> St Christopher’s Hospice annual report and accounts 2022-23 5 



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Manzoor at home with<br>a picture of his late wife<br>**----- End of picture text -----**<br>


## **Patient-centred care** 

We provide care and support for people at the end of life, carers and those who are bereaved through a range of services. This was to over 7,500 people in 2022-23. Operating in an environment of continuous improvement means putting the needs of the individual first, supporting people wherever they want to be and always ensuring a high quality of care. Over the last year, we’ve retained our Outstanding Care Quality Commission (CQC) rating and were early adopters of the CQC’s new self-service portal. 

## **What matters to you, matters to us** 

As an organisation, we’ve officially joined the **What matters to you?** (WMTY) movement, which has now spread to over 49 countries worldwide. 

WMTY is a simple question that can have a profound impact on a person’s engagement, overall experience and moves the culture away from starting with a diagnosis or solution to a symptom, to doing what matters most to the individual. 

Healthcare staff can be reluctant to ask “What matters to you?” because they’re concerned, in some cases, 

the response will not be actionable, but this holistic and patient-centred approach has proven to improve outcomes for patients and those closest to them. 

Following our work on a contemporary model of holistic rehabilitative palliative care at St Christopher’s, we wanted to be part of the movement by making WMTY central to all our conversations. It’s early days, but we’ve already seen incredible examples of where this question has supported a better overall outcome for people and we’ve appointed WMTY Ambassadors across the organisation to support staff to continue to make WMTY an essential part of each and every initial conversation. 

Knowing what matters to someone is also linked to happiness at work so we’re making it part of our staff culture too and are including it in our new appraisal process. 

## **Continuously learning to improve individualised care** 

Over the last year, we’ve revamped our research audit process and established a **Research, Audit and Clinical Effectiveness (RACE) Committee** to engage a wider range of staff in these aspects of quality and 

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## **We provided care and support for over 7,500 people** 

## **We had 547 inpatient admissions** 

ensure we’re continuously improving. In practice, this means we’ve increased focus on recent audits, quality improvements, and where we need to undertake any research to progress in a particular area. 

In June and July 2022, we held our second annual inpatient unit (IPU) quality days which were attended by 81 staff and the theme was ‘Enriching our care – enriching ourselves.’ The days included a variety of sessions from looking at feedback from people who have used our services and learning from complaints to helping staff to develop strategies when a situation is challenging and staff wellbeing and resilience. 

Over four days in September and October 2022, we held our second annual community quality days for all members of the multi-disciplinary team including nurses, administrators, doctors and members of the rehab and psychosocial teams. This year’s theme was empowerment: of the people we care for to live well and die well and of staff to have control and autonomy over their work and to strive for continuous improvement. The day was well evaluated by all 78 staff. 

We also introduced three clinical staff as **Quality Champions** . Representing three different teams, they work on a number of quality improvement areas including: audits; recruitment of people for focus groups and co-facilitating focus groups; the investigation of complaints/feedback, reviewing the quality of data and supporting staff with the implementation of learning from incidents and complaints. 

## **Manzoor and Nayeem’s story** 

Manzoor was supported by the St Christopher’s team within his own home. When asked “What matters to you?” by Maria, one of our clinical nurse specialists, Manzoor shared: “My family, my children, they mean so much to me.” He added: “If I can do anything for them it’s very encouraging.” 

Manzoor went on to speak lovingly about his late wife: “We never quarrelled, we never fought. Since I lost my wife I’ve tried to be independent and encourage myself as much as I can.” 

Maria then took the time to speak to Manzoor’s son Nayeem and ease his concerns about his father’s condition. Sadly, Manzoor died shortly after this visit. 

After we shared the photos that we took of Manzoor at his home, his son Nayeem told us: “I will treasure them for a long time to come. They are frame worthy! I’m so glad you were able to meet him.” 

Another way we cemented our commitment to continuous improvement was through **recording our phone calls** from December 2022. This has been instrumental in supporting care provision as well as providing us with a valuable opportunity for enhanced training for staff and to aid in the investigation of complaints. 

Early patient referral is crucial to create an individualised care plan and ensure anyone who needs us can gain access to our services, for free, as soon as possible. To better support our community teams and improve early patient referral, we’ve also increased the GP influence in our service care provision across all five boroughs. 

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## **We had 5,256 outpatient appointments – a 30% increase on the previous year** 

## **We made We cared 13,813 home for 5,785 visits – a patients – a 5% increase on the 4% increase on the previous year previous year** 

## **Care on our wards** 

At the hospice, it’s our job to make sure that we do all we can to offer help and support for those who need it. A big part of this is making sure people feel comfortable and at home whilst they stay with us on our wards. We only have one chance to get it right and we know that how people die remains in the memory of those who live on. 

## **Refreshing our wards** 

Our wards need some essential works to reflect the changing needs of the population and we want to make the spaces brighter and more welcoming, as well as better equipped, so we can support the people who stay with us each year in any way they need. 

Planned work to **refresh our wards** includes: 

- Making our wards the best they can be for people living with dementia – a significant number of people who stay with us are living with dementia and it’s vital we create an environment which is easy to navigate to minimise confusion and where they feel supported and understood 

- Converting some of our multiple occupancy rooms into larger, family-sized rooms – we know how important it is for different types of families to make the most of the precious time they have together 

- Ensuring we can best support larger patients. The number of people who are obese has almost 

**Over 540 people stayed at the hospice last year with the majority of our care provided in people’s own homes** 


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8 St Christopher’s Hospice annual report and accounts 2022-23 19-20<br>**----- End of picture text -----**<br>




“They’ve restored my confidence and made it easier for me to want to engage. I’m not just going to sit at home, waiting to die” 

## **Eileen’s story** 

Eileen was diagnosed with motor neurone disease (MND) in August 2022 following months of investigations for various symptoms, and ultimately, a respiratory failure she has no memory of. The news she had MND “knocked her sideways” and she described it as “receiving a death sentence”. St Christopher’s intervened when the local authority’s support for personal care stopped. 

The team sent an occupational therapist to Eileen’s home to assess her needs and come up with an ongoing plan to support her and enable continued independence. In addition to the at-home care, she also comes into the hospice for wellbeing and peer groups and to use our rehabilitation gym. Eileen said: “Everyone is so approachable, respectful and helpful. They’ve restored my confidence and made it easier for me to want to engage. I’m not just going to sit at home, waiting to die.” 

doubled in the past 20 years to 13 million, which is approximately 30% of the adult population. This requires an enhanced physical environment, including hoists and sufficient space. 

We’ve secured the support of CRASH – a charity that specialises in helping hospices and homelessness charities create spaces for people when they are at their most vulnerable. 

We are currently working with CRASH on plans for how we make the most of our wards space and plan to commence the project and the associated fundraising in 2023-24. 

## **Trialling innovative equipment** 

We partnered with Eitan Medical to trial a new prototype **syringe drive pump** , which can be used to administer subcutaneous medications. The pump has variations in settings, allowing larger volumes to be administered over differing times as well as enhanced software to support the review of individual patient treatments, which may be useful in community settings. 

The four-month trial supported 135 treatments for 15 patients over a range of 1-26 days. Thirty-three nursing staff from our IPU were trained to use the new pump, found it easy to use and are proposing to change to these new pumps following their evaluation. 

## **Community care** 

We know the majority of people want to remain at home, where they are most comfortable and in familiar surroundings, rather than be admitted to a hospital or hospice. We see the majority of patients wherever they call home with the supportive partnership of primary care providers, carers and family members. We made 13,813 home visits in 2022-23 – a 5% increase on the previous year. 

## **Improved services for people at home** 

We’ve also introduced individual caseloads for groups of St Christopher’s nurses, aligned to the patient’s primary healthcare team in order to provide better **continuity of care** . This means each group of nurses only sees around 30-40 patients (rather than hundreds), which enables our staff to get to know each individual better and provide a friendly, reliable face to patients who may otherwise feel very isolated. 

To continue to deliver comprehensive care for people with a prognosis of two to three weeks left to live, who wish to remain in their own homes, we expanded our **Choose Home** service across all five boroughs in 2022-23. We saw a 31% increase in the number of patients who were able to access this service and this team is now supporting ward discharge with a ‘day after discharge’ visit from a nurse known to the patient, 

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St Christopher’s Hospice annual report and accounts 2022-23 




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This year we had 5,256 outpatient appointments<br>– a 30% increase on the previous year<br>**----- End of picture text -----**<br>


providing better continuity of care. This visit is in addition to any ongoing at-home care package arranged with St Christopher’s and partner organisations upon discharge. 

We’re also involved in a new initiative in Bromley, known as **Virtual Wards** , which is currently being trialled and aims to provide intensive, hospital-level care for people with conditions that would normally require a hospital bed, or regular visits to a hospital, in the place they call home (including care homes). 

If this pilot in Bromley is successful, it will be a service we look to develop and offer across all five boroughs we serve in the future. 

## **Planning for the future** 

Croydon Commissioners approached us to work with one primary care network to identify people who would benefit from having an **urgent care plan** written to improve their quality of life. This work began in 

January 2023 and ran until mid-April, where a dedicated St Christopher’s nurse is having conversations with 71 people identified as fitting the project criteria. The aim is to have meaningful discussions about their wishes and life goals, which the nurse can translate into a plan and can be accessed by any healthcare service they may need to access now or in the future. 

In addition, we’ve secured funding from One Croydon to train five **end of life doulas** to support people who are reaching the end of life. An end of life doula is a non-medical, holistic practitioner who offers support, presence, companionship, education and advocacy for both the patient and their family during the dying process. 

There’s a marked inequity in Croydon for people accessing end of life services and it’s proposed that end of life doulas would support person-centred care and help reduce some of the existing health inequalities in the following groups: 

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- people in mental health/learning disability care provision 

- people living in care homes 

- the homeless population 

- refugees 

- other minority groups 

- prioritising those in the most deprived postcodes in Croydon. 

hospital admissions and the ability to reach patients who may currently struggle to access the support they need. 

At the end of this project, we’d like to develop a variety of learning opportunities for others who share our ambition to keep more people with advanced heart failure out of hospital and at home, where this is clinically appropriate and consistent with the patient’s wishes. 

This role will be alongside current specialist care provision and people who may benefit from the care of an end of life doula will also need to be under the care of St Christopher’s. 

And finally, a nurse-led project, funded by the Burdett Trust, is aiming to create and test an integrated model of community support for people living with, and dying from, **advanced heart failure** in Bromley and Croydon. 

We’re aiming to reach more than 150 patients (where heart failure is the primary reason for referral) across Bromley and Croydon and to support 75 carers for people with advanced heart failure diagnoses. Desired outcomes include improved quality of life, reduced 

“Everybody seemed to know who I was. They took time to listen to me and to understand what I was going through” 

## **Peter’s story** 

At the age of 74, Peter had never been in hospital before, and then in August 2022 he was diagnosed with chronic obstructive pulmonary disease. 

He started to experience significant breathlessness and was really frightened he was going to die. 

Peter was referred to St Christopher’s later that month for a series of breathlessness management sessions, where the team were able to guide him through exercises to help his breathlessness, which in turn alleviated his anxiety. 

He felt that the team at St Christopher’s took the time to get to know him, saying: “Everybody seemed to know who I was. They took time to listen to me and to understand what I was going through.” 

Peter is much calmer now and this support has given him a new sense of freedom; he is able to enjoy his independence again. 

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St Christopher’s Hospice annual report and accounts 2022-23 



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## **Professional learning** 

Through St Christopher’s CARE, we continued to provide a broad range of learning opportunities for professionals involved in health, social care and beyond. Over the last year our diverse learning programmes reached people globally, with 100% of learners rating their experience four or five stars (from a total of five). 

## **Conferences with a difference** 

Over the last year, we co-designed and provided cutting-edge, **in-person conferences** for more than 500 delegates, touching on new topics and engaging with new audiences. The conference programme addressed a range of diverse topics, including: 

- **Joining the Dots of Motor Neurone Disease Care** which we ran in partnership with King’s College, London, Power in Partnership. This conference focused on the urgent need for clearer, more transparent communication and a greater emphasis on patient and carer wishes, including compelling contributions from patients themselves 

- Recognising the limited or total lack of care at the end of life for people who are homeless, we hosted **Reaching the Forgotten** to raise awareness of the issues and start the process of developing a model of engagement and a network of professionals to support this growing population 


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More than 10,000 learners engaged with<br>St Christopher’s CARE over the last year<br>**----- End of picture text -----**<br>


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## **More than 10,000 learners engaged with St Christopher’s CARE** 

## **Learners 100% of attended from learners who nearly a third evaluated our of UK hospices learning events gave their experience four or five stars** 

- **Rehabilitation in Palliative Care: Contemporary Opportunities** which encouraged allied health professionals and their clinical colleagues to work more closely in delivering patients’ goals and wishes. 

## **Improving global skills in palliative care** 

## **Maxine’s story** 

Maxine is a clinical nurse specialist based at Ipswich Hospital in Suffolk and completed the Lantern Model programme through St Christopher’s CARE. Maxine shared: 

“I would like to say a massive thank you to all involved in the development of the Lantern Model programme. Every member of St Christopher’s team I have liaised with over the year have been helpful, engaging, compassionate and kind. They push us out of our comfort zones to think and explore palliative and end of life care in new and creative ways. 

I personally enjoy the fact it is multifaceted with webinars, community of practice forums, use of the communication platform Discord, the Lantern Model reflection tool and a never-ending bank of resources. I enjoy attending every session and exploring ideas and thoughts from all over the world with real people working in palliative and end of life care, from nurses to professors. 

I would highly recommend this programme to anyone with a keen interest in palliative and end of life care and can absolutely confirm it has made me a better clinical nurse specialist in every way possible.” 

Our work to increase the capabilities and insights of palliative care leaders globally, has also gone from strength to strength – most notably, through our continued flourishing partnership with the Institute of Palliative Medicine in Kerala, India. The **Fellowship in Palliative Care** saw 200 professionals aspiring to lead palliative care services benefit from this six-month learning programme. 

We also shaped a new initiative to improve the experience of dying for slum dwellers in Dhaka, Bangladesh, through direct support and a tailored training programme delivered to 53 professionals. 

## **Creating collaborative nursing communities** 

Working in partnership with Central and North-West London NHS Foundation Trust and University College Hospitals NHS Foundation Trust, we launched **Palliative Discovery** , a free network designed by and for clinical nurse specialists (CNS). 

Via the free online platform, more than 1,400 CNSs were able to access opportunities for learning in the form of talks, classes, roundtable discussions, as well as online tools, all tailored to sustain them as they continue to fulfil their key role in supporting people at the end of life. 

Carmel O’Donnell, Clinical Nursing Specialist at Letterkenny University Hospital, said: “As a senior nurse it’s so important to keep learning and Palliative Discovery has helped me do that. I’ve enhanced my knowledge, and this can only be good for the personcentred care I want to provide my patients.” 

Our Director of Academic Learning and Action, Heather Richardson, was the recipient of one of 14 **Burdett Hero** awards from the Burdett Trust for Nursing on behalf of the team that has led Palliative Discovery. 

Building on the success of Palliative Discovery, this year, we’ll be launching a **Global Palliative Care Nursing Network** to meet the ongoing demand for a place for nurses to learn, share and grow together. 

> St Christopher’s Hospice annual report and accounts 2022-23 13 




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Tom Pursglove, Minister for Disabled People, Health and Work,<br>pictured with colleagues from across the hospice on a recent visit<br>**----- End of picture text -----**<br>


## **Research and policy** 

At St Christopher’s our vision is of a world in which all dying people and those close to them have access to care and support when and wherever they need it. 

It is that drive, to improve care on a wider scale, which shapes our ambition to better understand the changing needs of people at the end of life, share our findings with others to evolve their service offers and lobby for wider policy change to improve people’s experiences at end of life. 

## **Assisted dying community project** 

We’re planning to understand more about people’s views on medically assisted death. In the UK it is currently illegal to use drugs to assist someone to die. 

However, the law might be changing in the next few years and the palliative care sector needs to be prepared to respond to this. 

In spring 2023 we launched a programme of public engagement around this issue, with those we serve in south east London. Through community-based conversations we will look to provide learning, data and insight for interested parties into people’s perspectives on assisted dying. 

This research will be with 50+ members of the public with a range of views, experiences, occupations and perspectives across five boroughs of south east London. 

Rather than surveying attitudes or opinions, which to date has shown polarisation and doesn’t allow for an understanding of why people think as they do, we will be adopting a qualitative research method to allow for deeper engagement. 

This approach will provide an openness to hearing community viewpoints on this challenging and complex issue. Through completing this work, we will be better prepared should a change in the law occur and have a much richer insight into people’s views and wishes around this complex area. 

## **Representation at Hospice UK** 

As part of our ongoing commitment to research, sharing knowledge and developing expertise on a national scale, 13 members of staff attended the annual Hospice UK conference in November. 

As an organisation, we shared our learning on 13 topics, our Nurse Consultant, Helen King and our Lead Palliative Care Consultant, Dr Joy Ross, led a panel discussion on Frailty and, for the first time, we took an exhibition stand promoting 

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## **1,358 carers received support – 953 had formal post-death bereavement support and 693 accessed pre-bereavement support from our wider multi-disciplinary team** 

## **We supported 445 children through our Candle bereavement service** 

the professional learning offer available through St Christopher’s CARE. 

## **Fast-tracked benefits for people at the end of life** 

Tom Pursglove, the Minister for Disabled People, Health and Work, visited the hospice in March 2023 to mark new positive changes in the Special Rules Policy, which enable people at end of life to claim fasttracked benefits paid at the highest rate. Under the new rules, which came into effect on Monday 3 April 2023, people with a prognosis of 12 months are now entitled to claim – up from six months previously. 

St Christopher’s submitted evidence in support of these changes as part of the consultation process – one of the many reasons we were chosen as the venue to launch this improved support. 

“It’s been a big help to me to open up and get things off my chest. I have ups and downs, but talking about my mum and grandad helps me to smile again” 

## **Bereavement** 

As the demand for bereavement services continues to increase we’ve reviewed and invested in our offer for all bereaved people, recognising the continued change in bereavement needs. 

## **Improving our support** 

Recognising that reaching out for support is hard enough, we’ve created new roles to ensure people calling in to receive bereavement support can immediately book a triage appointment with a bereavement specialist, enabling us to respond more quickly to their specific needs. 

## **Offering support at a time of public loss** 

In September 2022, we were deeply saddened to hear of the death of Her Majesty Queen Elizabeth II. A visit from Her Majesty on our 21st anniversary in 1988 remains a treasured memory in our organisation’s history and we extended our most heartfelt condolences to our Patron, HRH Princess Alexandra, The Honourable Lady Ogilvy, and to the Royal Family. 

There may be those in our communities who found this loss to be particularly difficult or unsettling. A public loss can also cause people to reflect on their own personal bereavements and brings their own mortality into view. We’d like to remind our communities that we 

## **Ben’s story** 

Ben was just 12 years old when his mum died. A school friend referred him to St Christopher’s for support where he accessed counselling on a regular basis through our child and young person’s bereavement service, known as Candle. 

Just a few years later, Ben also lost his grandfather and was overwhelmed by the deaths of two significant people in his life at such a young age. 

The team continue to support Ben and he said talking about it really helps: “It’s been a big help to me to open up and get things off my chest. I have ups and downs, but talking about my mum and grandad helps me to smile again.” 

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offer formal one-to-one sessions and peer-led groups to talk about and learn techniques to cope with grief. 

## **Collaborative community action** 

Through our Community Action team, we aim to find gaps and spaces in current support provisions to redress inequalities. We do this through: facilitated peer-to-peer support for those who are carers, bereaved or socially isolated for any reason; partnerships with other likeminded organisations; and community-based learning. 

## **One-to-one matched support** 

With our programmes offering one-to-one matched support, we match people with a volunteer who has been specifically trained to provide support and, in most cases, has lived experience of dealing with care, death, bereavement or isolation. 

## **Compassionate Neighbours** 

Funded by the City Bridge Trust, Compassionate Neighbours is a community-led initiative for people living with or caring for a person with a long term, life limiting or terminal illness, or people who are older and socially isolated. It’s a network of people who offer their time, companionship and support to people living in their local area. 

This initiative is extremely popular and we’ve had another great year supporting many people across the community who would otherwise have no one to turn to. 

## **Bereavement Buddies (pilot project)** 

Funded by The Mercer Trust, this brand-new initiative is designed to give early intervention bereavement support, and people are usually matched before the bereavement occurs. 


**----- Start of picture text -----**<br>
We offer a range of peer support and<br>championship programmes for people<br>across south east London<br>16 St Christopher’s Hospice annual report and accounts 2022-23<br>**----- End of picture text -----**<br>





**----- Start of picture text -----**<br>
Hilary, Kathleen and Issac take<br>a moment to reflect in our<br>hospice gardens<br>**----- End of picture text -----**<br>


Born out of work with people who have lived experience of bereavement, in just two months since launch we’ve had more than 50 people volunteer to become Bereavement Buddies. There is such a need for this peer-to-peer support before and immediately following the death of someone close when it can be confusing, overwhelming and frightening. We’re excited to see how this initiative develops over the next year. 

## **Carer Champions** 

Funded by Women in Fellowship, this project sees volunteers who have been carers themselves partnered up with people who are currently caring for someone with a long-term, life-limiting or terminal illness. The volunteers offer companionship to those who could otherwise feel quite isolated. 

As an organisation, we support carers in many ways, but this one-to-one connection with someone who is able to understand the daily challenges and obstacles which carers face, is invaluable. 

## **Therapy through creativity** 

Made possible by the Heritage Lottery Fund, we worked with artist Christopher Green to explore a new artistic concept reflecting on what we leave behind and how 

we choose how we’d like to be remembered. Working with Entelechy Arts, Christopher supported participants to build an online platform where everyone at any stage of their life can make or choose art, such as songs, poems or images, to create a digital legacy. 

One of our existing support groups is for households where someone is living with neurological conditions. Last year, we partnered with the City of London Symphonia and worked with our own music therapy team to facilitate a six-week project using music to tell stories. 

## **Community learning** 

One of our key objectives is to encourage people to talk about death and grief earlier. As part of this, we facilitated a number of initiatives over the last year including: 

- Developing and delivering a number of **community learning courses** from bespoke sessions, to open access groups for the public on the topics of ‘loss and legacy’ and ‘caring for carers’. Our open-to-all courses are free to access and explore subjects that may help give people a formative understanding of how we can approach and understand death, dying and grief experiences. They are offered both in 

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**----- Start of picture text -----**<br>
The Voices That Shaped Us: Modern Hospice in<br>the Making exhibition at St Christopher’s CARE<br>**----- End of picture text -----**<br>


person and online, and in the last year we have held 108 sessions which reached 708 attendees. 

- An **art-based session for teenagers** from South Bank University Academy exploring death, dying and bereavement, changemaking and social action. The teenagers used clothing from the St Christopher’s charity shops to weave their individual pieces, which all became part of the collective weavin 

- Hosting a **summer school for young people** (16-18 year-olds) where they had the space to work together to create their own end of life discussion, shifting the balance of power away from organisations and professionals. 

## **Stimulating conversations** 

We’re on a mission to transform the wider conversation around death and dying with thought-provoking dialogue and, in doing so, elevate the standards of end of life care for all. While we will all face our own death, it is still seen as one of society’s taboos. 

## **Death and grief on a national scale** 

We were thrilled to be part of two high-profile national television shows – **Kelsey Parker: Life After Tom** on ITV in January 2023 and **Antiques Roadshow: Nursing Special** on BBC 1 in February 2023. 

ITV’s six-part documentary following Kelsey Parker as she comes to terms with her husband’s death was also viewed by over four million people. The piece featured Kelsey returning to St Christopher’s and meeting up with members of staff who cared for Tom (from the boyband The Wanted) in the last few weeks of his life. 

During our segment on Antiques Roadshow, our Spiritual Care and Quality Lead and one of our Ward Managers were filmed speaking to antiques expert Siobhan Tyrrell about a number of items that were either previously owned by Dame Cicely Saunders or which provided insight into the origin of hospice care in the UK and St Christopher’s as an institution. The show regularly brings in up to eight million viewers per episode through live broadcasting and BBC iPlayer. 

18 St Christopher’s Hospice annual report and accounts 2022-23 



“I didn’t know what I was going to do, how I was going to survive, where my next pay cheque was going to come from and how I would pay the rent. I was like a lost little girl” 

## **Kathy’s story** 

Kathy’s husband Ernie was cared for at St Christopher’s by our ward teams. 

When Ernie died, his death plunged Kathy into poverty. Kathy was at risk of being evicted from her house, and the stress 

and anxiety on top of her bereavement led to her suffering from severe anxiety and depression. She had nowhere to turn until she received a phone call from our Welfare Team, who assisted with her financial support and provided a listening ear. 

The team managed to write off Kathy’s inherited debt and secure her housing, and also introduced her to a number of benefits that could help maximise her income. Kathy credits our Welfare Team lead and St Christopher’s with keeping her alive, repeatedly telling us “I wouldn’t be here without you.” 

## **Cost of living campaign** 

The devastating impact of the rise in cost of living is particularly poignant for people facing the end of life and those closest to them. That’s why during Hospice Care Week in October 2022, we filmed a video with Kathy who was plunged into debt following the death of her husband and was supported by the Welfare Team at St Christopher’s. You can read her story above. 

When shared, Kathy’s film had a combined reach of over 9,500 impressions across Twitter, Facebook, Instagram and LinkedIn, and the video was viewed over 5,000 times. Off the back of this campaign, Kathy was also invited to speak live at the Death Festival in Brighton in November 2022, and joined a panel alongside representatives from Hospice UK, Marie Curie and Down To Earth. 

## **Dead Good** 

In a bid to get people talking about death, we launched our very first podcast – **Dead Good** . Hosted by comedian Sajeela Kershi, it adopts a playful, at times humorous and, above all, thought-provoking tone. Each episode, a high-profile guest shares their own experiences around the topic, challenging the taboos that exist within society. 

The podcast is available to listen to on all major podcast platforms including iTunes and Spotify and over 1,200 

people from 33 countries have tuned in to listen so far. We are looking to launch season two in autumn 2023. 

## **The Voices That Shaped Us** 

After more than 18 months of planning and interviews, our oral history exhibition – **The Voices That Shaped Us: Modern Hospice in the Making** – launched in August 2022 both online and in person at St Christopher’s CARE. 

This groundbreaking exhibition told the story of St Christopher’s over the past seven decades using interviews with 77 people who helped shape our history. More than 800 people viewed the exhibition in person and a further 3,000 enjoyed reading and listening to the personal recollections of the doctors, nurses, volunteers and relatives at the heart of our story online. 

Meanwhile in Edinburgh, a new play, **Cicely and David** (sponsored by St Christopher’s) premiered at the Fringe, written by Dame Cicely Saunders’ biographer David Clark and produced by one of her former colleagues, Jo Hockley. 

It tells the story of Dame Cicely’s relationship with Polish migrant, David Tasma, how she helped him to find some resolution to what he felt had been a worthless life while also sparking her idea for what became modern end of life care, as part of the launch of St Christopher’s Hospice. The five-night run was sold out. 

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## 


**----- Start of picture text -----**<br>
We’re working hard to challenge<br>people’s views of a hospice, ensuring our<br>communities are aware of the breadth<br>of services that we offer for everyone<br>**----- End of picture text -----**<br>


## **With local communities** 

We’re here for anyone in our community that needs us, but we know that not everyone accesses our services. Many people still see a hospice as a place where people spend their final days, when in reality we offer so much more. 

We also know some people don’t see St Christopher’s as a place for them. We’re committed to changing this, ensuring that everyone, no matter who they are, feels welcome and able to access our services. We also rely heavily on our community of volunteers to help deliver our services, redress inequalities and ensure we can provide best-in-class care. 

## **Listening to our community** 

One way we are doing this is by better **understanding the views of our community** . In January 2023, we completed an extensive piece of public research to better understand people’s awareness of St Christopher’s and what we do, as well as gaining clarity on the barriers or misconceptions that stop people from accessing our support. Over 630 members of the public and 260 people already connected to the hospice shared their views with us. 

We’re now using those valuable insights to ensure we describe and position St Christopher’s as a place that meets their needs and challenges those misconceptions. 

20 St Christopher’s Hospice annual report and accounts 2022-23 



## **We have 1,017 volunteers, of which 19% have been with us for more than five years** 

In January, we published and distributed the first edition of our **rebranded hospice magazine** , formerly called _Connections_ and now known as _Connect_ . _Connect_ is larger, longer and more lifestyle focused, and contains stories, advice and features about death and grief as well as the usual information about our services and fundraising events. The first edition was well received, with many people commenting how much they’re enjoying the new content and layout! 

We also ran a collaborative community project to better understand people’s experiences of living with and supporting **people living with dementia** . Funded by the Hospice UK Masonic Charitable Foundation, we engaged with 20 people (and their households) plus 30 subject-matter stakeholders across Lewisham and Bromley. 

## **Partnering with others** 

Over the last year, we’ve been busy **rebuilding our volunteer base** as activities restarted post COVID-19. We’ve developed new roles and opportunities for volunteers to engage with us, providing some stability for our current volunteers and attracting new volunteers to St Christopher’s. This includes our new group of reception volunteers who welcome visitors to the hospice and help people to overcome any nervousness and preconceptions they may have when they arrive. 

Our **Volunteer Voices group** was also relaunched to advocate on behalf of all volunteers at St Christopher’s. We’re very grateful to this group who have shared useful insight about how we can improve our communication with volunteers and also recognise volunteer achievements appropriately. 

Following our successful **retail consultancy partnerships** with Greenwich & Bexley Community Hospice and our ongoing consultancy with Princess Alice Hospice, last year, we started retail consultancy with St Wilfrid’s Hospice looking at their property portfolio with the vision of increasing the number of shops. So far, we’ve completed one refit and are currently supporting them with negotiations on two new shops. These partnerships provide both financial income for St Christopher’s, and also results in more income for hospice care to be delivered in other parts of the country. 

## **84% of staff shared that they feel comfortable being themselves at work** 

## **Inclusivity** 

Ensuring everyone feels St Christopher’s is a place for them, where they are welcomed and included, is of the upmost importance to us. Over the last year, we’ve asked our teams what is most important to them when it comes to creating an inclusive environment and made sure we are responding accordingly, as described below. 

## **Creating a more equitable workplace** 

As an organisation, we’re working towards the **Investors in Diversity (IiD) accreditation** . Over the last year, this has included a staff survey, multiple workshops and the creation of an action plan to ensure we’re actively becoming a more inclusive place of work. 

We’ve also signed the pledge to become an **Age Friendly Employer** . 

## **Our people said, we did** 

In May we ran our **Birdsong staff survey** for the first time since 2019, which had a 65% overall response rate (an increase of 7% from the previous survey in 2019). We saw an increase in staff morale and people said they took pride in their role, had faith in the organisation and enjoyed working with great colleagues, as evidenced by the stats below: 

- 92% enjoy working with the people at St Christopher’s 

- 90% are proud to work at St Christopher’s 

- 84% feel comfortable being themselves at work 

- 82% feel supported by their manager. 

There were several areas where colleagues asked for further support, these are noted below and we’ve begun to address these in the months since. They said they’d like: 

- improved training and development opportunities 

- support to improve wellbeing at work 

- more effective communication between teams. 

## **Supporting staff** 

To ensure **staff feel supported financially** , we conducted a benchmarking pay review exercise across 

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## **12,524 people donated money to St Christopher’s** 

## **583,000 8,933 people customers raised £587,465 supported us through our in our shops hospice lottery** 

the organisation and provided support for those struggling with the effects of the cost of living crisis. 

From April to December 2022, we extended our **Elevate Programme of Managers** to a further 30 participants, meaning 70% of our current people managers have completed the programme since its launch. 

In March, we invested in a **brand-new online learning management system** to support engagement with mandatory training and collaborative peer-to-peer learning across the organisation. 

## **Sustainability** 

Ensuring the future sustainability of St Christopher’s and the planet remains a key priority for the hospice. 

Despite the financial pressures of the cost of living crisis, our Fundraising and Retail teams have worked hard to ensure we continue to raise much-needed funds to provide our caring services. It cost £25,320k to run the hospice last year, of which £17,170k came from our fundraising, shops and money people have left in Wills. 

We’ve been heartened by the support of our communities and thank you for choosing to support us in this way. 

## **Community support to raise funds** 

Post COVID-19, we have been delighted to see our communities and volunteers returning to take part in **in-person events** . Twenty-nine people took part in the London Marathon to raise funds for 

**Ensuring everyone feels St Christopher’s is a place for them, where they are welcomed and included, is of the utmost importance to us** 




**----- Start of picture text -----**<br>
Over 1,000 walkers joined us at<br>Bluebell Walk to raise much-needed<br>funds for the hospice<br>**----- End of picture text -----**<br>


St Christopher’s in October 2022, and raised over £60,000 between them. 

Volunteers have made a major contribution to our fundraising this year by organising events on our behalf and supporting our St Christopher’s events. Without them, we would not be able to do our work and we are incredibly grateful for their time, enthusiasm and commitment. 

The largest of our events was the much-loved **Bluebell Walk** , which returned in May 2022 with over 1,000 walkers registering for the event, raising an amazing £43,000. Thank you to everyone who took part in the walk, donated, came along on the day, sang, chanced it on the tombola and volunteered their time. 

In November, the annual legal dinner in support of St Christopher’s at the Great Hall of the **Goldsmiths’ Company** in the City of London took place. This dinner, attended by close to 200 private client lawyers and legal professionals, has been a firm fixture in the legal calendar since 2000. We were delighted to be joined by Heather Phillips, High Sheriff of Greater London (2022-23) who kindly gave up her time to be 

our engaging after-dinner speaker. We are grateful to our loyal sponsors as well as the generous donors who raised almost £90,000 on the night. 

In February, we held our second-ever **Snowdrops for St Christopher’s** installation at Down House, former home of Charles Darwin. Featuring 1,300 handcrafted iron snowdrops, supporters were invited to dedicate a snowdrop in memory of a loved one and to visit the installation to reflect and remember. This year’s Snowdrop campaign raised £44,001 during the year. We’re grateful to the staff and volunteers at Down House for facilitating the installation at no cost to St Christopher’s. 

Many of our donors and volunteers have a personal connection to St Christopher’s and we’ve once again, benefitted from **generous legacy donations** for which we are very grateful. Alongside our biannual Will Week campaign to encourage people in the community to make a Will for a small donation to us, people remembering us in their Wills is a fundamental to our financial sustainability and our ability to operate as a hospice. 

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St Christopher’s Hospice annual report and accounts 2022-23 



**Our shops raised £5m last year and supported environmental sustainability enabling people to donate and buy pre-loved items** 

**Our shops sold between £20-30k worth of items each and every week** 

**We sold more than 20,000 paper bags last year, saving plastic from going to landfill** 

**We opened our second children’s shop in Crystal Palace** 

## **Rallying for retail** 

This year, we have seen strong growth in our shops, and have generated more money from them than ever before, to help fund care for our patients. Selling 20-30k items every week, our shops have brought in £1,622k profit, which increases to £2,115k if the Gift Aid generated via our shops is also included. Continuing to innovate and specialise, we opened our second children’s shop in Crystal Palace in August 2022, which has been a great success to date and continues to grow weekly as reputation increases in the local area. 

Our shops provide goods to our community at cheaper prices than the rest of the high street, which is especially beneficial for our community during a cost of living crisis. 

Offering the ability to buy pre-loved and upcycle, they also support environmental sustainability. Another way that we have considered the environmental impact of people shopping with us, is that we decided to provide paper bags and charge shoppers, to incentivise them to bring their own bags. We sold more than 20,000 St Christopher’s paper bags in the last year, saving a lot of plastic from going to landfill. 

24 St Christopher’s Hospice annual report and accounts 2022-23 



## 

**St Christopher’s Hospice was incorporated as a company limited by guarantee on 21 January 1961 and is governed by its Articles of Association. St Christopher’s Hospice is registered with the Charity Commission for England and Wales.** 

St Christopher’s Hospice has a wholly owned subsidiary, St Christopher’s (Trading) Limited, company number 02604519. The registered office of St Christopher’s Hospice and its subsidiary is 51-59 Lawrie Park Road, Sydenham, London SE26 6DZ. 

## **How we are governed** 

The Board, consisting of the Trustees named at the back of this report, has ultimate responsibility for the proper and effective management of St Christopher’s Hospice. The Board is responsible for all major strategic decisions, for monitoring the organisation’s performance, and to ensure that it complies with its Articles of Association and applicable laws and regulations. 

Neil Goulden has been the Chair of the Trustees since 1 April 2021. The Vice Chair is Eleanor Brown, who took on the role following Jane Walters’ retirement as a Trustee on 21 July 2022. 

The Board delegates day-to-day management and decision making to the Executive Team, which is led by the Chief Executive. The Executive Team is required to act in furtherance of the charity’s strategy. The Board holds the Chief Executive and Executive Team to account for its leadership of the organisation. 

The governance structure is below. The Board has Trustee representation on the following five Board sub-committees: Governance, People & Workforce, Quality & Impact, Finance, Audit & Risk and Education, Research & End of Life Policy. Trustee representation is also in place on the following Boards and committees: Investment Committee, St Christopher’s Hospice Trading Board and 1985 Pension Scheme Board. 


**----- Start of picture text -----**<br>
St Christopher’s Board of Trustees<br>Education, Research  Finance, Audit  Quality  Governance  People and  Investments<br>and End of Life  and Risk  and Impact  Committee Workforce  Committee<br>Policy Committee Committee Committee Committee<br>Research, Audit<br>Workforce<br>and Clinical  Trading<br>Effectiveness (RACE)  Development Committee Board<br>Committee<br>Information Governance Committee User Safety Patient and Service  Committeeand Reach Activity  CommitteeUPROMS  Organisational CommitteeSafety  FREDIE Group Diversity and (Equality,  Pensions Board1985<br>Committee Inclusion)<br>Staff<br>Forum<br>Infection<br>Medical  Nutrition and  Tissue<br>Safeguarding  Falls   Prevention<br>Committee Optimisation  Group and Control  Dysphagia  Viability<br>Group (MOG) Group Group<br>Group<br>**----- End of picture text -----**<br>




Committee terms of reference define responsibilities and delegated responsibilities and are reviewed annually. The Board may delegate any of its powers to one of its committees. The committees report to the Board after each meeting. 

Trustees commissioned an external governance and effectiveness review during the year. This was carried out by Bayes Business School, who were selected as part of an external tender process. Following this review, Trustees received and discussed a report of recommendations from Bayes Business School. The Trustees will be addressing these recommendations from 2023-24. 

## **Trustees’ duty to promote the success of the Charity – Section 172 statement** 

The Trustees are the directors of St Christopher’s Hospice and have a duty to promote the success of the Charity and, in doing so, are required by section 172(1) of the Companies Act 2006 to have regard to various specific factors, including: 

- the likely consequences of decisions in the long term 

- the interests of employees 

- the need to foster the Charity’s relationships with third-party stakeholders which, in the case of St Christopher’s Hospice, includes dying people and those close to them, the local community, the NHS and our supporters 

- the impact of the Charity’s operations on the community and the environment 

- the desirability of the Charity maintaining a reputation for high standards of business conduct. 

The Charity’s strategy takes into account the likely consequence of any decision in the long term. The Trustees have recently approved the organisation’s strategy for the next three years. The areas of focus for our updated strategy for 2023-26 are set out on pages 58-59. 

The Board meets at least quarterly throughout the year. It assesses progress against the strategy, identifies areas for focus for the following year and receives updates 

on the Charity’s performance and plans. Its committees also review plans, strategies and activities with regard to the particular terms of reference overseen by the committee concerned. The Board also has an annual away day for strategic planning. 

The Board obtains assurance that attention is given to the factors set out in section 172 when promoting the success of the Charity, by monitoring that the Executive Team and the wider organisation are delivering the strategy and complying with specific policies. 

Engagement with the Charity’s main stakeholder groups are as set out on pages 6-24. The Executive Team reports to the Board on key stakeholder relations and engagement activities, current issues and relevant feedback received from interactions with stakeholders. 

The Trustees also follow a formal process to regularly manage and review risks that are faced by the Charity, set out on page 30. 

The Charity ensures that it maintains a reputation for high standards of business conduct by having in place a range of policies and processes that promote corporate responsibility and ethical behaviour. Areas covered include fundraising (our fundraising practices are discussed below), gifts, hospitality and antibribery, conflicts of interest, safeguarding, bullying and harassment, and whistleblowing. Policies are reviewed periodically. We have also dedicated leads for equality, diversity and inclusion, safeguarding and whistleblowing within the Executive Team and the Board of Trustees. 

## **Appointment of new Trustees** 

The Board is made up of individuals who have a diverse, varied and balanced cross section of life, skills and experience. When embarking on the recruitment process, the Trustee vacancy is advertised on the St Christopher’s website, in various publications and on social media. The specialist services of a recruitment agency may also be employed where necessary. Prospective candidates are invited to apply, outlining their relevance for the role. After the closing date, applicants are shortlisted against the person specification, and potential candidates are invited to interview. The interviews are usually carried out by 

26 St Christopher’s Hospice annual report and accounts 2022-23 



the Chair and a subset of other Trustees. Successful candidates are then formally appointed by a resolution of the Board. 

Trustees are appointed by resolution of the Board for a term of up to three years. Upon expiry, they shall be eligible for re-appointment for a further term or terms of up to three years. All Trustees sign a code of conduct on appointment. The Trustees, Chair and Vice Chair carry out their responsibilities in line with a documented description of their role. 

New Trustees undertake an induction process designed to equip them with the information and understanding they need to become effective and valuable members of the Board as quickly as possible. The induction process involves the following: 

- An induction pack containing key information about St Christopher’s, the governance structure, the roles and responsibilities of Trustees and the organisational work of the Board of Trustees and its committees 

- A Trustee mentor for at least the first year 

- An induction programme which enables new Trustees to gain a good understanding of the operations of the organisation 

- An informal review meeting with the Chair of the Board at the end of a Trustee’s first year. 

All Trustees give their time voluntarily and receive no benefit from the Charity. Out of pocket expenses incurred by the Trustees in carrying out the role can be reimbursed in accordance with the organisation’s expenses policy. No expenses were claimed from the Charity this financial year. All Trustees were required to complete and sign an annual declaration of interests and any relevant gifts received. 

## **Public benefit** 

The Board is aware of the Charity Commission’s guidance in relation to public benefit. The report indicates how our activities have delivered public benefit. 

## **Fundraising disclosure** 

St Christopher’s Hospice has voluntarily subscribed to the Fundraising Regulator and is committed to the 

Fundraising Promise and adherence to the Code of Fundraising Practice set by the Fundraising Regulator. 

We encourage the fundraising service providers we engage with to also sign up to the code. Our fundraising effort is led by Compton Fundraising Consultants who are members of the Association of Fundraising Consultants (AFC) promoting best practice and mission to set the very highest standards of fundraising. As a member of AFC, Compton Fundraising Consultants have signed the AFC code of practice together with the Fundraising Regulator’s code of practice. Compton Fundraising Consultants work very closely with the in-house Fundraising Team on a day-to-day basis and set and agree the annual fundraising targets with the St Christopher’s Executive Team. Performance against targets are monitored and formally presented monthly to the Chief Executive and the Director of Finance & Corporate Services. 

In addition, the Fundraising Team engages professional third-party suppliers to help us raise funds particularly where we do not have the expertise in-house. We have safeguards in place when working with suppliers so that we protect our supporters and the reputation of our charity, including Lottery Fundraising Services and Engage and Connect, the companies which support our lottery. We ensure all these agents observe the highest standards in terms of fundraising practice and monitor their performance through the use of mystery shopping and random checks with donors. 

St Christopher’s Hospice is a member of the Hospice Income Generation Network and many of our fundraisers are members of the Chartered Institute of Fundraising. 

Our website outlines our complaints policy for the public. We received three fundraising complaints in 2022-23 (2021-22: five fundraising complaints). Our policy is to respond to all complaints within 10 days. Serious complaints are escalated to our Executive Team and Trustees to consider lessons learnt. We report to the Fundraising Regulator and Gambling Commission on the totality of our complaints. 

We have policies and procedures in place to safeguard the vulnerable and we ensure our fundraisers and third-party suppliers adhere to these policies. We are also signed up to the Fundraising Preference Service to enable individuals to opt out from receiving fundraising 

27 

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communications from us. We received one request through this service last year. 

## **Pay policy for senior staff** 

The pay of the Chief Executive is set by the Governance Committee with any changes authorised by the Chair of the Board of Trustees. The pay for the remainder of the Executive Team is agreed by the Governance Committee in consultation with the Chief Executive. The pay for other senior staff is agreed by the Chief Executive in consultation with the Director of People & Organisational Development. 

## **People with a disability** 

St Christopher’s Hospice is a ‘Disability Confident’ Employer. This means that we undertake full and fair consideration of all applications for employment including those made by people with a disability. We offer a guaranteed interview to those applicants who qualify under the ‘Disability Confident’ scheme and we are also committed to supporting both people with a disability coming in to our workplace as well as supporting those people who develop a disability whilst employed by the organisation. St Christopher’s works with an occupational health service and in partnership with external organisations such as Access to Work, to provide support and advice to people with a disability working with us. 

St Christopher’s Hospice has been a signatory to the ‘Mindful Employer Charter’ since August 2016, demonstrating a commitment to supporting individuals with mental health illnesses and actively seeking to alleviate causes of workplace stress wherever possible. St Christopher’s trained ten members of staff to act as Mental Health First Aiders in 2021 to strengthen the support available to our workforce and provided refresher training in 2022 to these individuals to keep their skills and knowledge up to date.  We have further upheld the values of the Mindful Charter by: 

- Providing mental health training from Mind to those managers who are managing individuals with complex mental health issues 

- Coaching managers in the management of mental health related issues 

- Improving the data capture of mental health issues to enable early intervention. 

## **Equality and diversity** 

St Christopher’s is working with the National Centre for Diversity to achieve their Investors in Diversity accreditation. Following a staff survey in July 2022 to provide initial data, St Christopher’s developed an action plan to ensure demonstrable progress in line with the accreditation standards relating to culture, strategy, wellbeing, recruitment, reward, performance management and communications. This work is supported by the St Christopher’s FREDIE (Fairness, Respect, Equality, Diversity, Inclusion and Engagement) Group and progress is overseen and monitored by the People and Workforce Committee. 

The organisation has continued to carefully monitor and report on its workforce ethnicity rates. In the year to March 2023, St Christopher’s staff diversity of ethnic minority groups increased slightly to 21.8% (114). We are proud to have a diverse workforce at St Christopher’s with over 20 different nationalities represented across our staff. St Christopher’s was furthermore successful in its application to be an Employment Visa Sponsor Licence holder. This licence will help increase the diversity of our workforce whilst also helping to recruit hard to fill vacancies. 

## **Gender pay gap** 

Individuals performing the same role at St Christopher’s are paid equally regardless of gender or other protected characteristics. 

The Gender Pay Gap information shows the difference in the average earnings between all men and all women employed across the organisation on 5 April each year. This information is reported annually on the national Gender Pay Gap website. The April 2022 data identified that of our 465 staff (excluding bank workers), 83.4% were women and 16.6% were men. 

This year, we reported, for the second year in succession, that the average female salary was higher than the average male salary. Our gender pay gap has moved from -1.4% to -2.29%, which shows that 

28 St Christopher’s Hospice annual report and accounts 2022-23 



at St Christopher’s, women were on average earning slightly more than men. 

As a predominantly female workforce, however, even small fluctuations across the male workforce, such as the number of men employed in roles paid in the upper and upper middle quartiles, have a large impact on our gender pay gap. 

## **Employee information** 

St Christopher’s is committed to providing information to employees, when appropriate and feasible, on matters of concern to them and consulting with employees and/or their representatives on a regular basis. This is achieved through our Staff Forum which seeks feedback, when appropriate, on proposed changes to terms and conditions of service or ways of working. This feedback mechanism enables our employees’ views to be heard and considered during decision-making processes. 

## **Streamlined energy and carbon reporting (SECR)** 

In our third year of SECR, our UK greenhouse gas (GHG) emissions and energy use for the year were as set out in the table on the right. 

## **Quantification and reporting methodology** 

We have followed the 2019 HM Government Environmental Reporting Guidelines. We have also used the GHG Reporting Protocol – Corporate Standard and the UK Government’s Conversion Factors for Company Reporting. 

## **Intensity measurement** 

The chosen intensity measurement ratio is total gross emissions in metric tonnes per staff FTE. 

## **Measures taken to improve energy efficiency** 

Total energy use decreased during 2022-23 despite an increase in headcount. The average carbon usage per employee also decreased from 1.73 CO2e to 1.60 CO2e per staff member. 

Aside from an increased awareness of energy efficiency the most significant changes made during the year were: 

**UK GHG emissions and energy use data for the period 1 April to 31 March** 

|**period 1 April to 31 March**|||
|---|---|---|
||**2022-23**|**2021-22**|
|**Energy consumption**|||
|**used to calculate**|||
|**emissions (kWh)**|**2,853,275**|**2,918,826**|
|Energy consumption|||
|breakdown (kWh):|||
|•Gas|||
|•Electricity|||
|•Transport fuel|||
|Direct GHG emissions:|||
|gas consumption|**254.71**|**270.56**|
|Indirect energy|||
|emissions: purchased|||
|electricity|**228.69**|**229.71**|
|Other indirect emissions:|||
|employee mileage while|||
|undertaking activities for|||
|St Christopher’s|||
|Hospice|**108.16**|**100.93**|
|**Total gross emissions in**|||
|**metric tonnes CO2e**|**591.57**|**601.20**|
|**Intensity ratio metric**|||
|**tonnes CO2e per staf FTE**|<br>**1.60**|**1.73**|



- A gradual move to the installation of LED lighting across both main sites and our 23 shops 

- The introduction of electric vehicles to our car fleet. 

Our hospice building has solar panels on its roof. In addition, St Christopher’s CARE (completed in 2021) was designed and built using the latest methods in energy efficiency. The includes natural cooling in the majority of the building. 

Measures in progress to improve our energy efficiency further in future include: 

- Commissioning an environmental audit to better understand current energy usage 

- Further reducing use of plastic 

29 

St Christopher’s Hospice annual report and accounts 2022-23 



- Completing the installation of LED lighting throughout the rest of our premises 

- Transitioning more of our car fleet to electric vehicles over a period of time. 

## **Principal risks and uncertainties** 

The Trustees, in conjunction with the Executive Team, follow a formal process to manage the risks faced by the hospice. 

This process focuses on six potential areas of risk – strategic, financial, services, premises, workforce and information. Risks under each of these headings are assessed as to the severity of the risk to the organisation and accompanied with strategies to eliminate or mitigate the risk. 

The risk management process is conducted at least annually and comprises the following: 

- **1** Identification and review of key risks facing the organisation, accompanied by consideration of strategies/plans to be employed to mitigate risks by the Executive Team 

- **2** Review of the updated risk register and the mitigation plans by the Finance, Audit & Risk Committee 

- **3** Review and agreement of the risk register and mitigation plans by the Board of Trustees 

- **4** Receipt of reports regarding progress and success of mitigation plans by the Board of Trustees 

This process has confirmed that key risks facing the organisation pertain to: 

- Pressures within the health and social care system impact on our ability to deliver our services 

- Failure to recruit/retain staff in a competitive recruitment market impacts on business continuity 

- Failure to strike an appropriate balance between fair and affordable pay rises impacts on either staff moral or financial sustainability 

- A data breach 

- Cyber-attacks such as corruption via computer viruses and other malware, in an ever-changing cyber security environment 

Actions intended to mitigate these risks include: 

- Ongoing work to develop relationships with local commissioners and key influencers within the health system 

- Listening to and addressing staff feedback and an external review of salaries to confirm competitiveness 

- Implementing our People and Workforce Strategy 

- Ongoing reviews of our trading and fundraising strategies 

- Quality governance processes including our Information Governance Committee 

- Putting remaining measures in place to achieve the IT Security accreditation Cyber Essentials (Plus). 

## **COVID-19** 

The Trustees have considered the ongoing impact of COVID-19 on St Christopher’s Hospice and its subsidiary, St Christopher’s (Trading) Limited. 

COVID-19 has historically brought additional pressures on the wider health system. As a provider of health services, we will continue to support the wider health system and to provide capacity for it, where it is within our charitable remit. 

We deliver our services within COVID-19 health guidelines. This is with the support of our clinical teams and managed through our internal governance processes. This includes procedures to minimise infection risk and to identify infections. 

Should the COVID-19 pandemic re-emerge strongly, the most significant financial risk related to COVID-19 is that the shops operated by St Christopher’s (Trading) Limited have to close for an interim period to comply with public health guidelines. To date, St Christopher’s (Trading) Limited has received COVID-19 relief funding when there have been lockdowns. If further shops closures had to take place over the next year, without receipt of further relief funding, St Christopher’s Hospice has agreed to support St Christopher’s (Trading) Limited, and the Trustees consider that it has sufficient reserves to be able to do this. 

30 St Christopher’s Hospice annual report and accounts 2022-23 



## **Ukraine** 

The Trustees have also considered the ongoing impact of the conflict in Ukraine. There are uncertainties as to how the conflict will pan out and therefore the impact of this on St Christopher’s Hospice and its subsidiary, St Christopher’s (Trading) Limited. 

We consider the most likely impact of the conflict on St Christopher’s to be: 

- The conflict puts increased pressure on the UK economy (and cost inflation) and this increases costs and limits the money that our donors and the NHS can give to St Christopher’s 

- There are pressures on the supply of core goods (such as petrol, food and other consumables) which has an impact on the delivery of our services. 

While this would reduce the net income that we receive, Trustees consider that it has sufficient reserves to mitigate the financial impact of this in the short term. We also have procedures in place to reduce the impact of core goods not being available at short notice. 

> St Christopher’s Hospice annual report and accounts 2022-23 31 



## 

## 

**These financial statements include the results of St Christopher’s Hospice and its trading subsidiary, St Christopher’s (Trading) Limited for the year ended 31 March 2023.** 

The charitable activities of St Christopher’s Hospice are identified under five main headings in the Statement of Financial Activities: 

- **Inpatient care** 

- **Community care/outpatients** 

- **Education, research and policy** 

- **Bereavement services** 

- **Community action** . 

Except for education, research and policy, the services provided to a patient could include one or more of these activities during their care. The cost of individual patient care may span across one or more of the charitable activities identified. 

We have updated the five headings of charitable expenditure in 2022-23 (and restated the amounts allocated to these categories for prior years 202122 and 2020-21). This is so that the categories better reflect current activity undertaken by St Christopher’s Hospice, in particular the newly included categories of bereavement services and community action. 

In addition to these charitable activities, St Christopher’s Hospice has a retail company. The activity of this company is shown on the Statement of Financial Activities as income/costs of trading companies. 

For the year ended 31 March 2023, at an operational level, St Christopher’s Hospice recorded net income, before other recognised gains and losses, of £1,909k (2022: £6,935k net income). 

Overall, St Christopher’s Hospice generated a net increase in funds of £969k (2022: a net increase in funds of £7,182k). This was after recognising other unrealised gains and losses as follows: 

- **1 Unrealised loss from the investment portfolio of £1,292k (2022: unrealised gain of £352k) and a realised gain from the portfolio of £479k (2022: realised gain £198k)** 

Our investment portfolio managed by Cazenove Capital Management decreased in value from £13,720k in March 2022 to £13,059k in March 2023. This reduction is in line with market trends and the general downturn seen in the stock market during 2022-23. We have not drawn down on our investment portfolio during 2022-23, and there are no plans to draw down on it during 2023-24. 

Our bank deposits increased from £5,288k in March 2022 to £6,303k in March 2023. 

Taking our investment portfolio and bank deposits together, our overall investments increased from £19,008k in March 2022 to £19,362k in March 2023. 

## **2 An actuarial loss from the FRS 102 valuation of the St Christopher’s Hospice (1985) Pension Scheme of £127k (2022: loss £303k)** 

The FRS 102 actuarial loss is a result of four factors: 

- An actuarial gain on the scheme liabilities of £3,497k (2022: gain of £454k) arising from a change in the demographic and financial assumptions 

- An actuarial loss on the scheme investments portfolio of £3,801k (2022: gain of £286k) 

- Experience losses arising on the plan liabilities of £704k (2022: losses of £121k) 

- A gain of £881k to reflect the amount of the pension surplus that is not recoverable  (2022: loss of £922k). 

## **Income** 

Total income received in 2022-23 decreased by 7.7% to £27,229k (2022: £29,487k). The biggest variance was due to legacies income – we received £2,301k less legacies income during 2022-23 after an exceptionally high figure the previous year. 

Further details on our income variances are shown below. 

## **Donations and gifts** 

Income from donations and gifts was £4,508k, which was higher than the previous year (2022: £4,037k). We were pleased that, following the COVID-19 restrictions of the previous two years, our community were able to carry out community fundraising and to hold and support public events. As such, because of income 

32 St Christopher’s Hospice annual report and accounts 2022-23 



from initiatives such as our Bluebell Walk and Challenge events (e.g. London Marathon) income from donations and gifts was £471k (12%) higher than the previous year. 

We are overwhelmed by the generosity of our local community who were able to fundraise in innovative ways, and to donate this incredible amount during the year. 

## **Legacies** 

Legacies income of £7,657k was very strong compared to recent years, but was still less than 2021-22 (£9,958k), when we received our highest ever individual legacy, of approximately £3.6m. We have ringfenced a portion of this money to expand our charitable impact and to support our long-term sustainability, particularly for future years when legacy income may not be so substantial. See note 16 to the accounts. 

## **NHS contracts** 

Income from the NHS of £9,013k is significantly less than the prior year (2022: £10,036k), as income in 202122 included £1,653k from NHS England distributed via Hospice UK as part of COVID-19 relief monies when the Omicron variant and other winter pressures were present. 

## **Income and performance of trading subsidiaries** 

The core activity of St Christopher’s (Trading) Limited is the operation of shops with 23 shops as at March 2023 (23 shops as at March 2022), whose purpose is to raise money for the Charity to spend on charitable activities. 

Revenue from St Christopher’s (Trading) Limited increased by 13% to £5,005k (2022: £4,436k), and a net contribution to the Charity of £1,622k (2021: a net contribution of £1,311k). 

We are pleased to see that trade is surpassing the levels seen prior to the pandemic, with good income growth. 

## **Investment income** 

Investment income for the year of £368k was £215k higher than last year (2022: £153k). This is reflective of higher interest rates which brought in more bank interest. 

## **Education, fees and other income** 

Education, fees and other income was £678k, which was lower than last year (2022: £867k) partly due to specific projects ending in 2021-22. 

## **Expenditure** 

Total expenditure in 2022-23 was £25,320k, which was 12.3% higher than the previous year’s figure (£22,552k). This was largely due to a deliberate growth in headcount (+6%) to support our charitable activities and growing patient need, and to fund cost of living increases. 

The costs of raising voluntary income were £1,552k, which was slightly higher than the previous year’s figure (2022: £1,508k). 

## **Staff costs** 

During the year, the total average FTE headcount increased to 369 (2022: 348).  Staff costs account for 76.6% of the organisation’s total costs (2022: 76.9%). Further details of staff costs and staffing levels can be found in note 7 to the accounts. 

## **Reserves policy and going concern** 

St Christopher’s Hospice holds reserves to improve both the financial security and the operational flexibility of the Hospice. The Trustees believe the level of reserves held should be sufficient to cover the risks the Charity is exposed to, including safeguarding against the volatility of key income streams. 

The Trustees have taken a risk-based approach to assess the level of free reserves required by the Charity. They have also reviewed this alongside the level needed to operate effectively. Considering both aspects, the Trustees believe St Christopher’s Hospice should aim to hold free reserves equivalent to 9-12 months of its operating expenditure, currently equal to £19.0m - £25.3m. The Charity considers free reserves to be the total unrestricted Group reserves, less designated funds. The designated funds held by the Charity are listed in the notes to the accounts. They include a fund to manage the variability of year on year legacy income, a fund to 

33 

St Christopher’s Hospice annual report and accounts 2022-23 



ringfence money for anticipated future financial challenges resulting from the impact of COVID-19, a fund to expand our charitable impact and to support our long-term sustainability and funds for capital commitments and the net book value of fixed assets. On this basis, free reserves as of 31 March 2023 were £24,038k (2022: £21,543k), equivalent to 11.4 months of operating expenditure (2022: 11.5 months of operating expenditure). 

The Trustees have reviewed the financial position of the Charity and its subsidiaries, its forecast cash flows, and its liquidity position for the foreseeable future. This includes the impact of risks as described in the principal risks and uncertainties section above. The Trustees believe that the Charity has adequate resources to continue operational existence for the foreseeable future. As a result, they continue to adopt the going concern basis of accounting in preparing the Annual Report and Accounts. 

## **Investment policy** 

The Board of Trustees has approved an investment policy and strategy, which is supervised by the Investment Committee. 

The primary objective of the investment policy is to provide financial security and stability for the operation of St Christopher’s Hospice. The investment policy also recognises that the organisation is exposed to the risk of a sharp fall in its income due to the variability of legacy income and donations and uncertainty of funds from the NHS. To reflect this position, the Investment Committee with Cazenove Capital Management continues to invest in a varied portfolio in accordance with an asset allocation approved by the Investment Committee. 

Investment income has increased to £368k (2022: £153k), of which £208k (2022: £9k) is interest from cash deposits, and £160k (2022: £144k) is dividend and interest income from the Cazenove Capital Management charity portfolio. 

The Investment Policy states that, among other things, Trustees will not invest directly in a company if it carries out activities contrary to the Charity’s purposes and, therefore, against its interests and those of its beneficiaries. 

The Investment Committee encourages responsible investment. They are committed to appointing investment managers involved in applying Environment, Social and Governance (ESG) criteria across the investment process. Our existing investment manager, Cazenove Capital Management, has demonstrated that they use these criteria. 

## **Statement of Board’s responsibilities** 

The Board members (directors for the purposes of Company law) who served during the year, and the period for which they were in office, are detailed on page 62. 

The Board is responsible for preparing the Report of the Board of Trustees and the financial statements in accordance with applicable law and regulations. 

Company law requires the Board to prepare financial statements for each financial year. Under that law, the Board has elected to prepare the financial statements in accordance with United Kingdom Generally Accepted Accounting Practice (United Kingdom Accounting Standards and applicable law). Under company law, the Board must not approve the financial statements unless it is satisfied that they give a true and fair view of the state of affairs of the Charity and of the result of the Group for that period. In preparing these financial statements, the Board is required to: 

- select suitable accounting policies and then apply them consistently 

- make judgments and accounting estimates that are reasonable and prudent 

- follow applicable accounting standards 

- prepare the financial statements on the going concern basis unless it is inappropriate to presume that the group will continue in business. 

The Board is responsible for keeping adequate accounting records which are sufficient to show and explain the Group and Charity’s transactions and disclose with reasonable accuracy at any time the financial position of the group and enable it to ensure that the financial statements comply 

34 St Christopher’s Hospice annual report and accounts 2022-23 



with the Companies Act 2006. It is also responsible for safeguarding the assets of the Group and the Charity and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities. 

## **Statement as to disclosure of information to auditors** 

The Trustees have taken all necessary steps to make themselves aware of any relevant audit information and to establish that the auditors are aware of that information. 

As far as the Trustees are aware, there is no relevant audit information that the charity’s auditors are unaware of. 

## **Appointment of auditors** 

Moore Kingston Smith LLP were appointed as auditor to the Charity and in accordance with secion 485 of the Companies Act 2006, a resolution proposing that they be reappointed will be put at a general meeting. 

## **Signed on behalf of The Board of Trustees** 


## **Neil Goulden** 

Chair of the Board of Trustees St Christopher’s Hospice, 51-59 Lawrie Park Road, London SE26 6DZ 31 August 2023 

> St Christopher’s Hospice annual report and accounts 2022-23 35 



## **Independent auditor’s report to the Members and Trustees of St Christopher’s Hospice** 

## **Opinion** 

We have audited the financial statements of St Christopher’s Hospice (the ‘parent charitable company’) and its subsidiaries (the ’group’) for the year ended 31 March 2023 which comprise the Group Statement of Financial Activities, the Group and Parent Charitable Company Balance Sheets, the Group Cash Flow Statement and notes to the financial statements, including significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102 The Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice). 

In our opinion the financial statements: 

- give a true and fair view of the state of the group’s and the parent charitable company’s affairs as at 31 March 2023 and of the group’s incoming resources and application of resources, including its income and expenditure, for the year then ended; 

- have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice; and 

- have been prepared in accordance with the requirements of the Companies Act 2006. 

## **Basis for opinion** 

We conducted our audit in accordance with 

International Standards on Auditing (UK) (ISAs(UK)) and applicable law. Our responsibilities under those standards are further described in the Auditor’s Responsibilities for the audit of the financial statements section of our report. We are independent of the charitable company in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the FRC’s Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion. 

## **Conclusions relating to going concern** 

In auditing the financial statements, we have concluded that the trustees’ use of the going concern basis of accounting in the preparation of the financial statements is appropriate. 

Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the group’s and parent charitable company’s ability to continue as a going concern for a period of at least twelve months from when the financial statements are authorised for issue. 

Our responsibilities and the responsibilities of the trustees with respect to going concern are described in the relevant sections of this report. 

## **Other information** 

The other information comprises the information included in the annual report, other than the financial statements and our auditor’s report thereon. The trustees are responsible for the other information contained in the annual report. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon. 

Our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the course of the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether there is a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact. 

We have nothing to report in this regard. 

## **Opinions on other matters prescribed by the Companies Act 2006** 

In our opinion, based on the work undertaken in the course of the audit: 

36 St Christopher’s Hospice annual report and accounts 2022-23 



- the information given in the strategic report and the trustees’ annual report for the financial year for which the financial statements are prepared is consistent with the financial statements; and 

- the strategic report and the trustees’ annual report have been prepared in accordance with applicable legal requirements. 

## **Matters on which we are required to report by exception** 

In the light of the knowledge and understanding of the group and parent charitable company and their environment obtained in the course of the audit, we have not identified material misstatements in the strategic report or the trustees’ annual report. 

We have nothing to report in respect of the following matters where the Companies Act 2006 requires us to report to you if, in our opinion: 

- the parent charitable company has not kept adequate and sufficient accounting records, or returns adequate for our audit have not been received from branches not visited by us; or 

- the parent charitable company’s financial statements are not in agreement with the accounting records and returns; or 

- certain disclosures of trustees’ remuneration specified by law are not made; or 

- we have not received all the information and explanations we require for our audit. 

## **Responsibilities of trustees** 

As explained more fully in the trustees’ responsibilities statement set out on page 34, the trustees (who are also the directors of the charitable company for the purposes of company law) are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such internal control as the trustees determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error. 

In preparing the financial statements, the trustees are responsible for assessing the group and parent charitable company’s ability to continue as a going 

concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the trustees either intend to liquidate the group or parent charitable company or to cease operations, or have no realistic alternative but to do so. 

## **Auditor’s responsibilities for the audit of the financial statements** 

Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements. 

As part of an audit in accordance with ISAs (UK) we exercise professional judgement and maintain professional scepticism throughout the audit. We also: 

- Identify and assess the risks of material misstatement of the financial statements, whether due to fraud or error, design and perform audit procedures responsive to those risks, and obtain audit evidence that is sufficient and appropriate to provide a basis for our opinion. The risk of not detecting a material misstatement resulting from fraud is higher than for one resulting from error, as fraud may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal control. 

- Obtain an understanding of internal control relevant to the audit in order to design audit procedures that are appropriate in the circumstances, but not for the purposes of expressing an opinion on the effectiveness of the group and parent charitable company’s internal control. 

- Evaluate the appropriateness of accounting policies used and the reasonableness of accounting estimates and related disclosures made by the trustees. 

- Conclude on the appropriateness of the trustees’ use of the going concern basis of accounting and, based 

37 

St Christopher’s Hospice annual report and accounts 2022-23 



on the audit evidence obtained, whether a material uncertainty exists related to events or conditions that may cast significant doubt on the group and parent charitable company’s ability to continue as a going concern. If we conclude that a material uncertainty exists, we are required to draw attention in our auditor’s report to the related disclosures in the financial statements or, if such disclosures are inadequate, to modify our opinion. Our conclusions are based on the audit evidence obtained up to the date of our auditor’s report. However, future events or conditions may cause the group or parent charitable company to cease to continue as a going concern. 

- Evaluate the overall presentation, structure and content of the financial statements, including the disclosures, and whether the financial statements represent the underlying transactions and events in a manner that achieves fair presentation. 

- Obtain sufficient appropriate audit evidence regarding the financial information of the entities or business activities within the group to express an opinion on the consolidated financial statements. We are responsible for the direction, supervision and performance of the group audit. We remain solely responsible for our audit report. 

We communicate with those charged with governance regarding, among other matters, the planned scope and timing of the audit and significant audit findings, including any significant deficiencies in internal control that we identify during our audit. 

## **Explanation as to what extent the audit was considered capable of detecting irregularities, including fraud** 

Irregularities, including fraud, are instances of noncompliance with laws and regulations. We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud. The extent to which our procedures are capable of detecting irregularities, including fraud is detailed below. 

The objectives of our audit in respect of fraud, are; to identify and assess the risks of material misstatement of the financial statements due to fraud; to obtain sufficient appropriate audit evidence regarding the 

assessed risks of material misstatement due to fraud, through designing and implementing appropriate responses to those assessed risks; and to respond appropriately to instances of fraud or suspected fraud identified during the audit. However, the primary responsibility for the prevention and detection of fraud rests with both management and those charged with governance of the charitable company. 

Our approach was as follows: 

- We obtained an understanding of the legal and regulatory requirements applicable to the charitable company and considered that the most significant are the Companies Act 2006, the Charities Act 2011, the Charity SORP, and UK financial reporting standards as issued by the Financial Reporting Council. 

- We obtained an understanding of how the charitable company complies with these requirements by discussions with management and those charged with governance. 

- We assessed the risk of material misstatement of the financial statements, including the risk of material misstatement due to fraud and how it might occur, by holding discussions with management and those charged with governance. 

- We inquired of management and those charged with governance as to any known instances of noncompliance or suspected non-compliance with laws and regulations. 

- Based on this understanding, we designed specific appropriate audit procedures to identify instances of non-compliance with laws and regulations. This included making enquiries of management and those charged with governance and obtaining additional corroborative evidence as required. 

There are inherent limitations in the audit procedures described above. We are less likely to become aware of instances of non-compliance with laws and regulations that are not closely related to events and transactions reflected in the financial statements. Also, the risk of not detecting a material misstatement due to fraud is higher than the risk of not detecting one resulting from error, as fraud may involve deliberate concealment by, for example, forgery or intentional misrepresentations, or through collusion. 

38 St Christopher’s Hospice annual report and accounts 2022-23 



## **Use of our report** 

This report is made solely to the charitable company’s members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our audit work has been undertaken so that we might state to the charitable company’s members those matters which we are required to state to them in an auditor’s report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to any party other than the charitable company and charitable company’s members as a body, for our audit work, for this report, or for the opinions we have formed. 


## **James Saunders** 

Senior Statutory Auditor for and on behalf of Moore Kingston Smith LLP, Statutory Auditor 9 Appold Street, London EC2A 2AP 4 September 2023 

> St Christopher’s Hospice annual report and accounts 2022-23 39 



## **Financial statements** 

## **Consolidated statement of financial activities for the year ended 31 March 2023** 

|**Unrestricted Restricted**<br>**funds**<br>**funds**<br>**Notes**<br>**£’000**<br>**£’000**<br>**Income from**<br>Donations and gifts<br>3,966<br>542<br>Legacies<br>7,657<br>–<br>Charitable activities<br>_NHS funding for patient care_<br>**2**<br>9,013<br>–<br>_Education, fees and other income_<br>**3**<br>678<br>–<br>Other trading activities<br>_Income of trading companies_<br>**4**<br>5,005<br>–<br>_Investment income_<br>368<br>–<br>**Total income**<br>26,687<br>542<br>**Expenditure on**<br>Raising voluntary income<br>1,552<br>–<br>Trading companies<br>**4**<br>3,383<br>–<br>4,935<br>–<br>Charitable activities<br>_Inpatient care_<br>7,789<br>30<br>_Community care/outpatients_<br>9,809<br>148<br>_Bereavement services_<br>614<br>73<br>_Community action_<br>638<br>70<br>_Education, research and policy_<br>866<br>348<br>19,716<br>669<br>**Total expenditure**<br>**5**<br>24,651<br>669<br>**Net income/(expenditure) before transfers**<br>**6**<br>2,036<br>(127)<br>**Transfer between funds**<br>**(relate to capital programme)**<br>97<br>(97)<br>**Net income/(expenditure) before**<br>**other recognised gains and losses**<br>2,133<br>(224)<br>**Other recognised gains/(losses)**<br>Actuarial (losses) on defned<br>beneft pension scheme<br>**19**<br>(127)<br>–<br>Gains on investments: realised<br>**10**<br>479<br>–<br>(Losses)/gains on investments: unrealised<br>**10**<br>(1,292)<br>–<br>**Net movement in funds**<br>1,193<br>(224)<br>**Total funds at 1 April 2022**<br>**15, 16, 17**<br>41,614<br>2,955<br>**Total funds at 31 March 2023**<br>**15, 16, 17**<br>42,807<br>2,731|**2023**<br>**2022**<br>**total**<br>**restated**<br>**£’000**<br>**£’000**<br>4,508<br>4,037<br>7,657<br>9,958<br>9,013<br>10,036<br>678<br>867<br>5,005<br>4,436<br>368<br>153<br>27,229<br>29,487<br>1,552<br>1,508<br>3,383<br>3,125<br>4,935<br>4,633<br>7,819<br>6,861<br>9,957<br>8,847<br>687<br>701<br>708<br>444<br>1,214<br>1,066<br>20,385<br>17,919<br>25,320<br>22,552<br>1,909<br>6,935<br>–<br>–<br>1,909<br>6,935<br>(127)<br>(303)<br>479<br>198<br>(1,292)<br>352<br>969<br>7,182<br>44,569<br>37,387<br>45,538<br>44,569|
|---|---|



All recognised gains and losses are included in the consolidated statement of financial activities. St Christopher’s Hospice and St Christopher’s (Trading) Limited transactions are derived from continuing activities. An analysis of the results by company is shown in Note 4. 

The Statement of Financial Activities (SOFA) for 2022 has been restated to show a revised allocation between expenditure categories to better reflect current activity. Total expenditure for 2022 remains the same at £22,552k. 

The allocation between unrestricted and restricted funds for 2021-22 is shown in Note 18. 

40 St Christopher’s Hospice annual report and accounts 2022-23 



## **Consolidated balance sheet as at 31 March 2023** 

|**Notes**<br>**Fixed assets**<br>Tangible fxed assets<br>**9**<br>Intangible assets<br>**9**<br>Investments<br>**10**<br>**Current assets**<br>Debtors<br>**11**<br>Interest-bearing bank accounts<br>**Creditors**<br>Amounts falling due within one year<br>**12**<br>**Net current assets**<br>**Net assets**<br>**Funds**<br>Restricted<br>**15**<br>Unrestricted<br> _General_<br> _Designated_<br>**16**<br> _Non-charitable_<br>Total unrestricted funds<br>**Total funds**|**2023**<br>**£’000**<br>10,104<br>120<br>19,362<br>29,586<br>7,127<br>11,457<br>18,584<br>(2,632)<br>15,952<br>45,538<br>2,731<br>24,030<br>18,769<br>8<br>42,807<br>45,538|**2022**<br>**£’000**<br>10,322<br>179<br>19,008|
|---|---|---|
|||29,509|
|||8,555<br>8,614|
|||17,169|
|||(2,109)|
|||15,060|
|||44,569|
|||2,955<br>21,535<br>20,071<br>8|
|||41,614|
|||44,659|



The financial statements were approved by The Board of Trustees on 31 August 2023 and signed on its behalf by: 


**Neil Goulden** Chair of Trustees 


**Catherine McDonald** Trustee 

> St Christopher’s Hospice annual report and accounts 2022-23 41 



## **Balance sheet: St Christopher’s Hospice entity only as at 31 March 2023** 

|**Notes**<br>**Fixed assets**<br>Tangible fxed assets<br>**9**<br>Intangible assets<br>**9**<br>Investments<br>**10**<br>**Current assets**<br>Debtors<br>**11**<br>Interest-bearing bank accounts<br>**Creditors**<br>Amounts falling due within one year<br>**12**<br>**Net current assets**<br>**Net assets excluding pension scheme asset**<br>Defned beneft pension scheme asset<br>**19**<br>**Net assets including pension scheme asset**<br>**Funds**<br>Restricted<br>**15**<br>Unrestricted<br>_General_<br>_Designated_<br>**16**<br>**Total unrestricted funds**<br>**Total funds**|**2023**<br>**£’000**<br>9,864<br>120<br>19,762<br>29,746<br>10,595<br>7,630<br>18,225<br>(2,441)<br>15,784<br>45,530<br>–<br>45,530<br>2,731<br>24,030<br>18,769<br>42,799<br>45,530|**2022**<br>**£’000**<br>10,070<br>179<br>19,408|
|---|---|---|
|||29,657|
|||9,852<br>6,945|
|||16,797<br>(1,894)|
|||14,903|
|||44,560<br>–|
|||44,560|
|||2,955<br>21,534<br>20,071|
|||41,605|
|||44,560|



The financial statements were approved by The Board of Trustees on 31 August 2023 and signed on its behalf by: 


**Neil Goulden** Chair of Trustees 


**Catherine McDonald** Trustee 

42 St Christopher’s Hospice annual report and accounts 2022-23 



## **Consolidated statement of cash flows for the year ended 31 March 2023** 

|**Consolidated statement of cash fows**<br>**for the year ended 31 March 2023**|||
|---|---|---|
|**Notes**<br>Net cash generated by operating activities<br>**A**<br>**Cash fows from investing activities**<br>Interest and dividends received<br>Purchase of tangible and intangible fxed assets<br>Increase in investments<br>Net cash used in investing activities<br>Change in cash and cash equivalents in the year<br>Cash at the beginning of the year<br>Cash at the end of the year<br>**Reconciliation of net movement in funds**<br>**to net cash infow from operating activities**<br>**Notes**<br>**A**<br>Net income<br>Interest and dividends receivable<br>Depreciation and amortisation charges<br>Unrealised loss/(gain) on investments<br>Loss on the disposal of fxed assets<br>Cash received from the sale of assets<br>Decrease/(increase) in debtors<br>Increase in creditors<br>Decrease in dilapidations provision<br>Net cash generated by operating activities|**2023**<br>**£’000**<br>4,570<br>368<br>(449)<br>(1,646)<br>(1,727)<br>2,843<br>8,614<br>11,457<br>**2023**<br>**£’000**<br>969<br>(368)<br>675<br>1,292<br>(2)<br>3<br>1,428<br>523<br>50<br>4,570|**2022**<br>**£’000**<br>6,915<br>153<br>(889)<br>(4,475)|
|||(5,211)|
|||1,704<br>6,910|
|||8,614|
|||**2022**<br>**£’000**<br>7,182<br>(153)<br>746<br>(352)<br>11<br>–<br>(1,159)<br>640<br>–|
|||6,915|



43 

St Christopher’s Hospice annual report and accounts 2022-23 



## **Notes to the financial statements for the year ended 31 March 2023** 

## **1 Principal accounting policies** 

## **1.1 Basis of accounting** 

The financial statements are prepared under the historical cost basis and comply with the Companies Act 2006. The financial statements have been prepared in accordance with the Statement of Recommended Practice ( _Accounting and Reporting by Charities_ ), issued in October 2019 (FRS 102), other relevant provisions of the memorandum and articles of association, and with applicable UK accounting standards. 

The figures for both years reflect the full adoption of FRS (Financial Reporting Standard) 102. 

The Charity meets the definition of a public benefit entity under FRS 102. 

## **1.2 Going concern** 

These financial statements have been prepared on a going concern basis. 

The Trustees therefore consider that the Charity holds sufficient reserves for the going concern basis to be appropriate. 

## **1.3 Basis of consolidation** 

The statement of financial activities and balance sheet consolidate the financial statements of the charity and its wholly owned subsidiary St Christopher’s (Trading) Limited. 

No separate Statement of Financial Activities is presented for the charity as permitted by Section 408 of the Companies Act 2006 and SORP (FRS102). The net deficit dealt with in the Charity’s Statement of Financial Activities before the distribution from St Christopher’s (Trading) Limited for the year ended 31 March 2023 was £653k (2022: Income £5,871k), and the net income dealt with in the Charity’s Statement of Financial Activities after the distribution was £969k (2022: £7,096k). 

## **1.4 Fund accounting** 

## _Restricted income funds_ 

Restricted funds are funds subject to specific restricted conditions requested by the donors. Where the restriction relates to the purchase of a capital item then the condition will be treated as having been met when the asset is purchased. 

## _Unrestricted income funds_ 

Unrestricted funds comprise accumulated surpluses and deficits on general funds. They are available for use at the discretion of the Board in furtherance of the general charitable objects. 

Designated funds are amounts included within unrestricted funds that have been set aside by the Board for particular purposes. Designated funds include: 

- **Fixed assets** This reflects the net book value of unrestricted tangible and intangible fixed assets 

- **Pension liability** These are designated funds held against the defined benefit pension scheme deficit. The amount shown relates to the deficit from the most recent triennial valuation, less pension contributions made following this valuation, less the liability disclosed under FRS 102 

- **Ward refurbishment** These are designated monies to fund a modest wards refurbishment at the Sydenham site 

- **Strategic Ambitions Fund** This is a designated fund to focus on projects which will expand St Christopher’s charitable impact and to support its long-term sustainability 

- **Future Challenge Fund** This is a designated fund to allow for future years of financial challenge expected as a result of COVID-19 

- **Legacies Fund** To set aside legacies income, when it has been higher than budgeted in a particular year. This money will be drawn down to support future years, when legacies income is lower than budgeted. 

Details on the level of funds in each element are provided in notes 15 and 16. 

## **1.5 Income** 

Income represents the total income receivable during the year comprising donations, legacies, NHS contracts, grants, fees, interest and other income generated during the year. 

Legacies must be recognised when the following conditions are confirmed: 

44 St Christopher’s Hospice annual report and accounts 2022-23 



- There has been grant of probate 

- The executors have established that there are sufficient funds to pay the legacy 

- Any conditions attached to the legacy are either within the control of the Charity or have been met. 

NHS contracts and fees are recognised when it can reasonably be assumed that the Charity is entitled to the income and the amount can be estimated with sufficient reliability. 

Income from trading companies arises from sales of goods in charity shops. 

## **1.6 Expenditure** 

The costs of inpatient care; community care/outpatients; bereavement services; community action; education, research and policy; and raising voluntary income comprise expenditure both directly and indirectly attributable to the activity concerned. Indirectly attributable costs such as physiotherapy and social work have been allocated to activities using an appropriate cost allocation basis. 

Support costs have been allocated to activities on the basis of staff time spent. Governance costs, which are charitable, relate to the stewardship of the Charity’s assets, organisational administration and compliance with constitutional and statutory requirements. 

## **1.7 Taxation** 

St Christopher’s Hospice is a registered charity. Income and chargeable gains, which are applied for charitable purposes, are exempt from liability to direct taxation. Income tax recoverable in respect of donations under Gift Aid, investment income and legacies is included with the income to which it relates. 

## **1.8 Capitalisation and depreciation** 

Tangible fixed assets are capitalised with a £1k de minimis limit where relevant. 

If items are individually less than £1k, but are part of a project greater than £10k (e.g. as part of an agreed budget) then these are also capitalised as part of this project. 

Equipment is not capitalised if it is less than £1k per individual item, and purchased on a rolling basis. 

Assets under construction are not depreciated. Depreciation and amortisation are calculated to write off the cost of tangible fixed assets on a straight-line basis over the expected useful lives of the assets concerned at the following rates: 

|Leasehold buildings:|over the term of the lease|
|---|---|
|Freehold buildings:|2% straight-line basis|
|Freehold refurbishments and fxtures and fttings:  10% straight-line basis||
|Equipment and motor vehicles:|10% to 331⁄3% straight-line basis|
|Motor vehicles:|331⁄3% straight-line basis|
|Intangible assets:|20% straight-line basis|
|Shops dilapidations:|straight line over the length of the shop lease|



## **1.9 Pension schemes** 

St Christopher’s Hospice contributes to the St Christopher’s Hospice (1985) Pension Scheme, a defined benefit scheme. The pension scheme is administered by Trustees and is separate from the hospice. See note 19 for further details. 

St Christopher’s Hospice also contributes to a defined contribution scheme. Contributions in respect of the year are charged to the Statement of Financial Activities in the year to which they relate. 

St Christopher’s Hospice has an arrangement with the NHS that permits members of the NHS final salary pension scheme to maintain their membership when they are subsequently employed by the hospice. The NHS currently provides a subsidy on the contributions payable by the hospice. This subsidy, along with the contribution from St Christopher’s Hospice, are recognised in the Statement of Financial Activities in the year to which they relate. 

## **1.10 Operating leases** 

Rentals payable under operating leases are charged on a straight-line basis over the term of the lease. 

## **1.11 Estimation uncertainty and key judgements** 

Key judgements and areas of uncertainty are considered to be any defined pension liability and accrued legacy income. 

> St Christopher’s Hospice annual report and accounts 2022-23 45 



Please refer to note 19 for a detailed review of the relevant assumptions in relation to the defined benefit pension scheme. 

Accrued legacy income is calculated on the basis of the valuation of the net estate of each testator, based on management’s best estimate. The source of estimation uncertainty is that the valuation of the estates at a point in time is inherently uncertain and can change significantly over a short period of time. 

The carrying amount of legacies accrued (note 11) as at 31 March 2023 was £5,572k (2022: £6,276k). 

## **2 National Health Service** 

|**2023**<br>**£’000**<br>NHS contracts<br>9,013<br>NHSE funding (restricted see note 15)<br>–<br>9,013<br>**3 Education, fees and other income**<br>**2023**<br>**£’000**<br>Education<br>332<br>Fees and other income<br>346<br>678<br>**4 Group undertakings**<br>Summary of results of group undertakings:<br>**2023**<br>**St Christopher’s St Christopher’s**<br>**Hospice**<br>**(Trading) Ltd**<br>**£’000**<br>**£’000**<br>Income<br>22,224<br>5,005<br>Expenditure<br>(21,937)<br>(3,383)<br>Surplus/proft for the year<br>287<br>1,622<br>Other recognised losses<br>(940)<br>–<br>Distributions<br>1,622<br>(1,622)<br>Net income for the year<br>969<br>–|**2022**<br>**£’000**<br>8,383<br>1,653<br>10,036<br>**2022**<br>**£’000**<br>173<br>694<br>867<br>**Group**<br>**total**<br>**£’000**<br>27,229<br>(25,320)|**2022**<br>**£’000**<br>8,383<br>1,653|
|---|---|---|
|||10,036|
|||**2022**<br>**£’000**<br>173<br>694|
|||867|
||1,909<br>(940)<br>–||
||969||



The net assets of St Christopher’s (Trading) Limited were £408k at 31 March 2023. 

|**2022**<br>**St Christopher’s St Christopher’s**<br>**Hospice**<br>**(Trading) Ltd**<br>**£’000**<br>**£’000**<br>**£’000**<br>**£’000**<br>Income<br>25,051<br>4,436<br>Expenditure<br>(19,427)<br>(3,125)<br>Surplus/proft for the year<br>5,624<br>1,311<br>Other recognised gains<br>247<br>–<br>Distributions<br>1,225<br>(1,225)<br>Net income  for the year<br>7,096<br>86|**Group**<br>**total**<br>**£’000**<br>**£’000**<br>29,487<br>(22,552)|
|---|---|
||6,935<br>247<br>–|
||7,182|



The net assets of St Christopher’s (Trading) Limited were £408k  at 31 March 2022. 

St Christopher’s Hospice has one wholly owned subsidiary: 

**Company Activity Company number** St Christopher’s (Trading) Limited Operation of charity shops for the hospice 02604519 

46 St Christopher’s Hospice annual report and accounts 2022-23 



## **Related party transactions** 

During the year the company entered into transactions with related parties. Transactions entered into and balances outstanding are as follows: 

|**Re-charged to related parties**<br>Management charge<br>Salaries<br>Leasehold depreciation<br>Other costs<br>Total<br>Balance owed at 31 March<br>**5 Expenditure**<br>**Costs of raising funds**<br>Fundraising and publicity<br>Trading activities<br>**Charitable activities**<br>Inpatient care<br>Community care/outpatients<br>Bereavement services<br>Community action<br>Education, research and policy<br>Total cost of charitable activities<br>Total expenditure|**2023**<br>**2022**<br>**St Christopher’s St Christopher’s**<br>**(Trading) Ltd**<br>**(Trading) Ltd**<br>**£’000**<br>**£’000**<br>131<br>72<br>1,899<br>1,663<br>36<br>35<br>77<br>43<br>2,143<br>1,813<br>3,738<br>1,566<br>**Direct**<br>**Support**<br>**Total**<br>**Total**<br>**costs**<br>**costs**<br>**2023**<br>**2022**<br>**£’000**<br>**£’000**<br>**£’000**<br>**£’000**<br>1,379<br>173<br>1,552<br>1,508<br>3,383<br>–<br>3,383<br>3,125<br>4,762<br>173<br>4,935<br>4,633<br>6,189<br>1,630<br>7,819<br>6,861<br>7,968<br>1,989<br>9,957<br>8,847<br>545<br>142<br>687<br>701<br>538<br>170<br>708<br>444<br>1,078<br>136<br>1,214<br>1,066<br>16,318<br>4,067<br>20,385<br>17,919<br>21,080<br>4,240<br>25,320<br>22,552|**2023**<br>**2022**<br>**St Christopher’s St Christopher’s**<br>**(Trading) Ltd**<br>**(Trading) Ltd**<br>**£’000**<br>**£’000**<br>131<br>72<br>1,899<br>1,663<br>36<br>35<br>77<br>43<br>2,143<br>1,813<br>3,738<br>1,566<br>**Direct**<br>**Support**<br>**Total**<br>**Total**<br>**costs**<br>**costs**<br>**2023**<br>**2022**<br>**£’000**<br>**£’000**<br>**£’000**<br>**£’000**<br>1,379<br>173<br>1,552<br>1,508<br>3,383<br>–<br>3,383<br>3,125<br>4,762<br>173<br>4,935<br>4,633<br>6,189<br>1,630<br>7,819<br>6,861<br>7,968<br>1,989<br>9,957<br>8,847<br>545<br>142<br>687<br>701<br>538<br>170<br>708<br>444<br>1,078<br>136<br>1,214<br>1,066<br>16,318<br>4,067<br>20,385<br>17,919<br>21,080<br>4,240<br>25,320<br>22,552|**2023**<br>**2022**<br>**St Christopher’s St Christopher’s**<br>**(Trading) Ltd**<br>**(Trading) Ltd**<br>**£’000**<br>**£’000**<br>131<br>72<br>1,899<br>1,663<br>36<br>35<br>77<br>43<br>2,143<br>1,813<br>3,738<br>1,566<br>**Direct**<br>**Support**<br>**Total**<br>**Total**<br>**costs**<br>**costs**<br>**2023**<br>**2022**<br>**£’000**<br>**£’000**<br>**£’000**<br>**£’000**<br>1,379<br>173<br>1,552<br>1,508<br>3,383<br>–<br>3,383<br>3,125<br>4,762<br>173<br>4,935<br>4,633<br>6,189<br>1,630<br>7,819<br>6,861<br>7,968<br>1,989<br>9,957<br>8,847<br>545<br>142<br>687<br>701<br>538<br>170<br>708<br>444<br>1,078<br>136<br>1,214<br>1,066<br>16,318<br>4,067<br>20,385<br>17,919<br>21,080<br>4,240<br>25,320<br>22,552|
|---|---|---|---|
||||1,813|
||||1,566|
||||**Total**<br>**2022**<br>**£’000**<br>1,508<br>3,125|
||||4,633|
||||6,861<br>8,847<br>701<br>444<br>1,066|
||||17,919|
||||22,552|



Expenditure for 2022 has been restated to show a revised allocation between expenditure categories to better reflect current activity. Total expenditure for 2022 remains the same at £22,552k. 

Included in the costs above are governance costs of £101k (2022: £77k). 

## **Analysis of support costs** 

|Chief Executive ofce and governance<br>Facilities<br>IT<br>Finance<br>Workforce|**2023**<br>**£’000**<br>376<br>860<br>1,161<br>434<br>1,409<br>4,240|**2022**<br>**£’000**<br>335<br>745<br>993<br>388<br>1,108|
|---|---|---|
|||3,569|



Support costs have been allocated to activities on the basis of staff time spent. 

> St Christopher’s Hospice annual report and accounts 2022-23 47 



**6 Net income** 

|**6 Net income**|||
|---|---|---|
|**Net income is stated after charging/(crediting)**<br>Auditors’ remuneration: audit fee<br>Auditors’ remuneration: tax and tagging compliance services<br>Auditors’ remuneration: prior year<br>Auditors’ remuneration: pension<br>Operating lease rentals: land and buildings<br>Operating lease rentals: vehicles and equipment<br>Depreciation and amortisation<br>Interest receivable<br>**7 Staf costs**<br>Salaries and wages<br>Social security costs<br>Pension costs (see note 19 below)<br>Staf costs of the Charity<br>Staf costs of trading activities (includes pension costs of £77k in 2023 (2022: £67k)<br>Payments were made under a voluntary severance scheme of £35k (2022: £36k).<br>The average number of employees during the year (excluding bank) was:<br>**Head count Head count**<br>**restated**<br>**2023**<br>**2022**<br>Inpatient care<br>87<br>88<br>Community care/outpatients<br>117<br>109<br>Bereavement services<br>12<br>12<br>Community action<br>11<br>7<br>Education, research and policy<br>11<br>19<br>Fundraising<br>15<br>14<br>Other hospice (includes support staf)<br>147<br>120<br>Charity shops<br>86<br>75<br>486<br>444|**2023**<br>**2022**<br>**£’000**<br>**£’000**<br>34<br>36<br>6<br>5<br>1<br>–<br>6<br>6<br>784<br>802<br>69<br>–<br>675<br>746<br>(368)<br>(153)<br>**2023**<br>**2022**<br>**£’000**<br>**£’000**<br>14,866<br>13,297<br>1,352<br>1,125<br>1,156<br>1,195<br>17,374<br>15,617<br>2,030<br>1,735<br>19,404<br>17,352<br>**FTEs**<br>**FTEs**<br>**restated**<br>**2023**<br>**2022**<br>78<br>73<br>93<br>83<br>8<br>8<br>10<br>7<br>8<br>10<br>10<br>11<br>108<br>104<br>54<br>52<br>369<br>348|**2022**<br>**£’000**<br>36<br>5<br>–<br>6<br>802<br>–<br>746<br>(153)|
|||**2022**<br>**£’000**<br>13,297<br>1,125<br>1,195|
|||15,617<br>1,735|
|||17,352|
|||348|



The headcount and FTE figures for 2022 have been restated to show a revised allocation between categories to better reflect current activity. The number of employees whose earnings fell within the band: 

||**2023**|**2022**|
|---|---|---|
|£60,000 to £69,999|4|6|
|£70,000 to £79,999|6|6|
|£80,000 to £89,999|4|2|
|£90,000 to £99,999|1|2|
|£100,000 to £109,999|1|1|
|£120,000 to £129,999|1|1|
|£150,000 to £159,999|1|–|



Pension contributions of £158k (2022: £142k) were paid in respect of these employees. 

The Board of Trustees consider the key management personal to be the Executive Team of 5.40 FTEs (2022: 5.85 FTEs) and the total benefit paid to the key management personnel was £594k (2022: £572k). 

48 St Christopher’s Hospice annual report and accounts 2022-23 



## **8 Board of Trustees** 

## **Remuneration and reimbursed expenses** 

No remuneration was paid to members of the Board during either year. No expenses were reimbursed to Trustees (2022: £nil). £11k was incurred in respect of recruiting Trustees (2022: £nil). 

St Christopher’s Hospice paid £3,300 (2022: £3,969) for indemnity insurance for the Trustees of the St Christopher’s Hospice (1985) Pension Scheme. 

St Christopher’s Hospice also paid £3,416 (2022: £3,360) for Trustee Liability Insurance for its Trustees. 

## **Donations from Trustees** 

The Trustees have donated a total of £10k (2022: £17k) during the year. Of this, £9k was restricted to St Christopher’s CARE. 

## **9.1 Tangible fixed assets** 

|**Freehold**<br>**Freehold Equipment  Leasehold**<br>**Assets**<br>**land and**<br>**refurb- and motor**<br>**land and under con-**<br>**buildings**<br>**ishment**<br>**vehicles**<br>**buildings**<br>**truction**<br>**£’000**<br>**£’000**<br>**£’000**<br>**£’000**<br>**£’000**<br>**Group**<br>**Cost**<br>At 1 April 2022<br>12,890<br>3,896<br>434<br>1,177<br>–<br>Additions<br>30<br>–<br>7<br>343<br>12<br>Disposals<br>–<br>(50)<br>–<br>(11)<br>–<br>**At 31 March 2023**<br>12,920<br>3,846<br>441<br>1,509<br>12<br>**Depreciation**<br>At 1 April 2022<br>3,448<br>3,745<br>332<br>550<br>–<br>Amount provided<br>266<br>9<br>34<br>251<br>–<br>Disposal<br>–<br>–<br>–<br>(11)<br>–<br>At 31 March 2023<br>3,714<br>3,754<br>366<br>790<br>–<br>**Net book values**<br>At 31 March 2023<br>9,206<br>92<br>75<br>719<br>12<br>At 31 March 2022<br>9,442<br>151<br>102<br>627<br>–<br>**Charity**<br>**Cost**<br>At 1 April 2022<br>12,573<br>3,786<br>434<br>1,137<br>–<br>Additions<br>27<br>–<br>7<br>324<br>12<br>At 31 March 2023<br>12,600<br>3,786<br>441<br>1,461<br>12<br>**Depreciation**<br>At 1 April 2022<br>3,332<br>3,676<br>330<br>522<br>–<br>Amount provided<br>257<br>41<br>36<br>242<br>–<br>At 31 March 2023<br>3,589<br>3,717<br>366<br>764<br>–<br>**Net book values**<br>At 31 March 2023<br>9,011<br>69<br>75<br>697<br>12<br>At 31 March 2022<br>9,241<br>110<br>104<br>615<br>–|**Total**<br>**£’000**<br>18,397<br>392<br>(61)|
|---|---|
||18,728|
||8,075<br>560<br>(11)|
||8,624|
||10,104|
||10,322|
||17,930<br>370|
||18,300|
||7,860<br>576|
||8,436|
||9,864|
||10,070|



Caritas House, the freehold property in Orpington, was revalued by Jones Lang Lasalle in April 2014. Under the transitional arrangements of FRS 102, the valuation at the date of transition is considered to be the deemed cost of this property. 

> St Christopher’s Hospice annual report and accounts 2022-23 49 



## **9.2 Intangible fixed assets** 

|**9.2 Intangible fxed assets**||
|---|---|
||**Software**|
||**£’000**|
|**Group and Charity cost**||
|At 1 April 2022|657|
|Additions|57|
|Disposals|(58)|
|At 31 March 2023|656|
|**Amortisation**||
|At 1 April 2022|478|
|Amount provided|115|
|Disposals|(57)|
|At 31 March 2023|536|
|**Net book values**||
|At 31 March 2023|120|
|At 1 April 2022|179|
|The net book value at 31 March 2023 represents fxed assets used for:||



|**Freehold**<br>**Leasehold**<br>**Equipment**<br>**land and**<br>**land and and motor**<br>**buildings**<br>**buildings**<br>**vehicles**<br>**Software**<br>**£’000**<br>**£’000**<br>**£’000**<br>**£’000**<br>**Charitable purposes**<br>Inpatient care<br>5,277<br>–<br>419<br>78<br>Community care/outpatients<br>1,984<br>–<br>175<br>22<br>Education, research and policy<br>1,773<br>–<br>41<br>8<br>9,034<br>–<br>635<br>108<br>Charity shops<br>276<br>75<br>84<br>12<br>9,310<br>75<br>719<br>120|**Total**<br>**£’000**<br>5,774<br>2,181<br>1,822|
|---|---|
||9,777<br>447|
||10,224|



50 St Christopher’s Hospice annual report and accounts 2022-23 



## **10 Investments** 

|**10 Investments**|||||
|---|---|---|---|---|
||**Group**|**Group**|**Charity**|**Charity**|
||**2023**|**2022**|**2023**|**2022**|
||**£’000**|**£’000**|**£’000**|**£’000**|
|At 1 April 2022|19,008|14,181|19,408|14,581|
|Additions|2,657|4,168|2,657|4,168|
|Disposals|(3,185)|(1,969)|(3,185)|(1,969)|
|Increase in market value: realised|479|198|479|198|
|(Decrease)/increase in market value: unrealised|(1,292)|352|(1,292)|352|
||17,667|16,930|18,067|17,330|
|Movement in cash balance|1,695|2,078|1,695|2,078|
|At 31 March 2023|19,362|19,008|19,762|19,408|
|Analysed as follows:|||||
|**Funds managed by Cazenove Capital Management**|||||
|UK equities|1,419|1,848|1,419|1,848|
|International equities|6,821|7,453|6,821|7,453|
|Bonds|1,403|954|1,403|954|
|Property|807|1,053|807|1,053|
|Multi asset|–|512|–|512|
|Alternatives: other and commodities|1,842|1,813|1,842|1,813|
|Cash|767|87|767|87|
||13,059|13,720|13,059|13,720|
|**Other investments**|||||
|Bank deposits|6,303|5,288|6,303|5,288|
|Investment in subsidiary undertakings (below)|–|–|400|400|
||6,303|5,288|6,703|5,688|
|Total investments|19,362|19,008|19,762|19,408|
|The historical cost of the investments managed by Cazenove|Capital Management is £11,340k||(2022: £11,391k)||
|The Charity owns all of the 400,000 £1 ordinary shares in St Christopher’s (Trading) Limited.|||||
|**11 Debtors**|||||
||**Group**|**Group**|**Charity**|**Charity**|
||**2023**|**2022**|**2023**|**2022**|
||**£’000**|**£’000**|**£’000**|**£’000**|
|Trade debtors|341|74|341|64|
|Legacies receivable|5,572|6,276|5,572|6,276|
|Sundry debtors, prepayments and accrued income|1,214|2,205|944|1,946|
|Amount due from St Christopher’s (Trading) Limited|–|–|3,738|1,566|
||7,127|8,555|10,595|9,852|
|**12 Creditors: amounts falling due within one year**|||||
||**Group**|**Group**|**Charity**|**Charity**|
||**2023**|**2022**|**2023**|**2022**|
||**£’000**|**£’000**|**£’000**|**£’000**|
|Trade creditors|344|358|322|345|
|Payroll taxes and social security|558|478|558|477|
|Other creditors and accruals|904|609|735|408|
|Income received in advance|826|664|826|664|
||2,632|2,109|2,441|1,894|



> St Christopher’s Hospice annual report and accounts 2022-23 51 



## **13 Lease commitments** 

The Group leases a number of properties and motor vehicles under operating leases. 

||||**Motor**|**Motor**|
|---|---|---|---|---|
||||**vehicles**|**vehicles**|
||**Land and**|**Land and**|**and ofce**|**and ofce**|
||**buildings**|**buildings**|**equipment**|**equipment**|
||**2023**|**2022**|**2023**|**2022**|
||**£’000**|**£’000**|**£’000**|**£’000**|
|**Operating leases payments to be made**|||||
|Within one year|681|688|27|59|
|In two to fve years<br>Over fve years|1,010<br>47|1,268<br>2|–<br>–|16<br>–|
||1,738|1,958|27|75|



Land and buildings lease commitments are based on whichever is earlier out of the lease end date and the lease break-point date. 

## **14 Financial commitments** 

As at 31 March 2023, the following approved commitments were authorised by the Board of Trustees: 

• Up to £750k in respect of ward refurbishments. This will be funded through restricted and designated funds. 

## **15 Restricted funds** 

|**15 Restricted funds**||||||
|---|---|---|---|---|---|
||**Balance**|**Income**|**Expenditure**|**Transfers**|**Balance**|
||**1 April**||||**31 March**|
||**2022**||||**2023**|
||**£’000**|**£’000**|<br>**£’000**|**£’000**|**£’000**|
|3 IS Project|–|49|<br>–|–|49|
|Candle|–|73|<br>73|–|–|
|Carers|63|–|<br>26|–|37|
|Caritas House Building Fund|1,094|–|<br>32|–|1,062|
|Choose Home|41|–|<br>41|–|–|
|Connected in Loss|43|43|<br>33|–|53|
|Community Action|37|54|<br>35|–|56|
|Community of Nursing|27|–|<br>8|–|19|
|Dementia Caring Pathways|(6)|23|<br>17|–|–|
|Dementia–focused training and education|54|–|<br>9|–|45|
|Developing the practice of palliative nursing|–|26|<br>–|–|26|
|Education (bursaries)|47|15|<br>41|–|21|
|Inpatient equipment|–|21|<br>8|–|13|
|Lavender Room|30|–|<br>–|–|30|
|Nightingale Fellowship|94|–|<br>30|–|64|
|Oral History|(13)|71|<br>56|–|2|
|Palliative Works|27|–|<br>27|–|–|
|Patient equipment/premises extension|161|–|<br>–|–|161|
|Research: Stern Legacy|260|–|<br>31|–|229|
|Support for St Christopher’s CARE|884|–|<br>169|(88)|627|
|Ward refurbishment project|2|75|<br>–|–|77|
|Women in Fellowship Fund|37|29|<br>35|–|31|
|Other funds|73|63|<br>(2)|(9)|129|
|Total restricted funds|2,955|542|<br>669|(97)|2,731|



**Caritas House Building Fund** : this fund was originally established to cover the cost of building Harris HospisCare premises and offices. It now reflects the net book value of Caritas House. 

**Connected in Loss (formerly Coach4Care)** : supporting carers through end of life and bereavement experiences. 

52 St Christopher’s Hospice annual report and accounts 2022-23 



**Community Action** : supporting older, frail and socially isolated people within the local community. 

**Community of Nursing** : shared learning and support for newly qualified nurses. 

**Nightingale Fellowship** : hardship bursaries to nurses to assist with living costs. 

**Patient equipment/premises extension** : an amount left in a Will with a specific request for expenditure to be spent on either patient equipment or a premises extension. 

**Research: Stern legacy** : St Christopher’s Hospice was the beneficiary of a restricted legacy for use in research into myeloma and end of life palliative care. Accordingly, the funds have been used to establish a research project into myeloma at the Cicely Saunders International research institution and are being used to fund other research projects in end of life care. 

**Support for St Christopher’s CARE** : this fund is restricted to supporting expenditure for St Christopher’s CARE in its first years of operating. 

**Wards refurbishment project** : Relates to grant funding in respect of our upcoming inpatient unit wards refurbishment. 

## **16 Designated funds** 

|||**Balance at**|**New desig-**|**Balance at**|
|---|---|---|---|---|
|||**1 April**|**nations and**|**31 March**|
|||**2022**|**transfers**|**2023**|
|||**£’000**|**£’000**|**£’000**|
|Fixed assets||9,407|(245)|9,162|
|Strategic Ambitions Fund||6,292|(771)|5,521|
|Wards refurbishment||750|–|750|
|Future Challenge Fund||622|(286)|336|
|Legacies Fund|ww|3,000|–|3,000|
|||20,071|(1,302)|18,769|



**Fixed assets** : this reflects the net book value of unrestricted tangible and intangible fixed assets. 

**Wards refurbishment** : these are designated monies to fund a wards refurbishment at the Sydenham site. 

**Future Challenge Fund** : this is a designated fund to allow for future years of financial challenge expected as a result of COVID-19. 

**Legacies Fund** : to set aside legacies income when it has been higher than budgeted in a particular year. This money will then be released to general funds in future years if legacies income is lower than budgeted. 

**Strategic Ambitions Fund** : this is a designated fund to focus on projects which will expand St Christopher’s charitable impact and to support its long-term sustainability. 

## **17 Analysis of group net assets between funds** 

|Restricted income<br>Unrestricted income<br>_Designated_<br>_General_|**Fixed**<br>**Current**<br>**assets**<br>**assets**<br>**Creditors**<br>**£’000**<br>**£’000**<br>**£’000**<br>1,062<br>1,669<br>–<br>9,162<br>9,607<br>–<br>19,362<br>7,308<br>(2,632)<br>29,586<br>18,584<br>(2,632)|**Total**<br>**£’000**<br>2,731<br>18,769<br>24,038|
|---|---|---|
|||45,538|



> St Christopher’s Hospice annual report and accounts 2022-23 53 



## **18 Consolidated statement of financial activities for the year ended 31 March 2022** 

|**Unrestricted**<br>**Restricted**<br>**funds**<br>**funds**<br>**Total**<br>**Total**<br>**£’000**<br>**£’000**<br>**Income from**<br>Donations and gifts<br>3,484<br>553<br>Legacies<br>9,793<br>165<br>Charitable activities<br>_NHS funding for patient care_<br>8,383<br>1,653<br>_Education, fees and other income_<br>867<br>–<br>Other trading activities<br>_Income of trading companies_<br>4,436<br>–<br>_Investment income_<br>153<br>–<br>**Total income**<br>27,116<br>2,371<br>**Expenditure on**<br>Raising voluntary income<br>1,508<br>–<br>Trading companies<br>3,125<br>–<br>4,633<br>–<br>Charitable activities<br>_Inpatient care_<br>5,672<br>1,189<br>_Community care/outpatients_<br>8,122<br>725<br>_Bereavement services_<br>658<br>43<br>_Community action_<br>444<br>–<br>_Education, research and policy_<br>605<br>461<br>15,501<br>2,418<br>**Total expenditure**<br>20,134<br>2,418<br>**Net income/(expenditure)**<br>**before transfers**<br>6,982<br>(47)<br>**Transfer between funds**<br>**(relate to capital programme)**<br>111<br>(111)<br>**Net income/(expenditure) before**<br>**other recognised gains and losses**<br>7,093<br>(158)<br>**Other recognised gains/losses**<br>Actuarial losses on defned<br>beneft pension scheme<br>(303)<br>–<br>Gains on investments: realised<br>198<br>–<br>Gains on investments: unrealised<br>352<br>–<br>Net movement in funds<br>7,340<br>(158)<br>Total funds at 1 April 2021<br>34,274<br>3,113<br>Total funds at 31 March 2022<br>**41,614**<br>**2,955**|**2022**<br>**2021**<br>**Restated**<br>**Total**<br>**total**<br>**£’000**<br>**£’000**<br>4,037<br>4,242<br>9,958<br>6,104<br>10,036<br>12,607<br>867<br>1,000<br>4,436<br>3,241<br>153<br>143<br>29,487<br>27,337<br>1,508<br>1,499<br>3,125<br>3,592<br>4,633<br>5,091<br>6,861<br>6,971<br>8,847           8,978<br>701<br>606<br>444<br>255<br>1,066<br>966<br>17,919<br>17,776<br>22,552<br>22,867<br>6,935<br>4,470<br>–<br>–<br>6,935<br>4,470<br>(303)<br>(300)<br>198<br>132<br>352<br>2,162<br>7,182<br>6,464<br>37,387<br>30,923<br>**44,569**<br>**37,387**|**2022**<br>**2021**<br>**Restated**<br>**Total**<br>**total**<br>**£’000**<br>**£’000**<br>4,037<br>4,242<br>9,958<br>6,104<br>10,036<br>12,607<br>867<br>1,000<br>4,436<br>3,241<br>153<br>143<br>29,487<br>27,337<br>1,508<br>1,499<br>3,125<br>3,592<br>4,633<br>5,091<br>6,861<br>6,971<br>8,847           8,978<br>701<br>606<br>444<br>255<br>1,066<br>966<br>17,919<br>17,776<br>22,552<br>22,867<br>6,935<br>4,470<br>–<br>–<br>6,935<br>4,470<br>(303)<br>(300)<br>198<br>132<br>352<br>2,162<br>7,182<br>6,464<br>37,387<br>30,923<br>**44,569**<br>**37,387**|
|---|---|---|
|||27,337|
|||1,499<br>3,592|
|||5,091|
|||6,971<br>8,978<br>606<br>255<br>966|
|||17,776|
|||22,867|
|||4,470<br>–<br>4,470|
|||(300)<br>132<br>2,162|
|||6,464<br>30,923|
|||**37,387**|



The SOFAs for 2021 and 2022 have been restated to show revised allocations between expenditure categories to better reflect current activity. Total expenditure for 2021 and 2022 remains the same at £22,867k and £22,552k. 

54 St Christopher’s Hospice annual report and accounts 2022-23 



## **19 Pension schemes** 

## **a St Christopher’s Hospice (1985) scheme** 

The hospice operates a pension scheme, the St Christopher’s Hospice (1985) Pension Scheme, which provides benefits based on final pensionable salary. The assets of the scheme are held separately from those of the hospice. The scheme was closed to new members in April 2002 and closed to future accruals from March 2010. 

Contributions are charged to the Statement of Financial Activities so as to spread the cost of pensions over employees’ working lives. The pension charge for the year was £127k (2022: £303k). 

## _**Triennial valuation**_ 

The contribution rates are determined by a qualified actuary on the basis of triennial valuation. The results of the last triennial valuation at 31 March 2022 showed that the value of the scheme’s assets was £12,279k (2019: £10,413k) and that this represented 111% (2019: 94%) funding level, with a surplus of £1,226k (2019: deficit of 695k).  The actuary confirmed that the minimum funding requirement regulations had been met. 

In accordance with the actuarial valuation, the hospice has agreed with the Trustees that it will meet the expenses of the scheme and levies payable to the Pension Protection Fund. 

## _**FRS (Financial Reporting Standard) 102: Disclosure Report**_ 

FRS 102 is fully effective for accounting periods beginning on or after 1 January 2015. The statement of financial activities, the balance sheet and the disclosures in the notes to these financial statements meet the requirements of FRS 102. The major assumptions used by the actuary are shown below. 

_Present values of defined benefit obligation, fair value of assets and defined benefit asset (liability)_ 

|**31**<br>Fair value of plan assets<br>Present value of defned beneft obligation<br>Unrecognised surplus<br>Defned beneft asset to be recognised|**Period**<br>**ended**<br>**March**<br>**31**<br>**2023**<br>**£’000**<br>8,612<br>(7,597)<br>(1,015)<br>–|**Period**<br>**Period**<br>**ended**<br>**ended**<br>**March**<br>**31 March**<br>**2022**<br>**2021**<br>**£’000**<br>**£’000**<br>12,279<br>11,736<br>(10,434)<br>(10,832)<br>(1,845)<br>(904)<br>–<br>–|**Period**<br>**Period**<br>**ended**<br>**ended**<br>**March**<br>**31 March**<br>**2022**<br>**2021**<br>**£’000**<br>**£’000**<br>12,279<br>11,736<br>(10,434)<br>(10,832)<br>(1,845)<br>(904)<br>–<br>–|
|---|---|---|---|
||||–|



_Reconciliation of opening and closing balances of the defined benefit obligation_ 

|**31**<br>Net defned beneft obligation at start of period<br>Interest expense<br>Acturial losses<br>Benefts paid<br>Defned beneft obligation at end of year|**Period**<br>**ended**<br>**March**<br>**31**<br>**2023**<br>**£’000**<br>10,434<br>283<br>(2,793)<br>(327)<br>7,597|**Period**<br>**ended**<br>**March**<br>**2022**<br>**£’000**<br>10,832<br>224<br>(333)<br>(289)<br>10,434|
|---|---|---|



> St Christopher’s Hospice annual report and accounts 2022-23 55 



## _Reconciliation of opening and closing balances of the fair value of plan assets_ 

|**31**<br>Fair value of plan assets at start of period<br>Interest income<br>Actuarial (losses)/gains<br>Contributions by the Charity<br>Benefts paid<br>Fair value of plan assets at end of period|**Period**<br>**ended**<br>**March**<br>**31**<br>**2023**<br>**£’000**<br>12,279<br>336<br>(3,801)<br>125<br>(327)<br>8,612|**Period**<br>**ended**<br>**March**<br>**2022**<br>**£’000**<br>11,736<br>246<br>286<br>300<br>(289)<br>12,279|
|---|---|---|



The actual loss on the plan assets over the period ended 31 March 2023 was £3,465k (2022 a return of £532k). _Defined benefit costs recognised in net (expenditure)/income_ 

|**31**<br>Net interest cost<br>_Defned beneft costs recognised in other gains and losses_<br>**31**<br>Return on plan assets (excluding amounts included in net interest cost): (loss)/gain<br>Experience gains and losses arising on the plan liabilities: (loss)<br>Efects of changes in the demographic and fnancial assumptions underlying<br>the present value of the plan liabilities: gain<br>Efects of changes in the amount of surplus that is not recoverable<br>(excluding amounts included in net interest cost): gain/(loss)<br>Total amount recognised in other gains and losses<br>_Assets_<br>**31**<br>Diversifed growth assets<br>Debt instruments<br>Liability-driven investments<br>Equity instruments<br>Cash and cash equivalents<br>Total assets|**Period**<br>**ended**<br>**March**<br>**31**<br>**2023**<br>**£’000**<br>(2)<br>**Period**<br>**ended**<br>**March**<br>**31**<br>**2023**<br>**£’000**<br>(3,801)<br>(704)<br>3,497<br>881<br>(127)<br>**Period**<br>**ended**<br>**March**<br>**31**<br>**2023**<br>**£’000**<br>5,225<br>–<br>2,913<br>–<br>474<br>8,612|**Period**<br>**ended**<br>**March**<br>**2022**<br>**£’000**<br>(3)<br>**Period**<br>**ended**<br>**March**<br>**2022**<br>**£’000**<br>286<br>(121)<br>454<br>(922)<br>(303)<br>**Period**<br>**ended**<br>**March**<br>**31**<br>**2022**<br>**£’000**<br>9,071<br>–<br>3,025<br>–<br>183<br>12,279|**Period**<br>**ended**<br>**March**<br>**2021**<br>**£’000**<br>3,688<br>2,360<br>2,845<br>2,722<br>121|
|---|---|---|---|
||||11,736|



None of the fair values of the assets shown above include any direct investments in the hospice’s own financial instruments or any property occupied by, or other assets used by, the hospice. 

56 St Christopher’s Hospice annual report and accounts 2022-23 



_Assumptions_ 

|_Assumptions_||||
|---|---|---|---|
||**Period**|**Period**|**Period**|
||**ended**|**ended**|**ended**|
||**31 March**|**31 March**|**31 March**|
||**2023**|**2022**|**2021**|
||**% pa**|**% pa**|**% pa**|
|Discount rate|4.85|2.75|2.10|
|Infation (RPI)|3.50|4.00|3.50|
|Allowance for revaluation of deferred pensions of RPI or 5% p.a. if less|3.50|4.00|3.50|
|Allowance for pension in payment increases of RPI or 5% p.a. if less|3.20|4.00|3.50|
|Allowance for commutation of pension for cash at retirement|75%|<br>75%|75%|



The mortality assumptions adopted at 31 March 2023 imply the following life expectancies at age 65 years: 

|Male retiring in 2023:|20.8|
|---|---|
|Female retiring in 2023:|22.1|
|Male retiring in 2043:|22.1|
|Female retiring in 2043:|24.9|



As the pension scheme is in surplus, there are not expected to be any contributions paid by the hospice to the scheme for the period commencing 1 April 2023. 

## _Calculation of pension scheme asset_ 

|scheme for the period commencing 1 April 2023.<br>_Calculation of pension scheme asset_||
|---|---|
|Triennial valuation surplus in 2022<br>Less amounts paid by charity 2022-23<br>Surplus not recognised|**£’000**<br>1,296<br>(125)|
||1,171|



## **b St Christopher’s defined contribution scheme** 

The St Christopher’s defined contribution scheme was set up in September 2001. In April 2010 the St Christopher’s Personal Pension (2010) defined contribution scheme was established and members of the existing defined contribution scheme transferred to this new scheme with effect from January 2011. The contribution of the hospice was on average 21% for former members of the St Christopher’s (1985) scheme and 5% for all other members, which represented a total charge for the year of £483k (2022: £431k) to the St Christopher’s GPP (2010) defined contribution scheme. 

## **c NHS Pension Scheme** 

Details of the scheme are provided in note 1.9. The contribution of the hospice was 14.38%, which was offset by a 29% subsidy on the contribution. This represented a net charge for the year of £571k (2022: £492k). 

> St Christopher’s Hospice annual report and accounts 2022-23 57 




**We’re proud to launch our new strategy focusing on improving end of life care locally, nationally and internationally** 

## **St Christopher’s reach covers a diverse population of 1.6 million people across the five south east London boroughs of Bromley, Croydon, Lambeth, Lewisham and Southwark.** 

We have made great strides and progress over the last year, and we are proud of the care and support we have given to our patients and those close to them in south east London. We have also taken our learning from these services and shared this with others, as part of education and research. 

However, we know that not everyone currently has access to sufficient palliative and end of life care whether this be locally, nationally, or globally. 

In addition, the need for palliative and end of life care is growing. For example, within the UK we have an ageing population, which is resulting in more patients needing palliative and end of life care, and also an increase in conditions such as dementia and frailty. 

One key aspect of improving palliative and end of life care is to ensure that we challenge the inequalities on our doorstep. We know that access to services is neither equitable or equal. This is for many reasons including: 

- lack of knowledge about what is available and how it can help 

- marginalisation 

- some not accessing palliative care early enough through fear or misunderstanding 

- poor death literacy with many not considering or putting in place plans for the end of their life 

- poor referral processes meaning many don’t receive this support early enough or at all 

- lack of resources within the health system. 

Therefore, more needs to be done. As part of St Christopher’s determination to address this we have updated our strategy for the next three years (20232026) and this focuses on the five areas below. 

These are shown alongside our respective ambitions for each area. 

## **1 Break down inequalities in palliative and end of life care** 

- Understand and respond to the needs of our diverse minority communities 

58 St Christopher’s Hospice annual report and accounts 2022-23 




**----- Start of picture text -----**<br>
We want everyone to know<br>St Christopher’s is there for them and<br>that we offer a broad range of support<br>**----- End of picture text -----**<br>


- Develop further age-attuned palliative care for younger people right through to older people 

- Continue to develop clinical expertise to deliver high-class palliative and end of life care across our five boroughs, and to develop sustainable and improved relationships across the whole health economy 

- Tackle the misconceptions about hospice care and support. 

## **2 Equip the workforce in palliative and end of life care, for the future** 

- Develop pathways of learning to reflect career development opportunities 

- Develop new ways of learning to reflect contemporary preferences and pressures 

- Continue developing, and then to implement our people strategy. 

## **3 Maintain global leadership in palliative and end of life care** 

- Share cutting-edge thinking clarifying contemporary end of life issues and testing solutions 

- Share expertise generated through practice and research 

- Influence and work in partnership. 

## **4 Embed a sustainable business model** 

- Refresh our premises, while protecting the environment 

- Ensure we have sufficient finances to match our ambitions 

- Use resilient and secure technology that empowers people. 

## **5 Tackle the ethical challenges of the day** 

- Tackle the sensitive topic of assisted dying 

- Identify and highlight services under pressure and system wide gaps in provision 

- Advocate for improvement in funding centrally to support core palliative and end of life care across communities. 

> St Christopher’s Hospice annual report and accounts 2022-23 59 



## 

**We are hugely grateful to the individuals, corporate sponsors, trusts and all those who have so kindly chosen to remember St Christopher’s in their Wills. Thanks to you, we provided care and support to over 7,500 people last year. Thank you for making this possible.** 

## 5 Stone Buildings 

5th Beckenham South Scout Group Addington Court Golf Club Addington Palace Golf Club Amphlett Lissimore Anand International Ltd Anthony Gold Solicitors LLP Arnold Clarke Community Fund Baltic Exchange Batchelors Solicitors BBC Children in Need BDB Pitmans Beckenham United Reformed Church BNY Mellon Boodle Hatfield LLP BOOHOO.COM PLC Brilliant Solutions Bromley Reform Synagogue Bromley Well Innovation Fund C Brewer & Sons Ltd Trust Cabaret vs Cancer Capital Generation Partners Cecil Rosen Foundation Charles Russell Speechlys Chatterton Arms Chelsfield Lakes Golf Club Christ Church – Chislehurst Christ Church Beckenham Collyer Bristow LLP Coney Hall Village WI Croham Hurst Lodge 3968 Croydon Chantry Lodge No. 5063 Croydon Seventh-day Aventist Church Currey & Co LLP Day Lewis Plc - Head Office Direct Line Group Dixon Wilson Dr Friedrich Stock Memorial Trust Dulwich and Sydenham Hill Golf Club 

Dulwich Champagne Reception Committee Dulwich Friends of St Christopher’s EDF Trading EIG Ecclesiastical Evelyn Partners Ewings & Co Farrer & Co  LLP Fb Coales No 4 (Family)Trust Forsters Charitable Fund Forsters LLP Future Directions Financial Services Ltd Gower Associates Grant Saw Great Causes II Grips Tyres & Wheels Ltd Hospice Aid UK Hospice UK IdentityE2E Irwin Mitchell Jacob Charitable Trust Jet’s Charitable Trust John Lamb Hill Oldridge Knole Park Golf Club Ltd Kristina Martin Charitable Trust Lavender Lodge Of Instruction No. 6429 Linda Ruprai Memorial Event Link Group Linmara Trust Lloyd Eist Foundation London Catalyst London Metal Exchange Benevolent Fund Masonic Charitable Foundation Masonic Province Of West Kent Maurice Turnor Gardner LLP Maybrey Precision Castings Ltd Meerali Beedle Michelmores LLP Mishcon De Reya LLP Mrs Maud Van Norden’s Charitable Foundation 

60 

St Christopher’s Hospice annual report and accounts 2022-23 



National Lottery Heritage Fund Network Rail Orpington Spiritualist Church PA Media Payne Hicks Beach LLP Penguins Against Cancer Petts Woodstock Quartet Community Foundation Ravensbourne Trefoil Guild Rawlinson & Hunter Ray Jones Roofing Ltd Roseberys Auction House Rotary Club Of Bromley Rotary Club Of West Wickham Rothschild & Co Scannell Properties Shirley and District Probus Club Shirley Methodist Church Sinclair Gibson LLP Sir Walter St John Lodge Sotheby’s St Augustine Church St Bartholomew’s Church St Paul’s Parish Church Crofton STEP - Society of Trust & Estate Practitioners Stonehage Fleming Family and Partners Sundridge Park Golf Club Limited Sydenham Catholic Club Taylor Wessing The Albert Hunt Trust The Anthony Hart Charity Trust The Ardwick Trust The B & P Glasser Charitable Trust The Barleycorn Trust The Barnes Ouzounian Foundation The Bricklayers Arms The Burdett Trust for Nursing The Charity of Sir Richard Whittington The City Bridge Trust The Douglas-Morris Charitable Trust The Dulwich Almshouse Charity The Elizabeth & Prince Zaiger Trust 

The Elizabeth Frankland Moore and Star Foundation The Eversley Charitable Trust The February Foundation The Florabella Trust The G D Herbert Charitable Trust The Goldsmiths’ Company The Gower Family Trust The Green Hall Foundation The Guild of Nineteen Lubricators The Hayes (Kent) Trust The Health Foundation The Horner Family Charitable Fund The Hospital Saturday Fund The Hyne Trust The Incorporated Church Institute (Upper Tooting) Ltd The Irving Memorial Trust The Jack Petchey Foundation The John Horseman Trust The Kate Whiteman Trust The Kathleen Hannay Memorial Charity The Kathleen Smith Foundation 

The Light Fund The Mageni Trust The Margaret and David Walker Trust The Michael and Anna Wix Charitable Trust The Milton-Lloyd Charitable Trust The Outback Hair Salon The Thomas J. Horne Memorial Trust The Timothy Franey Charitable Foundation TK Maxx and Homesense Foundation Touron Trust Trustee Fire & Security Waitrose - Green Street Green Walder Wyss Ltd Wandle Lodge No. L2699 Wedlake Bell West Norwood Cemetery and Crematorium Wilsons Solicitors LLP Withers Worldwide Women in Fellowship 

> St Christopher’s Hospice annual report and accounts 2022-23 61 



## 

## **Executive Team** 


**Helen Simmons** Chief Executive **[1 ]** 


**Amanda Mayo** Care Director 


**Jan Noble** Director of Quality & Innovation 


**Dr Joy Ross** Lead Consultant in Palliative Care **[2]** 


**David Tullett** Director of People & Organisational Development **[3]** 


**David White** Director of Commercial Projects **[4]** 


**John Vickers** Director of Finance & Corporate Services 

## **Trustees** 



**Neil Goulden** Chair 

**Glenda Bonde** Trustee **[5]** 



**Eleanor Brown** Trustee/Vice Chair 

**Nick Diamond** Trustee 



**Vivian Bazalgette Tony Hunter** Trustee Trustee **Trustees who resigned in 2022-23** 

**Tony Hunter** Trustee 



**Terrence Collis** Trustee **[7]** 

**Joanna Donaldson** Trustee **[8]** 


**Ian Judson** Trustee 


**Daniel Kelly** Trustee 


**John King** Trustee 


**Nita Rogers** Trustee **[9]** 


**Catherine McDonald** Trustee 


**Satvinder Reyatt** Trustee **[6]** 


**Deepti Townsend** Trustee 


**Lila Thompson** Trustee **[10]** 

**Executive Team and Trustees who were appointed after 1 April 2022 1** 30 May 2022 **2** 1 November 2022 **3** 27 February 2023 **4** 1 April 2023 **5** 1 July 2023 **6** 1 July 2023 

**Trustees who resigned in 2022-23 7** 21 July 2022 **8** 21 July 2022 **9** 31 October 2022 **10** 31 January 2023 **11** 21 July 2022 


**Jane Walters** Trustee **[11]** 

62 St Christopher’s Hospice annual report and accounts 2022-23 



## **Patron** 

HRH Princess Alexandra 

## **President** 

Lord Ian McColl 

## **Vice Presidents** 

Rodney Bennion OBE Dr Catherine Dent Dr Tyrrell Evans Dr Gillian Ford CB Sheila Hancock OBE Dame Pauline Harris DBE DL Dr Sam Klagsbrun John Rhodes Barbara Richardson Colin Russell Ruth Saunders 

## **Company Secretary** 

John Vickers 

## **Registered office** 

51-59 Lawrie Park Road, Sydenham, London SE26 6DZ 

## **Bankers** 

HSBC Bank plc, 165 Fleet Street, London EC4A 2DY 

## **Independent auditor** 

Moore Kingston Smith LLP, 9 Appold Street, London EC2A 2AP 

## **Registration numbers** 

Registered charity number 210667 Registered company number 00681880 VAT registration number 523613961 


> St Christopher’s Hospice annual report and accounts 2022-23 63 



If you would like this information in a different format, such as audio tape, braille or large print, or in another language, please speak to the Communications Team on **020 8768 4500** or email **communications@stchristophers.org.uk** . 


## **Sydenham site** 

51-59 Lawrie Park Road, Sydenham, London SE26 6DZ 

## **Orpington site** 

Caritas House, Tregony Road, Orpington BR6 9XA 

Telephone **020 8768 4500** Email **info@stchristophers.org.uk** 

## **www.stchristophers.org.uk stchrishospice** 

Registered charity 210667 registered with the Fundraising Regulator Registered company number 00681880 © St Christopher’s Hospice September 2023