2021-03-31-accounts

Registered number: 241618 Charity number: 211058

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

FINANCIAL STATEMENTS

YEAR ENDED 31 MARCH 2021

LUBBOCK FINE LLP Chartered Accountants Paternoster House 65 St Paul's Churchyard London EC4M 8AB

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

CONTENTS

	Page
Reference and Administrative Details of the Charity, its Trustees and Advisers	1
Trustees' Report	2 - 28
Independent Auditors' Report on the Financial Statements	29 - 32
Statement of Financial Activities	33
Balance Sheet	34 - 35
Statement of Cash Flows	36
Notes to the Financial Statements	37 - 59

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

REFERENCE AND ADMINISTRATIVE DETAILS OF THE CHARITY, ITS TRUSTEES AND ADVISERS

FOR THE YEAR ENDED 31 MARCH 2021

Trustees	N Pearce, Chair
	S.J. Brough
	R Bryar
	R Harrison
	G Kent, Deputy Chair
	P Key
	M Maclean
	L Marks MBE
	A Njambi
	K Pinney
	S Ruszczynski
	J Smith
	R Roland Smith
	H Sundram
Company registered number 241618 Charity registered number 211058 Registered office 56-60 Hallam Street London W1W 6JL Independent auditors Lubbock Fine LLP Chartered Accountants & Statutory Auditors 3rd Floor, Paternoster House 65 St Paul's Churchyard London EC4M 8AB Bankers Cazenove Capital 12 Moorgate London EC2R 6DA National Westminister Bank plc 106 Finchley Road London NW3 5JF

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TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

TRUSTEES' REPORT

FOR THE YEAR ENDED 31 MARCH 2021

The Trustees present their annual report together with the audited financial statements of the Charity for the year from 1 April 2020 to 31 March 2021. The Annual Report serves the purposes of both a Trustees' report and a directors' report under company law. The Trustees confirm that the Annual Report and financial statements of the charitable company comply with the current statutory requirements, the requirements of the charitable company's governing document and the provisions of the Statement of Recommended Practice (SORP) applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS102) (effective 1 January 2019).

Since the Charity qualifies as small under section 383, the strategic report required of medium and large companies under The Companies Act 2006 (Strategic Report and Director's Report) Regulations 2013 is not required.

CHARITABLE OBJECTS AND ACTIVITIES

The objects of the charity as set out in its Memorandum of Association are:

• a) To promote the study and practice of psychotherapy and counselling and its application in a variety of settings.

• b) To promote and improve the quality of adult couple relationships, prevent family breakdown and enhance the lives of adults and their children by the provision of professional clinical services designed to alleviate family distress and breakdown, and training, consultation and other services which are designed to enhance and develop services to couples and families.

• c) To undertake research and publication of work that contributes to and promotes both professional and public understanding of couple and family relationships.

The Charity seeks to achieve its objects by:

• a) Developing and disseminating the research on couple relationships and how best to support them; promoting the value of seeking relationship help, particularly when going through life’s transitions.

• b) Training couple therapists to deliver the highest quality, expert help.

• c) Providing affordable, accessible, evidence-based services.

• d) Supporting front line practice to develop a strong focus on adult relationships.

• e) Developing innovative intervention projects, applying psychosocial and clinical expertise to supporting families.

In setting the objectives and planning the activity of the charity, the Trustees have given careful consideration to the Charity Commission’s general guidance on public benefit.

Further details of how the charity worked to achieving its objects are contained within the report on activities section of the annual accounts.

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TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

TRUSTEES' REPORT (CONTINUED)

FOR THE YEAR ENDED 31 MARCH 2021

RESERVES POLICY

Annually, the Trustees assess the financial and delivery commitments against its expectation of future organisational performance and financial risk, to determine the level of reserves required by the organisation. In determining the level of reserves required, the organisation seeks to achieve a balance of prudent financial management and the appropriate use of financial resources in pursuit of its charitable objectives.

As at 31 March 2021, the Trustees sought to hold available funds in line with those specified by its key funding contracts and required to ensure continuity of operations in the event of loss of revenues. Reserve funds held at the balance sheet date as detailed in note 16 are in line with this policy and the board will continue to target reserves of this level for the lifetime of the contractual commitments and to support operational continuity in the event of the loss of these funding sources.

Operational performance remains strong and the board expects that all agreed contributions to the pension fund deficit can be reasonably met from ordinary charitable activity. As such the pension deficit as valued at balance sheet date (£81,000) is not considered by the board to be an offsetting amount to the available funds.

The following table sets out the amount of reserves the Charity held as at 31 March 2021 after making allowance for restricted funds and the carrying amount of functional assets:

Restricted funds Unrestricted funds (excluding pension deficit) Total funds (excluding pension deficit) Less: Funds represented by functional tangible and intangible assets Available liquid reserves	31 March 2021 £ 50,397 1,382,687
	1,433,084 (739,911)
	693,173

*An agreement is in place with the Pension Scheme Trust for repayment of the pension deficit (£81,000) over time. The Trustees expect to be able to meet this obligation annually through ordinary operating activity.

At balance sheet date available liquid reserves totalled £693,173, the majority of which were held as investments.

INVESTMENT POLICY AND MANAGEMENT

The Trustees takes a prudent view to the investment of surplus funds as these are being retained for furthering the objects of the Charity. Accordingly, funds not required for expenditure in the short term are placed on deposit with the Charity's bankers.

The investment objective of the Charity is to keep a balance between capital growth and income with low risk.

The Trustees appointed Cazenove in February 2017 as their discretionary investment managers. Cazenove also act as the Charity's Investment Custodians, as nominees for the Charity. A Sub-committee of the Council meets regularly with Cazenove to receive and discuss progress reports.

RESULTS

The results for the year and the charity's financial position at the end of the year are shown in the attached financial statements.

FUTURE STRATEGIC OBJECTIVES

Our Vision

A world in which strong relationships provide stability and security for adults and children and form the foundation

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TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

TRUSTEES' REPORT (CONTINUED)

FOR THE YEAR ENDED 31 MARCH 2021

for the health and wellbeing of individuals and society as a whole, across the life cycle.

Our Mission

To improve practice and increase access to relationship support through the development of new methods, dissemination of knowledge and service provision to diverse communities.

Our Aims

• The importance of couple relationships for our mental health and societal wellbeing is widely recognized and understood.

• Support for couple relationships is a valued part of mental health and wellbeing provision for all our communities.

• A diverse community has access to training and resources in the field of couple relationship therapy.

• A range of interventions and therapeutic modalities are widely used to provide relationship support that is effective and accessible to diverse communities.

Objectives

1. Developing and disseminating research on the benefits of positive couple relationships, and how best to support them.

2. Promoting the value of seeking relationship help, particularly when going through life’s transitions.

3. Training and supporting couple therapists to deliver the highest quality, expert help.

4. Providing low and no fee services to those who would not otherwise be able to access support.

5. Enabling front line practitioners to develop a strong focus on adult relationships and their impact on individual and family wellbeing.

6. Developing innovative intervention projects, applying psychosocial and clinical expertise to supporting families and sharing our learning.

RISK REVIEW

A review has been undertaken of the major risks to which the Charity is exposed and policies and processes have been established to mitigate those risks.

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TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

TRUSTEES' REPORT (CONTINUED)

FOR THE YEAR ENDED 31 MARCH 2021

TRUSTEES

The Trustees who served the charity during the period were as follows:

N Pearce - Chair S.J. Brough (Temporarily stood down during the course of FY2021) R Bryar R Harrison G Kent P Key M Maclean L Marks MBE (appointed 26/06/2020) A Njambi K Pinney S Ruszczynski J Smith R Roland Smith H Sundram

No Trustee has any beneficial interest in the charity.

The charity is governed by its memorandum and articles of association. The power to appoint new members is by invitation of the existing members of Trustees and this is ratified by the members at the Annual General Meeting. Every new member is made aware of their responsibilities and given a full induction to the charity.

The pay of key management personnel is at the discretion of the Trustees.

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Chair’s message

Despite the delivery challenges which the global pandemic has continued to pose, I am proud to report that Tavistock Relationships has continued its exploration of novel ways to provide support to people experiencing relationship problems.

It is in the digital realm that this has been most notable this year, and we are pleased that our early moves to adopt technology solutions that enable service provision have positioned us well to continue to offer support to a wide range of clients throughout a challenging year. For not only has the charity managed to help hundreds of parents across large swathes of England, particularly through the provision of mentalization-based therapy online, but it has also delivered online training to practitioners from the UK and abroad on the relational aspects of dementia in the context of couple relationships, as well as embarking on a new project, funded by Children in Need, which sees us working in partnership with a local youth charity that provides online peer mentoring to young people whose parents are receiving online couple therapy.

In addition, Tavistock Relationships has developed one of the first relationship support apps in the world, with Between Us attracting more than 1,000 users in the first month after its release. We are well placed to explore opportunities for working with local authorities and other agencies over the coming year to utilize this tool as part of their community outreach programmes.

It is becoming increasingly clear how the pandemic has affected the quality of people’s relationships. Although some have managed to strengthen their relationships as a result of enforced proximity and home-working, others – most notably those whose relationships were under strain anyway before the pandemic – have experienced significant deterioration in the quality of their relationship with their partner, often related to increased stress and pre-existing vulnerabilities related to their mental health.

As we move, we hope, out of the worst of the pandemic, Tavistock Relationships stands ready to play its part in helping people find better, and less conflictual, ways of relating to partners, and of parenting their children in loving, warm and secure ways. I am extremely grateful to all the staff at Tavistock Relationships whose dedication and professionalism fills me with the confidence to make such a promise.

This year we have been joined by a new trustee, Lucy Marks. We are delighted to be able to draw on her wisdom and many years of experience as a health professional. I want to take this opportunity to thank all our trustees for many years of dedicated and diligent service to the charity.

Professor Nick Pearce

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Chief Executive’s report

As Chief Executive, I am immensely proud of the work which is detailed in this Annual Review. The range of work undertaken by Tavistock Relationships this year is testimony to what can be achieved by a staff team working creatively together, with a deep commitment to our charitable mission to ensure that effective relationship support is available to all.

As part of our charitable mission, we undertook survey research[1 ] to find out about how the UK’s relationships have fared during the Coronavirus pandemic. Our survey canvassed the views of more than 2,000 adults across the United Kingdom and the results paint a disturbing picture of the state of couples and families in post-pandemic Britain.

While some may have benefited from the opportunity to spend more time with their partners and families during the pandemic, for a significant number of families life has become much harder. Close to half of all respondents felt that the experience of lockdown would have long-term impacts on their mental health and a similar number said that the pandemic caused additional stress for their children and wider family. This is not surprising – families have had to bear the emotional strain as we have been cut-off from the outside world of work and wider social contexts. For many, the pandemic has meant that we have been reliant on our family relationships for our support. Where there have been underlying vulnerabilities in these relationships, these have inevitably become amplified. Never before has the link between our relationships and our mental health been so apparent.

Family relationships are under strain – and the people we surveyed believe that couple and family relationships need support now, just as our mental health does. Indeed, the experience of the pandemic has brought home to us what research has long shown: in many respects relationship health is mental health. When relationships are in trouble our mental health suffers. When relationship therapy is effective, we see significant improvements in mental health as well as in relationship quality. For example, year on year, figures released by NHS Digital indicate that couple therapy is one of the most effective psychological treatments for depression and anxiety[2] .This is so important not just for the wellbeing of parents, but for their children too. Those children whose parents are in poor mental health are more vulnerable to developing such problems themselves and this association has increased since the pandemic – as our most vulnerable families have become more disadvantaged than ever.

mental health been so apparent.

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This attests to the vital importance of the work that Tavistock Relationships does – now, more than ever, there is a need for innovative approaches to support relationships and mental health across all areas of our society. As you will see as you read on, this year we have worked hard to play our part in this, undertaking an exciting programme of intervention development, training and research, in diverse settings across the UK. Working online this last year has created a unique set of challenges and pressures for much of the country. Tavistock Relationships staff responded with incredible resilience and adaptability, ensuring our activities were sustained without interruption. My thanks and appreciation to all members of the Tavistock Relationships learning community, who worked so hard to enable us to continue to provide our services in this most challenging of years.

Highlights of the year include:

• Publishing Between Us, one of the world’s first relationship support apps.

• Supporting parents to achieve significant improvements in their mental health and reduce relationship conflict through delivery of the Government’s. Reducing Parental Conflict Programme.

• Working with a record number of NHS staff to train them in the highly effective programme, Couple Therapy for Depression.

• Strong demand from applicants for our new Diploma in Psychosexual Therapy resulting in fully subscribed courses, with the student cohorts including increased representation from participants from Black, Asian and Minority Ethnic backgrounds, in part, supported by our bursary programme.

• Successfully delivering our range of trainings in an online format, resulting in a significant increase in participants both nationally and internationally.

• Increasing the number of staff from Black, Asian and Minority Ethnic backgrounds employed as clinical lecturers, group analysts, and workshop facilitators across our trainings, in line with our strategic plan.

• Running our summer and winter schools to maximum capacity.

• Delivering more than 20,000 sessions of therapy to couples and individuals, representing nearly 1,500 cases.

• Continuing to demonstrate, through rigorous data collection, the positive impact of providing couple therapy – both in terms of the mental health and well-being of the adult partners, as well as their children.

• Commencing work on our collaboration with the City of London, through the City Wellbeing Centre, which delivers lowcost psychological therapy for workers and residents in the City of London and surrounding boroughs.

• More people attending our lectures and short courses in 2020-21 than any previous year.

• Publishing 27 book chapters or journal articles by Tavistock Relationships staff.

• 1 In July 2021 Tavistock Relationships commissioned a YouGov survey of more than 2,000 UK adults. Just over half of the respondents were in a relationship. The questions were designed to provide insights into the impact of the pandemic and social restriction on the relationships of couples, families, parents and children, and to consider how this had affected the nation’s mental health. All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 2,093 adults, of whom 1,401 were in a relationship. Fieldwork was undertaken between 22-23 July 2021. The survey was carried out online. The figures have been weighted and are representative of all UK adults (aged 18+).

• 2 Data derived from: https://digital.nhs.uk/data-andinformation/publications/statistical/psychologicaltherapies-annual-reports-on-the-use-of-iapt-services/ annual-report-2016-17-further-analyses

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Innovation and development

Tavistock Relationships prides itself on its considerable history of innovation, of developing and tailoring programmes to help couples and families in new ways. This year we have worked on the following:

Between Us – an app for relationship support

We published our new app, Between Us, in January 2021. Soon after this, the app was featured on the BBC’s technology programme, Click, which resulted in more than 1,000 downloads. Between Us marks a new departure for Tavistock Relationships and we are proud to have developed one of the first couple relationship support apps globally.

Reducing the impact of interparental conflict on children’s mental health

Our Children in Need-funded project, which sees Tavistock Relationships delivering couple therapy to parents locked in entrenched conflict, while their children receive peer mentoring from the youth charity Fitzrovia Youth in Action, is progressing well. Young people involved in the project created this short video about their experience: https://www.youtube.com/ watch?v=Z0_AtFFoxZc

Living Together with Dementia

This continues as a service operating within Tavistock Relationships, with a number of staff working to deliver clinical interventions for couples living with dementia, as well as ongoing research into the effectiveness of the clinical work and its associated training programme. In addition, three one-day workshops were delivered for people working in dementia care services, attracting interest from practitioners working in older adults’ services across the UK and Europe.

DWP Reducing Parental Conflict Programme (RPC): Westminster and Hertfordshire contract package areas

Our DWP funded programme in 2020-21 has had an excellent year. The contracts we were awarded by the DWP have enabled us to support over 1,300 parents across seven London boroughs and counties beyond London, including Hertfordshire, Cambridgeshire, Essex, and Buckinghamshire.

We have delivered our own Mentalization – based intervention, Parenting under Pressure, to more than 600 parents, as well as training and supervising practitioners in the North East, where they are also delivering this intervention. We have found highly significant improvements in all the areas that the Reducing Parental Conflict programme seeks to address, with highly significant reduction in a) conflict between parents in intact and separated relationships b) violent problem solving for all parents, for parents in intact relationships, and for parents in separated relationships and c) conflict about the children for all parents.

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Conflict between co-parents

Violent problem solving

----- Start of picture text -----
Key
Intact (n=98) Separated (n=91)
32
24
16
8
0
Pre-intervention Post-intervention
CCQ Score
----- End of picture text -----

Conflict about the children

----- Start of picture text -----
Key
All (n=209) Intact (n=97)
Separated (n=96)
7
6
5
4
3
Pre-intervention Post-intervention
CCQ Score
----- End of picture text -----

----- Start of picture text -----
Key
All (n=209) Intact (n=95)
Separated (n=85)
3
2.25
1.5
0.75
0
Pre-intervention Post-intervention
CCQ Score
----- End of picture text -----

Psychological distress

----- Start of picture text -----
Key
All (n=209) Intact (n=95)
Separated (n=85) Clinical threshold
13
10.75
8.5
6.25
4
Pre-intervention Post-intervention
CCQ Score
----- End of picture text -----

If I hadn’t had gone through this counselling process, I’m not sure what life would look like now. I know now that I can deal with my ex-partner… and I know that for my children life is a great deal easier, they feel less torn between us.

Parent from the DWP RPC programme

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Commissioned training

We were commissioned by the City of London Corporation to provide 6 half-day workshops on the impact of parental conflict on children within the family and within schools and a separate workshop on Understanding and working with domestic abuse. We have also delivered commissioned training with Brighton and Hove Schools on the Impact of Parental Conflict on Children in Schools.

Parents as Partners (PasP)

We have worked to support four local authorities in the delivery of this programme, providing supervision to their staff. In addition, three Welsh local authorities have commissioned training in this model. During this year, groups for parents which started in person have moved online. Consequently, we adapted the Parents as Partners training manual for online working and were greatly helped in this task by the four original programme developers, Professors Phil and Carolyn Cowan and Professors Marsha and Kyle Pruett. We continue to assess the programme’s effectiveness and are supervising internationally in Malta, Poland and Israel.

Couple Therapy for Depression Training for Delivery within the NHS, Improving Access to Psychological Therapies (IAPT)

In 2020/21, 119 practitioners within the NHS were trained in Couple Therapy for Depression compared with 64 in the previous year. In addition, we have trained 10 supervisors to work within IAPT services in a bid to increase sustainability. There has also been a CPD offered to trained practitioners to encourage those who have been trained by TR to continue to develop their practice.

All trainings, from June 2020, were conducted on-line and the feedback from trainees has been very positive.

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~~Developing the workforce~~ Practitioner trainings

Overall, in 2020/21 our trainings performed extremely well. We were, of course, recruiting during a pandemic and all selection and interviews took place online. On the practitioner training, we welcomed 13 students onto the first year of the psychodynamic programme, and 1 student on to the psychoanalytic practitioner programme. This year we also had the 5-yearly collaborative review with the University of East London and were commended on:

• excellent teaching and high-quality support.

• exceptional standard of the second marking process.

• quality of relationships between staff, students and UEL.

• quality of the preparatory paperwork.

Foundation courses

We started two Foundation courses in January this year, offering one in the evening and one during the day. We recruited 39 students in total: 22 students registered for the evening course (an almost identical number to 21 in the previous year) and 17 students were recruited for the daytime course.

students.

Psychosexual training

Our new Diploma in Psychosexual Therapy is recruiting very well. The course had an excellent accreditation report from COSRT, so is now fully accredited and establishing itself as one of the leading psychosexual therapy trainings in London. We have recruited a steady number since the first intake, and despite our other practitioner courses being impacted by the pandemic this year, the psychosexual Diploma managed to maintain its intake. It recruited 13 students this year: an almost identical number to the previous two years.

Our Psychosexual Certificate also recruited very well this year, 14 students enrolled on the course in April 2020 and 22 in January 2021. As reported last year, the move to online teaching has boosted the recruitment of both national and international students.

New courses

Three new courses started this year:

Certificate in the Study of the Couple Relationship. This is a year-long course for individually qualified counsellors and psychotherapists. The course started in September 2020 with 17 students.

Individual Training in Psychodynamic Psychotherapy. This is a year-long course which is a ‘top up’ training for students who have completed our Couple Psychoanalytic Psychotherapy training. This was accredited by the BPC in March 2021. The course commenced in January 2021 with 6 students.

Pre-Clinical Course: This is an Advanced Foundation course run for 6 weekends and is aimed at those who are interested and suitable for our clinical trainings. 10 students enrolled on this course in May 2021 and we are anticipating a high conversion rate to our psychodynamic training in September.

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Online training

All of our training has been delivered online this year, which has presented a huge opportunity for Tavistock Relationships to widen the reach of our trainings beyond London. We have seen a significant increase in the number of participants across our trainings from national and international students. Online delivery will remain a permanent feature of our practitioner trainings, with an anticipated blended model developed, (some aspects being delivered entirely online, and some face to face); and our other courses will offer both an online option and a face-to-face option.

All of our training, from one day courses to 4-year clinical trainings are carefully evaluated. Overall, the feedback we receive is outstanding. This is a selection of some of the comments we have received:

The organisation has a culture and atmosphere where thinking can take place and be cultivated. I feel there are a number of people/staff I can go to, to think about any difficulties or anxieties I may have. This makes for a safe learning environment.

A caring and containing environment is created and maintained at TR. As a student I trust that my well-being and my experience is being thought about. I feel supported and cared for.

Race and diversity bursary provision

We offer Bursary provision across all of our training courses to provide financial support to those who are on low incomes and from an under-represented ethnic group. Alongside this we are also developing a mentoring scheme where our Black, Asian and Minority Ethnic students are offered a Mentor from a current or recent Black, Asian or Minority Ethnic trainee.

The Training team have ongoing reviews of how issues of race are covered in both the curriculum and other teaching resources. This also includes ensuring an inclusive CPD programme with expert practitioners and clinicians from Black, Asian and Minority Ethnic groups.

Although we still have some way to go to realise our ambitions to increase diversity across our organisation, this year we have increased the number of staff identifying as being from Black, Asian and Minority Ethnic backgrounds, employed on our trainings as clinical lecturers, group analysts, and workshop facilitators.

Bursaries awarded 2020 – 2021

• Foundation Certificate in Couple Counselling and Psychotherapy 2 x 100% bursaries 2 x 50% bursaries.

• Psychosexual Certificate 2 x 100% bursaries (two staff members)

• Diploma in Psychosexual Therapy: 1 x 100% bursary.

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Short courses – CPDs and conferences

This has been a challenging year as the covid pandemic meant our programme of face-to-face events could not take place as planned, and we had to move quickly to online delivery.

During the first quarter we ran a series of early evening events. Andrew Balfour, Tavistock Relationship’s Chief Executive, presented a paper on psychoanalytic work with parental couples, repeated due to demand, and we had several presentations and discussion groups that directly addressed the sudden shift to online clinical work.

Over the subsequent year, we ran a mix of workshops and larger lecture-style events on Zoom. These courses attracted a diverse mix of therapists from a variety of theoretical perspectives, and the online medium meant we were able to expand our reach, attracting an audience from right round the world. More than 600 people attended our short courses in 2020-21, which was higher than the numbers from the previous year.

Summer and winter schools

Our annual Developing Skills in Couple Work summer school took place online for the first time. This was such a success, running at capacity, that we also ran it as a winter school in February. Again, it reached capacity, and attracted a good range of students, with a strong number of international participants joining our traditional UK base.

Our programme included a workshop on the impact of addiction on the couple, several training days from Dr Jan McGregor Hepburn on working with narcissistic states, a day with Professor Josh Cohen on the art of not working and our culture’s demonisation of idleness, a workshop on resistance to grief and mourning in the couple relationship, Dr Graham Music on the clinical challenges of working with emotionally flat or shutdown states, two study days with Mary Morgan and Catriona Wrottesley on the art of clinical interpretation, a workshop with Narendra Keval on the use and misuse of race in the clinical situation, Professor Brett Kahr on how to flourish as a psychotherapist in the time of Covid and Juliet Newbigin and Leezah Hertzmann on the clinical challenges of working with sexuality and gender. We launched a series of conversations with novelists which included an evening with the author Deborah Moggach.

Enid Balint lecture

Michael Parsons gave the 26th annual Enid Balint lecture, entitled Revisiting Before I Was I, in which he reflected on the experience of rereading Enid Balint’s collected papers, which he had co-edited, nearly 30 years later. The respondent was Andrew Balfour, chief executive of Tavistock Relationships.

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Our therapy services – supporting couples, parents and families

General clinical services

Despite an un-precedented level of change in our approach to service delivery this year, which has all moved online, we have continued to see a high demand for our clinical services. In total our general clinical service delivered 20,630 sessions from nearly 1,500 cases.

In light of the pandemic, all clinical work was delivered online, with great success. This was made possible by utilising our existing Online Therapy processes and systems which enabled the rapid upskilling of therapists and staff and minimised disruption. As a result, the vast majority of the pre-existing client group seen ‘in person’ before lockdown were able to engage well with both the technology and the differences with working therapeutically online.

Over the course of the year, we developed our range of digital platforms to support the delivery of therapy remotely and improve clinical operations including:

• introducing a new electronic client invoicing system to enable clients to pay online via Stripe.

• development of the Therapist Community platform to support therapists with accessing case information, including accessing up to date clinical information.

• digitalisation of all case documents and the development of an online clinical archive for closed records.

• introducing electronic access to clinical outcome measures.

• a new telephone system.

Initial consultations

Throughout the year we were able to continue to provide support to new clients via online consultation appointments booked via our online booking system. Booking levels were impacted by the national lockdowns. Despite this, 1,115 consultation appointments were undertaken with couples and individuals seeking relationship support.

The allocation of cases to ongoing therapy has been carefully managed by the Heads of Clinical Services who think carefully about which therapist and what therapeutic approach is most appropriate for each case. This process has continued to work efficiently remotely as a result of our CRM system developed over the past few years.

National reach of online therapy

Over the past year we have increased our national and international presence by nearly doubling the number of clients we see who live outside London (and surrounding areas). In total 2,300 sessions were delivered to people outside London compared to 1,281 in 2019/20.

My therapist is really helping us to explore dynamics between us that cause us to feel stuck in our relationships and through the sessions I am able to understand more about my feelings and actions and how they affect my relationship with my partner. The therapist is kind and patient and insightful.

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A range of specialised services

While the majority of sessions are delivered as part of our psychodynamic and psychoanalytic services, a wide range of other specialised services are also available, which include the Parenting Services, Psychosexual Therapy, Mentalization-Based Therapy for Couples, our Divorce and Separation Consultation Service and the Relationship Focussed Group Therapy for Individuals.

We were once again able to make use of a grant from the Peter Stebbings Trust which allowed us to provide some sessions completely free of charge to clients who would otherwise have been unable to access treatment within our specialist services.

In response to the difficulties arising from the pandemic, we introduced a new service called Living with Lockdown. This foursession brief intervention enabled clients to make use of therapy in a time when it may have felt difficult to make long term commitments. The service was available at a low fee price to support those on lower incomes with accessing support.

Tavistock provide an amazing service. Thank you for making this an easy process despite lockdown!

Clinical therapy outcomes

Routine outcome data and feedback from our clients have been collected throughout the year to monitor our service. Satisfaction with the service continued to be high, as was clients’ significant improvement according to the outcome data.

We assess clients using psychometric measures at the initial consultation and during the course of their therapy at the following time-points: six weeks, three months, six months, nine months, 12 months and the end of therapy.

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Psychometric measures

Three psychometric measures are used at each time point in order to measure clients’ a) psychological distress, b) relationship satisfaction, and c) report of their child’s outcome.

Psychological distress

Psychological distress was measured by the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM)[3] .

Average scores on this measure dropped below the clinical range at week 6 of treatment, and dropped further at the end of therapy. Statistical analysis showed that the improvement from intake to week 6 was significant, and 64% of clients who were within the clinical range at intake had moved to the non-clinical range at the end of therapy (the percentage of clients who recovered clinically in the NHS psychological therapy services 2018-19, Improving Access to Psychological Therapy (IAPT), is 52.1% nationally[4] .)

Relationship satisfaction

Relationship satisfaction was measured by the Couple Satisfaction Index (CSI)[5] . Significant improvement was found at week 6 to the end of therapy from intake: from intake to week 6; from intake to month 6, from intake to month 9, from intake to month 12 and from intake to end of therapy. Relationship satisfaction at the end of therapy was higher than any other time point – and shows a highly significant improvement in relationship satisfaction at the end of psychotherapy.

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My therapist was absolutely great. Insightful, thoughtful, measured, supportive, challenging, patient, kind and humorous when appropriate.

Child wellbeing

Child Wellbeing was measured by the Strengths and Difficulties Questionnaire (SDQ)[6] . This is a scale on which parents rate their children’s behavioural problems, which they rate as decreasing at week 6, month 3, month 9 and the end of therapy.

Satisfaction with clinical services

Analysis of clients’ feedback collected at week 6 and at the end of therapy indicates that the vast majority of clients were highly satisfied with our service.

The sessions provided a safe space to talk openly about our problems. Sessions were often difficult but did lead us to understand each other better.

Having a dedicated time and space for my partner and I to discuss our issues, with the impartial presence of a therapist, has been very useful and beneficial. I feel that our therapist takes us seriously, is fair and balanced and makes us listen to and think differently about each other.

3 Barkham, M., Mellor-Clark, J., Connell, J., & Cahill, J. (2006). A core approach to practice-based evidence: A brief history of the origins and applications of the CORE-OM and CORE System. Counselling and Psychotherapy Research, 6(1), 3-15.

4 Psychological Therapies: Annual Report on the use of IAPT services, England, 2018/19. https://files.digital.nhs.uk/1C/538E29/psych-ther-2018-19-ann-rep.pdf

5 Funk, J. & Rogge, R. (2007). Testing the ruler with item response theory: Increasing precision of measurement for relationship satisfaction with the Couples Satisfaction Index. Journal of Family Psychology, 21, 572-583.

6 Goodman, R. (1997). The Strengths and Difficulties Questionnaire: A research note. Journal of Child Psychology and Psychiatry , 38, 581-586.

18

Who do we help?

Age

The majority of clients who used our service this year were from the age groups 36 45 and 26-35 (37% and 35% respectively), followed by the age group 46-55 (18%), 56-65 (5%), 18-25 (3%), and 66 or over (2%).

Key 18-25 – 3% 36-45 – 37% 56-65 – 5% 26-35 – 35% 46-55 – 18% 66 or over – 2%

Gender

52% of the clients were female, 47% were male, and 0.49% were Other.

Employment and Disability Status

More than half (65%) of the clients were in full-time employment, 19% were parttime, 4% were students, 3% were full-time homemakers or carers, 2% were retired, and 7% were currently unemployed.

The majority (93%) of the clients were not disabled, and 6% described themselves as having a serious illness or disability. Only 1% of the clients described themselves as receiving statutory sick pay.

Ethnicity

The majority (79%) of the clients reported their ethnicity as White, including White British (53%), other White (23%) and White Irish (3%), followed by Asian (8%), Mixed (7%), Black (5%), and Chinese (1.4).

Sexual orientation

The majority (88%) of the clients were heterosexual, 4% were gay/lesbian, 5% were bisexual, and 2% did not indicate.

Children

50% of our clients had at least one child under 18.

19

Relationship characteristics

~~The majority of the clients were married~~ (45%) or co-habiting (30%), followed by non-cohabitating partners (12%), single (5%), separated or divorced (6%), and civil partnership (1%).

The lengths of the clients’ relationship were: 5% less than 1 year, 34% 1-5 years, 26% 6-10 years, 14% 11-15 years, 10% 16-20 years, 5% 21-25 years, 3% 26-30 years, and 2% more than 30 years. About half of the clients were seeking our service after having had relationship problems for less than 2 years (24% less than 1 year and 30% 1-2 years), 29% had relationship problems for 3 to 6 years, and 12% had problems for 10 years or more.

Key

Separated/divorced – 6% Single – 5% Co-habiting – 30% Non-cohabiting partners – 12% Married – 46% Civil partnership – 1%

City Wellbeing Centre

The City Wellbeing Centre aims to increase the range and access of therapeutic mental health treatments for workers and residents in the City of London and surrounding boroughs, i.e. Tower Hamlets, Camden, Islington, Hackney, Westminster, Southwark and Lambeth. It is supported by the City of London Corporation, who have provided us with premises for a period of three years, with the following outcomes in mind:

• increased breadth of choice of mental health therapies.

• increased accessibility to mental health treatments to all groups of the City of London resident and worker population.

• a sliding-scale fee structure to ensure that the provision of services is available irrespective of income.

• provision of longer-term therapies not widely available through the NHS.

The fit-out of the building was completed by the City Corporation who handed it over to Tavistock Relationships just as the country went into lockdown and, although we held an official launch in September 2020, the pandemic has made it challenging for us to develop the work of the centre. Despite this, we have offered our services online and have worked on a variety of fronts to further the outcomes of the original bid.

20

London ethnicity (2011 data)

Diversity

While we operate nationally, TR staff and clinical service clients predominantly come from London.

We seek to represent in our workforce, and work with clients from diverse communities that represent the population demographic of the area in which we work.

We are focused on ensuring that our service suits the community within which we operate and have been pleased to offer bursaries to support students from minority ethnic backgrounds to enable us to continue to increase diversity in our staff, particularly in senior and teaching roles.

40% representation

Key	London (%)	TR clinical service (%)	TR staff (%)
White British	45	53	39
White Irish	2	3	4
White Other	13	23	16
Mixed Race	5	7	6
Asian/ Asian British	19	8	6
Black/ Black British	13	5	14
Other ethnic	3	1	4
group
Prefer not to say	n/a	n/a	10

Ethnicity of clients in TR clinical service

Ethnic background of TR staff

21

The DWP supported programme for reducing parental conflict has been particularly effective in enabling us to work with diverse communities.

Ethnicity – RPC Hertfordshire CPA[*]

In Hertfordshire, 89% of the population identifies as being white (2016 data).

Key White British – 81% White Irish – 1% White Other – 7% Mixed race – 4% Black African/Caribbean – 2% Asian background – 2% Other ethnic groups – 1% Prefer not to say – 2%

• Buckinghamshire, Cambridgeshire, Peterborough, Hertfordshire, Essex, Southend-on-Sea and Thurrock

Ethnicity – Westminster RPC

In the Westminster contract area, more than 50% of programme participants identified as being from Black, Asian and Minority Ethnic communities.

Key

White British – 26% White Irish – 2% White Other – 13% Mixed race – 10% Asian/Asian British – 23% Black/Black British – 16% Chinese/Other ethnic group – 6% Prefer not to say – 4%

22

Influencing the policy environment

This year we continued to provide the secretariat to the All Party Parliamentary Group for Supporting Couple Relationships and Reducing Parental Conflict. Our first virtual meeting, held in October 2020, led to the creation of the APPG’s #SortItOut campaign. This campaign has garnered the support of more than 30 family, children’s and relationship support organisations, in addition to leading figures in the legal and academic worlds with an interest in improving and reforming systems to ensure that as few children as possible suffer as a result of exposure to frequent, intense and poorly resolved conflict between their parents.

Demonstrating the effectiveness of our work through research

This year has been defined by Covid and the task of moving our research functions online and of dealing with the complications of shifting from largely paper outcome measures to solely online questionnaires and surveys. This work has enabled us to have confidence in our clinical service outcome findings that high quality work continues to be done by our staff, visiting clinicians and our trainee therapists.

In addition to this, the Research team has continued to support the work of the projects that Tavistock Relationships has been running in this period, adding to the value of the data collected by the DWP in the Reducing Parental Conflict Project. We have been able to give timely indications of clinical risk, as well as breaking down outcomes into more meaningful information. These outcome analyses have been helpful in Tavistock Relationships’ policy work, as reported elsewhere.

One of Tavistock Relationships’ two research interns was successful in her application for Clinical Psychology training this year. We are pleased that we have been able to pay our Interns this year, having made a decision to allocate funds to these roles in addition to the experience and training that Interns benefit from by joining Tavistock Relationships. We hope that this will enable a wider range of applicants in the future. In addition to this, we offered 2 Masters student placements to University College London/ Anna Freud Centre with a brief to research the influence of race and ethnicity on our therapeutic work. They will report back in the summer. Our final Doctoral student successfully submitted his thesis for examination in the summer and we celebrated his success later in the year.

23

Financial overview

TR has achieved a pleasing operating surplus for the 2021 financial year of £59k (2020 £121k).

This performance was better than anticipated by the annual budget that anticipated a small operating loss and was bolstered further by positive movement on investment vales and a significant reduction in the defined benefit pension deficit bringing net assets to £1.35m.

Financial performance in FY 2021 was driven by increased revenues across most categories and particularly strong performance from government service revenue including the DWP Reducing Parental Conflict programme, delivered in partnership with our sub-contractors and the NHS increasing access to psychological therapies (IAPT), Couple Therapy for Depression programme (reflected as other training programmes).

----- Start of picture text -----
Total income by source
Key
DIE/DWP Projects/grants Other training programmes
Practitioner training Clinical services
£6,000,000
£5,000,000
£4,000,000
£3,000,000
£2,000,000
£1,000,000
£0
ACT ACT ACT ACT ACT ACT ACT ACT ACT
12/13 13/14 14/15 15/16 16/17 17/18 18/19 19/20 20/21
£5,076,802
£4,658,768
£4,303,889
£4,082,817
£3,914,086
£3,639,135
£3,445,601
£3,337,611
£2,535,486
----- End of picture text -----

24

Staff publications this year

April 2020 – March 2021

The organisation continues to publish in professional peer-reviewed journals and books, as below, and we are delighted that Mary Morgan’s key text ‘Couple State of Mind’ has now been published in Russian.

Abse, S. (2020) ‘Book Review of: How to Flourish as a Psychotherapist by Brett Kahr’, Couple and Family Psychoanalysis, 10(2), pp. 219-221.

Balfour, A. (2020) ‘A Brief History of Tavistock Relationships’, Couple and Family Psychoanalysis, 10(2), pp. 179-185. Also published in: Waddell, M. and Kraemer, S. (eds.) The Tavistock Century 2020 Vision. London: Phoenix Publishing House.

Boerma, M. and Wrottesley, C. (2020) ‘Responses to ‘Should “sensate focus” have a place in couple psychoanalytic psychotherapy’’, Couple and Family Psychoanalysis, 10(2), pp. 198-202.

Clulow, C. (2021a) ‘Book Review of: The Brain has a Mind of its Own: Attachment, Neurobiology and the New Science of Psychotherapy by Jeremy Holmes ‘, Couple and Family Psychoanalysis, 11(1), pp. 89-91.

Clulow, C. (2021b) ‘Foreword: Love in an age of Covid 19’, in Scharff, D.E. (ed.) Marriage and Family in Modern China. London: Routledge.

Cowan, P. A. and Cowan, C. P. (2020) ‘Four decades of international collaboration with Tavistock Relationships’, Couple and Family Psychoanalysis, 10(2), pp. 191-197.

Felton, L., Jowett, S., Begg, C. and Zhong, X. (2021) ‘A multistudy examination of the complementarity dimension of the coach-athlete relationship’, Sport, Exercise, and Performance Psychology, 10(1), pp. 27–42.

Hewison, D. (2020) ‘Mental health implications of COVID-19 quarantine and the experience of online couple therapy’, Couple and Family Psychoanalysis, 10(2), pp. 208–218.

Kahr, B. (2020) ‘The Tavistock Institute of Medical Psychology, 1920-2020’, Couple and Family Psychoanalysis, 10(2), pp. 173-178.

Kahr, B. (2021) ‘Micro-separations: how to traumatise your spouse on a daily basis’, Couple and Family Psychoanalysis, 11(1), pp. 76-88.

Ludlam, M. (2020a) ‘Arts Review of: Portrait of the Artist Käthe Kollwitz, Exhibition at The British Museum ‘, Couple and Family Psychoanalysis, 10(2), pp. 224-226.

Ludlam, M. (2020b) ‘Can the “internal couple” be our faithful life-long partner? ‘, Couple and Family Psychoanalysis, 10(2), pp. 129-142.

25

McCann, D., Lucarelli, D. and

Sommantico, M. (2020) ‘Introduction to special edition on homosexualities’, IACFP Review 22(1), pp. 4-8.

McCann, D. and Sandor, C. (2020) ‘Responding to the challenge that same-sex parents pose for psychoanalytic couple and family psychotherapists: Confronting implicit bias.’, IACFP Review 22(1), pp. 96-110.

Moran, P. and Tsatsas, N. (2021) ‘Film Review of: Hope Gap, directed by William Nicholson’, Couple and Family Psychoanalysis, 11(1), pp. 96-98.

Morgan, M. (2020a) ‘Being a couple and developing the capacity for creative parenting: a psychoanalytic perspective’, Journal of Child Psychotherapy, 46(2), pp. 191-205.

Morgan, M. ( 2020b) ‘Tavistock Relationships and the growth of couple psychoanalysis 1988-2019: a personal memoir’, in Waddell, M. and Kraemer, S. (eds.) The Tavistock Century 2020 Vision. London: Phoenix Publishing House.

Nyberg, V. ( 2021) ‘Film Review of: Marriage Story, directed by Noah Baumbach’, Couple and Family Psychoanalysis, 11(1), pp. 94-96.

Sehgal, A. (2021) ‘Fractured families, fractured systems: overcoming the silo mentality in family justice work’, Couple and Family Psychoanalysis, 11(1), pp. 27-40.

Shmueli, A. (2021a) ‘Documentary Review of: Supporting children when parents separate. An online resource from the Centre for Social Policy. A filmed interview of Professor Mervyn Murch by Dr Christopher Clulow ‘, Couple and Family Psychoanalysis, 11(1), pp. 99-100.

Shmueli, A. (2021b) ‘Notes on working with divorcing and separating couples’, Couple and Family Psychoanalysis, 11(1), pp. 1-13.

Thompson, K. (2021a) ‘Book Review of: Psychoanalytic Approaches to Loss: Mourning, Melancholia and Couples edited by Timothy Keogh and Cynthia Gregory-Roberts ‘, Couple and Family Psychoanalysis, 11(1), pp. 91-93.

Thompson, K. (2021b) ‘Editorial, Special Issue on Separation and Divorce’, Couple and Family Psychoanalysis, 11(1).

Thompson, K. (2021c) ‘In it together’, Drink and Drugs News, (April), pp. 20-21.

O’Connor, M. (2020) ‘Arts Review of: Fairview by Jackie Sibblies Drury, directed by Nadia Latif’, Couple and Family Psychoanalysis, 10(2), pp. 229-230.

Pacey, S. and Tsatsas, N. (2020) ‘Arts Review of: The Wife, directed by Björn Junge’, Couple and Family Psychoanalysis, 10(2), pp. 227-228.

Polek, E., Balfour, A., Williams, A.,

Monger, E. (2020). Pilot validation study on the Tavistock Relationships Observational Scale (TROS) for the assessment of the quality of dyadic relationships in couples in which one partner has dementia. Journal of Nursing Measures (in press).

23

Improving Lives for Generations

Contact us:

Hallam House, 56-60 Hallam Street,

and

020 7380 1975

020 7380 8288

www.TavistockRelationships.ac.uk

Press:

020 7380 1952

Clinical Services:

020 7380 1960

Social:

Registered Charity Number: 211058.

registered in England and Wales.

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

TRUSTEES' REPORT (CONTINUED)

FOR THE YEAR ENDED 31 MARCH 2021

TRUSTEES RESPONSIBILITIES

The Trustees (who are also directors of Tavistock Institute of Medical Psychology for the purposes of company law) are responsible for preparing the Trustees' Report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice).

Company law requires the Trustees to prepare financial statements for each financial year. Under company law the Trustees must not approve the financial statements unless they are satisfied that they give a true and fair view of the state of affairs of the charitable company and of the incoming resources and application of resources, including the income and expenditure, of the charitable company for that period. In preparing these financial statements, the Trustees are required to:

• select suitable accounting policies and then apply them consistently;

• observe the methods and principles in the Charities SORP;

• make judgments and accounting estimates that are reasonable and prudent;

• state whether applicable UK Accounting Standards have been followed, subject to any material departures disclosed and explained in the financial statements;

• prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charitable company will continue in operation.

The Trustees are responsible for keeping adequate accounting records that are sufficient to show and explain the charitable company's transactions and disclose with reasonable accuracy at any time the financial position of the charitable company and enable them to ensure that the financial statements comply with the Companies Act 2006. They are also responsible for safeguarding the assets of the charitable company and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

AUDITOR

Each of the persons who are Trustees at the time when this Trustees' Report is approved has confirmed that:

• so far as that Trustee is aware, there is no relevant audit information of which the charitable company's auditors are unaware, and

• that Trustee has taken all the steps that ought to have been taken as a Trustee in order to be aware of any relevant audit information and to establish that the charitable company's auditors are aware of that information.

In preparing this report, the trustees have taken advantage of the small company exemptions provided by section 415A of the Companies Act 2006.

This report was approved by the Trustees and signed on their behalf by:

N Pearce

(Trustee) Date: 17 December 2021

Page 28

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY (A Company Limited by Guarantee)

INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

FOR THE YEAR ENDED 31 MARCH 2021

Opinion

We have audited the financial statements of Tavistock Institute of Medical Psychology (the 'charity') for the year ended 31 March 2021 which comprise the Statement of Financial Activities, the Balance Sheet, the Statement of Cash Flows and the related notes, including a summary of 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 charitable company's affairs as at 31 March 2021 and of its 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 Auditors' 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 United Kingdom, including the Financial Reporting Council'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 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.

Page 29

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY (CONTINUED)

FOR THE YEAR ENDED 31 MARCH 2021

Other information

The other information comprises the information included in the Annual Report other than the financial statements and our Auditors' Report thereon. The Trustees are responsible for the other information contained within 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 this gives rise to 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.

Opinion on other matters prescribed by the Companies Act 2006

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

• the information given in the Trustees' Report for the financial year for which the financial statements are prepared is consistent with the financial statements.

• the Trustees' Report has been prepared in accordance with applicable legal requirements.

Matters on which we are required to report by exception

In the light of our knowledge and understanding of the charitable company and its environment obtained in the course of the audit, we have not identified material misstatements in the Trustees' Report.

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

• adequate accounting records have not been kept, or returns adequate for our audit have not been received from branches not visited by us; or

• the 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; or

• the Trustees were not entitled to prepare the financial statements in accordance with the small companies regime and take advantage of the small companies' exemptions in preparing the Trustees' Report and from the requirement to prepare a Strategic Report.

Page 30

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY (CONTINUED)

FOR THE YEAR ENDED 31 MARCH 2021

Responsibilities of trustees

As explained more fully in the Trustees' Responsibilities Statement, 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 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 charitable company or to cease operations, or have no realistic alternative but to do so.

Auditors' responsibilities for the audit of the financial statements

We have been appointed as auditor under section 144 of the Charities Act 2011 and report in accordance with the Act and relevant regulations made or having effect thereunder

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 Auditors' 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 the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements.

Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud. our

In identifying and assessing risks of material misstatement in respect of irregularities, including fraud and noncompliance with laws and regulations, we considered the following:

• The nature of the sector and the impact of Covid 19 on financial and operating performance and policies;

• Enquiries of management, including obtaining and reviewing supporting documentation, concerning the charity’s policies and procedures relating to:

• ° identifying, evaluating and complying with laws and regulations and whether they were aware of any instances of non-compliance

• ° detecting and responding to the risks of fraud and whether they have knowledge of any actual, suspected or alleged fraud; and

• ° the internal controls established to mitigate risks related to fraud or non-compliance of laws and regulations; and

• Discussions among the engagement team regarding how and where fraud might occur in the financial statements and any potential indicators of fraud. The engagement team includes audit partners and staff who have extensive experience of working with charities in similar sectors and this experience was relevant to the discussion about where fraud risks might arise.

We also obtained an understanding of the legal and regulatory framework that the charity operates in, focusing on provisions of those laws and regulations that had direct effect on the determination of material amounts and disclosures in the financial statements. The key laws and regulations we considered in this context included the UK Charities Act, Charities SORP 2019 and the Companies Act 2006.

In addition, we considered provisions of other laws and regulations that do not have a direct effect on the financial statements but compliance with which may be fundamental to the charity's ability to operate or to avoid a material penalty.

Page 31

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY (CONTINUED)

FOR THE YEAR ENDED 31 MARCH 2021

As a result of these procedures, we considered the particular areas that were susceptible to misstatement due to irregularities, including fraud were in respect of the revenue recognition and management override.

Our procedures to respond to risks identified included the following:

• reviewing the financial statement disclosures and testing to supporting documentation to assess compliance with provisions of relevant laws and regulations described as having a direct effect on the financial statements;

• enquiring of management concerning actual and potential litigation and claims;

• performing analytical procedures to identify any unusual or unexpected relationships that may indicate risks of material misstatement due to fraud;

• reading minutes of meetings of those charged with governance;

• in addressing the risk of fraud through management override of controls; assessing whether the judgements made in making accounting estimates are indicative of a potential bias; and evaluating the rationale of any significant transactions that are unusual or outside the normal course of the charity’s operations.

• reviewing contracts and grant agreements to verify that recognition of income is in line with accounting policies.

There are inherent limitations in the audit procedures described above and the further removed non-compliance with laws and regulations is from the events and transactions reflected in the financial statements, the less likely we would become aware of it. 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.

A further description of our responsibilities for the audit of the financial statements is located on the Financial Reporting Council's website at: www.frc.org.uk/auditorsresponsibilities. This description forms part of our Auditors' Report.

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 we are required to state to them in an Auditors' Report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the charitable company and its members, as a body, for our audit work, for this report, or for the opinions we have formed.

David Chandra (Senior Statutory Auditor)

for and on behalf of

Lubbock Fine LLP

Chartered Accountants & Statutory Auditors 3rd Floor, Paternoster House

65 St Paul's Churchyard London EC4M 8AB

Date:

Page 32

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

STATEMENT OF FINANCIAL ACTIVITIES INCORPORATING INCOME AND EXPENDITURE ACCOUNT FOR THE YEAR ENDED 31 MARCH 2021

Note Income from: Donations and grants 3 Charitable activities 4 Investments 5 Other income 6 Total income Expenditure on: Charitable activities 7 Total expenditure Net income/(expenditure) before net gains/(losses) on investments Net gains/(losses) on investments Net movement in funds before other recognised gains/(losses) Other recognised gains/(losses): Actuarial gains/(losses) on defined benefit pension schemes 21 Net movement in funds Reconciliation of funds: Total funds brought forward Net movement in funds Total funds carried forward	Unrestricted funds 2021 £ 58,913 5,061,616 8,038 88,109 5,216,676 5,154,609 5,154,609 62,067 70,637 132,704 458,000 590,704 710,983 590,704 1,301,687	Restricted funds 2021 £ - 2,000 - - 2,000 5,103 5,103 (3,103) - (3,103) - (3,103) 53,500 (3,103) 50,397	Total funds 2021 £ 58,913 5,063,616 8,038 88,109 5,218,676 5,159,712 5,159,712 58,964 70,637 129,601 458,000 587,601 764,483 587,601 1,352,084	Total funds 2020 £ 3,000 4,648,134 8,324 16,243 4,675,701 4,554,735 4,554,735 120,966 (23,017) 97,949 (300,000) (202,051) 966,534 (202,051) 764,483

The notes on pages 37 to 59 form part of these financial statements.

Page 33

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

REGISTERED NUMBER: 241618

BALANCE SHEET

AS AT 31 MARCH 2021

Note Fixed assets Intangible assets 11 Tangible assets 12 Investments 13 Current assets Debtors 14 Cash at bank and in hand Creditors: amounts falling due within one year 15 Net current assets Total assets less current liabilities Net assets excluding pension liability Defined benefit pension scheme liability 21 Total net assets Charity funds Restricted funds 16 Unrestricted funds excluding pension asset 16 Pension reserve 16 Total unrestricted funds 16 Total funds	2021 £ 849,480 493,180 1,342,660 (1,321,015) 1,382,687 (81,000)	2021 £ 74,138 665,773 671,528 1,411,439 21,645 1,433,084 1,433,084 (81,000) 1,352,084 50,397 1,301,687 1,352,084	2020 £ 709,360 365,081 1,074,441 (1,071,647) 1,286,983 (576,000)	2020 £ 56,457 708,878 572,354 1,337,689 2,794 1,340,483 1,340,483 (576,000) 764,483 53,500 710,983 764,483

Page 34

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY (A Company Limited by Guarantee)

REGISTERED NUMBER: 241618

BALANCE SHEET (CONTINUED)

AS AT 31 MARCH 2021

The financial statements have been prepared in accordance with the provisions applicable to entities subject to the small companies regime.

The financial statements were approved and authorised for issue by the Trustees and signed on their behalf by:

N Pearce

(Trustee) Date: 17 December 2021

The notes on pages 37 to 59 form part of these financial statements.

Page 35

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

STATEMENT OF CASH FLOWS

FOR THE YEAR ENDED 31 MARCH 2021

Note Cash flows from operating activities Net cash provided by/(used in) operating activities 18 Cash flows from investing activities Dividends, interests and rents from investments Purchase of tangible fixed assets Proceeds from sale of investments Purchase of investments Net cash (used in)/provided by investing activities Change in cash and cash equivalents in the year Cash and cash equivalents at the beginning of the year Cash and cash equivalents at the end of the year 19	2021 £ 264,441 8,038 (112,388) 800,556 (829,090) (132,884) 131,557 361,623 493,180	2020 £ (52,090) 8,324 (290,296) 846,393 (497,988) 66,433 14,343 347,280 361,623

The notes on pages 37 to 59 form part of these financial statements

Page 36

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2021

1. Accounting policies

1.1 Basis of preparation of financial statements

The financial statements have been prepared in accordance with the Charities SORP (FRS 102) - Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2019), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Companies Act 2006.

Tavistock Institute of Medical Psychology meets the definition of a public benefit entity under FRS 102. Assets and liabilities are initially recognised at historical cost or transaction value unless otherwise stated in the relevant accounting policy.

1.2 Going concern

The Charity's focus and level of operations is dependent on the availability of working capital provided by grants, contracts, donations and other income. The Board of Trustees are continuously monitoring the activities carried out by the Charity in order to ensure that sufficient income from services is available to cover the running expenses and will be available to cover the agreed contributions to the now-closed pension scheme as set out in note 21.

The Board of Trustees have prepared detailed forecasts for the period ended 31 December 2022 and anticipated results for periods thereafter which confirm that the Charity is expected to have the resources to continue as a going concern.

On 11 March 2020, the World Health Organisation declared the novel strain of coronavirus (COVID19) a global pandemic, and recommended containment and mitigation measures worldwide. This is a fast moving situation and the overall impact on charities and the economy is still unclear. The trustees have made an initial consideration of the impact of the pandemic on the charity and believe that the charity will continue to trade as it has been able to move its services online and will be able to rely on its reserves, contract and grant income to support any unforeseen decreases in clinical and training income.

On this basis, the Trustees consider it appropriate to prepare the financial statements on a going concern basis. The financial statements do not include any adjustment which would result if there was insufficiency of funds available in respect of the Charity's operations.

1.3 Company Status

The Charity is a company limited by guarantee. The members of the company are the Trustees named on page 1 . In the event of the Charity being wound up, the liability in respect of the guarantee is limited to £1 per member of the Charity.

The registered office and principal place of business is 56-60 Hallam Street, London, W1W 6JL.

Page 37

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2021

1. Accounting policies (continued)

1.4 Fund accounting

General funds are unrestricted funds which are available for use at the discretion of the Trustees in furtherance of the general objectives of the Charity and which have not been designated for other purposes.

Restricted funds are funds which are to be used in accordance with specific restrictions imposed by donors or which have been raised by the Charity for particular purposes. The costs of raising and administering such funds are charged against the specific fund. The aim and use of each restricted fund is set out in the notes to the financial statements.

Investment income, gains and losses are allocated to the appropriate fund.

1.5 Income

All income is recognised once the Charity has entitlement to the income, it is probable that the income will be received and the amount of income receivable can be measured reliably.

The recognition of income from legacies is dependent on establishing entitlement, the probability of receipt and the ability to estimate with sufficient accuracy the amount receivable. Evidence of entitlement to a legacy exists when the Charity has sufficient evidence that a gift has been left to them (through knowledge of the existence of a valid will and the death of the benefactor) and the executor is satisfied that the property in question will not be required to satisfy claims in the estate. Receipt of a legacy must be recognised when it is probable that it will be received and the fair value of the amount receivable, which will generally be the expected cash amount to be distributed to the Charity, can be reliably measured.

Income is the total receivable during the year which is recognised on the accruals basis of accounting.

1.6 Training fees

Training fee income is accounted for in the period to which it relates. Income received in advance is held in deferred income.

1.7 Grant and contract income

Revenue and capital grants are accounted for gross when notification is received and conditions are met. Where the grants or contracts specify the time period they relate to, they are recognised as income in that period. Other grant and contract income is recognised as income when received.

1.8 Expenditure

Expenditure is recognised once there is a legal or constructive obligation to make payment to a third party, it is probable that settlement will be required and the amount of the obligation can be measured reliably.

Charitable activity costs are costs incurred on the Charity's operations, including support costs and costs relating to the governance of the Charity apportioned to charitable activities.

Staff costs and overhead expenses are allocated to activities on the basis of staff time spent on those activities.

Page 38

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2021

1. Accounting policies (continued)

1.9 Irrecoverable VAT

The Charity's expenditure is inclusive of input VAT which cannot be recovered where expended for delivery of charitable activity.

1.10 Government grants

Other grants are credited to the Statement of Financial Activities as the related expenditure is incurred.

1.11 Intangible assets and amortisation

Intangible assets costing £1,000 or more are capitalised and recognised when future economic benefits are probable and the cost or value of the asset can be measured reliably.

Intangible assets are initially recognised at cost. After recognition, under the cost model, intangible assets are measured at cost less any accumulated amortisation and any accumulated impairment losses.

Amortisation is provided on intangible assets once ready for use at rates calculated to write off the cost of each asset on a straight-line basis over its expected useful life.

The estimated useful lives are as follows:

Amortisation is provided on the following basis:

Mobile Relationship Support App - 33 %

1.12 Tangible fixed assets and depreciation

Tangible fixed assets are carried at cost, net of depreciation and any provision for impairment. Depreciation is provided at rates calculated to write off the cost of fixed assets, less their estimated residual value, over their expected useful lives on the following bases:

Leasehold fittings - Over term of the lease - Fixtures and fittings 20% per annum straight line - Computer equipment 20 - 33% per annum straight line

1.13 Investments

Investments are a form of basic financial instrument and are initially recognised at their transaction value and subsequently measured at their fair value as at the balance sheet date using the closing quoted market price. The Statement of Financial Activities includes the net gains and losses arising on revaluation and disposals throughout the year.

1.14 Interest receivable

Interest on funds held on deposit is included when receivable and the amount can be measured reliably by the Charity; this is normally upon notification of the interest paid or payable by the institution with whom the funds are deposited.

Page 39

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2021

1. Accounting policies (continued)

1.15 Operating leases

Rentals under operating leases are charged to the Statement of Financial Activities on a straight line basis over the lease term.

Benefits received and receivable as an incentive to sign an operating lease are recognised on a straight line basis over the period until the date the rent is expected to be adjusted to the prevailing market rate unless another systematic basis is representative of the time pattern of the lessee’s benefit from the use of the leased asset.

1.16 Debtors

Trade and other debtors are recognised at the settlement amount after any trade discount offered. Prepayments are valued at the amount prepaid net of any trade discounts due.

1.17 Cash at bank and in hand

Cash at bank and in hand includes cash and short-term highly liquid investments with a short maturity of three months or less from the date of acquisition or opening of the deposit or similar account.

1.18 Creditors and provisions

Creditors and provisions are recognised where the Charity has a present obligation resulting from a past event that will probably result in the transfer of funds to a third party and the amount due to settle the obligation can be measured or estimated reliably. Creditors and provisions are normally recognised at their settlement amount after allowing for any trade discounts due.

Liabilities are recognised at the amount that the Charity anticipates it will pay to settle the debt or the amount it has received as advanced payments for the goods or services it must provide.

Provisions are measured at the best estimate of the amounts required to settle the obligation. Where the effect of the time value of money is material, the provision is based on the present value of those amounts, discounted at the pre-tax discount rate that reflects the risks specific to the liability. The unwinding of the discount is recognised in the Statement of Financial Activities as a finance cost.

1.19 Financial instruments

The Charity only has financial assets and financial liabilities of a kind that qualify as basic financial instruments. Basic financial instruments are initially recognised at transaction value and subsequently measured at their settlement value.

1.20 Defined benefit pension costs

The Charity operated a defined benefit pension scheme for employees. This is now closed. The assets of the scheme are held separately from those of the Charity. The contributions to the scheme are charged to the Statement of Financial Activities so as to spread the cost of pensions over the service lives of employees. Variations from the regular costs are spread over the average expected remaining working lives of current members in the scheme.

Current service costs, past service costs and gains and losses on settlements and curtailments are charged to appropriate resources expended categories in the statement of financial activities. Past service costs are recognised over the vesting period or immediately if the benefits have vested. When a settlement (eliminating all obligations for benefits already accrued) or a curtailment (reducing future obligations as a result of a material reduction in the scheme membership or a reduction in

Page 40

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2021

1. Accounting policies (continued)

1.20 Defined benefit pension costs (continued)

future entitlement) occurs, the obligation and related plan assets are re-measured using current actuarial assumptions and the resultant gain or loss is recognised in the statement of financial activities during the period in which the settlement or curtailment occurs.

The interest cost and the expected return on assets are shown as a net amount as other finance costs or income. Net pension finance costs are allocated to appropriate resources expended categories in the statement of financial activities. Net pension finance income is recognised as an incoming resource in the statement of financial activities. Actuarial gains and losses are recognised immediately as other recognised gains and losses in the statement of financial activities.

Pension scheme liabilities are measured on an actuarial basis using a projected unit method and are discounted to their present value using the discount rate which reflects the yield on an AA rated corporate bond index, which has a duration of around 15 years.

Pension scheme assets are valued at market value at the balance sheet date.

2. Critical accounting estimates and areas of judgment

The preparation of the financial statements requires management to make judgements, estimates and assumptions that affect the application of the accounting policies and the reported amounts of assets and liabilities, revenue and expenses. Actual results may differ from these estimates. Estimates and underlying assumptions are continually evaluated and are based on historical experience and other factors, including expectations that are believed to be reasonable under the circumstances. Revisions to accounting estimates are recognised in the period in which the estimates are revised and in any future periods affected.

The estimates and assumptions that have a significant risk of causing a material adjustment to the carrying amounts of assets and liabilities within the next financial year are as follows:

The charitable company has an obligation to pay pension benefits in respect of a now closed defined benefit pension scheme. The cost of these benefits and the present value of the obligation depend on a number of factors, including; life expectancy, asset valuations and the discount rate. Management estimates these factors in determining the net pension obligation in the Statement of Financial Position. The assumptions reflect historical experience and current trends. See note 21 for the disclosures relating to the defined benefit pension scheme.

Page 41

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2021

3. Income from donations and legacies

Unrestricted funds 2021 £ Donations 4,941 Gifts in kind 53,972 58,913 Unrestricted funds 2020 £ Donations 3,000	Total funds 2021 £ 4,941 53,972
	58,913
	Total funds 2020 £ 3,000

4. Income from charitable activities

Unrestricted funds 2021 £ IAPT Training fees 281,182 Training fees 626,063 Client fees 1,287,502 Proceeds from sale of publications and miscellaneous income 445 Project income 2,388,114 Client fees received for trainee services 478,310 5,061,616	Restricted funds 2021 £ - - - - 2,000 - 2,000	Total funds 2021 £ 281,182 626,063 1,287,502 445 2,390,114 478,310
		5,063,616

Page 42

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2021

4. Income from charitable activities (continued)

Unrestricted funds 2020 £ IAPT Training fees 229,972 Training fees 605,179 Client fees 1,281,329 Proceeds from sale of publications and miscellaneous income 813 Project income 1,746,053 Client fees received for trainee services 418,591 4,281,937	Restricted funds 2020 £ - - - - 366,197 - 366,197	Total funds 2020 £ 229,972 605,179 1,281,329 813 2,112,250 418,591
		4,648,134

5. Investment income

Unrestricted funds 2021 £ Income from investments 7,857 Bank interest 181 8,038 Unrestricted funds 2020 £ Income from investments 7,997 Bank interest 327 8,324	Total funds 2021 £ 7,857 181
	8,038
	Total funds 2020 £ 7,997 327
	8,324

Page 43

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2021

6. Other incoming resources

Other income Furlough income Other income	Unrestricted funds 2021 £ 17,497 70,612 88,109 Unrestricted funds 2020 £ 16,243	Total funds 2021 £ 17,497 70,612
		88,109
		Total funds 2020 £ 16,243

7. Analysis of expenditure by fund type

Unrestricted funds 2021 £ Advice, Counselling and Training 5,154,609 Unrestricted funds 2020 £ Advice, Counselling and Training 4,242,038	Restricted funds 2021 £ 5,103 Restricted funds 2020 £ 312,697	Total funds 2021 £ 5,159,712
		Total funds 2020 £ 4,554,735

Page 44

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2021

8. Analysis of expenditure by activities

Advice, Counselling and Training Advice, Counselling and Training	Activities undertaken directly 2021 £ 4,085,992 Activities undertaken directly 2020 £ 3,582,423	Support costs 2021 £ 1,073,720 Support costs 2020 £ 972,312	Total funds 2021 £ 5,159,712
			Total funds 2020 £ 4,554,735

Analysis of support costs

Staff costs Depreciation and amortisation Pension scheme costs Marketing Rent and services Office and maintenance and equipment costs Rates Dilapidation accrual Other support costs Finance costs Total 2021	Advice, Counselling and Training 2021 £ 339,474 137,812 61,410 85,193 162,791 27,539 14,052 2,760 201,326 41,363 1,073,720	Total funds 2021 £ 339,474 137,812 61,410 85,193 162,791 27,539 14,052 2,760 201,326 41,363
		1,073,720

Page 45

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2021

8. Analysis of expenditure by activities (continued)

Analysis of support costs (continued)

Staff costs Depreciation Pension scheme costs Marketing Rent and services Office and maintenance and equipment costs Rates Dilapidation accrual Other support costs Finance costs Total 2020	Advice, Counselling and Training 2020 £ 453,501 115,915 56,534 59,040 70,311 29,895 13,516 1,526 144,335 27,739 972,312	Total funds 2020 £ 453,501 115,915 56,534 59,040 70,311 29,895 13,516 1,526 144,335 27,739
		972,312

77% (2020: 82%) of the following expenditure categories are allocated to direct costs and 23% (2020: 18%) are allocated to support costs:

• Rent and services

• Office and maintenance and equipment costs

• Rates

• Dilapidation accrual

9. Net income/(expenditure)

This is stated after charging:

	2021	2020
	£	£
Depreciation of tangible fixed assets:
- owned by the charity	133,609	115,915
Auditors' remuneration - audit	15,000	14,700
Auditors' remuneration - other services	9,849	5,643
Staff pension contribution	112,846	111,364
Operating lease rentals	424,783	351,593

Page 46

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2021

10. Staff costs

Wages and salaries Social security costs Contribution to defined contribution pension schemes	2021 £ 1,821,295 176,999 112,846 2,111,140	2020 £ 1,761,653 163,946 111,364
		2,036,963

Pension costs relate to the charity's contributions to the employee personal pension schemes and do not include the administrative and finance costs in connection with the closed defined benefit scheme (see note 21).

The average number of persons employed by the Charity during the year was as follows:

Therapists Other Direct staff Support staff	2021 No. 16 22 13 51	2020 No. 18 23 11
		52

The number of employees whose employee benefits (excluding employer pension costs) exceeded £60,000 was:

		2021	2020
		No.	No.
In the band £60,001	- £70,000	1	3
In the band £70,001	- £80,000	1	-
In the band £90,001	- £100,000	1	1

Pension contributions of £15,802 (2020 - £13,492) were made in the year to the above higher paid employees.

Key management personnel received remuneration of £386,555 (2020 - £363,450) during the year ended 31 March 2021.

Particulars of Trustees' Remuneration and Expenses:

The Trustees received no remuneration, benefits in kind or reimbursement of expenditure during the current or prior year.

Page 47

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2021

11. Intangible assets

Cost At 1 April 2020 Additions At 31 March 2021 Amortisation Charge for the year At 31 March 2021 Net book value At 31 March 2021 At 31 March 2020	App develop -ment £ 56,457 21,884
	78,341
	4,203
	4,203
	74,138
	56,457

The additions in the year relate to the development of an application which was not operational until 1 February 2021 and therefore amortisation has only been charged since this date.

Page 48

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2021

12. Tangible fixed assets

Cost or valuation At 1 April 2020 Additions Disposals At 31 March 2021 Depreciation At 1 April 2020 Charge for the year On disposals At 31 March 2021 Net book value At 31 March 2021 At 31 March 2020	Leasehold improve -ments £ 896,719 11,489 (264,718) 643,490 402,392 57,351 (264,718) 195,025 448,465 494,327	Fixtures and fittings £ 153,040 - - 153,040 85,834 18,171 - 104,005 49,035 67,206	Computer equipment £ 276,704 79,015 (33,217) 322,502 129,359 58,087 (33,217) 154,229 168,273 147,345	Total £ 1,326,463 90,504 (297,935) 1,119,032 617,585 133,609 (297,935) 453,259 665,773 708,878

Page 49

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2021

13. Fixed asset investments

Cost or valuation At 1 April 2020 Additions Disposals Revaluations At 31 March 2021 Net book value At 31 March 2021 At 31 March 2020 Net (losses)/gains on investments	2021	Listed investments £ 572,354 829,090 (733,125) 3,209 671,528 671,528 572,354 2020
	£	£
Unrealised gains/(losses)	3,209	(57,273)
Realised gains/(losses)	67,428	34,256
Total	70,637	(23,017)

14. Debtors

Due after more than one year Other debtors Due within one year Trade debtors Other debtors Prepayments Accrued income	2021 £ 5,600 5,600 374,397 11,173 230,737 227,573 849,480	2020 £ 9,701 9,701 300,832 12,829 243,874 142,124 709,360

Page 50

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2021

15. Creditors: Amounts falling due within one year

Bank overdrafts Trade creditors Other taxation and social security Other creditors Deferred income	2021 £ - 343,181 54,289 636,243 287,302 1,321,015	2020 £ 3,458 272,343 44,352 332,916 418,578
		1,071,647

Deferred income relates to training courses which straddle the financial year end or are paid for in advance. Of the deferred income brought forward of £418,578, £393,963 was released in the year with additional deferred income introduced of £262,687 in the year.

Page 51

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2021

16. Statement of funds

Statement of funds - current year

Unrestricted funds Revaluation reserves General reserves Pension reserve Restricted funds Technology infrastructure grant DWP RPC Marketing grant Total of funds	Balance at 1 April 2020 £ 104,197 1,182,786 (576,000) 710,983 53,500 - 53,500 764,483	Income £ - 5,166,676 50,000 5,216,676 - 2,000 2,000 5,218,676	Expenditure £ - (5,141,609) (13,000) (5,154,609) (4,203) (900) (5,103) (5,159,712)	Gains/ (Losses) £ 3,209 67,428 458,000 528,637 - - - 528,637	Balance at 31 March 2021 £ 107,406 1,275,281 (81,000) 1,301,687 49,297 1,100 50,397 1,352,084

Page 52

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2021

16. Statement of funds (continued)

Statement of funds - prior year

	Balance at	Balance at					Transfers	Transfers	Gains/	Gains/		Balance at
1	April 2019		Income		Expenditure		in/out		(Losses)		31	March 2020
		£		£		£		£		£		£
Unrestricted
funds
Designated funds
Operating reserves		932,996			-		-	(932,996)			-	-
Capital reserves		195,068			-		-	(195,068)			-	-
		1,128,064			-		-	(1,128,064)			-	-
General funds
Revaluation reserves		161,470			-		-		-		(57,273)	104,197
General reserves		-		4,309,504		(4,235,038)		1,074,064			34,256	1,182,786
Pension reserve		(323,000)			-		(7,000)		54,000	(300,000)		(576,000)
		(161,530)		4,309,504		(4,242,038)		1,128,064		(323,017)		710,983
Total Unrestricted
funds		966,534			-	(4,242,038)			-	(323,017)		710,983
Restricted funds
DOHSC Grant		-			74,839		(74,839)		-		-	-
DWP RPC -
Challenge Fund
grant		-			229,654	(229,654)			-		-	-
DWP RPC -
Marketing		-			8,204		(8,204)		-		-	-
Technology
infrastructure grant		-			53,500		-		-		-	53,500
		-			366,197	(312,697)			-		-	53,500
Total of funds		966,534			366,197	(4,554,735)			-	(323,017)		764,483

Page 53

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2021

Designated funds:

Designated funds are amounts earmarked by the charity for a specific use in the future and as such are treated as unrestricted reserves.

Restricted funds:

The Department of Health and Social Care (DoHSC) grant aims to provide support to children with alcohol dependent parents.

The DWP RPC – Challenge Fund grant aims to train Practioners in MBS tools and techniques as well as provide parental couples to participate in MBA services.

The DWP RPC – Marketing grant aims to promote awareness for the DWP Hertfordshire and Westminster programmes.

The Technology infrastructure grant is to be used towards the building of an application to deliver digital therapy for couples where one or both are diagnosed with depression.

Transfers:

In the current year there was a £50,000 (2020: £54,000) transfer from the operating reserve to the Pension reserve. This represents the payments made by the charitable company to the defined benefit pension scheme.

17. Analysis of net assets between funds

Analysis of net assets between funds - current year

Unrestricted funds 2021 £ Tangible fixed assets 665,773 Intangible fixed assets 24,841 Fixed asset investments 671,528 Debtors due after more than one year 5,600 Current assets 1,335,960 Creditors due within one year (1,321,015) Provisions for liabilities and charges (81,000) Total 1,301,687	Restricted funds 2021 £ - 49,297 - - 1,100 - - 50,397	Total funds 2021 £ 665,773 74,138 671,528 5,600 1,337,060 (1,321,015) (81,000) 1,352,084

Page 54

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2021

17. Analysis of net assets between funds (continued) Analysis of net assets between funds - prior year

Unrestricted funds 2020 £ Tangible fixed assets 708,878 Intangible fixed assets 2,957 Fixed asset investments 572,354 Debtors due after more than one year 9,701 Current assets 1,064,740 Creditors due within one year (1,071,647) Provisions for liabilities and charges (576,000) Total 710,983	Restricted funds 2020 £ - 53,500 - - - - - 53,500	Total funds 2020 £ 708,878 56,457 572,354 9,701 1,064,740 (1,071,647) (576,000) 764,483

18. Reconciliation of net movement in funds to net cash flow from operating activities

Net income for the year (as per Statement of Financial Activities) Adjustments for: Depreciation and amortisation charges Losses on investments Dividends, interests and rents from investments Other (losses)/ gains Decrease/(increase) in debtors Increase/(decrease) in creditors Net cash (used in)/provided by operating activities	2021 £ 129,601 137,812 (67,430) (8,038) 458,000 (140,120) (245,384) 264,441	2020 £ 97,949 115,915 (57,273) (8,324) (300,000) 63,947 35,696 (52,090)

Page 55

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2021

19. Analysis of cash and cash equivalents

Cash in hand Cash held by broker Overdraft facility repayable on demand Total cash and cash equivalents	2021 £ 440,774 52,406 - 493,180	2020 £ 288,216 76,865 (3,458) 361,623

20. Analysis of changes in net debt

Cash at bank and in hand Bank overdrafts repayable on demand	At 1 April 2020 £ 365,081 (3,458) 361,623	Cash flows £ 128,099 3,458 131,557	At 31 March 2021 £ 493,180 - 493,180

21. Pension commitments

The Charity operates a defined benefit pension scheme. Principal actuarial assumptions at the Balance Sheet date (expressed as weighted averages):

	At 31 March	At 31 March
	2021	2020
	%	%
Discount rate	2.05	2.3
Rate of increase in price (RPI)	3.35	2.9

The Charity operated a pension scheme in the UK providing benefits based on final pensionable salary (a "defined benefits" scheme). The assets of the scheme are held separately from those of the Charity, being invested with insurance companies. This scheme has closed to new members.

Since employees will no longer be accruing a final salary pension after 31 March 2005, the employer has arranged for a replacement pension arrangement. This is entirely separate from the final salary scheme. This is in the form of a personal pension scheme, which belongs to the employee, but to which the employer contributes. The assets of the personal pension schemes are held separately from those of the charity in independently administered funds. The charge for the year was £112,846 (2020 - £111,364).

In respect of the final salary scheme, a full actuarial valuation was carried out at 31 March 2013.

In order to reduce the deficit on the pension fund the charity has committed to paying £50,000 (2020 - £54,000) per annum to the pension scheme.

Page 56

TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2021

21. Pension commitments (continued)

	2021	2020
	%	%
Equities (UK and overseas)	32	25
Fixed interest	30	30
Cash	2	3
Prudential Annuities	36	42

The Charity's share of the assets in the scheme was:

Equities Debt Instruments Cash and other liquid assets Prudential Annuities Total fair value of assets	At 31 March 2021 £ 2,042,000 1,970,000 130,000 2,340,000 6,482,000	At 31 March 2020 £ 1,495,000 1,782,000 186,000 2,473,000 5,936,000

The actual return on scheme assets was £822,000 (2020 - £(366,000)).

The amounts recognised in the Statement of Financial Activities are as follows:

2021 £ Interest cost 13,000 Movements in the present value of the defined benefit obligation were as follows: Opening defined benefit obligation Interest costs on defined benefit obligation Actuarial (gains)/losses Return on scheme assets excluding interest Benefits paid Closing defined benefit obligation	2020 £ 7,000 2021 £ 6,512,000 146,000 (458,000) 689,000 (326,000) 6,563,000

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TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2021

21. Pension commitments (continued)

Movements in the fair value of the Charity's share of scheme assets were as follows:

Opening fair value of scheme assets Interest income Return on scheme assets excluding interest income Contributions by employer Benefits paid Closing fair value of scheme assets	2021 £ 5,936,000 133,000 689,000 50,000 (326,000) 6,482,000

Amounts for the current and previous period are as follows:

Defined benefit pension schemes

	2021	2020
	£	£
Defined benefit obligation	(6,563,000)	(6,512,000)
Scheme assets	6,482,000	5,936,000
Deficit	(81,000)	(576,000)

Remeasurement of net defined benefit obligation

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TAVISTOCK INSTITUTE OF MEDICAL PSYCHOLOGY

(A Company Limited by Guarantee)

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2021

22. Operating lease commitments

At 31 March 2021 the Charity had commitments to make future minimum lease payments under noncancellable operating leases as follows:

Within 1 year Between 1 and 5 years After more than 5 years	2021 £ 578,142 2,153,883 1,695,165 4,427,190	2020 £ 338,142 2,313,883 2,113,307
		4,765,332

The following lease payments have been recognised as an expense in the Statement of Financial Activities:

	2021	2020
	£	£
Operating lease rentals	409,155	351,593

23. Related party transactions

There were no related party transactions in the current or prior year.

24. Post balance sheet events

The ongoing COVID-19 pandemic has adversely impacted global markets since inception, and it is expected that this could also adversely affect the value of the investments held by the Charity and income generated from these investments in the future. The extent of the impact on the value of investments held by the Charity will depend on future developments, including the duration and future spread of the outbreak, related advice and restrictions and the impact of COVID-19 on the financial markets and the overall economy, all of which are highly uncertain and cannot be predicted. If the financial markets and/or the overall economy are impacted for an extended period, the Charity’s results may be adversely affected and this could have an impact on the valuation of the Charity’s investments and the income generated from these investments. The Trustees are being kept up to date on the performance of the investment portfolio and will take the necessary steps to mitigate any significant adverse impact on the valuation of investments and income generated from these investments.

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