**Accounts April 2020 – March 2021** 




Launch of the Nightingale Frontline Leadership Support Service to support nurses and midwives during the COVID-19 pandemic, April 2020. 


Launch of the public fundraising appeal “Florence Nightingale White Rose Appeal”, ambassador Helena Bonham Carter CBE, 12[th] May 2020. 


The sole figure of Alumni Arlene Lee and the lamp at Westminster Abbey 12[th] May 2020 represents all nurses and midwives who had given so much during the pandemic and some had paid the ultimate sacrifice. 


Launch of “Nurse Behind the Mask” campaign 5[th] July 2020. 


Chair Dame Yvonne Moores DBE presented Geoffrey Walker with an FNF commemorative dish following 22 years’ service as a Trustee, Deputy Chair and Honorary Vice President of the Foundation, September 2020. 

Peter Siddall, Mary Spinks, Byran Wilson, Edward Libby and Colin Reeves also received the gift at the end of their tenures. 

umbers: 229229 England 


CEO Greta Westwood CBE and Director of the FNF Academy Gemma Stacey both returned to the NHS in January to support the UK vaccination programme. 

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Florence Nightingale Foundation Annual Report and Accounts 2020-21 

## **Contents** 

## **Annual Report** 

|Legal and Administration Information||6|
|---|---|---|
|Chair’s Introductions||8|
|Chief Executive’s Report||10|
|FNF – The Year in Pictures||12|
|**Report of the Trustees**||14|
|About the Foundation||14|
|Aims, Objectives and Activities||14|
|Our Vision||14|
|Our Mission||15|
|Our Values||15|
|Our Promise||15|
|Public Benefit||15|
|Strategic Plan||16|
|Activities and Performance||16|
|Financial Review||32|
|Fundraising||34|
|Governance and Risk||37|
|**Annual Accounts**|||
|Statement of Trustee Responsibilities||38|
|Report of the Independent Auditor||40|
|Annual Accounts||44|
|**For us who nurse, our**<br>**nursing is a thing which**|||
|**unless we are making**|||
|**progress every year, every**|||
|**month, every week, take my**<br>**word for it, we are going**|||
|**back…Florence Nightingale**|**5**||





Florence Nightingale Foundation Annual Report and Accounts 2020-21 

## **Legal & Administration Information** 

**Royal Patron** 

HRH Princess Alexandra The Hon Lady Ogilvy KG GCVO 

**Patrons** Sir Robert Francis QC Baroness Audrey Emerton DBE, GCStJ, FRCN **President** Baroness Watkins of Tavistock **Vice Presidents** The Rt Hon Lord Remnant CVO FCA Mr Bryan Wilson (Until September 2020) Mrs Avey Bhatia (From September 2020) **Honorary Vice Presidents** Mrs Mary Spinks CBE (Until September 2020) Mr Geoffrey Walker OBE (Until September 2020) **Chair** Dame Yvonne Moores DBE **Vice-Chairman** Mr Andrew Andrews MBE **Treasurer** Mr David Hulf Mr Simon Reiter (Acting from March 2021) 

## **Trustees** 

Mr Peter Siddall (Until September 2020) Mr Edward Libbey (Until September 2020) Professor Dame Jill Macleod Clark DBE Colonel Sharon Findlay Angela McLernon (Until November 2020) Joan Myers OBE Rhiannon Beaumont-Wood Professor Aisha Holloway Mr Peter Kay (from September 2020) Mrs Judy O Sullivan (from January 2021) Mr Simon Reiter (from January 2021) Mr Ben Edwards (from January 2021) 

**Key Management Personnel Chief Executive Officer Director of Academy** 

**Deputy Director of Academy Director of Finance Chief Financial Officer Head of Finance** 

Professor Greta Westwood CBE PhD RN 

Professor Gemma Stacey PhD RMN Lucy Brown (from June 2021) Edith Yembra (from June 2021) 

Andrew Thomas (from July 2020 to June 2021) Andrew Williams (from March to July 2020) 

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Florence Nightingale Foundation Annual Report and Accounts 2020-21 

**Director of Communications** Aysha Awan (Until August 2021) **Marketing and Events: Auditors:** Sayer Vincent LLP Invicta House 108-114 Golden Lane London EC1Y 0TL **Bankers** Coutts & Co 440 The Strand London WC2 0QS CCLA Charity Funds 80 Cheapside London EC2V 6DZ **Registered Office** 10-18 Union Street London SE1 1SZ **Charity Number** Registered in England and Wales with Charity Reg No. 229229  and in Scotland with Charity Reg No. SC044341 **Company Number** 0518623 Incorporated in England 

## **Contact Details** 

Email: admin@florence-nightingale-foundation.org.uk 




@FNightingaleF 

## @fnightingalef 

The Florence Nightingale Foundation 

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Florence Nightingale Foundation Annual Report and Accounts 2020-21 

## **Chair’s Introductions** 



This year will be remembered for all the sadness, suffering and bereavement which the people of the UK have endured, in lockdown, with schools and universities closed for much of the time and the NHS challenged as never before in its history to provide clinical services for so many very sick patients. Yet the Foundation has not only survived but flourished in this challenging environment by being agile, resilient, and responsive. It has sought out opportunities, further developed excellent relationships with key influencers and moved swiftly into the digital world of delivering educational programmes and support. At the outset of the pandemic the Board immediately set up the Chairs Action Group comprising of myself, the Vice-Chairman and Treasurer supported  by the Chief Executive to make quick decisions and support the executive team. 

My congratulations are extended to Professor Greta Westwood on her award of the Commander of the British Empire by Her Majesty the Queen in the New Year honours for her enormous contribution to the nursing and midwifery professions, including her leadership of the Foundation. Her leadership of our executive team throughout this year has been exemplary. 

Our achievements this year have been outstanding, and we have become recognised not only by the profession but much more widely as the “go-to” organisation for excellence in nurse leadership development and in influencing health policy. With the delivery of Nightingale Frontline, our support and emotional wellbeing programme, offered to all front-line nurses and midwives we have reached the many not just the few. The work of the FNF Academy has gone from strength to strength under the leadership of Professor Gemma Stacey including a very positive take up of our membership scheme. The Foundation’s account surplus this year represents nearly half of all the surpluses since the inception of the Foundation! 

I extend my deepest condolences to the family of Bryan Wilson and Theo Noel Smith, both long serving Vice- Presidents, who sadly passed away this year. I am also delighted that Avey Bhatia, Chief Nurse of Guys and St  Thomas’ NHS Foundation Trust, has been appointed as our Vice President. Both Mary Spinks and Geoffrey Walker completed their tenure as Honorary Vice-Presidents and the Foundation 

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Florence Nightingale Foundation Annual Report and Accounts 2020-21 

warmly appreciates their commitment over many years. David Hulf was appointed our Treasurer and the Board welcomes Peter Kay, Judy O’Sullivan, Ben Edwards, and Simon Reiter as new Trustees bringing fresh expertise to our deliberations in finance, investment, fundraising and governance. Peter Siddall, Edward Libbey and Angela McLernon have left the Foundation and again I would like to thank them for their contributions. In March, Simon Reiter became Acting Treasurer whilst David Hulf has taken a period of absence. 

My warmest appreciation to all our sponsors, donors, and supporters and especially our corporate sponsor of the year Nuffield Health for all their financial help during this difficult time. My congratulations to our many scholars and alumni for all their achievements and the impact they have all made on health and care across the UK. 

The future is exciting for the Foundation as the Board has agreed an ambitious business plan including a global strategy for the coming year. This plan and strategy will further extend our influence on people’s health and wellbeing and allow us to invest in even more scholarships to support our future nurse and midwife leaders. 


**Dame Yvonne Moores DBE Chair** 

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Florence Nightingale Foundation Annual Report and Accounts 2020-21 

## **Chief Executive’s Report** 



I write, one year since the start of the COVID-19 pandemic, a pandemic that threatened to derail and even close the Foundation, to report the enormous year that was. Despite this threat FNF has finished this year with a record financial unrestricted surplus, £359,000. This was achieved by my team, support from the Chairs Action Group and the Trustees who guided me throughout the year. My team has been innovative, dynamic, and agile and not only did they react to the here and now but also ensured the plans would impact on growth in the long term. 

The year’s continual focus ensured FNF work was relevant to the major crisis the world was facing and indeed nurses and midwives were a major focus of the pandemic crisis. As COVID-19 hit the UK it was apparent that frontline workers would be faced with challenges they had never faced before. Recognising these difficulties, FNF responded by focussing all its efforts and resources to supporting nurses and midwives at all levels. In April  2020, the “Nightingale Frontline Leadership Support Service” was launched with the sole purpose of providing emotional and wellbeing support to nurses and midwives working on the frontline. Additionally, whilst directing the work of the Foundation both myself and Professor Gemma Stacey, Director of the FNF Academy returned to our local NHS organisations to provide face-to-face Nightingale Frontline sessions from April until June 2020.  We returned once again to support the COVID19 vaccination programme from January until April 2021. 

From April all scholarship and leadership programmes were halted until they were converted to a digital platform  and since September 2020 this has been the exclusive mode of delivery. When able to meet face to face again the programmes will become a blended mix of digital and face to face delivery. FNF launched its first cohort of digital leadership scholars in England and Wales to equip nurses and midwives to lead the delivery of the digital future. Quite remarkably, when also supporting the COVID response, nurses and midwives have found precious time for their professional development, such commitment to their leadership endeavours. 

In September the Foundation launched membership of the FNF Academy, open to all Chief Nurses, Directors of Nursing and Executive Nurse Directors of health and care organisations for the benefit of 

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Florence Nightingale Foundation Annual Report and Accounts 2020-21 

their nurses and midwives. Thirty-four Chief Nurses have joined as members with benefits to approximately 110,000 nurses and midwives. This truly represents an external marker of the Foundation’s increased influence, presence, and impact. I thank Professor Gemma Stacey and her team that ensured all work delivered within year, on time and generated an over budget surplus. 

2020 was Florence Nightingale’s bicentenary, the year two planned major events were cancelled; the Nightingale2020 international conference and the Florence Nightingale Commemoration Service at Westminster Abbey. To recover from these missed major fundraising opportunities, the Foundation launched on 12[th] May 2020, a public fundraising campaign, The Florence Nightingale White Rose Appeal. I am delighted Helena Bonham Carter agreed to and continues to be the campaign ambassador. The fund now stands at £88,180, 88% of the £100,000 target. To replace the “in person” planned Nightingale2020 conference my team hosted a virtual two-day Nightingale2020 global conference. It attracted over 500 delegates from all continents. I wish to thank  Aysha Awan, Director of Communications, Marketing and Events, and her team for supporting and communicating FNF work, creating the Foundation’s now enormous UK and global visibility and reach. 

**I** welcomed Gary Justice the Head of Leadership Development, Flight Sergeant Jo Matheson, an RAF nurse seconded from PMRAFNS, Carmel Bond the Policy Writer, Adam Rabinowitz as Membership and Alumni Manager, Tammy Noble a Fundraising Manager, Jess Hutton the Communications Officer, Harshal Goswami and Carolina Barton Jones both Academy Assistants and Jana Adensamova the Finance Assistant. Congratulations to Sharon Thomas, Programme Manager, on the birth of her first-born daughter. I said goodbye to Andrew Williams, Hossein Ghasemi, Sema Gornall and Miriam Ezekiel Gwokyalya. 

The Foundation’s offices have not been used since the start of the pandemic and since December all property has been kept in storage. We shall be moving to new larger premises at the Royal College of Obstetrics and Gynaecology (RCOG), Union Street. The team will finally relocate in July 2021. 

I wish to thank all FNF sponsors who enable us to continue to maintain Florence’s legacy. Without this support, we would simply be unable to do what we do. I would also like to thank the trustees for their ongoing commitment and support, who give their time most generously to support me and the activities of the Foundation. 

Nothing could have prepared us for the last year, but we are ready for the next one. I am excited for the future and am inspired and motivated to increase the Foundation’s visibility nationally and globally, its influence for the benefit of the nursing and midwifery professions and its impact on health and patient care. FNF continues to support the many and no longer the few. 

Lastly, I would like to add how proud and honoured I am to have awarded a CBE in the New Year’s Honours 2021 for Services to Nursing and Midwifery, I thank you for all your good wishes. 


## **Greta Westwood Chief Executive Officer CBE PhD RN** 

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Florence Nightingale Foundation Annual Report 2020-21 


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Florence Nightingale Foundation Annual Report 2020-21 

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Florence Nightingale Foundation Annual Report 2020-21 

## **Report of the Trustees** 

The Board of Directors presents its annual report together with the annual accounts of The Florence Nightingale Foundation (FNF) for the year ended 31 March 2021. 

Reference and administrative information set out on pages 4 and 5 forms part of this report. The financial statements comply with current statutory requirements, the memorandum and articles of association, the requirements of a directors’ report as required under company law, and the Statement of Recommended Practice - Accounting and Reporting by Charities: SORP applicable to charities preparing their accounts in accordance with FRS 102. 

## **About the Foundation** 

Florence Nightingale is undoubtedly the world’s most famous nurse and her influence and legacy continue to affect the world today. When Florence died in 1910 at 90, the international nursing community wished to pay tribute to the life and work of this great nurse. At the International Council of Nurses (ICN) Congress held in Cologne in 1912, Mrs Ethel Bedford Fenwick in her speech at the final banquet proposed that ‘an appropriate memorial to Florence Nightingale be instituted’. She envisaged an educational foundation which would enable nurses ‘to prepare themselves most fitly to follow in her footsteps’. However, due to the 1914-1918 world war, it was not until 1929, at the ICN Grand Council in Montreal, that the memorial proposal was activated. The National Florence Nightingale Memorial Committee of Great Britain and Northern Ireland was subsequently established in 1934 and the name was changed to The Florence Nightingale Foundation (FNF) in 1994. 

The Florence Nightingale Foundation operates in England, Wales, Northern Ireland, and Scotland. 

## **Aims, Objectives and Activities** 

The Florence Nightingale Foundation is an independent charity set up to be a living memorial to Florence Nightingale by advancing the study of nursing and by promoting excellence in nursing, midwifery, and health visiting practice. 

The Foundation aims to improve health, clinical outcomes, and patient experience, through building nursing and midwifery clinical and research leadership capacity and capability. It does this by enabling nurses and midwives, our scholars, to access sophisticated and bespoke leadership development opportunities, both in the UK and overseas, tailored to the scholar. The bespoke leadership development programmes ensure the Foundation’s offer remains unique and highly sought after. All our scholars describe the experience with the Foundation as ‘life-changing’ both professionally and personally. This has given them the confidence to lead with integrity, challenge when they may not have done so previously, and importantly recognise that by staying within their professions they love, they can make a real difference to patient care and health outcomes. 

## **Our Vision** 

To be the leading scholarship provider for nursing and midwifery leadership development, recognised for influencing breakthroughs in health and social care policy and practice on a national and global level. 

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Florence Nightingale Foundation Annual Report 2020-21 

To be ‘the go-to place’ for professional opinion and debate, a recognised academy for healthcare thought, a voice for nursing and midwifery. Our scholars and our alumni will seek all opportunities to influence healthcare policy and practice. 

## **Our Mission** 

To pioneer change and improvements in patient and health outcomes, through nursing and midwifery clinical and research leadership, honouring Florence Nightingale’s legacy. 

## **Our Values** 

**Challenge:** We challenge norms and non-evidenced based nursing and midwifery practice. We promote transparency and lead communities to ignite change for the better. We use Florence’s legacy as leverage to intelligently influence those around us, unafraid to challenge the status quo when needed. 

**Promote** : We promote courageous leaders who discover new ways of working and forge a path to impact policy and practice at local, national, and international levels. 

**Care:** We care for nurses and midwives, and this is at the heart of what we do. Like Florence Nightingale, we have an overriding instinct to enable nurses and midwives to be better and discover new ways to improve patient care and health outcomes. 

**Nurture** : We nurture our scholars and provide the tools, confidence, and knowledge they need to lead change and influence those around them. 

**Partner:** We develop enduring relationships with the nursing and midwifery communities. 

## **Our Promise** 

## **We will:** 

**Select** the very best talent in nursing and midwifery as scholars of the Foundation. Through our bespoke leadership development programmes, we will inspire, nurture, and support their future success. Our programmes are designed and delivered through partnerships with leading organisations both in and outside health and social care. 

**Connect** nurses and midwives to become the positive voice of nursing and midwifery. 

**Shine** a light on nurses and midwives and their practice. We will commemorate Florence’s legacy and the impact she had on today’s nursing. We will support new research to generate new knowledge, communicate and celebrate our achievements and the impact our work has on improvements in health and social care. 

## **Public Benefit** 

In setting and supporting FNF’s strategy and business plan, the members of the Board continue to follow the Charity Commission’s general guidance on public benefit. 

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Florence Nightingale Foundation Annual Report 2020-21 

## **Strategic Plan (2018-2022)** 

FNF strategic goals were set out in the 2018-22 Strategic Plan. They are: 

**Goal 1: Demonstrate Impact** – Ensure our important work, and that of our nursing and midwifery scholars, is published to facilitate adoption by others, enhance the impact and raise the profile of the Foundation. 

**Goal 2: Increase National and Global Reputation, Visibility and Reach** – Develop our position and brand  as a credible voice of nursing and midwifery practice. 

**Goal 3: Influence Policy and Practice** – Support and develop nursing and midwifery clinical and research leaders to create the evidence base to change clinical practice and influence healthcare policy. 

**Goal 4: Grow and Sustain** – Secure and increase the financial position of the Foundation 

To deliver the strategic plan FNF will continue as the principal nursing and midwifery leadership charity that is recognised and valued for its expertise in developing leaders, impacting patient and health outcomes through clinical excellence, and influencing policy and practice. To deliver this strategic plan, FNF has continued to develop as an agile organisation and continues to seek additional funding. It recognises the significant contribution of existing funders as well as identifying and developing new, diverse, and sustainable sources of funding. Specific activities undertaken to date to achieve the objectives of completing FNF strategic plan are set out in ‘Achievements and Performance’ below. 

## **Organisational Development** 

During the most challenging of years in 2020-21, FNF continued to strengthen its reputation as a leading leadership development provider for nurses and midwives. 

During the year, FNF needed to be flexible in managing the financial and human resources to enable the charity to continue to work productively and effectively, looking to build a sustainable future in the context of much instability. 

The Trustees, through the Chairs Action Group, provided the expert governance and leadership required throughout the year to ensure the delivery of the strategic plan, robust business continuity and a positive future for the work of the charity. 

Four new Trustees were appointed and three retired in January 2020-21. 

The activities undertaken by FNF throughout 2020-21 to achieve the objectives are set out in the section ‘Achievements and Performance’. 

## **Covid 19: The Impact on the work of FNF** 

At the time of writing this report, the country is nearing the end of the third period of ‘lockdown’, and tragically, close to 130 thousand lives have been lost to the virus in the UK and families have been devastated by their losses. Hundreds of thousands more have been impacted by the long-term impact of COVID-19, ‘Long Covid’. 

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Florence Nightingale Foundation Annual Report 2020-21 

The planned FNF work in this year was impacted considerably by COVID-19, however, the charity has worked tirelessly to respond to the pandemic and stay true to our mission and values, whilst utilising our expertise and our networks to help in the national effort to manage the pandemic and mitigate its impact. 

## **Impact on FNF Planned Work** 

The FNF office was closed on 16[th] March 2020 and remained closed throughout the rest of the year. FNF new office from 1[st] September 2021 will be in the building of the Royal College of Obstetrics and Gynaecologists, Union Street, London, SE1 1SZ. All team members have worked remotely from their homes during this period. 

All face-to-face events were cancelled at the start of the pandemic, but many were later converted to online events and all programmes restarted in August 2020 and all those paused and those planned have been delivered. 

FNF launched a leadership support service “Nightingale Frontline” in April 2020, this has now supported over 1800 nurses and midwives to lead during this crisis. 

## **Financial Impact** 

Due to the innovation and hard work of the team and despite the initial pause to the delivery of all programmes the Foundation delivered an additional unrestricted surplus of £295,107 when compared with 2019-20. 

Initially at the start of the pandemic measures were taken to reduce costs, including furloughing four members of the team, terminating contractors, and not appointing to planned new appointments. 

All commissioners agreed to a pause the activities and defer funding until programmes restarted. They also agreed to the future remote delivery rather than waiting for lockdown to lift on a permanent basis. 

FNF launched a public fundraising appeal “Florence Nightingale White Rose Appeal” in April 2020 to honour nurses and midwives and this generated over £88,000. 

FNF was also awarded a large grant from The Garfield Weston Foundation in July 2020 to provide Nightingale Frontline for nurses from an Ethnic Minority (EM) background working in social care and Nuffield Health continued to provide financial support throughout the year. 

## **Achievements and Performance** 

The Florence Nightingale Foundation Academy was launched in January 2020 with the following aims: 

- Develop Leaders - to increase capacity and capability at every level in the nursing & midwifery professions 

- Utilise Evidence - to Inform policy and improve nursing practice, patient experience and health outcomes 

- Influence Policy - to improve nursing practice, patient experience and health outcomes 

- Mobilise the voice of nursing and midwifery in health policy agendas 

As the Academy comes to the end of its first year of operation, FNF is pleased to report all leadership programmes and scholarships have been delivered in line with the business and financial plans despite the pandemic's impact. This involved transferring all delivery to an online platform which has been received very positively and appears to have increased the accessibility of our programmes. 

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Florence Nightingale Foundation Annual Report 2020-21 

The Academy has been commissioned to deliver several policy-related thought leadership projects, which have been completed and welcomed by the relevant national strategy groups. Dissemination plans are currently in place to ensure the impact of this activity is widely known by utilising a range of media channels, including peer- review journals. 

Membership of the Academy was launched on 28th September 2021 through a live webinar. The interest and uptake of this offer has been overwhelmingly positive. The momentum generated from this event was continued when, just one month later, FNF held the Virtual Nightingale 2020 Conference. Both activities in quick succession have significantly impacted the external reputation and visibility of the Academy and the wider Foundation. 

The profile and standing of the FNF Academy as the "go-to service" for leadership development and wellinformed thought leadership has been established. This is evidenced by the successful attainment of contracts through competitive tendering processes to provide high profile leadership programmes that link directly with the Chief Nursing Officer (CNO) for England's top priorities. This has been combined with requests to undertake policy-related evaluations, which have the potential to make a significant impact on the international evidence base. The activity scheduled for 2021-22 is extremely promising for continued growth and expansion of influence. 

To respond proactively to the increased demand for educational and policy-related provision, the FNF Academy team has expanded significantly. This is with the view to ensuring our quality assurance is prioritised, and our reputation for delivering the highest standards is maintained. 

## **Developing Leaders** 

## **2019-20 Scholars** 

The completion date of the 2019-20 Scholarships was extended to March 2021 due to the COVID-19 pandemic. Several Scholars were unable to attend their bespoke elements as planned due to provider cancellations and clinical commitments. FNF is offering high levels of flexibility with the deadline for submitting the project abstract and publication arising from their scholarship and have given the option of submitting a presentation with audio recording as an alternative. FNF will be holding a Scholar Conference on 11[th] October 2021 to showcase and celebrate the outcome of their scholarship. FNF is unable to report on the satisfaction and impact of the Scholarships currently because of the delayed completion date. 

## **2020-21 Scholars** 

The completion date of the 2020-21 Scholarship has been extended to October 2021. The majority of the FNF core  programme has been delivered virtually, which has enabled the scholarship year to go ahead. However, some elements have been delayed until the summer, when they will be delivered face to face at the request of the Scholars. This group will also be invited to present at the Scholars Conference in October 2021. Again, FNF is not able to report on satisfaction and impact of the Scholarships currently because of the delayed completion date. 

## **2021-22 Scholars** 

The recruitment and selection of the 2021-22 Scholars commenced in November 2020 and was completed in March 2021. A total of 140 applications were received. This is a decrease on applications received last year, which may relate to the high levels of clinical demand associated with the pandemic during the recruitment period. The Emerging Leader Scholarship group received more applications this 

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Florence Nightingale Foundation Annual Report 2020-21 

year (94) than the other two scholarship groups. Applicants remain predominantly female nurses (86%) from England (93%). Total applications from nurses and midwives from a Minority Ethnic background was 22% which is a 9% increase from our previous year. 

FNF successfully secured funding from six of the seven NHS England Regions to provide a more equitable spread of scholarships across the country. NHSX continues to support the Digital Leadership pathway and has sponsored seven Scholars and two Fellows this year. This programme will be delivered in collaboration with the College of Healthcare Information Management Executives (CHIME) an international organisation who are the world leaders in developing digital health leaders. FNF continues to seek support for specific scholarships, which are exclusively available to nurses and midwives from a Minority Ethnic background. This year this included five "Windrush" Scholars sponsored by Health Education England, two Scholars sponsored by the CNO England, and an additional Scholar sponsored by the General Nursing Council for England and Wales Trust (GNCT). 

FNF has secured commitment from Health Education and Improvement Wales (HEIW) to fund four scholars for three years and an intention to continue to support the digital scholarship pathway. There were few applications from Scotland and Northern Ireland. FNF intends to work closely with the Chief Nursing Officers, our Academy members, and our Trustees to consider ways of raising the profile of the Foundation in all four countries of the UK. FNF is also planning to implement a "Champion" model whereby we identify two alumni from each of the NHS England regions and two alumni from Scotland, Northern Ireland, and Wales to promote the various opportunities. 

## **2021-22 Scholarships Awarded** 

In the Autumn of 2020, FNF started the recruitment process for the 2021-22 Scholars. The reduced number of applications did not impact the calibre of applications, and through a rigorous group selection process, FNF chose the top 35% of applicants to interview and of those awarded 81 Leadership Scholars and 3 Travel Scholars. When considered alongside the demographics breakdown of applications this demonstrates no groups were disproportionally offered. This is evidence that a non-discriminatory approach to selection has been undertaken. It should be noted that FNF no longer has funding to offer the Research Scholarships. 

## **Nightingale Frontline Leadership Support Service** 

The Nightingale Frontline Leadership Support Service was developed in response to the COVID-19 pandemic as a method of attending to the leadership support needs of the professions and was launched in April 2020. The service offers remote co-consulting sessions facilitated by FNF Associates and alumni and is delivered via a video conferencing platform. 

The service is funded by individual organisations and primarily via NHS hospital charities at the request of the Chief Nurse. Additionally, FNF received grant funding from the Garfield Weston Foundation to offer open access sessions to nurses working in social care from an ethnic minority background. 

FNF has provided 529 sessions in 2020-21 which offered support to 1,842 nurses and midwives. 72 organisations have accessed the service. 

## **Commissioned Leadership Programmes Delivered in 2020-21** 

The FNF Academy delivered the target number of cohorts of leadership programmes throughout 2020-21 using virtual learning platforms. The number of applications received was extremely high for both the Mental Health Nurse and Windrush programmes which demonstrates the increase in demand for the 

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Florence Nightingale Foundation Annual Report 2020-21 

programmes and the potential impact of expanded accessibility offered by virtual delivery. All programmes and the 323 participants are shown in the table below. 


## **Leadership Development Programmes Commissioned for 2021-22** 

Sixteen leadership programmes have already been commissioned for 2021-22 to include 517 programme participants. 

## **Membership of The FNF Academy** 

Membership of the FNF Academy has exceeded expectations for 2020-21. Membership now represents the 34 Chief Nurses who have taken up the membership offer. A further 13 expressions of interest have been received, including two Integrated Care Systems. A marketing plan is in place to expand the interest in 2021/22. 

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Florence Nightingale Foundation Annual Report 2020-21 

FNF are currently compiling a report for existing members which describes the benefits utilised by their organisation. This will include a request to express their intention to renew their membership for 202122, 13 organisations have already confirmed renewal. 

The online educational programme has commenced with great success. The programme aims to increase the political acumen of the workforce via exposure to established nurse leaders influencing in a range of settings, encouraging writing for publication, and developing leadership attributes relevant to the current context of health and social care. 

The Academy Advisory Group is functioning well with regular communication to support achievement of actions arising from bi-annual meetings. A Shared Governance Council is being convened, which comprises "point of care" nurses and midwives from each of the Advisory Group organisations. This group will hold devolved responsibility to ensure the benefits the membership and the priorities of the Academy remain responsive to the main concerns of the workforce. 

## **Progress Against Strategic Goals** 

## **Goal 1: Demonstrate Impact** 

We are collecting the publications and presentation of our scholars and leadership programme participants and showcasing them throughout our networks and social media. The development of an online library of their work for wide dissemination is currently underway as part of our new website. FNF are also focusing on developing case studies that specifically emphasise the impact of the programme on the person and their practice to illustrate the difference FNF development opportunities make to clinical excellence. 

The overall satisfaction rating of our leadership programmes averaged 4.9 out of 5, and 100% would recommend the programme to friends and colleagues. This continues to indicate a consistent and extremely high level of satisfaction despite the transfer to virtual methods of delivery. The quality of facilitation was reliably evaluated as high, including all FNF staff and Associates. Areas for improvement relate to the timeliness of dates and communication of information which has been highlighted as a quality indicator and will be monitored as part of our quality assurance process. 

Twenty per cent of our 2020-21 leadership programme participants have already notified us that they have been promoted. They have expressed their gratitude to the Foundation for the part the programme played in giving them the confidence to put themselves forward and the skills to excel at interview. 

The open evaluation comments demonstrate the impact on the participant in terms of confidence, learning, perception of self and influencing change. The quotes below are just a few examples to illustrate this impact. 

## **Confidence** 

_It was step-by-step confidence-building to become an effective leader, and the course facilitators were very knowledgeable._ 

_I found the course very empowering. It didn't have to do with recreating a new version of me but refocusing my attention on my own strengths and area of opportunities. That I am enough and what I have now, my personality, skills, workplace, relationships, and network can be used in a more effective way to become a better leader. In the beginning, my goal was to increase my confidence, and the course really helped with that._ 

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Florence Nightingale Foundation Annual Report 2020-21 

## **Learning** 

_I feel privileged to have met and learnt from inspirational course leaders and the other participants. The programme enabled me to find myself away from my work environment - it allowed the space for me to truly reflect on my professional goals and aspirations._ 

_Leadership requires continuous learning therefore will not stop there. With this programme I am now able to use  different Leadership energies understanding that people, scenarios, and situations are different._ 

## **Perception of Self** 

_After years in nursing, I thought I have developed enough, but after attending the Windrush FNF Programme, I realised I haven't been exposed and developed at all. This programme challenged me personally and professionally and opened up rooms for me to rise up and seek more. Aspire to challenge and change my mind about developing especially now, with the door opening for development, I am holding on tightly to continue acquiring skills._ 

_This has been an amazing, life-changing course. It not only taught me skills to further my career, but it taught me so much about myself that I did not know. It has given me the courage to be myself and given me the tools to become the best version of myself, including at work. I highly recommend this course._ 

_I have seen myself develop. Believe me... a leader has emerged. I am now able to influence change by being visible and being part of it. I have been able to connect and engage in the Executive Team and have been offered opportunities to participate in different things._ 

_I came out of the programme renewed and overflowing with empowerment and inspiration._ 

## **Influencing Change** 

_I have learned how to best use my power and authority for improved practice outcomes._ 

_This leadership programme had such an inspiring and fulfilling journey that left me overflowing with motivation, inspiration, and a renewed insight on the importance of leadership in initiating and sustaining changes within myself, others and the wider system._ 

## **FNF Network** 

_I also gained a network of similarly inspired, empowered and supportive leaders that I have met in my cohort through the programme. I feel so proud to become part of the FNF Alumni_ . 

Evaluation of the Nightingale Frontline Leadership Development service has demonstrated how it has also met a significant need within the workforce, and the impact is summarised below. 

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Florence Nightingale Foundation Annual Report 2020-21 



23 



Florence Nightingale Foundation Annual Report 2020-21 

## **FNF Clinical Professor Publications 2020-21** 

The six FNF Clinical Professors have between them published 66 peer-reviewed papers and 7 policy papers/guidelines. All links to the papers are highlighted on our website. 

One example by Professor Michelle Briggs and colleagues is summarised below: 

Khanom S, McDonagh JE, Briggs M, McBeth J (2020) **Characterising pain flares in adolescent inflammatory and non-inflammatory musculoskeletal disorders; a qualitative study using an interpretative phenomenological approach.** European Journal of Pain. DOI: **10.1002/ejp.1626** 

## **Background** 

Adolescents with musculoskeletal disorders experience acute exacerbations in pain, colloquially called “pain flares” in adult literature. This study aimed to explore adolescents' lived experience of pain flares, including what pain flares are, why they occur, how they are managed and what lasting effects they have on adolescents. 

## **Methods** 

A sample of 10 adolescents diagnosed with juvenile idiopathic arthritis or chronic idiopathic pain syndrome were  recruited from a tertiary hospital in the UK. Data were collected using semi-structured interviews and visual aids,  and analysed using interpretative phenomenological analysis. 

## **Results** 

Four broad themes were identified which describe as a journey of change from participants: (a) daily life with pain, where adolescents report a level of pain that is “normal” for them which they can tolerate and continue their daily routines around; (b) pre-flare period, where adolescents begin to notice pain increasing beyond normal levels and employ preventative strategies to reduce the risk of symptoms developing into a flare; (c) flare period, where adolescents describe the symptoms, frequency, duration, impact and their attempts to manage flares; to their (d) post-flare period, where symptoms begin to return to baseline levels and adolescents take actions to regain the level of normality experienced in daily life. 

## **Conclusion** 

This study has identified a number of components of the pain flare experience. Findings show that pain flares are more than an increase in pain intensity; they are multi-layered and require other features to change. These findings help to differentiate pain flares from typical fluctuations in pain. 

## **Significance Statement** 

Chronic musculoskeletal pain in adolescents is dynamic and fluctuates within and across days. This study found that not all fluctuations in pain are considered important by adolescents, and that a “pain flare” is a distinct fluctuation defined by worsening pain intensity and other factors including changes in function and emotions. These findings help to differentiate pain flares from adolescents' every day or typical fluctuations in pain. 

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Florence Nightingale Foundation Annual Report 2020-21 

## **FNF Employee Publications 2020-21** 

|**Year**|<br>**Employee**|**Author list**|**Title**||**Reference**|
|---|---|---|---|---|---|
|2021|**Carmel Bond**|**Bond C,**Tsikandilakis M,<br>**Stacey G,**Hui A, Timmons<br>S|The effects of compassion-based<br>feedback on wellbeing ratings during a<br>professional assessment healthcare<br>task||_Nurse Education_<br>_Today_. 99,|
|2021||**Bond C, Stacey G**, Gordon<br>E, Harling D|The Contributions and Experiences of<br>Learning Disability Nurses During the<br>First Peak of the COVID-19 Response||Learning Disability<br>Practice.<br>**doi:**10.7748/ldp.20<br>21.e2147|
|2021||Slade M, Rennick<br>Egglestone S, Llewellyn-<br>Beardsley J, Yeo C, Roe J,<br>Bailey S, Smith R, Booth S,<br>Harrison J, Bhogal A,<br>Penas Moran P, Hui A,<br>Quadri D, Robinson C,<br>Smuk M, Farkas M,<br>Davidson L, Van Der Krieke<br>L, Slade E,**Bond C,**<br>Nicholson J, Grundy A,<br>Charles A, Hare Duke L,<br>Pollock K, NG F|Using recorded mental health recovery<br>narratives as a resource for others:<br>Narrative Experiences Online (NEON)<br>intervention development.||_JMIR: Formative_<br>_Research_JMIR<br>Form Res. 2021<br>May<br>27;5(5):e24417.<br>doi:<br>10.2196/24417.|
|2021|**Gemma**<br>**Stacey**|Kenny, A., Dickson-Swift,<br>V., McKenna, L., Charette,<br>M., Rush, K.L.,**Stacey, G**.,<br>Darvill, A., Leigh, J.,<br>Burton, R. and Phillips, C.,|Interventions to support graduate<br>nurse transition to practice and<br>associated outcomes: a systematic<br>review.||Nurse Education<br>Today, p.104860.|
|2021||Bond, C., Tsikandilakis, M.,<br>**Stacey, G**. & Hui, A. &<br>Timmons, S.|The effects of compassion-based<br>feedback on wellbeing ratings during a<br>professional assessment healthcare<br>task||Nurse<br>Education<br>Today, Volume 99,<br>104788,<br>ISSN<br>0260-6917,<br> https://doi.org/10.1<br>016/j.nedt.2021.10<br>4788|
|2020||**G. Stacey**, G. Cook, A.<br>Aubeeluck, et al.,|The Implementation of Resilience<br>Based Clinical Supervision to Support<br>Transition to Practice in Newly<br>Qualified Healthcare Professionals||Nurse Education<br>Today,https://doi.or<br>g/10.1016/j.nedt.20<br>20.104564|
|2020||Stacey G|The Place of person-centred care in an<br>international response to the Covid-19<br>pandemic||The place of<br>person-centred<br>care in an<br>international<br>response to the<br>Covid-19<br>pandemic(Editorial)<br>International<br>Journal of Practice<br>Development (10)1<br>doi.org/10.19043/ip<br>dj.101.001|



25 



Florence Nightingale Foundation Annual Report 2020-21 

|2020||Bish, M.,**Stacey, G**.,<br>Shatto, B. and Meyer, G||Adopting a Global Virtual Team<br>Approach to Enhance Performance of<br>an International Nursing Research<br>Collaboration.||Nursing education<br>perspectives.|
|---|---|---|---|---|---|---|
|2021|**Greta**<br>**Westwood**|Lucy Dorey, Judith<br>Lathlean, Paul Roderick,<br>**Greta Westwood**||_Patient experiences of alcohol_<br>_specialist nurse interventions in a_<br>_general hospital, and onwards care_<br>_pathways_||_Journal of_<br>_Advanced Nursing_<br>_vol 27 (4)_1945-<br>1955 Published 16<br>February<br>2021https://doi.or<br>g/10.1111/jan.1477<br>7|
|2021||M Avery,**G Westwood,**A<br>Richardson.||_Enablers and barriers to progressing a_<br>_clinical academic career in nursing,_<br>_midwifery and allied health_<br>_professions: A cross sectional survey._||Journal of Clinical<br>Nursing Published<br>Jan 28<br>2021.https://doi.or<br>g/10.1111/jocn.156<br>73|
|2020||Michelle Vickery, Edwin<br>van Teijlingen, Vanora<br>Hundley, Gary B Smith,<br>Susan Way,**Greta**<br>**Westwood**||Midwives’views towards women using<br>mHealth and eHealth to self-monitor<br>their pregnancy: A systematic review<br>of the literature||Eur J<br>Midwifery. 2020; 4:<br>36. Published<br>online 2020 Sep<br>17. doi: 10.18332/ej<br>m/126625|
|2020||Greta Westwood||_The Nurse Behind the Mask_||**Nursing Times**<br>**(July 2020)**<br>https://www.nursing<br>times.net/opinion/th<br>e-nurse-behind-the-<br>mask-05-07-2020/|
|2020||Greta Westwood||How Florence Nightingale Paved the<br>Way for the Heroic Work of Nurses<br>Today||**TIME (12th May**<br>**2020)**  https://time.c<br>om/5835150/florenc<br>e-nightingale-<br>legacy-nurses/|



26 



Florence Nightingale Foundation Annual Report 2020-21 

## **Goal 2: Influence Policy and Practice** 

FNF continues to have a positive and ongoing relationship with the NHS England/Iimprovement policy unit. This has resulted in engagement with policy activity whereby FNF executives are representatives on the high-level steering groups to identify specific work packages or consultation exercises for FNF to take forward through the appropriate procurement process. 

|**Priority Area**|**Activity**|**Outputs**|
|---|---|---|
||||
|**Learning Disability Nursing**|Thought Leadership Paper exploring<br>experiences and contribution of LD nurses<br>during the first surge of Covid 19|Report presented to All England Plan Steering<br>group/ LD National Symposium<br>Easy read version of report presented to lived<br>experience advisory group<br>Paper accepted by peer review journal – Learning<br>Disability Practice|
|**Learning Disability Nursing**<br>**Leadership Development**|Evaluation of LD leadership programme<br>presented to All England Plan Steering<br>group<br>FNF Alumni have formed an editorial<br>advisory group for the HEE LD Nursing<br>Careers website.<br>FNF Alumni are members of curriculum<br>development groups for specialist post-<br>registration training for LD nurses|**Learning disability | Health Education England**<br>**(hee.nhs.uk)**|
|**Mental Health Nursing**<br>**(all England Plan steering group**<br>**meetings have been postponed**<br>**during second surge of**<br>**pandemic)**|Thought Leadership Paper exploring<br>experiences and contribution of MH<br>nurses during the first surge of Covid 19|Paper submitted to peer review journal – Journal<br>of Psychiatric and Mental Health Nursing.|
|**Mental Health Nursing**<br>**Leadership Development**|The National team are engaging with<br>current FNF MHN leadership programme<br>participants. Again, this has resulted in the<br>creation of an external reference group<br>contributing to the Post Graduate<br>Educational programme.|Ongoing|
|**Deteriorating Patient**|This group has paused activity during the<br>second surge of pandemic||
|**Continence**|Public information App developed and due<br>for launch March 2021 on NHS App<br>library. Funds for evaluation secured.|App launch<br>Relationship with LD national lead to look at<br>adaptations to App for this client group.|



The following research/evaluation projects have been commissioned to be undertaken in 2021-22. This represents an expansion of the Academy research activity and the opportunity to contribute directly to the evidence-based influencing policy. A report will be prepared for the commissioners and presented to the relevant National/Regional boards. In addition, a peer-review publication will be submitted for open access publication and an FNF dissemination plan implemented utilising a range of media outputs. 

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Florence Nightingale Foundation Annual Report 2020-21 

|**Topic**|**Funder**|**Method**|**Funding**|
|---|---|---|---|
|||||
|**Clinical Education Career Pathways**|HEE – South-East|Realist Evaluation|£50,000|
|**Student Shared Decision-Making**<br>**Council**|HEE – South-East|Participatory Action Research|£23,000|
|**National Shared Decision-Making**<br>**Council**|NHS E/I|Qualitative interview study|£10,000|



In 2020-21 the FNF Academy Member Advisory Group has selected the following priority areas for policy influence for 2021-22: 

- Sustained access to Clinical Supervision for nurses 

- Increased leadership development opportunity for nurses and midwives from Minority Ethnic Backgrounds 

Subject expert groups (SEGs) have been convened to define the strategy for taking forward these areas of influence. The SEGs include individual specialists, FNF Alumni and representatives of influential bodies who will ensure these issues are progressed in collaboration with the members. 

## **Goal 3: Increase National and Global Reputation, Visibility and Reach** 

## **Involvement with Governmental Bodies** 

In 20200-21 both the CEO and the Director of Academy have developed enduring relationships with the UK Chief Nursing Officers (CNOs) and the England Regional CNOs. The CEO had virtual meetings with all CNOs and RCNOs to explain progress of the FNF and proposed plans. Of importance this resulted in additional income for scholarships within most of the UK counties and all the England NHS regions and additional FNF Academy members. FNF is working with the CNO England International Nurse Recruitment Team to develop plans to support international nurses working in the NHS in England. The Prime Minister’s Office has confirmed that the PM and other ministers will attend the social distanced Westminster Abbey service on May 12[th] , 2021. 

## **Events and Communications Overview** 

The media profile and recognition of the Foundation has steadily grown since 2020, the bicentenary year of Florence Nightingale. This is in part thanks to the goodwill shown to nurses and midwives during the COVID-19 pandemic. Senior FNF staff, alumni and scholars were featured in national, regional and trade press throughout the year. Scholars, Alumni, and staff featured in a range of media outlets throughout 2020 that included The Times, The Daily Telegraph, The Sun and on BBC’s The One Show. 

To help nurses and midwives during the pandemic and beyond, the Foundation launched the Florence Nightingale White Rose Appeal on 12[th] May 2020 (Florence Nightingale’s Bicentenary and International Nurses’ Day). Members of the public were asked to buy an e-white rose in honour of a nurse or midwife. The appeal was launched by Appeal Ambassador and double Oscar-nominee, Helena Bonham Carter and has to date raised over £88,000 for the Foundation. 

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Florence Nightingale Foundation Annual Report 2020-21 

Coverage for the Appeal was vast with pick up in mainstream press including the  Daily Telegraph, Daily Mail and Evening Standard, Metro as well as regional and trade press including the Nursing Times and Nursing Standard. 


Despite the cancellation of the annual Florence Nightingale Commemoration Service at Westminster Abbey on 12[th] May, Arlene Lee, an Alumna and Senior Research Nurse, University Hospital Southampton NHS Foundation Trust was selected to hold the lamp for the front cover of the Times Newspaper, marking both Florence Nightingale’s bicentenary and International Nurses’ Day. 

The Foundation has hosted this service since 1964 and this was the first year that the service was cancelled. 

The Foundation launched the Nurse Behind the Mask campaign to mark the birthday of the NHS on 5[th] July 2020. The campaign highlighted that the NHS was built on the shoulders of immigrants, and it is nurses, midwives and other healthcare workers from ethnic minority backgrounds who have been disproportionately affected during the COVID-19 pandemic. The campaign was covered by nursing trade magazines and performed well across social media. Professor Greta Westwood wrote a special op-ed about the contribution of nurses and midwives from diverse backgrounds for the Nursing Times: https://www.nursingtimes.net/opinion/the-nurse-behind-the-mask-05-07-2020/ 



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Florence Nightingale Foundation Annual Report 2020-21 

## **Marking Black History Month** 

The second phase of the Nurse Behind the Mask campaign – The Voice Behind the Mask - was launched in October in collaboration with the Voice Newspaper. The Voice Behind the Mask, highlighted the contribution of nurses and midwives from ethnic minority backgrounds. A special 8-page supplement was produced with the Voice Newspaper featuring interviews with FNF alumni and scholars and included a special editorial piece by Professor Greta Westwood. This supplement coincided with Black History Month, positioning FNF as an organisation that supported the diverse healthcare workforce. The paper was distributed to 20,000 readers on a national and international scale. 



The virtual Nightingale2020 Conference that ran for two days (27[th] and 28[th] October) was a great success with up to 250 participants virtually attending the conference over the course of the two days. Due to the delegate make up of nurses and midwives, the Director of Communications focused on securing trade press coverage. Coverage included: 

Professor Greta Westwood received a CBE in the New Year Honours List for 2021 and this news was covered by national, regional, trade and online press outlets. Coverage was secured by highlighting the immense contribution that Professor Westwood had made during her career. 

## **Twitter & Social Media Update** 

Social media continues to go from strength to strength supported by the Communications and Marketing Officer who has expanded FNF’s reach across nursing and midwifery audiences and the general public. 

## **The Foundation now has:** 

- 16,050 Twitter followers (13,000 in 2020) 

   - The CEO has 3,843 Twitter followers (3,041 in 2020) 

   - `o` The Director of the FNF Academy has 2,100 Twitter followers (1,173 in 2020) `o` The Director of Communications has 578 Twitter followers (517 in 2020) 

- 2,136 LinkedIn followers (1,225 in 2020) 

- 560 Instagram followers (326 in 2020) 

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Florence Nightingale Foundation Annual Report 2020-21 

## **Goal 4: Grow and Sustain** 

During this year, the first year of the COVID-19 pandemic much effort has been made to increase the financial  base by diversifying the income streams including: 

- Scholarships 

- Commissioned Programmes 

- FNF Academy Membership 

- Nightingale Frontline 

- Fundraising 

- Corporate support 

The achievements of the FNF Academy demonstrate the growth in FNF provision particularly the increasing demand for commissioned leadership programmes. FNF has migrated its services into remote offerings and will therefore be able to offer digital learning in the future. The agility and flexibility of FNF was its greatest strength when readjusting its delivery to respond positively to the needs of the profession due to COVID-19. FNF used this opportunity to modernise its services to enable an increased number of nurses and midwives to access FNF leadership development through both accessible and alternative models of delivery. The maintenance of the FNF reputation is the highest priority and therefore robust and responsive evaluation strategies are fully embedded into the new ways of working. These will measure both experience and most importantly impact. 

There is clear evidence that FNF has continued to grow through the extended leadership development commissions, thought leadership work and now the FNF Academy membership providing benefits for chief nurses and their approximately 110,000 nurses and midwives 

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Florence Nightingale Foundation Annual Report 2020-21 

## **Financial Review** 

As with many organisations, the onset of the pandemic posed a material threat to the operations and finances of the Foundation. However, due to the outstanding response from the whole organisation the financial results for the year were the strongest ever, resulting in a significant increase in reserves that provides a strong basis from which to deliver the ambitious organisational strategy. 

The five-year financial strategy was updated to reflect the impact of the pandemic on both operations and financial metrics, but the key financial objectives remain the same; to generate surpluses; grow and diversify income; operate efficiently and effectively managing the cost of operation, deliver value for money; and to assess and manage risk in the Foundation’s growth and development activities. 

## **Results for 2020-21** 

Total income for 2020-21 was the highest ever achieved by the Foundation at £2,165k an increase of 35% on the (restated) 2020-21 outcome. Within this unrestricted income grew by 146% to £1,355k which delivered the highest ever unrestricted surplus (before investment gains) of £359k compared to £64k in 2019-20. 

This significant step forward in activity and performance was due to starting the year with a much stronger pipeline of commissioned programmes, which the newly established Academy team were able to rework to deliver virtually. Additionally, the decisions made at the Chair’s Action Group to develop new programs and fundraising appeals delivered significant new income streams. The launch of a membership scheme also contributed to the increased income and the Foundation received £13k under the Government’s furlough scheme. 

Costs rose because of higher variable programme delivery costs plus planned and responsive investment in capability and capacity to support the growing level of activity. Overall, costs were well managed with some additional pandemic driven increases offset by savings on areas such as property rental. 

The unrestricted net income for the year also benefited from a £149k unrealised gain on the investment portfolio as underlying investments recovered from the March 2020 lows seen at the outset of the pandemic. As a result, total unrestricted income for the year was £507k compared to £36k (restated) in 2019-20. Carried forward unrestricted funds at the end of the year were £1,345k an increase of 62%. 

During the year a review of income recognition standards resulted in the adoption of a new policy under which income for scholarships is recognised in the year in which the scholarship commences irrespective of when funding is received. In the case of multi-year funding, it is recognised for only one year of funding. In 2020-21 restricted income reflected 67 scholars commencing their programs with additional income for policy development work. 

At the year-end restricted funds of £408k principally represents funds relating to scholarships that have commenced but not completed. As at March 2021 the Foundation had invoiced or received funding for £1,890k  of scholarship programmes due to commence in April 2021 or subsequently. 

## **Investments** 

The Foundation’s investments are managed on our behalf by CCLA and are held in a range of asset classes including equities, property, fixed income securities and cash, and with a geographic spread. The equities funds do not invest in companies whose products are associated with tobacco or arms industries. During the year to 31 March 2021 the portfolio managed by CCLA delivered a positive total return of 

32 



Florence Nightingale Foundation Annual Report 2020-21 

17.7% well more than the target return of CPI +5% before costs. Within this the individual funds exceeded their respective benchmarks. 

The performance of our investment managers is reviewed on a regular basis (through quarterly reports and direct discussions) by the Finance and Investment Committee, who report to the Board of Directors. The Board of Directors’ objectives for investing funds continues to be to: 

- Act as a reserve to protect core activities in the event of unforeseen income shortfalls 

- Support longer term identifiable projects 

- Generate a return to support core services that are not specifically funded 

Total investments on 31st March 2021 amounted to £1,024k with interest and dividend income for the year of £31k. 

The Foundation periodically reviews its investment policy to ensure it remains appropriate in the context of the type and level of activity it is undertaking and the wider financial and investment markets. In Q4 the Foundation commenced such a review and after the year-end the Board approved a revised Reserves and Investment strategy which includes a lower target for investment returns to reduce the risk associated with asset volatility. 

## **Reserves** 

Unrestricted reserves provide some protection to the Foundation and its activities by allowing time to adjust to changing financial circumstances. The Board, via its Finance and Investment Committee reviews, on an annual basis, the level of unrestricted reserves by considering the risks associated with various income streams, expenditure plans and Balance Sheet items. This enables an estimate to be made of the level of reserves sufficient: 

- To allow time for the event of a downturn of income or asset value 

- To protect ongoing work programmes 

The Unrestricted reserves policy was reviewed by the Board of Trustees in December 2020 when it considered the revised 5-year Financial Strategy and budget for 2021/22. The Board agreed that the prudent level of reserves should not be less than 12 months of unrestricted expenditure, which at 31 March 2021 equates to reserves of £747k, versus the current level of £1,348k (being equivalent to 20 months of expenditure). This represented a change to the previous policy of at least 9 months of expenditure to reserves. 

Under the revised Reserves and Investment policy referred to above, the Board agreed that going forward the minimum level of reserves should be 15 months to provide greater financial security as the Foundation grows and expands internationally. The higher level of reserves also allows for a smaller reduction in the Investment returns target. 

Restricted reserves relate principally to the scholarship programmes and the sponsors funds and are net of the sponsor’s funds less any expenditure already incurred during the year. The scholarships’ programmes run each year from April through a 12-18-month period. Scholarship income is recognised in the year which the scholar commences their program and costs are recognised as incurred. The restricted reserves at the balance sheet date reflect residual scholarship funds that will be spent at a future date. The restricted reserves at the 31 March  2021 were £408k. 

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Florence Nightingale Foundation Annual Report 2020-21 

## **Going Concern** 

The accounts have been prepared on the going concern basis. 

The Foundation has demonstrated that, because of its ability to adapt and respond to the pandemic and its resilient business model (where funds are received before programmes and scholarships commence) that it is able to sustain and grow through a major economic shock. Nevertheless, the Board remain vigilant to financial and operational risk and have reviewed long term financial projections when setting the 2021/22 budget. The Board has also taken steps to reduce investment risk and maintain a higher minimum level of unrestricted reserves going forward. 

The Trustees are therefore confident, because of the above actions, that the Foundation has sufficient future cash generation capability and current reserves to fund the Foundation through the continuing Covid pandemic and into the future. They also recognise the need to closely monitor the ongoing  risks. 

## **Finance and Investment Committee** 

The Finance and Investment Committee is constituted as a committee of the Board of Directors to oversee the Foundation’s financial affairs. The Committee meets at least four times during the year and its membership consists of five trustees. It monitors and reviews, on behalf of the Board of Trustees, all aspects of the financial performance, financial management reporting, and the internal financial controls. It reviews and monitors performance against the 5-year financial strategy. It also monitors the performance of the investments to ensure consistency with the Foundation’s Investment Policy and oversees the Reserves Policy as well as other finance related policies. 

## **Fundraising** 

The Florence Nightingale Foundation continues to benefit from the support of loyal and committed supporters. 2020 has allowed the Foundation to test new ways of giving due to the pandemic. As the lockdown continued throughout 2020, the Foundation found new ways to grow its supporter base with initiatives that suited a new way of living and working for the rest of the country. By diversifying its fundraising mechanisms, the Foundation has been able to harness the goodwill being shown to nurses and midwives during the pandemic to help raise funds for nurses and midwives. 

To mark the bicentenary of Florence Nightingale and International Nurses Day, the Foundation launched its first ever public fundraising appeal for nurses and midwives working on the frontline and beyond – The Florence Nightingale White Rose Appeal. Double Oscar-nominated actress and Appeal Ambassador, Helena Bonham- Carter, launched the Florence Nightingale White Rose Appeal on 12[th] May and helped to raise over £88,000. 

At the end of 2019-20 FNF agreed a partnership with Nuffield Health to support FNF charitable activities, £100,000 was received in 2020-21. 

The Foundation received a restricted income grant from the Garfield Weston Foundation of £50,000 to expand the Nightingale Frontline: Leadership Support Service to nurses and midwives from an Ethnic Minority (EM) background working in social care. 

In 2020-21 FNF registered with the Fundraising Regulator. FNF has not received any complaints about its fundraising activities or any other approach to fundraising. 

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Florence Nightingale Foundation Annual Report 2020-21 

Bids or project grants are commenced by the Fundraiser and developed and submitted by the CEO and Director of Academy (DOA) as appropriate with support from key members of the team including the Chief Finance Officer (CFO). Sponsorship opportunities are explored by the CEO and DoA as appropriate. In October 2020, the Nightingale2020 online conference was free for attendees, but all were asked to donate to FNF. Several Alumni provide regular donations to the FNF as do FNF Trustees. In this year the FNF made new relationships with small corporate organisations (LifeSearch, Floris, Emma Bridgewater, Brora, Madeleine Floyd, and Kindred all gave donations throughout the year. A few alumni undertook sponsored activities to raise funds for the FNF, including the “2.6 Challenge” held on the day of the cancelled London Marathon 2020, 26[th] April. 

At the end of 2020 a new Fundraising Manager joined the Foundation to focus on Trust and Grant giving, Individual Giving and Corporate Fundraising. 

## **Sponsors** 

FNF is entirely grateful to its sponsors as without the generous funding its work would not be possible for the benefit of nurses and midwives. 

## **Scholarship Sponsors 2020-21** 

- Health Education England (HEE) 

- NHS England and NHS Improvement – CNO Office 

- HEE South-East 

- Health Education & Improvement Wales (HEIW) 

- NHS Wales 

- Northern Ireland Practice & Education Centre for Nursing & Midwifery (NIPEC) 

- Health Services Executive Ireland (HSE) 

- Dementia UK 

- Burdett Trust for Nursing 

- Company of Nurses 

- The Garfield Weston Foundation 

- Royal College of Nursing (RCN) Foundation 

- Teenage Cancer Trust 

- General Nursing Council Trust 

- Sandra Charitable Trust 

- Stephanie Thompson Memorial Trust 

## **Leadership Programmes 2020-21** 

- Health Education England (HEE) 

- HEE South-East 

- NHS England and NHS Improvement 

- Health Education Kent Surrey & Sussex 

- Dementia UK 

- Burdett Trust for Nursing 

- Sandra Charitable Trust 

- Queen Alexandra Royal Army Nursing Corps Association 

- Chief Nursing Officer (CNO) England 

- Cleveland Clinic 

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Florence Nightingale Foundation Annual Report 2020-21 

## **Corporate Sponsors 2020-21** 

- Nuffield Health 

- Brora 

- Floris London 

- LifeSearch 

- Freddie’s Flowers 

- Emma Bridgewater 

- • Kindred 

- Madeleine Floyd Designs 




















## **Alumni Community Fundraising** 

Due to the COVID-19 pandemic all alumni events in 2020-21 were cancelled. 

36 



Florence Nightingale Foundation Annual Report 2020-21 

## **Governance and Risk** 

The Governance and Assurance Committee is formally constituted as a Committee of the Board of Directors to monitor and oversee all aspects associated with the Foundation’s commitment to good governance and the requirements of the Charity Commission. Specifically, to provide assurance to the Board, that all likely risks to the Foundation, arising from its activities, have been identified and mitigated as far as possible. Good governance in charities is at the heart of their success. The Governance Committee is charged with ensuring the Code for the Voluntary and Community Sector (version for Small Organisations) including the identification of principal risks and uncertainties and how those risks are managed is implemented. 

All staff have annual performance appraisals against objectives linked to the business plan for the year. These are monitored monthly with the line manager. All new staff must pass a satisfactory six-month probation period at the start of their employment before becoming a permanent staff member. In 2020-21 a Pay Review Policy was approved by the Board setting out clear conditions and procedures for renumeration. The FNF Staff Handbook provides information on internal policies and ways of working and is available to all new starters. Croner, FNF Human Resources Partner, updates the Staff Handbook in line new employment legislation and all updates are provided to the team throughout the year. 

## **Major Risks and Key Mitigations** 

During the year the Foundation felt the full force and impact of COVID-19 on its operation and activities. At very short notice, staff were required to work from home, the office was closed, and a lockdown was imposed by the government. This brought to the fore unexpected and new risks which needed an immediate response and prompt mitigating actions. 

Instead of its normal quarterly meetings, the Committee met every two months. New policies were written and implemented including the COVID-19 Secure Policy, Mobile and Home Working Policy, Information Security Policy (including Cyber Security Guidance) and a Flexible Working Policy. Alongside this the Foundation was supported by four new policies: Study Leave, Procurement, Pay Review and Onboarding. In addition, eight existing policies were reviewed, and a revised and robust Conflict of Interest Policy and Procedure was introduced. 

The Corporate Risk Register, which has been kept under constant review has been reformatted and underpinned by a new Risk Management Policy. Its prime focus will be both identified risks and new risks created by the pandemic. A major risk identified during COVID-19 was the potential for cyber-security attacks, and the cessation of all fundraising activities. The Committee will ensure that appropriate action is implemented to reduce those risks as far as possible. The Committee is instituting a Monitoring and Assurance Programme to ensure adherence and compliance with existing policies and the first area for review is the Scheme of Delegated Authority. 

## **Conclusion** 

In the Autumn we said goodbye to Peter Siddall and Angela McLernon, and in January we welcomed Ben Edwards and Rhiannon Beaumont Wood. The Governance and Assurance Committee believes that all likely risks to the Foundation arising from activities in 2020-21 had been identified and mitigated against as far as possible. 


## **Andrew Andrews MBE** 

## **Vice-Chairman, Chair, Governance & Assurance Committee** 

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Florence Nightingale Foundation Annual Report 2020-21 

## **Annual Accounts** 

## **Statement of Trustee Responsibilities** 

The directors of FNF are also the trustees of the charity and are responsible for preparing the annual 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 directors to prepare financial statements for each financial year which 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 judgements and estimates that are reasonable and prudent 

- State whether applicable UK Accounting Standards and statements of recommended practice have been followed, subject to any material departures disclosed and explained in the financial statement 

- Prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charity will continue in operation 

The trustees are responsible for keeping adequate accounting records that 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. 

In so far as the trustees are aware: 

- There is no relevant audit information of which the charitable company’s auditor is unaware 

- The trustees have taken all steps that they ought to have taken to make themselves aware of any relevant audit information and to establish that the auditor is aware of that information 

The trustees are responsible for the maintenance and integrity of the corporate and financial information included on the charitable company's website. Legislation in the United Kingdom governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions. 

Members of the charity guarantee to contribute an amount not exceeding £1 to the assets of the charity in the event of winding up. The total number of such guarantees at 31 March 2020 was 19). The honorary officers and trustees are members of the charity, but this entitles them only to voting rights. The trustees have no beneficial interest in the charity. 

## **Auditor** 

Sayer Vincent LLP was appointed as the charitable company's auditor in September 2019 for a fiveyear term. It has expressed its willingness to continue in that capacity. 

The annual report has been prepared in accordance with the special provisions applicable to companies, subject to the small companies' regime. 

38 



Florence Nightingale Foundation Annual Report 2020-21 

The annual report has been approved by the Annual General Meeting on 14 September 2021 and signed on its behalf by the President. 


## **Baroness Watkins of Tavistock President** 

39 



Florence Nightingale Foundation Annual Report 2020-21 

## **Report of the Independent Auditor to the Members of The Florence Nightingale Foundation** 

## **The Florence Nightingale Foundation (A Company Limited by Guarantee)** 

## **Opinion** 

We have audited the financial statements of The Florence Nightingale Foundation (the ‘charitable company’) for the year ended 31 March 2021 which comprise the statement of financial activities, balance sheet, statement of cash flows and notes to the financial statements, including significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including FRS 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 

- Have been prepared in accordance with the requirements of the Companies Act 2006, the Charities and Trustee Investment (Scotland) Act 2005 and regulation 8 of the Charities Accounts (Scotland) Regulations 2006 (as amended) 

## **Basis for Opinion** 

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

## **Conclusions Relating to Going Concern** 

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

Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on The Florence Nightingale Foundation'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. 

**40** 



Florence Nightingale Foundation Annual Report 2020-21 

## **Other Information** 

The other information comprises the information included in the trustees’ annual report, other than the financial statements and our auditor’s 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. 

## **Opinions 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’ annual report for the financial year for which the financial statements are prepared is consistent with the financial statements; and 

- The trustees’ annual report has been prepared in accordance with applicable legal requirements 

## **Matters on Which We are Required to Report by Exception** 

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

We have nothing to report in respect of the following matters in relation to which the Companies Act 2006 and the Charities Accounts (Scotland) Regulations 2006 (as amended) require 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’ annual report and from the requirement to prepare a strategic report. 

## **Responsibilities of Trustees** 

As explained more fully in the statement of trustees’ responsibilities set out in the trustees’ annual report, 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 

**41** 



Florence Nightingale Foundation Annual Report 2020-21 

company or to cease operations or have no realistic alternative but to do so. 

## **Auditor’s Responsibilities for the Audit of the Financial Statements** 

We have been appointed as auditor under section 44(1)(c) of the Charities and Trustee Investment (Scotland) Act 2005 and under the Companies Act 2006 and report in accordance with regulations made under those Acts. 

Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in 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. The extent to which our procedures are capable of detecting irregularities, including fraud are set out below. 

## **Capability of the Audit in Detecting Irregularities** 

In identifying and assessing risks of material misstatement in respect of irregularities, including fraud and non- compliance with laws and regulations, our procedures included the following: 

- We enquired of management, which included 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; 

   - The internal controls established to mitigate risks related to fraud or non-compliance with laws and regulations. 

- 

   - We inspected the minutes of meetings of those charged with governance. 

- We obtained an understanding of the legal and regulatory framework that the charity operates in, focusing on those laws and regulations that had a material effect on the financial statements or that had a fundamental effect on the operations of the charity from our professional and sector experience. 

- We communicated applicable laws and regulations throughout the audit team and remained alert to any indications of non-compliance throughout the audit. 

- 

   - We reviewed any reports made to regulators. 

- We reviewed the financial statement disclosures and tested these to supporting documentation to assess compliance with applicable laws and regulations. 

- We performed analytical procedures to identify any unusual or unexpected relationships that may indicate risks of material misstatement due to fraud. 

- In addressing the risk of fraud through management override of controls, we tested the appropriateness    of journal entries and other adjustments, assessed whether the judgements made in making accounting estimates are indicative of a potential bias and tested significant transactions that are unusual or those outside the normal course of business. 

Because of the inherent limitations of an audit, there is a risk that we will not detect all irregularities, 

**42** 



Florence Nightingale Foundation Annual Report 2020-21 

including those leading to a material misstatement in the financial statements or non-compliance with regulation. This risk increases the more that compliance with a law or regulation is removed from the events and transactions reflected in the financial statements, as we will be less likely to become aware of instances of non-compliance. The risk is also greater regarding irregularities occurring due to fraud rather than error, as fraud involves intentional concealment, forgery, collusion, omission or misrepresentation. 

A further description of our responsibilities is available on the Financial Reporting Council’s website at:www.frc.org.uk/auditorsresponsibilities _._ This description forms part of our auditor’s 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 and section 44(1)(c) of the Charities and Trustee Investment (Scotland) Act 2005. 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 auditor’s 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 the charitable company's members as a body, for our audit work, for this report, or for the opinions we have formed. 


Fleur Holden (Senior statutory auditor) 24 September 2021 

for and on behalf of Sayer Vincent LLP, Statutory Auditor Invicta House, 108-114 Golden Lane, LONDON, EC1Y 0TL 

Sayer Vincent LLP is eligible to act as auditor in terms of section 1212 of the Companies Act 2006 

**43** 



Florence Nightingale Foundation Annual Report 2020-21 

## **Annual Accounts** 

**The Florence Nightingale Foundation (A Company Limited by Guarantee)** 

**Statement of Financial Activities Year Ended 31 March 2021** 

**The Florence Nightingale Foundation (A Company Limited by Guarantee)** 

**Statement of Financial Position at 31 March 2021** 

**The Florence Nightingale Foundation (A Company Limited by Guarantee)** 

**Cash Flow Statement For the Year Ended 31 March 2021** 

**The Florence Nightingale Foundation (A Company Limited by Guarantee)** 

**Notes to the Financial Statements Year Ended 31 March 2021** 

**44** 



Ff*the
od 11 2021
2020 a5
statEd
IM¢e 21)
2021
113.382
s&yo
5&YO
Jlar5h'p5
75.076
￿17.￿5
337.551
33.7%
3&11
1&6fy)
781615
B57,691
707.065
137.551
33.
74.129
361.481
1.010.029
1.084.157
361.481
Frortlino tr￿1￿￿j
MEmtQW5hip Ftts
27.820
46.420
25.(￿•
30.183
7S.O
30.183
31.495
31.49S
1.355.073
810.485 2.165.504
549.713
1.060.029
l.fm.761
I￿r￿j fund5
109.369
109.369
114.619
114.619
lar51ips
745.627
745,627
Gn.￿1
46.031
154.934
1.183.149
1.133.149
339.964
673.821
J3
127.114
339.964
Frortline C05
27.820
31.521
31.521
337
773.M7 1.769.ll4
48&104
1.133.149
1.619253
85&736
36.988
195.n4
68.629
173.12Ql
.492)
149.225
149225
7.551)
Q7.5511
507.961
544.949
3&078
(73.120J
07.043)
so7.￿1
36.988 S44.949
078
(73.1201
Q7,04J)
B40.S17 1.141.744 1.912261
1.035
1.387.621
I1￿5S6
21
1&404) (770.684) Q74.08&1
1943.¥11
<943.Mi)
837.113
371.W 1.208.171
1.035
HI.1￿ 1.245215
1.345.074
40B.￿a 1.753.122
837.113
371.060
1.20J.173
45

The Florence Nightingale Foundation
Balance sheet
Company no. 00518623
As ai 31 March 202 1
2020 as
Restated
(note 21}
Total as
rtststtd
2021
Total
Note
Fixed assetS-
Intrngible assets
Fixed asset5
Listed investments
Investrneni in subsidiary
21.183
32.655
1.024.457
29.657
21.105
875.232
1.078.295
926.094
Current assets:
Debtors
Cash at bank and in hand
1.265.972
3.114.501
932.970
2.030.995
4.380.473
2.963.965
Liabilities=
Creditors= amounts falling due within one year
13.258.358) (1.755.136}
Net current assets
1.122.115
1.208.829
Total assets less Currenl Ilabili1Ses
2.200.410
2,134,923
Creditors" amounts falling due after one year
(447.288
{926.750}
Total Net Assets
1.753.122
1.208.173
Funds-
Restricted income funds
Unrestricted income fund5=
General funds
408.048
371.(160
1.345.074
837.113
Total unrestricted funds
I.J45.074
837.113
Total funds
1.755.122
1.208.173
Approved by the trustees on __
and signed on their behalf bv
Dame Yvonne Moore5 OBE
Chair
Simon Reiler
Treasurer
46

The FIornACQ Illglrtiwalo Foundation
For th• y•ar •nd*d Ji Marth zozi
Nc¢e
2021
2020 as Re5tsred
NÈt ihC*)m* I lexpendr￿1EI for th* rtK>Orting pÈritid
las per the 5taternent of f￿￿￿111 aai¥iiies)
Deprociation thargos
IGwn511kn55es *)n ￿￿*s1￿entS
Di￿dendS and interest fr¢>m Th*stments
<ProPrt)iloss on the dispos31 of ftxed assets
Ilncreaselidecrease in *vrk in wogress
Ilncreaselidecrease in de￿01$
Incrwel(deueasel in credito
544.949
(206.395)
16.469
(149.225)
131.495)
i.ois
9.473
27.551
130.182)
112.295
1360.161)
798.385
(13$.002)
1.02a.760
osh I￿11d0d ￿ l (US￿ In) oporathg acthiitits
1.072.471
350.966
Dividend5 arhj interest fr¢>m Th*stments
Flythase of fimed a55ets
Pwchase of in¥estments
31.495
120.561)
30.182
120.038)
11001
ash I￿￿11d0d ￿ l (u5od in) Thysiiiig acisyiiie5
li.Oa4
10.044
chary• in ash and ush •q¥ival•ffls I￿ th• )•ar
1.083.505
361.010
Cash and ash equivalern5 at the begi￿￿￿ of the yw
2.030.995
1.669.984
Cash and cash equivalems at the end of the yoar
9.114.501
2.030.995
47

Th• Flornnc• NIgh￿ft￿￿ F•Und￿￿on
14rf*$ 1• tho flnanclal ststemonis
For the
tar *nd*d 31 Match 2021
l Accounting polici*s
Staurtory inforniaiion
The Florence Ni9hiing￿￿ Foundation 15 a chariiablo company limited by guaranieo and is incorporaiod in the Unittd
Kin9drrfn. The regi51ered office address and principal place of bu5ine5S 15 10-18 Union Strttt. London. SEI I I SZ.
b> lasfjs Of pr•patatlon
Tht finapitial stattments have beén prepared itr) xcordance with Accoutr)tiDg and Reporting by charitTres". 51atemeni
of RÈCOMM*nd￿ Practice applicablÈ to tharities preparing their accounts in accordance with the Financial Reporting
Stsndard applitable in th* UK and Rèpublic of IrÈland (FRS 102)- Icharr(iÈs SORP FRS 102). Th Financi￿ RÈportin9
Standard applicable in the UK and RepublK of Ireland IFRS 102) and the Cornpanies Ad 2006.
The Char￿ ￿s0 had a Whol￿ ownod subsidiary. Florenco Ni9htingalo Commorcial Limit*d_ Consolidated accounts
have not been prepared a5 the drlterence between parenr and group 15 irnmateri￿. The company YA5 dormant since
ifKowporation on 3 Ilay 2019. As no longer required this comparry wa5 deleted from the regi5teT a5 at 26th
DeCem￿r 2020.
A$5ets and liabilitie5 initial￿t rttognrsed at historical tilst or trtn5artiom value unless othern1￿ stated in thÈ
levant accounting polTrcy or nott.
In appfyin9 th* financL41 r*porting framowork. th* trustÈÈs havÈ mad* a nUffl￿r of Subjècti￿ jud9Èm*nts. for
oxamplo in rosp•a of significant a<counting ￿timat&S. Esiirnatos and judgomonis ar• continually ovaluatod and ar*
based on hi510rical experience and other faaor5. including expectations of fuwTe event5 Ihat are believed to b
wea50nable under the ci[cum5tances. The nature of the e5tiwnatTron mean5 the artual outcome5 could diffeT fiom
thoso &stimatos_ Any significant Qstimatos and judg*m4nts affocting th4so financiaj sw*m&nts aro dotailod wr(hin
tho r•lwant ￿cOUnting policy b•low.
The charrty rn••ts th• d•finiiion of a public b*nofrt ontity und*r FRS I02_
d> Going conc*
The Trustees <onfirmod that the going concern 15 ￿PrOpriate basi5 for preparing these accovnt5. They
r2coynise that ihere are uncertaintie5 in general about the future environrnenr bur given the a55ets. Teserves and the
vi&w of tho Foundation's futurn Lash flows considor th charity has th* ability to continuo as a 90in9 concorn.
Income is recogni5ed when the charity ha5 entrtlement ro the furK15. any performance condiiion5 attached ro the
ifKome have been met. it 15 probable that the income will be received and that the amount can be measured reliably.
Income received in advance of the provision of a specified servKe. including Commiss￿￿ed proyrammes and
Frontline ffaining incorne. 15 defevred UMI the criieria for income recognr(ion are met.
Income frr>m ScholaTships is Tetognistd in line wtth entTtlement to that in£¢)me. j.t. when a Schol￿ has been
soIKiod and th* scholarship comrn&ncod. Vth&r• funding is racoivod in yw for scholarships to bo providd in futur•
yoars th• incorno is rosrrthd.
Income received from scholarship fvnders as a coniribution t<Mards the costs of administering tho stholarship is
tyeatod as restricted incomo in the year that tho scholarship is undertakon.
Incom* rK*iv•d frorn 5cholarfs •mpl￿•T5 as a contribution tvwards th* costs of administ•rin9 tho scholarship is
treated a5 unre5trictEd income and recoyni5ed in the same period that the 5cholar5hip is undertaken.
Income from membership is re¢ognised in the period io tA*ith it relates. The annual meMbe￿hIP year runs fr¢)rn I
April to 31 March_
Claims mado through tho UK Covornmont's Coronavirus Job Rettniion and Support Sch*rno5 are rocognis*d as
income in the pEriod which the associated staff were furloughed. Thi5 income is consKlered io be unrestriaod.
48

Th• Flor•rt• NightithgaJ* F•und&tlo
For th•
•ar •hd•d 31 March 2021
l Accouniing polici•5 Ic•ntinu•OJ
Interest on fund5 held on deposit 15 intluded when reCe￿Ie and the amount can b* mtasur*d lt1￿b￿ by t
charrty: this is norniably upon ￿￿tItICation of the intertst paid or payable by the bank.
Fuhd accounting
R*StrItt￿ funds are to be used for specific pthrposés as I￿"d down by the donor. Expenditure which me*is these
<rit*ria 15 tg the fvnd_
Unrestiicted are donations and other incoming resources received or generated for the chariiable puryoses.
h) Expenditu￿ and Irrec•¥wable VAT
Empendiiure is recognised once there is a legal or constDJtti¥e obligation to make a payment to a third party. it is
probable thit settlement will be required and the amount of th* obligation be meas￿rnd rnliably. Expenditurn i5
Ila55ified under the following activtty headings-.
Costs of vaising funds relats to tho costs incurred by the charity in inducing third partiQ5 to rnakt voluntary
Contrib￿l0￿S to IL 15 TNell as the cost of any activities with a fundraising purpose.
ExpendTturÈ charitable activriies includes the costs of dÈlivèring our scholarships and training programmés
nderrAkon to further tho purposos of tho charity and thoir as50Ciited support costs_ This includes
Cornmissio￿Qd had•rship prI￿r￿M￿*S. frontlin* training and policy d•v•lopmMt
IrTecoverable VAT 15 charged a5 a <ost agaiTr￿ the artivity fow vA•ich the expenditure was incurTed.
•) Alloraii•n of 5upporr ro515
R*sour£es expèndèd art allocated to th* particular artivity where the cost rèlatès directly to that activity. However.
the cost of overall direction and administration of each activrty. comprising ihe Sa￿ and overhead costs of the
central funttion. is apportioned on the following basi5 i.e. fundrwsing l 0%. comrnissioned programmed 35%.
scholar prograrnme 24%. other activities I ￿. governance l 0% and SUPPDrt I l%. which are utimate. based on
5tsff time. of the amount attributable to each actrvity-
lthefe infonnai•on about the dims. obietti¥es and pfoiects of the charity is provided to potential beneficiaries. Ihe
osts a55ociatrd with this publicity allocatod to chiritabh *xp*nditurn.
Go¥ernaThce costs awe ihe costs assoiiaied with the governance aThan9emenis of the charity. These costs a
associated with cons11t￿lo￿al and suiutory requirernents and include any costs associ￿ed with the sirateglc
managerneni of the charity's aciivffjie5.
OprntiTrg
Rental Chargu arE charged on a straight line ba515 over the term of th* lea￿.
D Tan9lble fixed asseis
Items of equiprnent are upitali5ed where the purrhLst price exceed5 £1000. Thr5 includes grouped a55ets whtr
the ov*rall v&JuÈ of the 'set' of ittms is considtred. Depr￿latIon costs are allotat*d to actNtties tsn th* basis of tho
se of the related assets in those arti￿lIeS. Assets are reviewèd for impaim)ent rf circumstances indicate their
carryin9 valuo may oxcood thoir not roalisablo valuo and valuo in u5o_ Major £ompononts aro tr*ated as a s*parth
5s*i where th*y have significantly drfForont patt*rns of consurnption of oconomic b*n*ftts and doprnciatod
5eparitely over it5 Useful lrft.
Doprociation is provH1￿ at rat•s calculatod to write down tho cost gf eath •55et t(1 Irs estimated resid￿1 v4lue ovor
its expeuèd useful lrfe. The depreciation rntes in use are as follows".
Office equiprnent and fvrnirure
5 ￿&r$
49

Th* Flor*nc* Nlglbtlngah Foundatlon
Not•5 to th• fin￿(1a1 5tat•m•Trts
ear *nded 11 Marfh 2021
I AccouAtIAg p•llclos (corrtlnu•
ffl) Intanglbl• ass￿$
Intangibk a55*ts are capitsli5ed wh*re the purchase price exceeds £1000. Amortization costs art allocated to
ctiviiies on tho basis of tho us* of tho r*latod a5s*ts in thosQ aCtr¥ities. As5ors ar• reviowod for impairrn*rt if
cir£umstantÈs inditate thtir tarwng valut may exc*Èd th*ir ntt rtalisablt ￿lut valut in us*. Uaitir
components are treated as a 5tparat& a55et where thoy have signiticantly dtrf*ront patt*rn5 of ionsumption of
econi)mic benefits arbd are arnortj5ed soparately over it5 ysefyl lrfe_
Amortisation is provided at rates tal£ulatÈd to Ynitt down th* cost of eath asset to its Èstimattd rèsidual value ovtr
its expected useful lrfe. The amortisatioii rnie5 in use are ￿ follov45'.
Branding Mtheiing and Design
5 y•ars
List•d inv•stm•Thts
Investments are a form of basic financiaj in5tyvment and are iDirially recogni5ed at their tyansaaion value and
subsequently measured at their fair vajue as ai the balance sheet date using the closing quoted markei price. Any
chang* in fair valuo will bo r￿ognis￿d in the statornont of financial activitie5_ Invostmont gain5 and 1055Qs. whether
reali5ed or unreali5ed. are combined and shown in ihe heading "Ner gainslllosse51 on invesiment5" in the staternent
of financial art1vit￿5. Th• charity doo5 not acquir* put options. d*rivati￿S or oth•r <omplox finaniial instrum•nt5.
0> IwesThiofiis In subsidiarie5
In¥estrnents in subsbdiaries are at cost.
p> Debtors
Trade and other debtor5 are recogni5ed at th* stttl*mènt amount du*. Prtpaym*nts art valutd at tht am•urt
prepaid net of any trade discounts due.
q> Cash at bank and in hand
Cash ar bank and cash in hand includes cash and short ierm high￿ liquid invesThients wirh a short marurity of three
rnonths or ￿55 frorn the date of acquisition or opening of the deposit or similar accounL
t) Cff•ditors and provisions
Creditors and provisions are recoynised where the charity has a present obligarion resulting from a past evenr ih
will probably result in the transfer of funds io a third party and the amount due io settle the obligation can be
rneasured or esiimaied reliably. Creditor5 and provisions af* nornally rnco9nised at their 5enlement amount after
allowing for any trade discounts due.
s) Fin4n<i•l in5tThm•nts
The charity only ha5 financial assets and financial liabilities of a kind rhat qualify as basic financial instruments.
Basic financi￿ instruments are initialfy Tecognised at transariion val￿e and Subsequen￿ measured at their
setdement value with the ejtception of bank loans which are subsequently measured at ￿￿onISed cosi using the
effecri¥e intsrest meihtyj.
t) Penslons
Florence Nightingale FoundatioTr cOntrib￿te5 to a Defined Contribution Scheme operated by NEST.
50

Th• Flor•nE• Nightin￿￿ Foundatian
N•t*s t• th* fina￿111 stst*m*Ats
For lh•
oar •ndod 31 Marrh 2021
Z Inr•m• from don*ions
2020 as
Restated
T4xal
2021
T•uJ Vnresiricted
Vnrestrirred
Aestrirted
Kestritted
Gifts and donations frorn
fundraisin9 events
Evenr 5ponx)rship
Florence Alumni
Government Coronavirus Job
Reteniion and Support
Schern
96,281
3.668
935
96.2111
3.668
935
33.898
24.742
300
a3.89B
24.742
300
12,498
12.491
113.382
113.582
58.940
58.940
a lftcome from charlublo attiviilos
2020 as
Restatod
Total
(rèstated)
2021
Unre5tTiCted
(restated)
Resiricted
Ireststedl
Unrestritted
Aestricted
T•ial
scholarships res0￿￿e3
Scholarships support
670.000
12,615
670.000
187.691
98.836
898.836
185.321
75,076
74,129
Toral for 5(holarships
75.076
782.615
157.691
74.129
1.010.029
1.084.157
4 Incomo frrtrm thv*stmvrts
2021
Total UDrestricied
2020
Unrestrirted
RestrKted
Restritted
Divbdends
Bank btr)t*r*st
30.819
676
10.819
676
29.114
1.068
29.114
1.06
31.495
31.495
30.188
90.181
51

Th• Flgrnnr• Mightingal• Fouffl&ii4¥n
N•r*5 to ihe th￿￿￿(￿1 51ateinonrs
For th•
ar •Ad•d 31 March 2021
Sa Analysis of •xpthditur• <£urr•tht y•a
C•mmi55ior•od
Raising
funds
FN Frofflline
C95ts Other Artrvitses
Governance
Support
costs
2021
Tirtal
Prograrnrne5
5choknhip5
ost5
Stholarships wlarded
Comrni55i¢)ned Progr4mm* External Costs
FN Frontline Costs
Staff C0515
Redundancy Costs
CRM PROJECT
spec￿ E¥*nts
Office Admini￿rn￿)
511.554
511.554
311.344
.033
647.569
338.344
86.033
64.757
226.649
152.212
64.757
64.757
74.437
27.144
16.905
681
27.144
16,9)5
681
54.288
35.BlO
l.J62
Travel and Accommodation & SubSiste￿e
Trumee Empenses
Prof*55ional foos
Audit
Ac£ount*Ky
Deprec1￿10n. Amortis*ion & L055 on Di5P05
Sundry
10.95Q
i 0.000
5.580
8.743
17.139
10.950
21.900
10.000
5.580
8.743
19.139
17.486
36.278
64.757
564.993
663.766
86.033
64.757
161.899
163.579
1.769.784
Support Costs
Go¥errwice cost5
28.422
16.190
60.259
48.570
33.292
48.S70
41.607
48.570
(163.5791
1161.899>
Total *XP•Adltur• 2021
10g.Y69
673.821
745.627
86.033
154.914
1.769.784
Total •xpenditure 2020
14.619
339.964
33.148
31.521
1.619.254
52

The Florence Nightingale Foundation
Notes to the financial statements
For the
ear ended 31 March 2021
5b Analysis of expenditure {prior year a5 restated)
Commissioned
Leadership Scholarships as
Programmes
Restaied
2020 as
Restaied
Total
Orher
Activities
Governance
costs
Support
costs
Raising funds
Scholarships awaided
Commissioned Programme Exiernal Cosis
FN Frontline C05t5
Staff Cosis
Redundancy C05t5
CRM PROIECT
Special Evenis
Office Administration
Pieinise5
Travel and Accommodation & Subsistence
Trustee Expenses
Professional fees
Audii
Accouniancy
Depreciation, Amortlsation & Loss on Disposal
Sundry
758,551
758.551
172,976
172.976
48,394
1,913
10.691
4,862
64.898
2,565
14.336
6,520
164,986
6,520
36,446
16,575
12,100
478
2.673
1,216
16,132
638
3,564
1,621
15,991
17,823
7,837
4,614
36,291
13,300
19,488
4,737
4,243
16.132
638
3.564
1,621
15.991
17,823
7.837
4,614
36.291
13,300
19.488
4,737
4,243
322,642
12.752
71.274
32.414
31.982
35.646
5.673
9.227
72.581
26,600
38.975
9.474
8,486
65,860
261.294
983,078
16,466
146.277
146.277
1,619.253
Suppon costs
Governanie costs
14,628
34,131
43,883
34.787
73,883
76,188
13,883
1146,2771
1146,2771
Total expenditure 2020
114.619
339.964
1.133.148
31.521
1.619.253
Toial expendiiure 2019
69.104
1,216,879
1,285,983
53

onthd 31 IA￿ 2021
TIMS 15 Swed kn th￿lI¥j l
2021
2￿0
8.4n
4237
5236
Los5 on &sPJS￿ cl fixed a55ots
1.015
19.901
torfs (ex¢lthlir4VATr.
9.3tt+
17.SOQ
2021
2￿0
arns aThJ*3yes
5%.gn
291.723
12.752
25.337
41.501
9.097
647.569
335.396
2021
2020
£70.CQ)- £79.999
£BO.(￿- £89.999
£90.rA*)- £99.999
£341.322 Q02Q.. £215.966k
tharity vu5tres wve pawj rTh le￿￿*d ary(thr ber*fits frw *ith dwrity in the Jw 12020.. I￿J. clHw
£9.228J.
Tr* r•Jmber (rmrt based ￿ faThTknerdstalerylWI durry the)w*as 11.S (202tr. 8.(vJ.
2021
2QO
&0
54

1fid￿ 31 2021
rElaW p4rtytrwNth*￿5 ff* thd95e tr2027 202tr. rKfftl.
T￿1
thè start yw
42.%7
42367
th? end olth?
42.367
42367
startrfty*￿
12.710
8.474
12.710
8.474
21.104
21.TS3
21,1
29.657
29.657
Q4UiP
Tf
41.625
20.561
(10.643)
41.625
20.561
110.64•
in)w
111 lear
thEonddthEpr
51.543
Si.543
20.519
20.519
end ¢Ath?
1&888
32.655
12.655
21.1(
21.1(
55

Forth
11 2021
2021
2020
FaIrV￿u￿ at thE slart of thE
N# l Ow) on tharyp in fwr ￿lue
875232
149225
9J2,783
Q7.551)
J.024.457
8752a2
2021
2020
CaF Fixod lrterE5t
11.305
905.357
107.797
11,490
751.773
111.969
1.024.457
875232
1kn.ry 2019120. tl* chm Set up 5th￿lary. Rryence I￿￿1"￿e ts'n*•J. The rorywy¥Ya5 lirited iry
2021
1210.577
17.150
10.621
6.947
8252
I￿r dthor5
30.1
1265.972
932.970
2020 a5
X121
65.281
19.$33
IOA72
46.765
20.539
91.019
J.061.
160.063
1,524.366
1258351
i.￿5.736
2020 as
2021
447.281
926.750
56

F•rthÈ
1ftd￿ 31 2021
17 DEf*wed
X121
arKe * beginryry
rt rElea5od to incornE in the
rt deletyèj th thÈ ￿ar
2.451.116
0.524.%0
2.552.520
1.855.101
(687.660)
1283.675
8￿arKe at eThJ ofthe year
3.509270
2.451.116
3.C67.982
.524.366
2020 as
2•21
1.052.158
1.889.758
168.859
113.C
255.495
1.197.156
1253.
Frrthdine
3.509270
2.451.116
21.183
32.655
32,655
1.024.457
1.024.457
1.806.291
2.297.
4.184.097
(1.619.51J 11.442.4m 13.061.98
1447.2
1447.28ai
Tu¥Ji14E fixed ￿5<1$
currÈrt as5ots oxdLhliry dofErrod i1￿￿￿
Othfred ir*L￿. abTr)th)ts ￿lI￿j wiit•n cffje
Nrt 31 m￿h 202)
l.J45.074
4Ql.041 1.753.122
Tatsl
29.657
21.105
875.232
29.657
21,105
875232
Tu¥JibbE fixed a55*S
5te(1104E5trnerts
llvrtstn￿ in
Nei ojrfert assets exdthjirnj dllèrred
I.ICd175
11.197.15
1.625.020
2.713.195
1327.21(D 0.524.16
1926.750)
1926.MJ
D￿lfr￿ irKrAnE" aThLYrt5 ￿lIr￿j
S17.111
371.060
1.208.173
57

end￿ 31 2021
2020 as
2011
371.1
810.435
1773.44
3n.t
810.435
1773.44D
837.114
1.501298
1996.33n
1.345.075
837.114
1.501298
1996.a3
J.345.075
I.2￿774
2.314.733 (1.769.78¥)
1.753.12a
Iyb IIw•ntsits in furas
iAw4
2019 as Incrlrn & EXP￿1￿
31M
2020 as
444.IW I.1]60.029 11.I33.1+
3n.060
4H.I
i.(w.029 (1.135.149)
3n.060
1.035
522.182
1486.10
837.113
11.035
522.182
1486.10¢)
837.113
1.245.215
1.582211 (1.6192
1208.ln
2021
2020
32.4
C** to
37.
58

F•rtho
31 2021
Tf
840.517
1.141.744
iJ12261
¢ ￿11[￿￿ re4iewrfrestriaed sthlar5h'p irKr•
¢943.44l1
169.353
3.441)
169.3
13.4
31 2020
39.482
(245,8rn (Zl*J99
169.353
15gA
3&078
(73.12L
<17.04
21b p05iDQn
Trf
ai 2019
801.035
1.387.621
2.181.656
¢Y3.44l)
P4a.441)
A s(Warship hAs Thx¥bpen carried a OKyestablish*J. Therdtfe e*rr*nts d Ixrth sttthhp aTrJ
CLMntThssx*ned irmnÈ has bÈth rtCLyM*ed ￿(￿d¥*j￿y. A in i% in *ith FR5 102 afvj ￿ Ixs been
to£1.
59


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**T:** 020 7730 3030 **E:** admin@florence-nightingale-foundation.org.uk **W:** florence-nightingale-foundation.org.uk Florence Nightingale Foundation 10-18 Union Street, London, SE1 1SZ @FNightingaleF @fnightingalef The Florence Nightingale Foundation