ANNUAL REPORT AND FINANCIAL ACCOUNTS 2020-21
Annual Report and Financial Accounts **2020/21**
SECTION TITLE 1
ST ANN’S HOSPICE
## Contents
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01
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Our purpose, values and aims
2 CONTENTS
OUR PURPOSE, VALUES AND AIMS 3
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## Our purpose and our values
St Ann’s is one of the oldest and largest hospices outside of London, and we care for thousands of patients from across Greater Manchester every year. Our services are delivered from our sites in Heald Green and Little Hulton, as well as via a range of community and outreach services.
Our core purpose is ‘to provide excellent care and support to people living with, or affected by, life-limiting illnesses’.
We believe everyone has the right to access the same high quality, specialist care at the end of their life as they do when they’re born.
We’re passionate about providing care that supports our patients right from the point of diagnosis, through treatment, and beyond.
The care we provide is truly holistic. Our patients are individuals and our care addresses their unique needs, whatever they may be.
Our patients and their loved ones are at the heart of everything we do, and always will be.
## Our values
Our core values are embedded in all aspects of our work, and are at the heart of everything we do.
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Inclusive Professional
Compassionate Respectful
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## Strategic aims
As St Ann’s looks towards our 50th anniversary, it’s important that we ensure the hospice remains able to meet the changing care needs of future generations.
There are certain things which make us different:
- We’re a part of the broad health and social care environment but we’re also an independent charity, able to determine our own future.
- We don’t charge for our core service at the point of delivery.
- Our reputation is the key to our future and the type and quality of service we provide is therefore directly linked to that reputation.
- Our clinical strategy is at the heart of everything we do.
- Our workforce is supported by a large number of volunteers.
- We are a true local charity, serving our local communities.
- The majority of our funding comes directly from our supporters and local communities.
Our strategic aims put patients and their carers first:
**To provide world-class, innovative care:**
## **To be an organisation of choice:**
- Ensure St Ann’s remains a great place to work Foster development opportunities and engagement that leads to a skilled and engaged workforce
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- Delivery of excellent care, free of charge and equitably
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- Care at a time that’s right for each individual, including disadvantaged groups
- • Seek and share best practices • Integration of research, teaching and learning to improve patient care.
- Nurture staff and volunteer wellbeing
- • Endeavour to offer competitive terms, conditions and benefits.
**To continue to develop a valuesbased culture within which there are high-performing individuals and teams:**
## **To develop appropriate environments and outreach services to facilitate world-class specialist palliative and end of life care:**
- Ensure inspired, inspirational and visionary leadership, contributing to a highly capable, flexible workforce at all levels
- Deliver buildings and infrastructure we are proud of
- Continuous evaluation of Board performance and membership to ensure effective governance
- Ensure they are suitable, safe and facilitate effective performance
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- Enable flexibility to develop and meet emerging demands.
- Trustees, Executives and Senior Managers will lead by example, exhibiting our core values.
## **To continue to be financially viable:**
- Ensure effective financial governance at all times
- Increasing and sustaining engagement with statutory commissioners, NHS Trusts, and grant organisations to allow delivery of efficient, effective services
- Encourage innovative fundraising activity via sustainable, diverse income streams
- • Develop a robust retail strategy to increase Trading Company income.
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02
Highlights of 2020/21
Everyone is very friendly and professional in caring for me. Thank you. _St Ann’s Patient_
6 HIGHLIGHTS OF 2020/21
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## St Ann’s in numbers
Our online shops were incredibly popular this year, seeing an increase in sales of **12%.**
Statistics are important to us at St Ann’s, they help us demonstrate our impact and reach, but more often than not, they are interesting and insightful.
We need to raise around **£20,000** a day to keep our services running.
St Ann’s Our hospice **50th** lottery An army of membership **birthday** grew by is May 2021, **700** We support making us one volunteers support of the oldest and **thousands 5%** our work – of patients and those this year. largest hospices we’re looking closest to them every in the UK. forward to being year from our two able to invite many At the end of hospice sites and **Three quarters** more of them back March 2021 we had range of community of staff at the hospice to our sites and and outreach services. engaged with our shops soon, as Wellbeing Festival to help **28,618** We have pandemic restrictions followers on our support their health and continue to ease. social media channels. wellbeing. **350** Please do join them During staff who all work hard if you’re not already lockdown we following! to ensure patients are even arranged at the centre of **4** weddings everything we do.
During lockdown we even arranged **4** weddings for patients!
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**.** . We couldn’t possible list everything we’ve achieved in the last year, but here are a few highlights
**April 2020** We couldn’t do what we do without our amazing supporters, and in April thousands responded to our urgent funding appeal for help during the pandemic. We were so appreciative of everyone who thought of us and kindly donated so we could continue our care.
## **May 2020**
We celebrated International Nurses Day, thanking staff who continued to work hard on the front line – and some members of our nursing team even took to social media with a special dance routine that raised thousands of pounds for the hospice.
## **June 2020**
Our flagship fundraising event the Manchester Midnight Walk turned virtual this year, as hundreds of people took to the streets to walk whilst raising money for the hospice.
## **July 2020**
Most of our shops were safely reopened for customers in July, and staff and volunteers were thrilled to welcome back shoppers from across Greater Manchester. We also held special sales and Donation Drive-Thru events in our Distribution Centre to offer even more pre-loved and new goods to bargain hunters.
## **August 2020**
Our Catering Teams developed a range of new food options as part of an exciting project to further improve the food offering in our sites for staff, volunteers and visitors. Feedback is that the food is delicious, which is something our patients always comment on too!
## **September 2020**
The conversion of one of our outbuildings previously used for meetings into a safe, secure place for outpatients to come for appointments and therapies was opened. This was just one of a huge number of innovative ways we have reviewed and refreshed our service offering during the pandemic in line with restrictions and to meet the needs of our patients.
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## **October 2020**
Rachel McMillan was appointed as our new Chief Executive, taking over from Eamonn O’Neal who has now become our Director of Strategic Initiatives. This month we also held our Celebration Awards to recognise achievements of staff and volunteers across the organisation, and present long-service awards too. The event was virtual this year, but it was a fabulous opportunity to reflect and celebrate together.
## **January 2021**
In January as we kicked off our 50th anniversary year celebrations, we also held our first ever Wellbeing Festival for staff. A mixture of live and on demand activities and resources meant that employees could access information in a way that was best for them – and feedback was that everyone found the festival extremely helpful in highlighting the range of support available.
## **November 2020**
Our Practice Development Centre Team facilitated a series of webinars on inequalities in accessing palliative care, in collaboration with The Palliative and End of Life Care Greater Manchester and Eastern Cheshire Strategic Clinical Network teams. We’re passionate about improving access to care for all communities, and this was an exciting series to help inform and educate.
## **December 2020**
Christmas is always a special time at the hospice, as we prepare menus and activities for patients to help them create special memories. Our annual calendar is also packed as we celebrate and raise money during the festive season. A highlight, as always, was thousands of people joining us to take part in our Light up a Life appeal in memory of someone special.
## **February 2021**
Our brand new Move, Eat, Play, Give campaign saw businesses from Greater Manchester take on a series of challenges to raise money for the hospice.
## **March 2021**
A special 50th anniversary range of new goods was launched by our Trading Company Team, including bags, cups, badges and lots more limited edition items – all to mark our fantastic half-century milestone year!
What an incredible year.
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## 03
Chair and Chief Executive’s statement
Not content with maintaining the status quo, challenges have been turned into opportunities and services developed to ensure we have remained responsive, safe and compassionate throughout the pandemic. _Professor Jacqueline Oldham, Chair of the Board_
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## Joint Statement from the Chair and Chief Executive
St Ann’s first opened its doors in May 1971 and throughout 2021 we have been celebrating our 50th anniversary. A lot has changed since opening, but our ethos, to support people living with or affected by life-limiting illness has remained the same.
Throughout the year, teams The wellbeing of our staff and across the hospice have risen to volunteers and understanding the challenges of the COVID-19 their needs has also been a pandemic. Collaborating and priority. We have appointed adapting to constant change, 10 mental health first aiders staff, volunteers, local health across departments to support professionals, fundraising and people’s wellbeing and signpost other supporters have pulled to services. Enhanced leadership together to ensure patients training across all departments and their loved ones have has also strengthened remained at the heart of every knowledge and skills to develop decision made and have been individual and team resilience, able to access the care they maintain high performance and needed. Not content with ensure we continue to be an maintaining the status quo, employer of choice. challenges have been turned As we reflect on our into opportunities and services achievements outlined in developed to ensure we have these accounts we know they remained responsive, safe and would not have happened compassionate throughout.
own “roadmap to recovery” has enabled us to play a part in the mutual aid debate and locality planning during the pandemic. This in turn has resulted in raising our profile and an opportunity to showcase the instrumental role the hospice plays in the wider health and care system across Greater Manchester. These discussions
The we **l** being of our staff and volunteers and understanding their needs has also been a priority.
As we reflect on our into opportunities and services achievements outlined in developed to ensure we have these accounts we know they remained responsive, safe and would not have happened compassionate throughout. without extensive support and The COVID-19 pandemic collaboration. Developing our has also created significant fundraising challenges. Fundraising and Trading Company teams have been highly innovative displaying considerable creativity and seeking new opportunities to diversify our fundraising activity and portfolio of annual events. A COVID-19 urgent appeal at the beginning of the pandemic resulted in a considerable response. We have also welcomed additional COVID-19 response income from the Government Treasury and NHS, enabling us to keep our doors open to support those who have needed our care.
have also formed part of the wider Greater Manchester Hospice community debate and have provided more opportunity to share knowledge and services. Focussing now on the future we are contributing and influencing wider changes as Integrated Care Systems (ICS) are being developed and preparing for any impact on commissioning and contracting of services.
to provide specialist palliative concentrate on realisation of and end of life care to meet the our future strategy. We are now future needs of our patients committed to focussing on and and their families. We secured achieving our ambitious aims to planning permission in April continue to develop and deliver 2021 to build a completely world-class innovative care. new hospice on a site adjacent to the existing hospice. We have launched a major capital fundraising phased appeal and aim to commence building **Rachel McMillan** in Spring 2022. Meanwhile, Chief Executive of St Ann’s Hospice with external support, we are Date: 14th December 2021 investing also in a series of developments at our site in Little Hulton and are already embarking on significant refurbishment of our reception and coffee shop areas.
**Rachel McMillan** Chief Executive of St Ann’s Hospice Date: 14th December 2021
As we now look forward, we are proud to announce an exciting and ambitious initiative to create a new hospice for Manchester as we strive to continue to be an organisation of choice for people from across Greater Manchester. Our current Heald Green building is struggling to remain fit for purpose and we are moving forward at pace to ensure that we can continue
During the last 12 months we have remained focused, responded quickly and risen to the challenges of the COVID-19 pandemic whilst continuing to
**Professor Jacqueline Oldham** BSc (Hons) RGN PhD Chair of St Ann’s Hospice Date: 14th December 2021
Not content with maintaining the status quo, cha **l** enges have been turned into opportunities and services developed to ensure we have remained responsive, safe and compassionate throughout.
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ST ANN’S HOSPICE
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Trustees’ report and financial statements
I’ve been coming to St Ann’s for a while now. The staff and volunteers can’t do enough for you. It’s a lovely, calm and peaceful place to come. _St Ann’s Patient_
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ST ANN’S HOSPICE
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2020-21
## Trustees’ Report including Strategic Report
The Trustees of St Ann’s Hospice, who are also Directors of the company for the purposes of the Companies Act 2006, submit their annual report, together with the financial statements and auditor’s report for the year ended 31 March 2021.
The financial statements comply with the Charities Act 2011, the Companies Act 2006 and the Charities Statement of Recommended Practice (SORP) applicable to charities preparing their accounts in accordance with the Financial Reporting Standard (FRS102).
from its sites at St Ann’s Road North, Heald Green, Stockport; Meadowsweet Lane, off Peel Lane, Little Hulton, Salford; and The Neil Cliffe Centre at Wythenshawe Hospital, Manchester. The teams at the hospice also provide a range of community and outreach services to patients, including care in the place they call home via a Hospice at Home service available in Salford and Trafford. The hospice’s Community Specialist Palliative Care Team also supports patients in Salford, and a 24-hour telephone advice line is available to patients, carers and healthcare professionals in Salford, Manchester, Trafford and Stockport.
## **Constitution and**
## **governing documents**
St Ann’s Hospice is a company limited by guarantee (Company No 947220) and is registered as a charity under the Charities Act 1960 (Registered Charity No 258085). The company incorporated on 3rd February 1969 and is governed by a Memorandum and Articles of Association. A Board made up of Trustees (Directors) runs the company. Every Trustee undertakes to contribute to the assets of the company in the event of it being wound up during the time he/she is a Trustee or within one year afterwards. The amount that may be required will not exceed £1 (one pound) for payment of the debts and liabilities of the company contracted before the time when he/she ceases to be a Trustee.
## **Public benefit statement**
In setting our objectives and planning our services, the Trustees of St Ann’s Hospice have carefully considered the Charity Commission’s general guidance on public benefit. St Ann’s Hospice provides hospice services free of charge to those individuals aged over 18 years with life-limiting illness living in the Greater Manchester, Lancashire and Cheshire areas. The charity also provides supportive care for their families and carers and our care services are available, without restriction, to all groups in the communities we serve.
## **Aims and objectives**
The object of the charity, as set out in its Articles of Association, is to promote the relief of illness or suffering by:
- The expert care and support of people with palliative and end of life needs;
- The provision of services to promote health and wellbeing for patients and carers;
- The care and support of family and friends who have been bereaved; and
- The advancement of high quality and end of life care throughout the community.
St Ann’s Hospice provides holistic care to patients with life-limiting illnesses - comprising inpatient care, day therapy and supportive outpatient services -
## Governance
The Trustees are Directors of the company for the purposes of the Companies Act. The Articles of Association state there shall be a Board of Trustees (also referred to as the Board of Directors) which shall consist of not less than five members.
Trustees are appointed following advertisement and interview by a panel of existing Trustees. References and Disclosure and Barring Service checks are taken up before a formal recommendation is made to the Board by the Chair that the individual is appointed. Trustees have an annual appraisal, conducted by the Chair.
2006 to have regard to various structure. Each committee meets specific factors, including:: in between Board meetings and supports the Board with a. The likely consequences its work. The current structure of any decision in the long allows the Board to focus on term, strategic and big picture issues b. The interests of the charity’s by delegating responsibility and employees, empowering each committee to c. The need to foster the examine the detail and provide Charity’s relationships with the precise level of scrutiny third-party stakeholders that is necessary. By employing which, in the case of St Ann’s this structure, it allows the Hospice include people committees to provide affected by, or living with assurance to the Board and life-limiting illnesses, supports the flow of solutions, recommendations, and ideas.
## **Trustee Induction**
All new Trustees participate in an induction programme (reviewed and revised 2017/18) aimed at building knowledge and understanding of both the role and responsibilities of a Trustee and the work of the hospice. It includes attendance at the hospice’s organisational induction training attended by all new staff.
All staff and volunteers, including the trustees, must complete an annual mandatory training programme as well as attending ad-hoc training events, usually taking place at trustee away days. Our annual mandatory training includes, but is not limited to, data security awareness, conflict resolution, equality & diversity, human rights, fire safety, health & safety, and infection control, as well as fundraising, and more recently, COVID-19 guidance.
- d. The impact of the charity’s operations on the community and the **Delegated** environment, **Decision**
- e. The desirability of the charity **Making**
e. The desirability of the charity **Making** maintaining a reputation for A Scheme of Delegation high standards of business approved by the Board is in conduct, and place that sets out in detail the f. The need to act fairly as matters and powers delegated between members of the to the Chief Executive. The charity. Chief Executive is ultimately accountable to the Board for **Organisation** ensuring that the hospice meets The Board administers its obligation to perform its functions within the available the charity and meets financial and other resources.
## **Section 172(1)**
The Board administers the charity and meets a minimum of four
## **statement**
Trustees have a duty to promote the success of the Charity and, in doing so, are required by section 172(1) of the Companies Act
times each year. The hospice ensures good governance through an effective committee
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## **Internal Control and Risk**
**Management** The Audit Committee exists to advise on the effectiveness of the hospice’s internal control and management systems and to ensure all activities undertaken are subject to a continuous review for economy, effectiveness, and efficiency. The committee also has oversight of financial control, governance and risk-management across all facets of the organisation. The management of individual risks is delegated to relevant subcommittees of the Board. The Audit Committee receives reports from the internal auditor on both financial and nonfinancial matters. Clinical audit responsibilities are discharged to the Clinical Quality and Performance Committee. It also receives reports from the Executive Team and relevant sub-committees on the identification and management of strategic and operational risks. The Audit Committee also meets the external auditors.
**Engaging Stakeholders** Through regular engagement with key stakeholders, we maintain an understanding of their needs that informs how we define our organisational objectives, policies and strategy. The Board of Trustee’s decisionmaking process considers the impact of potential decisions on relevant stakeholders, and obtains assurance that proper
consideration is given by its Committees to stakeholder interests through regular reports from each Committee.
**Our Beneficiaries** We are keen to learn from our beneficiaries’ experiences at St Ann’s and actively seek feedback and suggestions that help us make positive changes. Our teams engage with numerous patients and their families on a day-today basis through the many services we provide. Our Trustees and Executive team carry out a monthly walk around on the IPUs (inpatient units) and listen to patients’ experiences. Our Executive team and Heads of Department regularly spend time with patients and help them complete a structured questionnaire that provides us with quantitative and qualitative data to inform our decisionmaking and help us make continuous improvements.
## **Our Supporters**
We engage with our supporters using a variety of proven and innovative strategies. To ensure our supporters remain with with us, we proactively engage with them by phone, email, or faceto-face meetings. We regularly thank our supporters for everything they do, constantly encouraging and nurturing them to become dynamic ambassadors that champion the hospice and its purpose. For those who have agreed to
receive communications from us, we send them ‘Friends’, our quarterly newsletter. The circular helps keep our supporters up-to-date with recent news, events, and stories from across the hospice. We also have invested effort in understanding our donor journey to ensure our supporters recognise the importance their support provides and enables them to see first-hand the impact it has. We have a significant presence online and across the social media platforms that we invest substantial effort in, creating interactive content and telling inspirational stories.
We invite all our supporters to our annual Light up a Life and Forget-me-not events as a way for us to come together as a community to remember and reflect. For those individuals who participate in any of our fundraising events, we build and develop strong relationships with them prior to the event by speaking them regularly over the phone and inviting them to in-person meet ups with other participants. This provides encouragement and support to their fundraising activity, but it helps strengthen our community and brings our supporters together to share their experiences.
Every year we hold a call-a-thon where the fundraising team attempt to phone as many of our supporters as possible in one day. We thank them for their ongoing support and loyalty and listen carefully to any feedback they have. In addition to our active communication approaches, we regularly ask
our supporters to complete surveys and questionnaires and encourage them to provide us with constructive criticism and feedback, especially where we can improve our engagement with them.
## **Our Staff & Volunteers**
We are proud that we have such a wonderful team of highly professional, caring staff at the hospice, who are passionate about what they do, and we recognise the importance of engaging with, and listening to them. Our weekly Chief Executive’s brief goes out to all staff and volunteers and once a month our Executive team hold a Director’s Drop-in. We have a number of working groups where membership includes various staff roles across the hospice. We use these groups to consult staff on new initiatives, ask them to participate in decision-making, and constructively provide feedback on policy and procedures. We also hold regular Schwartz rounds for staff and volunteers to share their experiences of working in what sometimes is a difficult and challenging environment.
At St Ann’s, volunteers work across the hospice in a variety of roles and with varying responsibilities. From running our coffee shop and providing visitors with a much-needed cup of tea, to tending to the hospice gardens, working in our charity shops, supporting the fundraising team with events or office work, or supporting staff on our wards with our
projects for our existing estate, and changing staff culture and behaviour.
celebrated drinks trolley, our volunteers are the lifeblood of the organisation. We want to encourage people, whatever their skills and background, to consider volunteering for us. We also want our volunteers to have every opportunity to develop themselves, and offer them the chance to apply for paid roles and access training and education to help support their personal and professional development.
**Carbon Dioxide Emissions (CO2e)** A total of 488.09 tonnes of CO2 generated by St Ann’s from Gas, Fuel for Transport and Electricity for fuel and/or transport.
- Gas = 368.33 tonnes CO2e
- • Electricity = 115.49 tonnes CO2e
- • Business Transport = 4.27 tonnes CO2e
## **Our**
Compared to 2019/20 figures below,
## **Suppliers**
St Ann’s Hospice • Gas = 263.89 tonnesCO2e works with key suppliers to • Electricity = 136.28 tonnes ensure the delivery of highquality services to its staff and CO2e beneficiaries through regular • Business Transport = 34.15 contract reviews and monitoring tonnes CO2e of quality. The supply of major • Total CO2e generated by services to the hospice are St Ann’s Hospice during regularly tendered to ensure high 2019/20 = 434.32 levels of service are maintained and delivered cost effectively.
## **Energy Consumed**
## **Environmental Sustainability**
The aggregate of the annual **Sustainability** quantity of energy consumed We remain committed to from activities for which the move our organisation to charity is responsible, in kWh is: more sustainable practices • 1,930,544.56 kWh through continually reviewing compared to 2,144,518.18 for and developing our working 2019/20. environments. Our aim is that informed and engaged employees work in low-carbon, **Methodology** efficient environments, using Energy consumption data was generated from minimum resources, producing billing information. Business minimum waste and travelling travel information was obtained only when necessary. Activities from staff mileage claims for the in this area range from, the period. As retrieving car type, development of a new modern hospice facility, efficiency
Energy consumption data was generated from billing information. Business travel information was obtained from staff mileage claims for the period. As retrieving car type,
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fuel type etc. was not possible, aggregated conversion factors were used for petrol & diesel cars, based on an “average” car in the government guidance. Ambulances and vans applied the category of “Managed Vans; Average; Diesel” for their conversion factor. Data on distance was taken from fuel invoice information with vehicle mpg information drawn from a number of online sources noted in supporting documentation (Energy Savings Opportunity Scheme - ESOS calculation spreadsheet). Current government guidance on all conversion factors was used throughout.
The ratio below is based on operational hours, for St Ann’s this equals::
- 8,760 per annum.
A ratio expressing annual emissions in relation to a quantifiable factor:
- 39.56 kgCO2e/operational hour
- 48.48 kgCO2e/operational hour 2019/20
**Energy Efficiency** The following measures were taken to increase energy efficiency in the reporting period:
- Introduction of SAH’s inaugural Sustainability Policy
- New smart meters sending daily readings to our suppliers allowing more accurate billing and access to better tarrifs
- New ‘smart zone’ heating system introduced at LH that heats areas in localised zones
meaning only populated areas are heated.
- DEC’s at both sites (Display Energy Certificates).
- Energy Efficiency reports for both sites.
- Development of video conferencing and remote working infrastructure and support.
- Appeals to staff to reduce business travel where possible (including proposals to liftshare cross-site)
- Input into HG newbuild design – requesting Mechanical and Electrical - M&E achieve net saving on current energy expenditure in what will be a significantly larger site.
- Information and
- communications technology - ICT strategy includes energy consumption as a key consideration regarding server upgrade v cloud-based computing
## **Notes**
The uplift in gas use may reflect reporting inaccuracies in the previous financial year. The switch to a daily report smart meter should provide a better reflection of actual use and will be assessed with year on year figures in 2021/22.
Fuel use/ambulance use was significantly reduced in 2020/21 due to covid. Cross site working reduced by around 80% and the closure of both day care services reduced use of ambulance transport.
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## Committees of the Board
Each Board committee is chaired by a Trustee who reports to the Board at each meeting on the matters considered by each committee. Membership of a committee varies, with each containing at least three Trustees, two or more Directors, and a handful of department heads.
## St Ann’s Directorates
Our executive team is responsible for each of the departments within the hospice. Our activities are organised under the following four directorates:
## **Clinical Services**
## **Audit Committee**
Responsible for ensuring St Ann’s fulfils its corporate **Audit** responsibilities in relation to financial reporting, internal control systems, risk management systems, internal and external audit function, and annual reporting. **Clinical Quality & Performance Committee** Responsible for ensuring appropriate scrutiny is provided into **Clinical Quality** quality standards, care delivery, and patient experience and **& Performance** safety, providing assurances on systems and processes, driving improvements in quality care, and monitoring all levels of risk. **Finance Committee** Responsible for high-level scrutiny of finance and business performance, robustness of financial systems, analyses and ~~**Finance**~~ assurances, strategic investments, pensions, risk, internal controls and policies, and annual reporting. **Human Resources Committee** Responsible for monitoring remuneration, employment policies, changes in conditions, overseeing matters of equality ~~**Human Resources** d~~ iversity and inclusivity, and monitoring the delivery of nonclinical training and development. **Strategic Development Committee** Responsible for optimising and developing new strategic **Strategic** opportunities, analysing the external environment and planning for sustainability, overseeing strategic developments **Development*** and reviewing all income generation strategies, including the capital fundraising campaign.
##
_*Assumed responsibility for the Capital Fundraising Appeal Committee (dissolved October 2019)_
**l** Throughout the year, teams across the hospice have risen to the cha enges of the COVID-19 pandemic.
Professor Jacqueline Oldham, Chair of the Board
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Deputy CEO
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**& Director of Clinical Services**
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Medical
Director
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**Director of Organisational Development & Support Services**
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Director of
Business
Development
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- Oversees strategic and operational clinical management and leadership across all patient services.
- Directorate comprises inpatient units, day therapy, supportive and medical outpatient services, Hospice@Home, Community Specialist Palliative Care Team, and the Practice Development Centre.
- The Director of Clinical Services is the Senior Information Risk Owner (SIRO) for the organisation.
## **Medical**
- The directorate comprises consultants and doctors that work both in the hospice and across the wider health and care ecosystem.
- Palliative care specialists that provide medical assessment and management of all hospice patients.
- The Medical Director is the Caldicott Guardian for the organisation.
## **Organisational Development & Support Services**
- Oversees a wide range of operational services and support functions across the hospice.
- Directorate comprises human resources, training and organisational development, estates, facilities, IT, and health and safety.
- Overseas the strategic development of the hospice through organisantional culture change, staff development, and idenitifyng new ways of working.
## **Business Development**
- Comprises four hospice departments; Finance, Fundriasing, Trading, and Communications.
- Oversees the strategic direction of the business thorugh maximising revenue, diversifying income streams, and ensuring the hospice is finacially viable.
- Immediate responsibility for the hopisce rebuild project at Heald Green and the concomitant Capital Campaign.
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## Our reach
St Ann’s is one of the oldest and largest hospices in the UK and our services span Greater Manchester and parts of Bolton, Wigan and East Cheshire.
We care for thousands of patients from across the area every year and provide support for their loved ones too.
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Ke St Ann y to ma ’s Hospice Sites p
@ Hospice@Home AreasSt Ann’s Hospice Sites
Hospice Shops
@ Hospice@Home Areas
Little Hulton Shop
Hospice Shops
Little Hulton Site M60
@
Community Specialists Nurses, Salford
@
Hospice@Home Salford
Ardwick
Furniture
@ Shop
Hospice@Home Trafford
Ladybarn
Furniture Shop
Sale Shop
Romiley Shop
Stockport Shop
Edgeley Shop
Neil Cliffe Centre
Heald Green Site
Altrincham Shop
Cheadle Hulme Shop
Heald Green Shop
**----- End of picture text -----**
We have to raise around **£20,000** a day to keep our services across Greater Manchester running.
## Achievements and Performance
standardised data set which will enable accurate benchmarking and contribute to the wider health and social care economy. This is a huge task and is ongoing.
## Medical and Clinical Services:
## **Clinical Services**
Our inpatient units have continued to operate a full inpatient service, throughout the last 12 months and we have seen an increase in admission numbers. This has been particularly evident at weekends and bank holidays due to our continuing work around access to seven-day services. Our staff have continued to support patients and their families with all aspects of their care, providing them with information to make informed choices including preferred priorities of care and preferred place of death (PPC & PPD), nutrition and hydration, medicines and visiting. Both inpatient units have seen a continuing flow of patients with increasing dependency, acuity, and complex needs throughout the patient pathway from referral to discharge or death.
There have not been any on-site inspections from the Care Quality Commission (CQC) during this period. However, due to the changes in 2018 of how hospices are being inspected currently and in the future – that being in the hospital directorate - St Ann’s has continued to engage with the relationship owner/ lead inspector at the CQC in what is proving to be a positive relationship.
## **The Being You Centre**
Our Being You Centre has continued in a virtual format over the last 12 months. These services have continued to include key worker reviews, signposting and psychological support. Our Being You Centre Team has been pivotal in supporting patients who would normally access services but have had to shield due to the COVID-19 pandemic. Feedback from patients had indicated that this has supported wellbeing and mental health throughout the last year. Our creative and music therapies have continued on our inpatient units and virtually, the teams have used video recordings to reach out to our patients. In addition, our Being You Centre staff implemented and rolled out our regular staff and visitor COVID-19 testing and throughout the pandemic we have provided ongoing delivery of specialist palliative medicine virtual and clinic support to those living in the community but requiring this specialist support.
The average monthly occupancy rate has been **77%,** 2019/20 - 81% and the average length of stay has reduced to **17** days calculated within the month from **22** in 2019/20. There has been an increase in the number of admissions to **628** from **558** in 2019/20. We have also seen a significant increase in weekend admissions from **29** in 2019/20 to **55** in 2020/21. We have had several patients with highly complex needs and therefore it has been difficult to transfer their care to an appropriate setting causing a longer than average length of stay which can further impact on the number of admissions. There has been a decrease in deaths to **58%** compared to last year’s figure of **63%** and the number of discharges has significantly increased to **40%** supporting patient choice and partnership working with community colleagues.
We have transformed the occupational therapy and physiotherapy face to face ‘Breathing Space’ programme to a series of four videos to enable these to be used during and after the pandemic for patients who may not be able to access face to face services at the hospice.
Our clinical services developed and are delivering on our clinical roadmap to recovery, embracing all the positive changes we have adopted during the COVID-19 pandemic to ensure ongoing delivery of safe and effective care to patients across all settings.
The reporting of clinical data is improving in accuracy and evolving as part of a project to inform our strategy. St Ann’s has been working alongside other Greater Manchester Hospices to develop a
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## **Commissioning for Quality and Innovation (CQUIN)**
St Ann’s was not required to implement the CQUIN requirements, carry out CQUIN audits nor submit CQUIN performance data. However, we have continued to actively participate in the CQUIN.
St Ann’s Hospice undertakes CQUIN projects each year in collaboration and agreement with Stockport CCG, as the lead CCG for the consortium. CQUIN projects set targets which are performance managed against a set criteria to ensure achievement and development within services. The CQUIN framework helps make quality part of the commissioner-provider discussion and allows us to look at the quality of our services and ensure that quality continues to improve. St Ann’s Hospice’s income in 2020/2021 was not conditional on achieving quality improvement and innovation goals through the Commissioning for Quality and Innovation payment framework because the operation of CQUIN has remained suspended for all providers until 31 March 2021 due to the COVID-19 pandemic
However, we have continued to implement CQUIN requirements, carry out CQUIN audits and record CQUIN performance data for projects which were already agreed prior to 1 April 2020. During the period 2020/2021 the following CQUIN projects were carried out/continued: 2020/2022 – Rehabilitative Palliative Care Approach. The rehabilitative palliative care CQUIN is looking at how as a hospice, we deliver care and support and ways in which we can further empower and enable patients, it is being supported by the rehab team but the changes are being led by other staff within the hospice to help support this significant culture change. As part of this work a cross site steering group has been developed to lead the changes across the whole organisation in line with the aims of the clinical strategy.
## **Quality Accounts**
The hospice published the Quality Accounts for this reporting period in line with national guidance.
## **Medical workforce**
St Ann’s medical workforce continues to comprise a spectrum of posts including Consultants, an Associate Specialist and Specialist
Doctor roles, as well as supporting rotational medical posts within the hospice sites. All doctors who work within the hospice are part of an annual appraisal and revalidation process.
The hospice has been able to recruit successfully to our medical posts over the past year and this has included the recruitment to two Consultant posts.
The medical team at the hospice provide support for patients and their families across both in-patient units, as well as within The Being You Centres, medical outpatient service and community. They also continue to support education and training of others, quality improvement, as well as strategic developments for the hospice.
Pilots and evaluation of different models of Consultant weekend working at the hospice have now concluded and a model has been agreed for 2021/22.
The hospice medical and wider team maintains strong links with the Greater Manchester and Eastern Cheshire Strategic Clinical Network Palliative Care Programme.
## **Community services**
Both the Hospice @ Home service and the Community Specialist Palliative Care Team (CSPCT) have had a busy year. There has been a significant increase in the total number of referrals to the community teams.
**----- Start of picture text -----**
Referrals Deaths Discharges
Hospice @ 47 13 14
Home Trafford
Hospice @ 287 110 66
Home Salford
Hospice @ 334 123 80
Home Total
Community 1080 412 187
Specialist
Palliative Care
Team
TOTAL 1414 535 267
**----- End of picture text -----**
Our Community Specialist Palliative Care Team has continued to provide a full face to face service during the last 12 months and have seen an increase in referrals during this time. The team has delivered specialist clinical leadership and expertise for patients,
our staff and acute hospital staff throughout the past year. The team has adapted services when required to include video and telephone consultation.
Our Hospice@Home Team has maintained a full service throughout 2020/2021. This service has successfully continued to triage referrals within 48 hours, assess the needs of patients at each visit and continued to provide ongoing emotional and psychological support for patients and their families, alongside collaborating more than ever with the District Nursing Teams.
Our Homeless Palliative Care Co-ordinator has maintained a full face to face service throughout 2020/2021. During this period, this service directly assisted 28 people in need of palliative care support across the GM footprint. In addition the service directly supported 42 people who had been impacted by loss. In addition, our Co-ordinator has worked collaboratively with our Community Specialist Palliative Care Team to make inroads into reaching out to this vulnerable population, working with the wider Greater Manchester homeless network.
## **Practice Development Centre**
Both our practice development centre (clinical training) and our Organisational Development and Training Manager (non-clinical) have continued to provide reduced programmes of training and education for staff throughout 2020/2021. We have adapted our training and worked innovatively to ensure that learning and education has remained a priority for our workforce. For example, our organisational induction programme has been adapted virtually to ensure new starters have been fully supported and our medical teams have facilitated monthly training sessions for all staff on a variety of relevant topics. Despite set-backs faced because of the COVID-19 pandemic, the remaining modules in the Inspire/Aspire Leadership Development Programme were adapted for virtual delivery and 13 individuals successfully completed the programme in February 2021. In addition, our Heads of Departments completed their external coaching support during 2020 and each gave positive feedback indicating that the programme was beneficial. Other training programmes which
we were unable to deliver will be rescheduled for the forthcoming year. Our Practice Education Facilitators (clinical) have continued to support staff throughout the pandemic to support clinical education and deliver training as needed. Sadly, due to the pandemic, we have been unable to facilitate our hospice exchange programme; however, we are hopeful we will be able to do so within the coming 12 months. Additionally, as an organisation through the early part of the pandemic, we retrained our staff as part of our re-deployment efforts to ensure that we had adequate numbers of staff, with the relevant skills and experience to continue to provide services during 2020/2021. Each redeployed staff member was supported with a buddy or mentor from the department they were redeployed to.
## **Clinical Audit and Quality**
We hold quarterly meetings where a rolling programme for clinical audit is agreed and reviewed. This includes clinical and medical staff from all services and departments. St Ann’s also participates in, and contributes to, the North West Regional Audit Group (NWAG) which is led by one of our consultants.
## **Patient Experience and User Involvement**
The comments scheme enables visitors, patients, volunteers, and staff to make suggestions for improvement or comments about our services. The Service Development Lead was responsible for managing the scheme and sending any comments received to the appropriate manager for consideration and ensuring a response if required. Actions included:
- Review of the disabled parking facilities
- Training update for volunteers on fire alarm procedure
- Provision of battery operated candles for the chapels.
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## **Patient and carer feedback**
St Ann’s is involved in a Greater Manchester hospicewide involvement group that aims to share current best practice in collecting patient and carer feedback. We are also working towards developing a process for seeking feedback from a wider cohort across the seven Greater Manchester hospices when larger datasets are required.
We also conduct the Friends and Family Test. During this reporting period, we have received excellent feedback to the two questions and many positive comments.
_How likely are you to recommend St Ann’s to friends and/or family members if they needed similar care or treatment?_
**----- Start of picture text -----**
IPU Being You Community
Centre
Extremely Likely 191 27 54
Likely 6 4 1
Neither likely or 0 0 0
unlikely
Extremely 0 0 0
unlikely
Don’t Know 0 0 0
Total completed 197 31 55
tests
**----- End of picture text -----**
## **Incident Reporting and Near Misses**
The hospice has a learning culture embedded in departments and encourages staff and volunteers to report and engage in the incident reporting system. This allows us to learn, improve, and prevent further incidents. Depending on the nature of the incident, they are discussed appropriately at the relevant committee to share learning across the organisation.
## **The year ahead**
St Ann’s Hospice celebrates a history of success, being one of the oldest and largest hospices in the UK. We feel highly privileged to be able to provide care and support to patients, their loved ones and care givers and will continue to work towards providing world class palliative and end of life care for all of those people we support. We will continue to work towards achieving our five year strategy during the coming 12 months alongside embedding our clinical strategy, as we reflect back on our achievements and challenges and look towards the requirements for our next five year strategy in 2022.
We will continue to monitor, measure and reflect on the quality of the services we provide and actively seek new ways to obtain feedback and establish where improvements can be made. As we celebrate our 50th year, we want to ensure our work and the services we provide are high quality, effective, efficient and dynamic as we face the future together.
## Organisational Development and Support Services
## **Digital Champions**
## Organisational Development
Digital skills have been identified as a key area of staff development and during the year a number of new initiatives were established to support this area. A Digital Champions development initiative has been launched to increase digital capability across the workforce with 18 individuals being assigned a digital buddy as part of an eight week programme of development. Subject matter experts have also been identified as Digital Champions and are available to provide ad-hoc support for quick queries.
## **Health & Wellbeing**
The Wellbeing Programme has continued to be rolled out with particular focus on wellbeing and resilience initiatives during the pandemic. Relationships have been built with the Greater Manchester Resilience Hub which is providing staff with additional support.
A week long Wellbeing Festival held in January was mainly delivered online due COVID-19 restrictions with live and recorded events. This included specialist blogs from members of staff, relaxation sessions with the hospices complementary therapists and sessions with the Greater Manchester Resilience Hub. A pocket-size guide was designed to support the Wellbeing Festival and issued to all staff signposting them to wellbeing resources.
## **Leadership Development**
Work has continued to support leadership development with all new leaders attending the hospice’s Inspire Leadership Development Programme and ongoing support and collaboration provided through the Leadership Exchange Network (LEN). This year’s LEN has focussed on wellbeing and has equipped leaders with tools to build their own and their team’s resilience.
During the year, ten employees have been trained as mental health first aiders and were launched at the Wellbeing Festival.
The new leadership behaviours, developed in 2019, have been embedded into the recruitment process and leadership development is targeted to support the behaviours. This is an important initiative as it formally defines the future skills and qualities needed by leaders to enable delivery of the strategic aims..
## **Apprenticeships**
Apprenticeships are supporting St Ann’s to attract high performing talent to the organisation along with investing in career development to assist with retention of talented individuals. The level at which employees are studying has increased, supporting our strategic aim of having high performing individuals and teams.
## **Staff Awards**
The hospice held its annual celebration event to celebrate staff and volunteers. Due to the pandemic restrictions this was a virtual event.
During the year the hospice has supported eleven apprentices ranging from Level 2 (equivalent to 5 G.C.S.E passes) to Level 7 (equivalent to Master’s Degree) supporting both clinical and nonclinical staff. The variety of careers supported by apprenticeships has also increased in diversity.
The event included awards in the following categories, as well as long service awards for employees and volunteers:
- Collaborative
This year the hospice has collaborated with external partners to support funding for apprenticeships.
- Innovative
- Initiative
- Together
- Team St Ann’s
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- Volunteer Special Recognition Award
A Covid-19 Special Recognition Award was presented to all teams through their Heads of Department in recognition of the extraordinary dedication and commitment they have given during challenging times.
## **Senior Staff Pay**
We aim to ensure that our employees’ salaries including our key leadership roles reflect the level of responsibility expected of them, and that they are comparable with the salaries paid by other voluntary organisations. This is in line with the National Council for Voluntary Organisations’ senior staff pay guidance that the aim of a charity’s pay policy should be to offer fair pay to attract and retain appropriately qualified individuals to lead, support and deliver the charity’s aims. By paying salaries that match similar roles at comparable organisations, we can attract and keep the highly skilled and committed staff the hospice requires. The salary structure and remuneration are considered in accordance with the Pay Policy and proposals are presented through the HR Committee and Finance Committee to the Board of Trustees.
## **Equality, Diversity and Inclusion**
St Ann’s Hospice is committed to equality, diversity and inclusion in volunteering, employment and workplace practices and to promoting equality, tackling discrimination and fostering good relationships between a diverse range of people, including service users. The hospice aims to create
an organisation that fosters good relationships between diverse groups, values diversity and promotes equality regardless of age, disability, gender, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief or sexual orientation as well as tackle unlawful discrimination proactively through policies, practice and procedures. At St Ann’s Hospice recruitment, selection, induction training, other opportunities for training, remuneration, Performance and Development Reviews, promotion, disciplinary action, dismissal, organisational communication and working practices take account of equal opportunities. Wherever possible the hospice will make reasonable adjustments to working practices and premises to support staff with a disability
## **Staff Engagement**
A variety of channels and forums have been developed to ensure effective communication and involvement including a weekly Chief Executive Brief, staff intranet and departmental team meetings. In addition departmental representatives are invited to attend quarterly Involve meetings providing a channel for communication and consultation in relation to:
- developing our workplace culture and working practices
- ensuring safety, wellbeing and happiness at work
- safeguarding and promoting our values
- reward and recognition
- development and career progression
- sustaining our future
## Support Services
## **Redevelopments at Little Hulton**
Planning permission was granted for the redevelopment of the “front of house” areas at Little Hulton including the Reception, Coffee Shop and Conservatory. This will provide much needed space for the Coffee Shop. Landscaping outside into the enclosed garden will create an outdoor sitting area for patients, relatives, staff and visitors.
Design drawing and specifications have been on-going with consultation and feedback being developed with key stakeholders and wider staff. Construction work is due to commence in Spring 2021.
## **Enhancements to Coffee Shop at Heald Green**
Investment has been made into the Coffee Shop at Heald Green with the installation of a sandwich and salad bar which was necessary to facilitate social distancing. However, the improved facility has enabled the development of a bespoke service with customers being able to order food to meet their own specifications. The new initiative is proving popular and the catering teams have been able to try some new ways of working in line with future plans within the new building at Heald Green.
## **Our Response to the COVID-19 Pandemic**
Throughout the last 12 months a number of initiatives have been put in place to ensure staff safety. This has included ensuring adequate supplies of PPE, undertaking individual COVID-19 risk assessments, developing a COVID-19 secure workplace and obtaining access to the vaccination programme in its early stages.
The pandemic has had an impact on everyone’s working and home life and alongside safety it was also important to consider emotional and practical support for staff. Support ranged from developing a section on the Staff Hub for COVID-19 related information and creating a “time-out” room for reflection to contacting local supermarkets to ensure hospice staff could take advantage of priority opening times. In addition, resources were provided to enable staff to digitally upskill as the requirement to use remote technology increased.
Relationships have been built with the Greater Manchester Resilience Hub which is providing staff with additional support. The hub also supported the hospice during the annual Wellbeing Festival and with staff both individually and within teams.
Measures have been taken across all hospice sites to ensure social distancing and safe working practices. Cleaning regimes have been stepped up with a particular focus on touch points, protective screens are in place, appropriate signage has been displayed and the number of hand sanitizer stations has increased.
The facilities teams have repurposed rooms to ensure social distancing and ensured all locations were equipped with appropriate technology to support virtual appointments and meetings.
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## Business Development
The last year has been challenging for the Business Development directorate, with shops closed for the majority of the year, community and corporate fundraising at a standstill, and many sporting and challenge events cancelled. This focussed our thinking and sparked innovation. Each team worked collaboratively to identify and implement new ways of generating income; we introduced the virtual Manchester Midnight Walk, our Distribution Centre started popup sales, and we increased resource in our online offering.
One of the most important pieces of work was our urgent funding appeal that went out to all our supporters. We contacted everyone we could and utilised all our communication channels. The appeal brought in a staggering £145k, which was heart-warming to know that when we needed it most, the support of our community was there.
The coming year will bring it’s own challenges and obstacles, but we have outstanding teams and inspirational leadership in place to drive our ambitious agenda forward. We will continue to develop the individual departmental and overall directorate strategies to deliver both long-term income growth and efficiency savings. This will help the hospice to continue to be finally viable.
due to the unbudgeted urgent appeal that delivered £145K in donations alongside lottery and regular giving sign ups which overall could deliver a lifetime value of £250K in total.
## Fundraising
Fundraising income from donations and legacies to the 31st March 2021 was £4,657,247 against the previous year of £4,755,048 (2019/20), a decrease of 2.1%. The COVID-19 pandemic caused our fundraising activities to change significantly from what we had originally planned with the cancellation of the majority of events and community activity. We were still able to progress against the fundraising strategy in the following ways:
Legacy income was 3.1% down at £2,4 million compared with the previous year, of £2.5 million but 0.4% ahead of budget The year started slowly, with the majority of both solicitors and will making organisations reducing to essential operations. We have now allocated a dedicated resource to recover outstanding payments and that is working well.
1. To increase Income to ensure the charity remains financially viable and that revenue income plans dovetail with the public phase of the capital campaign.
St Ann’s is working on a legacy programme with GM Hospices to increase the awareness of legacy giving across the Greater Manchester area. This will help strengthen our messaging.
Income has remained stable despite the challenges faced; community and events income only delivered 53% and 42% of their budget respectively. The JustHelping Christmas tree campaign was significant in this income resulting in over £50k for the hospice. Our flagship event, the Manchester Midnight Walk, became the Manchester Virtual Walk, which enabled us to recover some of the lost income. This in the main was well received by our supporters.
Our Grateful patient programme remains on hold until social restrictions lift.
2. To grow our volunteer network by recruiting and training money-generating volunteers.
- Volunteering has been largely on hold during 2020-21 due to social restrictions, some of our administration volunteers have been able to continue their support due to the investment in a cloud based system in 2019 and a limited number have supported in a COVID safe way in their community.
Other income streams outperformed the budget to make up for these losses – Major Gifts Trusts and Foundations (164%); corporate (160%) – specifically due to the successful application to Barclays for a £100K grant, and Individual giving (128%) primarily
3. To recruit and retain highly skilled individuals, investing in training and development opportunities.
The pandemic has allowed increased access to free and low cost training and development opportunities which have been enthusiastically embraced. In addition a number of St Ann’s staff have presented at regional and national conferences and webinars for the Institute of fundraising and the hospice income generation network.
4. To design and implement our donor journey to increase the retention of supporters.
Our donor journey work continues successfully with the integration of fundraising and trading databases to give all SAH supporters a seamless experience. In addition we have aligned direct mail across the two departments to increase options for donors to give in the way that they wish to do so. St Ann’s took part in a pilot scheme to integrate the Justgiving platform with Raiser’s Edge database, this enables us to spend less time on transactional administration and more time on supporter care and stewardship.
5. To ensure all our activities are underpinned with correct governance.
St Ann’s Hospice and St Ann’s Hospice Trading Company are a member of the Institute of Fundraising (IoF) and the Fundraising Regulator (FR). No incidents were reported in 2020/21.
We review all new activity in line with our information governance policy. In 2020/21 an ethical donations, fundraising data policies have been written and ratified. A Donor recognition policy is underway alongside a full fundraising policy in line with audit recommendations.
Fundraising was subject to the impact of a data breach from Blackbaud. This incident was resolved in line with information governance policy and was reported to both supporters who were affected and the ICO - Information Commission Office who notified us that no further action would be taken.
We continue to act ethically and responsibly, using best practice when communicating with our donors and supporters and adhere to The Code of Fundraising Practice and its associated Rulebooks for street and door fundraising that outline the standards expected of fundraising activity. In the Year 2020/21,
we received one request to cease communication through the Fundraising Preference Service. One complaint relating to Fundraising was received during the year, these were logged on our internal incident reporting register and actioned accordingly.
We display the trusted logo of the Fundraising Regulator on all our fundraising communications. The fundraising team and Trading Company undertake safeguarding training in line with the charity’s policy for protecting vulnerable people.
We engage with external fundraising contractors who act on our behalf to engage with Trusts & Foundations and carry out lottery promotions.
## Finance
Throughout 2020-21, the focus for the Finance Team was to continue to offer high quality finance support to the organisation whilst operating predominately on a remote basis because of COVID-19 restrictions.
We embraced digital solutions, including implementing new software enabling the team to process Direct Debit collections and BACS payments remotely from any location ensuring the continuity of service.
We worked closely with our fundraising colleagues to support new fundraising initiatives, undertaken as a response to COVID-19 restrictions limiting traditional methods of fundraising. We ensured the correct accounting treatment was utilised, and that procedures were in place to safeguard the smooth, efficient processing of income; maximising Gift Aid where appropriate.
During the year under review, the Finance team faced additional reporting requirements both internally, in terms of forecasting and scenario planning, and externally producing reports for Hospice UK to support the payment of grant income provided by NHS England.
During what has been an exceptionally busy year, we were also able to look to the future. We secured external funding to offer an accounting apprenticeship to a member of the team and took steps to record legacy notifications digitally on the donor database.
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## Trading Company
Trading Company turnover to the 31st March 2021 was **£2,268,942** against the previous year **£2,646,309** ; a decrease of **14.3%.** Operating profit in the year was **£562,735** , a **15.5%** decrease on 2019/20. The decrease in turnover and profit this year was due to the onset of COVID 19 and the introduction of government restrictions which resulted in all our high street shops being subject to closure restrictions on three occasions and for around seven months of the financial year, causing a significant impact on the business.
**----- Start of picture text -----**
Turnover to 31st March 2021
£2,268,942
a 14.3% decrease on 2019/20
Operating profit to 31st March 2021
£562,735
a 15.5% decrease on 2019/20
**----- End of picture text -----**
In addition, shop closures were further compounded by the restrictions on door-to-door lottery canvassing and despite engaging the services of a telephone campaign; the impact on business was felt at the start of the new financial year and negatively affected total income for the remaining year with a reduction of **7.9%** .
Conversely, during this period, our online retail operations continued to remain strong and sales increased year-on-year by **3.5%** . In addition, our house clearance service which operated within restrictions, achieved a **4%** increase on income.
## **Shops**
Shop overall income was down **36%** on the previous year, the impact of poor footfall, social distancing, and closures took its toll on the high street.
A new approach to generating income was quickly adopted and the Distribution Centre became a hub of activity. The team worked hard and introduced popup events as well as a click and collect facility. This resulted in the generation of **£43,000** - a brand new income stream.
In the absence of a bricks and mortar selling platform, a mail order catalogue featuring new goods was created and developed and posted out in conjunction with quarterly fundraising mailings. **18,053**
## **Lottery**
Since the onset of COVID
19 restrictions, plans were put in place to switch lottery recruitment from door-to-door to telephone recruitment.
Lottery membership at the end of March 2021 was **18,053** with an average of **78%** of members playing each week. During the 2020/21 financial year, membership grew by **5%** and the average number of active players grew by **9%** .
The number of canvassing companies were increased from one to three to gain flexibility in our approach to canvassing.
We continued to signup new lottery members via the lottery website at an average of **12** new plays each week with a total of **630** during the year.
The lottery received **1** complaint in 2020/21.
## **New initiatives**
Due to a restructure of the retail operations, the bridal shop is to be relocated to the top floor at Stockport.
The online operation is set to expand with the introduction of two new roles in order to facilitate the ongoing revenue growth and potential opportunities in this sector.
The expansion of e commerce will continue with the introduction of the Depop and vintage sales platforms.
The new goods catalogue is to be developed in both frequency and range.
A new 5 year strategic plan will be developed to incorporate new initiatives and the ever changing face of retailing.
## Marketing & Communications
also enabled us to reach out to communities across Greater Manchester and beyond.
Communications has arguably never been more important than this year, with changes to government restrictions, adaptations to our services to ensure we could continue to safely meet the needs of patients, regular changes to our retail offerings, and a range of fundraising appeals and activities all needing to be communicated in a timely, efficient and effective manner.
Content delivered includes blogs, videos, news stories, printed materials, photography, speaking opportunities, award entries, face-to-face engagement and numerous cross-channel campaigns supporting both fundraising activity and our service provision. Our internal communications also remain a vital part of our work, ensuring that our staff and volunteers have access to the most up to date information, whilst also supporting them with their health and wellbeing. The team, in partnership with the hospice’s HR department, developed a Wellbeing Festival which was held in January, and comprised a range of live and on-demand events and activities, as well as a range of resources aimed at raising awareness of health and wellbeing support available to employees. It also helped increase engagement with the organisation’s Staff Hub intranet site, with around three quarters of staff accessing resources at that time.
We have successfully increased activity across all elements of the marketing and communications mix again this year, leading to further growth in both the number of people reached and their engagement with our content.
- In this period, we generated **1,272** pieces of press coverage, reaching **112,921,083** people.
Numerous projects to test efficacy of - and engagement with - various pieces of digital content, to improve our online visitor journey and increase visitor numbers and reach proved successful this year. This work resulted in:
- An increase in the reach of our posts on Facebook and Twitter from **3,133,698** in 2019-20 to **3,842,535** in 2020-21.
The move from a transactional approach to communications to more strategic led activity will continue in the coming year, and is especially important as we work towards the launch of our capital campaign for our new hospice in Heald Green.
- An increase in the number of visitors to the hospice website from an average of **9,403** per month in 2019-20 to **11,719** in 2020-21.
- An increase in followers across our Facebook, Twitter, Instagram, Linked In and YouTube accounts, totalling **28,618** at the end of March 2021.
The multiplatform content creation and focus on storytelling has further helped to engage audiences and dispel myths around the care we provide and has
**----- Start of picture text -----**
1,272
pieces of press coverage
**----- End of picture text -----**
**----- Start of picture text -----**
28,618
website visitors a month
11,719
**----- End of picture text -----**
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## Our Response to the COVID-19 Pandemic
No one would ever imagine that we would still be in the midst of a global pandemic. The last few years have been one of the most challenging in our lifetime. Everyone has been affected, both personally and professionally, but we are still here, thriving, surviving, and adapting. We have all shown compassion and professionalism in all that we do.
The world around us is changing at a rapid pace, and we are extremely proud of the way every team across the organisation has pulled together to respond to the changing needs of our patients, the evolving guidance on COVID-19, and the various new ways of working. Hospices are crucial partners in the delivery of highly specialist palliative and end of life care, and we demonstrate enormous benefit to the wider health and social care system across the Greater Manchester and Cheshire area.
highly vulnerable or shielding category so unable to visit the hospice for an appointment. Patients and families have really valued this service, and anecdotal feedback as well as the NHS Friends and Family Test, all demonstrated that patients and their families feel supported.
Collaboration is always something we pride ourselves on, with the last few years being no exception; we have been even more proactive and responsive to our partners. We have been involved in mutual aid conversations with the neighbouring NHS Trusts and clinical commissioning groups. We have been the regional PPE hub for hospices, receiving weekly deliveries and distributing stock across many hospices in the North West. We have built a positive and collegiate relationship with our local infection prevention and control team at Manchester University NHS Foundation Trust (MFT) via an SLA that was already in place prior to the pandemic. This has proved invaluable when interpreting the latest and constantly changing guidance for health and social care settings.
All the teams across the organisation, whether that is at our hospice sites, our community services, or the Trading Company, have all worked tirelessly to ensure we can continue to deliver world-class innovative care and support to our patients and their families. St Ann’s response to the impact of COVID-19 continues to be managed through service preparedness, resilience and response structures, and well-documented processes. The health, safety, and wellbeing of our patients, staff, and families remains our absolute priority.
During this challenging time, we have been responsive and identified opportunities to adapt and flex our service delivery to continue to meet the needs of our patients and those close to them. We have kept abreast of the ever-changing government guidelines as well as those from Public Health England. We have gone above and beyond to ensure our staff have been consulted and communicated with at every step. We have maintained our performance as agreed with our commissioning colleagues and continued with our quality improvement projects despite the challenges of the pandemic.
The inclusive approach to effective communication internally was exceptional, with the support of our business continuity and risk management plan and process, instigating daily and weekly calls with the executive leadership team, heads of department, trustee representation, representatives from the clinical commissioning group, and infection prevention and control too.
All staff had an individual risk assessment completed with their line manager and any risks and appropriate actions identified. Staff wellbeing has been a priority and we listened and responded to staff need. The pandemic has had an impact on everyone’s working and home life, and alongside safety, it was also important to consider emotional and practical support for staff.
The majority of outpatient services have been conducted via telephone or virtual platforms, and medical consultations are done via AccuRX; a virtual secure platform used across the wider healthcare system. A proportion of our patients are in the
Staff support ranged from developing a section on the Staff Hub for COVID-19 related information and creating a “time-out” room for reflection, to contacting local supermarkets to ensure hospice staff could take advantage of priority opening times. In addition, we provided our staff with resources to enable them to digitally upskill as the requirement to use new remote tools and technologies increased.
Relationships were built with the Greater Manchester Resilience Hub, which is providing staff with additional support. The hub also supported the hospice during our annual Wellbeing Festival and with staff, both individually and within teams. We have trained 10 staff in new roles of Mental Health First Aiders. We have continued to deliver and offer Schwartz rounds for people to listen and reflect on their own wellbeing and experiences. We continued to deliver our LEN (Leadership Exchange Networks) workshops, for staff to take stock of their own leadership styles and necessary behaviours and resilience to enable them to lead themselves and their teams through the crisis.
We have regularly reviewed our hospice sites and shops to ensure the environment is safe and compliant with Public Health England and Government guidelines. Measures have been taken across all sites to ensure social distancing and safe working practices. Cleaning regimes have been stepped up, with a particular focus on touch points; protective screens are in place, appropriate signage has been displayed, and the number of hand sanitizer stations has increased.
The facilities teams have repurposed rooms to ensure social distancing and ensured all locations were equipped with appropriate technology to support
virtual appointments and meetings. We have invested in IT hardware to ensure those staff who can or need to work from home or have a hybridworking pattern.
We were proactive in ensuring all patients and staff were able to access appropriate COVID-19 testing, and we also introduced regular lateral flow tests (LFTs) for asymptomatic staff, volunteers, and visitors.
We ensured access to COVID-19 vaccines for staff and business critical volunteers was high priority by using our strong relationships with local partners. Frontline staff were offered the vaccine in December 2020 via Stockport Metropolitan Borough Council and Stepping Hill Hospital. Uptake of the vaccine has been good and feedback has been positive.
Following the announcement of the Government roadmap, the Director of Clinical Services has led on a piece of work to develop a clinical roadmap specific to St Ann’s. Each team leader was asked to share their ideas on how their service may recover with suggested timeframes. The roadmap will enable clinical teams to have a clear vision of how services will start to recover and adapt over the coming months. We will take a cautious approach and be flexible to changes in relation to the pandemic. This document has been shared across other teams and is delivered in conjunction with the Head of Facilities.
We will continue to monitor, measure, and reflect on the quality of the services we provide as we come out of the pandemic. We will constantly adapt and actively seek where improvements can be made. We want to ensure our work and the services we provide are always high quality, effective, efficient and dynamic as we face the future together.
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## Review of 2020-2021 Priorities
**3. Drive a culture of continuous improvement through high performing, resilient, and efficient teams and individuals**
## **1. Develop our clinical and medical ambitions to further enhance our patient and family services**
All band 5 staff nurses now have a live competency framework document which supports their development, conveys expectations, and rewards consistent good performance. All clinical patient-facing staff are able to demonstrate they have competent communication skills relevant to their role. We have started to embed a culture of rehabilitative palliative care focussed on personal priorities and was evaluated by the CCG through the Commissioning for Quality and Innovation (CQUIN) scheme. Patients can now access inpatient unit beds at weekends in a timely manner and have a senior medical review at weekends (if appropriate). In addition, staff from across the hospice have been widely consulted on requirements for our new build at Heald Green and our refurbishment at Little Hulton.
We have continued to review our strategy, our structure, and the roles within it, embedding a culture of change that drives efficiencies. We have asked all leaders to prepare succession plans for business critical roles within their areas, identifying training and development needs for individuals that will support their development and retain our talented staff.
We have introduced a number of wellbeing initiatives including a monthly wellbeing newsletter “Wellbeing Matters”, an annual wellbeing day, and access for all staff to the Greater Manchester Resilience Hub.
We have introduced formal proposals to review our pay structure to keep pace with the NHS and ensure staff engagement and recognition through the introduction of competency frameworks. Work is ongoing and we hope to start implementation the latter half of the financial year.
## **2. Ensure the organisation maintains its resilience and sustainability beyond the COVID-19 pandemic**
**4. Obtain successful planning permission for our new worldclass hospice facility at Heald**
The COVID-19 pandemic has presented a number of immediate and long-term challenges to our organisation, but at the same time, it has presented opportunities and new ways of working. More detail about our response to the COVID-19 pandemic can be found in the previous section of this document.
## **Green**
On 29th April 2021, Stockport Metropolitan Borough Council overwhelmingly voted in favour of our planning application and granted us planning permission to build our new world-class hospice facility on adjacent land at Heald Green. Outline planning
permission was also granted for up to 40 dwellings on our existing land that will be used to fund the construction cost.
## **5. Launch our ambitious capital fundraising campaign alongside our 50th year celebrations**
St Ann’s Hospice celebrated its 50th birthday in May 2021, a milestone only few hospices have achieved. We used our 50th birthday to promote and intensify our fundraising by significantly increasing the amount of press coverage. Our website and all our social media channels experienced a huge increase in traffic and engagement. This helped raise awareness and drive new supporters to our fundraising products.
We have launched our capital fundraising campaign to highnet-worth individuals and corporates as we remain in the ‘quiet’ phase and the advanced stages of planning. We aim to go public just before construction begins and will run a number of themed sub-campaigns over the course of the building project, using specific movements in time as the hook e.g. help us build our foundations, raise the roof, landscape our gardens etc.
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## Our priorities for 2021-2022
Our Five-Year Strategy 2017-2022 outlines what we hope to achieve as an organisation over a five-year period. As you would expect, at the heart of that strategy are our patients and their families. Everything we do at St Ann’s is aimed at ensuring they have the best possible levels of care.
Our priorities for the coming year define and determine our areas of focus so that we can maximise our impact and ensure we remain on track to deliver what we set out to in 2017. The priorities below are not a comprehensive list of everything we will do this year, it sets out where we will focus our efforts whilst retaining the flexibility to address new priorities and respond to emerging issues.
**1 Ensure the organisation is ready to start construction of the new Heald Green building by Q2 2022**
**Review our pay structure to ensure we remain 2 competitive, encourage staff development, and reward achievement**
**Continuously develop and deliver our clinical 3 services roadmap for recovery from the COVID-19 pandemic**
**Enhance our governance for clinical quality and 4 improvement to ensure our inspection readiness state is maintained**
**Complete the first phase of our redevelopment and 5 refurbishment work at our Little Hulton site.**
**Ensure the organisation is ready to start construction of the new Heald Green building by Q2 2022**
- In April 2021, we were granted planning permission for a new world-class hospice facility on land adjacent to the existing site, including outline planning for 40 housing units on the hospice’s existing site.
- • We will work closely with our expert consultants to agree the planning conditions and negotiate the complex Section 106 clauses, so a final decision notice is issued promptly.
- • The design team will accelerate their work to ensure a final design is ready to put out for tender, with the expectation that a building contractor will be selected and ready to start on site by Q2 2022.
- Fundraising relationships that have been developed over the past few years with Charitable Trusts and Foundations, Major Donors, and Corporates will now be utilised; applications will be submitted and direct asks will be made.
- • We will approach organisations and individuals who have expressed interest in purchasing our existing land for development and advance conversations to explore funding options that will benefit the hospice during the construction phase of the new facility.
- **Review** enabled care to improve and ensure a blended, timely
- **our pay** and safe approach to clinical
- **structure to** services.
- **ensure we remain** • Continue to care for our **competitive,** inpatients by identifying and **encourage staff** working to the COVID-19 pathway guidance including
- **development, and** access to the required level **reward achievement** of PPE for staff. • Consider alternative • Monitor the impact of structures for pay COVID-19 on all clinical progression which enables services and competiveness, fairness and resume our faceensures recognition to-face support
- • within the Seek feedback from staff on alternatives to the current hospice for our communitypay structure working based patients to ensure that closely with them to develop the hospice remains a place enhanced processes for of choice. reward. • We will review the clinical
- • volunteer roles and Assess the impact of previous pay award including reintroduce volunteers safely the ability to recruit and back into our clinical services •
- retain high performing Continue to explore individuals. collaborative opportunities
- • Monitor the impact of NHS with NHS Foundation Trusts pay awards and benchmark and other providers of health other external organisations and care and share best to ensure the hospice practice. remains competitive.
**Enhance our Continuously governance for develop clinical quality and and deliver improvement to our clinical ensure our inspection services roadmap for readiness state is recovery from the maintained COVID-19 pandemic** • We will assess and embed
- **COVID-19 pandemic** • We will assess and embed • Embed the transformations incident management within within clinical services to the hospice ensuring that support recovery from continuously improving the COVID-19 pandemic patient safety involves the and longer-term changes; hospice building on the including the redesign foundations of a patient of clinical pathways and safety culture and better use continued use of digitally of systems.
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- Construction started on site in July 2021 and will follow a 12-week project plan with the expectation that all work is complete by November 2021.
**Complete the first phase of our redevelopment and refurbishment work at our Little Hulton site.**
- Undertake a review of risk management within the hospice utilising Pineapple and a more robust risk management policy.
- To explore further quality improvement work across the organisation.
- • We will deliver internal and external training and education projects and launch those which were placed on hold due to the COVID-19 pandemic, ensuring a well-trained and compliant workforce.
- • We will continue to monitor, measure and reflect on the quality of the services we provide and actively seek new ways to obtain feedback and establish where improvements can be made
- **Hulton site.** • Phase 1 of the work will be supported financially by a
- • Work has been carried out major donor, with funding
- in consultation with staff to be sought from other
- and architects to develop a sources, including Charitable
- strategy for the space and Trusts and Foundations, for
- the needs of service users subsequent phases.
- and staff at the Little Hulton site.
- The focus is on a reconfiguration of rooms to enhance the existing building to support the provision of world-class care and to redevelop the site’s Coffee Shop.
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## Manchester’s New Hospice
St Ann’s is one of the oldest and largest hospices in the UK, caring for people throughout Greater Manchester. Thanks to the generosity and support of our local community we opened our doors 50 years ago, to look after people with life-limiting illnesses, and to provide support for their families.
We now need a new, purpose-built hospice that will serve the needs of our community now and in the future. If we do not act now, we’re at real risk of closing services in the near future. We will create a new hospice facility in Heald Green that ensures we can continue to deliver pioneering, world-class care for people in Greater Manchester for generations to come.
private space and facilities, and staff will benefit from an easier working environment and be able to focus more time on caring directly for patients.
## **World-Class Facilities**
## **Background & Vision**
The building will offer more flexible accommodation which will mean we can increase our admissions, and care for patients with complex needs more easily. People will benefit from improved privacy to attend consultations, assessments, activities and counselling therapies in a way that suits them; inpatients will have increased dignity with their own
St Ann’s new hospice will be a complete care facility in Greater Manchester that people can come to from diagnosis of a life-limiting illness, through treatment, and beyond. Our holistic approach to care will meet the complete medical, physical and spiritual needs of patients and their families, in an environment that is welcoming, caring and fully equipped with modern facilities.
The Being You Centre will be transformed by the increased space, offering an integrated dining area and lounge, consulting rooms for outpatient services – including counselling, patient and family support, and complementary therapies – and
Our new hospice will be a model of future hospice care; it will give us space to expand our work, becoming a centre of training and excellence and a hub of innovation, working with partners in palliative and end of life care across Greater Manchester. We know that care will change as the needs of our patients change, and we will be equipped for these changes so that we can always be at the forefront of innovative care – in the next 10, 50, or 100 years and beyond.
a fully equipped physiotherapy suite. Surrounding the whole facility will be landscaped gardens accessible to all patients and visitors.
The new hospice building will deliver improved social and financial sustainability, offering a training suite and bistro as available spaces for use by the local community. The environment focussed design will use the latest green initiatives. Ultimately, it will mean a better working environment for staff and volunteers and vitally, result in a hospice that will be able to care for whoever needs it for a further 50 years and more.
## **Planning & Construction**
On 29th April 2021, at the Planning & Highways Regulation Committee for Stockport Metropolitan Borough Council, the hospice requested full planning permission for the demolition of all existing buildings and the development of a new hospice facility, including access and landscaping. In addition, the hospice requested outline planning permission with all matters reserved, except for access for a residential development of up to 40 residential dwellings, landscaping, and other associated infrastructure on the existing hospice site. It was resolved (11 for, 1 against) that planning permission be granted.
Over the coming year, we will work with our expert consultants and legal team to agree and negotiate the planning conditions and a section 106
agreement. Once these are the reality. We have designated finalised, the planning authority **£13,778,294** of our reserves will issue the decision notice and towards the project; this is the hospice will complete the over 50% of the total amount purchase of the land. Our design required, but with no statutory team will continue to work in funding available for hospice consultation with hospice staff buildings, we need to raise the and volunteers to complete the rest. final design before it is put out Following a number of years for tender.
Following a number of years for tender. of extensive research and We will also approach a number planning, we have launched an of individuals and organisations ambitious capital fundraising who have expressed an interest campaign. We plan to submit in purchasing our land in the grant applications to charitable future for housing development. trusts and foundations, and We will investigate whether make direct asks to individuals there are any opportunities for and corporations who have unlocking a proportion of the the capacity and propensity value of our land to support us to give. When we are ready, during the construction period. we will launch a large public campaign that engages with the **Capital Fundraising** local and wider community to **Campaign** help us raise the final amount. This is an ambitious £20 million We anticipate fundraising to continue whilst the building project. But, it is essential so that is under construction. We we can continue to provide our will use the various stages of care into the future, and ensure construction to support the the palliative and end of life care public campaign message, for needs of patients in Greater Manchester can be met. example, help us cement our foundations for the future, or With the plans now in place, we buy-a-brick to build the walls of now need to raise the funds to our new hospice.
With the plans now in place, we now need to raise the funds to ensure that this vision becomes
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## Financial Review
The accounts for the year have been prepared in accordance with the Statement of Recommended Practice Accounting and Reporting by Charities (SORP 2019) and comply with all statutory requirements and the hospice’s governing document. The accounts consolidate the results of the hospice and its trading subsidiary.
The Trustees report a net increase to overall funds for the year of £5.1 million (2019/20: £1.2 million decrease) and an overall funds balance of £18.8 million at 31st March 2021 (£13.6 million at 31st March 2020). The financial position of the group is set out in the balance sheet on page 55. The Reserves Policy relating to the funds held by the hospice is described in the Reserves Policy below.
£0.6 million, 7.9% decrease compared to 2019/20. Investment income and interest receivable in 2020/21 was £0.1 million, this is a decrease of 44% compared with 2019/20 of £0.2 million.
The cost of Charitable Activities reduced slightly by 1.7% from £10 million in 2019/20 to £9.8 million in 2020/21. We continue to review our cost base to ensure that we are providing our services as efficiently as possible.
## **Income and expenditure**
The Statement of Financial Activities is set out on page 54 of these financial statements. From an operating point of view 2020/21 showed a surplus before investment (losses)/gains and pension liability movements of £2,363k (2019/20: deficit of £257k).
The actuarial gain in the pension fund is £1.6 million (2019/20 £0.6 million loss). In the Statement of Financial Activities there is a decrease in the liability to £2.4 million (2019/20 £3.9 million). The pension liability and its impact on the hospice’s financial position is monitored closely by the Trustees of the St Ann’s Pension Scheme. The major financial assumptions used to calculate the Pension Scheme Liability are shown in Note 22 to the Accounts.
The hospice’s principal sources of income are donations, legacies, NHS income and trading profits. Total income in 2020/21 was £14.6 million (2019/20 £12.5 million), an increase of 16.6%.
Income from donations is down this year at £2.2 million, an 2.4% decrease compared to the previous year (2019/20: £2.3 million).
Legacy income is 3.1% down this year (£2.4 million), recognised as received or as due under FRS102 (2019/20: £2.5 million).
Funding from NHS Clinical Commissioning Groups amounted to £5.1 million, an increase of 7% due to additional Covid 19 support (2019/20 £4.8 million).
The NHSE awarded funding to allow the hospice to make available bed capacity and community support from April 2020 to July 2020 to provide support to people with complex needs in the context of the COVID-19 situation and to provide bed capacity and community support from November 2020 to March 2021 for the same purpose.
The turnover of the Trading Company has decreased to £2.3 million compared to £2.6 million in 2019/21. An effect of the closure of the shops for a significant part of the year. The amount gifted to the hospice is
## **Investment Performance, Policy and Management**
At 31st March 2021 the value of the investment portfolio was £4.6 million (see note 15); a decrease of £1.8 million compared to 31st March 2020 balance of £6.4 million. During the year, income earned on the portfolio was reinvested. On a total return basis (income plus capital change), the portfolio experienced a return of 27.03% compared to the benchmarks, the WMA Income index and Brewin Dolphin’s benchmark, which experienced returns of 22.16% and 21.21% respectively. There has been a significant recovery this year as the impact of COVID subsides. Once again this year, the portfolio significantly outperformed its benchmarks.
The investment managers have been given delegated responsibility to manage the investment portfolio, subject to agreed asset allocations. Funds are invested in a portfolio of UK and overseas equities, fixed interest investments, and alternative investments such as property and cash. Investment performance is reviewed quarterly at each Finance Committee.
The investment policy is to seek the best financial return within an acceptable level of risk and the investment objectives are a balance between income and capital growth.
Investments made on behalf of the hospice are restricted in that no investments may be made directly in companies manufacturing tobacco related products.
## **Policy on Reserves**
A Statement of Unrestricted Funds is shown in Note 22 to the Accounts. The Charities SORP defines reserves as that part of a charity’s funds that is freely available to spend. The Trustees have agreed that these free reserves should not normally exceed one year’s running costs. The free reserves at 31st March 2021 are £3.1m (2019/20: £5.0 million) which represents three months of normal running costs for the hospice (2019/20: between five and six months).
The Charities SORP specifically allows for funds held as “tangible fixed assets for charity use” to be excluded from free reserves. The Trustees therefore set aside a designated fund of £1.7 million, equal to the net book value of tangible fixed assets (2019/20: £4.3 million). This amount has reduce significantly as the Trustees unanimously agreed to remove the proportion of funds attributed to the Heald Green site due to the forthcoming rebuild project and the planned demolition of the building on this site.
In addition, the Trustees have designated a fund to be held for Property Refurbishment and Development which totals £13.8 million (2019/20: £4.1 million). This fund relates mainly to the Heald Green site and reflects the immediate requirement to set aside funds towards the rebuilding of our new hospice to meet the increasingly complex clinical and care requirements of patients.
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## **Strategic Risks**
St Ann’s Hospice recognises the risks associated with voluntary income from fundraising, particularly legacies, which is an income stream that fluctuates unpredictably. Changes to legislation, downturns in the economy and activity from other charitable organisations, whether within or outside the hospice sector may all impact on fundraising revenue.
In mitigation of the potential risks, the Trustees regularly review external influences and legislative implications. We take a proactive approach in encouraging supporters to consider legacies and a strategic approach to securing Trusts and grant awards for both restricted and unrestricted monies. The St Ann’s Trading Company Board and management team monitor performance of the retail outlets and lottery against budget, forecasts and trends.
In April 2019 St Ann’s Hospice renewed the Clinical Commission Group consortium. This is a 3 year contract with the option to extend for a further 2 years.
St Ann’s Hospice continues to work collaboratively with Greater Manchester hospices to measure the impact of the devolved Greater Manchester Health and Social Care Partnership, which is considering options in the commissioning structure. The hospice team has regular, strategic engagement with the CCGs regarding funding that may be allocated according to levels of clinical activity and service delivery.
The hospice has identified a number of projects to assist with achieving its business objectives and ensuring and protecting financial viability. Some projects may result in changes for the existing workforce and will require appropriate levels of effective leadership in order to achieve success.
The hospice manages this risk by utilising a range of methods to communicate and update staff, including HR and executive director surgeries and open meetings. The ‘managing change’ workshop continues to link with INSPIRE and ASPIRE development programmes.
During the last year the hospice has developed a bespoke system to manage strategic and operational risks across the organisation. The intuitive and user-friendly system will support the hospice to
manage individual risks using mitigating actions and risk controls. The system allows users to create and update individual risk registers, view the audit history to understand how risks have changed over time, and evidence that risk owners are regularly reviewing and updating their risks.
## **Going Concern**
The Trustees are satisfied that the hospice has considerable financial resources available to be financially viable for the next twelve months. The hospice’s first quarter income has outperformed budget with legacies and the Trading Company doing particularly well.
The hospice has also made significant savings in expenditure from a wide range of areas due to the changes in working practices. Consequently, the Trustees believe that, overall, the hospice is in a strong position to manage its business risks successfully. Accordingly, they continue to adopt the going concern basis in preparing the Annual Report and Financial Statements.
## Trustees’ Responsibility Statement
The trustees (who are also directors of St Ann’s Hospice for the purposes of company law) are responsible for preparing the Trustees’ Annual Report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice) including FRS 102 “The Financial Reporting Standard applicable in the UK and Republic of Ireland”.
In so far as the trustees are aware:
Company law requires the trustees 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 the group and of the incoming resources and application of resources, including the income and expenditure, of the charitable company and the group for that period. In preparing these financial statements, the trustees are required to:
- there is no relevant audit information of which the charitable company’s auditor is unaware; and
- 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.
- 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 have been followed, and
The Trustees report, including the Strategic Report, was approved by the Board and signed on its behalf
- prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charitable company will continue in business.
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 the group and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.
**Professor Jacqueline Oldham** BSc (Hons) RGN PhD Chair of St Ann’s Hospice Date: 14th December 2021
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## Consolidated statement of financial activities (including consolidated income and expenditure account) **For the year ended 31st March 2021**
|**For the year ended 31st March 2021**|||||
|---|---|---|---|---|
|Note|Unrestricted
funds
£|Restricted
funds
£|Total funds
2021
£|Total funds
2020
£|
|INCOME FROM:|||||
|Voluntary income
Donations and legacies
3
Charitable activities
4
Other trading activities
5
Other Income
6
Investments
7|4,414,121
4,112,568
2,277,366
11,106
105,583|243,126
3,410,036
-
-
-|4,657,247
7,522,604
2,277,366
11,106
105,583|4,755,048
4,840,268
2,714,547
-
188,368|
|TOTAL INCOME|10,920,744|3,653,162|14,573,906|12,498,231|
||||||
|EXPENDITURE ON:|||||
|Raising funds
8
Charitable activities
9|2,380,997
6,312,039|-
3,517,412|2,380,997
9,829,451|2,756,035
9,998,951|
|TOTAL EXPENDITURE|8,693,036|3,517,412|12,210,448|12,754,986|
||||||
|Net income/(expenditure) before investment gains/(losses)|2,227,708|135,750|2,363,458|(256,755)|
|Net Gains/(losses) on Investments
16
Net income/(expenditure) before tax
10
Taxation
13|1,160,259
3,387,967
23,420|-
135,750
-|1,160,259
3,523,717
23,420|(352,060)
(608,815)
(29,496)|
||||||
|Net income/(expenditure) for the year|3,411,387|135,750|3,547,137|(638,311)|
|Transfer Between Funds
22
|91,089|(91,089)|-|-|
|Other Recognised Gains/(Losses):
|||||
|Actuarial Gains/(Losses) on Defined Benefit Schemes
24|1,595,000|-|1,595,000|(560,000)|
|NET MOVEMENT IN FUNDS
FUND BALANCES BROUGHT FORWARD AT
1st April|5,097,476
13,423,988|44,661
197,383|5,142,137
13,621,371|(1,198,311)
14,819,682|
|FUND BALANCES CARRIED FORWARD AT|||||
|31st March
22|18,521,464|242,044|18,763,508|13,621,371|
There were no other recognised gains or losses other than those listed above and the net income for the year. All There were no other recognised gains or losses other than those listed above and the net income for the year. All income and expenditure income and expenditure derives from continuing activities.derives from continuing activities.
The surplus/(deficit) of the parent charity for the year for Companies Act purposes is The surplus/(deficit) of the parent charity for the year for Companies Act purposes is 5,142,137 (2020 (£1,198,311)). £5,142,137 (2020 (£1,198,311)).
As permitted by Section 408 of the Companies Act 2006, no separate Statement of Financial Activities is presented in respect of the As permitted by Section 408 of the Companies Act 2006, no separate Statement of Financial Activities is presented in respect of the parent charity.parent charity.
## BALANCE SHEET **As at 31st March 2021**
|Note|Group
2021
2020
£
£|Group
2021
2020
£
£|Charity
2021
2020
£
£|Charity
2021
2020
£
£|
|---|---|---|---|---|
|FIXED ASSETS|||||
|Tangible assets for use by the charity
15
Investments
16|4,557,816
4,580,913|4,671,078
6,354,727|4,542,612
4,580,915|4,640,185
6,354,729|
||9,138,729|11,025,805|9,123,527|10,994,914|
|CURRENT ASSETS|||||
|Stocks
17
Debtors
18
Cash at bank and in hand
19|44,287
3,396,269
9,715,423|56,965
2,796,781
4,907,400|546
3,665,928
9,212,553|546
2,852,889
4,565,580|
||13,155,979|7,761,146|12,879,027|7,419,015|
|CREDITORS: amounts falling due
within one year
20|(1,111,200)|(1,262,580)|(819,046)|(889,558)|
|NET CURRENT ASSETS|12,044,779|6,498,566|12,059,981|6,529,457|
|TOTAL ASSETS LESS CURRRENT LIABILITIES|||||
|LIABILITIES|21,183,508|17,524,371|21,183,508|17,524,371|
|NET ASSETS EXCLUDING|||||
|PENSION LIABILITY|21,183,508|17,524,371|21,183,508|17,524,371|
|PENSION LIABILITY
24
NET ASSETS INCLUDING|(2,420,000)|(3,903,000)|(2,420,000)|(3,903,000)|
|PENSION LIABILITY|18,763,508|13,621,371|18,763,508|13,621,371|
||||||
|FUNDS
|||||
|Unrestricted Funds
Restricted funds|18,521,464
242,044|13,423,988
197,383|18,521,464
242,044|13,423,988
197,383|
|TOTAL FUNDS
22|18,763,508|13,621,371|18,763,508|13,621,371|
These financial statements of St Ann’s Hospice, (registered number 00947220), were approved by the Directors and authorised for issue on 14th December 2021. They were signed on its behalf by:
**Mr Darren Holt** Honorary Treasurer
See note 21 for the comparative consolidated statement of financial activities analysed by funds.See note 21 for the comparative consolidated statement of financial activities analysed by funds.
54 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 55
ST ANN’S HOSPICE
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2020-21
## CASH FLOW STATEMENT
## **For the year ended 31st March 2021**
||For the year ended 31 March 2021|Group
2021
£|Group
2020
£|
|---|---|---|---|
|||||
||Net cash flow used in operating activities|1,958,841|(693,438)|
|||||
||Cash flows from investing activities:|||
||Interest received
Investment net proceeds
Investment income received
Proceeds from sale of equipment
Purchase of property, plant and equipment|9,640
2,934,072
95,943
-
(190,471)|38,928
(117,438)
149,440
1,000
(498,578)|
||Net cash flows used in investing activities|2,849,184|(426,648)|
|||||
||Net increase/(decrease) in cash and cash equivalents|4,808,025|(1,120,086)|
|||||
||Cash and cash equivalent at beginning of year|4,907,400|6,027,486|
|||||
||Cash and cash equivalents at the end of the year|9,715,423|4,907,400|
||Reconciliation of net income and net cashflow
from operating activities
Net income/(expenditure) before investment gains/(losses)
Adjustments for:
Investment income
Interest Receivable
Corporation Tax Paid
Depreciation
Profit on sale of tangible fixed assets|Group
2021
£
2,363,458
(95,943)
(9,640)
(27,548)
303,733
-|Group
2020
£
(256,755)
(149,440)
(38,928)
-
320,342
(1,000)|
|||2,534,060|(125,781)|
||Decrease/(increase) in stock
Increase in debtors
(Decrease)/increase in creditors
Adjustment for pension funding|12,678
(599,488)
(100,409)
112,000|(1,092)
(920,125)
172,560
181,000|
|||1,958,841|(693,438)|
## Notes to the financial statements **For the year ended 31st March 2021**
## **1. ACCOUNTING POLICIES**
## **Company and charitable status**
St Ann’s Hospice, a public benefit entity, is incorporated in England and Wales as a company limited by guarantee not having a share capital. There are currently 11 Trustees who are also the members of the company. Each member has undertaken to contribute to the assets in the event of winding up a sum not exceeding £1. The charity is a registered charity. The registered office is given on page 91.
## **Basis of accounting**
The financial statements are prepared under the historical cost convention, with the exception of investments which have been included at market value, and in accordance with the Statement of Recommended Practice “Accounting and Reporting by Charities (SORP 2019) applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102), effective 1 January 2019; and the Companies Act 2006.
The principal accounting policies are set out below.
## **Preparation of financial statements - going concern basis**
The charity and group’s activities, together with the factors likely to affect its future development, performance and position are set out in the Trustees’ Report which also describes the financial position of the group including its cash, investments and reserves policies. The group forecasts and projections, taking account of reasonably possible changes in donations, legacies, fundraising activities and other income, show that the group should be able to operate with the current level of reserves it has. After making enquiries, the Trustees have a reasonable expectation that the charity and the group have adequate resources to continue in operational existence for the foreseeable future. Thus they continue to adopt the going concern basis of accounting in preparing the annual report and financial statements.
## **Basis of consolidation**
Group financial statements have been prepared in respect of the charity and its wholly owned subsidiary undertaking St. Ann’s Hospice Trading Company Limited. These financial statements have been consolidated on a line by line basis and the results of the subsidiary undertaking are disclosed in note 15.
## **Cash flow statement**
In accordance with FRS 102 the group is exempt from the requirement to present its parent charity cash flow statement.
## **Income**
Income is recognised when the group and charity has entitlement to the funds, any performance conditions attached to the item(s) of income have been met, it is probable that the income will be received and the amount can be measured reliably.
## _Donations and fundraising activities_
Donations and all other receipts from fundraising are reported gross and the related fundraising costs are reported in the costs of raising funds. Cash collections to which the charity is entitled but which it has not received by the year end are included in income in the statement of financial activities and shown as debtors in the balance sheet.
56 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 57
ST ANN’S HOSPICE
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2020-21
NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2021**
## NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2021**
## **1. ACCOUNTING POLICIES (continued)**
## **Income (continued)**
## _Legacies_
Legacies are accounted for when conditions for receipt have been met. Material legacies receivable at the year-end are included at their probate value.
## _Grants receivable_
Income from grants is included in income when receivable, except as follows:
- When donors specify that grants given to the charity must be used in future accounting periods, the income is deferred until those periods.
- When donors impose conditions which have to be fulfilled before the charity becomes entitled to use such income, the income is deferred and not included in income until pre-conditions for use have been met.
- When donors specify that grants, including capital grants are particular restricted purposes, which do not amount to pre-conditions regarding entitlement, this income is included in income of restricted funds when receivable.
## _Trading activities_
Income from trading activities includes fundraising revenue as well as sales recognised in the group’s trading subsidiary. The trading subsidiary’s turnover represents the net amount receivable from all activities, excluding value added tax. Turnover from the sale of goods is recognised upon exchange of goods for payment. Income from lottery ticket sales comprises income in relation to draws held in the period and is recognised upon completion of the draw. Receipts in advance of future draws are included in deferred income until the date of the draw.
## _Investment income_
## **1. ACCOUNTING POLICIES (continued)**
## **Expenditure**
Expenditure is recognised once there is a legal or constructive obligation to make a payment to a third party, it is probable that settlement will be required and the amount of the obligation can be measured reliably.
The charity’s operating costs include staff costs, premises costs, governance costs and other related costs. Such support costs are allocated between cost of raising funds and charitable expenditure. Staff costs are allocated according to the costs of staff working directly in the relevant activity and property costs are allocated according to the space used by each activity. Where costs are not directly attributable to any activity, they have been apportioned using an appropriate basis. Governance costs represent expenditure incurred in the management of the charity’s assets, organisational administration, and compliance with constitutional and statutory requirements
## _Charitable expenditure_
Costs of activities in furtherance of the charity’s objects include all expenditure directly related to the objects of the charity.
## _Cost of raising funds_
Cost of raising funds includes the following:
- _Fundraising and publicity_
- This represents expenditure in relation to staff members who are directly engaged in fundraising, and related costs of the fundraising activity.
- _Lottery and raffle prizes and organisation costs_ This represents expenditure by the trading company in relation to costs directly involved in organising the lottery and raffle, including the purchase of prizes and prize money.
- _Other costs associated with trading activities_
- This represents other costs incurred by the trading company for fundraising activities.
Investment income is accounted for when receivable.
## **Fund accounting**
## _Donated goods and services_
Donated professional services and donated facilities are recognised as income when the charity has control over the item, any conditions associated with the donated item have been met, the receipt of economic benefit from the use by the charity of the item is probable and that economic benefit can be measured reliably. In accordance with the SORP 2019, general volunteer time is not recognised - refer to the Trustees’ annual report for more information about their contribution.
On receipt, donated professional services and donated facilities are recognised on the basis of the value of the gift to the charity which is the amount the charity would have been willing to pay to obtain services or facilities of equivalent economic benefit on the open market; a corresponding amount is then recognised in expenditure in the period of receipt.
The charity maintains various types of funds as follows.
## _Restricted funds_
Restricted funds are funds subject to specific restrictions imposed by the funding authorities and donors. These funds are not available for the Trustees to apply at their discretion. The purpose and use of the restricted funds is set out in the notes to the financial statements. _Unrestricted funds_
- _General unrestricted funds_
- General unrestricted funds represent funds which are expendable at the discretion of the Trustees in furtherance of the objects of the charity. Such funds may be held in order to finance both working capital and capital investment.
- _Designated funds_
- Designated funds are amounts which have been put aside at the discretion of the Trustees.
58 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 59
ST ANN’S HOSPICE
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2020-21
NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2021**
NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2021**
## **1. ACCOUNTING POLICIES (continued)**
## **Taxation**
The parent company is a registered charity and has no liability to corporation tax on its charitable activities under the Corporation Tax Act 2010 (chapters 2 and 3 of part ii, section 466 onwards) or Section 256 of the Taxation for Chargeable Gains Act 1992, to the extent surpluses are applied to its charitable purposes.
Current tax for the subsidiary company, comprising UK corporation tax, is provided at amounts expected to be paid (or recovered) using the tax rates and laws that have been enacted or substantively enacted by the balance sheet date.
Deferred tax is recognised in respect of all timing differences that have originated but not reversed at the balance sheet date where transactions or events that result in an obligation to pay more tax in the future or a right to pay less tax in the future have occurred at the balance sheet date. Timing differences are differences between the trading company’s taxable profits and its results as stated in the financial statements that arise from the inclusion of gains and losses in tax assessments in periods different from those in which they are recognised in the financial statements.
Deferred tax is measured using the tax rates and laws that have been enacted or substantively enacted by the balance sheet date that are expected to apply to the reversal of the timing difference. Deferred tax is measured on a nondiscounted basis.
## **Tangible fixed assets and depreciation**
Tangible fixed assets are stated at cost, net of depreciation and any provision for impairment. Depreciation is provided on all tangible fixed assets, other than freehold land, at rates calculated to write off the cost or valuation, less estimated residual value, of each asset on a straight-line basis over its expected useful life, as follows:
|Freehold buildings|50 years|
|---|---|
|Leasehold improvements|period of the lease|
|Leasehold buildings|period of the lease|
|Fixtures, furniture and equipment|4 years|
|Motor vehicles|4 years|
## **Investments**
The fall in the value of £1.8 million in the year is due to £3 million being withdrawn for the redevelopment project. Overall the investments have made a £1,160,259 gain in 2020/21 compared to a £352,060 loss in 2019/20.
Investments are included in the financial statements at market value. The Statement of Financial Activities includes the net gains and losses arising on revaluations and disposals throughout the year.
Current investments represent monies invested in short-term liquid money market instruments.
The best evidence of fair value is a quoted price for an identical asset in an active market. When quoted prices are unavailable, the price of a recent transaction for an identical asset provides evidence of fair value as long as there has not been a significant change in economic circumstances or a significant lapse of time since the transaction took place. If the market is not active and recent transactions of an identical asset on their own are not a good estimate of fair value, the fair value is estimated by using a valuation technique.
In the parent charity balance sheet, investments in subsidiary undertakings are measured at cost less impairment.
## **1. ACCOUNTING POLICIES (continued)**
## **Stocks**
Stocks are stated at the lower of cost and estimated selling price less costs to sell, which is equivalent to the net realisable value. Cost is calculated using the FIFO (first-in, first-out) method. Provision is made for obsolete, slowmoving or defective items where appropriate. Items donated for resale are not included in the financial statements until they are sold.
## **Operating leases**
Rentals under operating leases are charged on a straight-line basis over the lease term, even if the payments are not made on such a basis. Benefits received and receivable as an incentive to sign an operating lease are similarly spread on a straight-line basis over the lease term.
## **Employee benefits**
For defined benefit schemes the amounts charged to the Statement of Financial Activities are the costs arising from employee services rendered during the period and the cost of plan introductions, benefit changes, settlements and curtailments. They are included as part of staff costs.
The net interest cost on the net defined benefit liability is charged to the Statement of Financial Activities and included within support costs. Remeasurement comprising actuarial gains and losses and the return on scheme assets (excluding amounts included in net interest on the net defined benefit liability) is recognised immediately in the Statement of Financial Activities.
Defined benefit schemes are funded, with the assets of the scheme held separately from those of the group, in separate trustee administered funds. Pension scheme assets are measured at fair value and liabilities are measured on an actuarial basis using the projected unit credit method. The actuarial valuations are obtained at least triennially and are updated at each balance sheet date.
For defined contribution schemes the amount charged to the Statement of Financial Activities in respect of pension costs and other retirement benefits is the contributions payable in the year. Differences between contributions payable in the year and contributions actually paid are shown as either accruals or prepayments in the balance sheet.
Other long-term employee benefits are measured at the present value of the benefit obligation at the reporting date.
## **Financial instruments**
Financial assets and financial liabilities are recognised when the group becomes a party to the contractual provisions of the instrument. All financial assets and liabilities are initially measured at transaction price (including transaction costs).
The charity and group only have financial assets and financial liabilities of a kind that qualify as basic financial instruments. With the exception of fixed asset investments, basic financial instruments are initially recognised at transaction value and subsequently measured at their settlement value.
Trade and other debtors are recognised at the settlement amount due after any trade discount offered. Prepayments are valued at the amount prepaid net of any trade discounts due.
Cash and cash equivalents includes cash and short term highly liquid investments with a short maturity of three months or less from the date of acquisition or opening of the deposit or similar account.
Creditors and provisions are recognised where the charity has a present obligation resulting from a past event that will probably result in the transfer of funds to a third party and the amount due to settle the obligation can be measured or estimated reliably. Creditors and provisions are normally recognised at their settlement amount after allowing for any trade discounts due.
60 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 61
ST ANN’S HOSPICE
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2020-21
NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2021**
**For the year ended 31st March 2021**
## NOTES TO THE FINANCIAL STATEMENTS
## **2. CRITICAL ACCOUNTING JUDGEMENTS AND KEY SOURCE OF ESTIMATION UNCERTAINTY**
In the application of the group’s accounting policies, which are described in note 1, the Trustees are required to make judgements, estimates and assumptions about the carrying amounts of assets and liabilities that are not readily apparent from other sources. The estimates and associated assumptions are based on historical experience and other factors that are considered to be relevant. Actual results may differ from these estimates.
The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised if the revision affects only that period, or in the period of the revision and future periods if the revision affects both current and future periods.
The Trustees do not consider there are any critical judgements or sources of estimation uncertainty requiring disclosure.
|3
ANALYSIS OF INCOME FROM DONATIONS AND LEGACIES|||
|---|---|---|
|Donations
Legacies
Donations - HG Capital Project|2021
£
2,213,500
2,410,253
33,494|2020
£
2,268,747
2,486,301
-|
||4,657,247|4,755,048|
||||
|4
ANALYSIS OF INCOME FROM CHARITABLE ACTIVITIES|||
|NHS Contracts
Grants
Job Retention Scheme
Hospice UK|2021
£
5,124,219
110,909
78,921
2,208,555|2020
£
4,788,183
52,085
-
-|
||7,522,604|4,840,268|
||||
|5
ANALYSIS OF INCOME FROM OTHER TRADING ACTIVITIES|||
|Fundraising activities
Lottery and raffle income from trading subsidiary
Other income from trading subsidiary
Trading Company Job Retention Scheme|2021
£
8,424
1,463,381
612,262
193,299|2020
£
68,238
1,405,902
1,240,407
-|
||2,277,366|2,714,547|
||||
|6
ANALYSIS OF INCOME FROM OTHER INCOME|||
|Other Income|2021
£
11,106|2020
£
-|
||11,106|-|
||||
|7
INVESTMENT INCOME|||
|UK listed investments
Bank Interest|2021
£
95,943
9,640|2020
£
149,440
38,928|
||105,583|188,368|
62 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 63
ST ANN’S HOSPICE
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2020-21
NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2021**
NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2021**
8 ANALYSIS OF EXPENDITURE ON RAISING FUNDS
|8
ANALYSIS OF EXPENDITURE ON RAISING FUNDS|||
|---|---|---|
|Employee costs
Office and sundry costs
Direct costs
Share of support costs
Lottery and raffle prizes and organisation costs
Other costs associated with trading activity|2021
£
464,072
63,393
116,715
68,610
544,147
1,124,060|2020
£
495,965
87,067
156,455
74,049
428,297
1,514,202|
||2,380,997|2,756,035|
|9
ANALYSIS OF EXPENDITURE ON CHARITABLE ACTIVITIES|9
ANALYSIS OF EXPENDITURE ON CHARITABLE ACTIVITIES|9
ANALYSIS OF EXPENDITURE ON CHARITABLE ACTIVITIES||
|---|---|---|---|
|2021
Provision of Hospice services:
In-patient Care
Day Therapy
Community Specialist
Palliative Care Team
Hospice at Home
Education
Out-patients|Activities
undertaken
directly
£
6,901,438
950,159
661,011
257,291
340,112
510,073|Support
costs
£
158,768
21,964
6,470
15,812
-
6,353|2021
Total
£
7,060,206
972,123
667,481
273,103
340,112
516,426|
||9,620,084|209,367|9,829,451|
|||||
||Activities|Support|2020|
|2020
Provision of Hospice services:
In-patient Care
Day Therapy
Community Specialist
Palliative Care Team
Hospice at Home
Education
Out-patients|undertaken
directly
£
7,016,733
999,819
612,889
278,973
322,800
533,610|costs
£
177,306
25,514
7,960
16,712
-
6,635|Total
£
7,194,039
1,025,333
620,849
295,685
322,800
540,245|
||9,764,824|234,127|9,998,951|
## 10 ANALYSIS OF SUPPORT COSTS
||In-patient
Day
Com-
munity
Hospice
at
Out-
Charitable
Activities
Raising
funds
2021
care
therapy
SPCT
Home
patients
Total
Total
Total
£
£
£
£
£
£
£
£|
|---|---|
|2021||
|Governance
Finance
Information Technology
Human Resources
Communications|84,650
11,735
3,527
8,620
3,392
111,924
36,678
148,602
30,791
4,250
1,223
2,988
1,230
40,482
13,266
53,748
16,682
2,302
662
1,619
666
21,931
7,187
29,118
19,016
2,624
755
1,845
760
25,000
8,193
33,193
7,629
1,053
303
740
305
10,030
3,288
13,318|
||158,768
21,964
6,470
15,812
6,353
209,367
68,612
277,979|
||In-patient
Day
Com-
munity
Hospice
at
Out-
Charitable
Activities
Raising
funds
2020
care
therapy
SPCT
Home
patients
Total
Total
Total
£
£
£
£
£
£
£
£|
|2020||
|Governance
Finance
Information Technology
Human Resources
Communications|90,724
13,151
4,337
9,106
3,409
120,727
38,183
158,910
44,046
6,289
1,843
3,869
1,641
57,688
18,245
75,933
16,366
2,337
685
1,438
610
21,436
6,780
28,216
18,985
2,711
794
1,668
707
24,865
7,864
32,729
7,185
1,026
301
631
268
9,411
2,977
12,388|
||177,306
25,514
7,960
16,712
6,635
234,127
74,049
308,176|
64 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 65
ST ANN’S HOSPICE
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2020-21
NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2021**
NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2021**
11 NET INCOME/(EXPENDITURE) FOR THE YEAR
||2021|2020|
|---|---|---|
|Net income/(expenditure) is stated after charging:|£|£|
|Depreciation of owned asset|178,163|201,901|
|Depreciation of leased assets|92,951|97,182|
|Depreciation of motor vehicles|32,619|21,259|
|Rentals under operating leases|||
|Land and buildings|190,035|238,184|
|Other|8,452|23,870|
|Auditor's remuneration|||
|Fees payable to the charity's auditor for the audit of the charity's annual|||
|financial statements*|14,000|13,400|
|Fees payable to the charity's auditor for other services to the group|-|-|
|The audit of the charity's subsidiary|6,000|5,700|
* Note: Deloitte LLP provide the audit of the statutory accounts at a discounted rate as a means to support the charity. The amount disclosed is the fair value of the services provided, £14,000 (2020: £13,400) was recognised in the year as a giftin-kind for the audit of the charity.
## 12 ANALYSIS OF STAFF COSTS, TRUSTEE REMUNERATION AND EXPENSES AND THE COST OF KEY MANAGEMENT PERSONNEL
||Group|Group|Charity|Charity|
|---|---|---|---|---|
|The average monthly number of employees was:|2021|2020|2021|2020|
|Charitable activity
Raising funds
Trading activities
Support|No.
226
20
32
73|No.
216
20
37
61|No.
226
18
-
73|No.
216
18
-
61|
||351|334|317|295|
||||||
|Their aggregate remuneration comprised:|||||
|Wages and salaries
Social security costs
Pension costs|2021
2020
£
£
7,619,263
7,627,895
630,406
601,843
628,541
600,533
Group||2021
2020
£
£
6,888,037
6,770,532
575,758
543,638
594,736
564,219
Charity||
||8,878,210|8,830,271|8,058,531|7,878,389|
66 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 67
ST ANN’S HOSPICE
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2020-21
NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2021**
NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2021**
13. ANALYSIS OF STAFF COSTS, TRUSTEE REMUNERATION AND EXPENSES AND THE COST OF KEY MANAGEMENT PERSONNEL (continued)
||2021|2020|
|---|---|---|
||No.|No.|
|£60,001 - £70,000|1|-|
|£70,001 - £80,000|2|2|
|£80,001 - £90,000|1|1|
|£90,001 - £100,000|2|1|
|£100,001 - £110,000|-|1|
## **Key Management Personnel**
## Key Management Personnel
The key management personnel of the parent charity and group are the same and are listed on page 91.The key management personnel of the parent charity and group are the same and are listed on page 81. The total remuneration (including pension contributions and employer’s national insurance costs)The total remuneration (including pension contributions and employer's national insurance costs) of the key management personnel of the charity and group for the year totalled £553,009 (2020 £555,866).of the key management personnel of the charity and group for the year totalled £553,009 (2020: £555,866).
## **Trustees remuneration**
## Trustees remuneration
No Trustees received any remuneration during the current or prior year. No travel and subsistence expenses were paid during the year No Trustees received any remuneration during the current or prior year. No travel and subsistence expenses were (2020: £Nil)paid during the year (2020: £Nil)
## 14. TAX ON PROFIT OF TRADING SUBSIDIARY
The hospice is not liable to corporation tax. The tax charge, all of which arises in the trading subsidiary comprises:
|Current tax on profit
UK corporation tax
Adjustments in respect of prior year|2021
£
41,124
(64,544)|2020
£
92,092
(62,596)|
|---|---|---|
|Total tax on profit|(23,420)|29,496|
The standard rate of tax for the year, based on the UK standard rate of corporation tax is 19%. The actual tax charge for the year differs from the standard rate for the following reasons:
|Profit before tax
Tax on profit at the standard rate - 19%
Effects of:
Gift aid donations at 20%
Expenses not deductible for tax purposes
Capital allowances (in excess of)/less than depreciation
Other timing differences
Adjustments to tax charge in respect of previous periods|2021
£
562,859
106,943
(111,393)
1,487
1,065
43,022
(64,544)|2020
£
666,275
126,592
(99,585)
2,741
(252)
62,596
(62,596)|
|---|---|---|
|Total tax (credit)/charge for the year|(23,420)|29,496|
In March 2021, the Chancellor in the Budget Statement announced an increase in the rate of corporation tax to 25% with effect from 1 April 2023. This does not constitute substantive enactment and therefore deferred tax assets and liabilities at the balance sheet date continue to be measured at the enacted tax rate of 19%.
## 15 TANGIBLE FIXED ASSETS FOR USE BY THE CHARITY
|||||||||
|---|---|---|---|---|---|---|---|
|GROUP|Assets
Under
Construction
£|Freehold
land and
buildings
£|Expenditure
on leasehold
property
£|Leasehold
buildings
£|Fixtures,
furniture and
equipment
£|Motor
vehicles
£|Total
£|
|Cost||||||||
|At 1 April 2020
Additions
Disposal|372,123
35,620
-|4,271,314
20,688
-|3,274,374
23,251
-|407,057
-
(10,280)|2,404,120
65,468
-|234,746
45,444
(15,947)|10,963,734
190,471
(26,227)|
|At 31 March 2021|407,743|4,292,002|3,297,625|396,777|2,469,588|264,243|11,127,978|
|||||||||
|Accumulated depreciation||||||||
|At 1 April 2020
Charge for the year
Disposal|-
-
-|1,747,487
84,999
-|1,703,751
88,549
-|399,648
4,402
(10,280)|2,260,766
93,164
-|181,004
32,619
(15,947)|6,292,656
303,733
(26,227)|
|At 31 March 2021|-|1,832,486|1,792,300|393,770|2,353,930|197,676|6,570,162|
|||||||||
|Net book value||||||||
|At 31 March 2021|407,743|2,459,516|1,505,325|3,007|115,658|66,567|4,557,816|
|||||||||
|At 31 March 2020|372,123|2,523,827|1,570,623|7,409|143,354|53,742|4,671,078|
|CHARITY||Assets
Under
Construction
£|Freehold
land and
buildings
£|Expenditure
on leasehold
property
£|Furniture
and
equipment
£|Motor
vehicles
£|Total
£|
|Cost||||||||
|At 1 April 2020
Additions
Disposals||372,123
35,620
-|4,271,314
20,688
-|3,274,374
23,251
-|1,989,163
64,821
-|189,314
45,444
-|10,096,288
189,824
-|
|At 31 March 2021||407,743|4,292,002|3,297,625|2,053,984|234,758|10,286,112|
|||||||||
|Accumulated depreciation||||||||
|At 1 April 2020
Charge for the year
Disposals||-
-
-|1,747,487
84,999
-|1,703,751
88,549
-|1,868,848
81,452
-|136,017
32,397
-|5,456,103
287,397
-|
|At 31 March 2021||-|1,832,486|1,792,300|1,950,300|168,414|5,743,500|
|||||||||
|Net book value||||||||
|At 31 March 2021||407,743|2,459,516|1,505,325|103,684|66,344|4,542,612|
|||||||||
|At 31 March 2020||372,123|2,523,827|1,570,623|120,315|53,297|4,640,185|
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 69
68 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
ST ANN’S HOSPICE
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2020-21
NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2021**
NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2021**
## 16 FIXED ASSET INVESTMENTS
|16
FIXED ASSET INVESTMENTS|||
|---|---|---|
|Market value at 1 April 2020
Additions
Disposals proceeds
Net Investment Gain/(Loss)
Movement in cash held by investment managers|2021
£
6,354,717
1,298,605
(4,238,010)
1,160,259
5,334
Group &|2020
£
6,589,339
2,084,760
(1,984,857)
(352,060)
17,535
Charity|
|Market value at 31 March 2021|4,580,903|6,354,717|
|Cost at 31st March 2020
Market value analysed between:
Investments
Cash held by investment managers|6,354,717
£
4,435,853
145,050|6,287,058
£
6,214,999
139,718|
||4,580,903|6,354,717|
|Investment in Hospice Quality Partnership|10|10|
|Total Group Investment|4,580,913|6,354,727|
|Investment in Subsidiary Trading Company|2|2|
|Charity Investment|4,580,915|6,354,729|
The Hospice Quality Partnership Company is owned by Hospices and was formed to help hospices save money by improving procurement, reducing operating costs and sharing data for best practice.
The charity owns the entire issued ordinary share capital of St Ann’s Hospice Trading Company Limited, a company incorporated and registered in England and Wales, whose principal activity is the management of the charity’s trading activities.
The result of the charity’s trading activities through its subsidiary is detailed below. St Ann’s Hospice Trading Company Limited’s taxable profits are donated to the charity annually.
## 16 FIXED ASSET INVESTMENTS (continued) RESULTS OF TRADING SUBSIDIARY
The results for St Ann's Hospice Trading Company Limited, a wholly owned subsidiary of St Ann's Hospice for the year ended 31 March 2021 are given below.
|for the year ended 31 March 2021 are given below.|||
|---|---|---|
|Turnover
Cost of sales
Gross profit
Administrative expenses
Operating profit
Interest receivable
Profit before taxation
Tax on profit|2021
£
2,268,942
(246,478)
2,022,464
(1,459,729)
562,735
124
562,859
23,420|2020
£
2,646,309
(306,038)
2,340,271
(1,674,461)
665,810
465
666,275
(29,496)|
|Profit for the financial year attributable to the equity shareholders
of the company|586,279|636,779|
||||
|Statement of changes in equity|||
|Balance at 1 April 2019
Profit after tax for the year
Gift aid distribution
Balance at 31 March 2020
Profit after tax for the year
Gift aid distribution||Profit and
loss account
£
-
636,779
(636,779)
-
586,279
(586,279)|
|Balance at 31 March 2021||-|
## BALANCE SHEET
The aggregate of the assets and liabilities was:
|Fixed assets
Current assets
Creditors: amounts falling due within one year|2021
£
15,204
677,442
(692,644)|2020
£
30,892
704,979
(735,869)|
|---|---|---|
|Total net assets|2|2|
70 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 71
ST ANN’S HOSPICE
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2020-21
NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2021**
NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2021**
|17
STOCKS|||||
|---|---|---|---|---|
||Group
2021
£|2020
£|Charity
2021
£|2020
£|
|Finished goods and goods for resale|44,287|56,965|546|546|
||||||
|18
DEBTORS|||||
|Trade debtors
VAT Recoverable
Prepayments and accrued income
Other debtors
Amounts due from subsidiary company|Group
2021
£
50,124
513,443
737,940
2,094,762
-|2020
£
65,831
486,333
266,422
1,978,195
-|Charity
2021
£
26,925
507,093
686,946
2,058,483
386,481|2020
£
42,654
479,903
215,564
1,792,756
322,012|
||3,396,269|2,796,781|3,665,928|2,852,889|
||||||
|19
CASH AND CASH EQUIVALENTS|||||
|Interest bearing accounts
Current accounts and cash|Group
2021
£
9,712,053
3,370|2020
£
4,904,263
3,137|Charity
2021
£
9,211,028
1,525|2020
£
4,564,288
1,292|
||9,715,423|4,907,400|9,212,553|4,565,580|
|20
CREDITORS (Amounts falling due within one year)|20
CREDITORS (Amounts falling due within one year)||||
|---|---|---|---|---|
|Trade Creditors
Accruals and deferred income
Taxation and social security
Other creditors
Amounts due to subsidiary company
Corporation tax|Group
2021
£
398,650
449,073
157,805
64,548
-
41,124|2020
£
454,591
465,265
165,426
85,206
-
92,092|Charity
2021
£
344,603
272,853
145,856
55,734
-
-|2020
£
454,111
232,711
148,051
54,685
-
-|
||1,111,200|1,262,580|819,046|889,558|
## 21 COMPARATIVE CONSOLIDATED STATEMENT OF FINANCIAL ACTIVITIES
|INCOME FROM:
Voluntary income
Donations and legacies
3
Charitable activities
4
Other trading activities
5
Investments
7|Unrestricted
funds
£
4,755,048
3,838,491
2,714,547
186,871|Restricted
funds
£
-
1,001,777
-
1,497|Total funds
2020
£
4,755,048
4,840,268
2,714,547
188,368|
|---|---|---|---|
|TOTAL INCOME|11,494,957|1,003,274|12,498,231|
|EXPENDITURE ON:
Raising funds
8
Charitable activities
9|2,756,035
9,046,671|-
952,280|2,756,035
9,998,951|
|TOTAL EXPENDITURE|11,802,706|952,280|12,754,986|
|Net (expenditure)/income before investment gains
Net gains on Investments
16
Net (expenditure)/income before tax
11
Taxation
14
Net (expenditure)/income for the year
Transfer Between Funds
22
Other Recognised Gains:
Actuarial Loss on Defined Benefit Schemes
25
NET MOVEMENT IN FUNDS
FUND BALANCES BROUGHT FORWARD AT
1st April 2019
FUND BALANCES CARRIED FORWARD AT|(307,749)
(352,060)
(659,809)
(29,496)
(689,305)
77,590
(560,000)
(1,171,715)
14,595,703|50,994
-
50,994
-
50,994
(77,590)
-
(26,596)
223,979|(256,755)
(352,060)
(608,815)
(29,496)
(638,311)
-
(560,000)
(1,198,311)
14,819,682|
|31st March 2020
22.23|13,423,988|197,383|13,621,371|
72 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 73
ST ANN’S HOSPICE
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2020-21
NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2021**
## NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2021**
22 STATEMENT OF RESERVES
|2021 Group
Unrestricted funds:
General fund
Designated funds
Fixed assets
Property refurbishment and
development
Unrestricted funds
Restricted Fund
Specific donations|At 1 April
2020
£
4,997,156
4,298,955
4,127,877
13,423,988
197,383|Income
£
10,920,744
-
-
10,920,744
3,653,162|Expenditure
(incl taxation)
£
(8,664,295)
-
(5,320)
(8,669,615)
(3,517,412)|Gains
£
2,755,259
-
-
2,755,259
-|Transfers
£
(6,956,251)
(2,608,398)
9,655,737
91,088
(91,089)|At 31 March
2021
£
3,052,613
1,690,557
13,778,294|
|---|---|---|---|---|---|---|
|||||||18,521,464
242,044|
||13,621,371|14,573,906|(12,187,027)|2,755,259|-|18,763,508|
|2021 CHARITY
Unrestricted funds:
General fund
Designated funds
Fixed assets
Subsidiary
Property refurbishment and
development
Unrestricted funds
Restricted Fund
Specific donations|At 1 April
2020
£
5,028,047
4,268,062
2
4,127,877
13,423,988
197,383|Income
£
9,275,957
-
-
-
9,275,957
3,653,162|Expenditure
(incl taxation)
£
(7,019,508)
-
-
(5,320)
(7,024,828)
(3,517,412)|Gains
£
2,755,259
-
-
-
2,755,259
-|Transfers
£
(6,971,940)
(2,592,709)
-
9,655,737
91,088
(91,089)|At 31 March
2021
£
3,067,815
1,675,353
2
13,778,294|
|||||||18,521,464
242,044|
||13,621,371|12,929,119|(10,542,240)|2,755,259|-|18,763,508|
The restricted reserves relate to donations or grants given with restrictions on the uses for the care of patients or for capital purchases. Once the capital purchases have been made the restriction is released and transferred to unrestricted funds.
To show urgency and their commitment to the Heald Green redevelopment project, the Trustees have agreed to designate further funds to the Property Refurbishment and Development fund for the construction of the new hospice facility at Heald Green. The amount in this fund has increased significantly this year due to the removal of the fixed asset fund attributed to the Heald Green building, and the reduction in free reserves from 6 months running costs to 3 months running cost.
The designated fixed asset fund represents the net book value of the Charity’s tangible fixed assets. This is used to fund annual depreciation costs as allowed by the Charities SORP. During the year the Trustees agreed to remove the net book value of the Heald Green site from this fund due to the forthcoming rebuild project and the planned demolition of the existing site.
|22 STATEMENT OF RESERVES (continued)|22 STATEMENT OF RESERVES (continued)|
|---|---|
|2020 Group
Unrestricted funds:
General fund
Designated funds
Fixed assets
Property refurbishment and
development
Unrestricted funds
Restricted Fund
Specific donations|At 1 April
Income
Expenditure
Losses
Transfers
At 31 March
2019
(incl taxation)
2020
£
£
£
£
£
£
5,602,861
11,494,957
(11,832,202)
(912,060)
643,600
4,997,156
4,492,842
-
-
-
(193,887)
4,298,955
4,500,000
-
-
-
(372,123)
4,127,877|
||14,595,703
11,494,957
(11,832,202)
(912,060)
77,590
13,423,988
223,979
1,003,274
(952,280)
-
(77,590)
197,383|
||14,819,682
12,498,231
(12,784,482)
(912,060)
-
13,621,371|
|2020 CHARITY
Unrestricted funds:
General fund
Designated funds
Fixed assets
Subsidiary
Property refurbishment and
development
Unrestricted funds
Restricted Fund
Specific donations|At 1 April
Income
Expenditure
Losses
Transfers
At 31 March
2019
(incl taxation)
2020
£
£
£
£
£
£
5,644,996
9,522,962
(9,860,207)
(912,060)
632,356
5,028,047
4,450,705
-
-
-
(182,643)
4,268,062
2
-
-
-
-
2
4,500,000
-
-
-
(372,123)
4,127,877|
||14,595,703
9,522,962
(9,860,207)
(912,060)
77,590
13,423,988
223,979
1,003,274
(952,280)
-
(77,590)
197,383|
||14,819,682
10,526,236
(10,812,487)
(912,060)
-
13,621,371|
74 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 75
ST ANN’S HOSPICE
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2020-21
NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2021**
NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2021**
23
## ANALYSIS OF ASSETS AND LIABILITIES BETWEEN FUNDS
## 24 EMPLOYEE RETIREMENT BENEFITS
## Group and charity
|2021 GROUP
Tangible fixed assets
Investments
Current assets
Current liabilities
Provision for pension scheme liability|Unrestricted
funds
£
4,557,816
4,580,913
12,913,935
(1,111,200)
(2,420,000)|Restricted
funds
£
-
-
242,044
-|Total
£
4,557,816
4,580,913
13,155,979
(1,111,200)
(2,420,000)|
|---|---|---|---|
|At 31 March 2021|18,521,464|242,044|18,763,508|
|2021 CHARITY
Tangible fixed assets
Investments
Current assets
Current liabilities
Provision for pension scheme liability|4,542,612
4,580,915
12,636,983
(819,046)
(2,420,000)|-
-
242,044
-
-|4,542,612
4,580,915
12,879,027
(819,046)
(2,420,000)|
|At 31 March 2021|18,521,464|242,044|18,763,508|
|2020 GROUP
Tangible fixed assets
Investments
Current assets
Current liabilities
Provision for pension scheme liability|4,671,078
6,354,727
7,563,763
(1,262,580)
(3,903,000)|-
-
197,383
-
-|4,671,078
6,354,727
7,761,146
(1,262,580)
(3,903,000)|
|At 31 March 2020|13,423,988|197,383|13,621,371|
|2020 CHARITY
Tangible fixed assets
Investments
Current assets
Current liabilities
Provision for pension scheme liability|4,640,185
6,354,729
7,221,632
(889,558)
(3,903,000)|-
-
197,383
-
-|4,640,185
6,354,729
7,419,015
(889,558)
(3,903,000)|
|At 31 March 2020|13,423,988|197,383|13,621,371|
The charity has two active pensions schemes for staff and these are described below.
|Pension Scheme
NHS Pension
Stakeholder
St Ann's Hospice Defined Benefit|2021
2021
£'000
£'000
375
375
322
322
22
2,157
Recognised in
SoFA
Contributions
Paid|2021
2021
£'000
£'000
375
375
322
322
22
2,157
Recognised in
SoFA
Contributions
Paid|
|---|---|---|
||719|2,854|
## **National Health Superannuation Scheme**
The Hospice is an admitted body for the purposes of the National Health Service Superannuation Scheme and members of staff who are former NHS employees are able to continue membership of the Scheme during their employment at St Ann’s.
The assets of the scheme are held separately by the National Health Service Superannuation Scheme.
Contributions to the scheme are charged to the Statement of Financial Activities so as to spread the cost of pensions over employees working lives with the group. This pension scheme does not have a real pension fund, but as a statutory scheme, benefits are fully guaranteed by the Government. Contributions from both members and Employers are paid to the Exchequer, which meet the cost of increasing benefits each year by the rate of inflation. This extra cost is not met by contributions from Scheme members or Employers.
As a result of the nature of the pension scheme, there are no separately identifiable assets and liabilities which can be identified as relating to St Ann’s Hospice therefore, the scheme has been accounted for as a defined contribution scheme.
The pension cost charge for the year amounted to £374,907 (2020: £330,327). An amount of £53,181 (2020: £49,546) is included in creditors, being the outstanding contributions to the scheme at the balance sheet date.
## **Stakeholder Pension Scheme**
The group supports a Stakeholder Pension Scheme which has been offered to staff since the closure of the defined benefit scheme.
The stakeholder pension scheme is operated by Scottish Widows. Employee contributions are collected by St Ann’s Hospice and the matching employers contribution passed to Scottish Widows.
All the assets of the scheme are held by Scottish Widows. As a result there are no separately identifiable assets or liabilities which can be identified as relating to St Ann’s Hospice. Therefore the scheme has been accounted for as a defined contribution scheme.
The pension cost charge for the year amounted to £322,138 (2020: £305,458). An amount of Nil (2020: Nil) is included in creditors, being the outstanding contributions to the scheme at the balance sheet date.
76 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 77
ST ANN’S HOSPICE
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2020-21
NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2021**
NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2021**
## 24 EMPLOYEE RETIREMENT BENEFITS (continued)
## **St Ann’s Hospice Pension Scheme**
The group operates a closed defined benefit scheme funded by contributions from members and from the group. The total pension cost of the group is assessed in accordance with the advice of an independent actuary.
The assets of the pension scheme are held in a separate trustee administered fund.
The most recent full actuarial valuation of scheme assets and the present value of the defined benefit obligations were carried out at 31 March 2018.
The Board of Directors are cognisant of their duty as an employer to ensure the solvency of the Pension Scheme. Therefore, in consultation with the Trustees if the St Ann’s Hospice Pensions Scheme and upon advice of the actuary, the Board agreed in 2010 to a 10 year funding recovery plan for the Pension Scheme Trustees and salary capping for pension purposes has already been adopted. Other options may need to be considered in the future.
The present value of the defined benefit obligation, the current related service cost and past service cost were measured using the projected unit credit method.
The projected unit credit method is an accrued benefits valuation method in which the scheme liabilities make allowance for projected earnings. The accumulated benefit obligation is an actuarial measure of the present value for service already rendered but differs from the projected unit credit method in that it includes no assumptions for future salary increases.
||2021|2020|
|---|---|---|
||%|%|
|Discount rate|2.10|2.30|
|Expected return on assets|2.10|2.30|
|Rate of increase in salaries|1.00|1.00|
|Rate of increase in pensions in payment|3.50|2.70|
## Mortality Assumptions
Investigations have been carried out within the past three years into the mortality experience of the group's defined benefit schemes. These investigations concluded that the current mortality assumptions include sufficient allowance for future improvements in mortality rates. The assumed life expectations on retirement at age 65 are:
||2021|2020|
|---|---|---|
||years|years|
|Retiring today:|||
|Males|85.5|85.3|
|Females|87.5|87.3|
|Retiring in 20 years|||
|Males|87.1|87|
|Females|89.3|89.1|
The amounts recognised in the statement of financial activities are as follows:
|Current service cost
Interest on obligations
Expected return on scheme assets|2021
£000's
(44)
348
258|2020
£000's
(124)
(388)
308|
|---|---|---|
|Total operating charge|562|(204)|
|Actuarial gain/(loss)|1,595|(560)|
|Total cost recognised in the statement of financial activities|2,157|(764)|
The amount included in the balance sheet arising from the group's obligations in respect of its defined benefit scheme is as follows:
|benefit scheme is as follows:|||
|---|---|---|
|Present value of defined benefit obligations
Fair value of scheme assets|2021
£000's
16,200
(13,780)|2020
£000's
15,400
(11,497)|
|Net liability recognised in the balance sheet|2,420|3,903|
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NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2021**
## NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2021**
## 24c EMPLOYEE RETIREMENT BENEFITS (continued)
## Movements in the present value of defined benefit obligations were as follows:
|At 1 April
Current service cost
Interest cost
Contributions by scheme participants
Administrative Expenses
Actuarial losses/(gains)
Benefits paid|2021
2020
£000's
£000's
15,400
15,800
44
124
348
388
11
12
-
(57)
1,011
(231)
(614)
(636)|
|---|---|
|At 31 March|16,200
15,400|
|Movements in the fair value of scheme assets were as follows:
2021
2020
£000's
£000's
Opening fair value of scheme assets
11,497
12,638
Expected return on scheme assets
258
308
Actuarial losses/(gains)
2,606
(791)
Contributions by the employer
22
23
Contributions by scheme participants
11
12
Benefits paid
(614)
(636)
Administration Expenses
-
(57)||
||13,780
11,497|
The analysis of the fair value of the scheme's assets at the balance sheet date was as follows:
|follows:|||
|---|---|---|
|Equities
Gilts and bonds
Cash|2021
£000's
10,207
3,437
136|2020
£000's
7,921
3,119
457|
||13,780|11,497|
## 25 FINANCIAL COMMITMENTS
## Operating lease commitments
The total future minimum lease payments under non-cancellable operating leases:
|GROUP
Land and
buildings
Leases which expire:
£
within one year
142,933
between one and five year
216,050
after five years
203,500
2021|2021|Other
£
6,150
4,918
-|2020|Other
£
14,035
11,068
-|
|---|---|---|---|---|
||||Land and
buildings
£
175,038
326,583
235,900||
||562,483|11,068|737,521|25,103|
|CHARITY
Leases which expire:
within one year
within one to five years
over five years|Land and
buildings
£
4,400
17,600
49,500|Other
£
-
-
-|Land and
buildings
£
4,400
17,600
53,900|Other
£
6,472
-
-|
||71,500|-|75,900|6,472|
## 26 RELATED PARTY TRANSACTIONS
All transactions between the charity and its subsidiary, St Ann's Hospice Trading Company Ltd, are eliminated on consolidation.
No trustee received payment for professional or other services supplied to the charity during the year (2020: Nil)
The total value of donations received from the trustees during the year was £8,383.55 (2020: £300)
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05
Independent Auditor’s Report
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## Independent auditor’s report to the members of St Ann’s Hospice
## **Basis for opinion**
## Report on the audit of the Financial Statements
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.
## **Opinion**
In our opinion the financial statements of St Ann’s Hospice (the ‘charitable company’) and its subsidiary (‘the group’):
- give a true and fair view of the state of the group’s and the parent charitable company’s affairs as at 31st March 2021 and of the group’s incoming resources and application of resources, including the group’s income and expenditure, for the year then ended;
We are independent of the group and of the parent charitable company in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the Financial Reporting Council’s (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.
- have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice, including Financial Reporting Standard 102 “The Financial Reporting Standard applicable in the UK and Republic of Ireland”; and
## **Conclusions relating to going**
## **concern**
- have been prepared in accordance with the requirements of the Companies Act 2006.
- We have audited the financial statements which comprise:
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.
- the group statement of financial activities;
Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the group’s and parent charitable company’s ability to continue as a going concern for a period of at least twelve months from when the financial statements are authorised for issue.
- the group summary income and expenditure account;
- the group and parent charitable company balance sheets;
- the group cash flow statement; and
- the related notes 1 to 26.
The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102 “The Financial Reporting Standard applicable in the UK and Republic of Ireland” (United Kingdom Generally Accepted Accounting Practice).
Our responsibilities and the responsibilities of the trustees with respect to going concern are described in the relevant sections of this report.
## **Other information**
The other information comprises the information included in the annual report, other than the financial statements and our auditor’s report thereon. The trustees are responsible for the other information contained 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.
## **Responsibilities of the trustees**
As explained more fully in the trustees’ responsibilities statement, the trustees (who are also the directors of the charitable company for the purpose of company law) are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such internal control as the trustees determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error.
In preparing the financial statements, the trustees are responsible for assessing the group’s and the parent charitable company’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the trustees either intend to liquidate the group or the parent charitable company or to cease operations, or have no realistic alternative but to do so.
## **Auditor’s responsibilities for the audit of the financial statements**
Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements.
A further description of our responsibilities for the audit of the financial statements is located on the FRC’s website at: www.frc.org.uk/auditorsresponsibilities. This description forms part of our auditor’s report.
## **Extent to which the audit was considered capable of detecting irregularities, including fraud**
Irregularities, including fraud, are instances of noncompliance with laws and regulations. We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud. The extent to which our procedures are capable of detecting irregularities, including fraud is detailed below.
We considered the nature of the group’s industry and its control environment, and reviewed the group’s documentation of their policies and procedures relating to fraud and compliance with laws and regulations. We also enquired of management about their own identification and assessment of the risks of irregularities.
We obtained an understanding of the legal and regulatory frameworks that the group operates in, and identified the key laws and regulations that:
- had a direct effect on the determination of material amounts and disclosures in the financial statements. These included UK Charities Act, UK Companies Act, pensions legislation; and
-
1 The terms used to describe the primary statements should be the same as those used by the trustees.
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- do not have a direct effect on the financial statements but compliance with which may be fundamental to the group’s ability to operate or to avoid a material penalty. These included regulations of the Charity Commission for England and Wales (Charity Commission), Care Quality Commission, Fundraising regulator and Gambling Commission.
We discussed among the audit engagement team regarding the opportunities and incentives that may exist within the organisation for fraud and how and where fraud might occur in the financial statements.
As a result of performing the above, we identified the greatest potential for fraud or non-compliance with laws and regulations in the following areas, and our specific procedures performed to address it are described below:
- recognition of legacy income in the correct accounting period. We assessed a sample of legacy agreements and probate evidence, to determine whether this has been recognised appropriately;
- completeness of donation income. To address this risk we have tested a sample of donations from source records to their supporting evidence and recorded income, and assessed the classification of the income as either restricted or unrestricted;
- classification of funds between restricted and unrestricted. To address this risk we have tested a sample of restricted income and expenditure to their supporting evidence to assess whether they have been classified appropriately; and
- recognition of trading income in the subsidiary company in the correct accounting period. We assessed a sample of shop till receipts and lottery records, to determine whether this has been recognised in the correct accounting period.
In common with all audits under ISAs (UK), we are also required to perform specific procedures to respond to the risk of management override. 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 evaluated the business rationale of any significant
transactions that are unusual or outside the normal course of business.
In addition to the above, our procedures to respond to the risks identified included the following:
- reviewing financial statement disclosures by testing to supporting documentation to assess compliance with provisions of relevant laws and regulations described as having a direct effect on the financial statements;
- performing analytical procedures to identify any unusual or unexpected relationships that may indicate risks of material misstatement due to fraud;
- enquiring of management potential litigation and claims, and instances of non-compliance with laws and regulations; and
- reading minutes of meetings of those charged with governance and reviewing correspondence with Charity Commission and Care Quality Commission.
## Report on other legal and regulatory requirements
## **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’ report, which includes the strategic report and the directors’ report prepared for the purposes of company law for the financial year for which the financial statements are prepared is consistent with the financial statements; and
- the strategic report and the directors’ report included within the trustees’ report have been prepared in accordance with applicable legal requirements.
In the light of the knowledge and understanding of the group and parent charitable company and their environment obtained in the course of the audit, we have not identified any material misstatements in the strategic report or the directors’ report included within the trustees’ report.
## **Matters on which we are required to report by exception**
Under the Companies Act 2006 we are required to report in respect of the following matters if, in our opinion:
- adequate accounting records have not been kept by the parent charitable company, or returns adequate for our audit have not been received from branches not visited by us; or
- the parent charitable company 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.
- We have nothing to report in respect of these matters.
## **Use of our report**
This report is made solely to the charitable company’s members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our audit work has been undertaken so that we might state to the charitable company’s members those matters we are required to state to them in an 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.
Sarah Anderson FCCA (Senior Statutory Auditor) For and on behalf of Deloitte LLP Statutory Auditor Manchester, United Kingdom
15 December 2021
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Officers and Professional Advisors
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## Officers and Professional Advisors
## **Trustees and Officers**
## **PRESIDENT**
The Right Reverend Dr David Walker Bishop of Manchester
## **VICE PRESIDENTS**
Sir Warren Smith KCVO KStJ JP HM Lord Lieutenant of Greater Manchester Mr Neil Cliffe (died on July 18th 2020) Mr Terry Lewis (ceased on 19th May 2021) Mr John McGuire (ceased on 19th May 2021) Mrs Anne Mack Mrs Ann Hughes
## **TRUSTEES**
## **CHAIR**
Professor Jacqueline Oldham BSc(Hons) RGN PhD
## **HON. TREASURER**
Mr Darren Holt BA FCA
Mr Mike Brown (Vice Chair) MSc FHSM CMIPM
Dr Stephanie Gomm MD FRCP
Mr Luke Dillon BA
Mr Alan Bond FCCA, ACIS
Mrs Fiona Taylor RGN, RM, RHV, Dip HE, BSc(Hons), MA
Ms Kate Squire BA (Hons)
Mr Steven Wilson CPFA BA (Hons) DipMHC Ms Melanie Odgen BPham FRPhamS
## **SPECIAL ADVISOR**
Mr Mike Walmsley MBE DL MCIOB BSc (Hons)
## **Key Management Personnel**
## **CHIEF EXECUTIVE**
Rachel McMillan RGN BA(Hons) MSc (appointed 5th October 2020)
Eamonn O’Neal DL BEd MSc DArts (changed role 5th October 2020)
## **DIRECTOR OF ORGANISATIONAL DEVELOPMENT & SUPPORT SERVICES**
Gill Turnpenney BA(Hons) CMCIPD
## **DIRECTOR OF BUSINESS DEVELOPMENT**
Dr Paul Jarvis MEng(Hons) MSc PhD
## **DIRECTOR OF CLINICAL SERVICES**
Emma Dixon RGN BA(Hons) (appointed 5th October 2020)
Rachel McMillan RGN BA(Hons) MSc (changed role 5th October 2020)
## **Professional Advisors and Registered Office**
## **SOLICITORS**
## **Brabners LLP**
55 King Street, Manchester M2 4LQ
and
Exchange Flags, Liverpool L2 3YL
## **AUDITOR**
## **Deloitte LLP**
Chartered Accountants and Statutory Auditor The Hanover Building, Corporation Street, Manchester, M4 4AH
## **INVESTMENT MANAGERS**
## **Brewin Dolphin**
1 The Avenue Spinningfields Square, Manchester M3 3AP
## **MEDICAL DIRECTOR**
## **BANKERS**
Dr David Waterman MBBS FRCP
## **The Royal Bank of Scotland**
## **ASSOCIATE MEDICAL DIRECTOR**
Dr Alison Roberts MBChB FRCP
## **DIRECTOR OF STRATEGIC INITIATIVES**
Eamonn O’Neal DL BEd MSc DArts (appointed 5th October 2020)
5th Floor 1 Spinningfields Square, Manchester M3 3AP
## **REGISTERED & PRINICPAL OFFICE**
## **St Ann’s Hospice**
St Ann’s Road North Heald Green, Stockport SK8 3SZ
## **ST ANN’S HOSPICE TRADING CO LTD**
Subsidiary of **St Ann’s Hospice**
90 OFFICERS AND PROFESSIONAL ADVISORS
OFFICERS AND PROFESSIONAL ADVISORS 91
## **Contact details**
**St Ann’s Hospice** St Ann’s Road North, Heald Green, Cheadle, Cheshire SK8 3SZ Tel: 0161 437 8136
**St Ann’s Hospice** Meadowsweet Lane, off Peel Lane, Little Hulton, Worsley, Manchester M28 0FE Tel: 0161 702 8181
## **Neil Cliffe Centre**
St Ann’s Road North, Heald Green, Cheadle, Cheshire SK8 3SZ Tel: 0161 437 8136
www.sah.org.uk www.facebook.com/StAnnsHospice @StAnnsHospice @StAnnsHospice
Registered charity number 258085. Registered in England No. 947220.