ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
Annual Report and Financial Accounts **2022/23**
SECTION TITLE 1
ST ANN’S HOSPICE
## Contents
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2 CONTENTS
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
01
Our purpose, values and aims
ST ANN’S HOSPICE
## 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, caring for people in the place they call home. Our support means different things to different people. Some people come to us for care at the end of their life, others for help managing their symptoms. Some join our outpatient sessions, while others enjoy complementary therapies or spend time with our counsellors. Our core purpose is to lead specialist care for people impacted by life-limiting illness.
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.
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We’re passionate about
providing care that
supports our patients
right from the point
of diagnosis, through
treatment, and beyond.
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Our patients and their Our patients are
loved ones are at the individuals, and our care
heart of everything we addresses their unique
do, and always will be. needs, whatever they
The care we provide is may be.
truly holistic.
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## Our values
Our values are a set of guiding principles and behaviours which shape how we go about our day-to-day jobs to achieve our longer-term goals and plans. If you’re supported by the hospice, or are a fundraiser, volunteer, shop customer or staff member, you’ll experience our values being put into practice. They are what make us so unique and make St Ann’s such a special place to work.
## People matter
People are at the centre of everything we do. We treat each other, and ourselves, with kindness and compassion. We value and celebrate diversity; recognising everyone as an individual.
## Brave and bold
We want to grow for the future, not settle. We’re not afraid to do things differently, get creative, challenge ourselves and the status quo. We’re ambitious in our aims, accountable for our actions and learn from our experiences and successes.
## Lead and learn
We’re experts in what we do, and we don’t stop there. We’re always learning; informing and shaping the sectors we’re in through education, training and research. We lead by example; sharing best practice, advancing in our fields and pioneering new approaches.
## Together we are stronger
Together, we’re stronger and have a bigger impact than we could have alone. As a charity, we work in collaboration with supporters, partners and the communities around us. We think beyond traditional boundaries to make sure we’re here for our communities for years to come.
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ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
## Strategic aims
Our new five year strategy for 2023-2028 builds on the previous version and will outline our ambitions and what we aspire to achieve during the next five years.
## **Our Six Strategic Aims**
## **Strategic Aim 1:**
To provide outstanding person-centred care that is innovative and evidence-based.
- We will deliver a consistent level of outstanding care using innovative and holistic approaches to individualised care and support
- Our care will be evidence-based and aligned to the GM Commitments for Palliative and End-of-Life Care. We will use a rehabilitative approach to planning and delivering care to people using a multidisciplinary framework
- We will ensure our services are accessible for those in all of our neighbourhoods and communities, whether that is in our hospice buildings or through our community and outreach services
- We will further develop and foster a cohesive and collaborative partnership approach to care to ensure we achieve the best outcomes for our patients
- We will further develop and enhance quality improvements using feedback and reported outcomes of care.
## **Strategic Aim 2:** To lead the sector in education, research and innovation.
- We will provide an outstanding learning experience that enhances the capabilities of individuals, leaders and teams
- We will enhance our collaboration with university partners to be recognised as a teaching hospice
- We will build the capacity and capability of our current and future workforce to embrace and actively engage with research and innovation
- We will build our reputation as a sector leader and centre of excellence for education, research and innovation.
## **Strategic Aim 3:**
## To be an organisation of choice for all.
- We will continue to enrich the culture of St Ann’s by further developing opportunities for staff and volunteers
- We will ensure that people who need our services are able to choose to access our care and that it is tailored to their needs
- We will listen and engage with staff and volunteers to support their wellbeing and remain a competitive employer considering terms and conditions and benefits
- We will listen to, engage with and consider the voice of those using our services to further enhance our clinical services.
OUR PURPOSE, VALUES AND AIMS 5
ST ANN’S HOSPICE
## **Strategic Aim 4:**
To sustain and further develop a values-based culture within which there are high-performing people and teams.
- We will continue to support our staff and volunteers to be the best versions of themselves
- We will ensure our leaders have integrity and credibility and are capable of inspiring others and achieving excellence
- We will live and breathe our values in everyday activities and ensure good governance is maintained and regularly reviewed throughout the organisation
- We will work proactively to champion social value through strong and effective leadership, building a shared understanding of social value throughout the hospice.
## **Strategic Aim 5:**
To ensure our buildings, estate and facilities are fit for the future to enable the delivery of outstanding person-centred care.
- We will build and open a new hospice building in Heald Green and further review our Little Hulton site, ensuring it remains fit for the future with the changing needs of the population and demand on services
- We will ensure our technical facilities are modern, robust and safe to deliver highquality care, education, training and research
- We will enhance our inclusive culture to identify and open some of our facilities to the public, building our networks and community cohesion
- We will review, refresh and promote our brand in readiness for the future.
## **Strategic Aim 6:**
## To be financially viable and develop growth in our business for future sustainability.
- We will ensure effective good governance is regularly reviewed and adhered to
- We will continue to develop our collaborative relationships with supporters and colleagues within the health and social care networks to enhance their financial contribution to care and service provision
- We will explore opportunities within the health and social care networks for financial sustainability.
- We will review the voluntary income streams including the effectiveness of the Trading Company strategic plan
- We will develop our entrepreneurial ability to identify diverse and sustainable income streams
- We will develop agile, efficient and flexible processes to reduce costs, enable prompt decision-making and maintain outstanding care delivery.
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Highlights of 2022/23 02
ST ANN’S HOSPICE
## St Ann’s in Numbers
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.
Our catering team prepared **28,000** delicious meals for our patients
Our housekeeping services team washed **14,000** bedsheets to ensure our patients’ comfort
The team from our Lymphoedema clinic carried out **463** initial assessments with new patients
**164 16** patients were companies discharged from volunteered for Our community team made our Inpatients us last year able to go homeUnit and were helping us withfundraising, **2,144** home visits to gardening and much more our patients
was raised from virtual **£32,000** Facebook challenges
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ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
Our Trading Company carried out **29** House Clearances raising **£36,692** for our hospice
Over **14,800** people played our lottery every week in 2022/23
**112** Wedding Dresses were sold at our Bridal shop in Stockport
**5,631** donations received for the capital campaign to build our new hospice at Heald Green
There were more than **42,000** entries in our Summer and Christmas Raffles
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£5,000
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people attended our **1,950** Light Up a Life services
HIGHLIGHTS OF 2022/23 9
ST ANN’S HOSPICE
## We couldn’t possibly list everything we’ve achieved in the last **.** . year, but here are a few highlights
## **April 2022**
Megan and Mark Whittaker took on a coastto-coast challenge on a tandem bike to raise money for Team St Ann’s. The couple cycled from Seascale in Cumbria to Whitby in North Yorkshire in just one day.
## **May 2022**
St Ann’s launched a new training and education programme, featuring a range of courses that enable health and social care professionals - and the wider business community across Greater Manchester - to benefit from its extensive experience of delivering the highest standards of palliative and end-of-life care.
## **June 2022**
We launched our Build it Together campaign - the £2 million public appeal for a new hospice building. The appeal is urging local people to come together to help us raise the final £2 million needed for our flagship new hospice, which will be a leading facility for end-of-life care in the UK.
As part of the launch, it was announced that actors Lee Boardman and Jennifer James would be ambassadors for the campaign. They experienced our support firsthand when Lee’s sister was cared for by St Ann’s. We delighted that they are able to get behind our campaign.
## **July 2022**
Fiona Sanderson, a lymphoedema specialist at St Ann’s Hospice, collected a bronze award at the British Journal of Nursing Awards 2022.
The honour took her by surprise as she was even unaware she had been nominated but she was proud to be recognised in the Chronic Oedema Nurse of the Year category. She hopes winning an award for her work will bring recognition for the condition.
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ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
## **August 2022**
We are always so delighted to hear from the loved ones of patients we have cared for at St Ann’s and hear what a difference our care made to their experience at such a sad time in their lives. As part of our Build it Together campaign, we were grateful to Judith Lacy for sharing her experience of St Ann’s when we cared for her husband Kevin. She was able to highlight the importance of having private bedrooms in our new Heald Green hospice.
## **September 2022**
Our experts at St Ann’s were able to share their knowledge and experience with our community throughout the year. When news of the death of Her Majesty the Queen was announced, our Senior Counsellor, Patrick Clark, offered advice and support to anyone who may be grieving her loss, or who found this national mourning reminds them of their own loss or grief. Patrick’s message of support reminded us all that “responses to grief are unique and personal to an individual.”
## **October 2022**
We celebrated Allied Health Professional (AHP)’s Day and recognised our St Ann’s AHP family for everything they do in providing outstanding care and support to our patients.
At St Ann’s we employ 11 AHPs in physiotherapy, occupational therapy and dietetics. They hold a range of positions at our hospices in Heald Green and Little Hulton, including team leaders, heads of department and our specialist lymphoedema team, and all play a vital role in patient treatment, rehabilitation and support.
HIGHLIGHTS OF 2022/23 11
ST ANN’S HOSPICE
## **November 2022**
Belinda Neild, an incredible art teacher from Salford, achieved the Guinness World Record as the fastest woman to run a marathon dressed as an item of stationery at the London Marathon, while raising money for St Ann’s Hospice. Belinda visited our Little Hulton hospice after her record-breaking success and celebrated with her family to recognise her incredible fundraising effort. Belinda was delighted to find she had raised over £20,000 for the hospice – something she only found out on the day!
Belinda has been raising money for St Ann’s over the last few years in memory of her mum, who was a patient at our Little Hulton site and died there in 2011.
## **December 2022**
Our Chief Executive, Rachel McMillan was interviewed on BBC Breakfast about the vital importance of hospices in the UK, and the challenges faced by the sector in light of the cost-of-living crisis.
In the interview, Rachel highlighted the fact that government funds only provide a third of the hospice’s income and the rest is found through fundraising. She invited government ministers to visit their local hospices to “really understand what the challenges are and the consequence and impact if we don’t survive”.
## **January 2023**
The Build it Together campaign for our new Heald Green hospice reached an important milestone in January. Thanks to the wonderful generosity of our supporters, St Ann’s reached the £500,000 fundraising mark towards the appeal.
Within that big number of half a million pounds are lots of individual acts of kindness and generosity – people have run for us, walked for us, baked cakes for us and of course donated directly to us too! There was still a long way to go to the £2 million target, but this was a wonderful milestone for the campaign.
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## **February 2023**
Supporter Tom Lowery jumped 11,000 feet from a plane in February in memory of his partner to raise money for St Ann’s Hospice.
Joan Lyons, Tom’s partner of 24 years, was a patient at St Ann’s Hospice in Little Hulton and was cared for there until she died in March 2022.
Tom, a retired HGV driver and Royal Signals veteran – who himself is going through health issues following his own cancer diagnosis – is 76 years old but was more than ready for his parachute jump in aid of St Ann’s.
Speaking before the jump, Tom said: “I think I’m looking forward to it, not long to go now! Thank you very much to everyone who has donated to St Ann’s Hospice, I hope they get lots of money to support them.”
## **March 2023**
On International Women’s Day we celebrated one of our founders for the incredible work she pioneered in Greater Manchester and the legacy she’s left for this to continue.
Dr Moya Cole OBE was one of the founders of the Heald Green hospice in Stockport in 1971, and was also instrumental in the decision for St Ann’s to open a second hospice in Little Hulton in Salford in 1979.
Moya was a monumental trailblazer for women as well as a huge intellect. Among her many achievements, she was the first person to give Tamoxifen to patients as part of a clinical trial in the early 1960s, publishing many papers on breast cancer.
Aside from her ground-breaking work on breast cancer, it is also fair to say that without Moya Cole’s vision and determination there would be no St Ann’s Hospice.
In 1967, Moya and the then Bishop of Manchester, the Rt Rev Dr William Greer, had the idea for a hospice for the people of Greater Manchester. Together, they worked for 18 months to win over businesses and the public; they were consequently successful in founding St Ann’s Hospice in 1969.
Without Moya’s pivotal role in Greater Manchester’s history there would not be a hospice that helps and supports thousands of people each year.
HIGHLIGHTS OF 2022/23 13
ST ANN’S HOSPICE
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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Chair and Chief Executive’s statement 03
ST ANN’S HOSPICE
## Joint Statement from the Chair and Chief Executive
St Ann’s is looking to the future and our commitment to care for the people in our community for generations to come. It has been a challenging year, but our resilience has seen us through, with much to celebrate.
Just like everyone else in our community, this year has been challenging in many ways for St Ann’s Hospice. We are incredibly proud of every member of our team that has worked together to ensure our patients continue to receive the highest levels of care, whilst always striving to innovate and improve our service.
It was with great relief that we were finally able to lift many of the restrictions imposed on our services during the Covid pandemic, but still, for much of the year, we faced compulsory mask-wearing, spikes in infection and a need to adapt to the new normal of the postpandemic world. Our team has been brave and bold in their approach to all these challenges, and we are continually proud and grateful for their resilience and strength. Despite its challenges, the pandemic also brought with it innovation and new approaches to our work, and we must ensure that we take these learnings and opportunities to continually improve our services.
Our teams have remained committed to meeting the unique needs of each patient we serve and as part of this approach, goal setting is worked through between clinical staff and individuals to ensure we
support what matters most to each patient and their families. This is different for everyone, as we are all unique in our preferences and experiences.
We are incredibly proud of every member of our team.
Our clinical staff spend time to understand specific needs, as these will shape the goals they choose to pursue. St Ann’s Hospice strives to keep this person-centred approach, so that the people we work with are supported, and we can address what’s important for
them. Keeping the individual at the centre of their care through this rehabilative approach is something we are so proud of at St Ann’s and we celebrate each and every goal achieved.
This year has also brought financial hardship for many, and the cost-of-living crisis has affected our community and our organisation. Rapidly increasing energy bills this winter caused us great concern and we have been working closely with other colleagues across the nine hospices in Greater Manchester to lobby the Government to do more to support hospices financially and ensure the continuation of our vital services for generations to come.
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As we have faced these challenges head on, we are reminded of one of our founders – Dr Moya Cole. Moya was an inspirational woman and a name we should all know – not only did she have the vision to establish St Ann’s Hospice in the late 1960s, but she graduated with a degree in physics from Queen’s University in Belfast way back in 1939, became our Medical Director in the 1980s, and led ground-breaking research on tamoxifen when she was a medical consultant at The Christie. She was also awarded an OBE.
Moya sets an inspiring example to us all. Her legacy of determination to make things better for patients continues at St Ann’s and we will always be inspired by Dr Moya Cole’s brave example.
Inspiration also comes from our community and we are constantly reminded of our hospice value that Together We Are Stronger as we receive donations and hear of fundraising endeavours for our hospice. It is thanks to the generosity of the public that we can continue with our vital care, whilst also looking to the future with our ambitious plans for a new hospice at Heald Green.
Our Build it Together campaign and the thousands of pounds raised to get the project underway are testament to our supporters. We know they share our ambition and vision for St Ann’s Hospice and realise just how important it is that we safeguard our services for the future.
## **Rachel McMillan**
Chief Executive of St Ann’s Hospice 14th February 2024
**Professor Jacqueline Oldham** BSc (Hons) RGN PhD Chair of St Ann’s Hospice 14th February 2024
It is thanks to the generosity of the public that we can continue with our vital care, whilst also looking to the future with our ambitious plans for a new hospice at Heald Green.
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ST ANN’S HOSPICE
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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04
Trustees’ report and financial statements
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ST ANN’S HOSPICE
## Trustees’ Report including Strategic Report
The Trustees of St Ann’s Hospice, 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 31st March 2023.
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).
## **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.
its sites at St Ann’s Road North, Heald Green, Stockport and Meadowsweet Lane, off Peel Lane, Little Hulton. 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 @ 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.
## **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 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, and supportive outpatient services - from
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## Governance
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.
## **Trustee Induction**
All new Trustees participate in an induction programme (reviewed annually) 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, risk management, and financial investments.
## **Section 172**
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 2006 to have regard to various
specific factors, including:
- The likely consequences of any decision in the long term;
- The interests of the charity’s employees;
- The need to foster the Charity’s relationships with third-party stakeholders which, in the case of St Ann’s Hospice include people affected by, or living with life-limiting illnesses;
- The impact of the charity’s operations on the community and the environment;
- The desirability of the charity maintaining a reputation for high standards of business conduct; and
- The need to act fairly as between members of the charity.
## **Organisation**
The Board administers the charity and meets a minimum of four times each year. The hospice ensures good governance through an effective committee structure. Each committee meets in between
Board meetings and supports the Board with its work. The current structure allows the Board to focus on strategic and big picture issues by delegating responsibility and empowering each committee to examine the detail and provide the precise level of scrutiny that is necessary. By employing this structure, it allows the committees to provide assurance to the Board and supports the flow of solutions, recommendations, and ideas.
## **Delegated Decision Making**
A Scheme of Delegation approved by the Board is in place that sets out in detail the matters and powers delegated to the Chief Executive. The Chief Executive is ultimately accountable to the Board for ensuring that the hospice meets its obligation to perform its functions within the available financial and other resources.
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ST ANN’S HOSPICE
## **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 Leadership Team and relevant sub-committees on the identification and management of strategic and operational risks. The Audit Committee also meets the external auditors.
Since 2021 the organisation has transitioned to use Pineapple; a bespoke piece of software developed in-house to support leadership teams in strategic and operational risk management. The system is used by leaders across the organisation to record, control, and monitor risk. The application is hosted securely in the cloud on Microsoft Azure servers. The aim over the next few years is to move the functionality of Pineapple
into a work management and productivity cloud-based platform like Monday.com or something similar that can be added onto Microsoft Teams or built within the Microsoft Office 365 suite of apps. This will lead to better maintenance and security whilst additionally supporting interoperability with other hospice systems and scalability across other domains.
## **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 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 us, we proactively engage with them by phone, email, or face-to-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 newsletter that is sent three times a year.. 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 to them regularly over the phone and inviting them to in-person meet ups
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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 thanka-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 leadership team hold a Director’s Drop-in. We have several 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 cafe 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 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.
## **Our Suppliers**
St Ann’s Hospice works with key suppliers to ensure the delivery of high-quality services to its staff and beneficiaries through regular contract reviews and monitoring of quality. A robust procurement process is in place to ensure the highest quality product is delivered at the most cost-effective price point.
**Environmental Sustainability** We remain committed to move our organisation to more sustainable practices through continually reviewing and developing our working environments. Our aim is that informed and engaged employees work in low-carbon, efficient environments, using minimum resources, producing minimum waste and travelling only when necessary. Activities in this area range from, the development of a new modern hospice facility, efficiency projects for our existing estate, and working closely with our staff to transform culture and behaviours.
## **Carbon Dioxide Emissions (CO2e)**
Tonnes of CO2e generated by St Ann’s from Gas, Fuel for Transport and Electricity for fuel and/or transport:
- Gas = 319.24 tonnes CO e 2
- Electricity = 135.05 tonnes CO e 2
- Business Transport = 18.61 tonnes CO e 2
The total CO2e generated by St Ann’s Hospice during 2022-23 is 472.90 tonnes CO2e (486.36 tonnes CO2e in 2021-22)
## **Energy Consumed**
The aggregate of the annual quantity of energy consumed from activities for which the charity is responsible during 2022/23 is 2,390,546 kWh (2,407,085.18 kWh in 2021/22).
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## **Methodology**
Energy consumption data was generated from billing information. Business travel information was obtained from staff mileage claims for the period. As retrieving car type, 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 number of online sources noted in supporting documentation (ESOS calculation spreadsheet). Current government guidance on all conversion factors was used throughout.
- New, more efficient servers installed
- All defective light ballasts switched to LED
- New build design to maximise sustainability and zero gas use encouraging renewable energy use
- Quotes for air source pumps to replace the gas provision at Little Hulton site when redundant
## **Water Use**
The Little Hulton site used 3,437m[3] of water in 2022/23 and the Heald Green site used 2,370m[3] of water for the same period.
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 i:
- 53.98 kg CO2e /operational hour
## **Energy Efficiency**
The following measures were taken to increase energy efficiency in the reporting period:
- A poster and screen saver campaign encouraging staff to turn off radiators etc when out of office
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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.
## **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)_
It has been a cha **l** enging year, but our resilience has seen us through, with much to celebrate.
Professor Jacqueline Oldham, Chair of the Board
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## St Ann’s Directorates
Our Executive Leadership Team is responsible for each of the departments within the hospice. Our activities are organised under the following four directorates:
## **Clinical Services**
- Oversees strategic and operational clinical management and leadership across all patient services.
## **Director of Clinical 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**
## **Medical Director**
- 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**
## **Director of 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**
## **Director of 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.
**----- Start of picture text -----**
Key to map
St Ann’s Hospice Sites
@ Hospice@Home Areas
Hospice Shops
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We have to raise around **£20,000** a day to keep our services across Greater Manchester running.
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## Achievements and Performance
## Medical and Clinical Services:
## **Clinical Services**
Throughout the reporting period of 2022/23, St. Ann’s has continued to adapt and reshape services to successfully live with the challenges posed by the ongoing presence of COVID-19. Over the course of the past year, our teams have worked diligently to provide services to patients, families, and their loved ones. We have exhibited flexibility and continually adapted as needed to prioritise the safety of our patients, visitors, staff, and volunteers whilst continuing to adhere to the safety requirements set out by Public Health England (PHE) and NHS England (NHSE).
In addition to prioritising safety, our teams have remained committed to meeting the unique needs of each patient we serve. Through ongoing communication and collaboration with patients and their families, we have strived to provide individualized care and support to ensure that their physical, emotional, and spiritual needs are met.
During the reporting period we have been reviewing and redesigning services to ensure financial sustainably for the future and in line with clinical data.
During the reporting period, Hospice UK received intellectual property right (IPR) permission from Healthcare Quality Improvement Partnership (HQIP) for its member hospices providing inpatient care to use the National Audit of Care at the End of Life (NACEL) case note review questionnaire for a single audit cycle. The primary objective of the audit is to evaluate and comprehend the level of care received by individuals during their hospice admission who are nearing the end of their life, as well as those who are important to the dying person. The goal is to enhance the quality of care received at the end of their life. St Ann’s Hospice took part in the NACEL audit.
## **Commissioning for Quality and Innovation (CQUIN)**
St Ann’s Hospice’s income in 2022/23 was not conditional on achieving quality improvement and innovation goals through the Commissioning for Quality and Innovation payment framework. This was because the operation of Quality Outcomes Framework (QOF) has remained suspended for all providers due to the COVID-19 pandemic. St Ann’s was not required to implement the QOF requirements, carry out QOF audits nor submit performance data. However, we have continued to actively participate in the Framework and further details are provided in the annual Quality Accounts.
## **Quality Accounts**
The hospice published the Quality Accounts for this reporting period in line with national guidance.
## **Clinical Teams**
## **Inpatient Units**
Throughout 2022/23, our inpatient units have been operating at full capacity, providing a comprehensive inpatient service. Our efforts to improve access to seven-day services have enabled us to admit patients on weekends and bank holidays, thereby ensuring uninterrupted care. Our dedicated staff have tirelessly supported patients and their families in every aspect of their care, offering valuable information to help them to set realistic goals and make informed decisions on matters such as preferred priorities of care, nutrition and hydration, medicines, and visitation.
## **Being You Centres**
At our Being You Centres, we have offered personalised face-to-face and virtual appointments to cater to individual needs. This ensures that all patients have access to medical, rehabilitation, and wellness services. In the last 12 months, our team has provided support to The Christie NHS Foundation Trust Systemic Anti-Cancer Therapy and Phlebotomy clinic. Furthermore, our Heald Green site has been
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hosting a monthly Stepping Hill HPB clinic (Hepatic, Pancreatic and Biliary) and upper GI (gastrointestinal) joint clinic.
The Being You Centre outreach service is also an integral part of the award-winning The One Stop Lung Cancer Clinic, a new initiative launched in June 2022 at Wythenshawe Hospital. The clinic provides a comprehensive, multi-disciplinary approach to shared decision-making and offers patients the opportunity to meet with a range of treatment specialists, including oncologists, physicians, cancer nurse specialists, and hospice nurse specialists. This approach empowers patients to make informed decisions about their treatment options and introduces them to the services available at St Ann’s Hospice.
## **Community Specialist Palliative Care Team**
Throughout 2022/23, our Community Specialist Palliative Care Team has maintained a complete range of services and observed a consistent growth in referral volumes. They have provided exceptional clinical guidance and proficiency for patients, our personnel, the community, and acute hospital personnel throughout the previous year. Moreover, the team has been adaptable in delivering services, including video and phone consultations, when necessary.
## **Homeless Palliative Care Co-ordinator**
This is the third year of five for The Big Lottery funded project and the post has continue to grow in strength. The coordinator has been asked to present at one national conference and at various events on a more local level. They continue to provide case management to patients open to their caseload and work collaboratively with other agencies and refer on when needed. They also facilitate a monthly ‘Complex Needs Community of Practice Forum’ and the ‘Inequalities Q&A’ virtual sessions.
## **Learning Disability (LD) & LGBTQ+ Palliative Care Co-ordinator**
These collaborative one-year projects have run from April 2022 and will finish in March 2023. The project
has worked with the Salford Community LD team to develop a LD palliative care flow chart currently being used in practice and, the coordinator has provided training on what Advance Care Planning (ACP) is and using accessible ways to approach this including an art-based method.
The LGBTQ+ project worked alongside the LGBT Foundation in an aim to understand what barriers to palliative care existed. This project has come with difficulties, primarily due to the fact there is a lack of data within health care settings relating to LGBT statistics. The coordinator recently piloted the ‘Box of Me’ (memory/ ACP box) with the Pride in Ageing advisory group, which received good feedback and therefore will be opened to the wider LGBT community.
Training has begun for internal and external staff with a focus on health and social care professionals in Salford. This training will continue in the form of an inequalities day after the project posts have concluded and the LGBT Foundation will also deliver LGBTQ+ EOLC (end of life care) training with our support.
The learning that is emerging from both projects suggests that individuals are not being diagnosed with advancing disease and there is a lack of awareness and knowledge of the importance of advance care planning, therefore conversations are not happening in a timely manner. We will embed this learning into our future training and into shaping our clinical services moving forwards.
Inequalities training including different approaches to ACP (advance care planning) discussions will continue after the project posts have concluded.
## **Hospice @ Home**
Throughout 2022/23, our Hospice @ Home Team has provided an uninterrupted full service. The team has efficiently triaged all referrals within 48 hours, assessed the unique needs of patients during each visit, and provided consistent emotional and psychological support to both patients and their families. Additionally, the Hospice @ Home staff have begun attending locality MDT (multi-disciplinary team) meetings to further enhance palliative and end of life care provision within the community.
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## **Rehabilitative Team**
Throughout 2022/23, our Rehabilitation Team has continued to provide critical services following the resumption of all services in the previous year.
Our Complementary Therapists have provided services in addition to supporting volunteers, enabling more patients to access these services.
Our Dietitian has continued to work closely with nursing and catering colleagues to review and enhance our ability to meet the nutritional needs of our patients effectively.
Furthermore, our team has played an essential role in promoting a more rehabilitative culture. For example, we have developed goal-setting training sessions as part of our mandatory training day, allowing all nursing staff to receive this training and enhance their skills.
In addition to the rehabilitation services mentioned, we have also provided specialist lymphoedema services to patients across Greater Manchester and Cheshire. Our team of experts has worked tirelessly to offer individualised treatment plans, including complex lymphatic drainage, compression bandaging, and skin care management, among other services.
We have also provided patients with education on self-management techniques to help them manage their condition at home. Our aim is to improve the quality of life for our patients by reducing pain, swelling, and discomfort associated with lymphoedema, and promoting self-confidence and independence.
Our specialist lymphoedema services have been highly valued by patients, and we are proud to have been able to continue providing these essential services throughout the pandemic.
## **Patient and Family Support Team**
Throughout 2022/23, our Patient and Family Support Team has provided comprehensive services to assist our patients, their families/carers, volunteers, and staff. The team has demonstrated flexibility and responsiveness in meeting the spiritual, psychological, and social requirements of our patients and their carers. Additionally, the team has supported the
mental health first aid initiative and facilitated regular Schwartz Rounds for our staff and volunteers. They have also provided clinical supervision to the Social Work Team at the Christie Hospital, while the Safeguarding Lead has delivered safeguarding training to a North West Hospice.
## **Pharmacy Team**
Our Pharmacy Team has continued to provide pharmacy services, throughout 2022/23 under our service level agreement with Salford and Wythenshawe. This team, with support from our Advanced Clinical Practitioners and Medical Team, has helped to maintain pain management, symptom management, medication administration and discharge planning.
## **Clinical Administration Team**
The Clinical Administration Team has supported the clinical and support services teams by working innovatively and collaboratively throughout 2022/23 whilst maintaining the administration of the clinical services and data collection.
## **Clinical Volunteers**
We are delighted to announce that we have successfully reintroduced our clinical volunteers to our services during 2022/23. The impact of their return has been significant, with volunteers providing invaluable support to our patients and clinical teams. We have also appointed a volunteer into our Practice Development Centre, who has carried out patient satisfaction surveys on both of our inpatient units. The feedback received from patients has been invaluable in helping us to identify areas for improvement and to enhance the quality of care we provide. Moving forward, we plan to complete this volunteer-led survey twice a year and extend it to other clinical services within the hospice. We are committed to continuing to involve our volunteers in shaping the services we provide and look forward to seeing the continued positive impact that they have on our patients, their families, and our staff.
## **Medical Team**
Throughout 2022/23, our consultant-led Medical Teams have persevered in delivering exceptional
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care across our inpatient units and the wider Salford and Trafford communities. Despite the challenges posed by the pandemic, our medical teams have maintained regular medical outpatient clinics at both sites, including clinics for motor neurone disease patients. To adapt to the changing needs of patients, these clinics have incorporated a blended approach of telephone, video and face-to-face consultations. Our medical teams have also continued to provide support for our 24-hour Advice Line.
## **Clinical Audit and Quality**
St Ann’s has remained focused on quality improvement within our services. Our Quality Improvement Group provides oversight, support, and direction to our quality improvement projects, audit, and research, across clinical services. 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 and carer feedback**
The Friends and Family Survey is an important feedback tool that supports the fundamental principle that people who use services should have the opportunity to provide feedback on their experience. It is a single question survey which invites feedback on the overall experience of using the service. Listening to the views of patients helps identify what is working well and what can be improved.
During 2022/23, with the support of our Quality Improvement Volunteer, we piloted a new patient and family experience questionnaire:
1. To establish the need for reintroduction of patient and family experience interviews as a means of capturing the patient voice
2. To evidence if we are compliant with Regulations 9, 10 11, 14, 16 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and NICE guideline CG138.
3. To establish if potential areas for quality improvement / future projects can be obtained from interviews.
The project was a success, themes were identified, and actions put in place.
As an organisation, St Ann’s continues to take complaints seriously, investigate appropriately, and manage compassionately. We encourage people to make complaints if they feel something has gone wrong. We want to learn from people’s experiences and improve our services wherever possible. We encourage openness and honesty, and our staff are supported by our complaints and whistleblowing policies.
## **Incident Reporting and Near Misses**
All incidents, accidents and near misses are reported at St Ann’s via our electronic incident management system. Staff are supported by a suite of policies, training, procedures and guidance around incident management within the organisation. Incidents and learning from incidents are discussed at the relevant team, departmental and committee meetings.
We have always encouraged openness and honesty, in line with both the professional and legislative duty of candour. Our culture encourages candour, openness and transparency across all departments within the hospice and in any communication with patients and families in relation to both notifiable safety incidents and non-notifiable safety incidents. We have ensured that the requirements to be open when things go wrong are explicit within our complaints, incident management and whistleblowing policies.
## **The Year Ahead**
At St Ann’s Hospice, we are committed to providing world-class palliative and end-of-life care for our patients, their families, and caregivers. As we move forward in 2023, we will continue to work towards achieving our five-year strategy while also incorporating our clinical strategy and hospice values.
Our goal is to take a collaborative approach to reviewing, reflecting, and monitoring the quality of our services to ensure that we are working effectively and efficiently and driving improvements. As a team, we will face both successes and challenges, and actively listen to and gain insight from our staff, patients, families, and volunteers. By doing so, we strive to enhance the accessibility, quality, and sustainability of our clinical services.
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## Organisational Development and Support Services
## Organisational Development
## **Career Pathways**
A number of career pathways have been developed to support individual development and career progression within the hospice. Each clinical role within the Community Specialist Palliative Care Team (CSPCT) is now part of a career framework with individual career profiles.
The pathways help employees to understand what career opportunities might be available for them encouraging them to acquire new skills and expand knowledge to enable progression internally. This enhances job satisfaction for individual employees and improves retention as well as aiding succession planning for the hospice. Guidance has also been created to enable clinical leaders to have career conversations with their staff.
## **Wellbeing Programme**
The hospice’s Wellbeing Programme has continued this year. The theme for Wellbeing Week focused on times of change and uncertainty and the support employees and volunteers could access. As the COVID-19 restrictions gradually eased, Wellbeing Week took a hybrid approach, with face to face and virtual sessions. There was a collaborative approach, with employees from different departments delivering sessions and contributing ideas. This included relaxation and wellbeing tips with the Complementary Therapists and the Physios providing tips on mind, body and life.
The Greater Manchester Resilience Hub delivered sessions to support staff in times of change and uncertainly. Staff could also access online sessions through Care First, the hospice’s Employee Assistance Programme providers.
## **Mental Health First Aiders (MHFAs)**
In January 2023, the hospice welcomed four new Mental Health First Aiders (MHFAs).
The hospice now has six MHFAs who provide support for staff and are involved in several initiatives to promote their roles. This has included, contributing to the content for hospice’s quarterly Wellbeing Matters newsletter and taking part in an introductory blog for the staff hub.
The MHFAs have been supported in a number of ways, for example, attending quarterly meetings, establishing a Microsoft Teams group and being offered and attending internal supervision. The Greater Manchester Resilience Hub has also presented a session to the MHFAs on the support the hub offers to all staff and also to the MHFAs individually.
## Support Services
## **Estates Leadership**
Changes have been made to the structure of the estate’s leadership team with a new Estates Manager joining the hospice at the end of the year. The changes will enable more time to be focused on staff engagement and development, quality improvement initiatives and agile working.
In addition, the structure will provide opportunities to explore further income generation in the cafés at both hospice sites.
## **Little Hulton**
## **Redevelopment**
A new café was opened at Little Hulton after its significant redevelopment programme. The café has availability for 24 covers and is offering a number of lunch options and fresh filter coffee.
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The hospice’s Catering team has developed workflows and processes and has liaised with the wider staff team to ensure an appropriate food and beverage offer. Consideration has also been given to the workforce requirements with the café being supported by both employees and volunteers.
An outside area has also been created with modern bistro style furniture, wooden topped tables and parasols and also a number of rattan arm chairs. This area is proving popular, especially during fine weather.
## **Improvements to Patient Areas and Facilities**
Throughout the year it has been possible to make a number of improvements including:
- New furniture and play equipment was purchased for the redeveloped children’s space adjacent to the café at Little Hulton. This is supporting families to spend time together away from the Inpatient Unit environment
- Repairs have been completed on the road at the Little Hulton site
- Aging laundry equipment has been replaced at both sites.
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## Business Development
The past year has been one of both challenges and calculated innovation for our Business Development Directorate. With the ongoing rise in interest rates, the focus has been increasingly centred on scrupulous financial management.
Our Finance team rose to the occasion by introducing a new system that puts Business Intelligence (BI) at its core. This development has been crucial in enhancing data-driven decisionmaking, thereby helping us maintain a tighter control on costs.
In alignment with the prevailing financial landscape, our Fundraising and Trading departments were particularly vigilant in their approach. Both departments concentrated on their strategies and prioritised activities that required minimal resources but provided a high Return on Investment (ROI). This conscious selection of activities reflects our agility and ability to adapt to changing conditions, ensuring sustainability and impact.
Unfortunately, the Capital Build project had its share of tribulations, encountering further difficulties as the year progressed. However, a significant milestone was achieved as we finally reached an agreement on the Section 106 legal text with Stockport Metropolitan Borough Council. This has considerably expedited the new build project, moving us much closer to its initiation
While some may argue that in a difficult economic landscape, it would be prudent to pause or scale back initiatives like the Capital Build project, we believe that pushing forward under well-planned conditions is key to our long-term vision and service expansion. By ensuring robust BI systems and focusing on high ROI activities, we are striving to balance immediate financial prudence with futureoriented growth.
Overall, the strategies we have implemented this year have been designed to mitigate risks while maximising opportunities. This ensures not only the ongoing viability of the hospice but also lays solid groundwork for our ambitious building project in Heald Green.
## Fundraising
Fundraising income from donations and legacies to the 31st March 2023 was **£5,909,716** against the previous year of **£6,795,953** (2021/22) a decrease of **13.0%.**
During 2022/23 we observed a slow, but steady return, to public confidence for fundraising events attendance and activities. The economic challenges created in the autumn impacted negatively on Christmas giving.
In June 2022 we successfully launched the public appeal for the new building in Heald Green. This received significant TV and print media coverage; income was above expected with many donors giving exceptional gifts.
Alongside the delivery of income, the fundraising team gave exceptional support to communications during a period of vacancies in the Spring/Summer.
The 2023-28 5 year strategy is now being implemented throughout the areas of fundraising with the vision to deliver a surplus income of £5m in the financial year of 2027/28.
In line with the strategy, we have delivered:
To build a more sustainable base of fundraising income by investing in sustainable income streams including regular giving, in aid of activity, and trusts and foundations, by increasing income by 50% across these streams.
We have invested in corporate volunteering, creating more opportunities to engage with groups of volunteers who may then in the future raise money for us.
To be digital first and digital efficient in the planning and delivery of activity.
We have a rolling programme of social media-based challenges following successful trials in 2021/22. We have engaged with a consultant to integrate our database and mailing software to more effectively
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target and test our electronic communications for greater return.
To increase our capacity to fundraise through recruiting and empowering volunteers
Work has commenced to reinvigorate the fundraising volunteer programme, with three new office-based volunteers recruited, focusing on Capital Fundraising, Legacies, and Community.
We engaged with final year students at Alliance Manchester Business School to research and benchmark St Ann’s activity against that of other Manchester based charities and similar sized hospices nationwide.
To protect future income by increasing legacy pledgers by 10% Year on Year
Our new individual giving fundraiser has commenced work on a new stewardship plan for legacy fundraising, activities have included calling all our legacy pledgers to thank them for their support, and invitation for them to meet key members of the St Ann’s team. Additional resource was allocated for ‘Will Month’ with Facebook advertising trials. This resulted in an uplift in appointments from 38 to 58 and an increase in income from £6,000 to £10,000.
To deliver sufficient income to build a new hospice at Heald Green
The successful launch of the public appeal, alongside the success of our trust and foundation fundraising activities, has helped cash and pledges reach an amazing £2.6 million, with £2.4 million left to raise. The public campaign on 20th November 2023 stood at £927,050.
The direct mailing was a particular success, where many long-term supporters gave a gift higher than their usual gift level. In addition, many local organisations including golf clubs, community groups, football fan groups, and schools, have been raising funds for the appeal.
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 the 12 months to 31st March 2023. We review all new activity in line with our information governance policy.
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 2022/23, we received no request to cease communication through the Fundraising Preference Service. One complaint relating to Fundraising was received during the year, this was 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.
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## Trading Company
Trading Company turnover in the year was **£2,546,496** (2021/22: £2,574,602), a **1.0%** decrease on 2021/22. Operating profit in the year was **£989,579** (2021/22: £844,857), a **17.1%** increase on 2021/22. Goods sold under the Gift Aid Scheme, which are reported as donations in the Charity, totalled **£225,500** (2021/22: £221,092), a **2.0%** increase.
**----- Start of picture text -----**
Turnover to 31st March 2023
£2,546,496
a 1.0% decrease on 2021/22
Operating profit to 31st March 2023
£989,579
a 17.1% increase on 2021/22
**----- End of picture text -----**
## **Retail**
Retail income reduced slightly on the previous year, **£773,972** (2021/22 £779,129) following the closure of two shops during 2021/22.
During the year the Retail Team focused on increasing brand awareness and community engagement to drive income though attendance at external events such as fashion shows, bridal fairs and late-night opening. The bridal department based at the Stockport Shop was runner up for the best window display at the Charity Retail Association awards. The team attended job fairs to promote vacancies and volunteering opportunities within the retail arm of the Trading Company.
In a bid to continue community engagement and drive income during the coming year the Retail Team will participate in the Big Help Out a volunteering project to celebrate the Coronation and continue to attend external events.
Having introduced a VOIP telephone system in 2022/23 the Retail Team plan to introduce a cloudbased EPOS till to ensure infrastructure is fit for the future.
## **Lottery**
**17,650**
Lottery membership at the end of March 2023 was **17,650** (2021/22 Lottery Members 18,298) with an average of 17,447 (98.8%) of members playing each week. During the 2022/23 membership decreased by 3.5%, the decline was largely due to challenges recruiting team members to our promotional campaign and the impact of the cost-of-living crisis in Autum/Winter 2022/23.
We continued to sign-up new lottery members via the lottery website at an average of 3 new online players each week.
In addition to the weekly lottery, two raffles were promoted in 2022/23 with total ticket sales of over **£42,000** (£20,675 Summer Raffle, £21,598 Christmas Raffle)
During the coming year the Lottery Team will continue to promote our lottery both by telephone and face to face and will look to increase the use of venue-based promotion.
Online sales of raffle tickets for the bi-annual raffles will be trailed alongside the traditional paper tickets.
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## Finance
Staffing challenges which were first felt in 2021/22 continued during 2022/23 with recruitment to vacant posts a particular challenge.
Despite these challenges the team successfully implemented new accounting software, going live in April 2022. The software has enabled processes within the Finance Team to be streamlined and work is ongoing to fully implement new features offered with the aim for the Finance Team to be fully paperless in 2025/26. In line with this aim a project is planned for 2023/24 which will enable electronic authorisation and storage of purchase invoices.
During the year the Finance Team continued to work closely with colleagues across the Organisation, supporting new fundraising initiatives, providing information to support grants and bids and providing input and advice for new projects.
The review of the payroll function planned for 2022/23 was delayed due to the recruitment of a permanent Payroll Manager not taking place until December 2022. This review will now take place in 2023/24.
## Marketing & Communications
For the majority of this year, Marketing and Communications at St Ann’s was under the stewardship of High Rise Communication – an agency who managed the department’s functions while the internal team was rebuilt after previous staff left. In November 2022, a new Head of Marketing and Communication started in post.
One of the largest projects for the team was the launch of the Build it Together new hospice appeal in the Summer of 2022. This saw a large about of media coverage for the hospice and supported the fundraising team in their direct mail appeal for the campaign.
Social media continued to be a key suite of channels for St Ann’s and engagement on all platforms, in particular Facebook and Instagram increased dramatically. The team also launched a new TikTok channels for the hospice to reach new audiences. The department continued to work closely with all other departments across the organisation, in particular the fundraising and trading teams to support them in their income generation for the hospice.
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## Review of 2022/23 Priorities Construction of the new hospice at Heald Green
The ambition to commence construction of the new hospice at Heald Green was met with a complex and layered year. However, despite some unforeseen challenges, substantial progress was made on several fronts.
## **Land Ownership Complications**
Just as it seemed we were nearing the completion of our Section 106 agreement, a last-minute discovery surfaced that a small strip of land, initially thought to be owned by the hospice, was in fact under the ownership of Cheadle Royal Hospital Charitable Trust (CRHCT), with Muse Developments holding the leasehold. The complication was exacerbated by the absence of any previous documentation from either the hospice or CRHCT. We were informed that given the lapse of time since the initial 2001 planning permission, a strong legal case for adverse possession could be made. However, thanks to the strong relationship between the hospice and CRHCT, Muse Developments agreed to release the lease back to CRHCT, who in turn transferred the freehold to the hospice for a nominal fee.
## **Capital Fundraising and Financial Gains**
Our capital campaign saw commendable progress, invigorated by new members joining the team. A successful direct mail campaign to our
community proved a significant financial boost, illustrating the strength and diversity of our income streams, supported by expert consultation.
## **Brand and Design**
Final brand proposals were warmly received not only by the Executive Leadership Team but also by the staff. The new brand resonates as modern, fresh, and forward-looking, aligning well with the ethos of the upcoming facility.
## **Completion and Milestones**
After navigating through these challenges, we achieved a significant milestone. The Section 106 agreement was finally signed off, and the Judicial Review Period elapsed without issues. The hospice formally acquired the land from CRHCT on 11th September 2023.
## **Conclusion**
There might be an argument that the legal complexities we faced could have been a sign to re-evaluate or halt the project. However, we believe that these challenges are often part and parcel of projects of such scale and ambition. Our ability to navigate these complexities stands as a testament to our resilience and the strength of our relationships with key stakeholders.
In summary, while the journey was laden with unforeseen obstacles, the concerted effort from all departments ensured
that the project not only remained on track but also adhered to budget constraints and mitigated risks. This lays a robust foundation for the final construction phase and positions us well for the planned completion in Summer 2025.
Review and enhance the flexible clinical services offer using lessons learnt from the COVID-19 pandemic
## **Introduction**
A central ambition for the year 2022/23 was to review and enrich our flexible clinical services by applying the lessons learnt during the COVID-19 pandemic. As the healthcare landscape continuously evolves, so must our commitment to deliver services that are not only exceptional in quality but also accessible and equitable. This priority marshals our focus into several areas, each significant to ensuring the delivery of patient-centred care that is also fiscally responsible and operationally effective.
## **Optimising Resources for Financial Sustainability**
In an era of constrained resources and complex care needs, financial sustainability is a non-negotiable cornerstone for the longevity and quality of hospice services. A considered decision was thus made to reduce our bed count by nine. While such a decision may draw some criticism for potentially affecting patient care, it is crucial to note that
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the reduction is part of an overarching strategy to optimise operational efficiency without compromising the quality of care provided.
## **Re-Evaluation of the Being You Centre**
The Being You Centre, as an outpatient hub, has undergone a robust re-evaluation to ensure it remains a vibrant, supportive space for patients and their families. Taking the ethos of adaptability and responsiveness to heart, the facility will feature enhanced services that reflect the changing needs and preferences of our patient population.
## **Policy and Guidelines Responsiveness**
Navigating the intricacies of ever-evolving healthcare policies and guidelines is a formidable task. However, our agility in rapidly adapting to these changes underscores our resilience and commitment to adhering to the highest standards of patient care and governance.
## **Innovations in Remote Care and Workforce Management**
The COVID-19 pandemic has been a game-changer in the way healthcare services are delivered. Building upon the lessons learned, we aim to incorporate innovations in remote care where applicable. Additionally, maintaining a resilient and adaptable workforce is vital for ensuring safe staffing levels and continuing to deliver high-quality patient care.
## **Conclusion**
While some may argue that a reduction in bed numbers or
changes in outpatient services could impact the quality of patient care, we believe these strategic shifts are both necessary and thoughtful. These activities are designed to keep pace with changing healthcare needs and ensure the sustainability of high-quality services. By embracing financial sustainability, adapting to policy changes, and implementing technological innovations, we are positioning ourselves to provide patientfocused, high-quality care well into the future.
In essence, the tasks ahead of us are challenging but critical to ensuring that we continue to offer a clinical service that is equitable, of high quality, and financially sustainable. This priority for 2022/23 set the course for a year of substantial advancement, building on a foundation that promises a safer, more efficient, and patientcentred service.
Review the staff survey
results and the impact of the implementation of the new pay framework aspiring to attract talent and retain high performing individuals and teams
## **Introduction**
In an evolving landscape of healthcare provision and an increasingly competitive job market, our commitment to creating a supportive, inclusive, and fulfilling workplace for our staff has never been more critical. The aspiration to retain high-performing individuals and attract new talent serves as the cornerstone for our 2022/23
priority. This priority entails a comprehensive review of the staff survey results and the impact of the new pay framework implemented.
## **Staff Survey and Internal Communications**
In response to the staff survey, we identified a gap in effective internal communications. A dedicated project has been launched to scrutinize and improve this crucial aspect. The aim is to ensure that staff across all departments feel heard, valued, and informed about organizational activities and opportunities for professional development.
## **Pay Framework and Line Manager Engagement**
Ongoing support has been channelled into the newly implemented pay framework. A crucial part of this has been the engagement with line managers, who have been reviewing progression pathways, evaluating performance metrics, and discussing career aspirations with their team members.
## **Monitoring of NHS Pay Deal**
Concurrent with our internal pay structure revisions, we have kept a keen eye on developments in the National Health Service (NHS) pay deal. The Board received recommendations for a costof-living increase in early 2023, which reflects our commitment to maintaining a competitive and fair pay structure. While some might argue that rigid adherence to NHS guidelines may not offer the flexibility a hospice needs, we believe that aligning closely with NHS standards ensures a level of
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consistency and fairness that is crucial for staff morale.
## **IT Infrastructure and Digital Upskilling**
As we transition into an increasingly digital era, we recognise the imperative of a robust IT infrastructure and a digitally skilled workforce. Work is ongoing to update our systems and offer digital upskilling sessions for our staff. These initiatives not only facilitate more efficient operations but also empower our staff to utilise digital tools effectively, thus adding another layer to our talent retention strategy.
## **Conclusion**
It’s possible to argue that focusing on pay structures and digital upskilling might divert attention and resources from core hospice services. However, we contend that an empowered, well-compensated, and digitally skilled staff is central to delivering excellent patient care and ensuring the long-term sustainability of the hospice.
In summary, our multi-pronged approach targeting pay, communication, and digital skills aims to create a more cohesive, efficient, and contented workforce. Each initiative, whether already implemented or on the horizon, has been carefully designed to build on the previous year’s achievements and lay a strong foundation for the future.
Review the next phase of the Little Hulton refurbishment
The 2021/22 annual report outlined several important initiatives to be undertaken
with respect to the Little Hulton refurbishment. This ranged from reviewing phase 1 developments, lobbying the Greater Manchester Mental Health NHS Foundation Trust (GMMH NHS Foundation Trust) for freehold approval, to involving a broad spectrum of staff, volunteers, and patients in the planning and design process.
## **Estates Development Paused and Resumed**
The fiscal concerns that led to a temporary halt on all estates developments in December 2022 have since been resolved. The Board, recognising the critical nature of the Little Hulton facility, gave the green light to resume estate developments in August 2023. This decision represents a significant step forward in securing the facility’s future, and the appointment of a full-time Estates Manager will undoubtedly expedite this process.
## **Engagement with Greater Manchester Mental Health NHS Foundation Trust**
One of the year’s highlights was establishing an open line of communication with the CEO of GMMH NHS Foundation Trust. The proactive approach of sending a letter from our Chair to theirs led to meaningful discussions on the freehold approval. This lays a strong foundation for future negotiations and likely accelerates the approval process.
## **Budget Constraints**
While the resumption of estate development was a positive move, it came after a period of uncertainty caused by budget deficits. Though the financial
situation was rectified, the delay may have downstream impacts, like increased costs or the reprioritisation of other initiatives.
## **Pending Freehold Approval**
Although communication channels with GMMH NHS Foundation Trust have improved, we are yet to receive a formal proposal from them. This remains a looming uncertainty, which could affect long-term planning for Little Hulton.
There might be some concerns about the pace at which these developments are unfolding, especially given the budgetary pause. However, it is essential to understand that such strategic moves often require meticulous planning and financial prudence. Rushing into decisions could lead to suboptimal outcomes.
## **Conclusion and Next Steps**
Despite the challenges encountered, the progress made in 2022/23 has been substantial. The resumed commitment to the Little Hulton refurbishment and enhanced relations with the GMMH NHS Foundation Trust set the stage for meaningful future developments.
While a faster pace would have been preferable, the measured approach, given the complex financial and operational aspects involved, is more prudent. The next steps involve eagerly awaiting the proposal from GMMH NHS Foundation Trust and kick-starting phase 2 developments with the guidance of our newly appointed Estates Manager.
We remain steadfast in our commitment to making the Little
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Hulton facility a state-of-the-art space that meets the needs of patients, staff, and volunteers alike.
Develop partnerships to enhance collaboration and co-production to deliver services, education and training and business development opportunities for future sustainability.
## **Introduction**
The priority for “Develop partnerships to enhance collaboration and co-production to deliver services, education, training, and business development opportunities for future sustainability” is both a strategic and operational imperative for the forthcoming year. The ever-changing landscape of healthcare and social care services necessitates a proactive approach to collaborative working. By leveraging existing partnerships and forging new alliances, we aim to position ourselves at the forefront of innovation, efficiency, and sustainable growth.
## **Educational Collaboration**
In continuation of our commitment to educational excellence and clinical leadership, we are proud to maintain our partnership arrangement with the University of Salford for the joint delivery of the Masters in Clinical Leadership. This synergy not only enhances our internal capacity but also enriches the broader healthcare sector through highlevel clinical training.
## **NHS and Hospice Sector Alliances**
Our established collaborations within the National Health Service (NHS) and the hospice sector continue to be vital cogs in our operational wheel. We are committed to enhancing these partnerships in the evolving Integrated Care System (ICS) framework, at both local and regional levels. This will help us deliver seamless, high-quality care and gain efficiencies through shared best practices.
## **Greater Manchester Hospice Collaborative**
We have proactively engaged with the Greater Manchester (GM) Hospice Collaborative to establish focused workstreams. These are aimed at driving enhanced efficiency and sustainability across our operations. This partnership is an excellent example of how co-production can yield effective strategies for patient care and operational excellence.
## **Expanding Executive Networks**
It is also a priority for our Executive Leadership Team to broaden their spheres of influence and responsibility across Manchester. By taking up positions such as volunteers or trustees in other charities and voluntary organisations in Stockport, they will create invaluable networking opportunities and open doors for future collaborations.
## **Advisory and Operational Support**
We plan to explore avenues where St Ann’s Hospice can offer advisory and/or operational
services to other hospices in GM, and to the wider Voluntary, Community, Faith and Social Enterprise (VCFSE) sector. This initiative aims to position St Ann’s as a centre of excellence and a resource hub for the hospice and healthcare community.
## **Conclusion**
While one might argue that extending our partnerships may divert focus and resources from our core activities, we believe that these collaborations are essential for long-term sustainability and improved patient care. The capacity to share resources, skills, and knowledge in a strategic manner outweighs the potential risks involved. Our position, therefore, is that a wellcoordinated partnership strategy not only complements but amplifies our mission and vision, making it a cornerstone of our future success.
In summary, the priority to develop partnerships is wellaligned with our organisational goals. It will allow us to leverage a range of opportunities for sustainable growth, continuous improvement, and community engagement. This multi-faceted approach to collaboration lays the groundwork for an exciting and transformative year ahead.
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## Our priorities for 2023 - 2024
In early 2023, St Ann’s Hospice unveiled its renewed five-year organisational strategy for 2023 – 2028. This blueprint is an evolutionary step, founded on the successes of our previous five-year strategic agenda. The strategy has been articulated in clear and concise terms to ensure it is accessible.
The updated strategy introduces a sixth strategic aim, an addition which explicitly focuses on the hospice’s commitment to educational excellence, research initiatives, and a continuous pursuit of innovation to address the challenges we face. The core principle of the strategy remains unaltered; we are steadfast in placing our patients and their loved ones at the heart of everything we do, aspiring to the highest standards of care and support for everyone.
For the upcoming year, our organisational imperatives will be centred on financial management, capital fundraising, and the construction of our state-of-the-art facility at Head Green. Concurrently, stabilising the hospice workforce will be a critical focus, particularly following the extensive restructuring of Clinical Services carried out in early 2023. Moreover, we are committed to resolving commissioning challenges emanating from the newly formed NHS Integrated Care Boards (ICBs). The ICBs are currently grappling with financial constraints, imposed by NHS England, which has had a crippling effect on their operational capabilities. This has created an environment where our NHS counterparts are increasingly strained for resources, leading to significant bottlenecks in decision-making and communication.
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.
**With secured finances and confirmation that adequate reserves can be 1 maintained, we will appoint a contractor and start construction of our new building at Heald Green.**
**We will intensify our capital fundraising campaign to achieve high 2 public visibility and meet predefined targets, backed by a series of contingency measures for assured success.**
**We will start to plan the transition to the new hospice building in 2025, focusing on stakeholder identification, logistics, staff engagement, asset management, and workforce planning.**
**3**
**We will review the care we provide and ensure our care is evidence4 based and aligned to the Greater Manchester Commitments for Palliative and End-of-Life Care.**
**We will review our education, training, and research activities, developing a strategy to address the challenges and position us as a centre of excellence in education, research, and innovation.**
**5**
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**With secured finances and confirmation that adequate reserves can be maintained, we will appoint a contractor and start construction of our new building at Heald Green.**
In alignment with our strategic priority for 2023/24, we are geared up to commence construction of our new hospice facility at Heald Green, fortified by secured finances and assurance of adequate reserves. A multitude of meticulous planning and preparation stages guide this crucial work:
We will continue to engage with our supportive architects to look at ensuring the space is used appropriately for the needs of the patients and can accommodate the staff and services.
- The final text of the Section 106 will be finalised in consultation with Stockport Metropolitan Borough Council (SMBC) and Cheadle Royal Hospital Charitable Trust (CRHCT). Following the passage of the judicial review without
objections, we will pay CRHCT the outstanding balance, thereby achieving legal completion and the requisite submission to the Land Registry.
• Caddick Construction, selected through a competitive tender process, will liaise closely with the project design team to account for any alterations in design since the last cost estimates. A comprehensive re-evaluation of the supply chain will follow to obtain updated quotations based on the latest designs.
• Our project design team, inclusive of interior designers, will collaborate with hospice stakeholders to put the final touches on any remaining design decisions, thereby enabling the final plans to be forwarded to the contractor.
- The Board of Trustees will be presented with the most accurate construction cost estimates along with high-level financial analysis and projections. This will encompass diverse income streams and capital fundraising strategies, factoring in their associated uncertainties. The affordability of the project through to its completion
will be thoroughly discussed, alongside a comprehensive risk assessment and any identified mitigations.
• After Board approval on project affordability, our Finance Committee will delve into the granular financial analyses for a final review. Upon their green light, legal experts will be engaged to draft, negotiate, and finalise a construction contract with Caddick Construction.
• The Project Manager and Caddick Construction will address and discharge all planning conditions. Environmental considerations will be considered, with tree felling and site access being established within permissible timelines. The site will then be cleared, levelled, and secured, setting the stage for construction to commence.
This ambitious project is enveloped by stringent governance and robust financial planning, ensuring not only its viability but also its alignment with our commitment to providing exceptional care and support to our patients and their families.
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**We will intensify our capital fundraising campaign to achieve high public visibility and meet predefined targets, backed by a series of contingency measures for assured success.**
In the upcoming year, a cornerstone of our organisational strategy will be to intensify our “Build it Together Capital Campaign.” Initially launched in the 2022/23 fiscal year, the campaign set its sights on a public appeal target of £2m, reaching out to both existing supporters and new potential donors across Greater Manchester. This bold initiative is slated to unfold over a five-year period, with particular focus on amplifying public visibility during its central three years.
• To meet our ambitious cumulative fundraising goal of £6.98m, we shall deploy a multifaceted strategy. This includes the utilisation of direct mail campaigns, applications to trusts and foundations, active solicitation from major donors, and the forging of robust corporate partnerships.
Additionally, we will engage community organisations and orchestrate a range of fundraising events, both domestically and internationally. Certain exclusive fundraising tactics are also in the pipeline, details of which will be divulged once finalised.
• Given the ambitious nature of our objectives, it’s essential to have contingency measures in place. We will meticulously evaluate the viability of each income stream and develop an exhaustive list of alternative strategies and mitigating actions; in case any aspect of our initial plan falls short or fails to materialise.
- It’s vital to recognise that while our capital fundraising activities are important, they should not overshadow or compromise our routine fundraising efforts essential for day-to-day hospice operations. Sufficient staffing and resource allocation will be imperative to achieve a balanced and effective approach in both fundraising workstreams.
- To support these complex financial dynamics, we will leverage our newly implemented Finance
and Accounting system. Comprehensive and realtime reporting will be made possible through Microsoft Power BI, enabling consistent and immediate data accessibility for the Finance Committee, Audit Committee, and the Board of Trustees. This digital infrastructure will not only streamline our financial oversight but will also contribute to agile, datadriven decision-making, ensuring that we remain on course to fulfil our fundraising ambitions.
Our intensified capital fundraising campaign for the upcoming year aims not just for financial targets but for a sustainable, balanced approach that supports the organisation’s broader mission. By employing a well-rounded, risk-mitigated strategy and making judicious use of cutting-edge financial technology, we are not merely aiming for success; we are planning for it. This multi-year initiative, embedded within our overall fundraising ecosystem, will play a pivotal role in shaping the future of hospice care, setting a precedent for what’s achievable through community engagement, strategic partnerships, and prudent financial governance.
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## **We will start to**
**plan the transition to the new hospice building, focusing on stakeholder identification, logistics, staff engagement, asset management, and workforce planning.**
In 2025, we will focus on planning the transition to the new hospice building at Heald Green. As we near the completion of the construction phase, it becomes critical to ensure seamless operational readiness for the new facility. Our priority will involve multi-layered planning that addresses the needs of various stakeholders and minimises disruption to our ongoing services.
• Identifying key stakeholders from the outset is crucial for ensuring a smooth transition. This will include internal stakeholders like staff and board members, as well as external ones such as patients, families, healthcare partners, and the broader community. Collaboration and communication will be key in understanding and meeting the expectations of these groups.
- The logistical aspects of the move will be meticulously planned. From the shifting of medical equipment to the allocation of space in the new facility, every detail will be accounted for. Special attention will be
paid to the continuity of care during the transition. This includes ensuring that essential services, particularly emergency and acute care, experience minimal disruption.
• Engaging staff early in the transition process is critical for its success. We will implement a comprehensive training and orientation programme to familiarise staff with the new facility. Feedback loops will be established to address concerns and gather suggestions, enabling a sense of ownership and aiding change management.
• An inventory of current assets will be created, followed by a needs assessment for the new facility. This will enable us to identify which assets can be transferred and what additional acquisitions will be necessary. Given the nature of hospice care, the asset management strategy might differ from that of a traditional hospital, particularly in the realm of specialised care equipment and patient comfort assets.
• Workforce requirements for the new facility will be carefully evaluated. This will involve understanding the staffing needs dictated by the new space, adjusting roles and responsibilities where needed, and ensuring adequate training. Workforce planning will also include contingency plans to account for potential staffing disruptions during the move.
• Communication will serve as the backbone of this entire operation. A multifaceted communication plan will be developed to ensure effective internal and external communication. We will utilise a variety of channels, from internal memos and meetings to community forums and digital platforms, to keep all stakeholders informed and engaged.
Planning the transition to our new hospice facility is not just about moving from one building to another; it’s about transforming how we deliver care. By focusing on stakeholder identification, logistics, staff engagement, asset management, and workforce planning, we aim to ensure that the new facility is operationally ready to offer seamless, high-quality care to our patients and community.
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**We will review the care we provide and ensure our care is evidence-based and aligned to the Greater Manchester Commitments for Palliative and End-ofLife Care.**
In alignment with the Greater Manchester Commitments for Palliative and End-of-Life Care, our priority for 2023/24 is to conduct a comprehensive review of the care we provide, ensuring it is not only evidence-based but also consistent with the highest standards of excellence.
• Our approach to patient care will be innovative and holistic, tailoring treatment plans to individual needs and circumstances. This commitment to personalised care will be backed by a multi-disciplinary framework, employing a rehabilitative approach to both planning and delivery. Our objective here is to create a cohesive and patient-focused experience that empowers our patients to set realistic and achievable goals.
• To underpin these efforts with concrete evidence, we will conduct an audit of end-of-life care in our hospice inpatient unit and community services. Concurrently, we will participate in the National Audit of Care at the End of Life (NACEL) case note review. These audits will
inform the continuous improvements we aim to make, ensuring we meet or exceed the standards set out by the Care Quality Commission (CQC).
• Quality improvements will not solely rely on clinical or regulatory benchmarks. We will actively solicit and incorporate feedback from our patients and their families, with particular focus on reported outcomes of care. Our performance in this area will be gauged through monitoring both complaints and compliments, specifically those related to patient empowerment and goal setting.
• Partnerships will play a critical role in achieving our objectives. We aim to strengthen collaborative approaches to care to achieve optimal patient outcomes. Our ambition extends beyond the walls of our hospice, as we plan to make our services more accessible across all neighbourhoods and communities. This will include improved access to community hospice-provided rehabilitation services.
• Alongside our clinical work, we will strive to enhance the hospice’s reputation in both clinical and educational sectors. This will not only involve building strong relationships but also an increased emphasis on community and educational outreach.
• Lastly, we will adopt cutting-edge administrative procedures, ensuring timely completion and reporting of Length of Stay (LoS), PatientPerceived Concerns, and Patient-Perceived Discomfort to the Clinical Quality Performance committee (CQP).
In summary, our strategy for the upcoming year is a robust, multi-faceted approach designed to elevate the standard of care we provide, enrich the patient experience, and adhere strictly to evidence-based practices. This aligns perfectly with the Greater Manchester Commitments for Palliative and End-of-Life Care, and we anticipate that this focus will not only improve outcomes but also enhance the integrity and reputation of our services.
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**We will review our education, training, and research activities, developing a strategy to address the challenges and position us as a centre of excellence in education, research, and innovation.**
For the 2023/24 period, one of our key priorities will be to review and revamp our education, training, and research activities, positioning St Ann’s Hospice as a Centre of Excellence in these domains. In line with this, our objectives are multifaceted, encompassing learning experiences, collaborative partnerships, and innovative research.
- We will invest in providing an outstanding learning experience that not only enhances the capabilities of individuals but also strengthens leadership and teamwork. This initiative will be backed by an Information Governance (IG) based Learning Needs Analysis
to tailor training resources for induction, refresh, and volunteer programmes.
• To progress and achieve these educational advances, we will develop and present comprehensive options papers. One will explore the potential of delivering the Clinical Leadership Masters Programme as an apprenticeship, funded through the hospice’s apprentice levy. A second paper will identify various methods for delivering Quality Improvement (QI) training and development, laying out a strategic framework that is both robust and adaptable.
• Our educational endeavours will be amplified through stronger collaborations with university partners, reinforcing our ambition to be recognised as a teaching hospice. This initiative will complement our existing collaborations with Greater Manchester (GM) Hospices and local system partners, as we jointly develop and implement an Education & Training Strategy specifically
geared towards palliative and end-of-life care.
• As we take these steps, we are not only focusing on internal growth but are also committed to building our reputation as a sector leader. The aim here is not just to elevate our standing in education but to also become a beacon for research and innovation. To achieve this, we will aggressively promote our advances and successes, targeting peer-reviewed journals, conferences, and public forums as mediums of dissemination.
In summary, our strategy aims to fuse top-tier education, cuttingedge research, and collaborative innovation into a coherent and impactful programme. This aligns seamlessly with our overall mission and will position us unequivocally as a Centre of Excellence. By tackling this priority head-on, we expect to deliver a ripple effect of improvements that will benefit not only our staff and volunteers but also the wider community and the sector at large.
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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 door more than 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.
## **Background & Vision**
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.
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.
## **World-Class Facilities**
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 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.
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 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
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(11 for, 1 against) that planning permission be granted.
During 2021/22 we worked with our expert consultants and legal team to agree and negotiate the planning conditions and a section 106 agreement. The Section 106 took far longer than we could have ever imagined and has resulted in significant delay to the project. The Section 106 agreement has now finally been signed off, and the Judicial Review Period elapsed without issues. The hospice formally acquired the land from Cheadle Royal Hospital Charitable Trust on 11th September 2023.
Our design team have now completed the final design and have spent the additional time looking at ways to value engineer the building to reduce any unnecessary expenditure and keep the project cost under control. In addition, we put the construction project out to tender to select a building contractor. In December 2021, Caddick Construction Limited were selected during a highly competitive process from an excellent pool of candidates.
To ensure we can fully finance the construction project and secure a loan against the value of our existing land, we have started the process of marketing our existing site for future sale. We have jointly appointed Avison Young and Cushman & Wakefield as agents to sell the site. The agents approached a number of local housebuilders to determine their interest. A number of formal tenders have been received and reviewed.
## **Capital Fundraising Campaign**
national grant givers. In 2022 the public appeal was designed and launched in the summer, raising over £600,000 in the first 12 months from individual donations, community and events activity. At the end of March 2023 the cash and pledge balance for the appeal sits at £2.6M. The public appeal will continue as the building is under construction fundraising through trust and foundation applications and further phases of the public appeal.
This is an ambitious £24 million project. It is essential this project is completed so we can continue to provide our care into the future and ensure the palliative and end of life care needs of patients in Greater Manchester can be met.
With the plans now in place, we now need to raise the remaining funds to ensure that this vision becomes a reality. We have increased the reserves we have designated to this project to £18,612,740. This is a huge commitment and over 50% of the total amount required. But with no statutory funding available for hospice buildings, we need to raise the rest.
An ambitious fundraising plan for the new hospice commenced in 2019. Initially a focus was placed on trust and foundation income from both regional and
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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 **£2.3 million** (2021/22 £4.6 million increase) and an overall funds balance of **£25.7 million** at 31st March 2023 (£23.4 million at 31st March 2022). The financial position of the group is set out in the balance sheet on page 57. The Reserves Policy relating to the funds held by the hospice is described in the Reserves Policy below.
## **Income and expenditure**
The Statement of Financial Activities is set out on page 56 of these financial statements. From an operating point of view, 2022/23 showed a surplus before investment gains/(losses) and pension liability movements of £1,561,418 (2021/22 surplus of £3,638,499).
The hospice’s principal sources of income are donations, legacies, NHS contracts and trading profits.
Total income in 2022/23 was £13.8 million (2021/22 £16.0 million), a decrease of 13.8%.
Income from donations (including capital build) in 2022/23 was £2.6 million, a 7.7% decrease compared to the previous year (2021/22 £2.8 million). The reduction was due to a large one-off donation and associated gift aid being received in 2021/22
Legacy income is 17.5% down this year (£3.3 million), recognised as received or as due under FRS102 (2021/22 £4.0 million).
Funding from NHS Clinical Commissioning Groups amounted to £5.1 million, an increase of 2.0% (2021/22 £5.0 million).
The turnover of the Trading Company saw no change and remained at £2.6 million. The amount donated to the hospice is £1.0 million, an 11.1% increase compared to 2021/22.
Investment income and interest receivable in 2022/23 was £157k, this is an increase of 127.5% compared with 2021/22 of £69k. This was driven by increasing interest rates.
The cost of Charitable Activities decreased slightly by 0.5% from £9.91 million in 2021/22 to £9.86 million in 2022/23. We continue to review our cost base to ensure that we are providing our services as efficiently as possible.
The actuarial gain in the pension fund is £1.09 million (2021/22 £0.9 million gain). In the Balance Sheet there is a decrease in the liability to £0.6 million (2021/22 £1.6 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 is shown in Note 24 in these financial statements.
## **Investment Performance, Policy & Management**
At 31st March 2023 the value of the investment portfolio was £2.2 million (note 16). compared to 31st March 2022 balance of £4.7m. In preparation for the Capital Build project £2m of investments were liquidated in September 2022.
During the year, income earned on the portfolio was reinvested.
The total return of the investment portfolio (income plus capital change) to the 31st March 2023 stood at –4.7%. This is against WMA Income index and Brewin Dolphin’s benchmark, which experienced returns of -1.8% and -2.7% respectively.
The effects of high inflation and the invasion of Ukraine have led to some degree of underperformance in the value of the portfolio. However, when viewed on a longer-term time frame the performance of the assets over a 3-year and 5-year rolling period continues to be strong and ahead of wider markets.
The investment managers have been given delegated
52 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
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 to reduce the level of free reserves held to a minimum of 3 months running costs, having previously stated they should not exceed more than twelve months running costs. The minimum target of free reserves for 2022/23 was 3 months running costs. This reduction is to allow for greater funds to be designated to the Capital Build project and recognises the diversified income streams of the Organisation.
The free reserves at 31st March 2023 are £3.01m (2021/22: £6.9 million), a decrease of £3.89m.
This represents three months of normal running costs for the hospice (2021/22 six to seven 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 (2021/22: £1.7 million). This amount has slightly increased on the previous year. In 2020/21 this fund reduced 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 £18.6 million (2021/22: £13.4 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.
The Trustees have agreed to create a new designated fund for Information Technology upgrade works £0.12m has been designated to this fund in 2022/23.
## **Strategic Risks**
The Trustees have oversight of the strategic and operational risks across the organisation through both the Board and
its committees. The three key strategic risks (red risks) facing the charity are the uncertainty of voluntary and Trading Company income; an IT system failure; and the Heald Green building is forced to close. These three risks are discussed in more detail below.
## **Uncertainty of voluntary and Trading Company income**
Voluntary income from fundraising, particularly legacies is uncertain by its very nature. Changes to legislation in relation to fundraising practices, could reduce income and the capacity to fundraise through usual channels. Downturns in the economy can reduce fundraising income. The hospice is in direct competition with other major charities for fundraising income.
Loss of key staff from income generating teams can lead to gaps and affect continuity and capacity to fundraise whilst a reduction in Lottery subscribers leads directly to a fall in income and profit. In mitigation of this risk, 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 Trading Company Corporate Strategy and the Fundraising Digital Transformation Strategy are now live, with the aim of identifying new income streams and building on the success of existing ones to support transformational income growth.
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 53
ST ANN’S HOSPICE
In addition, we are currently rebuilding the Communications & Marketing team, as this will be important to support the delivery of the Fundraising and Trading strategies and grow the brand across Greater Manchester and beyond.
## **IT System Failure**
The current IT system, specifically the servers, could fail particularly due to age, and lack of warranty and support. This would cause major disruption to the daily operational functioning of the hospice, resulting in patient information not being accessible and staff being unable to update patient records and work with other key software systems.
In mitigation of this risk, a review was commissioned with an external IT consultant in August 2021 and a report with a detailed review of the hospice’s network, hardware, and software configurations were produced. The report highlighted several risks across the organisation and provided guidance around how to mitigate these risks. Following the report, all recommendations were reviewed, and an action plan was created. The IT Team reviewed the various options available, including new onpremises servers, the use of cloud technology, or a hybrid combination of both. A Business Case for the purchase of new servers has been produced and has recommend the purchase of new on-premises servers and transition to the cloud over the next 5 years. The Business Case will be reviewed by the Strategic Development Committee and the Board, as it requires significant capital investment.
## **The Heald Green building is forced to close**
The Heald Green building is rapidly deteriorating and could eventually become unsuitable for the delivery of end of life and palliative care in line with relevant legislation and guidance. If the building was forced to close, St Ann’s Hospice would change beyond recognition. The charity would be without a facility to provide its clinical services from, to over half the population it serves, and nowhere for all its back-office functions such as Finance, HR, and Fundraising. This could result in a significant reduction of its services, or even worse, the closure of the charity.
In mitigation of this risk, the Trustees have acquired a piece of land, adjacent to the current Heald Green building, and nearly twice the size. The land is where the Trustees will build a new facility, fit for the future, and conducive to modern day healthcare delivery. A planning application was submitted to Stockport Council in April 2021 and approved. Construction is due to start Spring 2024 but is reliant on the remaining funds being secured from several different sources. The new building is due to be completed by the Summer 2025 and will be a huge step in protecting the charity against future challenges. More detailed information about the new Heald Green building can be found on Pages 50-51.
## **Going Concern**
The Trustees are satisfied that the hospice has considerable financial resources available to be financially viable from the date of signing this report. Total Hospice income is slightly behind budget. Fundraising income is behind budget, however legacy income, statutory income and investment income are all performing ahead of budget.
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.
54 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
## 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”.
Company law requires the trustees to prepare financial statements for each financial year which give a true and fair view of the situation of the charitable company and the group and of the incoming resources and application of resources, including the income and expenditure, of the charitable group for that period. In preparing these financial statements, the trustees are required to:
- select suitable accounting policies and then apply them consistently;
- observe the methods and principles in the Charities SORP;
- make judgements and estimates that are reasonable and prudent;
- state whether applicable UK Accounting Standards have been followed, and
- 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.
In so far as the trustees are aware:
- 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.
The Trustees report, including the Strategic Report, was approved by the Board and signed on its behalf.
**Professor Jacqueline Oldham** BSc (Hons) RGN PhD Chair of St Ann’s Hospice Date: 14th February 2024
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 55
ST ANN’S HOSPICE
## Consolidated statement of financial activities (including consolidated income and expenditure account) **For the year ended 31st March 2023**
|Note|Unrestricted
funds
£|Restricted
funds
£|Total funds
2023
£|Total funds
2022
£|
|---|---|---|---|---|
|INCOME FROM:|||||
|Donations and legacies
3
Charitable activities
4
Other trading activities
5
Other Income
6
Investments
7|5,047,883
4,022,472
2,561,605
962
155,961|861,833
1,182,175
-
-
855|5,909,716
5,204,647
2,561,605
962
156,816|6,795,953
6,553,773
2,617,238
4,778
68,698|
|TOTAL INCOME|11,788,883|2,044,863|13,833,746|16,040,440|
||||||
|EXPENDITURE ON:|||||
|Raising funds
8
Charitable activities
9|2,412,977
8,707,367|-
1,151,984|2,412,977
9,859,351|2,487,350
9,914,591|
|TOTAL EXPENDITURE|11,120,344|1,151,984|12,272,328|12,401,941|
||||||
|Net income/(expenditure) before investment gains/(losses)|668,539|892,879|1,561,418|3,638,499|
|Net Gains/(losses) on Investments
16
Net income/(expenditure) before tax
11
Taxation
14|(319,502)
349,037
477|-
892,879
-|(319,502)
1,241,916
477|110,671
3,749,170
(3,203)|
|Net income/(expenditure) for the year|349,514|892,879|1,242,393|3,745,967|
|Transfer Between Funds
22
Other Recognised Gains/(Losses):|48,925|(48,925)|-|-|
|Actuarial Gains/(Losses) on Defined Benefit Schemes
24|1,091,000|-|1,091,000|854,000|
|NET MOVEMENT IN FUNDS
FUND BALANCES BROUGHT FORWARD AT
1st April|1,489,439
22,043,445|843,954
1,320,030|2,333,393
23,363,475|4,599,967
18,763,508|
|FUND BALANCES CARRIED FORWARD AT|||||
|31st March
22|23,532,884|2,163,984|25,696,868|23,363,475|
There were no other recognised gains or losses other than those listed above and the net income for the year. All income and expenditure derives from continuing activities.
The surplus of the parent charity for the year for Companies Act purposes is £2,333,393 (2022: £4,599,967).
As permitted by Section 408 of the Companies Act 2006, no separate Statement of Financial Activities is presented in respect of the parent charity.
See note 21 for the comparative consolidated statement of financial activities analysed by funds.
56 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
## BALANCE SHEET **As at 31st March 2023**
|Note|Group
2023
2022
£
£|Group
2023
2022
£
£|Charity
2023
2022
£
£|Charity
2023
2022
£
£|
|---|---|---|---|---|
|FIXED ASSETS|||||
|Tangible assets for use by the charity
15
Investments
16|5,110,373
2,243,861|4,930,088
4,723,376|5,101,067
2,243,863|4,921,521
4,723,378|
||7,354,234|9,653,464|7,344,930|9,644,899|
|CURRENT ASSETS|||||
|Stocks
17
Debtors
18
Cash at bank and in hand
19|36,267
4,137,206
16,127,823|40,057
5,808,524
10,831,752|30
4,836,953
15,142,800|546
6,422,944
9,927,124|
||20,301,296|16,680,333|19,979,783|16,350,614|
|CREDITORS: amounts falling due
within one year
20|(1,331,662)|(1,332,322)|(1,000,845)|(994,038)|
|NET CURRENT ASSETS|18,969,634|15,348,011|18,978,938|15,356,576|
|TOTAL ASSETS LESS CURRRENT LIABILITIES|||||
|LIABILITIES|26,323,868|25,001,475|26,323,868|25,001,475|
|NET ASSETS EXCLUDING|||||
|PENSION LIABILITY|26,323,868|25,001,475|26,323,868|25,001,475|
|PENSION LIABILITY
24
NET ASSETS INCLUDING|(627,000)|(1,638,000)|(627,000)|(1,638,000)|
|PENSION LIABILITY|25,696,868|23,363,475|25,696,868|23,363,475|
||||||
|FUNDS|||||
|Unrestricted Funds
Restricted funds|23,532,884
2,163,984|22,043,445
1,320,030|23,532,884
2,163,984|22,043,445
1,320,030|
|TOTAL FUNDS
22|25,696,868|23,363,475|25,696,868|23,363,475|
These financial statements of St Ann’s Hospice,(registered number 00947220), were appoved by the DirectorsThese financial statements of St Ann's Hospice,(registered number 00947220), were appoved by the Directors and authorised for issue on 14th February 2024. They were signed on its behalf by:and authorised for issue on 22 January 2024. They were signed on its behalf by:
**Mr Darren Holt BA FCA** Honorary Treasurer
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 57
ST ANN’S HOSPICE
## CASH FLOW STATEMENT
## **For the year ended 31st March 2023**
||For the year ended 31 March 2023|Group
2023
£|Group
2022
£|
|---|---|---|---|
|||||
||Net cash flow from operating activities|3,447,400|1,751,635|
|||||
||Cash flows from investing activities:|||
||Interest received
Investment net proceeds
Investment income received
Proceeds from sale of equipment
Purchase of property, plant and equipment|92,241
2,160,013
64,575
-
(468,158)|7,549
(31,792)
61,149
1,500
(673,712)|
||Net cash flows from in investing activities|1,848,671|(635,306)|
|||||
||Net increase/(decrease) in cash and cash equivalents|5,296,071|1,116,329|
|||||
||Cash and cash equivalent at beginning of year|10,831,752|9,715,423|
|||||
||Cash and cash equivalents at the end of the year|16,127,823|10,831,752|
||Reconciliation of net income and net cashflow
from operating activities
Net income before investment gains
Adjustments for:
Investment income
Interest Receivable
Corporation Tax Paid
Depreciation
Profit on sale of tangible fixed assets|Group
2023
£
1,561,418
(64,575)
(92,241)
-
287,873
-|Group
2022
£
3,638,499
(61,149)
(7,549)
-
301,439
(1,500)|
|||1,692,475|3,869,740|
||Decrease in stock
Decrease/(Increase) in debtors
(Decrease)/increase in creditors
Adjustment for pension funding|3,790
1,671,318
(183)
80,000|4,230
(2,412,254)
217,919
72,000|
|||3,447,400|1,751,635|
58 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
## Notes to the financial statements **For the year ended 31st March 2023**
## **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 9 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 93.
## **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 from the date of signing. 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 16.
## **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.
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 59
ST ANN’S HOSPICE
## NOTES TO THE FINANCIAL STATEMENTS
## **For the year ended 31st March 2023**
## **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_
Investment income is accounted for when receivable.
## _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.
60 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
## NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2023**
## **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.
## **Fund accounting**
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.
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 61
ST ANN’S HOSPICE
**For the year ended 31st March 2023**
## NOTES TO THE FINANCIAL STATEMENTS
## **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**
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.
62 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2023**
## **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.
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 63
ST ANN’S HOSPICE
## NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2023**
## **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 acknowledge that judgement and estimates have been used in establishing legacy valuation, and are satisified these are based on acceptable underlying assumptions.
Estimates of the pension valuation depend on a number of complex judgments relating to the discount rate used, changes in retirement ages, mortality rates, and the calculation of pension increases. The group engages a firm of actuaries to provide expert advice about the assumptions made and the effect on the pension valuation of changes in these assumptions.
64 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
## NOTES TO THE FINANCIAL STATEMENTS
## **For the year ended 31st March 2023**
|3
ANALYSIS OF INCOME FROM DONATIONS AND LEGACIES|||
|---|---|---|
|Donations
Legacies
Donations - HG Capital Project|2023
£
1,860,268
3,298,611
750,837|2022
£
2,197,735
3,968,941
629,277|
||5,909,716|6,795,953|
||||
|4
ANALYSIS OF INCOME FROM CHARITABLE ACTIVITIES|||
|NHS Contracts
Grants
Job Retention Scheme
Hospice UK|2023
£
5,091,614
113,033
-
-|2022
£
5,003,140
112,209
11,790
1,426,634|
||5,204,647|6,553,773|
||||
|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|2023
£
15,109
1,651,312
895,184
-|2022
£
42,636
1,638,442
912,152
24,008|
||2,561,605|2,617,238|
||||
|6
ANALYSIS OF INCOME FROM OTHER INCOME|||
|Other Income|2023
£
962|2022
£
4,778|
||962|4,778|
||||
|7
INVESTMENT INCOME|||
|UK listed investments
Bank Interest|2023
£
64,575
92,241|2022
£
61,149
7,549|
||156,816|68,698|
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 65
ST ANN’S HOSPICE
## NOTES TO THE FINANCIAL STATEMENTS
## **For the year ended 31st March 2023**
## 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|2023
£
441,729
114,462
269,789
71,080
470,649
1,045,268|2022
£
491,524
67,825
168,803
70,453
540,323
1,148,422|
||2,412,977|2,487,350|
|9
ANALYSIS OF EXPENDITURE ON CHARITABLE ACTIVITIES|9
ANALYSIS OF EXPENDITURE ON CHARITABLE ACTIVITIES|9
ANALYSIS OF EXPENDITURE ON CHARITABLE ACTIVITIES||
|---|---|---|---|
|2023
Provision of Hospice services:
In-patient Care
Day Therapy
Community Specialist
Palliative Care Team
Hospice at Home
Education
Out-patients|Activities
undertaken
directly
£
6,943,609
935,429
693,197
225,980
405,421
420,068|Support
costs
£
177,143
24,411
7,362
20,891
-
5,840|2023
Total
£
7,120,752
959,840
700,559
246,871
405,421
425,908|
||9,623,704|235,647|9,859,351|
|||||
||Activities|Support|2022|
|2022
Provision of Hospice services:
In-patient Care
Day Therapy
Community Specialist
Palliative Care Team
Hospice at Home
Education
Out-patients|undertaken
directly
£
6,960,538
972,501
687,824
242,408
361,204
459,000|costs
£
173,550
24,523
7,282
19,340
-
6,421|Total
£
7,134,088
997,024
695,106
261,748
361,204
465,421|
||9,683,475|231,116|9,914,591|
66 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2023**
## 10 ANALYSIS OF SUPPORT COSTS
||In-patient
Day
Com-
munity
Hospice
at
Out-
Charitable
Activities
Raising
funds
2023
care
therapy
SPCT
Home
patients
Total
Total
Total
£
£
£
£
£
£
£
£|
|---|---|
|2023||
|Governance
Finance
Information Technology
Human Resources
Communications|91,536
12,838
4,314
12,243
3,056
123,987
37,399
161,386
37,329
5,047
1,329
3,771
1,214
48,690
14,687
63,377
19,500
2,636
694
1,970
634
25,434
7,672
33,106
18,641
2,520
664
1,883
606
24,314
7,334
31,648
10,137
1,370
361
1,024
330
13,222
3,989
17,211|
||177,143
24,411
7,362
20,891
5,840
235,647
71,081
306,728|
||In-patient
Day
Com-
munity
Hospice
at
Out-
Charitable
Activities
Raising
funds
2022
care
therapy
SPCT
Home
patients
Total
Total
Total
£
£
£
£
£
£
£
£|
|2022||
|Governance
Finance
Information Technology
Human Resources
Communications|95,177
13,556
4,357
11,571
3,538
128,199
39,080
167,279
30,365
4,249
1,133
3,010
1,117
39,874
12,155
52,029
19,602
2,743
732
1,943
721
25,741
7,847
33,588
20,493
2,868
765
2,032
754
26,912
8,204
35,116
7,913
1,107
295
784
291
10,390
3,168
13,558|
||173,550
24,523
7,282
19,340
6,421
231,116
70,454
301,570|
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 67
ST ANN’S HOSPICE
## NOTES TO THE FINANCIAL STATEMENTS
## **For the year ended 31st March 2023**
|11|NET INCOME/(EXPENDITURE) FOR THE YEAR|||
|---|---|---|---|
|||2023|2022|
||Net income/(expenditure) is stated after charging:|£|£|
||Depreciation of owned asset|172,347|169,210|
||Depreciation of leased assets|92,940|99,610|
||Depreciation of motor vehicles|22,586|32,619|
||Rentals under operating leases|||
||Land and buildings|121,853|178,790|
||Other|5,379|5,689|
||Auditor's remuneration|||
||Fees payable to the charity's auditor for the audit of the charity's annual|||
||financial statements*|32,500|45,000|
||Fees payable to the charity's auditor for other services to the group|-|-|
||The audit of the charity's subsidiary|7,950|6,300|
* This is the first year Crowe have provided audit services at a cost of £32,500. (2022: £45,000) Previous year completed by Deoitte and was recognised in the year as a gift-in-kind for the audit of the charity.
68 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
## NOTES TO THE FINANCIAL STATEMENTS
## **For the year ended 31st March 2023**
## 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:|2023|2022|2023|2022|
|
Charitable activity
Raising funds
Trading activities
Support|No.
191
15
24
57|No.
204
18
27
65|No.
191
13
-
57|No.
204
16
-
65|
||287|314|261|285|
||||||
|Their aggregate remuneration comprised:|||||
|Wages and salaries
Social security costs
Pension costs|2023
2022
£
£
7,568,504
7,394,840
681,039
640,699
742,834
720,933
Group||2023
2022
£
£
6,923,908
6,708,570
627,993
589,657
710,193
691,613
Charity||
||8,992,377|8,756,472|8,262,094|7,989,840|
Included in the 2023 aggregate remuneration are total redundancy costs amounting to £234,600 This is due to restructuring and the consultation period being completed in March 2023.
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 69
ST ANN’S HOSPICE
## NOTES TO THE FINANCIAL STATEMENTS
## **For the year ended 31st March 2023**
## 13. ANALYSIS OF STAFF COSTS, TRUSTEE REMUNERATION AND EXPENSES AND THE COST OF KEY MANAGEMENT PERSONNEL (continued)
||2023|2022|
|---|---|---|
||No.|No.|
|£60,001 - £70,000|-|1|
|£70,001 - £80,000|3|3|
|£80,001 - £90,000|-|-|
|£90,001 - £100,000|1|1|
|£100,001 - £110,000|1|1|
|£120,001 - £130,000|-|-|
## Key Management Personnel
The key management personnel of the parent charity and group are the same and are listed on page 93. 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 £484,323 (2022: £534,147).
## Trustees remuneration
No Trustees received any remuneration during the current or prior year. No travel and subsistence expenses were paid during the year (2022: £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|2023
£
43,850
(44,327)|2022
£
44,327
(41,124)|
|---|---|---|
|Total tax on profit|(477)|3,203|
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 on ordinary activities before tax
Tax on profit at the standard rate - 19% (2022 - 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|2023
£
993,931
188,847
(188,938)
103
(489)
44,327
(44,327)|2022
£
844,857
160,523
(159,914)
2,301
293
41,124
(41,124)|
|---|---|---|
|Total tax charge/(credit) for the year|(477)|3,203|
70 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
## NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2023**
## 15 TANGIBLE FIXED ASSETS FOR USE BY THE CHARITY
|GROUP|Assets
Under
Construction
£|Freehold
land and
buildings
£|Expenditure
on leasehold
property
£|Fixtures,
Leasehold
furniture and
buildings
equipment
£
£|Fixtures,
Leasehold
furniture and
buildings
equipment
£
£|Motor
vehicles
£|Total
£|
|---|---|---|---|---|---|---|---|
|Cost||||||||
|At 1 April 2022
Additions
Disposal|747,336
338,752
-|4,292,002
2,760
-|3,548,280
4,710
-|202,299
-
-|2,518,278
121,936
-|230,342
-
-|11,538,537
468,158
-|
|At 31 March 2023|1,086,088|4,294,762|3,552,990|202,299|2,640,214|230,342|12,006,695|
|||||||||
|Accumulated depreciation||||||||
|At 1 April 2022
Charge for the year
Disposal|-
-
-|1,917,485
85,054
-|1,889,854
92,396
-|201,348
544
-|2,403,367
87,293
-|196,395
22,586
-|6,608,449
287,873
-|
|At 31 March 2023|-|2,002,539|1,982,250|201,892|2,490,660|218,981|6,896,322|
|||||||||
|Net book value||||||||
|At 31 March 2023|1,086,088|2,292,223|1,570,740|407|149,554|11,361|5,110,373|
|||||||||
|At 31 March 2022|747,336|2,374,517|1,658,426|951|114,911|33,947|4,930,088|
|CHARITY||Assets
Under
Construction
£|Freehold
land and
buildings
£|Expenditure
on leasehold
property
£|Furniture
and
equipment
£|Motor
vehicles
£|Total
£|
|Cost||||||||
|At 1 April 2022
Additions
Disposals||747,336
338,752
-|4,292,002
2,760
-|3,548,280
4,710
-|2,129,653
115,486
-|221,045
-
-|10,938,316
461,708
-|
|At 31 March 2023||1,086,088|4,294,762|3,552,990|2,245,139|221,045|11,400,024|
|||||||||
|Accumulated depreciation||||||||
|At 1 April 2022
Charge for the year
Disposals||-
-
-|1,917,485
85,054
-|1,889,854
92,396
-|2,022,358
82,126
-|187,098
22,586
-|6,016,795
282,162
-|
|At 31 March 2023||-|2,002,539|1,982,250|2,104,484|209,684|6,298,957|
|||||||||
|Net book value||||||||
|At 31 March 2023||1,086,088|2,292,223|1,570,740|140,655|11,361|5,101,067|
|||||||||
|At 31 March 2022||747,336|2,374,517|1,658,426|107,295|33,947|4,921,521|
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 71
ST ANN’S HOSPICE
## NOTES TO THE FINANCIAL STATEMENTS
## **For the year ended 31st March 2023**
|16
FIXED ASSET INVESTMENTS|||
|---|---|---|
|Market value at 1 April 2022
Additions
Disposals proceeds
Net Investment Gain
Movement in cash held by investment managers|2023
£
4,723,366
2,310,658
(4,354,199)
(319,502)
(116,472)
Group &|2022
£
4,580,903
933,168
(920,086)
110,671
18,710
Charity|
|Market value at 31 March 2023|2,243,851|4,723,366|
|Cost at 31st March 2023
Market value analysed between:
Investments
Cash held by investment managers|6,354,717
£
2,080,091
163,760|6,354,717
£
4,559,606
163,760|
||2,243,851|4,723,366|
|Investment in Hospice Quality Partnership|10|10|
|Total Group Investment|2,243,861|4,723,376|
|Investment in Subsidiary Trading Company|2|2|
|Charity Investment|2,243,863|4,723,378|
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 1.5% of the issued ordinary share capital.
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.
72 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
## NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2023**
## 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 2023 are given below.
|for the year ended 31 March 2023 are given below.|||
|---|---|---|
|Turnover
Cost of sales
Gross profit
Administrative expenses
Operating profit
Interest receivable
Profit before taxation
Tax on profit|2023
£
2,546,496
(266,151)
2,280,345
(1,290,766)
989,579
4,352
993,931
477|2022
£
2,574,602
(258,237)
2,316,365
(1,471,508)
844,857
-
844,857
(3,203)|
|Profit for the financial year attributable to the equity shareholders
of the company|994,408|841,654|
||||
|Statement of changes in equity|||
|Balance at 1 April 2021
Profit after tax for the year
Gift aid distribution
Balance at 31 March 2022
Profit after tax for the year
Gift aid distribution||Profit and
loss account
£
-
841,654
(841,654)
-
994,408
(994,408)|
|Balance at 31 March 2023||-|
|BALANCE SHEET
The aggregate of the assets and liabilities was:
Fixed assets
Current assets
Creditors: amounts falling due within one year|2023
£
9,303
1,100,483
(1,109,784)|2022
£
8,567
1,038,436
(1,047,001)|
|Total net assets|2|2|
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 73
ST ANN’S HOSPICE
## NOTES TO THE FINANCIAL STATEMENTS
## **For the year ended 31st March 2023**
|17
STOCKS|||||
|---|---|---|---|---|
||Group
2023
£|2022
£|Charity
2023
£|2022
£|
|Finished goods and goods for resale|36,267|40,057|30|546|
||||||
|18
DEBTORS|||||
|Trade debtors
VAT Recoverable
Prepayments and accrued income
Other debtors
Amounts due from subsidiary company|Group
2023
£
61,866
565,857
145,068
3,364,415
-|2022
£
154,860
326,603
1,368,592
3,958,469
-|Charity
2023
£
59,466
576,390
105,774
3,326,886
768,437|2022
£
129,893
325,616
1,329,994
3,928,724
708,717|
||4,137,206|5,808,524|4,836,953|6,422,944|
||||||
|19
CASH AND CASH EQUIVALENTS|||||
|Interest bearing accounts
Current accounts and cash|Group
2023
£
16,126,324
1,499|2022
£
10,830,369
1,383|Charity
2023
£
15,141,301
1,499|2022
£
9,925,741
1,383|
||16,127,823|10,831,752|15,142,800|9,927,124|
||||||
|20
CREDITORS (Amounts falling due within one year)|||||
|Trade Creditors
Accruals and deferred income
Taxation and social security
Other creditors
Corporation tax|Group
2023
£
326,410
690,397
159,110
111,895
43,850|2022
£
396,746
640,759
140,803
109,687
44,327|Charity
2023
£
271,644
507,908
144,137
77,156
-|2022
£
342,139
433,754
136,604
81,541
-|
||1,331,662|1,332,322|1,000,845|994,038|
74 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
## NOTES TO THE FINANCIAL STATEMENTS
## **For the year ended 31st March 2023**
## 21 COMPARATIVE CONSOLIDATED STATEMENT OF FINANCIAL ACTIVITIES
|INCOME FROM:
Voluntary income
Donations and legacies
3
Charitable activities
4
Other trading activities
5
Other Income
6
Investments
7|Unrestricted
funds
£
5,842,215
4,051,067
2,617,238
3,146
67,717|Restricted
funds
£
953,738
2,502,706
-
1,632
981|Total funds
2022
£
6,795,953
6,553,773
2,617,238
4,778
68,698|
|---|---|---|---|
|TOTAL INCOME|12,581,383|3,459,057|16,040,440|
|EXPENDITURE ON:
Raising funds
8
Charitable activities
9|2,487,350
7,780,418|-
2,134,173|2,487,350
9,914,591|
|TOTAL EXPENDITURE|10,267,768|2,134,173|12,401,941|
|Net (expenditure)/income before investment gains
Net gains on Investments
16
Net income before tax
11
Taxation
14
Net (expenditure)/income for the year
Transfer Between Funds
22
Other Recognised Gains:
Actuarial Gain on Defined Benefit Schemes
25
NET MOVEMENT IN FUNDS
FUND BALANCES BROUGHT FORWARD AT
1st April 2021
FUND BALANCES CARRIED FORWARD AT|2,313,615
110,671
2,424,286
(3,203)
2,421,083
246,898
854,000
3,521,981
18,521,464|1,324,884
-
1,324,884
-
1,324,884
(246,898)
-
1,077,986
242,044|3,638,499
110,671
3,749,170
(3,203)
3,745,967
-
854,000
4,599,967
18,763,508|
|31st March 2022
22, 23|22,043,445|1,320,030|23,363,475|
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 75
ST ANN’S HOSPICE
## NOTES TO THE FINANCIAL STATEMENTS
## **For the year ended 31st March 2023**
## 22 STATEMENT OF RESERVES
|2023 Group
Unrestricted funds:
General fund
Designated funds
Fixed assets
IT upgrade
Property refurbishment and
development
Unrestricted funds
Restricted Fund
Specific donations|At 1 April
2022
£
6,881,507
1,723,237
-
13,438,701
22,043,445
1,320,030|Income
£
11,788,883
-
-
-
11,788,883
2,044,863|Expenditure
(incl taxation)
£
(11,119,867)
-
-
-
(11,119,867)
(1,151,984)|Gains
£
771,498
-
-
-
771,498
-|Transfers
£
(5,253,939)
8,825
120,000
5,174,039
48,925
(48,925)|At 31 March
2023
£
3,068,082
1,732,062
120,000
18,612,740
23,532,884
2,163,984|
|---|---|---|---|---|---|---|
||23,363,475|13,833,746|(12,271,851)|771,498|-|25,696,868|
|2023 CHARITY
Unrestricted funds:
General fund
Designated funds
Fixed assets
Subsidiary
IT upgrade
Property refurbishment and
development
Unrestricted funds
Restricted Fund
Specific donations|At 1 April
2022
£
6,890,072
1,714,670
2
-
13,438,701
22,043,445
1,320,030|Income
£
10,273,443
-
-
-
-
10,273,443
2,044,863|Expenditure
(incl taxation)
£
(9,604,427)
-
-
-
-
(9,604,427)
(1,151,984)|Gains
£
771,498
-
-
-
-
771,498
-|Transfers
£
(5,253,200)
8,086
-
120,000
5,174,039
48,925
(48,925)|At 31 March
2023
£
3,077,386
1,722,756
2
120,000
18,612,740
23,532,884
2,163,984|
||23,363,475|12,318,306|(10,756,411)|771,498|-|25,696,868|
> The restricted reserves relate to donations or grants given with restrictions on the uses for the care of patientsor for capital purchases. The restricted reserves relate to donations or grants given with restrictions on the uses for the care of patients
> Once the capital purchases have been made the restriction is released and transferred to unrestricted funds. or for capital purchases. Once the capital purchases have been made the restriction is released and
The designated fixed asset fund represents the net book value of the Charity’s tangible fixed assets. This is used to fund annual transferred to unrestricted funds. depreciation costs as allowed by the Charities SORP. In 2021 the Trustees agreed to remove the net book value of the Heald Green site The designated fixed asset fund represents the net book value of the Charity’s tangible fixed assets. This is from this fund due to the forthcoming rebuild project and the planned demolition of the existing site. used to fund annual depreciation costs as allowed by the Charities SORP. In 2021 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.
76 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
## NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2023**
|22 STATEMENT OF RESERVES (continued)|22 STATEMENT OF RESERVES (continued)|
|---|---|
|2022 Group
Unrestricted funds:
General fund
Designated funds
Fixed assets
Property refurbishment and
development
Unrestricted funds
Restricted Fund
Specific donations|At 1 April
Income
Expenditure
Gains
Transfers
At 31 March
2021
(incl taxation)
2022
£
£
£
£
£
£
3,052,613
12,581,383
(10,270,971)
964,671
553,811
6,881,507
1,690,557
-
-
-
32,680
1,723,237
13,778,294
-
-
-
(339,593)
13,438,701
18,521,464
12,581,383
(10,270,971)
964,671
246,898
22,043,445
242,044
3,459,057
(2,134,173)
-
(246,898)
1,320,030|
||18,763,508
16,040,440
(12,405,144)
964,671
-
23,363,475|
|2022 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
Gains
Transfers
At 31 March
2021
(incl taxation)
2022
£
£
£
£
£
£
3,067,815
10,889,435
(8,579,023)
964,671
547,174
6,890,072
1,675,353
-
-
-
39,317
1,714,670
2
-
-
-
-
2
13,778,294
-
-
-
(339,593)
13,438,701
18,521,464
10,889,435
(8,579,023)
964,671
246,898
22,043,445
242,044
3,459,057
(2,134,173)
-
(246,898)
1,320,030|
||18,763,508
14,348,492
(10,713,196)
964,671
-
23,363,475|
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 77
ST ANN’S HOSPICE
## NOTES TO THE FINANCIAL STATEMENTS
## **For the year ended 31st March 2023**
|23
ANALYSIS OF ASSETS AND LIABILITIES BETWEEN FUNDS|23
ANALYSIS OF ASSETS AND LIABILITIES BETWEEN FUNDS|||
|---|---|---|---|
|2023 GROUP
Tangible fixed assets
Investments
Current assets
Current liabilities
Provision for pension scheme liability|Unrestricted
funds
£
5,110,373
2,243,861
18,137,312
(1,331,662)
(627,000)|Restricted
funds
£
-
-
2,163,984
-|Total
£
5,110,373
2,243,861
20,301,296
(1,331,662)
(627,000)|
|At 31 March 2023|23,532,884|2,163,984|25,696,868|
|2023 CHARITY
Tangible fixed assets
Investments
Current assets
Current liabilities
Provision for pension scheme liability|5,101,067
2,243,863
17,815,799
(1,000,845)
(627,000)|-
-
2,163,984
-
-|5,101,067
2,243,863
19,979,783
(1,000,845)
(627,000)|
|At 31 March 2023|23,532,884|2,163,984|25,696,868|
|2022 GROUP
Tangible fixed assets
Investments
Current assets
Current liabilities
Provision for pension scheme liability|4,930,088
4,723,376
15,360,303
(1,332,322)
(1,638,000)|-
-
1,320,030
-
-|4,930,088
4,723,376
16,680,333
(1,332,322)
(1,638,000)|
|At 31 March 2022|22,043,445|1,320,030|23,363,475|
|2022 CHARITY
Tangible fixed assets
Investments
Current assets
Current liabilities
Provision for pension scheme liability|4,921,521
4,723,378
15,030,584
(994,038)
(1,638,000)|-
-
1,320,030
-
-|4,921,521
4,723,378
16,350,614
(994,038)
(1,638,000)|
|At 31 March 2022|22,043,445|1,320,030|23,363,475|
78 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2023**
|24|EMPLOYEE RETIREMENT BENEFITS|
|---|---|
||Group and charity|
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|2023
2023
£'000
£'000
411
411
383
383
18
993
Recognised in
SoFA
Contributions
Paid|2023
2023
£'000
£'000
411
411
383
383
18
993
Recognised in
SoFA
Contributions
Paid|
|---|---|---|
||812|1,787|
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 79
ST ANN’S HOSPICE
## NOTES TO THE FINANCIAL STATEMENTS
## **For the year ended 31st March 2023**
## 24 EMPLOYEE RETIREMENT BENEFITS (continued)
## **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 £411,261 (2022: £397,181). An amount of £62,508.11 (2022: £57,009) 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 £382,922 (2022: £373,717). An amount of Nil (2022: £29,248) is included in creditors, being the outstanding contributions to the scheme at the balance sheet date.
80 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
## NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2023**
||2023|2022|
|---|---|---|
||%|%|
|Discount rate|4.70|2.80|
|Expected return on assets|4.70|2.80|
|Rate of increase in salaries|1.00|1.00|
|Rate of increase in pensions in payment|3.70|4.00|
## 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:
||2023|2022|
|---|---|---|
||years|years|
|Retiring today:|||
|Males|85.8|85.5|
|Females|88.3|87.5|
|Retiring in 20 years|||
|Males|87.5|87.1|
|Females|90.0|89.3|
The amounts recognised in the statement of financial activities are as follows:
|Current service cost
Interest on obligations
Expected return on scheme assets|2023
£000's
(52)
(419)
373|2022
£000's
(40)
(334)
282|
|---|---|---|
|Total operating charge|(98)|(92)|
|Actuarial gain|1,091|854|
|Total cost recognised in the statement of financial activities|993|762|
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|2023
£000's
11,300
(10,673)|2022
£000's
15,300
(13,662)|
|Net liability recognised in the balance sheet|627|1,638|
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 81
ST ANN’S HOSPICE
## NOTES TO THE FINANCIAL STATEMENTS
## **For the year ended 31st March 2023**
## 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 (gains)
Benefits paid|2023
£000's
15,300
52
419
9
(28)
(3,776)
(676)|2022
£000's
16,200
40
334
10
-
(593)
(691)|
|---|---|---|
|At 31 March|11,300|15,300|
|Movements in the fair value of scheme assets were as follows:
2023
£000's
Opening fair value of scheme assets
13,662
Expected return on scheme assets
373
Actuarial (losses)/gains
(2,685)
Contributions by the employer
18
Contributions by scheme participants
9
Benefits paid
(676)
Administration Expenses
(28)||2022
£000's
13,780
282
261
20
10
(691)
-|
||10,673|13,662|
The analysis of the fair value of the scheme's assets at the balance sheet date was as follows:
|follows:|||
|---|---|---|
|Equities
Gilts and bonds
Liability Driven Investment
Cash|2023
£000's
4,252
1,064
5,248
109|2022
£000's
10,440
2,882
-
340|
||10,673|13,662|
82 TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
NOTES TO THE FINANCIAL STATEMENTS **For the year ended 31st March 2023**
## 25 FINANCIAL COMMITMENTS
## Operating lease commitments
At the balance sheet date the total future minimum lease payments under non-cancellable operating leases were as follows:
|GROUP
Land and
buildings
Leases which expire:
£
within one year
133,094
between one and five year
396,673
after five years
412,617
2023|GROUP
Land and
buildings
Leases which expire:
£
within one year
133,094
between one and five year
396,673
after five years
412,617
2023|Other
£
4,834
-
-|Land and
buildings
£
121,853
245,651
129,283
2022|Other
£
5,379
-
-|
|---|---|---|---|---|
||942,384|4,834|496,787|5,379|
|CHARITY
Leases which expire:
within one year
within one to five years
over five years|Land and
buildings
£
4,400
17,600
40,700|Other
£
-
-
-|Land and
buildings
£
4,400
17,600
45,100|Other
£
-
-
-|
|
62,700||-|67,100|-|
## 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 (2022: Nil)
The total value of donations received from the trustees during the year was £1,186 (2022: £1,049)
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 83
ST ANN’S HOSPICE
84 INDEPENDENT AUDITOR’S REPORT
05
Independent Auditor’s Report
INDEPENDENT AUDITOR’S REPORT 85
ST ANN’S HOSPICE
## Independent Auditor’s Report to the Members of St Ann’s Hospice
## **Opinion**
We have audited the financial statements of St. Ann’s Hospice ‘the charitable company’ and its subsidiary St. Ann’s Hospice Trading Company Limited ‘the group’ for the year ended 31st March 2023 which comprise the statement of financial activities, balance sheet, cash flow statement and notes to the financial statements, including significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102 The Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice). In our opinion the financial statements:
- give a true and fair view of the state of the group’s and the charitable company’s affairs as at 31st March 2023 and of the group’s income and expenditure, for the year then ended;
- have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice; and
- have been prepared in accordance with the requirements of the Companies Act 2006
## **Basis for opinion**
We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under those standards are further described in the Auditor’s responsibilities for the audit of the financial statements section of our report. We are independent of the group in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the FRC’s Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.
## **Conclusions relating to going concern**
In auditing the financial statements, we have concluded that the trustee’s use of the going concern basis of accounting in the preparation of the financial statements is appropriate.
Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the charitable company’s or the group’s ability to continue as a going concern for a period of at least twelve months from when the financial statements are authorised for issue.
Our responsibilities and the responsibilities of the trustees with respect to going concern are described in the relevant sections of this report.
## **Other information**
The trustees are responsible for the other information contained within the annual report. The other information comprises the information included in the annual report, other than the financial statements and our auditor’s report thereon. 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 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.
86 INDEPENDENT AUDITOR’S REPORT
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
## **Opinions on other matters prescribed by the Companies Act 2006**
In our opinion based on the work undertaken in the course of our audit
- the information given in the trustees’ report, which includes 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 directors’ report included within the trustees’ report have been prepared in accordance with applicable legal requirements.
## **Matters on which we are required to report by exception**
In light of the knowledge and understanding of the group and charitable company and their environment obtained in the course of the audit, we have not identified material misstatements in the directors’ report included within the trustees’ report.
We have nothing to report in respect of the following matters in relation to which the Companies Act 2006 requires us to report to you if, in our opinion:
- adequate and proper accounting records have not been kept or
- the financial statements are not in agreement with the accounting records and returns; or
- certain disclosures of trustees’ remuneration specified by law are not made; or
- we have not received all the information and explanations we require for our audit.
## **Responsibilities of trustees**
As explained more fully in the trustees’ responsibilities statement set out on page 55, the trustees (who are also the directors of the charitable company for the purposes of company law) are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such internal control as the trustees determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error.
In preparing the financial statements, the trustees are responsible for assessing the charitable company’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the trustees either intend to liquidate the charitable company or to cease operations, or have no realistic alternative but to do so.
## **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.
Details of the extent to which the audit was considered capable of detecting irregularities, including fraud and non-compliance with laws and regulations are set out below.
A further description of our responsibilities for the audit of the financial statements is located on the Financial Reporting Council’s website at: www.frc.org. uk/auditorsresponsibilities. This description forms part of our 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 identified and assessed the risks of material misstatement of the financial statements from irregularities, whether due to fraud or error, and discussed these between our audit team members. We then designed and performed audit procedures responsive to those risks, including obtaining audit evidence sufficient and appropriate to provide a basis for our opinion.
We obtained an understanding of the legal and regulatory frameworks within which the charitable
INDEPENDENT AUDITOR’S REPORT 87
ST ANN’S HOSPICE
company and group operates, focusing on those laws and regulations that have a direct effect on the determination of material amounts and disclosures in the financial statements. The laws and regulations we considered in this context were the Companies Act 2006 together with the Charities SORP (FRS102) 2019. We assessed the required compliance with these laws and regulations as part of our audit procedures on the related financial statement items.
In addition, we considered provisions of other laws and regulations that do not have a direct effect on the financial statements but compliance with which might be fundamental to the charitable company’s and the group’s ability to operate or to avoid a material penalty. We also considered the opportunities and incentives that may exist within the charitable company and the group for fraud. The laws and regulations we considered in this context for the UK operations were the Companies Act 2006 and the Charities Act 2011 together with the Charities SORP (FRS 102). We assessed the required compliance with these laws and regulations as part of our audit procedures on the related financial statement items.
In addition, we considered provisions of other laws and regulations that do not have a direct effect on the financial statements but compliance with which might be fundamental to the charitable company’s ability to operate or to avoid a material penalty. We also considered the opportunities and incentives that may exist within the charitable company for fraud.
Auditing standards limit the required audit procedures to identify non-compliance with these laws and regulations to enquiry of the Trustees and other management and inspection of regulatory and legal correspondence, if any.
We identified the greatest risk of material impact on the financial statements from irregularities, including fraud, to be within the timing of recognition of legacy and grant income and the override of controls by management. Our audit procedures to respond to these risks included enquiries of management, and the Trustees about their own identification and assessment of the risks of irregularities, sample testing on the posting of journals, reviewing accounting estimates for biases, reviewing regulatory correspondence with the Charity Commission, and
reading minutes of meetings of those charged with governance.
Owing to the inherent limitations of an audit, there is an unavoidable risk that we may not have detected some material misstatements in the financial statements, even though we have properly planned and performed our audit in accordance with auditing standards. For example, the further removed noncompliance with laws and regulations (irregularities) is from the events and transactions reflected in the financial statements, the less likely the inherently limited procedures required by auditing standards would identify it. In addition, as with any audit, there remained a higher risk of non-detection of irregularities, as these may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal controls. We are not responsible for preventing non-compliance and cannot be expected to detect non-compliance with all laws and regulations.
## **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.
Vicky Szulist Senior Statutory Auditor For and on behalf of Crowe U.K. LLP Statutory Auditor The Lexicon Mount Street Manchester M2 5NT
15th March 2024
88 INDEPENDENT AUDITOR’S REPORT
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
INDEPENDENT AUDITOR’S REPORT 89
ST ANN’S HOSPICE
90 OFFICERS AND PROFESSIONAL ADVISORS
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
06
Officers and Professional Advisors
OFFICERS AND PROFESSIONAL ADVISORS 91
ST ANN’S HOSPICE
## Officers and Professional Advisors
## **Trustees and Officers**
## **PRESIDENT**
The Right Reverend Prof. David Walker Bishop of Manchester
## **TRUSTEES**
## **CHAIR**
Professor Jacqueline Oldham BSc(Hons) RGN PhD
## **HON. TREASURER**
## **VICE PRESIDENTS**
Sir Warren Smith KCVO KStJ JP HM Lord Lieutenant of Greater Manchester (resigned 1st September 2023)
Mrs Anne Mack
Mrs Ann Hughes
Professor Sir Cary Lynn Cooper CBE FAcSS Kathy Cowell OBE DL
Mr Darren Holt BA FCA
Mr Mike Brown (Vice Chair) MSc FHSM CMIPM
Dr Stephanie Gomm MD FRCP
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
92 OFFICERS AND PROFESSIONAL ADVISORS
ANNUAL REPORT AND FINANCIAL ACCOUNTS 2022/23
## **Key Management Personnel**
## **CHIEF EXECUTIVE & COMPANY SECRETARY**
(appointed Company Secretary 22nd January 2024) Rachel McMillan RGN BA(Hons) MSc
## **DIRECTOR OF PEOPLE, CULTURE, & SUPPORT SERVICES**
## **Professional Advisors and Registered Office**
## **SOLICITORS**
## **Brabners LLP**
55 King Street, Manchester M2 4LQ and Exchange Flags, Liverpool L2 3YL
Gill Turnpenney BA(Hons) CMCIPD
## **AUDITOR**
## **DIRECTOR OF BUSINESS DEVELOPMENT & COMPANY SECRETARY**
(Resigned 19th January 2024) Dr Paul Jarvis MEng(Hons) MSc PhD
## **Crowe UK LLP**
3rd Floor, The Lexicon, Mount Street, Manchester, M2 5NT
## **INVESTMENT MANAGERS**
## **DIRECTOR OF CLINICAL SERVICES**
## **Brewin Dolphin**
Emma Dixon RGN BA(Hons)
1 The Avenue Spinningfields Square, Manchester M3 3AP
## **MEDICAL DIRECTOR**
Dr David Waterman MBBS FRCP
## **BANKERS**
## **ASSOCIATE MEDICAL DIRECTOR**
Dr Alison Roberts MBChB FRCP
## **The Royal Bank of Scotland**
5th Floor 1 Spinningfields Square, Manchester M3 3AP
## **REGISTERED & PRINCIPAL 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**
## **COMPANY DIRECTORS**
Dr Paul Jarvis (resigned 19th January 2024)
Gill Turnpenney
Rachel McMillan
OFFICERS AND PROFESSIONAL ADVISORS 93
## **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
www.sah.org.uk www.facebook.com/StAnnsHospice @StAnnsHospice @StAnnsHospice
Registered charity number 258085. Registered in England No. 947220.