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2022-03-31-accounts

St Nicholas Hospice (Suffolk)

Annual Report and Financial Statements

Year ended 31 March 2022

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Contents Contents
4 Trustees’ Report
6 Introduction from CEO and Chair of the Board of Trustees
8 Strategic report
10 Plans for future periods
12 Financial review
16 Trustees’ Report
18 Objectives and Activities
20 Stories of Equip, Provide, Strive
26 Structure, governance and management
32 Our people
34 Clinical quality and assurance
38 Income generation
44 Going concern
46 Independent Auditors’ Report
50 Consolidated Statement of Financial Activities
52 Group and Charity Balance Sheets
54 Consolidated Cash Flow Statement
56 Notes to the Financial Statements

Trustees’ Report and Annual Accounts 2021–22 3

Trustees’ Report for the year ended 31 March 2022

4

Trustees and advisors

Board of Trustees

Charles Simpson[ 1 4 5] Chair Susan Hayter[ 3 4] Vice Chair Michelle Masson[ 1 ] Honorary Treasurer Marion Miles[ 2 4] Ann Langdon[ 2] Chris Minett[ 3] Resigned 8 December 2021 Karen Chandler-Smith[ 1] Anne Fisher[3] Donna Forster[1] Neil Morgan[3] Sam Turner[ 2] Appointed 29 April 2021 Kate Vaughton[3] Appointed 26 May 2022

Chair Vice Chair Honorary Treasurer Resigned 8 December 2021

Secretary and registered/principal office

Fiona Heath, St Nicholas Way, Hardwick Lane, Bury St Edmunds, Suffolk, IP33 2QY

Chief Executive

Dr Barbara Gale MBE[5 ] To 8 December 2021 Linda McEnhill[5] From 13 December 2021

Directorate

Georgina Bissell Deputy Chief Executive Officer to 30 June 2022 Sharon Basson Clinical Services Director, Registered Manager from 18 June 2021 Jelena Sarubina Director of Corporate Services from 7 February 2022 Clare Chater Director of Income Generation from 11 April 2022

Data Protection Officer Sara Taylor to 31 March 2022 Michael Pollington from 1 April 2022

Auditors

RSM UK Audit LLP, Blenheim House, Newmarket Road, Bury St Edmunds, Suffolk, IP33 3SB

Solicitors

Ellisons Solicitors incorporating Gross & Co, 83-84 Guildhall Street, Bury St Edmunds, Suffolk, IP33 1LN

Bankers

Barclays Bank plc, 20/21 Cornhill, Bury St Edmunds IP33 1DY

Investment managers

Rathbones Investment Management Limited, 159 New Bond Street, London, W1S 2UD Sarasin & Partners LLP, Juxon House, 100 St Paul’s Churchyard, London, EC4M 8BU

Registered Charity number: 287773 Registered Charity name: St Nicholas Hospice (Suffolk) Other name used: St Nicholas Hospice Care Company number: 1748046

1 Finance and Income Generation Committee member 2 HR Committee member 3 Clinical Committee member

4 Remuneration Committee 5 Director of St Nicholas Hospice Trading Ltd

5

Introduction from the Chief Executive Officer and the Chair of the Board of Trustees

St Nicholas Hospice Care

6

e are delighted to present the 2021-2022 Annual Report. It has been another complex and W challenging year due to the pandemic and one in which we have been consistently grateful to our staff, volunteers, and supporters for enabling us to continue to provide the best end of life and bereavement care for the people of West Suffolk and Thetford.

In early December, I left my post as CEO of Ardgowan Hospice in Scotland and joined the enthusiastic, compassionate, and vibrant St Nic’s team. Both hospices were simultaneously experiencing an increase in staff Covid-19 cases and thus my fond farewells and wholehearted hellos were virtual affairs. It is testament to the generosity of internal and external colleagues that their welcome was not diminished by the challenges of online communication.

the speed at which we have been able to implement our financial strategy, but we continue to focus on financial sustainability as we move forward into the next year. We have much to be proud of, as I hope you will appreciate when reading this report.

Returning to St Nic’s some 16 years after I left my previous post here (Head of Family Support Services) means that, in many cases, I have been refreshing connections. Much, of course, has changed in the world since then, and in the world of hospice care, but St Nic’s core commitment to serving our communities and to working in partnership have sustained and developed, never more so than during the pandemic.

Charles Simpson, Chair

Linda McEnhill, Chief Executive Officer

Both in the Sylvan Ward and out in the community we have continued our services, and wherever possible, we have supported our partner organisations by offering them space for their operations, supplementing their diminished workforce with our own staff or by increasing the number of inpatient beds to help reduce pressure on West Suffolk Hospital. We have worked very hard to play our part. We have done this despite an excruciatingly difficult financial landscape and the reduction of many of our primary income generating activities. Inevitably, despite our best efforts, these combined factors have undermined

Trustees’ Report and Annual Accounts 2021–22 7

Strategic Report

In 2020/21 By March 2022 we said we would: we had:

Implement our equip approach in our communities by:

Extended and rolled out our GraveTalk sessions including providing these online.

Developed plans which have relaunched our Bereavement Cafés and launched a new project to support care home staff, residents and their families who have experienced loss.

Community Connectors have continued to develop links in the Newmarket area.

Develop a specialist care model that works collaboratively alongside our colleagues in the wider healthcare system, ensuring equity across our community by:

Increased the number of beds available during the year.

Developed a virtual ward pilot. The Hospice Extra Support Team will aim to prevent unplanned hospital admissions with collaborative and responsive approaches across our clinical services.

Focus on:

Appointed a new CEO (in post Dec 2021), Clinical Services Director (in post Sept 2021) and Corporate Services Director (in post Feb 2022). Recruited an Income Generation Director (to start April 2022).

Recruited volunteers to the Clinical Admin and Ward Reception team. We have worked with volunteer feedback to develop our approaches further.

St Nicholas Hospice Care

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The impact of Covid-19 on

Trust;

Income generation activities

the Charity’s activities

Covid-19 has significantly affected the provision of hospice care. We have had to prioritise services, work within safety guidance, and support the changing needs of those facing dying, caring and grief.

Sadly, some services such as day care, group activities and non-essential face-to-face contact have remained paused or limited. However, we have been able to increase inpatient bed capacity when spikes in local cases created pressures on other parts of the system e.g. hospital beds. To manage this responsive approach, we have regularly met with wider system colleagues.

To secure our work environments, we have continuously reviewed our infection prevention training and procedures, and monitored our staff supply and the use of Personal Protective Equipment (PPE). Although, inevitably we did have incidences of staff infections which caused operational challenges. However, our inpatient ward stayed open throughout the pandemic.

We have continued with many of the new ways of working adopted during the pandemic, and have used them to sustain an increased level of support. We continue to:

Our Charity’s income streams have been greatly affected by the pandemic and its impact on our community. Wherever possible, we have continued our retail operation and fundraising activities, but we had extended shop closures and event cancellations whenever local cases spiked.

We have focused, and continue to focus, on income streams that support financial sustainability. This includes our Friends of St Nic’s (a regular giving ask) and our weekly lottery. We were delighted to plan for an in-person Girl’s Night Out walk in September 2021, but due to delays in the lifting of legal restrictions we experienced lower-than-usual levels of participation.

We continue to strive to be agile in seeking opportunities to generate the income needed to sustain services, as we can no longer rely on the same level of Government financial support that was available at the start of the pandemic.

Supporting our people

We have continued to support our staff to adapt to new in-person or hybrid working models. Some staff and volunteers have been required to shield or work from home. To support these changes in our working practices, we introduced Wellbeing Champions, a staff-led group focused on mental, emotional and physical health. In addition, we continue to hold SPACE, a regular session where staff can take part in a confidential support group.

Staff who don’t use the internet can have an in-person or telephone conversation, these sessions extend throughout the Hospice operation and include people working in retail or remotely.

The Mutual Aid Agreement with local statutory services continues. This has enabled us to facilitate Hopsice staff to work in the community with NHS colleagues, alongside other external colleagues joining the Hospice team.

Trustees’ Report and Annual Accounts 2021–22 9

Plans for future periods

The CEO and Directorate will work alongside the Trustees, Leadership Team, staff and volunteers to revise the organisation’s strategy. Our aim will be to refresh and affirm the Hospice’s commitment to providing the best end of life and bereavement care for all our communities within West Suffolk and Thetford.

The revised plan must also factor in recent changes in the world, which have caused great shifts in care needs and the economy. We understand that resourcefulness, financial robustness and the capability to evidence our impact must be key areas of focus within our new plan. Our response must also be developed with stakeholders and our people. Statutory and public funders need clear evidence that assures them we are making a difference to those we help. In addition, staff, volunteers and partners should understand and feel motivated by the Hospice’s mission.

As part of the development of our revised strategy, we will factor in the following key pieces of activity:

10 St Nicholas Hospice Care

In March 2022, the High Sheriff for Suffolk, Mr Creasy, presented the organisation with a certificate in recognition of the dedicated work of our staff and volunteers during the pandemic.

Trustees’ Report and Annual Accounts 2021–22

11

Financial review

The consolidated financial statements include the results of the Charity together with those of the trading company, St Nicholas Hospice Trading Limited, a wholly-owned subsidiary that donates under Gift Aid the maximum available profits to the Charity.

The Hospice, along with the rest of the sector, faced a second year of unprecedented financial challenges as a result of the continued pandemic, albeit there were fewer months of lockdown required than in the previous year. Overall, our operating income was greater than the previous year and our operating expenditure was lower. The non-recurrent Government funding in response to Covid-19, together with additional support from our local Clinical Commissioning Group (CCG) continued, but at a lower level, which meant our total charitable activities income for the year was substantially less than the previous year. This was mitigated by a significant improvement in retail income and a very high level of legacy income. The full-year effect of savings implemented in the previous year, together with vacant posts in clinical, income generation and support departments, resulted in a reduction in the operating expenditure compared with 2020/21. This produced an operating surplus of approximately £0.60m, which was a considerable improvement against the deficit plan and the previous year deficit of £0.67m. However, the war in Ukraine had a negative impact on some of our investments and, by the end of the financial year, the net gain had fallen to £0.16m. Therefore, the Charity returned a surplus of £0.76m and net movement to reserves of £0.76m, which was an improved position compared to a much smaller surplus of £0.03m in 2020/21.

The trading activity of St Nicholas Hospice Trading Limited (consolidated in the above figures) was once again negatively impacted by the pandemic. House clearances and the Haven Café were unable to trade for several months, but were successful once reopened. The turnover of £0.41m and a profit of £0.08m (2021: £0.04m) were both double that achieved in the previous year.

Income

Income has increased by £0.86m from £6.09m to £6.95m (14%). Income from charitable

activities decreased from £2.98m in 2020/21 to £2.07m in 2021/22 and although additional non-recurrent funding was received to support the Hospice during the continued pandemic, it was, understandably, at a much lower level. Notably, the Government funding via Hospice UK, to make available bed capacity and community support during the pandemic, was a quarter of the funding received in 2020/21. Our commitment to working in partnership with our local CCGs to continue to provide our services and reduce the overall burden on the NHS was again clearly demonstrated. In response, we received an additional £0.249m from the West Suffolk CCG, specifically to support the Hospice’s services during the pandemic. This funding was in addition to the non-recurrent contribution of £0.23m from West Suffolk CCG, previously agreed in order to increase the grant value in the interim before the full impact of the incremental recurrent increases (as per the fouryear grant agreement for 2020/21 - 2023/2024) comes into effect. During the year, West Suffolk CCG also agreed a 2% uplift to the core grant in recognition of cost pressures; a 2% uplift will be applied to the annual grant value for the remainder of the current grant agreement.

The Hospice also received non-recurrent income (£0.03m) from the Government funding schemes to support organisations through the pandemic, including the Retail Restart Grant and the Coronavirus Job Retention Scheme, but this was much less than in the previous year.

Income generation activities across the Charity continued to feel the impact of the pandemic. However, fundraising income began to recover, and some events were successfully held. Although, lottery income and donations were slightly lower than in the previous year. Income from retail shops more than doubled compared with 2020/21, as the shops were closed for fewer months and customer confidence grew following the lifting of the national restrictions. Legacy income increased hugely from the previous year and totalled £1.66m, well above the five-year average. The delays in probate experienced in 2020/21 appeared to be reducing and the legacy income recognised in 2021/22 likely includes the previous year’s shortfall.

St Nicholas Hospice Care

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Comparison of income for 2020-21 and 2021-22
1800
1600
1400
1200
1000
800
600
400
200
0
2020-21 Actual Income 2021-22 Actual Income
Charitable activities Charitable activities (Covid-19) Other (Gov Covid) Donations Fundraising Legacies Lottery Shops Other
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Income sources 2021-22
Legacies
Charitable activities
Shops
Donations
Charitable activities (Covid-19)
Lottery
Other
Fundraising
Other (Covid-19)
----- End of picture text -----

Trustees’ Report and Annual Accounts 2021–22 13

Expenditure

Expenditure 2021-2022

Expenditure has decreased by £0.40m from £6.75m to £6.35m (6%).

Expenditure on charitable activities reduced across most departments. The reduction in costs is a result of various factors: the full year effect of the implementation of the organisational wide restructure undertaken in 2020/21, which included the closure of the day care unit; staffing vacancies due to the natural turnover of staff; cost savings associated with the continued provision of some services on a virtual basis rather than face-to-face; and remote working of many support staff.

Expenditure on income generation decreased reflecting the organisational restructure but retail expenditure increased as the shops extended their opening hours during the year as customer confidence returned. A small pay award was made in the year, which incorporated increases for the national living wage, with a pay review planned for 2022/23.

Comparison of expenditure for 2020-21 and 2021-22

Clinical Services - 59%

Grants, Donations and Legacies - 10%

Other Trading - 31%

Investments - 1%

Numbers total 101% due to rounding.

5000

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4000
3000
2000
1000
0
Clinical Grants, Other Investments
Services Donations Trading
& Legacies
2020-21 Actual 2021-22 Actual
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Investments

The Hospice has a diversified investment portfolio comprising of listed equities and unit trusts, fixed interest securities and cash and is managed by independent investment managers.

The investment portfolio is apportioned between and managed by two independent investment managers, Rathbones Investment Management Limited and Sarasin & Partners LLP, appointed by the Board of Trustees. The Trustees, through the Finance and Investment Committee, consult with the investment managers, to take advice on the management of the portfolios and to monitor their performance.

During the year, our investment funds decreased in value by £0.28m. It was necessary to drawdown £0.50m to support the operational cash flow in the third quarter and our investment managers have advised that the uncertainty surrounding the impact of the conflict between Russia and Ukraine, expectations of higher inflation and a tighter interest rate policy weighed negatively on the valuations.

St Nicholas Hospice Care

14

The Hospice investment policy remains unchanged. Over the long-term, we aim to maintain and increase the real capital value of the investment funds to achieve returns from a diversified portfolio of equities, fixed interest securities and cash within a medium to low risk/ reward profile as agreed by the Finance and Investment Committee. Where appropriate and within the investment objectives, the Trustees will attempt to invest in ethical and socially responsible organisations. The Finance and Investment Committee considered that the investment account had performed satisfactorily given the market conditions.

or the equivalent of approximately twelve months’ worth of total running costs. This ensures that the organisation can continue to support beneficiaries in periods of financial downturn, but also enables funds to be invested in future Hospice services and revenue-generating projects.

New building and maintenance fund

This is a designated fund for the purposes of maintaining and updating the existing Hospice building and allocating funds for future building requirements. This fund has not been drawn on during 2021/22.

Reserves

Total reserves at the end of the year amounted to £8.78m (2021: £8.03m), of which £0.05m (2021: £0.06m) were restricted. The Charity also benefits from the Earl of Euston 2009 Endowment Fund of £47k. The attributed income (£363) from this fund was used in furtherance of the objectives of the Hospice. The total value of designated funds is £5.35m.

The reserves policy, agreed by the Trustees, remains unchanged and requires that the Charity must hold a minimum level of reserves equivalent to approximately six months’ worth of total running costs, circa £3.2m. Free reserves at the end of the year totalled £6.47m (2021: £5.60m)

----- Start of picture text -----
Designated – Designated - Undesigned –
SNHC Funds Total
Not Free Free Reserves Free Reserves
as at 31 March
2022 £000s
£000s £000s £000s
Fixed
Asset Fund
2,211 2,211
(represented
by assets)
New building 2,250 2,250
Information
16 16
technology
Service
474 474
development
Income
399 399
generation
General
3,333 3,333
reserves
TOTAL 2,211 3,139 3,333 8,683
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IT systems fund

The Charity has a number of IT systems and hardware which require replacing or upgrading to develop greater resilience, functionality and efficiency to support the services we deliver and the way in which we work, now and in the future. This fund has not been drawn on during 2021/22.

Service development fund

The purpose of this fund is to develop and test new service delivery models across our entire service offering in all settings. The fund will continue to support the ongoing development, testing and planning of services. This fund has not been drawn on during 2021/22.

Income generation fund

The purpose of this fund is to develop income generation through new and existing income streams that are sustainable and resilient to economic and social challenges. This fund has not been drawn on during 2021/22.

No additional funds have been designated in 2021/22, as the Trustees consider the current designated funds to be sufficient to support the development of our services and income streams.

Trustees’ Report and Annual Accounts 2021–22 15

Trustees’ reportTrustees’ Report

The Board of Trustees presents their annual report on the affairs of the Charity, together with the financial statements for the year ended 31 March 2022.

Background

St Nicholas Hospice Care has been supporting the people of West Suffolk and Thetford since 1984. This catchment area includes a population of approximately 270,000 (240,000 in West Suffolk and 30,000 in the Thetford area).

Every year we support nearly 2,000 local people, delivering care to people in their own homes, as well as in outpatient sessions and

our inpatient ward. Services are not just for patients, but for their family and friends too, and include everything from specialist medical care to bereavement support and practical help. We also, work with other community service and provide a variety of training and education to local professionals and carers about palliative care and bereavement.

Our vision

For everyone to matter in life and death.

Our mission

For everyone to be informed, equipped and able to live with dying, death and grief.

St Nicholas Hospice Care

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Our values

Compassion

From our people you can expect care, warmth, kindness and honesty.

Listen

We listen to what is important to you. What you tell us will be understood and not judged.

Team spirit

We work together with respect, friendship, trust and a touch of laughter.

Learn

We lead and develop, sharing knowledge

and skills generously.

Resilience

Our attitude towards change and the future has the courage to move and grow with life’s changes.

17

Trustees’ Report and Annual Accounts 2021–22

Objectives and Activities

Charitable activities

The Charity reviews its objectives and activities annually, identifying achievements and outcomes and ensuring that the activities relate to the aims and objectives set.

Hospice services

Our services are provided free to patients and their families and friends; however, some educational sessions do require payment. A clinical team led by the Clinical Services Director and Consultants in Palliative Medicine deliver the clinical services.

The Clinical Services Director is also the Registered Manager, Clinical Information Governance Lead and Accountable Officer (for Controlled Drugs). One of the Consultants in Palliative Medicine is the Caldicott Guardian. We have developed a flexible and experienced skill mix of people, ranging from employed staff such as palliative care clinicians, therapists and carers, to our broad mix of volunteers who provide support to all our services and organisational functions and work across all settings. This enables us to focus on proactive care planning and management, which aids effective people-centred decision-making.

Our services ensure that specialist support and advice is available to people wherever they are whether at home, in a care home, in a hospital or without a home. Some 88% of people receiving hospice care are at home.

However, we also support people in many different settings, from the Hospice itself in Bury St Edmunds, which has a 12 bedded inpatient unit, to West Suffolk Hospital and working in local communities.

In line with our Equip Provide Strive Strategy our services to those facing dying, death and grief are provided by:

• A locality approach where our teams are connecting and working with:

• Education and training for people, families and professionals about caring and supporting people at the end of life and those bereaved, including:

St Nicholas Hospice Care

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Who uses and benefits from the Hospice’s services?

Our purpose is to benefit

Our services are available to people living within the West Suffolk and Thetford areas (South Norfolk). Whenever possible, we will also help people outside our immediate catchment area if it is their wish to be supported by us.

As well as working with fellow healthcare professionals, we promote self-referral or contact from family or friends on behalf of others. We actively encourage people and their families to contact us early so we can help them live well and maintain their independence. Our services

are there to support anyone who needs us, sometimes from the point of diagnosis onwards, not just in the last year or months of life.

Additionally, the Hospice works with teenagers, young people, and their families. To promote continuity, Hospice staff collaborate with East Anglia’s Children’s Hospices to help meet the needs of young people transitioning from child to adult services.

The growing need in our community

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Brandon
Thetford
Lakenheath
Botesdale
Mildenhall
Stanton
Cavenham Ixworth
Newmarket Barrow Bury St Edmunds
Woolpit
Whepstead
Hawkedon Thorpe
Morieux
Haverhill Clare
Long Melford
Sudbury
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----- Start of picture text -----
Haverhill
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1,355

Approximately 270,000 people live in our service area. The Suffolk Public Health Team has projected that West Suffolk CCG’s ageing population will grow; those aged 65 - 84 by 20.5% , and those 85+ by 45.3% by 2028.

Total annual deaths in West Suffolk Local Authority, 2011 - 2018 1,698

Since the last census in 2011, by 2018 the number of deaths in the West Suffolk local authority area had grown 25% . It can be estimated anywhere between 69% - 82% of dying people need palliative care. (Murtagh, 2014)

Trustees’ Report and Annual Accounts 2021–22 19

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130
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GraveTalk
Attendees
381
Received 121
bereavement
sessions
118
Received Hospice
Neighbour support
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Equip

The Hospice uses education, public awareness and community development approaches to support and build compassionate communities.

The Hospice equips local communities by growing links and relationships between Hospice teams, local people and organisations. We inspire local groups to ask ‘what they can do’ in their areas to support people who are experiencing dying, death and grief.

Recognition for collaborative Dying Matters campaign

For ‘Dying Matters Week’ in May 2021, we planned and delivered a diverse programme of events to inspire the public to have conversations on death, dying and bereavement.

A partnership between St Nicholas Hospice Care, St Elizabeth Hospice, St Helena Hospice, University of East Anglia Health and Social Care Partners and NIHR Applied Research

20 St Nicholas Hospice Care

Collaboration East of England led to the formation of ‘Compassionate Communities East’. An assortment of events were delivered, ranging from radio shows, online videos and training sessions, to campfires for remembrance and reflection. The Hospice collaboration was nationally recognised by Hospice U.K, winning the ‘Innovation In Dying Matters’ award.

For the collaboration, the Hospice developed an animated video to help raise awareness of ‘acts of kindness’ and our Hospice Neighbours programme, which has 130 volunteers who provide companionship and practical help in people’s homes.

The Neighbourliness is You video is available on Youtube and our website.

Acknowledgement of the first World Compassionate Communities Day

In November 2021, the Hospice used social media to share content on the topic of dying and death.

Death and Dying day

In March 2022, the St Nic’s Education and Community Connector teams attended a Death and Dying Day, at the University of Suffolk,

in Ipswich. These types of events provide an opportunity to network with fellow professionals and academics.

Inter Faith Week

In November 2021, our Chaplaincy and Spiritual team worked in partnership with other local organisations to support strengthening good interfaith relations at all levels.

We worked with colleagues from West Suffolk Hospital and Wedgwood to produce a video and content to raise awareness of the week online.

Trustees’ Report and Annual Accounts 2021–22 21

Provide

194

Ward admissions

including re-admissions

540

Consultant patient sessions at WSH

1,659 home visits were made

The Provide element of the Hospice’s model focuses on the specialist clinical expertise and care we are able to offer to those at the end of their lives, as well as support for their carers and those important to them.

Our clinical team, made up of consultants in palliative medicine, doctors, specialist nurses, therapists, healthcare assistants and advanced practitioners, all provide highly skilled and expert advice and support for those most in need of very complex intervention.

Service development: Hospice Extra Support Team

In November 2021, a new virtual ward service was designed to prevent unplanned hospital and ward admissions. A team of registered nurses and hospice care assistants will provide enhanced contact and hands-on support to patients and families, including:

22 St Nicholas Hospice Care

The team works closely with healthcare colleagues in West Suffolk to ensure care is coordinated alongside other providers.

Recruitment has now since taken place and the Hospice Extra Support Team service began operating in May 2022.

Return of in-person community-based services

In July 2021, Nicky’s Way and Family Support Teams, alongside some of their wonderful volunteers, hosted their first Childrens’ bereavement group session since November 2019.

three clinical leadership vacancies, including the Clinical Services Director post (May 2021). The new leadership team then led a recruitment drive for nursing and care assistant roles.

Although the recruitment market for clinical roles has been competitive, the leadership team have been able to fill vacancies which has improved bed capacity and increased time spent on staff development and learning.

Continued virtual support: Singing Group

The Hospice’s Virtual Singing Group is run by Hospice volunteers and offers music as a therapeutic form of support.

This group is aimed at encouraging everyone in the Hospice community to sing. It is increasingly well documented that regular singing has significant health and psychological benefits. The group meets online every Monday morning.

Six bereaved families benefited from the programme’s first two-day workshop. This marked the return of a service being delivered out in the community, which was an important part of our services before the pandemic.

The Hospice will continue to develop the availability of services in the community. In 2022, St Nic’s has relaunched the Bereavement Café in Bury St Edmunds, and is looking for more locations.

Recruitment challenges

Recruitment to vacancies has been a priority to ensure safe and effective services.

Whilst awaiting the appointment of a new CEO (December 2021), the Hospice recruited to

Trustees’ Report and Annual Accounts 2021–22 23

1,236

New Referrals

Strive Listening to people’s experiences

St Nicholas Hospice Care supported Healthwatch Suffolk to promote a survey of people across Suffolk and North East Essex, to ask about their experiences of end-of-life care in 2020/21.

The Covid-19 pandemic has highlighted many important themes related to dying, caring and grief. The Hospice, alongside its partners, was keen to learn what opportunities exist to improve services and support at the end of life in the area.

1,389

People Supported

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643
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Total Deaths

Of course, the experiences people had were affected by Covid-19. The pandemic had impacted almost every experience shared with Healthwatch Suffolk. The report was published on 26 July 2021.

“This report highlights the good work that is happening in our area, but also that there is so much more we can all do to make sure the experiences people have when facing dying, caring and grief are as good as they can be. “This isn’t work that one organisation can do on its own; as a community, we have to come together to see what we can change so that the end-of-life experiences people have can be the best they can be.

“As the report highlights, experiences were better when people were prepared for a death when they had an understanding of what to expect and when important conversations around death and dying had been had with family, friends and professionals.”

You can view the report at: https://healthwatchsuffolk.co.uk/report/ end-of-life-care-in-suffolk-and-north-eastEssex-2020-21/

St Nicholas Hospice Care

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Education – Professional Development Nurse

We have appointed a new Professional Development Nurse to support learning and the adoption of best practice across our clinical settings.

The new role is based in our Education Team, and represents a commitment to developing our teams and individuals - an important response to the recruitment environment and our staff’s career satisfaction.

Working with NHS partners

As part of a formal lease agreement, the West Suffolk Hospital’s Medical Treatment Unit (MTU) moved into the Hospice’s Hardwick Lane site, in July 2021. We were able to make this space available due to changes in our service model caused by the pandemic.

This supported West Suffolk Hospital with some of their short-term needs as they prepare for a new hospital building development, and has also resulted in some income for St Nic’s.

Adopting the Lantern Model

Our staff have engaged with the Lantern Model developed by St Christopher’s Hospice. As well as considering the basis of our approach to care delivery, we have three lanterns throughout our ward.

In the Latern Model, we have focus on how we say goodbye.

A lit lantern signifies a period of time when we ask individuals to be respectful and reflective due to a recent death of someone in our care.

One lantern is situated at the main entrance to the ward, one is in the main staff office, and one is located in the Sylvan Ward reception area.

Trustees’ Report and Annual Accounts 2021–22 25

Structure, governance and management

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Chief Executive Officer
Linda McEnhill
Executive Assistant to the CEO
Adrienne Jackson
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Director Georgina Bissell (To 30 June 2022)

Corporate Services Director Jelena Sarubina

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Head of Finance
Head of
Corporate Services
Facilities Manager
HR Operations
Manager
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St Nicholas Hospice Care

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Income Generation Director Clinical Services Director
Clare Chater (From 11 April 2022) Sharon Basson
Executive Assistant
to the Clinical
Head of
Directorate Head of Community
Marketing and
Services
Communications
Hospice Advanced
Nurse Practitioner
Head of
Head of Retail Psychological
Services
Consultants in
Palliative Care
Head of Head of Inpatient &
Fundraising Education Services
----- End of picture text -----

Trustees’ Report and Annual Accounts 2021–22 27

The Trustees confirm that they have given due consideration to the Charity Commission’s published guidance on the Public Benefit requirement under the Charities Act 2011.

1. Management and decision-making

St Nicholas Hospice (Suffolk) is a company limited by guarantee and is governed, under its Memorandum and Articles of Association, through a 62-strong membership association made of persons from the community. The Association, in turn, appoints and monitors the performance of the Trustees. It delegates the effective Governance of the Charity to the Board of Trustees and receives reports at least once per annum. The full Board of Trustees meets quarterly to review performance and delivery of the strategic plan. Additional meetings are held to cover specific areas of focus, review strategy and direction, and the governance arrangements in place.

2. Register of members

The register of members is available for inspection free of charge, at the registered office of the charitable company.

3. Our workforce and management structure

The management and leadership of the Hospice is led by the Chief Executive Officer, who chairs a weekly Directorate meeting with the Clinical Services Director, Director of Corporate Services, and Director of Income Generation. The Directorate meets regularly with the Leadership Team, which comprises of Heads of Services from across the Hospice, and conducts a regular all-staff meeting to ensure good communication across all levels of staff and across the entire operation. The Chief Executive meets formally with the Chair of the Board of Trustees and/ or Vice Chair at least once a month. Average headcount figures for 2021/22 were 154 / 175 compared to 175 / 194 in 2020/21. The full-time equivalent (FTE) figures for the same periods are 120 / 138 (2021/22) and 138 / 156 (2020/21). This represents a decrease in FTE.

4. Board of Trustees committees

During the year, the Board has continued to operate four committees with specific terms of reference and functions delegated by the Board and with a Trustee as Chair appointed by the Board - Clinical Committee, Finance and Income Generation Committee, the Human Resources and Remuneration Committee. These committees include co-opted members with relevant experience from the Association and the Trustees. Trustees, aside from the Chair, serve on at least one Sub Committee. The meetings are attended by the Chief Executive and relevant Director or Head of Department; other Directors attend when requested. The Board is currently reviewing the terms of reference for the committees to ensure they continue to be fit for purpose. The committees review directorate KPIs, monitor risk, incidents, complaints, health and safety and managers’ recommendations for developments. The Chair of each committee reports back to the Board about matters discussed at each meeting.

  1. The Clinical Committee oversees all clinical matters with particular reference to palliative care and clinical standards and medicines management. It monitors performance and quality. The meetings are attended by the Chief Executive, the Clinical Services Director and the Consultant in Palliative Medicine.

  2. The Finance and Income Generation Committee oversees all financial aspects of the Charity’s activities. It reviews the budget and monitors performance. It also considers the appointment, resignation or dismissal of the external auditors and approves their annual fee. The meetings are attended by the Chief Executive, the Director of Corporate Services, the Director of Income Generation and the Head of Finance, and include:

  3. Review and monitoring of the Charity’s investment strategy;

  4. Oversight of the retail, fundraising and marketing strategy, policy and performance, and reports its findings and recommendations to the Board;

  5. Audits financial statements of the Charity and recommends them to the Board;

  6. Facilitates reports from the external auditors and monitors management actions to implement recommendations made in reports from the auditors.

St Nicholas Hospice Care

28

  1. The Human Resources Committee and monitors employment policy, and recommends the annual employee percentage salary increase to the Board of Trustees. The meetings are attended by the Chief Executive Officer, the Corporate Services Director and the Human Resources Operations Manager.

  2. The Remuneration Committee meets once a year to agree CEO and Directors remuneration. The meetings are attended by the committee Chairs and the Chair of the Board of Trustess.

The Board of Trustees fulfils their key role and function in overseeing and directing the affairs of the Charity, ensuring that it is well-run and delivering the charitable outcomes for which it was established. The above committees are part of that process. The day-to-day running of the Hospice is entrusted to the Chief Executive who delegates that work through the Directorate and Leadership Team to the staff and volunteers deployed across the Charity’s services.

Our Trustees

The Board of Trustees is made up of no less than seven and no more than twelve Trustees.

Risk and internal control

The Trustees have overall responsibility for ensuring that the Charity has an appropriate system of controls, financial and otherwise. Trustees are also responsible for safeguarding the assets of the Charity and for taking reasonable steps for the prevention and detection of fraud and other irregularities and to provide assurance that:

Trustee recruitment and induction

All current Board members have been appointed based on their experience and expertise, their involvement in the community, and their commitment and passion for the work of St Nicholas Hospice Care and the hospice movement in general. All appointments to the Board are confirmed by the Association at its Annual General Meeting (AGM). The Board Chairman and Committee Chairs oversee the process of succession planning, recruitment and induction of Trustees and recruitment of Association Members serving on the Board Committees and will also meet with all prospective Trustees. Their work will include an ongoing skills audit and looking at different methods of recruitment. As part of their induction, Trustees receive introductory information, including planning and financial documents, national guidance about being a Trustee and information relevant to the Hospice. They see the work of the Charity first-hand and are given ample opportunities to engage with the Charity’s activities, services, staff and volunteers – and with service users as appropriate. Prospective Trustees will normally attend at least one Trustee meeting, before being asked to enter the formal processes of application and acceptance. Once approved, new Trustees will usually identify particular areas of interest and will spend time in those areas.

As part of the Charity’s risk management process the Trustees acknowledge their responsibility for the Charity’s system of internal control and reviewing its effectiveness. The Trustees recognise that such a system is designed to manage rather than eliminate the risk of failure to achieve the Charity’s objectives and can only provide reasonable, not absolute, reassurance against material misstatement or loss.

The Charity has undertaken a strategic review of our services and delivery models to ensure we continue to serve our local communities in the best possible way. St Nicholas Hospice Care operates in a highly regulated and complex environment. Clinical quality and safety are paramount for our patients and staff, as is ensuring we raise funds in an appropriate way and that we care for people’s data correctly. These operational risks are managed through the Charity’s policies, staff training and development, and governance arrangements.

Strategically, the main risks for the Charity continue to be developing a robust leadership structure following the retirement of the current CEO and vacancies at directorate level in 2021. Ensuring sufficient income to meet increasing costs, as well as meeting the growing demand from our local population, some of which is in response to the Covid-19 pandemic, continue to be risks which need managing. These risks are being managed by:

Trustees’ Report and Annual Accounts 2021–22 29

Senior leadership recruitment process - by 9 November 2021, a new CEO, Clinical Services Director and Corporate Services Director had been appointed, and a new Director of Income Generation was appointed in February 2022.

A system of financial controls designed to mitigate risk includes an operational plan, an annual budget and regularly updated forecasts including cash flow.

Regular scrutiny by the Trustees to monitor actual performance against the budget and forecasts and the formal delegation of authority to spend within clearly defined authorisation limits.

Demand

The need for hospice support continues to grow due to demographic changes, the impact of Covid-19 and continuing pressure on public services. This year we continued with the plans to deliver a more sustainable clinical model of care and cost savings, the plans have also needed to accommodate the impact of Covid-19 on clinical care.

Income Generation

The current economic climate continues to be uncertain, with macro-economic risks potentially affecting our investment portfolio and the possible negative impact of inflation on the economy.

We work closely with our local CCGs who continue to offer additional financial support to enable and extend the provision of our services. In addition, the Trustees have ensured the Charity remains in a strong financial position by maintaining sufficient reserves. The income portfolio is diverse, and we constantly seek new opportunities to improve income or find new sources of income.

30 St Nicholas Hospice Care

Picture-perfect portraits painted by a volunteer made wonderful retirement gifts for two longserving Hospice staff members.

The outdoor presentation saw Hospice Nurse, Louise Whitehead, and Hospice Care Assistant, Penny Gunsman, presented with portraits painted by Thetford artist, Chris Goddard.

With more than 28 years of service, Louise joined St Nic’s in March 1993, with Penny initially starting at the Hospice as a bank carer in 2004, before becoming a permanent member of staff in 2005.

Trustees’ Report and Annual Accounts 2021–22

31

Our people

Recruitment

Employee wellbeing

Post-pandemic, recruitment levels have returned to normal.

Average headcount figures for 2021/22 were 154 / 175 compared to 175 / 194 in 2020/21. The full-time equivalent (FTE) figures for the same periods are 120 / 138 (2021/22) and 138 / 156 (2020/21). This represents a decrease in FTE.

Total New Starters 2021/2022

The Hospice continues to implement its wellbeing strategy, which incorporates a group of mental health first aiders and wellbeing champions.

Development of staff

The key focus areas for 2021/22 were on compliance with all mandatory and statutory training and to facilitate a return to some inperson training when it was perceived to be a benefit.

----- Start of picture text -----
Income
30%
Generation
Support and
19%
Admin
Service
51%
Delivery
----- End of picture text -----

Volunteering

Average head count 2021/22 was 540.

Remuneration and benefits

Employee Costs were £4.53m compared to £5.27m last year.

Some 42 employees are in the NHS pension scheme (principally clinical staff), and 106 employees in the Aegon Group Personal Pension Plan.

The employer’s contributions to the NHS pension Scheme were made at the rate of 20.68% (2021: 20.68%). The increase from 14.38% is still being funded by the NHS Pension Schemes transitional arrangments resulting in no additional costs to the Charity.

The employer’s contributions vary from 14.38% for those in the NHS scheme, and either 5% or 7% for those in the Group Personal Pensions Scheme.

St Nicholas Hospice Care

32

Apprenticeships making a difference to staff development

Apprentices make a huge difference to so many organisations, including our own. Judy Cornwall became our first Hospice Apprenticeship Nurse.

A huge well done to Judy, who is in the final weeks of her apprenticeship nursing degree, having received a first in her dissertation.

33

Trustees’ Report and Annual Accounts 2021–22

Clinical quality and assurance

The structures in place to support clinical quality across the organisation provide assurance of patient safety. We aim to demonstrate a culture of transparency, learning and continuous improvement to deliver the Hospice strategy.

Quality assurance monitoring and reporting structure

Clinical Committee

Clinical Quality and Governance Group

----- Start of picture text -----
Incidents,
complaints,
Hospice concerns,
UK patient safeguarding Medicines
safety project and management
benchmarking compliments
monitoring
and learning
----- End of picture text -----

----- Start of picture text -----
Clinical
Audit
guideline Hospice
monitoring
monitoring Advisory
and review
and review Group
----- End of picture text -----

St Nicholas Hospice Care

34

Clinical incidents

Serious incidents 3 Safeguarding 9 General 9 Data Protection/ 0 GDPR Covid-19 0 Medication 64 Slips, trips and falls 13 Pressure ulcer 16 Total 114

Clinical complaints and concerns Concerns 4 Complaints 4 Total 8

Figures: 1 April 2021 - 31 March 2022.

Patient harm is viewed seriously, and we constantly strive to deliver high-quality care. The robust reporting and investigation of incidents, complaints and concerns allows us to understand our performance, how we could have performed better and, essentially, if learning is achieved to ensure that this is shared with our teams.

Hospice UK benchmarking figures

Trustees’ Report and Annual Accounts 2021–22 35

Covid-19

The Leadership Team supported clinical staff to provide safe patient care during the pandemic by implementing a responsive approach to Covid-19 measures. This included:

Safeguarding Hub for further investigation.

All of the safeguarding policies and clinical guidelines have been reviewed and the latest legislation included, as required. There is a weekly presence from the leads on the Hospice’s internal social network to ensure that this remains fresh in people’s minds.

Care Quality Commission (CQC) preparation

We confirmed, with our CCG colleagues, one staff outbreak during the period after identifying multiple staff cases and reviewing their activity and contact. There were subsequent staff infections, but these did not warrant declaring a further outbreak as they were smaller in number. This mirrors the experiences of other health and social care providers.

In preparation for our expected CQC inspection we have continued to work towards robust alignment of our services with the five Key Lines of Enquiry upon which we are measured:

We supported patients and system partners by working in different ways. We continued to perform risk assessments before patient visits, undertake remote consultations where necessary, and held reviews at multi-disciplinary team meetings. We also extended support on Sylvan Ward. During September 2021 to March 2022 we were able to support 10 patients, an increase from 8.

In order to ensure that this is our standard approach, we established a Quality Assurance and Compliance Group. This short programme of improvement, involving leaders from across the organisation, ensures risks are identified and action plans are established.

Safeguarding

In July 2021, the Hospice appointed two new safeguarding leads. Working with the Suffolk Safeguarding Partnership they have been promoting that abuse is not normal and that safeguarding is everyone’s responsibility. They are committed to ensuring the Hospice:

Since their commencement there have been 9 safeguarding enquiries from staff, seven of these were referred to the Suffolk Multi-Agency

36 St Nicholas Hospice Care

Celebrating International Nurses Day.

Staff and Trustees from across the Hospice shared messages to form a display of thanks and support.

A short event to mark the day was livestreamed via our staff’s internal social network channel. The ceremony thanked all of our nurses, healthcare assistants, doctors, clinical teams, staff and volunteers for their amazing work and commitment to the people we all support.

37

Trustees’ Report and Annual Accounts 2021–22

Income generation

£7m

St Nicholas Hospice Care is reliant on voluntary income, and without the committed support of many inspiring people we could not help as many people as we do. We highlight just some of those tremendous people here.

total Hospice income in the financial year 2021/22

Donations, Legacies and Grants totalled

In May 2021, 280 runners, walkers and Nordic walkers took on the 18-mile Bury to Clare Challenge in aid of St Nic’s.

Over the years, Kevin Marshall, of Positive Steps, has raised more than £67,000, through donations of events fees and encouraging his participants to fundraise.

£2.6m

The Hospice’s Lottery raised £ 392k

St Nicholas Hospice Care

38

Having not run since she was a child, Sarah McKay, who lives in Haverhill, pulled on her trainers and completed a marathon distance to raise funds for us.

Sarah is spurred on to fundraise for us in memory of her Nan, Margaret Gascoine. Sarah says Margaret,

who had many children and grandchildren, was like a second mum to her. She hopes her fundraising efforts will allow other families to have the support her Nan did and not have to face death alone.

In June 2021, Melanie Sturman completed her 30 half marathons in 30 days for St Nic’s and she raised an amazing £2,400.

When they started their business, Jess Darnell (pictured) and Lucy Newell from The Coffee House (which has shops in Fornham All Saints and Moreton Hall), pledged to donate 1p from every coffee sold to us.

Thank you to John and Denise Maxim, for all their hard work in making such a success of 2021’s ‘St Nic’s does Elvis and Neil Diamond’.

It was the occasion’s best year yet, raising a fantastic £8,034.80. More than 200 attended the event, and we also had business sponsors supporting the night from around our region.

We were delighted to announce the official total for Jaynic’s Girls Night Out 2021 was an incredible £124,368! The event returned to its in-person format after the pandemic inspired a virtual version in 2020.

Trustees’ Report and Annual Accounts 2021–22 39

Retail

----- Start of picture text -----
Shops
----- End of picture text -----

----- Start of picture text -----
Shops
220,904
Transactions
Kay, Monique and Sarah from the Brandon Shop
team did a lovely job dressing up the shop’s
window with handmade flowers as part of a
Biodiversity Day competition.
105,078kg
Saved from landfil
The House Clearance Team had a busy new year
with their successful Christmas tree recycling
service.
The service enjoyed a record-breaking year with
243 33
around 2,500 trees collected and a wonderful
£10,195 raised. Well done to the team who
Volunteers Staff worked so hard to make sure trees were
collected.
----- End of picture text -----

St Nicholas Hospice Care

40

A special thank you also goes to Euston Estates who supported the initiative in 2022 by kindly agreeing to recycle all of the trees free of charge. They chipped the firs and used them around newly planted trees on the estate.

For the first time in two years, our team at the Donation Centre were able to welcome the public back to view and purchase pre-loved goods.

The sales, which were a monthly occurrence before the pandemic.

Garry Marjoram, the donation centre’s manager, said at the time: “We are so pleased to be able to restart our monthly warehouse sales. These events raise much-needed funds for the Hospice and have always proved very popular with the public.”

Goods on sale will include donated furniture, bric-a-brac, electrical items, gardening tools, books, clothes and more. Everything is reasonably priced and the team is always open to sensible offers.

E-Commerce 6,213 Transactions

House Clearance £85K Total stock sold

Warehouse 3,745 Donations

Trustees’ Report and Annual Accounts 2021–22 41

Fundraising Compliance Report

St Nicholas Hospice Care employs a core fundraising staff to develop, promote and run a range of fundraising campaigns, assisted by vital volunteers and taken up by our supporters. We steward our donors and promote our fundraising campaigns to them, and the wider community which we serve, through direct mail, e-mail contact, telephone and digitally. During the pandemic, we did not engage in any canvassing activity to promote our lottery.

place to monitor third parties who carry out work for us, or whom we enter into contracts with. We appraise the commercial marketplace before entering into contracts with others and ensure our supporters enter into written agreements with us when promoting or selling products or activities which raise funds for us. Our staff are encouraged to be actively involved with these organisations at a strategic level and we meet the standards required of these memberships.

We constantly monitor the cost and time which goes into each fundraising activity against the financial return to ensure we are making the most of every donation received. Many of our income streams were adversely affected by the Covid-19 pandemic, but this loss was offset by income received through government grants in this exceptional year.

We received no suppressions of contact through the Fundraising Regulator in this year, and received no other complaints.

We review the frequency and appropriateness of our communications and provide an option for supporters to ‘opt-out’ of our communications. We contact based on legitimate interest, and also run vulnerability checks and have a self-exclusion form on our website for gambling-related products.

We are registered with the Fundraising Regulator and work in accordance with the Code of Fundraising Practice, and the best practice laid out by the Hospice Lotteries Association, Chartered Institute of Fundraising and Institute of Legacy Management. Our lottery and raffles are promoted in accordance with the Gambling Commission guidelines, and we have checks in

We continue to listen to our supporters and to learn from them to shape our fundraising activity. Our supporters are very important to us, and we put them at the heart of everything we do.

Thank you to all of the Trusts and Foundations who have supported our work during 2021/22

We are grateful for funding from Suffolk Community Foundation through the Suffolk Coronavirus Community Fund, Bluebell Fund, Martineau Fund, Food and Drink Fund, Miller Fund and the Suffolk Giving Fund.

42 St Nicholas Hospice Care

A story of kindness that took place at our Haverhill Hub.

After the washing machine broke and needed replacing, a Hospice supporter generously made a donation for a new machine and Haverhill-based M J Pipe very kindly gave their time and services to plumb the new machine in, free of charge. One of their employees shared with us how much the Hospice meant to him as not only was his Dad cared for at the end of his life, but he also received support himself.

Thank you so much to everyone involved.

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Trustees’ Report and Annual Accounts 2021–22

Going concern

Like many other charities, the Hospice faces the challenge of providing an equitable service which can respond flexibly to the changing and growing needs expressed by people in the local community, as well as ensuring the charity remains financially sustainable, despite the additional challenges imposed as a result of the pandemic. The Trustees have considered the following areas specifically in their assessment of going concern:

Fundraising

St Nicholas Hospice Care has a diverse range of income-generating activities including grants and donations, investments, fundraising, retail, events and lottery income. Some of these income streams are inherently volatile and our income generation strategy was remodelled in recognition of the challenges of Covid-19; we continue to review this regularly in light of a number of ongoing challenging economic factors. In addition, the Charity has policies in place to manage these risks including specific investment and reserves policies, explained in the Trustees Report. The ongoing use of designated funds to improve existing or to develop new income streams will add to this diversification and enable the Charity to continue serving our local population.

Reserves

At the end of the financial year 2021/22, the Charity has reserves amounting to £8.78m of which £6.47m are free reserves and is double the minimum target of six months total running costs. This allows for investment in services, income generation and infrastructure to further the Charity’s aims and objectives as well as providing funds to mitigate against economic uncertainty including any future impact of the pandemic and the cost-of-living crisis.

NHS Grant Funding

The Suffolk and North East Essex (SNEE) Integrated Care Board (ICB) (previously the West Suffolk Clinical Commissioning Group) (WSCCG) is the main single NHS funder and continues to support the work of the Charity. The Charity has agreed with WSCCG that there will be a gradual increase in income over five years, from £945k to £1.4m March 2024. A small amount of funding £77,539 is also received from Norfolk and Waveney ICB each year.

44 St Nicholas Hospice Care

Trustees’ responsibilities in relation to the financial

statements

The trustees (who are also directors 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).

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

The trustees are responsible for maintaining proper accounting records which disclose with reasonable accuracy at any time the financial position of the Group and to enable them to ensure that the accounts comply with the Companies Act 2006. They are also responsible for safeguarding the assets of the Group and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

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

Statement as to disclosure of information to the Auditor

In accordance with company law, as the charity’s Trustees, we certify that:

This Annual Report was approved by the Trustees on Thursday 8 December.

Charles Simpson Chair

Trustees’ Report and Annual Accounts 2021–22 45

Independent Auditors’ Report For the year ended 31 March 2022

2 46 St Nicholas Hospice Care

INDEPENDENT AUDITOR’S REPORT TO THE MEMBERS OF ST NICHOLAS HOSPICE (SUFFOLK)

Opinion

We have audited the financial statements of St Nicholas Hospice (Suffolk) (the ‘parent charitable company’) and its subsidiary (the ‘group’) for the year ended 31 March 2022 which comprise the Consolidated statement of financial activities, the Group and Charity Balance Sheets, the Consolidated 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 FRS 102 “The Financial Reporting Standard applicable in the UK and Republic of Ireland” (United Kingdom Generally Accepted Accounting Practice).

In our opinion the financial statements:

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 and parent charitable company in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the FRC’s Ethical Standard and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.

Conclusions relating to going concern

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

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

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

Other information

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

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

We have nothing to report in this regard.

St Nicholas Hospice (Suffolk) Independent Auditors Report for the year ended 31 March 2022

47

Opinions on other matters prescribed by the Companies Act 2006

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

Matters on which we are required to report by exception

In the light of the knowledge and understanding of the group and the parent charitable company and their environment obtained in the course of the audit, we have not identified material misstatements in the Directors’ Report or the Strategic Report included within the Trustees’ Report.

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

Responsibilities of trustees

As explained more fully in the Statement of Trustees’ responsibilities set out on page 45, the trustees (who are also the directors of the charitable company for the purposes of company law) are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such internal control as the trustees determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error.

In preparing the financial statements, the trustees are responsible for assessing the group’s and parent charitable company’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the trustees either intend to liquidate the group or parent charitable company or to cease operations, or have no realistic alternative but to do so.

Auditor’s responsibilities for the audit of the financial statements

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

The extent to which the audit was considered capable of detecting irregularities, including fraud Irregularities are instances of non-compliance with laws and regulations. The objectives of our audit are to obtain sufficient appropriate audit evidence regarding compliance with laws and regulations that have a direct effect on the determination of material amounts and disclosures in the financial statements, to perform audit procedures to help identify instances of non-compliance with other laws and regulations that may have a material effect on the financial statements, and to respond appropriately to identified or suspected non-compliance with laws and regulations identified during the audit.

In relation to fraud, the objectives of our audit are to identify and assess the risk of material misstatement of the financial statements due to fraud, to obtain sufficient appropriate audit evidence regarding the assessed risks of material misstatement due to fraud through designing and implementing appropriate responses and to respond appropriately to fraud or suspected fraud identified during the audit.

48 St Nicholas Hospice Care

However, it is the primary responsibility of management, with the oversight of those charged with governance, to ensure that the entity’s operations are conducted in accordance with the provisions of laws and regulations and for the prevention and detection of fraud.

In identifying and assessing risks of material misstatement in respect of irregularities, including fraud, the group audit engagement team:

As a result of these procedures we consider the most significant laws and regulations that have a direct impact on the financial statements are FRS 102, Charities SORP (FRS 102), Companies Act 2006, Charities Act 2011, the parent charitable company’s governing document, tax legislation and Charities (Protection and Social Investment) Act 2016. We performed audit procedures to detect non-compliances which may have a material impact on the financial statements which included reviewing the financial statements including the Trustees’ Report and remaining alert to any new or unusual transactions which may not be in accordance with the governing documents.

The most significant laws and regulations that have an indirect impact on the financial statements are those in relation to the Care Quality Commission. We performed audit procedures to inquire of management and those charged with governance whether the group is in compliance with these law and regulations and inspected correspondence with the regulator during the year.

The group audit engagement team identified the risk of management override of controls and the completeness of certain income streams as the areas where the financial statements were most susceptible to material misstatement due to fraud. Audit procedures performed included but were not limited to testing manual journal entries and other adjustments, evaluating the business rationale in relation to any significant, unusual transactions and transactions entered into outside the normal course of business and performing tests of detail in relation to the completeness of income.

A further description of our responsibilities for the audit of the financial statements is provided on the Financial Reporting Council’s website at http://www.frc.org.uk/auditorsresponsibilities. This description forms part of our auditor’s report.

Use of our report

This report is made solely to the charitable company’s members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. 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.

Claire Sutherland

CLAIRE SUTHERLAND (Senior Statutory Auditor) For and on behalf of RSM UK AUDIT LLP, Statutory Auditor Chartered Accountants Blenheim House Newmarket Road Bury St Edmunds Suffolk IP33 3SB

16/12/22

St Nicholas Hospice (Suffolk) Independent Auditors Report for the year ended 31 March 2022

49

Consolidated Statement of financial activities (incorporating the income and expenditure statement) For the year ended 31 March 2022 3 50 St Nicholas Hospice Care

Note
Income from
Grants, donations and
Legacies
Donations
Legacies
Grants
Charitable activities2
Other trading activities:
Shops
Lottery
Fundraising
Other
3
Investments
4
Other
5
Total Income
Expenditure on:
Raising funds
Raising grants, donations
and legacies
Other trading activities
Investment management
Charitable activities
In patient care
Day care
Community services
Family support and bereavement
Education & research
Total Expenditure
6
Net (losses) /gains on
investments
12
Net movement in funds
9
Reconciliation of funds:
Total funds brought
forward
Transfer between funds
Total funds carried
forward		 2022
2021		 2022
2021
Unrestricted
Funds
Restricted
Funds
Endowment
Funds
Total
£
£
£
£
750,699
162,152
-
912,851
1,656,111
-
-
1,656,111
-
-
-
-		 Unrestricted
Funds
Restricted
Funds
Endowment
Funds
Total
£
£
£
£
794,595
156,373
-
950,968
428,128
-
-
428,128
-
-
-
-
2,406,810
162,152
-
2,568,962		 1,222,723
156,373
-
1,379,096
1,792,452
277,618
-
2,070,070
1,493,526
-
-
1,493,526
392,272
-
-
392,272
168,426
-
-
168,426
95,021
-
-
95,021		 1,938,011
1,043,463
-
2,981,474
656,441
-
-
656,441
405,256
-
-
405,256
114,351
-
-
114,351
42,902
-
-
42,902
2,149,245
-
-
2,149,245		 1,218,950
-
-
1,218,950
130,391
-
363
130,754
27,955
-
-
27,955		 137,889
-
431
138,320
362,926
-
-
362,926
6,506,853
439,770
363
6,946,986		 4,880,499
1,199,836
431
6,080,766
(611,959)
(345)
-
(612,304)
(1,978,388)
-
-
(1,978,388)
(38,227)
-
-
(38,227)		 (625,132)
(2,767)
-
(627,899)
(1,840,781)
-
-
(1,840,781)
(35,965)
-
-
(35,965)
(2,628,574)
(345)
-
(2,628,919)		 (2,501,878)
(2,767)
-
(2,504,645)
(1,676,108)
(175,772)
(363)
(1,852,242)
(7,113)
-
-
(7,113)
(1,164,004)
(253,974)
-
(1,417,978)
(331,716)
(75)
-
(331,791)
(111,155)
(2,530)
-
(113,685)		 (1,392,707)
(576,020)
(431)
(1,969,158)
(66,976)
(9,800)
-
(76,776)
(1,003,817)
(594,163)
-
(1,597,980)
(394,683)
(4,743)
-
(399,426)
(204,797)
(1,210)
-
(206,007)
(3,290,095)
(432,351)
(363)
(3,722,809)		 (3,062,980)
(1,185,936)
(431)
(4,249,347)
(5,918,669)
(432,696)
(363)
(6,351,728)		 (5,564,858)
(1,188,703)
(431)
(6,753,992)
159,433
-
965
160,398		 698,913
-
2,493
701,406
747,617
7074
965
755,656		 14,554
11,133
2,493
28,180
7,920,667
14,135
59,701
(14,135)
46,623
-
8,026,991
-		 7,895,025
11,088
59,656
(11,088)
44,130
-
7,998,811
-
8,682,419
52,640
47,588
8,782,647		 7,920,667
59,701
46,623
8,026,991

St Nicholas Hospice (Suffolk) Consolidated statement of financial activities 51 (incorporating the income and expenditure statement) for the year ended 31 March 2022

Group and Charity Balance Sheets For the year ended 31 March 2022

4 52 St Nicholas Hospice Care

Note
Fixed assets
Tangible assets
11
Investments
12
Current assets
Stock
Debtors
13
Cash at bank and in hand
Creditors: amounts falling due within one
year
14
Net current assets
Net assets
The funds of the charity
Restricted income funds
15
Unrestricted funds:
General fund
16
Designated fund
16
Endowment fund
17
Total funds
18		 Group
2022
2021
£
£
2,210,526
2,318,149
4,775,860
5,058,847
6,986,386
7,376,996
24,725
31,556
2,089,540
2,093,874
630,758
527,647
2,745,023
2,653,077
948,762
2,003,082
1,796,261
649,995
8,782,647
8,026,991
52,640
59,701
3,332,910
2,463,535
5,349,509
5,457,132
47,588
46,623
8,782,647
8,026,991		 Charity
2022
2021
£
£
2,210,526
2,318,149
4,810,866
5,093,853
7,021,392
7,412,002
-
-
2,112,794
2,117,040
538,164
510,514
2,650,958
2,627,554
953,240
2,038,963
1,697,718
588,591
8,719,110
8,000,593
52,640
59,701
3,269,373
2,437,137
5,349,509
5,457,132
47,588
46,623
8,719,110
8,000,593

A separate Statement of Financial Activities (SOFA) is not presented because the Charity has taken advantage of the exemptions afforded by Section 408 of the Companies Act 2006. The net movement in funds was a surplus of £718,517.

The financial statements were approved and authorised for issue by the Board of Trustees on Thursday 8 December.

Charles Simpson

Chairman

The notes on pages 56 -73 form part of these financial statements.

St Nicholas Hospice (Suffolk) Balance Sheet as at 31 March 2022 53

Consolidated cash flow statement For the year ended 31 March 2022

5 54 St Nicholas Hospice Care

Note
Cash flows from operating activities:
Net cash used in operating activities
21
Cash flows from investing activities:
Dividends and interest from investments
Interest received
Proceeds from the sale of tangible fixed assets
Payments to acquire tangible fixed assets
Proceeds from the sale of investments
Purchase of investments
Net cash provided by investing activities
Change in cash and cash equivalents in the year
Cash and cash equivalents at the beginning of the year
Cash and cash equivalents at end of the year
22,23		 Group
2022
2021
£
£
(406,770)
(601,282)
130,568
137,973
811
971
-
-
(64,883)
(59,010)
487,512
1,408,838
(734,494)
(468,802)
(180,486)
1,019,970
(587,256)
418,688
1,346,504
927,816
759,248
1,346,504

St Nicholas Hospice (Suffolk) Cash flow statement for the year ended 31 March 2022 55

Notes forming part of the financial statements For the year ended 31 March 2022 6 56 St Nicholas Hospice Care

Basis of preparation

St Nicholas Hospice (Suffolk) is a private company limited by guarantee, and is registered, domiciled and incorporated in England. The registered office of the company is Hardwick Lane, Bury St Edmunds, Suffolk, IP33 2QY.

The financial statements are prepared under the historical cost convention, with the exception of investments which are stated at market value, and in accordance with applicable accounting standards and the Companies Act 2006. The financial statements also comply with the Statement of Recommended Practice applicable to charities preparing their accounts in accordance with FRS 102 and the Charity SORP (FRS 102).

The financial statements are prepared in sterling, which is the functional currency of the company. Monetary amounts in these financial statements are rounded to the nearest £.

Going concern

The Trustees have considered the financial position of the Group and Charity, the investment portfolio, the 2022/23 and the 2023/24 budgets and the planned service delivery model. As a consequence, the Trustees believe that the Group and Charity can manage its business risks successfully through these difficult and uncertain times.

The Trustees have a reasonable expectation that the Group and Charity has adequate resources to continue in operational existence for at least 12 months from the date of approval of the financial statements, due to:

The Trustees have not identified any material uncertainties in relation to going concern and therefore continue to adopt a going concern basis of accounting in preparing the financial statements.

Group accounts

The consolidated financial statements incorporate the accounts of the Charity and those of its trading subsidiary, St Nicholas Hospice Trading Limited for the year ended 31 March 2022. The Charity has taken advantage of the exemption from disclosing the following information, as permitted by the reduced disclosure regime within FRS 102: - Section 7 ‘Statement of Cash Flows’ – Presentation of a Statement of Cash Flow and related notes and disclosure.

Income

Income is included in the Statement of Financial Activities when the charity is entitled to the income, the amount can be quantified with reasonable accuracy and there is probability of receipt.

Income from government and other grants, whether ‘capital’ grants or ‘revenue’ grants, is recognised when the charity has entitlement to the funds, any performance conditions attached to the grants have been met, it is probable that the income will be received and the amount can be measured reliably and is not deferred.

Income from NHS contracts and other grants is included on a receivable basis. Recognised when the charity has entitlement to the funds, any performance conditions attached to the funds, any performance conditions attached to the grants have been met, it is probable that the income will be received and the amount can be measured reliably and is not deferred.

Legacies and donations are included when the aforementioned recognition criteria have been met.

Dividends and interest on fixed interest securities are included in the accounts when due.

Lottery income is accounted for in respect of those draws that have taken place in the year.

St Nicholas Hospice (Suffolk) Notes forming part of the financial statements for the year ended 31 March 2022

57

1 Accounting policies (continued)

Expenditure and irrecoverable VAT

All expenditure is accounted for on an accruals basis (that is, recognised once there is a legal or constructive obligation committing the charity to the expenditure), and has been classified under the headings that aggregate all costs related to the category. Where costs cannot be directly attributed to particular headings they have been allocated to activities on a basis consistent with use of resources.

Irrecoverable VAT is charged against the category of expenditure for which it was incurred.

Volunteers

The value of services provided by volunteers is not incorporated into these financial statements. Further details of the contribution made by volunteers can be found in note 8 to the accounts and within the Trustees report.

Tangible fixed assets and depreciation

Fixed assets costing more than £500 are capitalised and capital project related expenditure all of which is capitalised irrespective of value.

Depreciation is provided to write off the cost, less estimated residual values, of all fixed assets evenly over their expected useful lives. It is calculated at the following rates:-


xpected useful lives. It is calculated
at the following rates:-
Leasehold buildings - remaining term of lease
Furniture and equipment - 10% - 50% per annum
Motor vehicles - 20% per annum
IT Equipment - 10% - 50% per annum

Fixed assets donated

Donated assets provided for use by the charity are taken to income and capitalised in the accounts at their estimated market value when donated.

Investments

In the Group and Charity Balance Sheet, Listed Investments are stated at market value, less any provision for impairment. The Statement of Financial Activity includes gains and losses arising on revaluation and disposals throughout the year.

Realised gains and losses represent the difference between the market value at the previous balance sheet date and the eventual sale proceeds or the acquisition price if bought and sold within the same year. Unrealised gains and losses represent the difference between market value at the previous balance sheet date or cost of any purchases during the year and the market value at the current balance sheet date.

In the Charity Balance Sheet, ‘Investments’ includes the investment in a subsidiary, which is recorded at cost.

Stocks

Stock of retail goods is included at the lower of cost and net realisable value. Donated items of stock for resale or distribution are not included in the financial statements until they are sold or distributed. The Trustees consider it impractical to be able to assess the amount of donated stocks as there are no systems in place which record these items until they are sold and undertaking a stock take would incur undue cost for the charity which far outweigh the benefits

Pension costs

The charity contributes to a group personal pension plan and a defined benefit pension scheme. Contributions paid into these pension arrangements are charged to the Statement of Financial Activity when due.

A number of employees contribute to the NHS Superannuation scheme and certain other employees participate in personal pension plans. Whilst the NHS Superannuation scheme is a Defined Benefit Scheme, it is a multi-employer scheme for which the Charity’s share of the underlying assets and liabilities cannot be identified; it is therefore accounted for as a Defined Contribution Scheme in accordance with FRS 102. The Charity’s contributions to these schemes are therefore charged to the Statement of Financial Activity when due.

58 St Nicholas Hospice Care

1 Accounting policies (continued)

Operating leases

Rentals paid under operating leases are charged to the Statement of Financial Activity over the period in which the cost is incurred.

Employee benefits

The best estimate of the expenditure required to settle an obligation for termination benefits is recognised immediately as an expense when the company is demonstrably committed to terminate the employment of an employee or to provide termination benefits.

Fund accounting

Unrestricted funds comprise accumulated surpluses and deficits on the general fund and designated funds. They are available for use at the discretion of the Trustees in furtherance of the charity’s objectives.

Designated funds are those funds designated for particular purposes or projects at the discretion of the Trustees.

Restricted funds are created when grants or donations are made for a particular purpose, the use of which is restricted to that purpose.

Endowment funds represent funds which must be held permanently by the Charity, principally as investments. Income arising on each of the endowment funds can be used in accordance with the objects of each fund and is shown as income against that fund and allocated to costs as appropriate. Any material gains or losses arising on the investment forms part of the fund.

Taxation

The income and gains of the charity are exempt from corporation tax to the extent that they are applied to its charitable objectives. Recoverable income tax is accrued within the financial statements.

Debtors

Trade and other debtors are recognised at the settlement amount due. Prepayments are valued at the amount prepaid. Accrued income and tax recoverable is included in the best estimate of the amounts receivable at the balance sheet date.

Creditors

Creditors 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 are normally recognised at their settlement amount after allowing for any discounts due.

Cash at Bank and in hand

Cash at bank and cash in hand includes cash and short term liquid investments with a short maturity of three months or less.

Financial Instruments

The charity only has financial assets and financial liabilities of a kind that qualify as a basic financial instrument. Basic financial instruments are initially recognised at transaction value and subsequently measured at amortised costs using the effective interest method, apart from listed investments, which are held at fair value, derived as noted within the investments accounting policy.

Critical accounting estimates and areas of judgement

Estimates and judgements are continually evaluated and are based on historical experience and other factors, including expectations of future events that are believed to be reasonable under the circumstances.

Critical accounting estimates and assumptions

The Group makes estimates and assumptions concerning the future. The resulting accounting estimates and assumptions will, by definition, seldom equal the related actual results. There are not considered to be any estimates or assumptions that have a significant risk of causing a material adjustment to the carrying amounts of assets and liabilities within the next financial year.

Critical areas of judgement

The Trustees do not consider that there are any critical areas of judgement applied in the preparation of these financial t t t

St Nicholas Hospice (Suffolk) Notes forming part of the financial statements for the year ended 31 March 2022

59

2 Income from charitable activities

In patient care
Day care
Community services
Family support & bereavement
Hospital services
Education and research
Hospice UK – NHSE Funding
 2022
£
899,241
-
687,085
154,594
-
51,532
277,618


2,070,070		 2021
£
891,914
37,329
765,236
149,314
597
93,621
1,043,463
2,981,474

The NHSE awarded funding to allow the hospice to make available bed capacity and community support from December 2021 to March 2022 to provide support to people with complex needs in the context of the COVID-19 situation.

3 Other income

Catering income
Other income
estment income
Dividend – equities
Interest – fixed interest securities
Bank interest		 2022
£
25,289
69,732

95,021

2022
£
122,980
7,588
186

130,754		 2021
£
24,130
18,772
42,902
2021
£
129,579
8,394
347
138,320

4 Investment income

5 Other Incoming resources

Government Grant – Coronavirus Job Retention Scheme
Government Grant – Retail Business Grant
Education Grant		 2022
£
5,411
21,334
1,210

27,955		 2021
£
261,863
101,063
-
362,926

St Nicholas Hospice Care

60

6 Analysis of expenditure

Costs of raising grants, donations and
legacies
Other trading activities
Shop costs
Lottery costs
Events costs
Other income
Corporation tax
Investment management costs
In patient care
Day care
Community services
Family support & bereavement
Education and research
Total		 2022
Direct
Costs
Support Costs
(note 7)
Total Costs
£
£
£
480,007
132,297
612,304
480,007
132,297
612,304		 2021
Total Costs
£
627,899
627,899
1,294,791
295,531
1,590,322
158,770
14,227
172,997
32,306
22,187
54,493
51,919
108,658
160,577
-
-
-
1,537,786
440,603
1,978,389
36,094
2,133
38,227
2,053,887
575,033
2,628,920
1,335,511
516,731
1,852,242
6,716
397
7,113
1,095,241
322,737
1,417,978
254,406
77,384
331,791
81,020
32,664
113,685
2,772,894
949,915
3,722,809
4,826,780
1,524,948
6,351,728		 1,418,879
169,712
74,769
173,204
4,217
1,840,781
35,965
2,504,645
1,969,158
76,776
1,597,980
399,426
206,007
4,249,347
6,753,992

7 Analysis of support costs

Cost of raising grants,
donations and legacies
Other trading activities
Investment management costs
In patient care
Day care
Community services
Family support & bereavement
Education and research
Charitable services
Total		 2022
2021
Admin,
Finance & IT
Human
Resources
Maintenance
and Domestics
Catering
Governance
Costs
Total
Total
£
£
£
£
£
£
£

64,308
28,205
11,423
-
28,361
132,297
100,515
206,102
90,395
2,681
76,241
65,184
440,603
381,327
-
-
-
-
2,133
2,133
1,164
270,410
118,600
14,104
76,241
95,678
575,033
483,006
123,088
53,985
146,388
114,362
78,908
516,731
521,661
-
-
-
-
397
397
22,077
134,672
59,066
64,286
-
64,713
322,737
300,919
34,585
15,169
12,599
-
15,032
77,385
94,759
17,583
7,712
2,584
-
4,786
32,665
47,983
309,928
135,932
225,857
114,362
163,836
949,915
987,399
580,338
254,532
239,961
190,604
259,514
1,524,948
1,470,405

St Nicholas Hospice (Suffolk) Notes forming part of the financial statements for the year ended 31 March 2022

61

8 Employee Costs

Wages and salaries
Social security costs
Pension costs
Other employee benefits		 2022
£
3,890,644
341,355
292,323
6,037

4,530,359		 2021
£
4,446,096
385,303
336,154
101,406

5,268,959

Full time equivalent employees during the year were 120 (2021:138) and analysis of the headcount in the year was:

Direct charitable services
Fundraising services
Support services		 2022
Number
91
50
13

154		 2021
Number
108
50
17

175

The number of employees whose total employee benefits excluding pension contributions earning over £60,000, classified within bands of £10,000 is as follows:

£60,000-£69,999
£80,000-£89,999
£100,000-£109,999
Total		 2022
Actual
Number

2
1
1

4		 2021
Actual
Number
2
2
1

5

Pension costs relating to those staff earning over £60,000 totalled £39,761 in 2022 (2021: £46,881).

Termination payments amounted to £4,312 (number of people 1) (2021: £101,406) and no funding was received relating to this payment.

The Hospice considers that the key management personnel comprise of nine of the senior management team – who are the Chief Executive(s) and seven other key personnel. In 2021/22 there were a number of changes in the senior management structure. The total employee benefits of the key management personnel of the Hospice were £490,341 (2021: £519,931)

The Hospice had an average of 540 volunteers as at 31 March 2022 (2021: 630) who provided their services in the following areas:

Retail
Clinical
Hospice Neighbours
Fundraising and support services
Trustees
Associates		 2022
Number
248
119
100
53
11
9
540		 2021
Number
276
137
109
86
12
10
630

62 St Nicholas Hospice Care

9 Net movement in funds

Net movement is stated after charging/(crediting):
Depreciation
Auditor’s remuneration
-Statutory audit of charity and group
-Statutory audit of subsidiary
-Tax advisory
-Other services
(Profit)/loss on sale of fixed assets
Government grants
Operating lease rentals		 2022
2021
£
£
168,473
181,197
17,975
16,950
3,900
3,500
1,800
1,615
8,880
16,477
(4,033)
869
(27,955)
(362,926)
219,268
222,912

10 Taxation

St Nicholas Hospice (Suffolk) is a registered charity and as such is exempt from taxation on its income and gains falling within section 505 of the Taxes act 1988 or section 252 of the Taxation of chargeable Gains Act 1992 to the extent that these are applied for charitable purposes.

The subsidiary trading company paid no corporation tax in the year (2021: £4,217).

11 Tangible fixed assets (Charity and Group)

Cost
At 1 April 2021
Additions
Disposals
At 31 March 2022
Depreciation
At 1 April 2021
Charge for the year
Disposals
At 31 March 2022
Net book value
At 31 March 2022
At 31 March 2021		 Long
Leasehold
Buildings
£
4,050,763
26,841
(8,000)
4,069,604
1,981,292
82,213
(3,967)
2,059,538
2,010,066
2,069,471		 Furniture and
Equipment
£
1,214,994
18,601
(5,622)
1,227,973
1,103,303
33,898
(5,622)
1,131,579
96,394
111,691		 ICT
Equipment
£
412,374
19,441
-
431,815
286,649
41,933
-
328,582
103,233
125,725		 Motor
Vehicles
£
67,280
-
-
67,280
56,018
10,429
-
66,447
833
11,262		 Total
£
5,745,411
64,883
(13,622)
5,796,672
3,427,262
168,473
(9,589)
3,586,146
2,210,526
2,318,149

The long leasehold expenditure represents:

All fixed assets of the charity are used for charitable purposes.

St Nicholas Hospice (Suffolk) Notes forming part of the financial statements for the year ended 31 March 2022 63

12
Investments
A) Summary
At start of the year
Additions
Disposals
Realised gains / (losses)
Unrealised gains / (losses)
Cash held as part of the investment portfolio
Equity investment in subsidiary
B) Analysis of investments
Equities
Fixed interest securities
Cash held as part of the investment portfolio
Total group
Equity investment in subsidiary
Total charity
C) Historical cost of investments
Rathbones
Sarasin & Partners
Equity Investment in Subsidiary
Total charity		 Group
2022
2021
£
£
4,239,990
4,478,619
734,494
468,803
(487,512)
(1,408,838)
35,355
113,319
125,043
588,087
4,647,370
4,239,990
128,490
818,857
-
-
4,775,860
5,058,847		 Charity
2022
2021
£
£
4,239,990
4,478,619
734,494
468,803
(487,512)
(1,408,838)
35,355
113,319
125,043
588,087

4,647,370
4,239,990
128,490
818,857
35,006
35,006

4,810,866
5,093,853


2022
2021
£
£
3,909,280
3,589,896
738,090
650,094
128,490
818,857

4,775,860
5,058,847
35,006
35,006

4,810,866
5,093,853

2022
2021
£
£
1,664,943
1,365,579
2,302,187
2,231,649

3,967,130
35,006
3,597,228
35,006

4,002,136
3,632,234

D) Trading subsidiary

The Charity holds 100% of the issued share capital of St Nicholas Hospice Trading Limited (company number 02176804), a company incorporated in the UK. The principal activity of St Nicholas Hospice Trading Limited during the year was the sale of the bought in goods, house clearances and income from the Haven Café.

The company gifts its taxable profits to St Nicholas Hospice (Suffolk) under gift aid and the aggregate capital and reserves of St Nicholas Hospice Trading Limited at 31 March 2022 were £98,543 (2021: £61,405).

All items of income or expenditure reported on the Group Statement of Financial Activities have been shown after the removal of intra group transactions.

64 St Nicholas Hospice Care

12 Investments (continued)

The trading results for the year ended 31 March 2022 and 31 March 2021 are show below:

2022 2021
£ £
Turnover 417,049 223,613
Cost of sales (258,637) (197,456)
Gross profit
158,412
26,157
Operating expenses (82,343) (6,754)
Other operating income 3,225 21,253
Profit on ordinary activities before interest
79,294
40,656
Interest payable on concessionary loan to hospice (625) (625)
Net trading profit
78,669
40,031
Assets
146,582
106,902
Liabilities (48,039) (45,497)
Net assets
98,543
61,405
Represented by:
Capital 35,006 35,006
Reserves 63,537 26,399
Net assets
98,543
61,405

13 Debtors

Debtors
Trade debtors
Taxation recoverable
Other debtors
Prepayments
Accrued income
Legacies
Amounts due greater than one year:
Loan due from subsidiary undertaking		 Group
2022
2021
£
£
190,379
1,319,067
35,423
25,673
761
23,633
187,375
211,727
348,920
216,402
1,326,682
297,372
2,089,540
2,093,874
-
-
2,089,540
2,093,874		 Charity
2022
2021
£
£
188,843
1,317,567
35,423
25,673
761
23,633
187,210
211,393
348,875
216,402
1,326,682
297,372
2,087,794
2,092,040
25,000
25,000
2,112,794
2,117,040

In 2018/19, the charity entered into a new loan agreement to the subsidiary undertaking to fund working capital, secured by a fixed charge over goodwill and a floating charge over all assets of the company with interest charged at 2.5%. The balance on this loan will be repaid in full on 15 November 2028.

Included within prepayments is £113,372 (2021: £117,365) for a lease which falls due greater than one year.

St Nicholas Hospice (Suffolk) Notes forming part of the financial statements for the year ended 31 March 2022

65

14 Creditors: amounts falling due within one year

Trade creditors
Amounts due to subsidiary undertaking
Taxation and social security
Other creditors
Accruals
Deferred income – lottery
Deferred income - other		 Group
2022
2021
£
£
45,999
37,608
-
-
100,244
95,364
49,626
44,444
278,938
264,896
62,965
65,902
410,990
1,494,868
948,762
2,003,082		 Charity
2022
2021
£
£
45,881
37,341
27,517
56,378
94,925
89,388
49,626
44,444
269,816
257,592
62,965
65,902
402,510
1,487,918
953,240
2,038,963

Deferred income reconciliation – lottery

Balance brought forward
Amounts released to income in the year
Amount deferred in the year
Balance carried forward
Deferred income reconciliation – other
Balance brought forward
Amounts released to income in the year
Amount deferred in the year
Balance carried forward		 Group
2022
2021
£
£
65,902
74,956
(65,902)
(74,956)
62,965
65,902
62,965
65,902
£
£
1,494,868
1,430,485
(1,494,868)
(1,430,485)
410,990
1,494,868
410,990
1,494,868		 Charity
2022
2021
£
£
65,902
74,956
(65,902)
(74,956)
62,965
65,902
62,965
65,902
£
£
1,487,918
1,427,665
(1,487,918)
(1,427,665)
402,510
1,487,918
402,510
1,487,918

Deferred income relates to income for future events, house clearances, lottery subscriptions and the CCG grant paid in advance.

15 Restricted funds (Group and Charity)

In patient care
Day care
Community services
Family support and
bereavement
Education and research
Fundraising
Catering (Haven Café)
Facilities		 Balance at
31 March 2021
Income
Expenditure
Transfers
Balance at
31 March 2022
£
£
£
£
£
7,050
178,763
(175,772)
(8,331)
1,710
49,631
1,938
-
(4,854)
46,715
-
253,974
(253,974)
-
-
-
75
(75)
-
-
2,675
3,580
(2,530)
-
3,725
345
-
-
-
450
990
(345)
-
-
-
(450)
(500)
-
-
490
59,701
439,770
(432,696)
(14,135)
52,640

66 St Nicholas Hospice Care

15 Restricted funds (Group and Charity) (continued)

In patient care
Day care
Community services
Family support and
bereavement
Education and research
Fundraising		 Balance at
31 March 2020
Income
Expenditure
Transfers
Balance at
31 March 2021
£
£
£
£
£
2,053
582,070
(576,020)
(1,053)
7,050
47,887
15,763
(9,800)
(4,219)
49,631
5,676
594,162
(594,162)
(5,676)
-
155
4,728
(4,743)
(140)
-
3,885
-
(1,210)
-
2,675
-
3,113
(2,768)
-
345
59,656
1,199,836
(1,188,703)
(11,088)
59,701

In Patient Care Fund incorporates:

Hospice UK Funding. The NHSE awarded funding to allow the hospice to make available bed capacity and community support from December 2021 to March 2022 to provide support to people with complex needs in the context of the COVID-19 situation. This funding has now been fully expended.

The Beds fund specifically received and fully expended for the purchase of beds for the Hospice.

The Sylvan Ward fund specifically received towards the revenue funding for the running cost of the in-patient unit and now fully expended.

Memorable Moments specifically received to provide a memorable experience for patients who are nearing the end of their life.

Sylvan Ward Kitchen fund specifically received to replace the existing kitchen; now fully expended.

Day Care Fund incorporates;

The Clinical Equipment fund was specifically received for and partially expended on palliative care equipment. The equipment that has already been purchased is represented within furniture and equipment (Note 11).

Community services restricted funds incorporates;

Hospice UK Funding. The NHSE awarded funding to allow the hospice to make available bed capacity and community support from December 2021 to March 2022 to provide support to people with complex needs in the context of the COVID-19 situation. This funding has now been fully expended.

Community Connectors fund is to build community capacity to support people and their families facing long term illnesses, dying, death and grief. This funding has now been fully expended.

The Hospice Neighbours Project fund relates to revenue funding to maintain and grow a volunteer scheme to provide practical support to people in their own homes. This funding is fully expended.

The Community Hospice Team fund relates to specific revenue funding received and fully expended in the year for the Community Hospice Team Service which includes Community Nurse Specialists and community based Nursing Assistants.

Family Support and Bereavement restricted funds incorporates;

The Nicky’s Way fund relates to specific revenue funding received and expended in the year for the children’s bereavement support service known as Nicky’s Way.

Education and Research restricted funds incorporates;

The HOPE course fund relates to revenue funding received for co-ordinating a course for cancer patients entitled ‘Help Overcoming Problems Effectively’.

The My Care Wishes Fund is a specific piece of funding received from the Clinical Commission Group to deliver advanced care planning to West Suffolk care homes.

The West Suffolk Hospital training fund relates to revenue funding received for the training of palliative care staff at West Suffolk Hospital.

St Nicholas Hospice (Suffolk) Notes forming part of the financial statements for the year ended 31 March 2022

67

Fundraising restricted funds incorporates;

Community Fundraising Vehicle Sponsorship A number of individual corporate funders sponsored the organisation to cover the lease payments for a new fundraising vehicle and is fully expended.

Catering restricted fund incorporates;

The Catering fund is for catering equipment and is fully expended.

Facilities fund incorporates;

The Facilities fund includes funding for equipment and a memorial in the hospice garden.

The transfer for the year reallocates the net book value of the fixed assets held within the restricted fund to the Building/Fixed Asset Fund to realign the fund.

16 Unrestricted funds

Unrestricted funds
Charity
Designated funds
Building / Fixed Asset Fund
New building and maintenance fund
IT Systems fund
Service development fund
Income generation project fund
General fund
Group

Designated funds
Building/Fixed Asset fund
New building and maintenance fund
IT Systems fund
Service development fund
Income generation project fund
General fund		 Balance at
31 March
2021
Income
Expenditure
Investment
gains/ (losses)
Transfers
Balance at
31 March
2022
£
£
£
£
£
£
2,318,149
-
-
-
(107,623)
2,210,526
2,250,000
-
-
-
-
2,250,000
16,217
-
-
-
-
16,217
474,102
-
-
-
-
474,102
398,664
-
-
-
-
398,664
5,457,132
-
-
-
(107,623)
5,349,509
2,437,137
6,128,735
(5,577,690)
159,433
121,758
3,269,373
7,894,269
6,128,735
(5,577,690)
159,433
14,135
8,618,882
Balance at
31 March
2021
Income
Expenditure
Investment
gains/ (losses)
Transfers
Balance at
31 March
2022
£
£
£
£
£
£
2,318,149
-
-
-
(107,623)
2,210,526
2,250,000
-
-
-
-
2,250,000
16,217
-
-
-
-
16,217
474,102
-
-
-
-
474,102
398,664
-
-
-
-
398,664
5,457,132
-
-
-
(107,623)
5,349,509
2,463,535
6,506,853
(5,918,670)
159,433
121,758
3,332,909
7,920,667
6,506,853
(5,918,670)
159,433
14,135
8,682,418

St Nicholas Hospice Care

68

16 Unrestricted funds (Continued)

Charity

Designated funds
Building/Fixed Asset fund
New building and maintenance fund
IT Systems fund
Service development fund
Income generation project fund
General fund		 Balance at
31 March
2020
Income
Expenditure
Investment
gains/
(losses)
Transfers
Balance at
31 March 2021
£
£
£
£
£
£
2,441,205
-
-
-
(123,056)
2,318,149
2,250,000
-
-
-
-
2,250,000
76,005
-
(59,788)
-
-
16,217
475,026
-
(924)
-
-
474,102
398,664
-
-
-
-
398,664
5,640,900
-
(60,712)
-
(123,056)
5,457,132
2,196,239
4,705,059
(5,297,218)
698,913
134,144
2,437,137
7,837,139
4,705,059
(5,357,930)
698,913
11,088
7,894,269

Group

Designated funds
Building/Fixed Asset fund
New building and maintenance fund
IT Systems fund
Service development fund
Income generation project fund
General fund		 Balance at
31 March
2020
Income
Expenditure
Investment
gains/ (losses)
Transfers
Balance at
31 March 2021
£
£
£
£
£
£
2,441,205
-
-
-
(123,056)
2,318,149
2,250,000
-
-
-
-
2,250,000
76,005
-
(59,788)
-
-
16,217
475,026
-
(924)
-
-
474,102
398,664
-
-
-
-
398,664
5,640,900
-
(60,712)
-
(123,056)
5,457,132
2,254,125
4,880,499
(5,504,146)
698,913
134,144
2,463,535
7,895,025
4,880,499
(5,564,858)
698,913
11,088
7,920,667

Building/Fixed Asset fund

This is a designated fund representing the construction costs of the existing building to 31 March 2022 less depreciation

St Nicholas Hospice (Suffolk) Notes forming part of the financial statements for the year ended 31 March 2022

69

16 Unrestricted funds (continued)

New building and maintenance fund

This is a designated fund for the purposes of maintain and updating the existing hospice building and allocating funds for future building requirements. This fund has not been drawn on during 2021/22.

IT systems fund

The charity has a number of IT systems and hardware which require replacing or upgrading to develop greater reliance, functionality and efficiency to support the services we deliver and the way in which we work, now and in the future. This fund has not been drawn on during 2021/22.

Service development fund

The purpose of this fund is to develop and test new service delivery models across our entire service offering in all settings. The fund will continue to support the ongoing development, testing and planning of services. This fund has not been drawn on during 2021/22.

Income generation fund

The fund is to develop income generation through new and existing income streams that are sustainable and resilient to economic and social challenges. This fund has not been drawn on during 2021/22.

17 Endowment funds

Balance at Balance at
1 April 2021 Income Expenditure Investment gain 31 March 2022
£ £ £ £ £
The Earl of Euston 2009 Fund 46,623 363 (363) 965 47,588

The income earned by the Group and Charity from the investment of the fund, £363 must be spent in accordance with the objects of the Charity.

The gain arising on the investment of the fund was £965 and the value of the fund was increased by this at 31 March 2022. The investment management charge attributable to the fund at £142 was immaterial and no adjustment has been made to the value of the fund

Balance at Balance at Balance at
1 April 2020 Income Expenditure
Investment gain
31 March 2021
£ £ £ £ £
The Earl of Euston 2009 Fund 44,130 431 (431) 2,493
46,623
et assets by funds
Group General
Restricted		 Endowment Total Funds
Funds Funds Fund 31 March
2022
£ £ £ £
Investments 4,728,272 - 47,588 4,775,860
Tangible fixed assets 2,210,526 - - 2,210,526
Current assets 2,692,383 52,640 - 2,745,023
Creditors falling due within (948,762) - - (948,762)
one year
8,682,419 52,640 47,588 8,782,647

18 Net assets by funds

St Nicholas Hospice Care

70

18 Net assets by funds (continued)

et assets by funds (continued)
Charity
Investments
Tangible fixed assets
Current assets
Creditors falling due within
one year
Group
Investments
Tangible fixed assets
Current assets
Creditors falling due within
one year
Charity
Investments
Tangible fixed assets
Current assets
Creditors falling due within
one year		 General
Funds
Restricted
Funds
Endowment
Total Funds
31 March
2022
£
£
£
£
4,763,278
-
47,588
4,810,866
2,210,526
-
-
2,210,526
2,598,318
52,640
-
2,650,958
(953,240)
-
-
(953,240)
8,618,882
52,640
47,588
8,719,110
General
Funds
Restricted
Funds
Endowment
Fund
Total Funds
31 March
2021
£
£
£
£
5,012,224
-
46,623
5,058,847
2,318,149
-
-
2,318,149
2,593,376
59,701
-
2,653,077
(2,003,082)
-
-
(2,003,082)
7,920,667
59,701
46,623
8,026,991
General
Funds
Restricted
Funds
Endowment
Total Funds
31 March
2021
£
£
£
£
5,047,230
-
46,623
5,093,853
2,318,149
-
-
2,318,149
2,567,853
59,701
-
2,627,554
(2,038,963)
-
-
(2,038,963)
7,894,269
59,701
46,623
8,000,593

19 Related party transactions

None of the charity trustees or connected persons received remuneration in the year (2021: £1,350).

Trustee indemnity insurance is included within total insurance costs of £59,601 (2021: £53,947). It is not possible to quantify the trustee indemnity element from the overall insurance cost.

Three trustees were St Nicholas Hospice Care Lottery subscribers in the year (2021: three) and in total paid £208 (2021: £260). Their winnings amounted to £10 (2021: £10).

During the year one trustee commissioned the services of the house clearance team and paid a fee of £300 (2021: £300).

During the year fourteen trustees and associates (2021: 14) made donations totalling £560 (2021: £1,849).

Transactions with the subsidiary undertaking were:

Transactions with the subsidiary undertaking were:
2022 2021
£ £
Loan outstanding from the trading company to the charity 25,000 25,000
Current account balance from the trading company to the charity 27,517 57,878
Gift aid donation from the trading company to the charity 41,531 68,801
Recharged costs from the charity to the trading company 120,418 4,019
Recharged income from the charity to the trading company 149,555 71,315
Interest paid/received on loan to subsidiary 625 625

St Nicholas Hospice (Suffolk) Notes forming part of the financial statements for the year ended 31 March 2022

71

20 Financial commitments

As at 31 March 2022, the charitable company had annual commitments under non-cancellable operating leases as set out below:


Operating leases which expire:
Within one year
Later than one year but not later than five
Later than five years		 Land and buildings
Other
2022
2021
2022
£
£
£
126,289
178,595
15,740
277,873
282,735
18,058
82,825
10,080
-

486,987
471,410
33,798
2021
£
17,464
16,637
-
34,101

21 Reconciliation of net income / (expenditure) to net cash flows from operating activities

Net income / (expenditure)
Adjusted for:
Depreciation charges
(Gains)/ Losses on investments
Dividends received from investments
Interest received
Loss/(profit)/on the sale of fixed assets
Decrease in stocks
Decrease/(increase) in debtors
(Decrease)/increase in creditors
Net cash used in operating activities		 Group
2022
2021
£
£
755,655
28,180
168,473
181,197
(160,398)
(701,406)
(130,568)
(137,973)
(811)
(971)
4,033
869
6,832
(1,861)
4,334
8,466
(1,054,320)
22,217
(406,770)
(601,282)

22 Analysis of changes in net funds

Opening net funds
Cash and cash equivalents
Changes in net fund arising from cash flow of the group
Closing net funds
Cash and cash equivalents
nalysis of cash and cash equivalents
Cash at bank and in hand
Cash held as part of the investment portfolio		 Group
2022
2021
£
£
1,346,504
927,816
(587,256)
418,688
759,248
1,346,504
Group
Charity
2022
2021
2022
2021
£
£
£
£
630,758
527,647
538,164
510,514
128,490
818,857
128,490
818,857
759,248
1,346,504
666,654
1,329,371

23 Analysis of cash and cash equivalents

24 Members guarantee

The charity has no share capital but is limited by guarantee. Every member of the charitable company is a guarantor and undertakes to contribute to the assets of the charitable company, in the event of it being wound up, such amounts as may be required. Each guarantor’s liability is limited to £1.

St Nicholas Hospice Care

72

25 Pension costs

A group personal pension plan is operated on behalf of certain employees. The assets are held separately from those of the charity in independently administered funds. The pension charge represents contributions payable by the charity to the plan at rates ranging from 5% to 7%. Contributions paid by the charity during the year amounted to £131,812 (2021: £157,792). Contributions outstanding at 31 March 2022 amounted to £22,765 (2021: £20,550) and were included within other creditors.

In addition, certain other employees previously employed by the National Health Service have, by arrangement, continued to be members of the NHS Pension Scheme, a multi-employer defined benefit scheme, whilst in the employment of St Nicholas’ Hospice (Suffolk). Contributions paid by the charitable company during the year amounted to £158,867 (2021: £179,157). Contributions outstanding at 31 March 2022 amounted to £25,822 (2021; £22,965) and were included within other creditors.

The scheme is not designed to be run in a way that would enable NHS bodies to identify their share on the underlying scheme assets and liabilities. Therefore, the scheme is accounted for as if it were a defined contribution scheme: the cost to the Hospice of participating in the scheme is taken as equal to the contributions payable to the scheme for the accounting period.

Employers’ contributions to the NHS pension scheme were made at the rate of 20.68% (2021: 20.68%). The increase from 14.38% is still being funded by the NHS Pension Schemes transitional arrangements resulting in no additional costs to the charity. This transitional arrangement is to continue into 2022/23. Employee contributions ranged from 5.6% to 13.5%.

26 Material legacies

Legacy income is only included in incoming resources where receipt is probable and the amount can be measured reliably, or the legacy has been received. There were no additional notifications which could be determined to be probable, material or reliably measured over and above those already recognised in the financial statements as at 31 March 2022 (2021: £Nil).

27 Capital commitments

In respect of the Group and Charity, there was £2,710 of expenditure authorised and contracted (2021: £18,634) at the end of the financial year.

28 Financial Instruments

Financial assets:
Instruments measured at fair value through profit & loss		 Group
2022
2021
£
£
4,647,370
4,239,990		 Charity
2022
2021
£
£
4,647,370
4,239,990

29 Contingent Liabilities

The Charity is registered within the VAT group with St Nicholas Hospice Trading Limited. The maximum potential liability at 31 March 2022 was £5,319 (2021: £5,977).

30 Acting as Agent

The Charitable Company acts as agent holding funding on behalf of the CCG for two projects. The following transactions have taken place in the year. An invoice was raised in 2021-22 to the CCG for £361,000 to support the ROSI project and £125,000 to support DDaT Transformation. There was no disbursement against either fund during 2021-2022.

St Nicholas Hospice (Suffolk) Notes forming part of the financial statements for the year ended 31 March 2022

73

because you matter St Nicholas Hospice Care A R&Ji4lewJ Charw No. 287Th3