St Nicholas Hospice (Suffolk)
Trustees report and financial statements
for the year ended 31 March 2024
Company number: 1748046
Charity number: 287773

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St Nicholas Hospice (Suffolk)
Trustees. annual report
For the
ear ended 31 March 2024
Contents
Trustees, annual report.......-.......................
Independent auditors report.....
..42
Statement of financi81 activities (incorporating an income and expenditure accounts)..47
Balance sheel................................
..48
Stalement ofcash flows...............
..49
Notes to the financial statements........................
..50

Reference and Administrative information
The trustees. who are also the directors for the purposes of company law. present their
report and audited consolidated financial statements of the charity and group for the
year ended 31 March 2024.
The financial statements have been prepared in accordan￿ with Ihe accounting
policies set out in the notes to the acGounts and comply with the charity's governing
document, the Charities Act 2011 and Companies Act 2006, and Accounting and
Reporting by Charities.. Statement of Recommended Practice appli¢able lo charities
preparing their accounts in accordance with the Financial Reporting Standard applicable
in the UK and RepubliG of Ireland published in October 2019.
St Nicholas Hospice (Suffolk)
Registered charity..
Company number..
1748046
Charity number..
Registered office..
287773
St Nicholas Way, Hardwick Lane. Bury St Edmunds, Suffolk,
IP33 2QY
County of
incorporatlon..
United Kingdom
Trustees..
The trustees, who are also directors under company law, who
served during the year and up to the date of this report were
as follows:
Charles Simpson
Chair of the Board ofTrustees-
Resigned - 3011112023
Chair of the Board of Trustees -
Appointed 3011112023
Anne Fisher
Karen Chandler-male
Max Drinkwater
Dave Evans
Donna Forster
Anthony Faulkner
Jo Howlett
Anita Pearson
Paul Siklos
Sam Turner
Kale Vaughton
Vice Chair

Key
management..
Linda McEnhill
Sharon Basson
Jelena Sarubina
Clare Chater
Chief Exe¢utive Officer
Director of Clinical Services
Direcior of Corporate Services
Director of Income Generation
Resigned.. 0610312024
Secretary."
Bankers..
Fiona Heath
Barclays Bank plc
20121 Comhill, Bury St Edmunds IP33 1 DY.
Ellisons Solicitors incorporating Gross & Co
83-84 Guildhall Street, Bury St Edmunds, Suffolk IP33 1 LN.
Rathbones Investment Management Limited, 159 New Bond Street,
London, W1S 2UD.
Sarasin & Partners LLP, Juxon House. 100 St Paul's Churchyard,
London, EC4M 8BU.
Solicitors."
Investment
hlanagers."
Audltors..
Lovewell Blake LLP, Chartered accountants & ststutory auditor,
Bankside 300, Peachman Way. Broadland Business
Park. Norwich. NR7 OLB.

Objectives and Activities
In the Objectives and Activities section of this annual report. we spotlight our Hospice's
core mission and its implementslion. Here, we highlight our diverse services,
meaningful interactions. and impaclful initiatives that define our commilment to
improving experiencRs for people at the end of life.
The purpose of the charity set out in its Articles of Association is '
-to promote the relief
of persons of either sex {withoul regard to race or creed) who are suffering from any
chronic or terminal illness or disease attributable to old age or from any other physical
or mental infirmity or disease in suGh ways as the Association shall from time to time
think fit.
In setting our programme each year we have regard to the Charity Commission's
general guidance on public benefit. The trustees always ensure that Ihe programme we
undertake is in line with our charilable objects and aims.
Vision
Everyone in our communities has support, dignity and choice when facing dying,
death and grief.
Mlsslon statement
We strive for something better in the pmvision of high-quality, specialist palliative
care, emotional and practical support, so that no-one in West Suffolk and
Thetford has to face dying, death and grief alone.
Vlslon
Compassion, Accountability, Respect, Equity.
Beneficiaries
Serving communities in West Suffolk and Thetford. the Charity's key ben6ficiari8S
include patients approaching the end of life with a teminal illness or life-limiling
¢ondilion. We support their family members. caregivers. friends, and the broadér
community too. We also support medical, health and social care professionals, whilst
offering open access bereavement support for adults and children.
Activities
The primary focus is on providing comfort, emotional support, and symptom management
Ihrough the provision of dinical serVi￿S staffed with specialist teams and supported by
volunteers. However. the trustees rewgnise Ihe k)ng-tenn impact of rydising awareness of
end￿f-Iife issues to enhance quality of care in general. Therefore, we ensure the charity's
speaalist knO￿edge is ac￿Ssible to the wder community by offering advice, education and
strategic partnerships wilh health and soaal care partners.

St Nicholas Hospice {Suffolk)
Trustees. annual report
Forth6
èar ended 31 March 2024
The activilies currently carried out for the public benefit by the charity can be broadly
categorised into the following programmes..
Hospi￿ Care.. Providing specialised nursing, medical and therapeutic care. This
includes pain management, symptom relief and advance care planning, as well
as emotional and spiritual support if requested, improving the quality of life for
patients.
End-of-Life Care.- Offering compassionate care and support lo patients during
their final stages of life, ensuring their comfort and dignity.
Psychological, Bereavement and Practical Support.. Extending counselling and
assistance to the families and loved ones of people who are dying or have died,
helping them cope with grief and loss. This includes support for people whose
loved ones may not have died in our care.
Community Outreach.. Engaging with the local comrnunity to raise awareness
about hospice care and end-of-life issues, promoting educab'on and
understanding.
Income Generation.. Raising funds for the Hospice's operations and services,
ensuring sustainability-
Volunteer Programmes.. Engaging volunteers who contribute their time and skills
to assist with various tssks, inciuding patient care, administrative work, retail and
fundraising activities.
There were 68 new volunteers who joined us between April 1, 2023 and March
31, 2024. Totsl volunteers we had at the end of March was 397.
Education and Training: Providing training and resources to health and soc4al
care professionals and family caregivers to enhance their understanding of
hospi￿ care, advanced care planning, and end-of-life support.
Advocacy.. Advocating for policies and initiatives Ihat support and improve end-
of-life care. bereavement and advance the hospice care field.
Collaboralions and partnerships: Working with other health and social care
organisalions, institutions, and community stakeholders to create a seamless
nelwork of care for patients and families.

How we work
The Charity delivers its charitable aims in the following ways..
Our care is provided free of charge and is available to individuals through referral
by their GP, or other professionals, such as hospital doctors or dislnct nurses.
As well as working with fellow heallhcare professionals, we promote sglf-referral
or contaGI from family or friends on behalf of olhers.
Our servic8s are there to support anyone who needs us, somelimes from Ihe
point of diagnosis onwards, nol just in the last year or months of life.
We support people in many different settings, from the Hospice itself in Bury St
Edmunds, which has a bedded unit (Sylvan Ward). to working in local
communities, to the place people call home. Our services also ensure that
specialist support and advice is available to people wherever they are.
We have developed a flexible and experienced skill mix of people, ranging from
employed slaff such as palliative care clinicians, therapisls, counsellors and
carers, to a broad mix of volunteers who provide support to all our services and
organisational funclions and work across all settings. This enables us lo focus on
proactive care planning and management, which aids effective person-centered
care.
The Hospice provides the following clinical setvices to deliver multidisctplinary
and holistic support..
Sylvan Ward - bedded unit with 2417 access to palliative Ca￿ specialists.
Community Nursing Team- specialist care and education support.
Psychological Servi¢es Team - psychotherapy. counselling and practical
support.
Spiritual Care and Chaplaincy Team
spiritual support, facilitation of
cultural and reltgious support for people of all falths and none.
Independent Living Team
physiotherapy. occupational therapy and
rehabilitative support.
o Hospice Neighbours
help.
Education - training, support and information.
volunleer-delivered companionship and practical
The Hospi￿ also works to educate and support communities in developing their
understanding of end-of-life issues. We help build mulual support and resilience
among community members so Ihose with life limiting illness can remain
independent for as long as possible and do not feel alone. We athieve this

St Nlcholas Hosplce (Suffolk)
Trustees. annual report
Forthe
earended 31 Mar¢h 2024
through our Hospic8 Neighbours (trained volunteers), and a range of qualified
staff who provide education and training.
St Nicholas Hospice Care also proactively develops slralegic partnerships to
ensure the best possible endthof-life care is available wilhin the communities we
serve. We work with other health and social care providers to share experlise
and knowledge. give specialist advice through a 2417 helpline. and to collaborate
on innovalive solutions that improve care for people and their families. The
Hospice's leadership team are actsve participants in key forums thal bring
together professionals and organisations across the local health and soaal care
system.
St Nicholas Hospice Care is part of the Suffolk and North East Essex (SNEE)
Integrated Care System {ICS) Die Well work for West Suffolk, which delivers on
Ihe Integrated Care Board Joint Forward Plan. This details the five-year strategy
for health and care partners to improv8 health and wellbeing outGomes and
reduce h8allh inequity for the people of Suffolk and North East Essex.
The trustees and executive team review support services and management
structures and arrangemenls regularly.
How our services are funded
The charily receives some statutory funding from the Integrated Care Boards of Norfolk
and Waveney and Suffolk and North East Essex,. the majority of ils funding comes from
voluntary, Gommer¢ial, and charitsble means, including..
Charitable donations= Generous gifts provided by individuals, organisalions, and
ommunity groups.
Legacy giving= Gifts in Wills from compassionate indiwduals continue to have a
lasting impact on our ability to provide care.
Fundraising events.
Corporate partnerships.. Including donations, fundraising and sponsorship.
Lottery and raffles.
Grants and trusts.. We submit applications for funding for activities, projects and
Capital items.
Gift Aid.. Tax relief on charitable giving maximises the value of donations. making
every contribution even more impactful.

Retail and olher trading activities- We sell donated and new 9oods through our
charity shops and online sales. Our house clearance Servi￿ generates income
through a paid-for service and by providing stock for our retail channels.
Investment and reserves.. Our prudenl management of investments and reserves
ensures steady income to support our long-term goals.
Thank you to all the trusts and foundations who have supported
our worf( in 2023-24.
St Nicholas Hospice Care gratefully
acknowledges the generous support
of the Julia Rausing Trust, whose
grant of £300,000 will help us meet
rising costs and continue to provide
vitsl care to our community.
JULIA IIAUSING
TRUST
We are grateful for funding from the
David and Jill Simpson Fund through
Suffolk Community Foundation.
SUFFOLK
Community
Foundation

St Nicholas Hospice {Suffolk}
Trustees, annual report
For the tsar ended 31 March 2024
Achievements and performance
Executive Summary of impact of St Nicholas Hospice Care's
charitable activities
Trustee Chalr's Introduction.. Reflecting on 40 Years of Commltment and a Year of
Challenge
As Chair of St Nicholas Hospi￿ Care, it is with both joy and concem that I reflect on the
past year-a year that also marked our 401h anniversary. For four decades, our hospice
has been a comerstone of care for thè communities of West Suffolk and Thetford,
supporting individuals and families during some of the most difficull moments of their
lives. This mileslone is a testament to the dedication of our staff, volunteers, and
supporters who have shaped our legacy of care.
However, this year has also brought significant financAal challenges-nol just for us, but
for hospices across the UK. The national funding crisis is having a profound impact on
organisations like ours. In particular. we were notified, just days before the new 2024-
25 finanrjal year, ofthe loss of£79,000 in statutory funding from the Norfolk and
Waveney Integrated Care System (ICSI. This is part ofa broader systemic issue
affecting many hospices. We are now at a critical juncture where sustainable funding is
needed lo ensure that we can continue lo provide the care our communities depend on.
Despite these challenges, the resilience and dedication of our team have been
ex￿Ptional. They have gone above and beyond to ensure that we continue to meet the
needs of those we serve. Bul as we move forward, we must address the serious
financial challenges we face to safeguard the future of our hospice and conlinue th8
legacy of care we've built over the past 40 years.
CEO'S Statement on Financial Performance and Operational Achievements
This year, Sl Nicholas Hospice Care faced an increasingly difficult financial landscape,
one that reflects the broader national crisis confronting hospices across the UK. While
our work continues to be heavily reliant on voluntsry income, the rising costs of care
and redu¢éd statutory funding are making this model increasingly unsustainable.
Wilhout siable and reliable financial support, we risk being unable to meet the growing
demand for our services in the future.
Despite these pressures, l am pleased to report that, Ihrough ¢ar6ful financial
management, we achieved a small operating surplus of£O.01 million. However, this
was mainly due to exceptional legacy income and temporary savings from vacant staff

positions. Our inveslment portfolio also contributed, but these gains are unpredictable
and cannot be relied upon long-term. This surplus should not be seen as a sign of
financial security-it masks the serious challenges we face in maintaining our services,
and wilhoul urgent action, our ability to deliver care is undér Ihreat in the long term.
Despite these challenges, the Hospi￿ has made significant achievemenls this year.
Our Sylvan Ward provided speaalist care to 174 patients, with an 840/0 bed occupancy
rate. and we adapted to rising demand by increasing Gapacity when needed. Our
community nursing teams supported 1.901 patients in their homes. and our
Psychological Services team managed 667 referrals, delivering crucial emotional
support to patients and their families.
Looking ahead, our focus 15 on expanding our services to ensure greater access and
equity. We aim lo expand Sylvan Ward to its full 12-bed rApacity and relaunch
ouipatient services. However, the future success of these plans depends on seGuring
the financial stsbility we need to operate effectively. Without a sustainable funding
model, the hospice sector will continue to face uncertainty, and we must work
collaboratively with our partners, local authorities, and govemmenl bodies to address
this crisis.
A particular highlight of our 40th-anniversary celebrations was the Thankful event, held
at St Edmundsbury Cathedral in May. This service brought together hundreds of
families, supporters, volunteers, and staff in remembrance and ￿lebratiOn of the lives
we've touthed over the years. It was a moving and meaningful o¢casion that reflected
the depth of conneclion belween our hospi￿ and Ihe community we serve.
These accomplishments underS￿re our ongoing commitment to delivering the highest
standards of care during our 401h year.
Key areas of impact
Clinical Care and patient support
Sylvan Ward.. The ward provided specialisl palliative and end-of-life care to 174
patients, maintaining an average stay of 13 days. With a high bed occupancy rate of
840/0, Sylvan Ward adapted to increased demand, including the addition of beds for
dementia care during the winter period, ensuring ¢omprehensive and ttimpassionate
care.
Community Nursing.. The Community Team supported 1.901 patients, managing
complex care needs and maintaining high acceptance rates into Ihe service. The
Inlegration of the Hospice Extra Support Team model ensured responsive care during
peak periods, highlighting Ihe team's flexibilily and reSoUr￿fulness.
10

St Nlcholas Hospice (Suffolkl
Trustees, annual report
For the
ear ended 31 March 2024
Independent Living= Supporting 279 patients, the team offered vital services, including
O¢CLtpational therapy, physiotherapy, and ward support. promoting independence and
enhancing qualily of life.
Psychological and spiritual support
Psychological Services= With 667 referrals. the team provided extensive emotional and
psychological support, including speGialised group support like Nicky's Way
bereavement service for children. The launch of new educational initiatives and the
recruitrnent of volunteers slrenglhened Ihe team's capacity and outreach.
Spiritual Care and Chaplaincy.. The team, one full-time and two bank chaplains and
twenty volunteers facilitated 1,030 conlacts and 125 home visits, offering round-the-
clock spiritual support. They also organised significant community events. such as the
Light Up a Life gatherings. which saw a 39 % increase in attendance on the previous
year.
Education and professional developmont
The Clinical Educ2tion Team facilitated 73 education sessions, attended by 1,311
individuals enhancing skills and knowledge in palliative care. Collaboration with Ihe East
of England Ambulance Service Trust and other entities furthered professional
development and improved care delivery slandards. Additionally, the hospice hosted a
national, online conference focused on 'The Arts and Demenb'a, in partnership with
another charity, Hope for Home, with delegates attending from across the UK as well as
our own staff.
Medlcal Team contributions
Following a resignation, we were successful in recruiting for the Senior Hospice
Physician post. Collaboration wilh the West Suffolk Foundation Trust colleagues who
work Closely with St. Nicholas Hospice Care, enhanced the level of expertise across the
medical team.
Impact against the Charity's Mission
St Nicholas Hospice Care's mission
To strive for something better in the provision of
highquality, specialist pallialive care, emotional and practical support. so that no-one in
West Suffolk and Thetford has to face dying, death and grief alone-was realised
through its mulli-faceted approach, encompassing clinical excellence. emotional and
psychological support, and communily engagemenl. The Hospice's efforts in promoting
independence, supporting families, and ensuring access to high-quality care were
evident across all Servi￿5.
The organisation's ability to adapl to challenges. such as staffing shortages and
increased demand, without compromising care quality, reflects its dedication to

conlinuous improvement and patient-cenlred care. Staff respond to service needs by
working across different departments when required. in order to maintain business
continuity. The exlensive Iraining and educational initiatives underscore a commitment
to building a well-equipped and knowledgeable workforce, essential for sustsining high
standards ofcare.
Conclusion
In alignment with its mission. St Nicholas Hospi￿ Care has effectively addressed the
complex needs of ils palients and Ihe wider community. Through specialised services,
compassionate support. and proactive engagement, the hospice has made a profound
impacl, ensuring that individuals and families receive the care and support they need
during life's most challenging moments. This yèar's achievements set a strong
foundation for Gonlinued excellence in the future period.
Impact by service area
Aco)unt oflE Hospi?'s serTh is availatAe on Our￿EbsIte..
ww.shithoL9shos ice.0
Sylvan Ward impact
Service Continuity and capacity management.. Throughout 2023-24, Sylvan Ward
m8inlained full operational Gapauty of 6 inpatient beds, providing specialist palliative
and end-of-life care without any need to reduce bed capaaty. The ward was proactive in
responding to fluctuating demands across the local community, extending capacity on
three occasions to manage seasonal pressures and admission avoidance. Notably,
from January 8 to March 31, 2024, additional beds were added to accommodate
patients with dementia. in response to requests from other parts of the health service.
Individual and Family Support.. Sylvan Ward emphasised a family-centred approach,
facilitating overnight slays for families wishing to be close to their loved ones. This
supportive environment, which was redecorated to enhance comfort, ensured that
family members could remain involved and present during critical times.
Key melri¢s=
Totsl admissions: 174, with 640/0 of Sylvan Ward stays ending in the death of the
individual and 36 % in disGharge home or to another care setting-
Average length of slay.- 13 days, indicaling a balan￿ be￿een admittFng and
planning discharge approprialely.
Bed oGcupancy'. The ward maintsined high bed occupancy rates, with 84 % in
2023124, slightly up from 830/0 in the previous year.
Number of bed days- Out of 2,522 available bed days, 2,129 were occupied.
reflecting efficient use of resources.
12

St Ni¢holas Hospice (Suffolkl
Trustees, annual report
For the ear endèd 31 March 2024
Infection control and staff management..
The Clinical team adhered slrictly to national infection pr8vention guidelines,
effectively managing isolated Covid-19 cases without any outbreaks. Despite
facing high levels of Hospice Nurse va￿ncieS, the ward ensured safe clinical
care through rigorous and responsive operational planning. co-operation with
trusted agency providers and the flexibility of our slaff. who worked across
departments lo maintain safety and quality of care. Temporary staff with palliative
care experience w8re employed to maintain consistency and quality of care.
Overall impact:
Sylvan Ward's commitment to maintaining capacity, supporting families, and adhering to
high clini(xl slandards has ensured continuous, qualily ¢are for patients. The ward's
adaptability in managing resources and staffing challenges, alongside its proactive
approach lo infection ¢ontrol, underscores its role as a reliable provider of specialist
palliative care services.
Medical Team impact
The Medical Team at St Nicholas Hospice Care has made significant contributions to
both palienl care and the broader medical community, particularly in the field of
palliative care. The key impacts and achievements for the 2023-24 period are:
Key personnel and collaborations=
The team welcomed 2 Senior Hospice Physicians into P05t, enhancing the
clinical capacity following Ihe departure of previous colleagues.
Collaboration with the West Suffolk Foundation Trust has been strengthened,
supported by Iwo additional Pallialive Care Consultanls who play a crucial role in
community care and in the shared support of people re¢eiving care in the
ommunity.
Clinical trials and research=
The hospi￿ a¢tively participated in the CHELsea 11 clinical trial. a major national
study involving 80 hOSpi￿S, investigating the impact of administering fluids by
sub-cutaneous infusion at the end of life. Under the leadership of a Senior
Hospi￿ Physician and with significant support from experienced hospiGe nurses,
the hospice ex￿eded its initial patient recruitment target, resulting in an invitstion
to extend involvement and enroll further participants into the study,
demonstrating effective engagement and ¢ontribution to the research.
Eye donation advocacy..
13

Th8 Medical Team continues to promole the right of individuals lo donate their
eyes after death. The l&am's commitment is highlighted by the Palliative Care
Consultant's leadership role as the chair of the national Hospice Eye Donation
Steering Group, which underscores the hospice's influence in national advocacy
and policy shaping.
Innovakn'ons and presentstions:
One of our Palliative Care Consultants presented significant work on Family
Adrninislered Medication at the Hospice UK Conference in November 2023. This
work focuses on creating a standardised training process for the administration of
medications by family members, aimed at ensLtring consistency and safety
across the Integrated Care System (ICS) in Suffolk and North East Essex.
Fulure planning and innovations:
The clinical leadership team is CL¢rrently exploring the feasibility of adopting
electronic prescribing and medication administration pro￿sSes, with an
anticipated implementslion timeline of 2025-26. This initiative represents a
forward-thinking approach to enhancing medication management and Glini¢al
safety, it is a significant project. which will require ¢areful planning and resource.
Overall impact..
The Medical Team has demonstrated a strong ￿MmItMent to advancing palliative care
through clinical excellence, research participation, and innovation. Their efforts not only
improve patient oulcomes bul also contribute significantly to national and regional
healthcare practices and policies. The team's proactive approach in areas like clinical
trials, advocacy for eye donation, and the development of new medication management
processes highlights their role as leaders in the palliative care field.
Out-of-hours clinical advice impact
In 2023124, St Nicholas Hospice Care's"Out of Hours Clinical Advic8" service provided
vital support to patients and families during nOn￿ffiCe hours. Our Clini¢al Nurse
Specialists and Sylvan Ward Hospice Nurses, in collaboration with the West Suffolk
Foundation Trust Early Intervention Team, delivered timely telephone advice and
assistance. This service ensured continuous care and immediate access lo professional
guidance, even outside regular hours including access to Palliative Care Consultant
advice.
Key achievernents:
Calls Received: A total of 2,664 calls were managed, with 2,628 (990/0) lasting up
to 15 minutes, and an additional 36 lasting 15-30 minutes.
Comprehensive Support.. Th6 service was fvrther strengthened by the
participation of our Trainee Advanced Clinical Practitioner, who provided on-call
14

St Nicholas Hospi¢e {Suffolkl
Trustees, annual report
For th6
ear ended 31 March 2024
support alongside our medical team, ensuring that complex cases received Ihe
necessary specialisl allention. This colleague has followed a Masters programme
in Advanced Clinical Practice. to enable them to undertake independent
assessment and diagnostic skills for people on Sylvan Ward, including Ihe
prescribing of medication and development of treatment plans.
This service highlights our commitment lo providing round-the-clock care and support,
ensuring that people in our care and their families receive the assistance they need at
any time. The efficient response times and collaboration with extemal healthcare
partners underscore the effectiveness and dedication of our team in delivering high-
quality palliative care.
Spiritual Care and Chaplaincy impact
During 2023-24, the Spiritual Care and Chaplaincy team at St Ni¢holas Hospice Care
had a significant impact on the well-being of patients, families. and the wider
community. The team handled 164 referrals, leading to 1,030 separate contacts and
125 home visits. They provided 2417 on-call support for patients on the Sylvan Ward,
including 31 out-of-hours visits, ensuring spiritual care was available whenever needed.
Community engagement and events:
The team organised bereavement events in local care homes and led
Remembrance and Christmas events, fostering a supportive environment for
grieving families.
The popular Light Up a Life events saw a 390/0 increase in attendance on the
previous year. reflecting their importance in the community.
Funerals were conducted upon request, providing personalised support for
families during times of loss.
Our Head of Chaplaincy Services {supported by the Executive Assistant to the
CEO} led the development and delivery of our 40 anniversary service 'Thankful'.
The evenl was hosted by St Edmundsbury Cathedral and attended by
approximately 600 people {including staff, volunteers, supporters, current and
previous service users). This was a momentous undertaking but an incredibly
important event marking 40 years of caring for our community.
Stsff and community well-being:
The team offered restorative aGlivtties for slaff, such as Sanctuary, Thirsty
Thursday and SPACE sessions, promoling menlal well-being.
They facilitated Bereavement Buttefflies. allowing community members to
participate in remembrance actiwties through creative means.
15

Educational and cultural Gontributions..
The team hosled Church of England ministers for placements. sharing insights
into hospice ministry.
St Nic's Sings, a community singing group, was launched as part of the hospice's
40th-anniversary Gelebrations and will conts'nue due to its success.
Additional acltvities:
The Head of Chaplaincy Gontributed to professional discourse with a soon-to-be
published artiGle on Chaplaincy and Hospitality.
Overall impact..
The Spirilual Care and Chaplaincy team significanlly enhanced the hospice's holistic
care approach, addressing nol only the spiritual needs of patients and families but also
contributing to staff well-being and ￿mmUnItY enrichment. Their work has been integral
in providing comfort, guidance, and a sense of community during times of profound
transition and loss. Through a combination of personalised care, community
engagement. and educational ¢ontributions, the team has made a lasting positive
impacl on all those they serve.
Community Team Impact
In 2023-24, the St Nicholas Hospice Care Community Team continued to provide
essential pallialive care seNices al home, even amidsl funding and staffing challenges.
The team briefly offered the Hospice Extra Support Team (HEST) service, which was
subsequently inlegraled inlo Ihe broader community palliative care framework due to
funding constraints. This integration ensured continued, responsive support for
individuals experiencing critirAI needs at the end of life.
Key achievements..
Referrals managed.. The team received 1,901 referrals, with an 89 % acceptance
rate, highlighting their robust response to community needs.
Geographic reach.. Services were provided across West Suffolk, including the
localities of Newmarket1148), Bury Town (496), Bury Rural {267), Sudbury (273},
Haverhill (264), and Foresl Heath (2281, including Thelford {138) among others,
ensuring widespread support within the community.
Operational highlights-
The team main18ined clinical safety and Servi￿ continuity across the
organisation during a period of high staff vacancy on the Sylvan Ward by
temporarily redeploying staff and implementing a business conlinuity strategy.
The implementation of a new framework for clinical safety and oversight,
induding daily briefings, weekly Multidisciplinary Team Meetings, and regular
16

St Nicholas Hospi¢e {Suffolk}
Trustees, annual report
For the
ear ended 31 March 2024
Case Review Meetings, facilitated prompt and effective responses to clinical
concerns including senior oversight for people with a deteriorating condition, or
increasingly complex need.
These efforts underscore the Community Team's commitment to delivering specialised
care, leveraging partnerships, and adapting to changing circumstsnces to ensure high-
quality palliative care services. The combination of extensive outreach, strategic
integration, and robust operational management has enabled the hospice to maintain its
crucial role in the community.
Independent Living Team (IL T) impact
In 2023-24, the Independenl Living Team at Sl Nicholas Hospice Care provided critical
support to patients, fo¢using on enhancing quality of life and promoting independence.
The team offered a range of services. addressing both physical and praclical needs, to
help patients manage their Gonditions and maintain their daily activities.
Key achievemenls and services provided:
Tolal ILT patients supported.. The team assisted 279 patients. offering
specialised ¢are tailored to individual needs.
Service breakdown..
Occupational therapy= Supported 102 patients, helping them adapt to changes in
physical abilities and mainlain their independence.
Physiotherapy: Provided 10 59 patients, focusing on improving mobility and
physical well-being.
Therapy assislance- Offered to 30 patients, providing additional support and
therapeutic intervenlions under the direction of the Occupational Therapist and
Physiotherapist.
Sylvan Ward support.. Delivered to 88 patients, ensuring comprehensive care and
assistance during their stay.
The Independent Living Team's efforts have been pivotal in supporting patients, abilities
to live as independently as possible. providing essential therapies and support that
contribute significantly to Iheir overall well-being and quality of life. The diverse range of
services offered highlighls the team's commitment to addressing the multifaceted needs
of patients in a holistic manner.
Psychological Services Team impa¢t
The Psychological SeNces Team at Sl Nicholas Hospice Care has conlinued to play a
vitsl role in providing comprehensive psychological and emotional care to both child and
adult beneficiaries. This includes pre-bereavement and posl-bereavement support.

Throughoul the year, the team experienced a notable increase in referrals, underscoring
the growing demand and increasing complexity of need for these essential services.
Key achievements and activities-
Total service referrals.. The team re￿IVed 667 referrals. reflecting the
community's need for psychological support.
Assessments and waiting lisl.. Of those referred, 690/0 completed assessments.
with 310/0 remaining on the waiting list. indicating a high demand for services.
Volunteer recruitment and Iraining: In April 2023, an open event successfully
recruiled new volunteers, following an intense six-week training course. This
initiative expanded the team's capacity to provide supporl.
Special programs and initiatives..
Nicky's Way bereavement service= This service continued to offer lailored
support for children and young people, including one-to-one and group sessions.
The programme included four after-school groups and a special activity morning
at Curve Motion, whiGh provided a joyful and supportive environment for
participating children. The annual Nicky's Way Christmas party was well-
received, with a snow machine proving extremely popular.
Educational initiatives.. March 2024 saw the launch of Nicky's Way Education,
including the creation of Conversation Starter card packs for grieving children, a
resource for parents and professionals. This initiative received positive feedback
and we distributed all our initial stock, highlighling ils importance and success.
During the year, 221 young people, 18 and under, were supported by the
hospice. Many of whom received support from the Psychological Services team.
44 ofthese children engaged in Nicky's Way group sessions.
Professional development and community engagement-
The team provided a rich learning environment for seven student placements,
enhancing their professional development.
Several Iraining sessions were conducted in various settings, including GP
surgeries, care homes, children's daycare nurseries and schools, extending the
team's impacl beyond direct client work.
The Psychological Services Team's efforts have not only provided vital support to those
directly affected by grief and loss but have also built capacity through volunteer
engagement and community training. The successful implemenlation of n8W
educational resources and the maintenance of a high level of service despite increased
demand underscore the team's dedication and effectiveness in delivering psychological
care.
18

St Nlcholas Hosplce {Suffolk)
Trustees, annual report
For the
ear ended 31 March 2024
Education impact
During the 2023-24 period, the Clinical Education Team at St Nicholas Hospice Care
delivered comprehensive training and educational support to a wide audience,
significantly conlributing to the professional development of healthcare professionals in
West Suffolk and Thetford.
Training and sessions delivered..
Total training participants: 1,311 individuals received training.
Number of sessions: 73 training sessions Covared a broad range of topics
relevant to palliative Care. many ofwhich were based upon requests from the
teams themselves having been identified training needs from clinical Pfdctice
Student placement support:
Tolal students supported: 63 students from various professional backgrounds
received hands-on placement support within the organisation.
Key educational iniliatives..
Manual handling Iraining.. Our Health Care Assistant Educator completed the
Train the Trainer course, enabling in-house delivery of essential Manual Handling
training for all clinical staff.
Collaboralion with EEAST.. A Trainee Advanced Clinical Practitioner (ACP)
developed and facililated bespoke education sessions for the East of England
Ambulance Service Trust IEEAST). This initiative allowed learners to gain
valuable insights into palliative care, including hands-on shadowing opportunities
with hospice stsff.
Advanced training for EEAST ACPS: The Trainee ACP also provided face-to-fa
training sessions for the EEAST ACP peer group. focusing on the management
of anticipatory medication for end-of-life symptom management.
Feedback and future plans:
The collaborative and practical natura of the Iraining sessions received excellent
feedbacK, highlighting the effectiveness of the hands-on. immersive educational
approaGh. Plans for further sessions in 2024-25 are in place, aiming to continue
expanding the knowledge and skills of healthcare professionals in palliative care.
Overall impact..
The Clinical Educxtion Team has made substantial contributions to enhancing
the skills and knowledge of both internal staff and external healthcare
professionals, Ihereby improving the quality of palliative Care services in the
19

region. Their efforts in providing comprehensive training and professional support
have been instrumental in fostering a well-informed and capable healthcare
workforce.
20

st Nicholas Hospice {Suffolk}
Tru$tee$' annual report
For the
ear ended 31 March 2024
Achievements against set out objectives 2023124
Infrastructure
We plan to update the building to make sure
it 15 fit for the future.
We held discussions With architects and
internal stakeholders. We have Since focused
on assessing our clinical areas alongside what
we can do to make improvements for our
dedicated staff and volunteers.
Service objectives
We will develop our service5 based on equity, We began a primary research study to
diversity and inclusion across our community. understand our organisational position
regarding equity, diverslty and inclusion. We
will use this knowledge to develop and
deliver our EDI Strategy, to develop services
based upon EDI.
We willensure our 12-1x1 inpatMtward rur6
effect￿e￿a￿l we have the caparityt05UPFK¥t as
many ￿tientsa5 PC69ble.
We have made significant stride5 to recruit
new staff, increasing our ward team size to
achieve an increase in capatity.
We will relaunch H05pice outpatient services
Clinical nurse Specialists, our Independent
to make most effective use of our resources
Living team and our Complementary
to reach more people in our community, and Therapist have begun to offer outpatient
locality-based hospice day services to reach
clinics on the hospice site and our Clinical
those in underrepresented areas of our
Nurse Specialists are also providing some
community.
outpatient cllnics at our Haverhill Hub. We
launched a campaign to deliver on the
recruitment of staff required to support the
opening of an additional 6 beds on Sylvan
Ward. taking capacity to 12 beds. This
enables us to extend our reach and widen
access to deliver 5UPPOrt for more people
who need Sylvan Ward care.
We will actively champion for a virtual ward
We have provided clinical training for staff
service which will meet the needs of people
nvolved in Virtual Ward, ensuring that they
at the end of Ilfe in West Suffolk and play our are equipped to recognise dying and act
part in ensuring the delivery of it.
appropriately, and that palliative care
21

interventions and emergencies are
responded to in a timely manner.
We will work with our local health and social Our Director of Care is the Executive Lead for
care partners to cooperate and coordinate,
the West Suffolk ICS Die Well Group, which is
so that we give our patients the best care.
tommitted to collaborative worklng in order
to coordinate palliative and end of life care.
People and culture objectives
We will use creative solutions and
We have continued to review our strotegies
opportunities to develop and deliver the
to enhance the skills, capability and capacity
workforce of the future so that we have a
of the workforce, both paid and voluntary.
robust staff and volunteer workforce
We have introduced new role5 and
matched to beneficiaries needs and a defined developed existing staff into these role5. We
progression pathway with fitting support,
have developed a new pay structure which
remuneration and opportunities for
will better ref lect the skills, qualrfications and
development.
responsibilities associated with each position.
We will implement a new pay and reward
structure based on the outcomes of our
organisation wide Job Evaluation project.
We have successfully progressed with our job
evaluation project and have completed a
comprehensive review of all job descriptions
within our organisation, conducted an
extensive benchmarking review to ensure
competitive market positioning and
developed our new pay structure.
We will embed the revised values of
Compassion, Respect, Accountability and
Equity throughout our paid and volunteer
workforce.
We have, through the Leadership Team,
engaged staff in deep discussions about our
new values, and inserted the values into
communications. To ensure that these are
constantly reflected across all areas of the
organisation, we started the process of
embedding these values within human
resources processes including
recruitment/selection,
onboarding/orientation and performance
management.
We will appoint to a Volunteer Coordinator
role and refresh the volunteering strategy.
We reviewed our volunteering resources and,
based on our findings, developed a job
description for the position of Volunteer
Coordinator, recruiting in 2024125.
22

St Nlcholas Hospice (Suffolkl
Tru$t¢o$' annual report
For the ear ended 31 March 2024
Fundlng objectlves
We will develop and implement a new,
integrated Income Generation strategy to
aliEn retail and fundraising activity and
deliver a £lm increase in net contribution by
year three.
Work was initiated on this, but further work
is needed in 24125 given the financial
pressures we and other hospices are
currently facing. An external review of our
Retail operation is also planned.
We will scope and launch a significant 'Fit for
the Future, appeal to fund the upgrading of
the hospice estate to support safe and
excellent patient and family care and a
facilitative working environment.
We continue to secure restricted *unding to
Improve the hospice estate but will be using
24125 to review the potential for a future
capital appeal.
We will increase core income through robust We have participateLI in ongoin8 negotiations
commissioning relationships and a revised
with Suffolk & North East Essex Integrated
income generation and retail strategy.
Care Board about our statutory fundin8
alongside our partner SNEE hospice5. The
outcome of this will be communicated in
Autumn 2024. Sadly, the grant funding that
we receive from Norfolk and Waveney ICS for
the care of people in Thetford was not
renewed, with very little advance notice
given. SNHC continues to challenge this
decision.
Flnancial & administration objectives
We will embed the new IAccessl finance
We have successfully implemented the new
System to support the achievement of agreed finance system. This has enabled us to
budgets. and to ensure longer term financial
streamline processes and develop more
and service sustainability through strict
effective workflows,. enhance compliance and
financial contro15 and compliance with the
provide better user experience and
reserves policy and by increasing source5 0*
functionality. We also began to modify and
income.
introduce analytical and reporting features to
enhance financial management.
23

Environmental, social and corporate governance objectives
We will use data to support service design
We have invested in expertise to ensure that
and demonstrate patient outcomes, develop
we are using our electronic patient record
digital resource5 that support data driven
system more effectively. We engage with ICS
decision making and our ability to engage
olleagues to review data relating to patient
with a population health analysis of palliative outcomes during the last year of life. We will
care need in West Suffolk and Thetford.
review our digital resource5 in order to
develop analytical tools.
We will ensure robust clinical 8overnance
processes.
We are confident in the use of RADAR
software, which supports governan
processes. We have begun the process of
adopting the Patient Safety Incident
Response Framework IPSIRFI into our
proce55e5, having received support from ICS
colleagues. We have also introdured
additional clinical governance processes to
maintain safety.
We will aspire to reach carbon neutrality.
We have ensured that all our sites use lOO%
renewable electricity, and we continue to
implement changes in how we operate,
including installation of new energy efficient
lighting.
24

St Nlcholas Hospice {SL¢ffolkl
Tru$tee$' annual report
Forthe
ear ended 31 March 2024
Financial review
The consolidated financial statements indude 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 2023-24 financial year saw ongoing financial challenges, predominately associated
with the cost-of-living crisis and associated pay increases, bul these pressures were
negated, during Ihe year, by higher-than-average legacy income and savings from
several vacant posts.
The financial outturn was a small net operating surplus of £0.01m which was a
signific2nt improvoment compared with the deficit plan and the previous year. Our
investmenl portfolio resulted in net realised and unrealised gains of £0.28m which
increased the surplus, meaning that there was an increase in our reserves of £0.29m
from £8.38m (2023} to £8.67m. The trading activity of St Nicholas Hospi￿ Trading
Limited {consolidated in the above figures) produced a similar lurnover to the previous
year but an increase in profit to £0.07m (2023.. £0.05m).
The resulls are detailed in the accounts and are as follows..
2023124
£OOOs
2022123
£OOOs i
Income
Donations & Legacies
Charitsble activities (NHS income)
Shop and other trading income
Other fundraising activities
Investment income
Other income
Total income
2,231 i
2,237
1.780
543
140
1,883 j.
1,859
448
185
6.931
Expenditure
Shop and other trading costs
Fundraising costs
Charitable expenditure
Other
Total expenditure
Net gains l (losses} on investmènts
Net operating income l (expendituro)
2.262 1
885
4,261 i
31
7,439 i
278
285 |
2,024
646
4,340
33
7,043
(290)
{402)
25

Income
Income increased appre¢iably from £6.93m to £7.45m. However, income from
charitable activitses reduced from £2.23m in 2022-23 to £1.88m in 2023-24. This was
largely because the non-recurrent funding (£0.61m) from the Suffolk and North East
Essex (SNEEI ICS, specifically to provide a new service (HEST, HospicE Exlra Support
Team) for patients at home, for a 12 month period. was withdrawn in 2023-24.
Additional funding of£O.06m was received as we continued to work in partnership with
our local ICSS lo provide our services and help to reduce the overall burden on the
NHS.
This funding was in addition to a 3.60kn {£0.05m) uplift to the core grant in recognition of
cost pressures.
Overall, income generation was £5.38m, significantly greater than £4.55m achieved in
the previous year. Some income generation aclivilies, particularly fundraising. were still
hindered by the longer-term impact of the pandemic and together with a change in the
fundraising portfolio, resulled in several of our income streams falling below the
previous year. Lottery, individual giving, and events were most adversely affected.
Conversely, we received legacy income1£1.65m) which exceeded the five-year average
and was £0.48m higher than the previous year {2023'. £1.17m), philanthropy and trust
income was particularly strong. The hospiGe also benefited from continued growth in
retail income in line with the positive trend across the charity retail sector.
Expenditure
Expenditure has increased by £0.40m from £7.1)4m to £7.44m160A increase). In
recognition that pay had fallen behind that of other comparable employers, a job
evaluation exercise was undertaken to review pay for staff.
The first phase was implemented, adding approximately £0.2m to our cost base during
the year {for which funding was held in the Job Evaluation designated reserve). Ovorall
expenditure on charitable activities decreased due to the termination of the non-
recurrent funding for HEST which was received in 2022-23. There was a significant
increase in expenditure on income generation activities due lo a restructuring of the
directorate and increased activity as new evenls were established.
The ongoing cost-of-living pressures continued to increase our cost base, notably in
respect of IT systems and software, telephony, professional fees and servI￿s, and
energy costs. Despite the cost pressures, the vacancy gap savings across the hospice
resulted in lower Ihan budgeted expenditure.

St Nicholas Hospice (Suffolk}
Trustses, annual rèport
For the
ear ¢nd8d 31 March 2024
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 independent
investment managers, Rathbones Investment Management Limited and Sarasin &
Partners LLP, appointed by the Board of Trustees. The Trustees. through the FinanGe
and Income Generation Committee (FIGI, consult wilh the investment managers, to
take advice on the management of the portfolios and to monitor their performance.
During the year. no drawdown was required to support the operational cash flow and
together with realised and unrealised gains, our investment funds increased in value by
£0.34m to £4.46m. The perfomance of the portfolios was a significant improvement
from the £0.29m realised and unrealised losses in the previous year.
The Hospice investment policy remains unthanged. Over the long-lerm, we aim to
maintain and increase the real capital value of the investment funds to achieve retums
from a diversifi8d portfolio of equitie5, fixed inlerest securities and cash within a mèd ium
to low riskl reward profile as agreed by the Finance and Income Generation Committee.
Where appropriate and within the inveslrnenl objectives, Ihe Trustees will attempt to
invest in ethical and socially responsible organisations and include enmronmenta I,
social and corporate governance IESGI considerations. The Finance and Investment
Committee considered that the investment account had performed satisfactorily given
the market conditions.
Reserves
The reserves policy. agreed by the Trustees, remains unchanged and requires that the
Charity musl hold a minimum level of free reserves equivalent to approximately six
months, worth oftotal running costs, circa £3.8m. This ensures a balance be￿een
sustainability, to conlinue to support beneficiaries in a period of financial downturn and
the avoidance of excessive reserve balances, to enable funds to be invested in future
Hospi￿ services and revenue-generating projects.
Free reserves (including investments} at the end of the year equaled to £6.48m {2023-.
£6.13ml or the equivalent of approximately 10 months, worth of total wnning costs. The
designated reserves {£3.24m), included in the free r8seNes, are lower than last year
{£5.59m) following the decision of the Board to un-designate the building mainlenan¢e
fund (£2.25ml. There is a new designated reserve of £0.10m following a donation to
create the Simon Steady Memorial Fund. The designated funds are as follows..
Fixed Asset fund (£2.01m>
This is a designated fund representing the construction costs of the original
building 10 31 March 2024 less depreciation.
27

Maintenance fund (£ NIL
This designated fund {previously named New building and mainlenance fund) for
the purposes of maintaining and updating the èxisling hospice building and
allocating funds for future building requirements. During the year. Ihe Board of
Trustees decided to un-designate the reserve.
IT systems fund (£0.22m)
The charity has a number of IT systems and hardware which require replacing or
upgrading to develop greater resilien¢e, functionality and efficiency to support the
services we deliver and the way in which we work. The designated reserve was
insufficient to support the required investment and the Trustees approved an
increase of £100,000 in November 2022. This fund has not been drawn on during
2023124.
Service development fund (£0.47m)
The purpose of this fund is to develop and test new service delivery models
across our entire service offering in all seltings. The fund will continue to support
the ongoing development, testing and planning of services. This fund has not
been drawn on during 2023124.
Income generation fund (£0.40m)
The fund is to develop incorne 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 2023124.
Job evaluation fund (£0.05m)
The fund is lo support the costs associaled with the job evaluation programme.
which commenced in 2023124, and the potential resultanl increase in staffing
costs, for a maximum period of years. Thereafter, the resultant staff costs will
be accommodated within the operating costs ofthe hospice. The costs of the
implementation of the first phase of the job evaluation programme have been
charged againsl this fund in 2023124.
A new fund has been de&gnated by the Trustees in 2023/24."
Simon Steady Memorlal Fund I£0.10m>
The fund of £100,000 was established from a donation and is to support children
and young people who have been bereaved {or are expected to be bereaved in
the near future i.e. pre-bereavemenl support).
28

St Ni¢holas Hosplce ISLrffolk)
Trustees, annual report
Fof the oar endèd 31 March 2024
Total reserves at the end of the year incffased to £8.67m (2023.. £8.38m), ofwhich
£0.13m {2023-. £0.11m) were restricted. The Charity also benefits from the Earl of
Euston 2009 Endowment Fund of £47k. The attributed income from this fund was used
in furtherance ofthe objectives of the Hospice.
Going concern
In common with many other charilies, 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 and cost-of-living crisis.
The Trusleès have considered the following areas specifically in their assessment of
going Con￿rn..
Fundraising
St Nicholas Hospice Care has a diverse range of income-generating activities
including granls and donations, investments, fundraising. retail. events and
lottery income. Some of these income slreams are inherently volatile and our
income generation strategy continues to evolve in recognition of the residual
hallenges ofthe pandemic and the currenl economic climate. In addition, the
Charity has policies in pla￿ 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 in¢ome streams will add
to this diversification and anable the Charity to conts'nue serving our local
population.
NHS Grant Funding
The Suffolk and North East Essex {SNEE) Inlegraled Care Board (ICBI is the
main NHS funder and continues to support the work of the Charity. The Charity
and SNEE ICB have commenced discussions to establish a new funding
agreement across all SNEE hospices which should have come into effect from
April 2024 when the previous 4-year agreement with STNH ended. However, the
analysis of direct costs across all three hospices has proved more complex than
was first envisaged. so the hospi￿ received a temporary extension of ils
previous grant whilst Ihe final financial modelling is completed. A small amount of
funding, £79k, is also normally re￿iVed from Norfolk and Waveney ICB but.
sadly, SNHC was advised on the 26th March 2024 that the grant agreement
would nol be renewed on 1st April 2024. The hospice continues to challenge this
decision.
29

Reseryes policy and Going Concern
At the end of the financial year 2023-24, the Charity has reserves amounting to
£8.67rn ofwhich £6.48m are free reserves, which exceeds the minimum target
criteria of six months totsl running costs. This allows for investment in servI￿s,
income generation and infrastnjcture to further the Charity's aims and objectives
as well as providing funds to mitigate against economic uncertainty including any
future impact of another pandemic andlor the cost-of-living Crisis.
The trustees have reviewed the circumstances of St Nicholas Hospice Care and
its group company and consider that adequate resources Gontinue to be
available lo fund the activities of the charity and the group for the foreseeable
future. The trustees are of the view that St Nicholas Hospice Care and the group
company are a going concem and likely to remain so for the foreseeable future.
Principal risks and uncertainties
The trustees have the overall responsibility for ensuring that the charity has an
appropriate system of controls, finanGial and otherwise. The trustees and management
team work closely together in policy setting and monitoring to ensure Ihat the charity is
working to the highest stsndards. The truslees have a risk management strategy that
includas..
Maintaining a risk register covering all parts of the organisation,.
Regular reviews of the risks the charity may face.
Establishment of systems and proc8dures to mitigate risks idenlified in the plan.
Maintaining adequate Insuran￿ cover.
The major risks the charity manages are as follows..
Fundlng and financial sustainability
Risks: Reduced opportunities for statutory funding., economic uncertainty and
cost-of-living increases impa¢ling expenditure levels, incorne generation and
investments.
Mitsgation.. We are committed to divèrsifying our funding SoUr￿S by seeking
grants, fundraising. trading through retail oullels, and appealing for donations
and gifts in wills and implementing a robust financial forecasting process to
manage cosls effectively. We are engaging with a national legacy programme
(hosted by Hospice UK) which launches at the beginning of 2025, and we will be
outsourcing our in-house lottery programme from January 2025 to enhance the
return on investment of this activity-
20

St Nlcholas Hospic• {SLrffolk}
Trustees. annual report
Foythe
ear ended 31 March 2024
Regulatory and compliance..
Risk.. Hospice operations are facing a growing and increasingly complex
regulatory environment {heallhcAre, health & safely, fundraising and trading).
Mitigation: Our dedicaled compliance team will continue to monitor evolving
regulations, conducl regular audits to ensure adherence, support the
development of effective policy and prO￿dure, and provide ongoing staff and
volunteer Iraining to maintain compliance with changing requirements. We are
aware that we have not received a full CQC assessment since 2016. We adopt a
partnership approach to our relationship with CQC and continue to prepare to
demonstrate our safe, caring, responsive, effective and well-led care and
practice, as required.
Workft>rce and stafflng..
Risk.. Shortage of skilled professionals, increased agency costs and staff bumoul
due lo the impact of managing vacancies.
Mitigation: We recognise Ihe Importan￿ of our Workfor￿ and will strive to offer
competitive compensation packages, invest in professional development
opportunities, implement measures lo prevent staff burnout. and foster
partnerships with relèvant professional and educational institutions to ensure a
skilled workforce. The first stage of a whole organisation job evaluation project
has been completed, which will result in increased salary rates for all stsff in
2024-25.
Patlent care and quality..
Risk: Failure to provide consistent, safe, high-quality care and deliver patient
satisfaction.
Mitigation.. We are dedicaled lo maintaining a high slandard of care through
rigorous quality assurance programs. continuous staff training through continued
professional developmenl, our inlemal education resources, and open
communication channels with our patients and their families lo address their
needs effeclively. The charity is regulated by the Care Quality Commission
(CQC) and subject to onsite inspections and regular meetings to disGuss
compliance matters.
Community engagement and reputation
Risk.. Loss of positive reputation andlor inability to address misconceptions
results in poor perception and decreased support for Hospice.
31

Mitigation- The charity employs specialist resources to manage public relations
8nd communications, dala and cyber security, health and safety, HR Law.
fundraising practicE and patient safety.
Legal and liability."
Risk.. Potential issues arising from management of legal claims.
Mitigation.. We maintain thorough documentation. invesl in liability insurance. and
implement policies aligned with legal standards.
Fraud, data management and other irregularltles..
Risk: System or procedural failures result in loss of income, identity theft,
compromised data integrity, cyber-attack andlor data breach.
Mitigation: We ensure that proper recnrds are maintained and archived
approprialely, that robust data security measures are in place, and adequate
training is provided for staff.
Fundraising practices
St Nicholas Hospice Care employs a core fundraising staff team lo develop, promote
and deliver a range of fundraising activities, assisted by vilal volunteers and laken up by
our SUPPDrters. We steward our donors and promote our fundraising campaigns to
them. and the wider community which we serve. through printed media, direct mail, e-
mail, telephone and digital channels.
We constantly monitor the cost and time which goes into each fundraising activity
against the financial return to ensure we are making Ihe most of every donation
received.
We are registered with the Fundraising Regulator and the Gambling Commission and
work in accordance with the Code of Fundraising Practice, and the best practice laid out
by the Hospice Lotteries AssoGiation. Chartered Institute of Fundraising and Institute of
Legacy Managemenl. Our staff are encouraged to be actively involved wilh these
organisalions at a strategic level and we meet the standards required of these
memberships.
Our lottery and raffles are promoled in accordance the Gambling Commission
guidelines, and we have checks in place to monitor third parties who c8rry oul work for
us, or whom we enter into contracts with. We appraise the commercial marketplace
before engaging in contracts with others and ensure our supporters enter into written
agreements wilh us when promoting or selling products or activities which raise funds
for us. This year, we didn'l get any requests from the publi¢ to stop contact through the
Fundraising Regulator, and we received Iwo complaints about fundraising.

St Nlcholas Hospice (Suffolk)
Trustses. annual report
Forthe
ear ended 31 Mar¢h 2024
We review the frequency and approprialeness of our communications and provide an
option for supporters to 'opt-OUt' of being contacted. We contact based on legitimate
interest or consent, as appropriate depending on the format of the communication. For
gambling-related products we follow Gambling Commission guidance, promoting
Gamble Aware throughoul our advertising, and including a self-èxclusion form on our
website. We continue to listen lo our supporters and to learn from them to shape our
fundraising activity- Our supporters are very important to us, and we pul them at the
heart of everything we do.
33

Plans for future periods
Our future plans will develop in line with our Vision and Mission and under our four new
strategic aims established in March 2023 whith are..
Provide high-quality. responsive and accessible specialist palliative care and
psychosocial support. putting the person at the Gentre of all we do.
Enable our communities lo develop their understanding of end-of-life issues,
build mutual support and resilience, and utilise their assets lo remain
independent for as long as possible.
Proactively develop robust strategic partnerships to ensure best end of lrfe care
for the people of Wesl Suffolk and Thetford.
Thrive as a safe, effective and sustainable organisation, which is driven by
eviden¢e-based innovation and where our values are lived in all that we do.
Inlrastructure objectives
The Board recognises that the Hospice's building, based in Bury St Edmunds, is
now thirty years old and requires maintenan￿. We plan to update the building to
make sure it is fit for the future and offers a high-quality experien￿ for our
patients and families, stsff and volunteers, regulators, and commissioners.
During 2023-2024 we have begun to idenlify the areas for refurbishment and to
consult with stsff on the same. In 2025 we will continue to scope the Gosls of the
desired improvements and to plan for a capital campaign to achieve the requisite
funding.
Seryice objectives
Widen access~ develop our services based on equity. diversity. and inclusion
across our community.
Achieve effective use of our increased 12-bed capacily, including recruitment to a
new administrative role. which will effectively manage discharge procedures to
sustain bed ocGupancy at 850/0.
Relaunching Hospice outpatient services to make most effective use of our
resources to reach more people in our community, and locality-based hospice
day services to rea¢h those in underrepresented areas ofour community.
Progress relaunch of oulpatienl services by developing Clinical Nurse Specialist
and Trainee Advanced Care Practitioner workstreams, alongside continued use
of Consultant Clinics.
Work in partnership with neighbouring hospices to develop a robusl Provider
Collaboralive to reduce inequity and ensure consistent, adequately funded

St Nicholas Hosplce (Suffolk)
Trustees, annual report
For the
ear ended 31 March 2024
provision of end-of-life and bereavement care across Suffolk and North-East
Essex.
Collaborate in the Suffolk and North East Essex Education Collaborative
alongside St Elizabeth Hospice and St Helena Hospi￿ to create an equitable
approach to specialist clinical eduGation in the Integrated Care System.
Champion Ihe West Suffolk Foundation Trust virtual ward service by contributing
to the education of staff, who deliver palliative care for Ihis group of patients.
We work with our local health and social care partners to cooperale and
Coordinate, so that we give our patients the best care.
We are piloting an Out-of-Hours service with funds from the Better Care Fund.
The pilot will be for one year and will be proof of concept to identify the potential
need for overnight visiling.
People and culture objecfives
Sustainable workforce- Use crealive solutions and opportunities to develop and
deliver the workforce oflhe future so that we have a robusl staff and volunteer
workforce matched to beneficiaries needs and a defined progression pathway
with fitting supporl, remuneration and opportunilies for development.
Sustainable workforce- Continue developing and delivering the workforce of the
future. ensuring a robust staff and volunteer workforce matched to beneficiaries
needs or organisational operational requirements by using creative solutions and
opportunilies for progression and remuneration.
Pay- Implement a new pay and reward structure based on the outcomes of our
organisation wide Job Evaluation project.
Embed the revised values of Compassion, A¢¢ountability, Respect, and Equily
(CARE), throughout our paid and volunteer workforce.
Appoint to a Volunteer Coordinator role and refresh Ihe volunteering strategy.
Fundlng objectives
Develop and implement a new, integrated Income Generation strategy to align
retail and fundraising activity and deliver a sustainable increase in net income.
Continue to scope a ' Fit for the Future, appeal to fund the upgrading of the
hospice estate lo support safe and excellent patient and family care and a
facilitative working environm8nt.
Increase core income through robusl commissioning relationships and a revised
income generation and retsil strategy.
35

Financial objective
Embed the new (Access) finance system to support the achievement of agreed
budgets, and to ensure longer term finanGi81 and service sustainability Ihrough
strict financial controls and Compliance with the reserves policy and by increasing
sour¢es of income.
Environmental, social and corporate governance objectfves
Data quality- Use data to support service design and demonstrate patient
outcomes. develop digital resour¢8S that support data driven decision making
and our ability to engage with a population health analysis of palliative care need
in West Suffolk and Thetford.
High quality care - Ensure robust clinical governance processes.
Environmentsl sustainability is one of the Hospice's strategic priorities - The
organisation aspires to reach carbon neutrality by combining efficiency measures
across the hospice and engaging with external organisalions that support
emission reduction. Durin9 Ihe past year, we considered alternative energy
sources and continued our program lo become more energy-efficient by
introducing new energy-efficient lighting syslems.
Joint Closing Remarks." Celebrating 40 Years and a call for continued
support
Chair:
As we Gommemorate 40 years of St Nicholas Hospice Care, we celebrate not only the
care we have provided but also the community that has made il possible. Our
supporters-whether donors, volunteers. or parlners-are the cornerstone ofour ability
lo provide compassionate care. But we cannot rely on this support alone. We must
continue to advocale for the finanaal fesources neGessary to maintain and grow our
services and build on the foundation we have created over the past four decades.
CEO:
In the months leading up to and beyond our Annual General Meeting in December, we
will continue to raise awareness of the financia5 challenges facing our hospi￿ and the
sector. Your continued support is vital to ensuring that no one in our community is left
without the care they need at the end of life. Together, we can build a sustsinable future
for hospice care. where essential services are not only preserved but enhanced,
ensuring St Nicholas Hospi¢e Care remains a vital resour￿ for generations to ¢om8.

St Nicholas Hospice (Suffolk)
Trustses. annual report
For the
ear ended 31 March 2024
Structure, governance and management
Management and decision-making
Sl Nichola5 Hospice (Sufft)Ikl is a company limited by guarantee, incorporated on 24th
August 1983, and registered as a charity on 4th November 1983, and is governed under
its Memorandum and Articles of Association, through a 62-strong membership
association comprised of persons from the community. The Association. in turn,
appoinls and monitors the performance of the trustees. It delegates the effe¢tive
governance of the charity to the Board of Trustees and receives reports al leasl once
per annum. The full Board of Trustees meets six times per year lo review performance
and delivery of the strategic plan. Addilional meetings are held to cover specific areas of
focus, review strategy and direction, and the governance arrangem8nts in place.
Our trustees
The Board of Truslees is made up of no less than 58v6n and no more than ￿e1ve
trustees.
All trustees give their time voluntsrily and receive no benefits from the charity- Any
expenses reclaimed from the charity are set out in note 19 to the accounts.
Board of trustees. committees
During the year, the board has Continued to operate four committees with specific lerms
of reference and functions delegated by the board and with a trustee as chair appoinled
by the board - Clinical Committee, Finance and Income Generation Committee, the
Human Resources Committee, and the Remuneration Committee. These commiUee5
include co-opted, associate, members with relevant experience from the association
and the trustees. Truslees, aside from the chair, serve on al least one sub-committee.
The meetings are allended by Ihe Chief Executive Officer and relevanl director{s), other
directors or heads of departments attend when requested. The committees review
directorate KPIS, monitor risk, incidents, complaints, health and safety and director's
recommendations for developments. The chair of each committee reporls back to the
board aboul matters discussed at each meeling.
The Clinical Committee oversees all clini(al matters with particular reference to
palliative care and clinical standards and medicines management. It monilors
Performan￿ and quality. The meetings are attended by the Chief Executive Officer, the
Clinical Services Director, the consultant in palliative medicine, the head of nursing and
quality and the head of supportive care.
The Finance and Income Generation Committee manages charity finan￿S, reviews
finan¢e stralegies, audit statements. and oversees external audit actions. Attendees
37

include the Chief Execulive Officer. Corporate Services Director, Income Generation
Director. and the Head of Finan￿.
The Human Resources Committee monilors employmenl 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 Operalions Manager.
The Remunerats'on Committee meets On￿ a year to agree the Chief Executive Officer
and Directors, remuneration. The meetings are attended by the CEO, committee chairs
and the chair ofthe Board of Trustees. Although this committee consists ofa subset of
the board of trvslees, any decisions are taken by Ihe full board.
The Board of Trustees fulfil their key role and funclion 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.
Management and Leadership
The day-to-day running ofthe Hospice is entrusted to the Chief Executive Officer who
delegates thal work through the directorate and lèadership team to Ihe staff and
volunteers deployed across the charity's services.
The Chief Executive Officer chairs a weekly directorate meeting with the Clinical
Services Director. Director of Corporate Services. and Diredor of Income Generation.
The directorate mgets regularly with the leadership team, which is comprised of heads
of services. The Chief Executive Officer meels forma51y with Ihe Chair of the Board of
Trustees andl or Vice Chair at least once a month.
Internal communication.. A regular all-staff meeting, emails. newsletters, stsff intranet
and internal social nelwork ensures good communication a¢ross all levels of staff and
aGross the entire operation.
Trustee recrultment and appointment
Atl current board members have been appointed based on their experience and
expertise, their involvement in the community. and their commitmenl and passion for Ihe
work of St Nicholas Hospice Care and the hospice movement in general.
The board chair and the committee chairs oversee the process of succession planning,
recruitment and induction of Iruslees 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.
Prospective trustees undergo a Ihorough recruitsnenl process which ensures that they
align with the fit and proper person's test and can add value to the governance of the
hospice. All appointments to the board are confimied by the association at its Annual
General Meeting (AGMI.
38

Sl Nicholas Hosplce (Suffolk)
Trustees, annual report
For the ear ended 31 March 2024
Trustee Induction and training
New trustees receive introductory infomialion. induding national guidance about being
a Irustee and information relevant to the governance and life of the Hospi¢e. A staged
induction programme orientales them to the various departments of the hospice and
provides the opportunity lo engage with staff holding responsibility for oversight for
these, this includes seeing the work of the charity first-hand. All trustees are expected to
undertake stslulory and mandatory training including safeguarding training. This year
we have appointed two of our trustees to take a lead role on safeguarding wthin the
hospi￿.
Chair
Trustees eled a chair and vice chair from within their numbers. There is no limit to the
number of times a person can be elected or elected to a specific role with the board.
The current chair is Anne Fisher, and the VI￿ Chair is Kale Vaughton.
Related Parties and relationships with other organisations
None of the trustees receive remuneration or other benefilfrom their work with the
charity or St Nicholas Hospice Trading Limited.
St Nicholas Hospice Care and St Nicholas Hospice Trading Limited requires trustees
and executive directors lo dedare any interests thal they may have oulside of the
charity. Transactions and contractual relationships with related parties musl be
disclosed.
Employee information
Recruitment
Average headcount figures for 2023124 were 154 compare(I to 163 in 2022123.
Average full-time equivalent (￿E) figures for 2023124 were 117 compared to 127 in
2022123.
Remuneration and benefits
Employee Costs were £5.31 m compared to £5.12m last year.
52 employees ara in Ihe NHS pension scheme (principally clinical staff), and 107
employees are in the Aegon Group Personal Pension Plan.
Employers, contributions to the NHS pension scheme were made at the rate of 20.60/0
(plus 0.080/0 for the NHS pension administration, the same applied to 2023 figure..
20.68¢/0). The increase from 14.3010 {plus 0.080/0 administration fee - same for 2023) is
still being funded by the NHS Pension Schemes transitional arrangements resulting in
39

no additional costs to the charity- This transitional arrangement is lo continue into
2024125. Employee contributions ranged from 5.10/¢ to 13.5 0/0.
Employee wellbeing
The Hospice continues to implement its wellbeing slrategy which incorporates a group
of wellbeing champions and mental health first aiders.
Development of staff
The key focus areas for 2023124 were to focus on continued compliance with all
mandatory and stalutory training and development of staff members, focusin9 on
promoting internal nursing talent in response to recruitment challenges.
Statement of Trustees, responsibilities
The truslees (who are also direclors af St Nicholas Hospice {Suffolk} for the purposes of
company law) are responsible for preparing the Trustees, Annual Report and the
financial ststemenls in accordance with applicable law and United Kingdom Accounting
Slandards (United Kingdom Generally AC￿pted A¢¢ounting 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 Ihat they give a true and fair view of the state of affairs of the
charitable company and the group and oflhe incoming resources and applic£tion of
resources, induding the income and expenditure, of the charitable company and the
group for that period. In preparing these financial slatemenls, the trustees are required
to=
Selecl suitable accounting policies and then apply them consistently.
Observe Ihe methods and principles in the Charilies SORP 2019 IFRS 102}.
Make judgements and estimales that are reasonable and prudent.
State whether applicable UK accounting standards have been followed, subject
to any departures disclosed and explained in the financial statements.
Prepare the financial statements on a going Goncern basis unless it is
inappropriate lo presume that the group will continue in operation.
The trustees are responsible for maintsining proper accounting records which disclose
with reasonable accuracy at any time the financial position of the group and lo 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 deleclion of fraud and other irregularities.
The truslees are responsible for the Maintenan￿ and integrity of the corporate and
financial information included on the company's website. Legislation in the United
40

St Nicholas Hospice ISuffolk}
Trustees. annual report
For the
ear ended 31 March 2024
Kingdom governing the preparation and dissemination of the financial slatements and
other information included in annual reports may differ from legislalion in other
jurisdictions.
In so far as the trustees are aware=
There is no relevant audit infomiation of which the charitable company's auditor
is unaware.
The trustees have taken all the steps Ihey ought to have taken lo make
themselves aware of any relevant audit information and to establish that Ihe
charity's auditor is aware of the information.
Small company provisions
This report has been prepared tsking advantage of the small companies, exemption of
section 45A ofthe Companies Act 2006.
The auditor is deemed to have been re-appointed in aGGordance with section 487 of the
Companies Act 2006.
This Annual Report was approved by the Trustees on 5 December 2024.
Anne Fisher, ￿81r
41

St Nicholas Hospice (Suffolk)
Company limited by Guarantee
Independent Auditor's Report to the Members and Trustees of St
Nicholas Hospice (Suffolk)
Year ended 31 March 2024
Oplnion
We have audited the financial statements of Sl Nicholas Hospice (Suffolkl (the 'parent
charitable company,) and its subsidiary {the 'group'l for the year ended 31 March 2024
which comprise Consolidaled Statement of Financial Activities (including income and
expenditure account). Consolidated Balance Sheet, Consolidated Statement of Cash
Flow and notes to the finanGial stat8ments, including a summary of significant
accounting policies. The financial reporting framework thal has been applied in their
preparation is applicable law and United Kingdom Accounting Standards, including
Financial Reporting Standard 102 The Financlal Reporting Slandard applicable in the
UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practi￿).
In our opinion the financial statements:
give a true and fair view ofthe state of the group's and parent charitsble
company's affairs as at 31 March 2024, and of the group's incoming resources
and application of resources, including its income and expenditure, for the year
then ended-
have been properly prepared in accordance with United Kingdom Generally
Accepled Accounting Practice..
and have been prepared in accordance with the requirements of the Companies
Act 2006.
Basis for opinion
We conducted our audit in accordance with International Standards on Auditing (UK)
{ISAs {UK)} and applicable law. Our responsibilities under those stsndards are further
described in the Auditors responsibilities for the audit of the financial statements section
ofour 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.
42

St Nicholas Hospice {Suffolkl - Company limited by Guarantee
Independent Auditor's Report to the Members and Trustees of St Nicholas Hospice (Suffolk)
For the
ear ended 31 Ma￿h 2024
Conclusions relating to golng concern
In auditing ihe financial statements, we have concluded Ihal the trustees, use of the
going concern basis of a¢counting in the preparation of the financial statements is
appropriale.
Based on the work we have performed. we have nol identified any material
uncertainties relating to evenls or conditions that, individually or collectively, may cast
significant doubl on the group and parent charitable company's ability to continue as a
going ¢oncern for a period of al least twelve monlhs from when the finanaal statements
are authorised for issue.
Our responsibilities and Ihe responsibilities of the trustees with respect to going concem
are described in the relevant se¢lions of this report.
Other information
The other information comprises the information included in the trustees. annual report.
other than the financial statements and our auditor's report thereon. The trustees are
responsible for the other infomiation. 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 nol express any form of assurance condusion thereon.
Our responsibility IS to read the other information and, in doing so, consider whether the
other infonnation is mater*ally inconsistent with the financial statements or our
knowledge obtained in Ihe 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 material misstatement in the financial
ststemènts 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.
Oplnions on other matters prescribed by the Companles Act 2006
In our opinion, based on the work undertaken in the course of the audit..
the information given in the trustees, report which includes the directors, report
prepared for the purposes of company law, for the financial year for which the
financial statements are prepared is consistent with the financial statements. and
the directors, report included within the trustees, report has been prepared in
accordance with applicable legal requirements.
43

Matters on which we are required to report by exception
In the light of the knowledge and understanding of the group and parent charitable
company and ils environment obtained in the course of the audit, we have not identified
material misstatements in the directors, report.
We have nothing lo report in respect of the following matters in relation to which the
Companies Act 2006 requires us to report to you if, in our opinion..
adequate accounting records have not been kept by the parent charitable
company, or returns adequate for our audil have not been received from
branches not visited by us., or
the parent charitable company's financial statements are not in agreement with
the accounting records and returns- or
certain disclosures of trustees, remuneration specified by law are not made., or
we have not received all the information and explanations we require for our
audit. or
the trustees were not entilled to prepare the financial statements in accordance
with the small companies, regime and tak8 advantage of the small companies,
exemptions in prepanng the directors. report and from the requirement to prepare
a strategic report.
Responsibilities of trustees
As explained more fully in the trustees. responsibilities statement (set out on page
4041), Ihe trustees (who are also the directofs of the parent Gharitable company for the
purposes of company lawl are responsible for the preparation of financial statements
and for being satisfied that they give a true and fair view. and for such intemal control as
Ihe Iruslees determine is necessary to enable the preparation of financial statements
thal are free from material misstslement, whether due to fraud or error.
In preparing Ihe finanaal statements, the trustees are responsible for assessing the
group's and parent charitable company's ability to continue as a going concem,
disclosing. as applicable, matters related to going concern and using ihe going concem
basis of accounting unless the trustees eilher intend to liquidate the group or parent
charitable ¢ompany or to cease operations. or have no realistic alternalive but to do so.
Auditor fesponsibilities for the audit of the financial statements
Our objectives are to obtain reasonable assurance about whether the financial
stslements as a whole are free from malerial misstatement. whether due to fraud or
error, and to issue an auditols report that includes our opinion. Reasonable assurance
is a high level of assufance, but is not a guarantee that an audit conducted in
accordance with ISA5 (UK) will always deteGI a material misstatement when it exists.
44

St Nicholas Hosplce {Suffolkl - Company Limited by Guarantee
Independent Auditor's Report to the Members and Trustees of St Nicholas Hospice {Suffolk}
For the
earended 31 March 2024
Misstatements can arise from fraud or error and are considered material if. individually
or in the aggregate. they could reasonably be expected lo influence the economi¢
decisions of users laken on the basis of these financial statements.
Irregularities, inclL6ding fraud, are instances of non-compliance with laws and
regulations. We design procedures in line wilh our responsibilities, outlined above, to
detect material misstatements in respect of irregularilies, including fraud. The extent to
which our proGedures are capable of delecting irregularities, induding fraud is detailed
below..
Enouiry of management and those charged with governance to confirm there are
no instances of fraud or non-compliance with laws and regulations.
Review of disclosures within the financial statements and vou¢hing these to
supporting documentation to ensure compliance with applicable laws and
regulations.
Review of key accounting estimates. to ensure reasonable and no signs of
managemenl bias.
Performing audit work over the risk of management override of controls, including
testing of journal entrie5 and other adjustments for appropriateness, evaluating
the rationale of significant transactions outside the normal course of activities and
reviewing acwunts estimates for bias.
Because of the inherent limitations of an audit, there is a risk that we will nol detect all
irregularities, including Ihose leading lo a material misstatement in the financial
ststements or non-compliance with regulation. This risk increases the more that
compliance with a law or regulation is removed from the events and transactions
reflected in the financial statements. as we will be less likely lo become aware of
instances of non-complian￿. The risk is also greater regarding irregularities occurring
due to fraud rather than error. as fraud involves intentional concEalment. forgery,
collusion, omission or misrepresentation.
A further descriplion of our responsibilities is available on the Financial Reporting
Council's website at.. htt s'.Ilwww.frc.or
.uklOur-WorklAudillAudit-and-
assurancelSlandards-8nd
uidancelSlandards-and-
uidance-forauditorslAuditors-
res
ansibilities-for-audiuDescri
tion-of-auditors-res
onsibilities-for-audit.as
x. This
descripts'on forms part of our auditorfs report.
45

Use of our report
This report is made solely lo the charitsble company's members, as a body, in
accordance with Chapter 3 of Part 16 ofthe Companies Act 2006. Our audit work has
been undertaken so that we might state to the charitable ¢ompany's members and its
trustees 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 olher than the Gharitable company and the charitsble
company's members as a body. for our audit work, for this report, or for the opinions we
have formed.
Mark Proctor FCA DChA (Senior Statutory Auditor>
For and on behalf of
Lovewell Blake LLP
Chartered Accountants & statutory auditor
Bankside 300
Peachman Way
Broadland Business Park
Norwith
NR7 OLB
46

StNlcholas Hosplcel5uffo*l
Er￿L￿ Irf￿F¥
6D1&14
LYFO
tsL79B
J.fA7SJ&
614
797
Jo
?JJDW9
)ts12A*3
1.?5¥291
19
L>55.2>1
)645
4hlweJ￿rts
i￿.3￿
IU4045
107.$59
104.ty45
I.￿.559
F51
)￿15
IL*F
IBq6J
12fft21
IW.777}
(>A7P.WI
IL704.97•1
CthmffiurJt¥5Ervk*
{15D7.7851
1475.4ag1
IL&67.2A51
IIA2.9911
11741571
IL85Y
IJM1&741>
15FXQJJ
4JIWI 11475
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l.W.75ZJ
(4JIF.1S11 ILi¥75
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•44
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.Mi.034
4758
IVl6n7
47

St Nicholas Hospice Isuffolkl
Consolidated and company balgnfe sheets as at 31 March 2024
Company Mo.. 1748046
Grvup
31 Mar¢h 24
31 March 23
tharitv
31 Marth 24
31 Marth 23
NotES
FINerfossets
Tongible ossets
li
1,995.072
2,098,788
I.995￿72
2,098.788
InvEstJ>tents
12
4.1163.331
6,458,403
4.086,415
fj.185,103
4.498,337
6,494.409
4,121.421
6.210.209
currenr¢75S￿5
Stdtk
DeJ)tors
lAt￿cOmp0￿Ydebtor
C05h trtbonkond inhand
21,324
IA07,914
30.332
1.733.648
13
1,406,185
75,433
1,383,331
2,864￿9
1,781224
24
1,536,155
965.39J
920,251
2.684,231
821,449
2.603.673
Credttor5.'<TmOurttslollln9 due wirhth one
14
757.874
488.400
745,316
473.9S0
2.207.519
1,195AYI
2.119ffi33
2.129,7Z3
14etossets
8.665,922
,381,034
8.613
8.349,931
Credirors. omoLints/olllngdue qwterthfjn orte yeor
Totalne1055ets
8.665,921
.381.034
,613,042
B.349.932
ThefvfidsoJthEdJarlty.'
RestrKtedinromefvnds
15
128.230
104,649
128.230
104,649
Generoljunds
Deslonotedfvnds
Endowment
16
16
17
18
5,247,106
3,243,505
47.081
8,665,92t
2.637,622
5.592.348
46,415
8.381.034
5.194.2Z
3.243.5D5
47.081
,61¥,IMI
2,606.520
5.592.348
46.ajs
8J49.9J2
DurSn8 the year the charitable company made a 5urplusof £263k12023.. deficit of £369kl IndudlngBIft aid from 5ubsldlary of £45k12023..
£78kl.
The financial statementson pages 47-63 were approved by the Tiustees and authorised for I￿￿e on Sth December 2024 and are signed
on their behalf by..
Anne Fi5hei, ChalrofTrustee5
The nO￿50n pagÈ5 s￿63fOrM part of these financial statements.
48

St Nicholas Hosplce (Suffolk)
Consolldatsd ststement of tashflow forthe year ended 31st March 2024
Group
Note
2024
2023
tssh flows from operatin8 actNltles:
Net <ash used in operating attivities
21
573,445
1179,9311
Cash fftows from Investlng artmtles:
Dividends and interest recèived from investment5
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
123.893
61.507
111,866
8,589
20D
50,951
971,493
659.040
382,157
143,4161
267.185
1270,3211
138.848
Change In cash and ¢ash equlvalents In the year
712,293
Z02,226
Cash and cash equNalents at the beginning of the year
961.474
759.248
Cash and tash elulvalents at the end of the year
22,23
1.673,767
961,474
The notes on page5 50-63 form part of these financial statements.
49

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51

Accoun￿￿? policie5 (continue
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52

2023
IThw￿tcar
cOrnm￿nity
F¥mUy ￿p￿t￿b￿re8Vefflen1
••7.955
980.355
61U.299 1.043.e04
166.U
132.260
70
013
19.
E(MN*on andies•wth
1,861*92 2.23r,122
OthèrYradin9 Incom
2024
2023
49,202
30.120
54.091
hErlncor
20¥ts
123H93
123.BS9
(091- fjx¢JynieMis¢urte$
6Br* Inieitsi
5B.240
7,964
185.400
139.846
QthorlnGvmo
2022
Analyshs of *xp8ndllure
2Q24
2023
2024
Total CoSl¥
DkOthCosts Trtsi Co&is Tola&c￿
670.749
205,126
884,B7S
e84.B7S
dp%
679.749
205.126
6.319
814.875
Othwtradinyath¥ibe¥
Shopcosts
Lotterycosts
E￿￿tsC0St5
OthorlnC￿
1.478.628 J58.ffK) 1,866,71JJ
I￿.60?
20.671
174.27B
60.076
37.X
97.270
$7.È82
65.493
1.750.193
511.451
1.651.6U4
Z.7T3
?7.131
.261.fj47 2.O2).777
97.276
1.884.826
30,255
2A60.196
gD7
687
717N87 3,177,686 2.7Q2.6
31,1
In p￿￿￿1
D¥ycai
275.260 2,C49,306
274
1.2U.5ID
241.275 1.507.785
1.667.
3¥,125
80.314
471.439
407.300
125,536
53.535
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133.2•5
3.610,409
550.S58 1.261.QfjY
4.UO.472
Y¢ È07 1 J6B 145 7 431.702 7.U3.255
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2.089.358
9,414
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4.161.06
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53

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126,787
49.097
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20J74
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rtrèJiN
In¥*$bMimanao•Thnicost
337￿71
130.721
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326.228
792
484,358
717.487
425.7
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24.*1
186260
54.373
274
37.951
11.840
3.763
274260
174
241.27S
10.314
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420A97
genices
48,330
.178
32.198
6.075
2$3.829
26.150
31.500
Educatsllnandr¢sea
31.802
2V7.417
80.JI•
264,711
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2$$
EMp￿ye*Costs
2023
4.524,281 4,376,8?ts
422.U2
413,729
J62,781
33125$
se¢uiW¢Q&
P•DI￿nI￿>SL%
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2024
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2023
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54

N&tmo¥gffl•nt
2025
14ei k¢on*wr•soLYlleS L%st4tedaftEI
tiepreoaii¢n
147.132
154.848
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2.136.493 1.122.946
77.304
37.892
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213,797 1.157A6S
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55

InvèÈtmènts
Gmup
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2024
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2￿)
2023
Ats81 ofth¢ ywr
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t16PWI$
4.041.192 4.647.370
270,221
659.040
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