2023-12-31-accounts

CONTENTS
ChairofTrustee'sStatement	2
ChiefExecutive'sStatement	3
TrusteesReport
AboutHMT	5
Ourstrategy,charitablemission,visionandpurpose	8
Ourvalues	9
Buildingourbrandandgrowingourbusiness	10
Organisationalpriorities	11
OurCare	12
Patientandresidentengagement	15
Ourpeople	17
Technology	25
Environmentandsustainability	27
Engagementwithkeystakeholders-keydecisions	32
Financialreview	37
Structure,governanceandmanagement	40
Trusteebiographies	43
Attendanceatboardmeetings	48
Trusteeremuneration,conflictsofinterestandstatementofadherencetothe
fundraisingregulatorcode	54
Trustees'responsibilitystatement	55
Independentauditor'sreport	56
Statementoffinancialactivities	61
Balancesheet	62
Statementofcashflows	63
Notetotheaccounts	70
Referenceandadministrationdetails	84

TRUSTEES, REPORT INCLUDING SECTION 172 STATEMENT AND STRATEGIC REPORT

	ColomaCourt	MarieLouise House	StHugh's	SanctaMaria
Overallcurrent CQC/HIW Rating	Outstanding	Good	Requires Improvement	HIW
LastFocused Inspection Date	04/08/2020	31/01/2022	05/03/2019	AwaitingHIW report(asat31 December 2023)*
Reviewof data	Nilconcernraised	Nilconcerns raised	Nooutstanding concerns.	Nooutstanding concerns.
	Received9th	Received11th
PIR- Requests	February 2023Submitted	January 2023Submitted	N/A	N/A
	date22/02/2023	08/02/23

		FY23		FY22		%change
Energy(kWh)
	Naturalgas		3,058,236		3,337,250		-8.4%
	Companyvehicles		13,904		10,388		34.5%
	Electricity		2,034,183		2,056,311		-1.1%
	Businesstravel		57,066		78,351		-27.2%
	Totalenergy		5,163,389		5,482,300		-5.8%
Emissions(tCO2e)
Scope1	Naturalgas		559.4		609.2		-8.2%
Scope1	Companyvehicles		3.3		2.8		25.0%
Scope2	Electricity(LB)		421.2		397.6		5.9%
Scope3	Businesstravel		13.8		19.3		-28.5%
	TotalSECR emissions		997.7		1,028.9		-3.0%
Emissionintensity
ratio
	Full-timeemployee		465		465		0.0%
Emissionsintensity
(tCO2e/Full-time employee)			2.146		2.213		-3.0%

S172	SpecificExamplescoveredinthisreport
(a)thelikelyconsequencesofany	DevelopmentofnewStrategy
decisioninthelongterm	Significantinvestmentinnewsystems
	Overseasrecruitment
(b)theinterestsofthecompany's	PayawardCostofLivingPayment
employees	LearningandDevelopment
	SpeakingUpCommunicationwithcolleagues
(c)theneedtofosterthe	Residentandpatientfeedback
company'sbusinessrelationships	Regularmeetingswithsuppliers
withsuppliers,customersand	EnsuringHMTengagesinthefutureshapeofhealthandsocialcare
others;	serviceprovision
(d)theimpactofthecompany's operationsonthecommunityand theenvironment	AppointmentofNetZeroLead Sustainabledevelopmentofnewservices
(e)thedesirabilityofthecompany
maintainingareputationforhigh	CareQualityCommissionandHIWComplianceratings
standardsofbusinessconduct
(f)theneedtoactfairlybetween membersofthecompany	ReviewandchangeofGovernanceStructure

Risk	DescriptionandPotentialImpact	Keycontrolsandmitigatingfactors
		Inordertoensureweareattractiveina
Recruitment	Thereisanationalshortageofhealthandsocialcare workers.Thereisariskthatwewillbeabletocontinueto attractsuitabilitytrainedstaff,particularlyinspecialistareas. Thiscouldleadtogreaterrelianceuponagencystaff,impacting financialperformanceandcontinuousqualitypatientand residentcare.	highlycompetitivemarket;weregularly reviewourpayandbenefitsframeworkto ensureweareofferingafairand competitivepackage.Weinvestinour colleaguesintraininganddevelopment. Wecontinuetoreviewourwellbeing programmeofferedtostaff.Wehave
		widenedrecruitmenttooverseas.
Estateand property	Thereisaneedforcontinuedsignificantinvestmentand maintenance/remedialworktoHMT'spropertyandunderlease repairingobligations.Theadversefinancialpositioninprevious yearshascauseddelaystothecapitalexpenditureprogramme ofwork.	Surveyforallsiteshavebeenobtained andtheextentoftheworksareknown. The2024budgethasprovisionforyear1 ofsuchworks.
Increasedcosts andinflationary pressures	Theannualrateofinflationreached11.1%inOctober2022,a 41-yearhigh,beforesubsequentlyeasing.Highinflationaffects theaffordabilityofgoodsandservices,notonlyforHMTbut alsoforourservicesusers.WhilsttheUK'sannualinflationrate fellin2023itisstillhigh.	Weensurethatweworkcloselywith supplierstoensurethatthebestratesare achieved.Wecontinuouslylookfor efficienciesinprocesses.
Activityand Occupancy	Thereisacontinuingchallengeoftheeconomicclimateandits impactonHMT'spatientsandresidents'abilitytoself-fund treatmentandcareatitshospitalsandcarehomes,resultingin budgetedactivityandoccupancylevelsnotbeingachieved.	Wecontinuetomarketand communicationtheservicesofferedby HMTandworkcloselywithpartners,such astheNHSandlocalauthorities. Efficiencyplanningisalwaysconsidered.
CQC/HIW	Failureforourservicestomaintain/achievegoodor	Siteshaveactionplansinplacetoensure
Ratingand	outstandingcompliancewiththeCQC/HIWcouldleadto	complianceandcontinuousquality
compliance	financiallossesandreputationaldamage.	improvement.
		HMTattemptstomitigatetheserisks
Government Policy	Thefundingforhealthandsocialcareisthegovernment's responsibility.HMThassignificantcontractsandframework agreementsinplacewiththeNHS.TheNHStariffincreases generallyhavebeenbelowthegeneralinflationrateandwe haveseenourmarginonNHSworkeroded.Otherrisks includeNationalMinimumWage,Brexit,theGovernment's approachtohealthandsocialcare.	throughtheregularreviewofstrategyto ensurethatwecanbeflexibletotake accountofexternalconditions.Weare workcloselywithlocalcommissionersand throughtheIndependentHealthcare ProvidersNetworkandtheNationalCare Forumonanationallevel,toendeavour toaddressthesechallengesandinform
		thereformagenda.
Compliance	Failuretocomplywithlegislationandregulationcouldleadto	Weensurecompliancethroughpolicies
withlegislation	financialloss,reputationaldamage,claimsagainstHMT,	andprocedures,riskassessments,internal
andregulation	prosecution,andlossofregistration.	audits,insurance,andtraining.
		Thereareanumberofpoliciesinplace
Majorincident	Aseriousincidentresultinginavoidableharm,resultingin seriousinjuryordeathtoapatient,resident,oremployee.	andmonitoringofhealthandsafety requirements.ClinicalGovernanceand Qualitymanagementisahighpriorityand
		robustlymonitored.

Trustee	Originallyappointed	Re-appointed
DJones	12/12/2012	26/07/2023
MGerold	16/09/2015	27/07/2022
GvonMalachowski	20/04/2016	26/07/2023
CFryar	25/05/2022*
LGeary	25/05/2022
JSanders	25/05/2022
MShenouda	26/07/2023
MBriggs	27/09/2023**

	13.02.2023	13.05.2023	12.07.2023	29.11.2023
DJones	
JSanders				
MGerold				
GvonMalachowski				
LGeary	X	X		

	13.04.2023	12.10.2023
LDinner	
LRoberts	
GvonMalachowski		
CFryar	X	
MBriggs		V
MShenouda		V

	27.09.23
DJones	V
MGerold	V
GvonMalachowski	V
CFryar	V
LGeary	V
JSanders	V
NDraper	V
MShenouda	V

03 June 2024

StatementofFinancialactivities
FORTHEYEARENDED31DECEMBER2023	Notes	Totalfunds 2023	Totalfunds 2022
		£	£
INCOMEANDEXPENDITUREACCOUNT
INCOMEFROM:
Donationsandlegacies		31,494	730
Investmentincomeandinterestreceivable	1	67,151	7,009
Charitableactivities
.Healthcareestablishmentfeesandrelatedcharges	2	50,460,543	45,553,965
Totalincome		50,559,188	45,561,704
EXPENDITUREON:
Raisingfunds
Investmentmanager'sfees			4,179
Financingcosts	3	530,938	473,452
		530,938	477,631
Charitableactivities
Promotionanddevelopmentofhealthcare
.Healthcareestablishmentexpenses	4	47,835,857	46,747,143
.Charitablegrants	5	188,553	47,045
		48,024,410	46,794,188
Totalexpenditure		48,555,348	47,271,819
Netincome(expenditure)beforelossesoninvestments	7	2,003,840	(1,710,115)
Net(losses)onlistedinvestments(fullyliquidatedin2022)			(41,040)
Netincome(expenditure)fortheyearandnetmovementinfunds		2,003,840	(1,751,155)
Reconciliationoffunds:
Balancesbroughtforwardat1January2023		18,994,063	20,745,218
Balancescarriedforwardat31December2023		20,997,902	18,994,063

BALANCESHEET
FORTHEYEARENDED31DECEMBER2023	Notes	2023 £	2022 £
Fixedassets
Tangiblefixedassets	10	30,733,509	30,724,348
		30,733,509	30,724,348
Currentassets
Stocks	11	556,715	562,042
Debtors	12	2,606,568	2,500,374
Cashatbankandinhand		6,200,509	3,605,296
		9,363,792	6,667,712
Creditors:amountsfallingduewithinoneyear:	13	(8,644,883)	(7,029.539)
Netcurrentassets(liabilities)		718,909	(361,827)
Totalassetslesscurrentliabilities		31,452,418	30,362,521
Creditors:amountsfallingdueafteroneyear	14	(10,454,516)	(11,368,458)
Totalnetassets		20,997,902	18,994,063
ThefundsoftheTrust
Generalfunds		1,361,442	428,393
Tangiblefixedassetsfund	15	19,214,849	18,290,549
Designatedfunds	16	421,611	275,121
		20,997,902	18,994,063

		2023	2022
	Notes	£	£
Cashflowsfromoperatingactivities:
Netcashprovidedby(usedin)operatingactivities	A	6,121,036	(596,444)
Cashflowsfrominvestingactivities:
Investmentincomeandinterestreceived		67,151	7,009
Purchaseoftangiblefixedassets		(2,148,094)	(891,591)
Proceedsfromdisposaloffixedassets			800,000
Proceedsfromthedisposalofinvestments			1,535,290
Netcash(usedin)providedbyinvestingactivities		(2,080,943)	1,450,708
Cashflowsfromfinancingactivities:
Interestpaid		(530,938)	(473,452)
Repaymentsofborrowing		(575,000)	(575,000)
Repaymentsoffinanceleases		(338,942)	(489,204)
Netcash(usedin)financingactivities		(1,444,880)	(1,537,656)
Changeincashandcashequivalentsintheyear		2,595,213	(683,391)
Cashandcashequivalentsat1January2023	B	3,605,296	4,288,687
Cashandcashequivalentsat31December2023	B	6,200,509	3,605,296

	2023	2022
Netmovementinfunds(asperthestatementoffinancialactivities)	2,003,840	(1,751,155)
Adjustmentsfor:
Depreciationcharge	2,076,117	2,108,642
Lossesoninvestments		41,040
Investmentincomeandinterestreceivable	(67,151)	(7,009)
Interestpayable	530,938	473,452
Lossondisposaloftangiblefixedassets	62,815	201,124
Decreaseinstocks	5,327	6,341
(Increase)decreaseindebtors	(106,194)	805,381
Increase(decrease)increditors	1,615,344	(2,474.260)
Netcashprovidedby(usedin)operatingactivities	6,121,036	(596,444)
BAnalysisofcashandcashequivalents	2023	2022
Cashatbankandinhand	6,200,509	3,605,296
Totalcashandcashequivalents	6,200,509	3,605,296

CAnalysisofchangesinnetdebt	At1January 2023 £'000	Cash flows £'000	Other non-cash changes £'000	At31 December 2023 £'000
Cash	3,605,296	2,595,213		1,010,083
Financeleaseobligations	(1,508,798)	340,138		1,168,660
Loans	(10,925,000)	575,000		11,500,000
Total	(8,828,502)	3,510,351		11,658,577

1.Investmentincomeandinterestreceivable	Unrestricted	funds
	2023	2022
	£	£
Incomefromlistedinvestments		5,957
Interestreceivable	67,151	1,052
	67,151	7,009

2.Healthcareestablishmentfeesandrelatedcharges	Unrestrict	edfunds
	2023	2022
	£	£
Managementandconsultancyfees	99,866	60,014
Hospitalfeesandrelatedcharges	40,996,502	37,873,903
Nursingandresidentialhomefeesandrelatedcharges	9,364,175	7,620,048
	50,460,543	45,553,965

3.Financingcosts	Unrestricted	funds
	2023	2022
	£	£
Interestpayableonbankloansandfinanceleases	530,938	473,452

	2023	2022
	£	£
Staffcosts(note8)	19,331,010	18,625,944
Premisesandequipment	6,532,729	6,208,334
Medicalandwelfare	18,565,394	17,740,495
Governancecosts(note6)	62,743	91,360
Otherexpenses	3,343,982	4,081,011
	47,835,858	46,747,143

		2023	2022
		£	£
Charitabledonationsandshareofsurplus(note	18)	188,553	47,045

	2023	2022
	£	£
Internalaudit	-	12,808
Externalaudit,committeeandothercosts	62,743	78,552
	62,743	91,360

7.Netincome(expenditure)beforelossesoninvestments	Unrestrictedfunds	Unrestrictedfunds
Thisisstatedaftercharging:	2023	2022
Staffcosts(note8)	19,331,010	18,625,944
Externalauditor'sremuneration
Auditservices(includingVAT)	41,267	41,375
Depreciation	2,076,117	2,108,642
Operatingleaserentals	577,340	489,503
Hireofplantandmachinery
Rentalofnon-medicalequipment	165,436	90,878
Rentalofmedicalequipment	1,459,367	1,022,599
8.StaffcostsandTrustees'remuneration
	2023	2022
	£	£
Staffcostsduringtheyearwereasfollows:
Wagesandsalaries	16,222,062	14,892,405
Socialsecuritycosts	1,547,043	1,445,569
Otherpensioncosts	565,882	510,903
Apprenticeshiplevy	68,438	58,794
Paymentstoemployedstaff	18,403,425	16,907,670
Paymentstoagencystaff	927,585	1,718,274
	19,331,010	18,625,944

	Full	timeequivalents	Headcount
	2023	2022	2023	2022
Healthcareservices	492	465	627	594

	2023	2022
£60,001-£70,000	9	6
£70,001-£80,000	8*	3
£80,001-£90,000	2	2
£90,001-£100,000	1	1*
£100,001-£110,000		1
£110,001-£120,000		1
£130,001-£140,000		1
£140,001-£150,000	1
£150,001-£160,000	1
£160,001-£170,000	1*	2*
£190,001-£200,000	1	1*
£280,001-£290,000		1*

	Freehold property	Leasehold property	Fixturesand fittings	Plantand equipment	Total
Costorvaluation
At1January2023	4,041,153	22,126,323	4,324,933	15,456,045	45,948,454
Additions	122,605	519,557	487,446	1,018,486	2,148,094
Disposals			(492,419)	(1,436,896)	(1,929,315)
At31December2023	4,163,758	22,645,880	4,319,960	15,037,635	46,167,2333
Cost	2,913,758	22,645,880	4,319,960	15,037,635	44,917,233
Deemedcost:Valuation -1990	1,250,000				1,250,000
	4,163,758	22,645,880	4,319,960	15,037,635	46,917,233
Depreciation
At1January2023	1,141,193	585,650	2,503,860	10,993,403	15,224,106
Providedintheyear	73,349	385,119	396,501	1,221,148	2,076,117
Reclassification		19,471	(19,471)
Ondisposals			(277,695)	(1,588,805)	(1,866,500)
At31December2023	1,214,542	990,240	2,603,195	10,625,746	15,433,723
Netbookvalues
At31December2023	2,949,216	21,655,640	1,716,765	4,411,889	30,733,510
At31December2022	2,899,960	21,540,673	1,821,075	4,462,640	30,724,348

Cost	1,023,209
Accumulateddepreciation	(758,842)
Netbookamountat31December2023	264,367
Netbookvalueat31December2022	289,847

11.Stocks
	2023	2022
	£	£
Drugs,dressingsandconsumables	556,715	562,042
12.Debtors
	2023	2022
	£	£
Feesandrelatedcharges	1,498,147	1,467,457
Otherdebtors	3,247	6,558
Prepaymentsandaccruedincome	1,105,174	1,026,359
	2,606,568	2,500,375

	2023	2022
	£	£
Expensecreditors	2,745,036	2,718,009
Socialsecurityandothertaxes	556,164	373,310
Othercreditors	45,046	30,285
Accrualsanddeferredincome	3,316,959	2,255,794
SanctaMariaconstructioncreditors	586,800	586,800
Financeleaserepayablewithinoneyear	489,144	490,341
Bankloanrepayablewithinoneyear	575,000	575,000
	8,644,883	7,029,539

14.Creditors:amountsfallingdueafteroneyear
	2023	2022
	£	£
Financeleaserepayable(seebelow)	679,516	1,018,458
Bankloan(seebelow)	9,775,000	10,350,000
	10,454,516	11,368,458

Financelease
	2023	2022
Amountsdue:
Withinoneyear(note13)	489,144	490,341
Betweenoneandtwoyears	144,233	483,165
Betweentwoandfiveyears	535,293	535,293
	679,516	1,018,458
	1,168,660	1,508,799

	2023	2022
Amountsdue:
Withinoneyear(note14)	575,000	575,000
Betweenoneandtwoyears	575,000	575,000
Betweentwoandfiveyears	1,725,000	1,725,000
Betweenfiveandsevenyears	7,475,000	8,050,000
	9,775,000	10,350,000
	10,350,000	10,925,000

15.Tangiblefixedassetsfund
	Total	Total
	2023	2022
	£	£
At1January2023	30,724,348	32,942,525
Netmovementintheyear	9,161	(2,218,177)
	30,733,509	30,724,348
Less:Bankloanandfinanceleasestofinancetheconstructionand acquisitionoftangiblefixedassets	(11,518,660)	(12,433,799)
At31December2023	19,214,849	18,290,549

	At1 January 2023	New designations	Released or utilised	At31 December 2023
			£	£
MarieLouiseHousebuildingand equipmentreserve	3,144	6,489		9,633
ColomaCourtbuildingreserve	271,977	140,000		411,978
	275,121	146,489		421,611
	At1 January 2022	New designations	Released or utilised	At31 December 2022
			£	£
MarieLouiseHousebuildingand equipmentreserve	3,144			3,144
ColomaCourtbuildingreserve	271,977			271,977
	275,121			275,121

	General funds	Tangiblefixed assets fund	Designated funds £	Total 2023 £
Tangiblefixedassets	—	30,733,509	-	30,733,509
Netcurrentassets	1,361,440	(1,064,144)	421,611	718,907
Creditors:Amountsfallingdueafter oneyear	-	(10,454,516)	-	(10,454,516)
	1,361,440	19,214,849	421,611	20,997,901
	General funds	Tangiblefixed assets fund	Designated funds £	Total 2022 £
Tangiblefixedassets	—	30,724,348		30,724,348
Netcurrentassets	428,393	(1,065,341)	275,121	(361,827)
Creditors:Amountsfallingdueafter oneyear		(11,368,458)		(11,368,458)
	428,393	18,290,549	275,121	18,994,063

theCompaniesAct2006.Movementsinunrealisedgainsduringthe	yearwereasfollo	ws:
	2023	2022
Unrealisedgainsincludedabove:
Onfreeholdproperty	69,870	64,200
Totalunrealisedgainsat31December2023	69,870	64,200
Reconciliationofmovementsinunrealisedgains
Unrealisedgainsat1January2023	64,200	203,087
Differencebetweenhistoricalcostrealisedgains/lossesonlisted
investmentsandtheactualrealisedgains/lossesthereoncalculated		(144,557)
ontherevaluedamounts
Differencebetweenthedepreciationchargebasedonhistoriccost andthatbasedontherevaluedamounts	5,670	5,670
Totalunrealisedgainsat31December2023	69,870	64,200
80 HealthcareManagementTrust

	Landand	buildings	Other
	2023	2022	2023	2022
	£	£	£	£
Operatingleaseswhichexpire:
Withinoneyear	813,808	505,245	69,502	72,095
Withintwotofiveyears	3,237,938	1,087,608	43,636	118,365
Over5years	19,520,000
	23,571,746	1,592,853	113,138	190,460

Company number 01932882

I

*HMT HEALTHCARE MANAGEMENT TRUST