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|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|





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TRUSTEES, REPORT
INCLUDING SECTION 172 STATEMENT AND STRATEGIC REPORT

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







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|||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<br>emissions||997.7||1,028.9||-3.0%|
|Emissionintensity||||||||
|ratio||||||||
||Full-timeemployee||465||465||0.0%|
|Emissionsintensity||||||||
|(tCO2e/Full-time<br>employee)|||2.146||2.213||-3.0%|





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|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<br>operationsonthecommunityand<br>theenvironment|AppointmentofNetZeroLead<br>Sustainabledevelopmentofnewservices|
|(e)thedesirabilityofthecompany||
|maintainingareputationforhigh|CareQualityCommissionandHIWComplianceratings|
|standardsofbusinessconduct||
|(f)theneedtoactfairlybetween<br>membersofthecompany|ReviewandchangeofGovernanceStructure|





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





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|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**||






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||13.02.2023|13.05.2023|12.07.2023|29.11.2023|
|---|---|---|---|---|
|DJones|||||
|JSanders|||||
|MGerold|||||
|GvonMalachowski|||||
|LGeary|X|X|||



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||13.04.2023|12.10.2023|
|---|---|---|
|LDinner|||
|LRoberts|||
|GvonMalachowski|||
|CFryar|X||
|MBriggs||V|
|MShenouda||V|





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





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# 03 June 2024 




## 

|StatementofFinancialactivities||||
|---|---|---|---|
|FORTHEYEARENDED31DECEMBER2023|Notes|Totalfunds<br>2023|Totalfunds<br>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|





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|BALANCESHEET||||
|---|---|---|---|
|FORTHEYEARENDED31DECEMBER2023|Notes|2023<br>£|2022<br>£|
|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|





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|||2023|2022|
|---|---|---|---|
||Notes|<br>£|£|
|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<br>2023<br>£'000|Cash<br>flows<br>£'000|Other<br>non-cash<br>changes<br>£'000|At31<br>December<br>2023<br>£'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|





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|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|





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||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|



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||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|<br>2022|2023|2022|
|Healthcareservices|492|465|627|594|





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||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*|






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||Freehold<br>property|Leasehold<br>property|Fixturesand<br>fittings|Plantand<br>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<br>-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|





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



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|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|



## 



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||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<br>acquisitionoftangiblefixedassets|(11,518,660)|(12,433,799)|
|At31December2023|19,214,849|18,290,549|





## 

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






## 

||General<br>funds|Tangiblefixed<br>assets<br>fund|Designated<br>funds<br>£|Total<br>2023<br>£|
|---|---|---|---|---|
|Tangiblefixedassets|—|30,733,509|-|30,733,509|
|Netcurrentassets|1,361,440|(1,064,144)|421,611|718,907|
|Creditors:Amountsfallingdueafter<br>oneyear|-|(10,454,516)|-|(10,454,516)|
||1,361,440|19,214,849|421,611|20,997,901|
||General<br>funds|Tangiblefixed<br>assets<br>fund|Designated<br>funds<br>£|Total<br>2022<br>£|
|Tangiblefixedassets|—|30,724,348||30,724,348|
|Netcurrentassets|428,393|(1,065,341)|275,121|(361,827)|
|Creditors:Amountsfallingdueafter<br>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<br>andthatbasedontherevaluedamounts|5,670|5,670|
|Totalunrealisedgainsat31December2023|69,870|64,200|
|80<br>HealthcareManagementTrust|||





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||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