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2021-03-31-accounts

Action against Medical Accidents Report and financial statements For the year ended 31 March 2021

Company number: 2239250 Charity number: 299123 OSCR number: SCO39683

Contents

Reference and administrative details 1 . . . . . . . . . . . . . . . . Report of the Council of Management . . . . . . . . . . . . . . . . 2 Objectives and activities . . . . . . . . . . . . . . . . . . . . . . . . . 2 Structure, governance & management . . . . . . . . . . . . . . . . 8 Financial review 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Reserves and investment policy . . . . . . . . . . . . . . . . . . . 12 Statement of responsibilities of the Council of Management . . 13 Independent auditor’s report . . . . . . . . . . . . . . . . . . . . 14 Statement of financial activities . . . . . . . . . . . . . . . . . . . 17 Balance sheet 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Statement of cash flows . . . . . . . . . . . . . . . . . . . . . . . . 19 Notes to the financial statements . . . . . . . . . . . . . . . . . . 20

Action against Medical Accidents Report and financial statements for the year ended 31 March 2021

Reference and administrative details

Action against Medical Accidents (also known as “AvMA”)

Company number 2239250

Country of incorporation England

Charity number 299123

Country of registration England

OSCR number SCO39683

Registered and principal office address Freedman House Christopher Wren Yard 117 High Street CROYDON, CR0 1QG

Patrons

Peter Ransley (Honorary President) Baroness Masham of Ilton Umesh Prabhu James Badenoch QC Dame Professor Donna Kinnair

Honorary officers

Moi Ali Chair (from December 2020) Caroline Browne Vice-Chair Jonathan Hazan Treasurer (from October 2021)

Trustees

Moi Ali Michael Andersson Angela Brown (retired October 2021) Caroline Browne Janine Collier (appointed March 2021) Jocelyn Cornwell (appointed March 2021) Maggie Davies (appointed March 2021) Jonathan Hazan Nigel Holland Linda Kenward (resigned October 2021) Bill Kilvington (appointed March 2021) Suzanne Shale (resigned December 2020) Rachael Vasmer (resigned December 2020)

Trainee trustees (non-voting) Amrat Khorana (appointed March 2021) Mary Smith (appointed March 2021)

Key management personnel

Peter Walsh Chief Executive Nicky Rushden Finance Manager

Bankers

Co-operative Bank plc Delf House, Southway SKELMERSDALE, WN8 6NY

Gale and Phillipson Ltd Gallowfields House, Fairfield Way RICHMOND, DL10 4TB

Tavistock Private Client Ltd The Barn, Downing Park Station Rd, Swaffham Bulbeck CAMBRIDGE, CB25 0NW

Independent financial advisors Castlefield Advisory Partners Ltd 4-6 Staple Inn, High Holborn LONDON, WC1V 7QH

Auditor

Sayer Vincent LLP Chartered Accountants and Statutory Auditors Invicta House, 108-114 Golden Lane LONDON, EC1Y 0TL

Solicitors

Tees Law Tees House 95 London Road Bishop’s Stortford HERTFORDSHIRE, CM23 3GW

Action against Medical Accidents Report and financial statements for the year ended 31 March 2021

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Report of the Council of Management

The Council of Management presents its report and the audited financial statements for the year ended 31 March 2021 .

Reference and administrative information set out on page 1 forms part of this report . The financial statements comply with current statutory requirements, the memorandum and articles of association and the Statement of Recommended Practice – Accounting and Reporting by Charities: SORP applicable to charities preparing their accounts in accordance with FRS 102 .

Objectives and activities

The chief objects of the charity described in the memorandum of association are:

“The relief of sickness and conditions of need, hardship and distress arising as a result of medical accidents” and;

“To advance public education in the care of victims of medical accidents and in the law relating to such accidents” .

In ordinary language trustees believe our purpose can best be described as “to support people affected by avoidable harm in healthcare; to help them achieve justice; and to promote better patient safety for all” .

Our beneficiaries

AvMA’s beneficiaries are people who have been affected by avoidable harm in healthcare and who are directly helped by our services; and others who benefit from the changes in policy and practice we bring about through our public education and influencing work . Below we describe how we help our beneficiaries through our main activities .

2020-21 in a nutshell: Our key activities, including achievements and performance in 2020 – 2021

The achievements of particular note during the year were:

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Advice, information and support

The advice and support we provide to people affected by avoidable harm in healthcare is at the very heart of what AvMA does, and the experience of our clients informs everything we do . In 2020-21 we directly helped 2,590 people (just 6% less than the previous year, despite the pandemic), with many others benefitting from our self-help guides and online information . There were nearly 11,500 downloads of these .

Our Helpline provides specialist, sympathetic support to people when they are coping with the trauma of their experience . It reassures them that an organisation exists which understands their plight and is here to help them . Our helpline staff and volunteers explain people’s rights, how different medico-legal processes and procedures work, and they put people in touch with other specialist support where needed . We are grateful to our team of 60 trained volunteers who enable us to make this service available Monday to Friday 10am-3 .30pm . In 2020-21 we advised on 1,894 calls, often involving extremely serious and complex cases . AvMA is the only charity providing a specialist medico-legal helpline in the UK and it can get very busy .

AvMA’s caseworkers, who are all experienced professionals and are either medically and/or legally qualified, often provide in-depth advice that would not be available from any other agency . Sometimes, the referral of a healthcare professional to their regulator may be recommended, or the case may have broader lessons for patient safety, or link with one of AvMA’s campaign priorities . In 2020-21 we opened 613 new casework files .

Impact

Callers to our helpline and recipients of our written casework service feel understood and supported at a time of extreme stress and anxiety. They are enabled to make better informed decisions about what to do next through our specialist advice and are better equipped to make use of the procedures available to them. Often, this enables them to access a specialist solicitor and eventually obtain compensation; and/or, to have their complaints or concerns properly addressed and resolved; and/or to achieve measures to protect other patients/ improve patient safety.

An important part of our casework is the support we provide to families involved in healthcare related inquests . This empowers families and maximises the opportunity for the right questions to be asked and learning to come from the inquest . Whereas NHS bodies and individual health professionals are usually legally represented at inquests, bereaved families are often not . We try to address this uneven playing field through our inquest support service . Often this involves AvMA in intensive work instructing counsel to represent the family . This service is made possible by barristers’ generous donation of time, and also involves a huge investment of time and effort in our staff instructing the barrister, supporting the family, and attending the inquests . We helped eight families in this way over the year and started preparatory work for representing two other families . A number of important conclusions were arrived at in inquests where we arranged representation for families, including recommendations for improving patient safety, which may not have been had we not been involved . Families gained a better insight into the circumstances leading to their family member’s death . In addition we gave advice to a further 76 families who were facing a forthcoming inquest, to help them prepare and/or to get legal representation at the inquest . Supporting families at inquests was made more challenging due to the pandemic, as coroners’ courts closed for a period; travel was not always possible; and some hearings and meetings had to be held online . We have noticed a trend in inquests becoming more complex and taking more time (more often than not being listed for a minimum of 3 days, and in one of our inquests lasting 6 days) . This reduces the number of inquests we are able to take on with existing resources . We assisted through the pandemic by participating in remote and partial remote hearings and pre inquest review hearings . Remote/partial remote hearings are likely to be part of the future . We were able to do this because our IT was able to facilitate participation in remote hearings .

Impact

Families who have lost a family member as a result of avoidable harm in healthcare are legally represented and feel empowered to have the right issues and questions addressed at inquests. The coroner is sometimes helped to recognise issues that need to be addressed to protect future patients/improve patient safety and to issue a ‘prevention of future deaths’ letter.

We have developed systems for collecting and analysing feedback from our beneficiaries, which helps us judge satisfaction and the impact of our work with them .

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Policy and external relations (Influencing policy & practice)

Whilst the direct support we provide to our beneficiaries - people whose lives have been affected by safety failures - is vitally important in its own right, it also informs our policy and campaigns work . It fuels our passion to bring about changes that will benefit many more people than we can ever reach ourselves . 2020-21 was another busy year for AvMA in contributing to important policy initiatives and debates, which fell full-square in our area of concern and expertise . Increasingly AvMA is expected to take a lead on issues around patient safety and access to justice on behalf of patients due to its unique role .

Whilst the NHS response to the pandemic – particularly the role played by health and social care staff – was impressive and often heroic, we quickly became aware of the knock-on effects of the disruption of services for patients with non-Covid-19 conditions . For example, some estimates of lost lives/opportunities for cancer patients put the avoidable deaths as high potentially as deaths due to Covid-19 itself . We took a lead together with other stakeholders and experts to raise awareness of the problem and seek more urgent action to address it, achieving substantial media coverage and attention being given to this issue .

Our work around ‘just culture’ in healthcare and the work we did with our beneficiaries on understanding the harmed patient’s journey led us to recognise the need to look at how the NHS should deal with the holistic needs of harmed patients and their families . Together with colleagues in the new organisation Harmed Patients Alliance, we developed the concept of a ‘Harmed Patient Care Pathway’ – an acknowledgement of a specific duty of care for patients who experience harm, and their families, and a set of different kinds of support which should be made available to them . We jointly launched a campaign for a Harmed Patient Care Pathway and formed an advisory group of stakeholders . This has been very well received by many stakeholders in healthcare and our beneficiaries . Our hope is that following further development of the concept and piloting of the approach this will lead to a much better defined and resourced approach to supporting harmed patients and their families .

We continued to engage with key stakeholders across the UK about the Duty of Candour, including better implementation of it in England and Scotland and its adoption in Wales and Northern Ireland . We worked with the Department of Health in Northern Ireland in helping them design a Duty of Candour there as a result of the Hyponatraemia Inquiry recommendations .

We worked collaboratively with NHS Resolution and other organisations to develop a Clinical Negligence Protocol for cases during the pandemic . This facilitated additional protections for clients by making suspension of the limitation period a right (subject to criteria stipulated in the CNP being met) . We have been able to protect families who are attending inquests by making provision for the limitation period to be suspended for three months for any civil/Human Rights Act claim identified either before or as a result of the inquest hearing . It is estimated that the Protocol may have saved around three million pounds of taxpayers money already . Going forward we hope to build on this collaborative approach even when the pandemic is over .

Government proposals for fixed recoverable costs in clinical negligence continued to be a key area of concern . Proposals from Government have been delayed, probably due to the pandemic, but are expected to emerge in 2021-22 and may now include even more radical proposals . We continued to make the case for full access to justice for harmed patients/their families; that this is a vital part of a ‘just culture’, and also important for ensuring lessons are learnt for patient safety .

As well as work that grabs the headlines, AvMA continued to bring an expert patient perspective to patient safety and justice issues through ongoing relationships with public bodies, policy makers and fellow patients’ groups and participation in a raft of meetings and working groups . For example, we were an active member of the steering group working on a Complaints Standard Framework for England, led by the Parliamentary and Health Service Ombudsman . Staff and trustees were also represented on several advisory groups for relevant research projects . We gave evidence to the Health and Social Care Select Committee’s review of safety in maternity services and to the Justice Committee’s review of the Coroners’ Service . The Justice Committee’s report quoted AvMA’s evidence and made welcome recommendations in line with our advice, including making legal aid available for legal representation of families at inquests . We also made submissions to several formal consultations including NHS England/Improvement’s Framework for Involving Patients and Families in patient Safety .

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Impact

Conferences and training (Spreading awareness and good practice)

AvMA rolled out an impressive portfolio of conferences, training and events in spite of the pandemic meaning face-to-face events were not possible . Unfortunately, our flagship annual Clinical Negligence and Medical Law conference, which was to be held in Bournemouth in 2020, had to be cancelled, as did other planned faceto-face events, resulting in large reductions in anticipated income . However, we adapted well to the changed circumstances by developing virtual online events . These proved popular and profitable and this is something we will benefit from going forward with what will probably be a mixed portfolio of face-to-face and virtual events . Overall, 612 delegates benefited from our 6 online conferences during 2020-2021 compared with 1,123 in 2019-20 . A further 128 viewed our online webinars . 100% of attendees who completed evaluation forms for our events replied “Yes” when asked “Do you expect that you will use the learning from this conference in your work?”. Whilst attendees commented on advantages of online events, including not having to travel and the online ‘chat’ function, comments also reflected an appetite for face-to-face events returning – especially the annual Clinical Negligence and Medical Law conference . To maximise chances of this going ahead in 2021-22, and delegates feeling safe to attend, our next Clinical Negligence and Medical Law conference has been put back to March 2022 (in Leeds) .

Impact

Enhancing the skills and knowledge of legal and health professionals results in our beneficiaries receiving good quality advice and representation from them.

Medico-legal services

Although the majority of people AvMA helps do not take legal action, some of the most vulnerable people AvMA serves rely on the services of solicitors . In addition to awarding our quality mark where appropriate, AvMA continued to run a Lawyers’ Service which helps law firms provide the best possible services in this specialist area . We recommend medical experts from our comprehensive database, keep lawyers up to date on case law and policy, and help with interpreting medical issues . Law firms subscribe to this service, which provides AvMA’s single biggest income stream . Most of the services continued to be provided uninterrupted by the pandemic, with staff working from home . However, our regional Lawyers’ Service Group meetings had to move to an online format . These meetings usually involve a medical and a legal speaker as well as an AvMA update and provide an opportunity for networking . The online meetings were well received in the circumstances, but we are exploring how best to arrange these meetings going forward .

Impact

Our support services for solicitors practising in clinical negligence means that our beneficiaries are more likely to experience a good service and successful result.

We continued to assess and accredit clinical negligence solicitors for our specialist clinical negligence panel . AvMA’s quality mark is the best indicator available that the solicitors have the necessary expertise, experience and integrity to do a good job for people affected by clinical negligence . Our panel members also usually have supervisory responsibilities in their firms, thereby helping assure quality in the firms as a whole . We see the importance of being able to recognise a genuine specialist as all the more important as a result of current upheaval of the legal system . In spite of the difficult environment for clinical negligence solicitors, interest in being on AvMA’s panel remained strong . We made 11 new appointments to the panel during the year and reaccredited 29 panel members – very much on a par with recent years in spite of the pandemic . One of the key aims in the operation of the AvMA Panel is improving standards of clinical negligence practice by sharing best practice . Best practice benchmarks are drawn from applications to the panel, particularly from the most experienced senior lawyers, as well as the contribution of external interviewers, but always with a focus on what is in clients’ best interests . Those benchmarks are continually changing as standards improve . We always interview new applicants, including those who have been advised they do not meet the

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required standard, as this enables us to offer advice on how they can improve . We do this as they will be providing clinical negligence advice with or without us, so we wish to ensure that their clients receive the best service . We are very grateful to David Kerry, an experienced former panel member, who helps us on a voluntary basis with assessing and interviewing applicants .

Impact

Our panel, and the quality mark denoting membership of it, makes it easier for our beneficiaries who need to take legal action to find a genuinely specialist solicitor with the appropriate qualities, knowledge and skills. This results in our beneficiaries receiving more expert advice and representation and, in our opinion, greater likelihood of a successful outcome.

AvMA’s work in Scotland

As a charity registered in Scotland (as well as England and Wales) our activities north of the border include our Helpline and Casework Service, which can be accessed by people in Scotland . We continued to liaise with bodies such as Scottish Government, NHS Improvement Scotland, the Scottish Public Services Ombudsman and the Patient Advice and Support Service Scotland and contributed to discussions about patient safety and justice . In particular, we continued to engage about implementation of the Duty of Candour in Scotland .

Public benefit

The Council of Management has referred to the guidance contained in the Charity Commission’s general guidance on public benefit when reviewing the charity’s aims and objectives and in planning its future activities . In particular, the Council considers how planned activities will contribute to the aims and objectives that have been set .

Fundraising

AvMA is a member of the Fundraising Regulator Scheme and follows its code of conduct . Chief fundraising responsibility is held by the Marketing & Communications Manager, in conjunction with the Chief Executive . However, other departments also source sponsorship for events and may hold a fundraising activity at events . AvMA’s main fundraising comes from donations from supporters; fundraising events held by other organisations benefitting AvMA; our own fundraising events; corporate sponsorship; and occasional bequests . AvMA does not employ or commission external fundraising professionals or companies . AvMA does not make unsolicited approaches to individuals . No complaints have been received about AvMA’s fundraising .

Assuring the quality of our work

The charity has a Quality and Outcomes sub-committee to help take forward its work on quality and impact measurement . Part of its remit is to review any complaints made about AvMA’s work and be sure that any learning points are acted upon . We received no formal complaints about AvMA during the year . However, we continue to monitor feedback and look into any concerns expressed . We introduced a “you said, we did” section to our Newsletter to demonstrate we take such feedback seriously .

We have developed a range of different ways in which people can give us feedback on our services and all comments, positive and negative, are reviewed regularly . Where possible, we contact people who leave negative feedback to see if we can resolve the problem they raise .

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Action against Medical Accidents Report and financial statements for the year ended 31 March 2021

Plans for the future

Our five-year strategic plan sets out our strategic objectives for five years from 2019-2024 and our plans for achieving them . We held a mid-term review of our strategy in October 2021 .

AvMA’s plans for 2021-22 include:

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Structure, governance & management

The organisation is a charitable company limited by guarantee, incorporated on 4 April 1988 and registered as a charity on 17 April 1988 . The organisation changed its name to Action against Medical Accidents (AvMA) on 3 December 2003 .

The company was established under a memorandum of association which established the objects and powers of the charitable company and is governed under its articles of association .

Trustees collectively form the Council of Management .

Council of Management and appointment of Council members

Individual trustees (members of the council) are appointed by the Council of management . Not less than 6 nor more than 20 Council members may be appointed . The Council may co-opt persons to fill casual vacancies provided the maximum of 20 is not exceeded . Approximately one third of the Council must retire each year, those being the longest serving since their previous election . Retiring members are eligible for re-election, which takes place at the annual general meeting .

Recruitment of new trustees takes place as and when the Council believes this is necessary to add to or complement the experience, knowledge and skills available to the Council . Usually “vacancies” for new trustees are advertised . Potential new trustees are interviewed by at least two trustees usually including the Chair, and the Chief Executive . Based on objective criteria, the recommendations to appoint a new trustee are put to the full Council together with the candidate’s background details for a decision . During 2020-21 two trustees resigned and four were appointed bringing the total number of trustees to eleven at the year end . Since the year end one trustee has retired and one has resigned bringing the current total to nine . In addition, two new ‘trainee trustees’ were appointed during the year .

Members of the charitable company guarantee to contribute an amount not exceeding £1 to the assets of the charitable company in the event of winding up . The total number of such guarantees at 31 March 2021 was 11 (2020 - 9) . Members of the Council of Management have no beneficial interest in the charitable company .

The Council of Management met four times during the year . AvMA has adopted a five year strategic plan for 2019-20 onwards . This is accompanied by annual operational plan . Progress on meeting strategic objectives is reviewed regularly . An ‘Executive Committee’ comprising the Chair, Vice Chair, Treasurer and Chief Executive meets between Council meetings to deal with urgent business and reports to the Council . A ‘Finance and Investment Committee’ and ‘Quality & Outcomes Committee’ also meet between Council meetings .

AvMA has a trading company, AvMA Services Ltd, which is used when there has been non-charitable trading beyond the amount permissible by the Charity Commission . AvMA Services Ltd has been inactive in 2020-21 .

Honorary officers

The charity has adopted the practice of electing a Chair, Vice-Chair and Treasurer for a one-year term at the charity’s AGM . December 2020 saw the resignation of Suzanne Shale as Chair and Trustee, Moi Ali was elected as Chair, Angela Brown was re-elected as Treasurer and Caroline Browne was re-elected as Vice-Chair . Jonathan Hazan was appointed treasurer on an interim basis following Angela Brown’s retirement in October 2021 .

Delegation of day to day running of the charity

Trustees delegate the day to day running of the charity to the Chief Executive, Peter Walsh .

All new trustees receive an induction into the work of the charity and their roles and responsibilities as trustees . Trustees are asked to declare any conflicts of interest or matters which may disqualify them as a trustee . Trustees are also encouraged to attend further training where appropriate .

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Action against Medical Accidents Report and financial statements for the year ended 31 March 2021

Patrons

The role of patron does not involve any legal or governance responsibilities . Patrons act as ambassadors for the charity and help by providing advice, taking part in events, making introductions and generally spreading the word about AvMA and its work .

Remuneration of key management personnel

The Council of Management has a remuneration policy covering all employees . All personnel are paid within a defined salary band with annual increments until the top of the band is reached . Salary bands are set and reviewed through trustees’ review of pay scales available in comparable organisations (for example by reviewing job advertisements and/or speaking to recruitment agencies) and by reference to the NJC and NHS Pay Scales . Annual cost of living increments are awarded at the discretion of the Council of Management, based on the Consumer Price Index for the previous calendar year and bearing in mind the charity’s finances and the financial climate generally . AvMA’s full remuneration policy is published on the charity’s website .

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Financial review

Our Medico-Legal department made a contribution (calculated by income less direct costs from note 6) of £219,034 in the year and Other Charitable Trading generated £115,896 . Other income was badly hit by Covid-19: Conferences and Training made a loss of £54,056; Fundraising generated a contribution of £37,099 plus a generous legacy of £450,000 which was received in June 2021 and accrued in the year . Overall this covered the net cost of our public-facing Advice and Information Service of £227,131, our Policy & External Relations costs of £42,828 and our support costs, giving an overall net income of £85,506 for the year . In addition, we had unrealised gains on investments of £214,533, most of which was realised after the year end in a portfolio restructure .

AvMA receives no ongoing funding from NHS or government agencies and is therefore very reliant on its own income generation activities and the generosity of the people we have helped, other supporters and sponsors . For this we are extremely grateful .

The receipt of the Judith Freedman legacy in 2011 means that the charity has been able to invest for its future . The single most significant use of the legacy was the purchase of “Freedman House” on a 999 year lease . This was revalued at £1,600,000 as at 31 March 2021, a fall of £300,000 in the year as a result of changes in the market for office properties; it is still £393,341 higher than the original cost . We also currently hold £1,183,707 in an investment portfolio (see note14) .

As well as no longer paying rent, we are letting out some of the office space to provide us with additional income . We have also been able to operate a deliberate deficit operating budget in order to provide maximum impact to our beneficiaries from our services and operations and invest in new ideas for business development .

Principal risks and uncertainties

The main risk facing the charity continues to be the uncertainty facing the future of clinical negligence litigation . Most of the charity’s income is generated through the provision of services to clinical negligence lawyers, both through the Lawyers’ Service and the provision of conferences and training . Recent legal reforms including the removal of legal aid for the vast majority of clinical negligence cases have already created difficulties for law firms wishing to practice in clinical negligence, which is beginning to see mergers or firms dropping out of clinical

negligence work . This is resulting in a decline in income from lawyers’ service subscriptions and conference delegate places . Government proposals for the introduction of a ‘fixed recoverable costs’ regime could have a much larger impact (as well as threatening access to justice for AvMA’s beneficiaries and the likelihood of the NHS learning from errors) . The charity is addressing this risk by attempting to diversify and develop new sources of income and also planning for managing an anticipated fall in income by reducing expenditure in a carefully planned and staged way . The situation is kept under constant review .

Another principal risk is the uncertainty in financial markets which may affect the charity’s investments . In the light of this, the trustees have reviewed the charity’s investment strategy, de-risking the short-term element of the portfolio and assuming medium risk for the long-term part .

AvMA relies on part of its income coming from rent and service charges received for two floors of Freedman House . The economic situation means that that office space has become harder to let . There is therefore a significant risk income from this source will drop . One floor has been leased for ten years and two other floors are being marketed for lease .

Trustees consider known significant risks and strategies for mitigating them through a risk register which is reviewed regularly by the Finance & Investment Committee, Quality & Outcomes Committee and the Executive Committee, which report to the Council of Management . The risk register is also reviewed annually by the full Council at the charity’s AGM .

Impact of Covid-19 on the charity

Throughout the year we kept operations running smoothly . Fortunately, we had already invested in technology which enabled staff to continue to work from home very efficiently without impacting services to our beneficiaries and other activities, except our conferences and events including fundraising based on events . Our enquiries remained at normal levels throughout the year .

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Face to face events have had to be cancelled or rescheduled due to Covid-19 . The second main lockdown meant the ACNC was not feasible as face to face in April 2021 and it was not possible to reschedule for later in the year; the next one will be in March 2022 . We have been successful in adapting our portfolio of events post Covid-19 to include more profitable/popular virtual events on an ongoing basis as well as planning to return to face-to-face events where appropriate . The virtual ‘not the ACNC’ event was a great success .

Events based fundraising has also not been possible with restrictions in place . We have been concentrating on maximising income from non-events based fundraising whilst these are not possible and are working with our supporters to plan ahead for events once this is possible . Notwithstanding all the challenges, every effort has been made to maximise alternative fundraising and sponsorship income and the financial year finished on a positive note with the pandemic having less impact than originally feared, leaving forecast income from fundraising at 77% of the original budget . In addition we received £450,000 of the anticipated legacy after the year end, with a small additional amount expected

Covid-19 has been specifically considered in all areas of our Risk Register, and the impact has factored into our ten year financial plan . We anticipate that income streams will return to close to normal levels within the next two years . Fortunately, we have sufficient reserves to be able to cope with the temporarily reduced income without major impact to our operations . We continue to monitor the situation and the risks very closely .

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Reserves and investment policy

Background and financial strategy

As set out above, we are in a period when income from our traditional revenue sources is declining significantly, against a background of the current deliberate deficit budget . Current trends and uncertainties lead us to expect this fall to continue in the coming few years .

The trustees have worked hard to develop a long-range financial strategy to address the situation on a timely and considered basis . Our financial strategy is to move to a sustainable balanced budget over a period of 10 years to 2026/27, against the background of anticipated contraction of our traditional revenue streams, through developing new sources of income and making cost efficiencies in a carefully planned manner .

We plan to utilise our current reserves to fund the (reducing) shortfall each year, to continue to provide maximum impact to our beneficiaries, and also to continue to invest carefully in new development activities as appropriate . This is expected to reduce reserves to the target level by the end of the 10-year strategy period . These reserves are held as a separate designated fund, and 1/10 is released each year to general funds, as per note 20 .

Reserves policy

At current activity levels this amounts to target reserves of £558,123 .

Level of reserves

We have free reserves of £624,285 at the year end (£799,693 general funds of which £175,408 is tied up in investments) (see note 19a) . This is an excess of £66,162 against the above year-end target . However, liquidity is carefully managed and the balance is in line with our 10-year financial strategy as explained above .

Investment policy

The trustees have agreed to invest the reserves in an ethical investment portfolio, to achieve returns that enable the funding of AvMA’s requirements both in the short and the long-term . Short-term requirements (up to 3 years) are placed on deposit using a specialist cash management service to optimise returns whilst ensuring appropriate liquidity . The remaining reserves are within a long-term investment portfolio managed by Castlefield . The total investment portfolio including the cash is conservatively structured with an emphasis on capital preservation, but also likely to achieve an overall return in the region of 2 .5% .

Management and trustees monitor the financial plan, reserves levels and investment policy closely in the light of changing circumstances .

We own our office building, Freedman House, outright . This provides cover for catastrophic events, and also for an orderly wind down should this ever be necessary, as well as generating an income and savings on what would be spent on rent .

The trustees have a policy to retain sufficient free reserves to cover working capital requirements and realistic contingencies . This is calculated as:

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Statement of responsibilities of the Council of Management

The Council of Management (whose members are also directors of Action against Medical Accidents for the purposes of company law) is responsible for preparing the report of the Council of Management and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice) .

Company law requires the Council of Management to prepare financial statements for each financial year which give a true and fair view of the state of affairs of the charitable company and the group and of the incoming resources and application of resources, including the income and expenditure, of the charitable company and the group for that period . In preparing these financial statements, the Council of Management are required to:

The Council of Management is responsible for keeping adequate accounting records which disclose with reasonable accuracy at any time the financial position of the charitable company and enable them to ensure that the financial statements comply with the Companies Act 2006, the Charities and Trustee Investment (Scotland) Act 2005 and the Charities Accounts (Scotland) Regulations 2006 (as amended) . It is also responsible for safeguarding the assets of the charitable company and the group and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities .

In so far as the Council of Management is aware:

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

Auditor

Sayer Vincent LLP was re-appointed as the charitable company’s auditor during the year and has expressed its willingness to continue in that capacity .

Approved by the Council of Management on 7 December 2021 and signed on its behalf by

Nigel Holland

Trustee

Peter Walsh

Company Secretary

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Independent auditor’s report To the members of Action Against Medical Accidents

Opinion

We have audited the financial statements of Action against Medical Accidents (the ‘charitable company’) for the year ended 31 March 2021 which comprise the statement of financial activities, balance sheet, statement of cash flows and notes to the financial statements, including significant accounting policies . The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including FRS 102 The Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice) .

In our opinion, the financial statements:

Basis for opinion

We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law . Our responsibilities under those standards are further described in the Auditor’s responsibilities for the audit of the financial statements section of our report . We are independent of the charitable company in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the FRC’s Ethical Standard and we have fulfilled our other ethical responsibilities in accordance with these requirements . We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion .

Conclusions relating to going concern

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

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

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

Other information

The other information comprises the information included in the trustees’ annual report, other than the financial statements and our auditor’s report thereon . The trustees are responsible for the other information contained within the annual report . Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon . Our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the course of the audit, or otherwise appears to be materially misstated . If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether this gives rise to a material misstatement in the financial statements themselves . If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact .

We have nothing to report in this regard .

Action against Medical Accidents Report and financial statements for the year ended 31 March 2021

14

Opinions on other matters prescribed by the Companies Act 2006

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

Matters on which we are required to report by exception

In the light of the knowledge and understanding of the charitable company and its environment obtained in the course of the audit, we have not identified material misstatements in the trustees’ annual report,

We have nothing to report in respect of the following matters in relation to which the Companies Act 2006 and the Charities Accounts (Scotland) Regulations 2006 (as amended) require us to report to you if, in our opinion:

Responsibilities of trustees

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

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

Auditor’s responsibilities for the audit of the financial statements

We have been appointed as auditor under section 44(1)(c) of the Charities and Trustee Investment (Scotland) Act 2005 and under the Companies Act 2006 and report in accordance with regulations made under those Acts .

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

Irregularities, including fraud, are instances of non-compliance with laws and regulations . We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud . The extent to which our procedures are capable of detecting irregularities, including fraud are set out below .

Action against Medical Accidents Report and financial statements for the year ended 31 March 2021

15

Capability of the audit in detecting irregularities

In identifying and assessing risks of material misstatement in respect of irregularities, including fraud and non-compliance with laws and regulations, our procedures included the following:

Because of the inherent limitations of an audit, there is a risk that we will not detect all irregularities, including those leading to a material misstatement in the financial statements 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 to become aware of instances of non-compliance . 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 description of our responsibilities is available on the Financial Reporting Council’s website at: www frc org uk/auditorsresponsibilities . This description forms part of our auditor’s report .

Use of our report

This report is made solely to the charitable company’s members as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006 and section 44(1) (c) of the Charities and Trustee Investment (Scotland) Act 2005 . Our audit work has been undertaken so that we might state to the charitable company’s members those matters we are required to state to them in an auditor’s report and for no other purpose . To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the charitable company and the charitable company’s members as a body, for our audit work, for this report, or for the opinions we have formed .

Noelia Serrano (Senior statutory auditor)

10 December 2021

for and on behalf of Sayer Vincent LLP, Statutory Auditor

Invicta House, 108-114 Golden Lane, LONDON, EC1Y 0TL

Sayer Vincent LLP is eligible to act as auditor in terms of section 1212 of the Companies Act 2006

16

Action against Medical Accidents Report and financial statements for the year ended 31 March 2021

Statement of financial activities

(Incorporating an income and expenditure account)

For the year ended 31 March 2021

Income from:
Note
Donations and legacies
2
Charitable activities
Conferences and training
3
Medico-legal services
3
Advice, information and support
3
Other trading activities
4
Investments
5
Other
Total income
Expenditure on:
Raising funds
6
Charitable activities
Conferences and training
6
Medico-legal services
6
Advice, information and support
6
Policy and external relations
6
Charitable trading activities
6
Total expenditure
Net income / (expenditure) before net
gains on investments
Net (losses)/gains on investments
14
Net losses on investment property
13b
Impairment loss on leasehold property
13a
Net income / (expenditure) for the year
7
Reconciliation of funds:
Total funds brought forward
20
Total funds carried forward
20		 Restricted
£
-
-
-
-
-
-
-
-
-
-
-
162
-
-
162
(162)
-
-
-
(162)
162
-		 Unrestricted
£
518,898
82,675
394,370
796
140,353
50,391
228
1,187,711
46,619
236,766
317,979
403,290
62,743
34,646
1,102,043
85,668
214,533
(150,000)
(150,000)
201
3,890,599
3,890,800		 2021
Total
£
518,898
82,675
394,370
796
140,353
50,391
228
1,187,711
46,619
236,766
317,979
403,452
62,743
34,646
1,102,205
85,506
214,533
(150,000)
(150,000)
39
3,890,761
3,890,800		 Restricted
£
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
162
162		 Unrestricted
£
147,440
381,692
432,873
1,283
134,983
47,022
169
1,145,462
45,140
364,959
292,455
349,358
74,166
29,305
1,155,383
(9,921)
(46,721)
-
-
(56,642)
3,947,241
3,890,599		 2020
Total
£
147,440
381,692
432,873
1,283
134,983
47,022
169
1,145,462
45,140
364,959
292,455
349,358
74,166
29,305
1,155,383
(9,921)
(46,721)
-
-
(56,642)
3,947,403
3,890,761

All of the above results are derived from continuing activities . There were no other recognised gains or losses other than those stated above . Movements in funds are disclosed in Note 20 to the financial statements .

Action against Medical Accidents Report and financial statements for the year ended 31 March 2021

17

Balance sheet

As at 31 March 2021 Company number 2239250

Fixed assets:
Note
Tangible assets: other
12
Tangible assets: leasehold property
13a
Investment property
13b
Investments
14
Current assets:
Debtors
15
Investments: short term deposits
Cash at bank and in hand
Liabilities:
Creditors: amounts falling due within one
year
16
Net current assets
Total assets less current liabilities
Total net assets
The funds of the charity:
20a
Restricted income funds
Unrestricted income funds:
Designated funds
Fair value reserve
General funds
Total unrestricted funds
Total charity funds		 £
605,254
-
1,038,455
1,643,709
541,077
2,786,690
304,417
799,693		 2021
£
4,362
800,000
800,000
1,183,806
2,788,168
1,102,632
3,890,800
3,890,800
-
3,890,800
3,890,800		 £
95,277
240,000
907,259
1,242,536
337,221
2,732,675
77,363
1,080,561		 2020
£
14,002
950,000
950,000
1,071,444
2,985,446
905,315
3,890,761
3,890,761
162
3,890,599
3,890,761

Approved by the trustees on 7 December 2021 and signed on their behalf by

Nigel Holland Trustee

18

Action against Medical Accidents Report and financial statements for the year ended 31 March 2021

Statement of cash flows

For the year ended 31 March 2021

Reconciliation of net income / (expenditure) to net cash fow from operating activities
Net income / (expenditure) for the reporting period
(as per the statement of fnancial activities)
Depreciation charges
(Gains)/losses on investments
Loss on property revaluation
Dividends, interest and rent from investments
(Increase)/decrease in debtors
Increase/(decrease) in creditors
Net cash used in operating activities
Cash fows from operating activities
£
Net cash used in operating activities
Cash fows from investing activities:
Dividends, interest and rents from investments
50,391
Purchase of fxed assets
(2,290)
Proceeds from sale of investments
99,980
Purchase of fxed asset investments and cash invested into portfolio
2,191
Net sale of current asset investments
240,000
Net cash from investing activities
Change in cash and cash equivalents in the year
Cash and cash equivalents at the beginning of the year
Cash and cash equivalents at the end of the year
Analysis of cash and cash equivalents and of net debt
Cash at bank and in hand
Notice deposits (less than three months)
Total cash and cash equivalents
Total		 2021
£
(259,076)
390,272
131,196
907,259
1,038,455
At 1 April 2020
£
214,032
693,227
907,259
907,259		 2021
£
39
11,930
(214,533 )
300,000
(50,391)
(509,977)
203,856
(259,076)
£
47,022
(6,990 )
670,088
(668,647)
244,370
Cash fows
£
87,930
43,266
131,196
131,196		 2020
£
(56,642
12,702
46,721
-
(47,022 )
32,735
(77,224 )
(88,730)
2020
£
(88,730)
285,843
197,113
710,146
907,259
At 31 March 2021
£
301,962
736,493
1,038,455
1,038,455

Action against Medical Accidents Report and financial statements for the year ended 31 March 2021

19

Notes to the financial statements For the year ended 31 March 2021

1 Accounting policies

a) Statutory information

Action against Medical Accidents is a charitable company limited by guarantee and is incorporated in England .

The registered office address and principal place of business is Freedman House, Christopher Wren Yard, 117 High Street, Croydon CR0 1QG .

b) Basis of preparation

The financial statements have been prepared in accordance with Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) - (Charities SORP FRS 102), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Companies Act 2006 .

Assets and liabilities are initially recognised at historical cost or transaction value unless otherwise stated in the relevant accounting policy or note .

c) The charitable company meets the definition of a public benefit entity under FRS 102 .

d) Going concern

The trustees consider that there are no material uncertainties about the charitable company’s ability to continue as a going concern .

The trustees do not consider that there are any sources of estimation uncertainty at the reporting date that have a significant risk of causing a material adjustment to the carrying amounts of assets and liabilities within the next reporting period, including the impact of Covid-19 on the charity within the year and going forward .

For legacies, entitlement is taken as the earlier of the date on which either: the charity is aware that probate has been granted, the estate has been finalised and notification has been made by the executor(s) to the charity that a distribution will be made, or when a distribution is received from the estate . Receipt of a legacy, in whole or in part, is only considered probable when the amount can be measured reliably and the charity has been notified of the executor’s intention to make a distribution . Where legacies have been notified to the charity, or the charity is aware of the granting of probate, and the criteria for income recognition have not been met, then the legacy is a treated as a contingent asset and disclosed if material .

Income received in advance of the provision of a specified service is deferred until the criteria for income recognition are met .

f) Donations of gifts, services and facilities

Donated professional services and donated facilities are recognised as income when the charity has control over the item or received the service, any conditions associated with the donation have been met, the receipt of economic benefit from the use by the charity of the item is probable and that economic benefit can be measured reliably . In accordance with the Charities SORP (FRS 102), volunteer time is not recognised so refer to the trustees’ annual report for more information about their contribution .

On receipt, donated gifts, professional services and donated facilities are recognised on the basis of the value of the gift to the charity which is the amount the charity would have been willing to pay to obtain services or facilities of equivalent economic benefit on the open market; a corresponding amount is then recognised in expenditure in the period of receipt .

g) Interest receivable

Interest on funds held on deposit is included when receivable and the amount can be measured reliably by the charity; this is normally upon notification of the interest paid or payable by the bank .

e) Income

Income is recognised when the charity has entitlement to the funds, any performance conditions attached to the income have been met, it is probable that the income will be received and that the amount can be measured reliably .

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

h) Fund accounting

Restricted funds are to be used for specific purposes as laid down by the donor . Expenditure which meets these criteria is charged to the fund . Restricted funds are set out in note 20 below .

Unrestricted funds are donations and other incoming resources received or generated for the charitable purposes .

Designated funds are unrestricted funds earmarked by the trustees for particular purposes .

Action against Medical Accidents Report and financial statements for the year ended 31 March 2021

20

1 Accounting policies (continued)

i) Expenditure and irrecoverable VAT

Expenditure is recognised once there is a legal or constructive obligation to make a payment to a third party, it is probable that settlement will be required and the amount of the obligation can be measured reliably .

Expenditure is classified under the following activity headings:

Irrecoverable VAT is charged as a cost against the activity for which the expenditure was incurred .

j) Allocation of support costs

Support and governance costs are re-allocated to each of the activities on the following basis which is an estimate, based on staff time, of the amount attributable to each activity:

• Conferences and training 22%
• Medico-legal services 31%
• Advice, information and support 38%
• Policy and external relations 4%
• Raising funds 3%
• Charitable trading activities 2%

Governance costs are the costs associated with the governance arrangements of the charity . These costs are associated with constitutional and statutory requirements and include any costs associated with the strategic management of the charity’s activities .

k) Operating leases

Rental charges are charged on a straight line basis over the term of the lease .

l) Tangible fixed assets

Items of equipment are capitalised where the purchase price exceeds £200 . Depreciation costs are allocated to activities on the basis of the use of the related assets in those activities . Assets are reviewed for impairment if circumstances indicate their carrying value may exceed their net realisable value and value in use .

Where fixed assets have been revalued, any excess between the revalued amount and the historic cost of the asset will be shown as a revaluation reserve in the balance sheet . Property revaluation is included within the property designated fund .

Depreciation is provided at rates calculated to write down the cost of each asset to its estimated residual value over its expected useful life . The depreciation rates in use are as follows:

m) Listed investments

Investments are a form of basic financial instrument and are initially recognised at their transaction value and subsequently measured at their fair value as at the balance sheet date using the closing quoted market price . Any change in fair value will be recognised in the statement of financial activities and any excess of fair value over the historic cost of the investments will be shown as a fair value reserve in the balance sheet . Investment gains and losses, whether realised or unrealised, are combined and shown in the heading “Net gains/ (losses) on investments” in the statement of financial activities . The charity does not acquire put options, derivatives or other complex financial instruments .

Investments in subsidiaries

Investments in subsidiaries are at cost .

Investment properties

Investment properties are measured initially at cost and subsequently included in the balance sheet at fair value . Investment properties are not depreciated . Any change in fair value is recognised in the statement of financial activities . The valuation method used to determine fair value will be stated in the notes to the accounts .

n) Debtors

Trade and other debtors are recognised at the settlement amount due after any trade discount offered . Prepayments are valued at the amount prepaid net of any trade discounts due .

o) Cash at bank and in hand

Cash at bank and cash in hand includes cash and short term highly liquid investments with a short maturity of three months or less from the date of acquisition or opening of the deposit or similar account . Cash balances exclude any funds held on behalf of service users .

Action against Medical Accidents Report and financial statements for the year ended 31 March 2021

21

1 Accounting policies (continued)

p) Creditors and provisions

Creditors and provisions are recognised where the charity has a present obligation resulting from a past event that will probably result in the transfer of funds to a third party and the amount due to settle the obligation can be measured or estimated reliably . Creditors and provisions are normally recognised at their settlement amount after allowing for any trade discounts due .

q) Financial instruments

The charity only has financial assets and financial liabilities of a kind that qualify as basic financial instruments . Basic financial instruments are initially recognised at transaction value and subsequently measured at their settlement value with the exception of bank loans which are subsequently measured at amortised cost using the effective interest method .

r) Pensions

The charitable company offers all staff a stakeholder pension scheme in accordance with auto enrolment requirements . The charitable company pays an agreed contribution to this scheme on their behalf . The assets of the pension fund are independent from the company and the pension cost charge represents contributions payable . The charitable company has no additional liability other than for the payment of those contributions .

2 Income from donations and legacies

Income from donations and legacies
Experts’ donations
Others’ events
Unclaimed clients’ money
Legacies
Other donations
Corporate sponsorship
Sponsored leafets
Other fundraising		 2021
Total
£
11,496
(64)
19,242
456,327
9,804
7,500
13,605
987
518,898		 2020
Total
£
26,653
22,650
47,194
-
16,067
7,500
16,161
11,215
147,440

All funds for 2021 and 2020 were unrestricted .

3 Income from charitable activities

Income from charitable activities
Delegate, sponsor and webinar income
Total: conferences and training
Subscription fees
Referral panel fees
Total: medico-legal services
Other
Total: advice, information and support
Total income from charitable activities
All funds for 2021 and 2020 were unrestricted
Income from other trading activities
AvMA events
Website subscriptions
Lawyers’ service directory
Publications
Fees earned
All funds for 2021 and 2020 were unrestricted
Income from investments
Dividends and interest
Rent		 2021
Total
£
82,675
82,675
381,920
12,450
394,370
796
796
477,841
2021
Total
£
-
101,532
11,040
12,714
15,066
140,353
2021
Total
£
8,811
41,580
50,391		 2020
Total
£
381,692
381,692
413,973
18,900
432,873
1,283
1,283
815,848
2020
Total
£
1,071
98,007
11,874
12,678
11,353
134,983
2020
Total
£
23,042
23,980
47,022

4 Income from other trading activities

5 Income from investments

All funds for 2021 and 2020 were unrestricted .

Action against Medical Accidents Report and financial statements for the year ended 31 March 2021

22

6a Analysis of expenditure (current year)

Analysis of expenditure (current year)
Staf costs (Note 8)
Direct cost of events
Travel, subsistence and accommodation
Call handling
Investment management fees
Other professional fees
Ofce costs
Premises costs
Depreciation
Training and development
Major projects
Sundry
Direct expenditure
Support costs
Governance costs
Total expenditure 2021
Total expenditure 2020		 Cost of
raising funds
£
31,553
-
-
-
-
-
246
-
-
-
-
-
31,799
13,572
1,248
46,619
45,140		 Charitable activities Charitable
trading
activities
£
19,877
3,980
-
-
-
600
-
-
-
-
-
-
24,457
9,331
858
34,646
29,305		 Governance
costs
£
31,476
-
55
-
-
7,300
23
-
-
-
-
143
38,997
-
(38,997)
-
-		 Support
costs
£
230,690
-
-
-
9,629
5,851
49,106
56,250
11,930
1,809
52,759
6,106
424,130
(424,130)
-
-
-		 2021
Total
£
872,132
16,442
97
4,792
9,629
14,201
55,830
56,250
11,930
1,809
52,759
6,334
1,102,204
-
-
1,102,204		 2020
Total
£
828,877
151,856
4,490
3,141
13,665
15,248
69,971
46,403
12,702
5,461
-
3,569
Conferences
and training
Medico-legal
services
£
£
126,122
170,877
10,159
1,507
-
-
-
-
-
-
-
-
449
2,867
-
-
-
-
-
-
-
-
-
85
136,730
175,336
91,612
130,632
8,423
12,011
236,766
317,979
364,959
292,455		 Advice,
information
and support
£
219,203
796
42
4,792
-
-
3,094
-
-
-
-
-
227,927
160,745
14,780
403,452
349,358		 Policy and
external
relations
£
42,333
-
-
-
-
450
45
-
-
-
-
-
42,828
18,238
1,677
62,743
74,166
1,155,383
-
-
1,155,383
1,155,383

In 2021 £162 expenditure was restricted, the balance was unrestricted . In 2020 all expenditure was unrestricted .

Action against Medical Accidents Report and financial statements for the year ended 31 March 2021

23

6b Analysis of expenditure (prior year)

Analysis of expenditure (prior year)
Staf costs (Note 8)
Direct cost of events
Travel, subsistence and accommodation
Call handling
Investment management fees
Other professional fees
Ofce costs
Premises costs
Depreciation
Training and development
Sundry
Direct expenditure
Support costs
Governance costs
Total expenditure 2020		 Cost of raising
funds
£
30,813
-
5
-
-
-
1,131
-
-
-
-
31,949
11,771
1,420
45,140		 Charitable activities Charitable
trading
activities
£
19,187
557
-
-
-
600
293
-
-
-
-
20,637
7,735
933
29,305		 Governance
costs
£
31,370
-
1,469
-
-
7,650
20
-
-
-
57
40,566
-
(40,566)
-		 Support costs
£
186,465
-
826
-
13,665
6,998
60,274
46,403
12,702
5,461
3,509
336,303
(336,303)
-
-		 2020
Total
£
828,877
151,856
4,490
3,141
13,665
15,248
69,971
46,403
12,702
5,461
3,569
Conferences
and training
£
127,943
148,087
65
-
-
-
1,054
-
-
-
-
277,149
78,358
9,452
364,959		 Medico-legal
services
£
174,107
1,400
348
-
-
-
2,782
-
-
-
3
178,640
101,564
12,251
292,455		 Advice,
information
and support
£
206,095
1,812
106
3,141
-
-
4,417
-
-
-
-
215,571
119,386
14,401
349,358		 Policy and
external
relations
£
52,897
-
1,671
-
-
-
-
-
-
-
-
54,568
17,489
2,109
74,166
1,155,383
-
-
1,155,383

Action against Medical Accidents Report and financial statements for the year ended 31 March 2021

24

7 Net incoming resources for the year

Net incoming resources for the year
This is stated after charging / (crediting): 2021 2020
£ £
Depreciation 11,930 12,702
Auditor’s remuneration (excluding VAT):
Audit - current year 7,300 7,150
Foreign exchange losses/(gains) 102 (5)
personnel
Staf costs were as follows:
Salaries and wages
Social security costs
Employer’s contribution to defned contribution
pension schemes		 2021
£
786,315
68,506
17,311
872,132		 2020
£
745,643
66,252
16,982
828,877

The following number of employees received employee benefits (excluding employer pension costs and national insurance) during the year between:

2021 2020
No. No
£70,000 - £79,999 1 1
£60,000 - £69,999 1 1

The total employee benefits including pension contributions and employer’s national insurance of the key management personnel were £141,628 (2020: £126,200) . The increase is due to a change in staff responsibilities arising from the retirement of the deputy chief executive .

The charity trustees were not paid or received any other benefits from employment with the charity in the year (2020: £nil) . No charity trustee received payment for professional or other services supplied to the charity (2020: £nil) .

Trustees’ expenses represents the payment or reimbursement of travel, subsistence and accommodation costs totalling £55 (2020: £1,556) incurred by one (2020: 5) member relating to attendance at trustee meetings and events and telephone costs .

9 Staff numbers

The average number of employees (head count based on total number of staff employed) during the year was as follows:

during the year was as follows:
Raising funds
Conferences and training
Medico-legal services
Advice, information and support
Policy and external relations
Charitable trading activities
Support
Governance		 2021
No.
0.6
4.0
5.7
7.0
0.8
0.4
5.5
0.6
24.6		 2020
No
0 6
4 0
5 2
6 1
0 9
0 4
5 0
0 6
22 8

The average number of employees (based on equivalent number of full-time staff employed) during the year was as follows:

during the year was as follows:
Raising funds
Conferences and training
Medico-legal services
Advice, information and support
Policy and external relations
Charitable trading activities
Support
Governance		 2021
No.
0.6
3.0
3.8
4.9
0.7
0.3
4.2
0.5
18.0		 2020
No
0 6
3 1
4 0
5 7
0 8
0 3
4 1
0 5
19 1

Action against Medical Accidents Report and financial statements for the year ended 31 March 2021

25

10 Related party transactions

There are no related party transactions to disclose for 2021 (2020: none) .

There are no donations from related parties which are outside the normal course of business and no restricted donations from related parties (2020: none) .

11 Taxation

The charitable company is exempt from corporation tax as all its income is charitable and is applied for charitable purposes .

12 Tangible fixed assets

Tangible fxed assets
Cost or valuation
At the start of the year
Additions in year
Disposals in year
At the end of the year
Depreciation
At the start of the year
Charge for the year
Eliminated on disposal
At the end of the year
Net book value
At the end of the year
At the start of the year		 Computer
equipment
and website
£
90,779
2,290
-
93,069
78,704
11,022
-
89,726
3,343
12,075		 Ofce
equipment
and furniture
EMIS database
£
£
61,372
20,000
-
-
-
-
61,372
20,000
59,445
20,000
908
-
-
-
60,353
20,000
1,019
-
1,927
-		 Total
£
172,151
2,290
-
174,441
158,149
11,930
-
170,079
4,362
14,002

All of the above assets are used for charitable purposes . The leasehold property is disclosed separately, see note 13 .

13 Property

The charity owns the leasehold to Freedman House which comprises 4 floors . The ground and first floor are currently occupied by the charity and disclosed as tangible fixed assets . The second and third floors are rental and disclosed as investment property . The original cost in 2013 was £1,206,659 .

As at 31 March 2018 the value for the total property was £2,050,000; at 31 March 2019 and 2020 it was £1,900,000 . The trustees obtained an informal valuation at 31 March 2021 from our estate agent, based on potential resale value . The value has fallen by £300,000 to £1,600,000 in the year as a result of adjustments in the market . This is £393,341 higher than the original cost .

13a Tangible fixed assets: Leasehold property (ground and first floors)

Valuation
At the start of the year
Additions in year
At the end of the year
Depreciation
At the start of the year
Impairment losses
At the end of the year
Net book value
At the end of the year		 2021
£
1,025,000
-
1,025,000
75,000
150,000
225,000
800,000		 2020
£
1,025,000
-
1,025,000
75,000
-
75,000
950,000

13b Investment property (second and third floors)

Investment property (second and third foors)
Fair value at the start of the year
Additions
Disposals
Revaluation during the year
Fair value at the end of the year		 2021
£
950,000
-
-
(150,000)
800,000		 2020
£
950,000
-
-
-
950,000

26

Action against Medical Accidents Report and financial statements for the year ended 31 March 2021

14 Investments

Investments
Fair value at the start of the year
Additions at cost
Disposal proceeds
Net gain/(loss) on change in fair value
Movements in cash element of portfolio
Fair value at the end of the year
Historic cost at the end of the year
Investments comprise:
Investment Trusts/OEICs/REITs/SICAVs
Cash
Share in subsidary undertaking (see below)		 2021
£
1,071,345
-
(99,980)
214,533
(2,191)
1,183,707
879,290
1,150,863
32,844
1,183,707
99
1,183,806		 2020
£
1,119,507
668,560
(670,088)
(46,721)
87
1,071,345
993,982
1,036,310
35,035
1,071,345
99
1,071,444

16 Creditors: amounts falling due within one year

Creditors: amounts falling due within one year
Taxation and social security
Other creditors
Accruals
Deferred income (note 17)		 2021
£
50,038
18,908
37,921
434,210
541,077		 2020
£
39,461
8,286
19,139
270,335
337,221

17 Deferred income

Deferred income comprises subscriptions, conference fees and other income received in advance

advance
Balance at the beginning of the year
Amount released to income in the year
Amount deferred in the year
Balance at the end of the year		 2021
£
270,335
(270,335)
434,210
434,210		 2020
£
329,319
(329,319)
270,335
270,335

Subsidiary undertaking

The charitable company owns the whole of the issued ordinary share capital of AVMA Services Limited, a company registered in England . The company did not trade in this or the prior financial year . The subsidiary’s net assets are £99 (2020: £99) .

18 Pension scheme

The charity contributes to a defined contribution stakeholder pension scheme for its employees . Contributions are set out in note 8 above . There were no amounts owed at 31 March 2021 (2020: £nil) .

15 Debtors

Debtors
Trade debtors
Other debtors
Prepayments
Accrued income		 2021
£
47,467
17,686
84,729
455,372
605,254		 2020
£
1,382
28,168
52,731
12,996
95,277

Action against Medical Accidents Report and financial statements for the year ended 31 March 2021

27

19a Analysis of net assets between funds (current year)

Tangible fxed assets - other
Tangible fxed assets -
leasehold property
Investment property
Fixed asset investments
Accrued income
Other net current assets
Net assets at the end of
the year		 Restricted
General
unrestricted
£
£
-
-
-
-
-
-
-
175,408
-
455,372
-
168,913
-
799,693		 Fair value
reserve
Designated
Total funds
£
£
£
-
4,362
4,362
-
800,000
800,000
-
800,000
800,000
304,417
703,981
1,183,806
-
-
455,372
-
478,347
647,260
304,417
2,786,690
3,890,800		 Fair value
reserve
Designated
Total funds
£
£
£
-
4,362
4,362
-
800,000
800,000
-
800,000
800,000
304,417
703,981
1,183,806
-
-
455,372
-
478,347
647,260
304,417
2,786,690
3,890,800
3,890,800

19b Analysis of net assets between funds (prior year)

Tangible fxed assets -
other
Tangible fxed assets -
leasehold property
Investment property
Fixed asset investments
Investments - notice
deposits
Accrued income
Other net current assets
Net assets at the end of
the year		 Restricted
General
unrestricted
£
£
-
-
-
-
-
-
-
175,408
-
240,000
-
12,996
162
652,157
162
1,080,561		 Fair value
reserve
Designated
Total funds
£
£
£
-
14,002
14,002
-
950,000
950,000
-
950,000
950,000
77,363
818,673
1,071,444
-
-
240,000
-
-
12,996
-
-
652,319
77,363
2,732,675
3,890,761		 Fair value
reserve
Designated
Total funds
£
£
£
-
14,002
14,002
-
950,000
950,000
-
950,000
950,000
77,363
818,673
1,071,444
-
-
240,000
-
-
12,996
-
-
652,319
77,363
2,732,675
3,890,761
3,890,761

20a Movements in funds (current year)

Restricted funds:
Access audit
Total restricted funds
Unrestricted funds:
Designated funds:
Property value
Other fxed assets
Major repairs and
maintenance
ICT replacement
Transitional fund
Connect Assist project
CRM replacement
Business development
projects
New website and fnance
software
Laptop replacement
Total designated funds
Fair value reserve
General funds
Total unrestricted funds
Total funds		 At the start
of the year
£
162
162
1,900,000
14,002
200,000
12,618
600,000
6,055
-
-
-
-
2,732,675
77,363
1,080,561
3,890,599
3,890,761		 Incoming
and gains
Expenditure
and losses
£
£
-
(162)
-
(162)
-
-
-
(11,930)
-
-
-
-
-
-
-
(3,250)
-
-
-
-
-
-
-
-
-
(15,180)
-
-
1,402,244
(1,386,863)
1,402,244
(1,402,043)
1,402,244
(1,402,205)		 Transfers
£
-
-
(300,000)
2,290
-
(2,290)
(100,000)
(2,805)
202,000
175,000
70,000
25,000
69,195
227,054
(296,249)
-
-		 At the end
of the year
£
-
-
1,600,000
4,362
200,000
10,328
500,000
-
202,000
175,000
70,000
25,000
2,786,690
304,417
799,693
3,890,800
3,890,800

28

Action against Medical Accidents Report and financial statements for the year ended 31 March 2021

20b Movements in funds (prior year)

At the start
of the year
(restated)		 Incoming
and gains		 Expenditure
and losses		 Transfers At the end
of the year
£ £ £ £ £
Restricted funds:
Access audit 162 - - - 162
Total restricted funds 162 - - - 162
Unrestricted funds:
Designated funds:
Property value 1,900,000 - - - 1,900,000
Other fxed assets 19,713 - (12,701) 6,990 14,002
Major repairs and
maintenance		 200,000 - - - 200,000
ICT replacement 18,067 - - (5,449) 12,618
Transitional fund 700,000 - - (100,000) 600,000
Connect Assist project 6,055 - - - 6,055
Total designated funds 2,843,835 - (12,701) (98,459) 2,732,675
Fair value reserve 306,888 - - (229,525) 77,363
General funds 796,518 1,098,741 (1,142,682) 327,984 1,080,561
Total unrestricted funds 3,947,241 1,098,741 (1,155,383) - 3,890,599
Total funds 3,947,403 1,098,741 (1,155,383) - 3,890,761

Purposes of restricted funds

Access audit: received from City Bridge Trust to carry out an access audit of Freedman House . The balance has been spent on similar work in 2020/21 .

Purposes of designated funds

Property value: the charity purchased the leasehold to Freedman House on 2 May 2013 for £1 .2 million . This has been carried at valuation since 31 March 2018, and is split 50:50 between functional fixed assets (ground & 1st floors) and investment property (2nd & 3rd floors) .

Major repairs and maintenance: for major works to maintain the value of the property in the future .

ICT replacement: to cover programme of ICT replacement . Transfers reflect ICT equipment which has been purchased during the year .

Transitional fund: to allow the charity to continue to meet its charitable objects at as near as possible the level of activity and impact as the year 2015/16 whilst new sources of income are explored and where necessary expenditure reduced, moving toward a sustainable balanced budget in accordance with our 10-year financial plan . The funds are released on a straight line basis over 10 years .

Connect Assist project: to implement recommendations of Connect Assist report on data, website and helpline, including employment of temporary IT worker and software/website development costs . The balance has been spent in 2020/21 on helpline and CRM development .

CRM replacement: to complete the project to replace our legacy CRM system Seneca . Includes development costs and project management .

Business development projects: to invest in projects to develop new recurring income streams for the future .

New website and finance software: to implement new finance software Iplicit and develop new website for the organisation .

Laptop replacement: one-off project to replace the laptops used by all staff .

Fair value reserve: this represents the unrealised gains/losses on fixed asset investments .

21 Capital commitments

At the balance sheet date, the charity had no capital commitments (2020: £nil) .

22 Contingent assets and liabilities

At the balance sheet date the charity had no contingent liabilities .

23 Legal status of the charity

The charity is a company limited by guarantee and has no share capital . The liability of each member in the event of winding up is limited to £1 .

24 Post Balance Sheet events

As stated in note 13 above, the ground and first floor are currently occupied by the charity, the second and third floors are rental . This gives a 50:50 split between tangible fixed assets and investment property . Due to the impact of the pandemic and the uptake in remote working, since the year end it has been decided to free up one of the floors that we occupy and market it for rental . This will make the split 25:75, and this will be reflected in the 2022 accounts .

Other fixed assets: reflects the reducing net book value of the ICT, website, furniture and office equipment . The transfer represents the cost of assets purchased in the year .

Action against Medical Accidents Report and financial statements for the year ended 31 March 2021

29

Action against Medical Accidents

Freedman House Christopher Wren Yard 117 High Street Croydon CR0 1QG 020 8688 9555 www.avma.org.uk

[www.facebook.com/AvMAuk]

[@AvMAuk]

Action against Medical Accidents (AvMA) is a registered charity in England and Wales (number 299123) and in Scotland (number SCO39683)