2022-03-31-accounts

Company number: 2239250 Charity number.. 299123 OSCR number.. SC039683 Action against Medical Accidents Report and financial statements For the year ended 31 March 2022 SA YER V I NCENT

Artion against Medical Accidents Contents For the year ended 31 March 2022 Reference and administrative details Report of the Board of Trnstees Independenr auditor's report Statement of financial activities Balance sheet Sratement of cash flows Notes to the financial statements -22 -23 -24 .25

Actlon against Medical Accidents Reference and adminlstrative detai15 For the year ended 31 March 2022 Action agalnst Medical Accidents lalso known as "AVMA") Company number Country of Incorporatton 2239250 United Kingdom Charity number Country of registration 299123 England & Wales OSCR number SC039683 Registered and principal office address Freedman House Christopher Wren Yard, 117 High Street CROYDON, CIO I QG Patrons Peter Ransley (Honorary Presiderjtl Baroness Masham of Iiton Ume5h Prabhu Jame5 Badenoch QC Dame Professor Donna Kinnair Honorary officers Jocelyn Cornwell Nigel Holland Caroline Browne Chair lelecred December 20211 Treasurer (elected December 20211 Senior Independent Director l July 20221 Trustees Moi Ali Michael Andersson Angela Brown Caroline Browne Janine Collier Jocelyn Cornwell Maggie Davies Jonathan Hazan Nigel Holland Linda Kenward Amrat Khorana Bill Kilvington Mary Smith (resigned December 20211 (retired October 20211 (resigned December 2021) (resigned October 2021) (appointed December 20211 (appointed December 20211 Key management personnel Peter Walsh Nathan Bacon Nicky Rushden Chief Executive Iriternal Resources Manager Finance Manager

Action agalnst Medical Accldents Reference and administratlve details For the year ended 31 March 2022 Bankers Co-operative Bank plc Delf House. Southway SKELMERSDALE. WN8 6NY Tavi5tock Private Client Ltd The Barn. Downing Park Station Rd, Swaffham Bulbeck CAMBRIDGE, CB25 ONW Independent financial advisors Casrlefield Advisory Partners Ltd 4-6 Staple Inn, High Holborn LONDON, WCIV 7QH Audltor Sayer Vincenl LLP Chartered Accouncanrs and SraELJrory Audiior5 nvicia House, 108-114 Golden Lane LONDON. ECI Y OTL Solicitor5 Tees Law Tees House 95 London Road Bishop's Storrford HERTFORDSHIRE, CM23 3GW

Action Against Medical Accidents Report of thè Board of Trustees For the year ended 31 March 2022 The Board of Trustees presents irs reporr and the alsdited financial statements for (he year ended 31 March 2022. Reference and administrative information Sei out on pages l and 2 forms part of thi5 report. The financial statements comply with curreni siatuiory requirements, Ihe 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. iv s and Activities The chief objects of the charity described in the memorandum of association are.. he relief of sickness and condition5 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 'lo support people affected by avoidable harm in healthcare- to help them achieve justice-, and to promote better patient safety for all". Our beneficlarles 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 change5 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. utshell- Our ke actlvltles Includln rformance in 2021 The achievements of panicular note during the year were= We started 2021-22 with a refreshed board of trustees Wlth four new trustees with impressive background5 appointed in March 2021 . We also took the innovative step of recruiting two 'trainee trustees. to help attract new talent without formal board experience so that they can gain governance experience before taking on the full trustee role. Both went on to be appointed as full trustees In December 2021, when we also appointed a new Chair, Jocelyn Cornwell. We took the lead in making the case for the 'lndependent Senior Advocates. (recommended by Donna Ockenden in her review of Shrewsbury and Telford NHS Trust maternity failures) needing to be genuinely independent, rather than employed by the NHS itself. We continued to get excellent feedback on the quality of advice provided to people affected by healthcare harm and Increased the number of people we helped direcrly

Artion Agalnst Medical Accidents Report of the Board of Trustees For the year ended 31 March 2022 Our work on the 'Harmed Patient Care Pathway, received widespread recognition, with several NHS trusts offering to pilot the approach and elements of the Pathway being adopted by the Patient Safety Incident Response Framework. Advice Information and Su ort The advice and sUPPOrt we provide to people affected by avoidable harm in healthcare is at the very heart of what AvK4A does, and the experience of our clients informs everything we do. In 2021-22 we directly helpecl 2,717 people lup from 2,590 in 2020-21 I, with many others benefirring from our self-help guides and online information. There were 13,705 download5 of these lup from 11,500 in 2020-211. Our Helpline provides specialist, sympathetic support to people when they are coping with the trauma of their experience. It reassures rhem that an organisation exists which understands their plight and is here to help them. Our helpline staff and VDlunteers explain people's rights. how different med ico-legal proces5e5 and procedures work, and they put people in touch with other 5pecialisr support where needed. We trained 50 new volunteers in the year. We are grateful co our team of 97 trained volunteers who enable us to make this service available Monday to Friday l Oam-3.30pm. In 2021 -22 we advised on 2.052 calls lup from 1.894 in 2020-21). These are often exirernely serious and complex cases. AVMA is the only charity providing a specialisr medico-legal helpline in the UK and it can get very busy. AVMA'S caseworkers, who are all experienced professionals and are either medically andlor 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 rhe case may have broader lesson5 for patient safery, or link with one of AVMA'S campaign priorities. In 2021-22 we opened S 5 S new casework files. IMPAcf- Caller5 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 infomied decisions about what ￿ do next through our specialist advice and are better equipped to make use of the procedures available to them. Often. this enables them to acce55 a specialist solicitor and eventualty obtain cornpensation- andlor. to have their complaint5 or concerns properly addressed and resolved-, andlor to achieve mea5ure5 to protect other patients/improve patient safety. An important part of our casework is the SLtpport we provide to families involved in healthcare relared inquests. This empowers familles 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 inquesis, 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, giving their time, advocacy ski115 and expertise freely. It also involves a huge investmeni of time and effort in our caseworkers considering. researching and investigating the

Acrion Against Medical Accidents Repor[ of the Board of Trustees For the year ended 31 March 2022 issues (medical and circumstantiall believed to be relared EO rhe death and where appropriate Ill5trurting the barrister, supporting the family. and attending the inquests. We helped five families in this way over the year, involving multiple hearings. A nurnber of important conclusions have been arrived at in inquests where we arranged representation for families, including recommendations for improving patient safety, via Prevention Future Death IPFDI reports which may not have been achieved had we not been involved. In some circumstances Serious Investigation Reports (SIRI or equivalent processes were instigated as a direct result of AvMA's involvement. these processes would likely have been avoided without that involvement. Some of the SIR offered up Action Plans which may obviate the need for a PFD. Arguably where a trust offers up its own action plan it may be just as influential for improving patient safety as a PFD. Thls Is because the impetus for change comes from the trust itself. it is not imposed on it by direction of the coroner. Families gained a better insight iTrto the circumstances leading to their family member's death. In addition we gave advice and information to a further 95 families who were facing a forrhcoming inquest. to help them prepare and lor to get legal representarion at the inquest lup from 76 in 2020-21). Some of these cases are very complex and time consuming. Supporting families at inquest5 was made more challenging due ro the pandemic, as coroners. courts closed for a period- travel was not always possible,. and some hearings and pre inquest reviews had to be held online {via Teamslzoomlsimilar) or phone, this approach was referred to as remote or partial remote hearings . Demand for rhe inque5r Service exceeds what we can supply by way of representarion 50 we have written criteria for the cases we will take on, all applications for representation are judged against these criteria, which ensures equality and fairne55 in the process. All applications are read by caseworkers and then discussed at a weekly allocation meeting where views on rhe merits of rhe case are shared. We have noticed a trend in inquests becoming more complex and taking Knore 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 can take on with existing resources. We assisted through the pandemic by preparing families and helping to manage their expectations about remote and partial remote hearing5 a5 well as the coronial process more generally. Remotelpartial 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 and our professionally qualified caseworkers were able to accommodate the challenge and uncertainty created by this change in process. IMPA￿. Families who have105t a family member as a result of avoidable harm are all given information and advice on the coronial process, on limitation and on the terms of the pro bono inquest service. The beneficiaries we are able to provide assistance to at the healthcare inquest hearlng are represented by qualified barristers and feel empowered by havlng a legal representative raise relevant point5 of law (for example. Article 2 arguments- neglect as a rider to a conclusion) and pose questions to the coroner and other witnesses attendlng to give evidence at inquests. The coroner is sometlmes helped to recognise issues that need to be addressed to protect future patlentslimprove patient safery and to Issue a 'prevention of future deaths. letter. It can also encourage the coroner to seek independent medical expert evldence before the full hearing thereby contributlng to the coroner holdlng a full and fearle55 enquiry and ensuring that the evidence is available to be consldered when the coroner arrives at their conclusion. Early

Attion Agalnst medic￿ Accidents Report of the Board of Trustees For the year ended 31 March 2022 involvement before the full hearing can enable famllies to Invlte the coroner to call relevant witnesses to glve evldence at the hearlng which they may have omltted to do wlthout our involvement. Poli relatlons Inftuencin Poli Whilst the direct supporr we provide to our beneficiarie5 - people whose lives have been affected by safety failures IS Vltally important in its own right, it also informs our policy and campaigns work. It fuels our passion to bring abour changes that will benefit many more people than we can ever reach ourselves. 2021-22 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 acces5 to justice on behalf of Parients due to its unique role. The initial report by Donna Ockenden in 2021 into maternity service failures at Shrewsbury and Telford NHS Trust included a recommendation for the role of Independent Senior Advocates to be developed. The advocates would support women and families who experience adverse incidents and face investigations. We participated in a 'stakeholder group. to advise NHS Englandllmprovement on taking this fonvard but the group only met once before the group was suddenly informed in November 2021 that a decision had been taken that the 'lndependent Advocates. would be employed by the NHS. We worked with other stakeholder5 to try to persuade NHS England that this would nor be 'independent' or enjoy the confidence of harmed women or their families. We continue to try ro find a solution and avoid what would be a missed opportunity to provide much needed support to these people. Our work around Just culture. in healihcare and Ihe 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. This has been very well received by many stakeholders in healthcare and our beneficiaries. Our hope is that following furEher development of the concepr and piloting of the approach thi5 will lead to a rnuch better defined and resourced approach to supporting harmed patients and their families. 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, bur are experted to emerge in 2022-23 and may now include even more radical proposals. We continued to make the case for full access to justice for harmed patientsltheir families., that this is a vital part of a 'just culture, and also important for ensuring lessons are learnt for patient safety. In particular, we gave evidence to the Health and Social Care Committee investigation looking at NHS Litigation Reform and developed a comprehensive response to the formal consultation on fixed

Artion Against Medlcal Accidents Report of the Board of Trustees For the year ended 31 March 2022 recoverable cost in clinical negligence. We also convened a 'Legal Think Tank. of lawyers to help plan and prepare for further experted leg31 reform proposals for clinical negligence. We were pleased that the Justice Committee's review of the Coroners, service rook on board evidence from ourselves and others and made a recommendation for legal aid to be available for families who face inquests into public disasters or deaths where public bodies are legally represented. Sadly. the Minisrry of Justice is still not accepting thls recommendation. but our work goes on to try to address Ihis clear injustice. We continued to work with NHS Resolution and other5 building on Ihe 5ucce55ful co-operaiion over a legal protocol for clinical negligence cases during the covid pandemic. 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 various meetings and working groups Staff and trustees were also represented on several advisory groups for relevant research projects. In 2021- 22 we also made formal responses to the following consultations.. "Regulating Health Professionals,. protecting the Public" Department of Health & Social Care "Duty of Candour in Northern Ireland" Department of Health, Northern Ireland "Review of the Parliamentary and Health Service Ombudsman" the Public Administration & Constitutional Affairs Committee -NHS Litigation Reform evidence to Health & Social Care Committee "Pre-Action Protocol" Civil Justice Council IMPA￿. Our work on the duty of candour wlll mean that more people get to hear the truth about what happened and are told in a compassionate way. Our work on 'fixed recoverable costs. Jaccess to justice should mean that more people retain the ability to access justice and ensure health providers recognise they have made a mistake. Conferences and t 21 readin Awaren d Practlce In spite of disruption due to the covid pandemic continuing to disrupt events in 2021 a total of 788 delegates attended AVMA'S four physical 'face to face. events in 2021-22 (Court of Protection, Panel Meeting, Christmas Drinks Reception, and our Annual Clinical Negligence Conference). A further 469 joined the two online conferences live. with 2 58 accessing the content on demand after the event. 262 delegates joined our live webinars, with a further 201 accessing the content on demand. This means a total of 2,040 people benefitted from our training and events in 2021- 22 compared with 740 in 2020-21 and I ,123 in 2019-20. Despite having to postpone some events due to Covid during the 2021-22 financial year we still comfortably surpassed budger due to the success of the Annual Conference and the three other physical events that we were able to run in September and December and the popularity of online events earlier in the financial

Actlon Against Medlcal Accidents Report of the Board of Trustees Forthe year ended 31 March 2022 year. The 32nd Annual Clinical Negligence Conference {ACNCI took place on 24-25 March 2022 in Leeds, after a three-year hiatus due ro Covid. The event was a great success, with delegate bookings nearly reaching the same levels as 2019. a record number of exhibirion bookings and a healthy profit well ahead of budget. I 00% of attendees who completed evalLiation forms for our events replied 'Yes" when asked "Do you expect that you will use the learning from thi5 conference in your work?. ImpA￿-. Enhancing the 5ki11s and knowledge of legal and health professionals results in our beneficiaries receiving good quality advice and representation from them. Medi al services Although rhe majority of people AVMA helps do not take legal action, some of the mosr vulnerable people AVMA seNes 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 POS5ible 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 interpreiing medical issues. Law firms subscribe to this service, which provides AvMA'5 single biggest income stream. Most of the services continued to be provided uninterrupted by the pandemic, wirh staff working from home. However, our regional Lawyers, Service Group meetings had to move ro an online format. These meetings usually involve a medical and a legal speaker as well as an AVMA update and provide an opportuniry for networking. The online meetings were well received in the circumstances. but we are exploring how besi to arrange these meetings going foNard. IMPAcf- Our 5UPPQrt services for solicitors pratti5ing in clinical negligence m&7ns 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 501icitors have the necessary expertise, experience and integrity ro 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 recogni5e a genuine specialist as all the more important as a result of current upheaval of the legal sysrem. In spite of the difficult environment for clinical negligence solicitors, interest in bein9 on AVMA'S panel remained strong. We made 5 new appointments to the panel during the year and reaccredited 15 panel members. These figures are down from I l and 29 respectively in 2020-21 . which may be a reflection of the pandemic. We also had 5 panel members retire during the year. so we are conscious of the need to recruit more. However, we are re-assured by feedback suggesting the AVMA panel accrediiatioll IS Still held in very high regard. 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 rhe panel, particularly from the most experienced senior lawyers. as well as the

Attion Agalnst Medical Accidents Report of the Board of Trustees For the year ended 31 March 2022 contribution of external inteNiewers, but always with a focus on what is in clients. best inrerests. Those benchmarks are continually changing as standards improve. We always interview new applicants. including those who have been advised they do not meet the required standard, as this enables us 10 offer advice on how they can improve. We do this as they will be providing clinical negligence advice with or without U5, $0 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. IMPA￿. 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 genulnely specialist solicitor with the approprlate quaiities. knowledge and skills. This re5uIt5 in our beneficiaries receiving more expert advice and representatlon and. in our opinion. greater likelihood of a successful outcome. AVMA'S work in Scotland As a charity registered in Scotland las 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 coniinued to liaise with bodies such as Scottish Government, NHS Improvement Scotland, Ihe Scottish Public Services Ombudsman and the Patient Advice and Support SeNice Scotland and contributed to discussions about patierbt safety and justice. In particular, we continued to engage about implementation of the Duty of Candour in Scotland. Public Benefit The Board of Trustees 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 fuiure activities. In particular, the Board considers how planned activiries will contribute to the aims and objectives thar 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 Markering & Communications Manager, in conjunction with rhe Chief Executive. However, other departmenrs also source sponsorship for events and may hold a fundraising acrivity at events. AVMA'S main fundraising comes from donations from supporters,. fundr315ing event5 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

Action Against Medical Accidents Report of the Board of Trustees For the year ended 31 March 2022 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 seryices and all commenrs, positive and negative, are reviewed regularly. Where possible, we contact people who leave negarive feedback to see if we can resolve the problem they raise. 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 plan5 for 2022-23 include- Full implementation a new CRM Idatabasel the biggest infrascructure investment AVMA has ever made, which will greatly improve our efficiency The recruitment and Induction of our new chief executive. Peter Walsh retires at the end of 2022 and is being replaced by Paul Whiteing. Further development of a 'Harmed Patient Care Pathway'i seeking to ensure a consistent approach is taken to meet the needs of harmed patients and their families Renting out three floors of our property. retaining just one for our own use Intensive policy and influencing work around the Government's expected legal reforms. including proposals for 'fixed recoverable costs, in clinical negligence and other legal reforms which we fear may be injurious to access to justice and patient safety. The launch of a new 'junior solicitor, cerrificaiion scheme to acknowledge and develop solicitors to become full panel members in the future. Continuing to work hard to try to diversify income streams and generate new income to address the forecasr operational deficit and enable maintenance of services and meeting charitable objectives long term. Obtaining accrediiation of our advice services. Commissioning a new website ANK YOU- AVMA provides all of its services to the public for free and receives no State funding. It has to rely on its own fundraising and income generation activities to keep going. We are very grateful to all of our supporters., donors., paying customers-, and business partners for making this happen. We would like to say a special thank you to the following companie5 who Supported us in 2021-22.. Partners in C05ts (Our Platinum medico-legal sponsor and organiser of famous curry nightsll BD lour PlatillUTn 'Partners for Patient Safety, corporate member) Radar Healthcare {our Gold 'Partners for Patient Safety. corporate member) Pentland Medical lour Silver 'Partners for Patient Safety. corporate member)

Action Against Medlcal Accidents Report of the Board of Trustees For the year ended 31 March 2022 cruRE GOVERNANCE 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 IAVMAI on 3 December 2003. The company was established Ltnder 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 Board of Trustees. Board of Trustees and appointment of Board members Individual trustees {members of the Board) are appointed by the Board of Trustees. Not less rhan 6 nor more than 20 Board members may be appointed. The Board may co-opt persons to fill casual vacancies provbded the maximum of 20 is not exceeded. Approximately one third of the Board must reiire each year, those being the longest serving since their previous election. Reiiring members are eligible for re-elecrion, which takes place at the annual general meeting. Recruitment of new trustees takes place as and when the Board believes this 15 necessary to add to or complement the experience. knowledge and skills available to the Board. Usually 'vacancies" for new trustees are advertised. Potential new trustees are inteNiewed by at least 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 Board together with the candidate's background details for a decision. During 2021-22 four trustee5 resigned or retired and our 'rrainee trustees were appoinied as full trustees, bringing the total number of trustees to nirke at the year end. There have been no changes since the year end. All new rrustees 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 furrher training where appropriate. Members of the charitable company guarantee to contribute an amount not exceeding £ I to the assets of the charitable company in the event of winding up. The total number of such guarantees at 31 March 2022 was 912021 1 I l. Members of the Board of Trustees have no beneficial interest in the charitable company. The Board of Trustees 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 sirategic objecrives is reviewed regularly. A 'Finance and Investment Committee. and 'Quality & Outcomes Committee, meei between Board meetings. AVMA has a trading company. AVMA Services Ltd, which is Used when there has been non- charitable trading beyond the amouni permissible by the Charity Commission. AVMA Services Ltd has been inactive in 2021-22.

Attion Against Medical Accidents Report of the Board of Trustees For the year ended 31 March 2022 Honorary Offlcers 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 2021 saw the appointment of Jocelyn Cornwell as Chair and Nigel Holland as Treasurer. The charity has decided not to coniinue to elecr a vice-chair and instead to create a position of Senior Independent Director. to which Caroline Browne was appointed in July 2022. Delegation of day to day running of the charity Trustees delegate the day to day running of the charity to the Chief Executive {currently Peter Walshl. Peter Walsh is due to retire in December 2022. 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 Board of Trustees 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 15 reached. Salary bands are set and reviewed through trustees, review of pay scales available in comparable organisations Ifor example by reviewing job advertisements and lor speaking to recruitment agencies) and by reference to the NJC and NHS Pay Scales. Annual cost of living increments are awarded ar rhe discrerion of the Board of Trustees, with reference to 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. Financial Our Medico-Legal departmenE made a contribution (calculated by income less direct costs from note 61 of £222,53 7 in the year. Other Charirable Trading generated £13 2.102 and Conferences and Training recovered after Covid-19 to generate £164.618. Fundraising wa5 Still subdued and generated a contribution of £36.830. Overall this covered the net C05t of our public-facing Advice and Information Service of £229,617, our Policy & External Relation5 Costs of £38, 592 and our support cost5, giving an overall net expenditure of £48.801 for rhe year. In addition, we had unrealised gains on investmerits of £8.224 in a challenging year. vi 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 rhe people we have helped, other supporters and sponsors. For this we are extremely grateful. The receipt of the Judith Freedman legacy in 201 I means that the charity has been abse to invest for its future. The single most significant use of the legacy was the purchase of "Freedman House" on a 999 year lease. Thi5 was revalued at £1,780,000 as at 31 March 2022. an increase of

Artion Against Medical Accidents Report of the Board of Trustee5 For the year ended 31 March 2022 £180.000 in the year,. this is £573.341 higher than the original cost. We also currently hold £1 ,194.199 in an invesrment portfolio Isee note141. As well as no longer paying rent. we are letting out some of the office space ro provide us with additional income. We have also been able 10 operare a deliberaie deficii operating budget in order to provide maximum impact to our beneficiaries from our services and operations and invest in new ideas for business developmeni. Princ tle The main risk facing the charity continues to be the uncertainty facing the future of clinical egligence litigation. Most of the charity's income is generated through the provision of services to clinical negligence lawyers. both through rhe Lawryers, Setvtce 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 facing the charity 15 the impatt of the current high levels of inflation. The charity may not be able to increase income in all areas sufficient to cover higher costs. Also. using estimates of future inflation poses a challenge to the accuracy of the financial planning process. The charity is addressing this risk by keeping it under constant review and remaining flexible in its financial planning, together wirh analysing inflation informaiion from the best sources, to include the most appropriate rates in the planning. A further principal risk is the uncerrainty 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 it5 income coming from rent and seNice charges received for two floors of Freedman House. The economic situation yneans that that office space has become harder to let. There is therefore a significant risk income fr05n this SOL5rce will drop. One floor has been leased for ten years, one floor has been leased since the year end and one further floor is being vacated by AVMA and 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 and Quality & Outcomes Committee, which report to the Board of Trustees. The risk register is also reviewed annually by the full Board at the charity's AGM.

Action Agalnst Medical Accidents Report of the Board of Trustees For the year ended 31 March 2022 Reserves and I Background and financial strategy As set out above, we are in a period when income fro￿ our traditional revenue sources is declining significantly, against a background of the current deliberate deficit budget. Current trend5 and ullcertainties lead us to expect this fall to conrinue in the coming few years. The trustees have worked hard ro develop a long-range financial strategy to address the siiuation on a timely and considered basis. Our financial strategy is to move to a sustainable balanced budger over a period of l O years to 2026127, against the background of anticipated contraction of our Eraditional revenue streams. through developing new sources of Income and making cost effticiencies in a carefully planned manner. This is reviewed each year on a rolling basis. and this year was extended by a further 3 years to 2029130. We plan to utilise our current rese￿e5 to fund the (reducing) shonfall 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 strategy period. These reserves are held as a separate designated fund, and I I l O is released each year to general funds, as per note 20. Reserves policy We own our office building, Freedman House, outrighr. This provides cover for catastrophic events. and also for an orderly wind down should thi5 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 resetrves to cover working capital requirements and realistic contingencies. This is calculated as.. Working capital.. 3 months. running costs including salaries, and 75% of conference venue Costs. Contingency reserve £1 00.000.. to cover the risk of a short-term fall in income over committed expenditure. together with operational risks and exceptional costs. At current activity levels this amounis io target reserves of £464,984. Level of reserves We have free reserves of £838,878 ar the year end. This is an excess of £373.894 agalnst the above year-end target. due primarily to the receipt of the legacy of £450,000 in the year (which was accrued at 3113121 l. Liquidity is carefully managed and the balance is in line with our long- range financial strategy as explained above.

Actlon Against Medical Accidents Report of the Board of Trustees For the year ended 31 March 2022 Inve5trnent policy The trustees have agreed to invest the reserves in an ethical invesrment porrfolio, to achieve returns that enable the funding of AVMA'S requirements borh in the short and the long-term. Short-term requiremenis {up to 3 years) are placed on deposit to achieve some return whilst ensuring appropriate liquidity. using a specialist cash management service where possible. The remaining reseNes are held within a long-term investment portfolio managed by Castlefield. The total investment ponfolio including the cash is conservatively structured with an emphasis on capital preseNation. bLtt 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. Statement of Res onslbllltles of the Board of Trustees The Board of Trustees (whose members are also directors of Actlon against Medical Accidents for the purposes of company lawl is responsible for preparing the trustees, reporr and the financial statements in accordance with applicable law and United Kingdom Accounting Standards Iunlted Kingdom Generally Accepted Accounting Practice). Company law requires the trustees 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 haritable company and the group for that period. In preparing these financial statements, the Board of Trustees are required to.. Select suitable accounting policies and then apply them consistently.. ObseNe the methods and principles in the Charities SORP- Make judgemenrs and estimates that are reasonable and prudent., State whether applicable UK Accounting Standards have been followed, subject to any material departure5 disclosed and explained in the financial statements., and Prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charitable company will continue in operation. The Board of Trustees 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 financi31 statements comply with the Companies Act 2006, the Charitie5 and Trustee Investment (Scotlandl Act 2005 and the Charities Accounts (Scotland) Regulations 2006 (as amended). li is also responsible for safeguarding the assets of the charitable company and the group and hence for raking reasonable steps for the prevention and dereccion of fraud and other irregularities. In so far a5 the Board of Trustees is aware- There is no relevant audit information of which the charitable company's auditor5 are unaware.. and

Action Agalnst Medical Accidents Report of the Board of Tru5tee5 For the year ended 31 March 2022 The Board's members have taken all steps that they ought to have taken to make themselves aware of any relevant audit information and to establish that the auditors are aware of that information. The Board of Trustees is responsible for the maintenance and integrity of the corporare and financial information included on the charitable company's websire. Legislation in the United Kingdom governing the preparation and dissemination of financial 51atements may differ from legislation in OTher jurisdicEions. Auditor Sayer Vincent LLP was re-appointed as the charitable company's auditor during the year and has expressed its willingrke55 to continue in that capacity. Approved by the Board of Trustees on 13 December 2022 and signed on its behalf by Peter Walsh Company Secretary

Independent auditor's report To the members of Action Against Medical Accidents Opinion We have audited the financial statements of Actlon against Medical Accidents (the 'charltable company'l for the year ended 31 March 2022 which comprise the statement of financial acriviries. balance sheet, statement of cash flows and notes ro the financial starements, 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 rhe Financ131 Reporting Standard applicable in rhe UK and Republic oflre/and (United Kingdom Generally Accepted Accounting Practice). In our opinion, the financial statements.. Give a true anLI fair view of the state of the charitable company's affairs as at 31 March 2022 and of its i ncoming resources and application of resources. including its income and expenditure, for the year then ended Have been properly prepared in accordance with United Kingdom Generally Accepted Accounring Practice Have been prepared in accordance with the requirements of the Companies Act 2006. the Charities and Trustee Investment (Scotlandl Act 2005 and regulation 8 of the Charities Accounis Iscorlandl Regulations 2006 las amended) Basis for opinion We conducted our audit in accordance with International Standards on Audlting (UKI IISAS IUKI) and applicable law. Our responsibilities under Ihose standards are further described in the Auditor's responsibilities for the audit of the financial statements section of our report. We are independenr of the charitable company in accordance with the ethical requirements that are relevant ro our audit of the financial statements in the UK, including the FRC'S Erhical 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 rhar, individually or collectively, may cast significant doubt on Action against Medical Accidents. ability to conrinue as a going concern for a period of at least twelve months from when the financial statements are authorised for issue.

Independent audltor's report To the members of Action Against Medical Accidents OLtr responsibiliries and the responsibilitles 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 repon, other than the financial statement5 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 othenvise 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 maierially inconsistent with the financial statements or our knowledge obtained in rhe 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 statemenrs themselves. If, based on rhe work we have performed, we conclude that there is a material misstatement of this other information, we are required 10 report that fact. We have nothlng to report in this regard. Opinions on other matters prescribed by the Companies Act 2006 In Ouf opinion. based on Ihe work underEaken in the course of the audit.. The informaiion given in the Erusrees, annijal report for Ihe financia5 year for which the financial 51atemenis are prepared 15 con5iSteni with Ihe financial statements., and The trusrees, annual repon has been prepared in accordance wilh applicable legal requiremenis 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 mi55tatements in the tru5tee5' annual report, We have nothing to report in respect of the following marrers in relation to which the Companies Act 2006 and the Charities Account5 (Scotlandl Regulations 2006 las amended) require us to report to you if, in our opinion= Adequate accounting records have not been kept. or returns adequate for our audir have not been received from branches not visited by us., or The financial statemenrs are not in agreement with the accounting records and returns- or Certain disclosures of trustees, remuneration specified by law are not made., or We have not received all the informarion and explanations we require for our audit., or

Independent auditor's report To the member5 of Artion Against Medlcal Accidents The directors were not entitled to prepare the financial statements in accordance with rhe small companies regime and take advantage of the Small companies, exemptions in preparing the trustees. annual report and from the requirement to prepare a strategic report. Re5pon5ibilities of trustees As explained more fully in the sratemenr of trustees, responsibilities set out in the tru5tees' annual report, the trustees {who are a150 rhe directors of the charirable company for the purposes of company lawl are responsible for the prepararion 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 Ilcl of the Charities and Trustee Investment (Scotlandl Act 2005 and under the Companies Act 2006 and report in accordance with regulation5 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 ro fraud or error. and to issue an audiror'5 repon that includes our opinion. Reasonable a55vrance is a high level of assurance, but is not a guaraniee Ihat an audit conducted in accordance wilh ISAS (UK) will always detect a material misstatemeni when it exists. Missiatements 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 regulation5. We design procedures in line with our responsibilities. outlined above, to detect material misstatements in respect of irregularities, including fraud. The extent EO which our procedures are capable of detecting irregularities. including fraud are set out below.

Independent auditor's report To the members of Attlon Against Medical Accidents Capability of the audit in detecting irregularities In identifying and assessing risks of material misstatement in respect of irregularities, including fraud and nors-compliance with laws and regulations, our procedures included the following: We enquired of managemenr, finance committee, which included obtaining and reviewing supporting documentation. concerning the charity'5 policies and procedures relating to.. Identifying, evaluating, and complying with laws and regulations and whether they we aware of any instances of non-compliance. Detecting and responding to the risks of fraud and whether they have knowledge of any actual, suspected, or alleged fraud- The internal controls established to mitigate risks related to fraud or non-compliance with laws and regulations. We inspected the minutes of meetings of those charged with governance. We obtained an understanding of the legal and regulatory framework thar the chariry operate5 in, focusing on those laws and regulation5 thar had a material effect on the financial statements or that had a fundamental effecr on the operations of the charity from our professional and sector experience. We communicated applicable laws and regulations throughout the audit team and remained alen to any indications of non-compliance throughout the audit. We reviewed any repon5 made to regularors. We reviewed the financial statement disclosures and tested these to supponlng documentation to assess comp5iance with applicable laws and regulations. We performed analytical procedures to identify any unusual or unexpected relationships that may indicate risk5 of material misstatement due ro fraud. In addressing the risk of fraud through management override of controls. we tested the appropriatene55 of journal entries and other adjusimenrs, assessed whether the judgements made in making accounting estimares are indicarive of a potential bias and tested significant tran5action5 that are unusua5 or those outside the normal course of business. 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 rnisstatement 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.or .uk audiioisres -￿0()51b141[les. This description forms part of our auditor's report. 20

Independent audltor's report To the members of Action Against Medlcal Accidents Use of our report This reporr 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 4411 Ilc) of rhe Charities and Trustee Investmeni (Scotlandl 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 audiror's report and for no other purpose. To the fullesi 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) Date L5 December 2022 for and on behalf of Sayer Vincent LLP, Statutory Auditor Invicta House. 108-114 Golden Lane, LONDON, ECI Y OTL Sayer Vincent LLP is eligible to act as auditor in terms of section 1212 of the Companies Act 2006

Actlo &g￿n5r Mediol Acclderrts Statement of financial activities lincorporaiing an income and expenditure account) Forthe ended 31 March 2022 2022 Total 2021 Total Restriaed Unre51ricted Restricted Unrestricted Nore l#coThe fraTh: Donaiions and legacies Charitsble all1￿￿e5 Conferentes and training Medico-le9al servios Advice, inforrnarion and 5UPPOrt (Xher trading activitiÈ5 Investments Other 72.277 72,277 518.898 518.898 437.348 392.909 785 1 62.630 56,096 437.348 392.909 785 162.630 56.096 82.675 394.370 796 140.353 50,391 228 82.675 394.370 796 140.353 50.391 228 Total I￿ome 1,122.046 1,122,046 1,187.711 Expenditure on.. ising fund5 Charitable a¢TTvr¢ies Conferences and irainjng Medico-legal servlces Adwce, informaiièn and supporr PoliLy and exTernal rel&ion5 Charitable tradlng acrivitios TO￿ ¢xpendiwr¢ 46.937 46,937 46.619 46.619 368,468 281.528 378.478 55.482 39,954 368,468 281,528 378,478 55,482 39.954 236,766 317.979 403.290 62.743 34.646 236.766 317.979 403.452 62.743 34.646 162 1,170,847 I.I70.847 162 1,102,043 1,102,205 Net (expenditure) lincome before net galns on investments 148.801) 85,668 85,506 Nei gains Qrt invesTTnents lQeT Qainsll50sses1 on iDve5tment property Revalualion gainllimpairrnent10551 on leasehdd proper Net income I (ex￿ndIt￿re) for the year 8,224 90,000 90.000 8,224 90,000 90,000 214.533 1150.000) 1150.0001 214.533 1150.0001 {150.0001 13b 13a 139.423 139,423 1162) 201 39 Reconciliation of funds.. Total funds brou9hr forbvard TO￿ funds carrled 20 3.890,800 3,890,800 162 3.890,599 3,890.761 20 4.030.223 4,030,223 3.890,800 3,890.80Q l ofthe abwe results are derwÈd from c¢ntihuing actrrfffies. There were no oiher reco9nised 9ains or l¢sses otherr￿ thos¢ srÈd abtsve. m￿MentS in fund5 are di5c105ed In Note 20 thÈ financial statements. 22

Attion against Medical Accidents Balance sheet Company no. 2239250 As at 31 March 2022 2022 2021 Note Fixed a55ets= Tangible assets.- other Tangible assets.. leasehold property Investment property Inve51ments 142.716 890,000 890,000 1.194,298 4.362 800,000 800,000 1,183,806 13a 13b 3.117.014 2.788,168 Current assets= Debtors Cash at bank and in hand 147.244 1.188.531 605.254 1,038,455 1.335.775 1.643.709 Ltabilities-. Creditors.. amount5 falling due within one year 422,566 541,077 Net current assets 913,209 1,102,632 Total net assets 4,030.223 3.890,800 The funds of the charity. Restricted income funds Unrestricted income funds.. Designated funds Fair value reserve General funds 20a 3.157,483 33.862 838.878 2.786,690 304,417 799.693 Total unresrricted funds 4.030.223 3.890,800 Total charity funds 4,030,223 3,890.800 Approved by the trustees on 13 December 2022 and signed on their behalf by Dr Jocelyn Cornwell Chair Nigel Holland Treasurer 23

Artton agalnst Medlcal Acadents Statement of cash flows Forthe ear ended 31 March 2022 Reconciliation of net income / lexpenditurel to net cash flow from operating acuvities 2022 2021 Net income for the reportln9 perlod las per the statement of financsal activities) Depreciation charges (Gains) on investments IGainlllos5 on property revaluarion Dividends. interest and rent from investments Decreasel Ilncreasel in debiors (Decreasellincrease in creditors 139.423 39 2.984 (8.2241 (180.0001 156.0961 458,010 (718.510) 11,930 1214,5331 300,000 150.3911 1509,9771 203,856 Net cash froml(used inl used In operatln9 acrlvities 237.587 1259.0761 2022 2021 Cash flows from operdting attivitie5 Net cash provided byl (used inl operating activÉties 237,587 {259.076} Cash flows from investing artivities= Dividend5, interest and rents from investments Purchase of fixed assets Proceeds from sale of investments Purchase of fixed asset investments and cash invesied into portfolio Net sale of curreni asset investments 56,096 1141,3381 1,016,152 50.391 12,2901 99,980 (1.018.421) 2,191 240,000 Net cash from investing aaivities 187.511} 390.272 Change In cash and cash equ(valents in the year I SO.076 131.196 Cash and cash equivalents ai ihe beginning of the vear 1.038.455 907.2 59 Cash and cash equlvaients at the end of the year 7,188.531 1,038.455 Analysis of cash and cash equivalents and of net debt At l April 2021 At 31 March 2022 Cash flows Cash at bank and In hand Notice deposits (less than three months) 301,962 736,493 149,044 1.032 451.006 737.525 Total cash and cash equlvalents 1,038,455 150,076 l.T88.531 Total .038.455 150.076 1,188,53T 24

Artion agaln5t Medical AccidÈnts Notes to the financial statements For the ar ended 31 March 2022 l Accounting poliaes a) Statutory infomiation 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 CRO I QG. b) Basis of preparation The financial statements have been prepared in accordance with Accounting and Reporting by Charities". Statement of Recommended Practice applicable to chariries preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland IFRS 102) (Charities SORP FRS 1021, the Financial Reporting Standard applicable in the UK and Republic of Ireland IFRS 1021 and the Companies Act 2006. Assets and liabilities are initially recognised at historical cost or transaction value unles5 Otherwise stated in the relevant accounting pcilicy or nore. c) The charitable company meets the defjnition of a public benefit entthty under FRS 102. d) Golng 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 thar have a 5ignificani risk of causing a material adjustment tci the carrying amounts of assets and liabilities within the next reporting period. including the impact of covid on the charity within the year and going fo￿ard. e) Income Income is recognised when the charity has entitlement to the fund5, 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 govÈrnment and othèr grants. whether 'capital' grants or 'revenue' grants. is recognised when rhe charity has entitlement to the funds, any performance conditions attached to the grants have been met. it is probable rhat the income will be received and the amount can be measured reliably and is not deferred. For legacies, entitlement is taken as the earlier of the date on which either.. the chariry is aware that probate has been granted, the estate has been finalised and notification has been made by the executorlsl to the charity that a distribuiion will be made, or when a disiribuiion is received from the estate. Receipt of a legacy, in whole or in part, is only considÈred probable when the amount can be rne￿ured reliably and the chariiy has been notified of the executor's intention to make a distribution. Where legacie5 have been ntstified to the charity. or the charity is aware of the granting of probate, and the criteria for income recognition have nor 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 recognirion are met. 25

Action ag￿n$t Medical Accidents Notes to the financial statements For the ear ended 31 March 2022 l Accounting policies Icontinuedl Donatlons of gifts, seThices and facilities Donated professional services and donated facilities are recognised as income when the charity has control over the item or received thÈ service, any conditions associated with the donation have been met, the receipt of economic benefir from the use by the charity of the item is probablo and that economic benefit can be measured reliably. In accordance with the Charities SORP IFRS 1021. volunteer time is not recognised so refer to the Irustees, annual report for more informarion 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 charitrl would have been willing ro pay to obtain services or facilities of equivalent economic benefit on the open market,. a corresponding amount is thèn reco9nised in expenditure in the period of receipt. gl Interest receivable Intèrest on funds held on deposit is included when receivable and the amount can bé measured reliably by the charity., this is normally upon notification of the interest paid or payable by the bank. h) Fund accounting Restricted funds are to be used for specific purposes as laid down by the donor. Expenditure which meets these criteria is chargèd to the fund. Restritted 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. i) Expenditure and irrecoverable VAT Expenditure is recognised once thére is a legal or constructive obligation to make a payment to a third party. it 15 probable that Settlement will be required and the amount of the obligation can be measured reliably. Expenditure is classified under the following activity headings.. Costs of raising funds relate to the costs incurred by the charitable company in inducing third parties to make voluntary contributions to it, as well as the cost of any activities with a fundraising purpose Expenditure on charitable artivitie5 includes the costs of delivering services, events and other educational activities undertaken to further the purposes of the charity and their associated support costs Irrecoverable VAT is charged as a cost against the activity for which the expenditure was incurred. j) Allocation of support costs Resources expended are allocated to the particular actiViD/ where the cost relates directly to that activity- Support and governance costs are re-allocated ro each of the attivitie5 on the following basis which is an estimate, based on Staff time, of the amount attributable to each activity.. Raising funds Conference5 and training Medico-legal service5 Advice. information and sijpport Policy and external relations Charitable trading attivities 24% 38% 4% Governance costs are the costs associated with the governance arrangements of the charity. These costs are associated with constitutional and SEatutory requirements and include any costs associated with the Strategic management of the charity's artivities. 26

Attlon against Medlcal Accldents Note5 to the flnancial statements For the ear ended 31 March 2022 l Accounting policies (continued) k) Operating leases Rental charges are charged on a straight line basis over the term of the lease. 11 Tangible fixed assèts Items of equipment are capitalised where the purchase price exceeds £200. Depreciation costs are allocated to activitie5 on the basis of the use of the relaied assets in rh05e activities. Assets are reviewed for impairment if circumstances indicate their carrying value may exceed Iheir nei realisable value and value in use. Where fixed assèts have been revalued, any excess between the revalued amount and the historic cost of the asset will be shown a5 a revaluation reserve in rhe balance sheet. Properly 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 irs expected useful life. The depreciation rates in use are as follows.. Computer equipment and website development 3 years Office equipment and furniture 5 years Databases l O years The leasehold property is valued under the revaluation model. No depreciation is charged on the leasehold property on the grounds of immaterially due to a long expected life and high residual value. m) Llsted investments Investments are a form of basic financial instrument and are initially recognised at their transaction value and subsequently measured at thÈir fair value a5 at the balance Sheet date using the closing quotod market price. Any change in fair value will be recognised in the statement of financial attivities 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. Inve5trnent gains and losses, whether realised or unrealised, are combined and shown ITh the heading "Net oainslllossesl on investments" in the statement of financial activities. The chariry does not acquire put options, derivatives or other complex financial instruments. Investments in subsldiaries Investments in subsidiaries are at cost. Investment properrle5 Investment properties are measured inirially at cost and subsequenily included in the balancè sheet at fair value. Investment properties are not depreciated. Any change in fair value is recognised in the starement of financial artivities. The valuation method used to determine fair value will be stared in the notes ro the accounts. ny Debtors Trade and othèr debtors are reco9nised at the settlement amount due after any trade discount offered. Prepayrnents 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 le55 from the date of acquisition or opening of the deposit or similar account. Cash balances exclude any funds held on behalf of service users. pl Creditors and provislons Creditors and provisions are recognised where the charity has a prÈsent obligation resulting from a past event that will probably result in the transfer of funds to a third pany and the amount due to setrle the obligation can be measured or estimated reliably. Creditors and provisions are normally recognised at their settlement amount after allowin9 for any trade discounts due. 27

Artion against Medlcal Accidents Notes to the financial statements For the ear ended 31 March 2022 l Accounting policies (continuÈdl q) Finan0￿ instruments The charity only has financial assets and financial liabilities of a kind that qualify as basic financial instruments. Basic financial instruments are initially recogni5ed at transattion value and subsequently measured at their settlement value with the exception of bank loans which are SL4bsequently 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 2022 Total 2021 Total Experts, donations Corporate donations Unclaimed clienis. money Legacies Other donations Corporate sponsorship Sponsored leaflet5 Other fundraising 11.121 7.315 14.113 11,496 556 19,242 456,327 9,185 7.500 13.605 987 12.670 4.750 15.552 6,756 72.277 518,898 All funds for 2022 and 2021 were unrestricted. 28

Actron against Medical Acddents Notes to the financial statements For the ear ended 31 March 2022 3 Income from charitable actlvltles 2022 Total 2021 Total Delegate. sponsor and webinar income 437.348 82,675 Tot￿.. conferences and tralnlng 437,348 82.675 Subscription fees Referral panel fees 379,709 13,200 381,920 12,450 Total: medlco-legal services 392.909 394.370 Other 785 796 Total: admce. infomiation and support 785 796 Totat income from charitable actiwtie5 831.042 477,841 All funds for 2022 and 2021 were unrestricted. 4 Income from other trading activities 2022 Total 2021 Total AVMA events Web51te subscriptions Lawyers, service dirertory Publi￿tIOnS Fees earned 2.230 108,230 10,502 12.512 29,156 101.532 11,040 12.714 15.066 162,630 140.353 All funds for 2022 and 2021 were unrestricted. 5 Income from investments 2022 Total 2021 Total Dividends and interest Rent 14.516 41.580 8.811 41,580 56.096 50,391 All funds for 2022 and 2021 were unrestricted. 29

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Acdon against Medlcal Accidents Note5 to the financial statement5 For the ear ended 31 March 2022 Net incomin9 resources for the year This is stated after charging I (crediting).. 2022 2021 Depreciation Audiror's remuneration {excluding VAn-. Audit - current year Foreign exchange lossesllgainsl 2,984 11.930 7,675 7.300 102 An￿yS1$ of staff costs, trustee remuneration and expenses. and the cost of key management personnel Staff costs were as follows." 2022 2021 Salaries and wages Social security costs Employer's contribution to defined contribution pension schemes 760.479 73.229 17,704 786,315 68,506 17.311 851,412 872,132 The following number of employees received employee benefits (excluding employer pension cosis and national insurancel during rhe year berween-. 2022 No. 2021 No. £70.000- £79.999 £60,000- £69.999 The total employee benefits including pension conrributions and ernployer's naiional insurance of the key managerneni personnel were £184,706 12021.. £141,628). The increase is due to a change in staff responslbilities since the retiremeni of Ihe deputy chief executive. The charity trustees were not paid or received any other benefits from employment with the charity in the year 12021.. £nill. No charity trustee received payment for professional or other services supplied to the charity 12021.. £nill. Trustees, expenses represents the payment or reimbursement of travel, subsistence and accommodaiion costs totalling £970 {2021- £551 incurred by 6 (2021.. 1 I members relating to attendance at trustee meetings and events and telephone costs. 32

Action agalnst Medlcal Accldents Note5 to the financial statements For the ear ended 31 March 2022 stsff numbers The average number of employees (head count based on tota number of stsff employed) during Ihe year wa5 as follows.. 2022 No. 2021 No. Raising funds Conferences and training Medico-legal Services Advice, information and suppon Policy and external relations Charitable trading activities Support Governance 22.2 24.6 The average number of employees (based on equivalent number of full-time staff employed) during the year was as follows.. 2022 No. 2021 No. Raising funds Conferences and training Medico-le9al services Advice, information and support Policy and external relations Charitable trading activities Support Governance 18.5 18.0 l O Related party transactions There are no related party transattions to disclose for 202212021: none). There are no donarions from related parties which are ourside the normal course of business and no restricted donations from related parties (2021.. none). I l Taxation The charitable company is exempt from corporarion tax as all its income 15 charirable and 15 applied for charitable purposes. 33

Attlon against Medlcal Accldents Notes to the financlal statements For the r ended 31 March 2022 12 Tangible fixed assets Office equipment and furniture Computer equipment and website MS Dynamics CRM database EMIS database Total Cost or valuation At the start of che year Additions in year 93,069 61,372 20,000 174,441 141,338 141,338 At the end of the year 93,069 61.372 20,000 141.338 315.779 Depreciation At the start of the year Charge for the year 89,726 2,580 60.353 404 20,000 170.079 2.984 At the end of the year Net book value At the end of the year 92,306 60,757 20,000 173.063 763 615 141.338 142,716 At the start of the year 3.343 1.019 4,362 All of the above assets are used for charitable purposes. The leasehold property is disclosed separately, see note 13. The Microsoft Dynamics CRM database was still in development at the year end and so no depreciation has been charged in the year. 13 Property The charity owns the leasehtsld 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 a5 investment properry. The original cost in 2013 was £1.206,6S9. The value for the total property was £2,050,000 at 3113118, £1,900,000 at 3113119 and 3113120, £1,600,000 at 3113121. The trustees obtained an informal valuation at 31 March 2022 from a property consultant, OvingtOn5. based on potential resale value. The value has increased by £180,000 10 £1.780.000 in the year as a result of adjustments in the market. This 15 £573,341 hi9her than the ori9inal cost. 34

Artion against Med1￿ Accidents Notes to the financial statsments For the ear ended 31 March 2022 13a Tangible fixed assets.. Leasehold property (ground and first floors) 2022 2021 Valuation At the start of the year 1.025.000 1 ,025.000 At the end of the year 1.025.000 1.025,000 Depreciation At the srarr of the year Impairment gains Illosses written backl 225.000 (90.000) 75,000 150,000 At the end of rhe year Net book value At the end of the year 135.000 225,000 890.000 800,000 13b Investment property (second and third floors) 2022 2021 Fair value at the start of the year Revaluation during the year 800.000 90,000 950.000 1150,0001 Fair value at the end of the year 890,000 800,000 35

Actlon against Medlcal Accidents Notes to the financial statements For the ar ended 31 March 2022 14 Investments 2022 2021 Fair value at the start of the year Additions at cost Disposal proceeds Nei gain on change in fair value Movements in cash element of portfolio 1,183.707 1,042.575 (1.016.152) 8.224 (24,155) 1.071,345 199,9801 214.533 12,191) Fair value at the end of rhe year 1.194.199 1,183,707 Hisrorlc cost at rhe end of the year 1.160.337 879.290 Investments compri5e= Investment TrustslOEICslREITslSICAVs Cash 1.185.509 8,690 1,150,863 32,844 1,194.199 99 1,183.707 99 Share in subsidary undertaking {see below) 1,194.298 1.183,806 The tota] value of the investments have reduced to £l,114.471 as at 25111122, partly as a result of the effett on the global downiurn and volarility of the markets. There is no immediate requirement for the investments, so they will be held until value recovers. bshdiary undertiknng The charitable company owns the whole of the issued ordinary share capiial 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 12021.. £991. 15 Detrtors 2022 2021 Trade debtors Other debtors Prepayments Accrued income 87.189 22.028 30.815 7.212 47,467 17,686 84,729 455,372 147.244 605,254 16 Credltors= amounts falllng due wirhin one year 2022 2021 Taxation and social security Other creditors Accruals Deferred income (note 171 40,902 39,895 39,113 302,656 50,038 18,908 37,921 434,210 422.566 541.077 36

Actlon against Iledical Accidents Notes to the finanaal statements For the ear ended 31 Marth 2022 17 Deferred income Deferred income comprises subscriptions. conference fees and other income received in advance 2022 2021 Balance at the beginning of the year Amount released ro income in the year Amount deferred in rhe year 434,210 {434.2101 302.656 270.335 1270,3351 434,210 Balance at the end of the year 302.656 434.210 18 Pension scheme The charity contributes to a defined contribution siakeholder pension scherne for its employees. ConEriburions are set out in note 8 above. Theie were no arnounts owed at 3 1 March 2022 12021 .. £nill. 19a Analy515 of net assets be￿een funds (current year) General Restricted unrestricted Fair value reserve Total fund5 Designated Tangible fixed assets - other Tangible fixed assets - database Tangible fixed assets - leasehold Investment property Fixed asset investments Net current assets 1.378 141.338 890,000 890,000 1.160,436 74,331 1.378 141.338 890.000 890,000 1,194.298 913.209 33.862 838,878 Net assets at 31 March 2022 838.878 33.862 3.1 57.483 4.030.223 19b An￿y515 of net assets be￿een funds {prior year) General unrestricted Fair value reserve To fund5 Restricted Designated Tangible fixed assets - other Tangible fixed assets - leasehold Investment property Fixed asset investments Accrued income Other net current assets 4,362 800,000 80Q,000 703,981 4.362 800,000 800,000 1.183,806 455.372 647.260 175.408 455.372 168,913 304,417 478,347 Net assets at 31 March 2021 799,693 304.417 2,786,690 3,890.800 37

Actlon against Medlcal Accidents Notrs ts• the financiaj statements For the ear ended 31 March 2022 20a Movements in funds (current yearl At l April 2021 Income & gains Expenditure & losses At 31 March 2022 Transfers Unrestricted funds- Designated funds: Fixed assets - property Fixed assets CRM database Fixed assets - other Major repairs and maintenance ICT replacement Transitional fund CRM replacement Business developmeni projects New website and finance software Laptop replacement 1,600,000 180,000 141.338 1.780.000 141.338 1,378 200.000 10.328 700.000 58.812 175.000 65.627 25.000 4,362 200,000 10.328 500.000 202,000 175,000 70,000 25,000 (2.9841 200.000 1141.3381 11.8501 14,3731 Total designated fund5 2.786,690 19.2071 380.000 3,157,483 Fair value reserve 304.417 1270.5551 33.862 General funds 799.693 1.310,270 11 161.6401 1109.4451 838.878 TO￿ unrestricted funds 3,890,800 1,310,270 11, 170,8471 4.030,223 Total funds 3.890,800 1,310,270 {1,170.847) 4.030,223 38

Action against Medical Accidents Notes to the financi￿ 5tatementS For the ear ended 31 March 2022 20b Movements in funds {prlor year) At l April 2020 Income & gains Expenditure & losses At 31 March 2021 Transfers Restricted funds: Access audir 162 (1621 Total restricted funds 162 {162) Unrestricted funds: Designated funds.. Fixed assets - property Fixed a55ets other Major repairs and maintenance ICT replacement Transitional fund Connect Asslst project CRM replacemeni Busine55 development projects New website and finance software Laptop replacement 1,900,000 14,002 200,000 12,618 600,000 6,055 1300,0001 2,290 1.600.000 4.362 200.000 10.328 soo.000 111,9301 12.2901 (i 00,0001 12.8051 202,000 175.000 70,000 25,000 13.2501 202,000 175,000 70,000 25,000 Total designated funds 2,732,67S 115.1801 69,195 2.786,690 Fair value reserve 77,363 227.054 304.417 General fund5 1.080.561 1,402,244 (1.386.863) {296.2491 799.693 Total unrestricted funds 3.890,599 1,402,244 11.402,0431 3,890,800 Total furtds 3.890.761 1,402,244 11,402,205) 3.890.800 Purpose5 of restricted funds Access audit= received from City Bridge Trust to carry out an access audit of Freedman House. The balance was spenr on similar work in 2020121. 39

Actlon ag￿nst Medld Accidents Note5 to the financial statements For the ear ended 31 March 2022 Purposes of deslgnated funds Fixed as5et- propety. the charity purchased the leasehold to Freedman House on 2 May 2013 for £1.2 million. This ha5 been carried at valuation since 31 March 2018. and is split 50'.$0 bettveen functional fixed asset5 (ground & I st floors) and investment property12nd & 3rd floors). Fixed asset- CRM databa5e- reflects the development cost to date of the new CRM database, Microsoft Dynamics. The development was noi compleie by the year end. Depreciarion will be charged ro thi5 fund in future years. Other fixed assets- reflect5 rhe reducing net book value of the ICT, website, furniture and office equipment. The transfer represents rhe cost of assets purchased in the year. Major repair5 and maintenance= for major works to maintain the value of the property in the future. I￿ replacement: to cover programme of Icf replacement. Transfers reflett Icr equipment which has been purchased during the year. Transitional fiJnd- to allow the charity ro continue to meet its charitable objects at as near a5 Possible the level of activity and impact as the year 2015116 whilst new sources of income are explored and where necessary expendsture reduced. movin9 toward a sustainable balanced budget in 2026127 in accordance with our long range financial plan. The funds are released on a straight line basis over l O years. This ha5 been rolled forward for a further 3 years 10 2029130. Connect Assist project.. to implement recommendations of Connect Assist report on data, website an(S helpline. including employment of temporary IT worker and softyvarelwebsite development Costs. The balance was spent in 202012 1 on helpline and CRM developmenr. CRM replacementr. to ctsmplete the project to replace our legacy CRM system Seneca. Includes development costs and project management. Bu5ine55 development projects-. to invest in projects to develop new recurring income streams for the future. New website and finance software= EO irnplemenr new finance software Iplicit and develop new website for the organisatlon. Laptop replacement. one-off project to replace the laprops used by all staff. Fair value reserve. this represents the unrealised gainsl1055es on fixed asset investments. 21 CapStat Ccsmmltments At the balance 5heei dare, the charity had capiial commitments of £12,729 for the balance of the CRM development work12021.. £nill. 22 Contingent assets and liabilities At the balance sheet date the charity had no contingent11abilities. 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 ro £1. 40

Actlon agalnst Medical Accidents Notes to the financial statements For the ear ended 31 March 2022 24 Post Balance Sheet events As slated in note 13 above. the ground and first floor are currently occupied by the charity. the second and third floors are rental. ThTS gives a 50-. 50 split between tangible fixed assets and inve5tmenr property. Due 10 the impact of the pandemic and the uptake in remote working, since the year end ir has been decided ro free up the firsr floor which we currently occupy and market it for rental. This will make the split 25=75. and this will be reflecred in rhe 2023 accounts. 41