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

## Action against Medical Accidents 

Report and financial statements For the year ended 31 March 2024 




Action against Medical Accidents 

## Contents 

For the year ended 31 March 2024 

Reference and administrative details  .............................................................................................. 1 Report of the Board of Trustees  ..................................................................................................... 3 Independent auditor’s report  ....................................................................................................... 18 Statement of financial activities  .................................................................................................... 23 Balance sheet  ............................................................................................................................... 24 Statement of cash flows  ............................................................................................................... 25 Notes to the financial statements  ................................................................................................. 26 



Action against Medical Accidents 

## Reference and administrative details 

For the year ended 31 March 2024 

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

|Company number|2239250||
|---|---|---|
|Country of incorporation|United Kingdom||
|Charity number|299123||
|Country of registration|England & Wales||
|OSCR number|SCO39683||
|Registered and principal|Freedman House||
|office address|Christopher Wren Yard, 117 High Street||
||CROYDON, CR0 1QG||
|Patrons|Peter Ransley  (Honorary Life President)||
||Umesh Prabhu||
||James Badenoch KC||
||Dame Professor Donna Kinnair||
|Honorary officers|Jocelyn Cornwell|Chair|
||Michele Salter|Treasurer (December 2023)|
||Caroline Browne|Senior Independent Director|
|Trustees|Michael Andersson||
||Caroline Browne||
||Janine Collier||
||Jocelyn Cornwell||
||Jane Hawdon|(appointed Sept 2023, resigned Feb 2024)|
||<br>Nigel Holland|(retired December 2023)|
||Amrat Khorana||
||Bill Kilvington||
||Carol Parsons|(appointed June 2023)|
||Farrah Pradhan|(associate trustee, appointed June 2023)|
||Michele Salter|(appointed June 2023, Treasurer from|
|||December 2023)|
|Key management personnel|Paul Whiteing|Chief Executive|
||Nathan Bacon|Operations Director|
||Nicky Rushden|Finance Manager|



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Action against Medical Accidents 

## Reference and administrative details 

## For the year ended 31 March 2024 

Bankers Co-operative Bank plc Delf House, Southway SKELMERSDALE, WN8 6NY Tavistock Private Client Ltd The Barn, Downing Park Station Rd, Swaffham Bulbeck CAMBRIDGE, CB25 0NW Independent financial Castlefield Advisory Partners Ltd advisors 8[th] floor, 111 Piccadilly MANCHESTER, M12HY 8th Floor, 111 Piccadilly,  Manchester, M1 2HY Auditor Sayer Vincent LLP Chartered Accountants and Statutory Auditors 110 Golden Lane LONDON, EC1Y 0TG Solicitors Tees Law Tees House 95 London Road Bishop’s Stortford HERTFORDSHIRE, CM23 3GW 

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Action Against Medical Accidents 

Report of the Board of Trustees 

For the year ended 31 March 2024 

The Board of Trustees presents its report and the audited financial statements for the year ended 31 March 2024. 

Reference and administrative information set out on pages 1 and 2 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 medical harm in healthcare and to help them get the outcome they need; 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 and supported 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. 

## 2023-24 in summary 

This year marked the final year of AvMA’s five-year strategic plan and the creation of the next plan covering the period 2024-2029. Trustees and senior staff spent time together at a facilitated day in October 2023 working through our vision, mission and strategic objectives for the next five years having regard to the various challenges and opportunities we face into both internally and externally. Following the day, there were a series of further discussions and iterations of the strategic plan that was then published in April 2024. A copy is available on the AvMA website, and we will report on progress in delivery against the strategy in future impact and annual reports. 

- The Board met 4 times in the year. During the year one trustee resigned for personal reasons and, after the year-end, it was decided to undertake a skills audit of trustees in order to inform the board as to gaps in the skills that should be recruited to later in 2024. 

- During the year the board agreed to engage consultants to assist in developing a more diverse and resilient income base for the charity. The consultants identified a number of potential opportunities for expanding income, not least through additional fundraising. Trustees agreed that we should expand our capacity in this area through the recruitment of a Fundraising, Marketing and Communications Director which will be completed later in 2024. 

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Action Against Medical Accidents 

## Report of the Board of Trustees 

## For the year ended 31 March 2024 

- We continued to campaign for a range of changes we would like to see to healthcare and systems of justice. In respect of healthcare, the case for senior independent advocates to support harmed patients continued to be made. In respect of access to justice, the charity made responses to government changes to the recovery of costs in litigation that were brought forward in the year such as in respect of Fixed Recoverable Costs. We also joined the charity, Inquest, in their call for a National Oversight Mechanism (NOM) for inquests. In particular, recommendations made by Coroners in Prevention of Future Death reports, which In AvMA’s experience too often get ignored need greater scrutiny and oversight. This is because opportunities for learning and improvement from patient safety incidents are often then missed. 

- The quality of advice we provided continued to get excellent feedback from those we support and we  increased the number of people we helped directly. 

- We continued to develop our work on the ‘Harmed Patient Pathway’ and had an opportunity at the 2023 Patient Safety Congress in Manchester to showcase to healthcare providers the potential benefits of such a pathway. 

- At the end of the year, we held our Annual Clinical Negligence Conference in Leeds and had the highest attendance ever (over 500 delegates) and a record level of exhibitors supporting the event. 

## 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 is something we plan to expand by seeking to reach people in disadvantaged communities who, we believe, may be in need of our services. The experience of those we support informs everything we do. In 2023-24 we directly helped 3,008 people (2,464 in 2022-23) with many others benefiting from our self-help guides and online information through our website. 

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. By the end of the year, we had around 100 volunteers working on our helpline. We are grateful to our team of trained volunteers who enable us to make this service available Monday to Friday 10am-3.30pm. In 2023-24 we advised on 2,451 calls (2,045 in 202223). These are often extremely serious and complex cases. AvMA is the only charity providing a specialist medico-legal helpline in the UK and we continue to make every effort to promote the helpline to other organisations that signpost people for advice and assistance. 

AvMA's Medico Legal Advisors are all experienced professionals and are either medically and/or legally qualified, often providing 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 2023-24 we opened 480 new casework files (413 in 2022-23). 

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Action Against Medical Accidents 

Report of the Board of Trustees 

For the year ended 31 March 2024 

IMPACT: Callers to our helpline and recipients of our written casework service frequently tell us they 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. 

## Our Inquest Service 

An important part of our public-facing work is the support we provide to families involved in healthcare-related inquests. This empowers families and maximises the opportunity for patient safety issues to be identified through either written questions or representation by counsel at the inquest hearing. The aim is to create opportunities for learning to come from the inquest, together with achieving justice and accountability for families. 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 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 skills and expertise freely. 

We gave advice and information to 70 families who were facing a forthcoming inquest, to help them prepare and/or to get legal representation at the inquest.  Some of these cases are very complex and time consuming. 

However, due to capacity constraints, we were unable to provide representation in any inquest cases (pre inquest reviews or full hearings) last year as a key member of staff left AvMA; inherent capacity issues within the department meant that the representation element of the service was suspended from October 2023 – March 2024 at which point the full service was reintroduced following successful recruitment of a new Team Leader.  The two AvMA Inquest cases which had been fixed for a full hearing in this financial year were referred to one of our panel firms, RWK Goodman who ran the cases on the same terms as AvMA’s Inquest Service. 

A number 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 (PFD) reports which may not have been achieved had we not been involved. In some circumstances Serious Investigation Reports (SIR) 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.  This is because the impetus for change comes from the trust itself, it is not imposed on it by direction of the coroner. However, there is no independent 

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Action Against Medical Accidents 

## Report of the Board of Trustees 

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organisation to confirm that the action promised has been introduced hence our support for a National Oversight Mechanism (NOM) to scrutinise such action plans. 

Supporting families at inquests was made more challenging due to the continuing after effect of the pandemic, as coroners’ courts deal with a continuing backlog of cases. Demand for the inquest service exceeds what we can supply by way of representation so we have written criteria for the cases we will take on, all applications for representation are judged against these criteria, which ensures equality and fairness in the process. 

IMPACT: People who have lost 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 families we are able to provide assistance to at the healthcare inquest hearing are represented by qualified barristers and feel empowered by having a legal representative raise relevant points of law (for example, Article 2 arguments; neglect as a rider to a conclusion) and pose questions to the coroner and other witnesses attending to give evidence 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.  It can also encourage the coroner to seek independent medical expert evidence before the full hearing thereby contributing to the coroner holding a full and fearless enquiry and ensuring that the evidence is available to be considered when the coroner arrives at their conclusion.  Early involvement before the full hearing can enable families to invite the coroner to call relevant witnesses to give evidence at the hearing which they may have omitted to do without our involvement. 

## Policy and external relations (Influencing Policy & Practice) 

Whilst the direct support we provide to those we support - 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. 

In 2023-24, AvMA policy and campaign work focused on addressing healthcare and access to justice inequalities, highlighting systemic issues within the NHS that hinder patient safety and transparency, and advocating against legal changes that would limit patients’ ability to seek redress for clinical negligence. 

AvMA emphasized the practical negative impact that changes to fixed recoverable costs rules would have for harmed patients who would most likely see their damages eaten into by legal costs even though they were the successful party. 

In total 8 consultation responses were made to government and regulatory bodies about healthcare and legal reforms putting the patient perspective: 

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Action Against Medical Accidents 

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- response to Department of Health and Social Care consultation on regulating anesthesia associates and physician associates, May 2023 

- response to Civil Procedures Rules Committee consultation on issues related to the new FRC regime, July 2023 

- consideration of Ministry of Justice response to the consultation on new Fixed Recoverable Costs regime, September 2023 

- response to the Department of Health and Social Care consultation on Fixed Recoverable Costs in lower damages clinical negligence claims – a supplementary consultation on disbursements, October 2023 

- response to Justice Committee’s new inquiry into the Coroner Service to examine progress since 2021, January 2024 

- response to Department of Health and Social Care duty of candour review: terms of reference, February 2024 

- response to Ministry of Justice review of civil legal aid, February 2024 

- evidence to Health and Social Care Committee on NHS leadership, performance and patient safety March 2024 

A further 22 media enquiries and interviews were made covering national newspapers, TV, Radio and local media. These also provided an opportunity to amplify our campaign priorities as well as raise the profile of and promote our work to those who may be in need of our services. 

The need to influence and engage with a variety of healthcare and professional regulators is also important if we are to assert our influence and bring the harmed patient perspective to policy makers’ attention. During the year we attended over 100 meetings with healthcare and professional regulators, NHSE and NHS Resolution. We also frequently met with other campaigners, charities and groups with an interest in patient safety and access to justice in order to identify opportunities for collaboration and joint campaigning opportunities alongside information sharing. 

We continued to work with NHS Resolution and Society Clinical Injury Lawyers (SCIL) on designing a successor agreement to the Clinical Negligence Protocol.  The clinical negligence protocol was introduced in 2021 to help manage the running of clinical negligence claims during the covid pandemic, an initiative which has resulted in an estimated 6% reduction in the volume of clinical negligence claims creating savings benefiting the NHS and patients.  The successor agreement (the Clinical Negligence Claims Management Agreement (CNCM)) will be rolled out in the financial year ending 31.03.2025, it builds on that successful co-operation.    The CNCM agreement introduces for the first time in a litigation process a provision where trusts which have admitted liability are expected to send a meaningful letter of apology which also identifies any patient safety lessons that have been learned from the case and any measures put in place as a result, as well as any lessons from the investigations conducted. 

IMPACT:  Our work on the need for independent advocacy and a pathway for harmed patients should mean that more people will get the right support they need in a compassionate and timely way.  Our work on ‘fixed recoverable costs’/access to justice should mean that more people retain 

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Action Against Medical Accidents 

Report of the Board of Trustees 

For the year ended 31 March 2024 

the ability to access justice and ensure health providers recognise they have made a mistake. More generally, making sure that we represent the voice of harmed patients should help ensure that in designing new approaches to patient safety, full consideration is given to the needs of patients and families which are otherwise too often neglected. 

## Conferences and training (Spreading Awareness and Good Practice) 

A record total of 1,682 delegates attended a wide range of AvMA’s in-person and online events in 2023-24. The continuing appetite among delegates and sponsors is for larger scale events which offer networking opportunities. Our flagship conference, the Annual Clinical Negligence Conference (ACNC), took place in March 2024 in Leeds and attracted 540 attendees, and a record number of exhibitors) and a healthy profit well ahead of budget. There were 659 views of our webinar content in 2023-24. 

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 are seeking the services of solicitors. In addition to awarding our AvMA panel accreditation quality mark where appropriate, AvMA continues to run a Lawyers’ Service which law firms subscribe to.  The Lawyer Service includes a database of over 600 medico-legal experts.  Experts cannot pay to be on AvMA’s database but are only accepted if they can meet the high standards required of our experts.  AvMA will provide Lawyer Service member firms with details of relevant medico legal experts to help them investigate the client/beneficiaries case as fearlessly, openly and honestly as possible, in this way AvMA helps law firms provide the best possible services in this specialist area. We keep lawyers up to date on case law and policy and help with interpreting medical issues through the Lawyer Service Newsletter. Law firms subscribe to this service, which provides AvMA’s single biggest income stream. 

IMPACT: Our support services for solicitors practicing in clinical negligence means that our beneficiaries are more likely to experience a good service and successful result.  It is cost effective for the legal firm instructing the experts as it means they can expect to receive an appropriate medico-legal report which will help them identify the case’s prospect of success at the earliest opportunity.  Those cases that do not have reasonable prospects of succeeding (success might be considered likely where prospects are greater than 50% chance although more often firms use a higher benchmark) are turned down quickly. This reduces the stress on clients and hopefully provides some answers to their questions.  Those which continue should have substantive issues and a good chance of being resolved. 

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. Being able to recognise a genuine specialist 

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Action Against Medical Accidents 

## Report of the Board of Trustees 

## For the year ended 31 March 2024 

is all the more important as a result of the 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 and we now have 180 members of the panel. 

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 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 various experienced (former) panel members who have helped us on a voluntary basis with assessing and interviewing applicants during the year. 

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. 

## Public Benefit 

The Board of Trustees is aware of the guidance contained in the Charity Commission’s general guidance on public benefit when considering the charity’s aims and objectives and in planning its future activities. In particular, the Board considers how planned activities will contribute to the aims and objectives that have been set. 

AvMA remains committed to promoting patient safety and ensuring justice for those affected by medical accidents. Over the past year, our work has delivered tangible benefits by: 

- Supporting individuals: As shown earlier through our impact statements, by providing free, expert advice and support to patients and families affected by medical accidents, helping them to navigate complex processes, access compensation and secure appropriate accountability. 

- Driving systemic change: Advocating for improvements in patient safety across the NHS and private healthcare systems through policy reform and partnerships with healthcare bodies. Our focus on preventing future harm benefits the wider public by improving safety and quality of healthcare for all. 

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Action Against Medical Accidents 

## Report of the Board of Trustees 

## For the year ended 31 March 2024 

- Raising awareness: Informing the public and professionals on patient safety issues, patient rights and the important of learning from errors. We help to empower individuals to understand their rights and secure the outcome they seek. 

## Fundraising 

AvMA is a member of the Fundraising Regulator Scheme and follows its code of conduct. AvMA’s main fundraising comes from donations from supporters; fundraising events held by other organisations benefiting AvMA; our own fundraising events; corporate sponsorship; and occasional bequests. AvMA has in the year taken professional advice about expanding its fundraising activities and will be acting on this advice.   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 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. 

## Plans for the future 

Our five-year strategic plan sets out our strategic objectives for five years from 2024-2029 and our plans for achieving them. 

All of our work plans are driven by the 4 key strategic objectives that make up the plan. These are: 

Objective one: to expand the range of communities we serve to enable more people experiencing avoidable medical harm to access services from us that meet their needs. 

Objective two: to empower more people to secure the outcomes they need following an incident of avoidable medical harm while providing caring and compassionate support. 

Objective three: to eliminate compounded harm following avoidable medical harm. 

Objective four: to have the necessary diversity of sustainable resources and capacities to deliver this strategy. 

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Action Against Medical Accidents 

## Report of the Board of Trustees 

## For the year ended 31 March 2024 

Within the context of those objectives some key priorities for 2024/25 include: 

- Completion of the implementation of a new CRM (database) – the biggest infrastructure investment AvMA has ever made, which will greatly improve our efficiency 

- Recruitment of a Fundraising, Marketing and Communication Director and devising of an ambitious fundraising plan of action aimed to both increase and diversify further AvMA’s sources of income. 

- Scoping work to expand our reach into targeted areas and groups that are currently underrepresented service users of AvMA’s 

- The re-location of the AvMA’s office to a smaller, more flexible office space 

- Further development of a ‘Harmed Patient Pathway’, seeking to ensure a consistent approach is taken to meet the needs of harmed patients and their families 

- Continuing policy and influencing work around possible further Government legal reforms, including continuing 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 the Certificates of Competence Scheme (CCS), an initiative which aims to enable AvMA to better engage with paralegals as well as newly qualified and junior solicitors.  CCS is a certification scheme comprised of three levels which intends to reflect progress and development of those participating in the scheme as they specialise in claimant clinical negligence work.  It should act as an indicator that the applicants going through the scheme are on track to become full panel members in the future, however it is not a passport to AvMA Panel Accreditation.  It will also offer the public some protection on low value claims in the event a FRC regime is introduced as lawyers who successfully complete the three stages of the CCS scheme will be able to demonstrate some level of expertise and advertise this fact.  If a FRC scheme is introduced then increasingly low value work will be undertaken by junior staff, not AvMA Panel members, this simply reflects the existing trend in the clinical negligence market. 

- Continue to consider ways in which we can meaningfully support our beneficiaries who are unable to secure legal representation now and as a FRC regime is introduced. 

- Continue to engage with NHS Resolution and in particular the Maternity Voices Group (MVAG) which is part of the Early Notification Scheme (ENS) working party to influence the way in which the ENS is delivered by them and to ensure so far as possible that families with potentially complex claims involving babies brain injured at birth understand the process and their right to legal advice. 

- Continue to engage with MNSI Maternity and Newborn Safety Investigations to promote the best service to families and to assist them wherever we can in bringing down the number of obstetric injuries occurring by promoting learning. 

- Working with other stakeholders such as Society Clinical Injury Lawyers (SCIL), Association Personal Injury Lawyers (APIL) to name but two in bringing about objectives identified in this section. 

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Action Against Medical Accidents 

Report of the Board of Trustees 

For the year ended 31 March 2024 

## “THANK 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 companies who supported us in 2023-24: 

- Those we support and others who made a donation to us or left us a legacy and to the many firms who organised fundraising events for us in the year 

- Barristers and others who provided pro bono services to our beneficiaries such as through an inquest 

- Partners in Costs (Our Platinum medico-legal sponsor and organiser of famous curry nights) 

- BD (our Platinum ‘Partners for Patient Safety’ corporate member) 

- Radar Healthcare (our Gold ‘Partners for Patient Safety’ corporate member) 

- Pentland Medical (our Silver ‘Partners for Patient Safety’ corporate member) 

We would also like to thank all of those who volunteer on our Helpline; without that support we could not provide a service that we know has such an important impact for so many of the beneficiaries who first come to us through that route. 

## 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 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 than 6 nor more than 20 Board members may be appointed. The Board may co-opt persons to fill casual vacancies provided the maximum of 20 is not exceeded. Approximately one third of the Board 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 Board believes this is 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 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 Board together with the candidate’s background details for a decision.  We also have the role of ‘associate trustees’ to help attract new talent without formal board experience so that they can gain governance experience before taking on the full 

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Action Against Medical Accidents 

## Report of the Board of Trustees 

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trustee role. They are not legally full trustees and so are not registered with Companies House or the Charity Commission. 

During 2023-24 three new trustees and one associate trustee were appointed. Two trustees resigned or retired, bringing the total number of trustees to nine at the year end. 

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. 

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. Trustees continue to be guarantors for a year following resignation. The total number of such guarantees at 31 March 2024 was 10 (2023 - 9). 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 new five-year strategic plan for 2024-25 onwards. This is accompanied by annual operational plan. Progress on meeting strategic objectives is reviewed regularly. The Finance and Investment Committee, Quality & Outcomes Committee, Income Generation Working Group and IT and Digital Support Group all meet between Board meetings. 

AvMA has a trading company, AvMA Services Ltd, which is used when there has been noncharitable trading beyond the amount permissible by the Charity Commission. AvMA Services Ltd has been inactive in 2023-24. 

## Honorary Officers 

The Board appoints members to serve as Chairperson, Treasurer and Senior Independent Director for three years at the Annual General Meeting falling closest to the end of their three-year terms as trustees.  December 2023 saw the re-appointment of Caroline Browne as Senior Independent Director and the appointment of Michele Salter as Treasurer.  Jocelyn Cornwell continues as Chair. 

## Delegation of day to day running of the charity 

Trustees delegate the day to day running of the charity to the Chief Executive. 

## Patrons 

The role of patron does not involve any legal or governance responsibilities. 

## Remuneration of key management personnel 

The Board of Trustees has a remuneration policy covering all employees. Salary levels are set and reviewed through trustees’ review of salaries 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 

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Action Against Medical Accidents 

## Report of the Board of Trustees 

## For the year ended 31 March 2024 

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 Review 

Our Medico-Legal department made a contribution (calculated by income less direct costs from note 6) of £207,923 in the year, Other Charitable Trading generated £145,642 and Conferences and Training generated £184,705. Fundraising generated a contribution of £247,065 of which £232,000 was legacies. Rent and investment income amounted to £105,722. Overall, this covered the net cost of our public-facing Advice and Information Service of £206,592, our Policy & External Relations costs of £47,267 and our support costs, giving an overall net income of £114,187 for the year. In addition we had unrealised gains of £15,672 on our investment portfolio. The value of Freedman House was written down by £120,000 in total to reflect the agreed sale price post year end. 

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 was 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 valued at £1,500,000 as at 31 March 2024, which is £120,000 lower than at 31/3/23 and £293,341 higher than the original cost.  We also currently hold £1,147,897 in an investment portfolio (see note 14). 

## 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 putting increasing pressure on our abilities to generate income. 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 in a carefully planned and staged way. The situation is kept under constant review. 

Another principal risk facing the charity is the impact 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 

14 



Action Against Medical Accidents 

## Report of the Board of Trustees 

For the year ended 31 March 2024 

financial planning, together with analysing inflation information from the best sources, to include the most appropriate rates in the planning. 

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

Trustees consider known significant risks and strategies for mitigating them through a risk register which is reviewed regularly by the Board and its committees. 

## 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 planned deficit operating budget. Current trends and uncertainties lead us to expect this fall to continue in the coming few years. We have received two generous legacies in the past 4 years; whilst very welcome, we cannot count on legacies as a reliable income stream each year. 

The trustees have 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 time, 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. This is reviewed each year on a rolling basis. 

We plan to utilise our current reserves to fund the (reducing) operating 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 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. 

The long-term financial strategy is currently under review as part of the strategic planning work and a new 5-year financial plan is being drafted. 

## Reserves policy 

At the year end we owned our office building, Freedman House, outright. This provided 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. As set out in note 23, the property was sold on 30 August 2024 for £1.5m. In the short to medium term the proceeds, ringfenced and suitably invested, will provide the same cover as above. 

15 



Action Against Medical Accidents 

## Report of the Board of Trustees 

## For the year ended 31 March 2024 

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

- Working capital: 6 months’ running costs including salaries, and 75% of conference venue costs. 

- Contingency reserve £200,000: 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 amounts to target reserves of £938,400. 

## Level of reserves 

We have free reserves of £1,019,219 at the year end. This is an excess of £80,819 against the above year-end target, due primarily to the accrual of the generous legacy from the estate of Mr G Walker of an estimated £190,000. Liquidity is carefully managed and the balance is in line with our long-range 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 to achieve some return whilst ensuring appropriate liquidity, using a specialist cash management service where possible. The remaining reserves are held 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 with an overall target return in the region of 2.5%. This target has been exceeded overall since inception, although in the current market conditions the return is not being made in the short term but is starting to recover. 

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

## Statement of Responsibilities of the Board of Trustees 

The Board of Trustees (whose members are also directors of Action against Medical Accidents for the purposes of company law) is responsible for preparing the trustees’ report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United 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 charitable 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; 

- Observe the methods and principles in the Charities SORP; 

- Make judgements and estimates that are reasonable and prudent; 

16 



Action Against Medical Accidents 

Report of the Board of Trustees 

## For the year ended 31 March 2024 

- State whether applicable UK Accounting Standards have been followed, subject to any material departures 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 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 Board of Trustees is aware: 

- There is no relevant audit information of which the charitable company’s auditors are unaware; and 

- 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 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 Board of Trustees on 12 December 2024 and signed on its behalf by 

Paul Whiteing Company Secretary 

17 



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 2024 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: 

- Give a true and fair view of the state of the charitable company’s affairs as at 31 March 2024 and of its incoming resources and application of resources, including its income and expenditure, for the year then ended 

- Have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice 

- Have been prepared in accordance with the requirements of the Companies Act 2006, the Charities and Trustee Investment (Scotland) Act 2005 and regulation 8 of the Charities Accounts (Scotland) Regulations 2006 (as amended) 

## 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. 

18 



Independent auditor’s report 

To the members of 

## Action Against Medical Accidents 

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. 

## Opinions on other matters prescribed by the Companies Act 2006 

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

- The information given in the trustees’ annual report for the financial year for which the financial statements are prepared is consistent with the financial statements; and 

- The trustees’ annual report has been prepared in accordance with applicable legal requirements 

## 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: 

- Adequate accounting records have not been kept, or returns adequate for our audit have not been received from branches not visited by us; or 

19 



Independent auditor’s report 

## To the members of 

## Action Against Medical Accidents 

- The financial statements are not in agreement with the accounting records and returns; or 

- Certain disclosures of trustees’ remuneration specified by law are not made; or 

- We have not received all the information and explanations we require for our audit; or 

- The directors were not entitled to prepare the financial statements in accordance with the 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. 

## 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 

20 



Independent auditor’s report 

To the members of 

## Action Against Medical Accidents 

misstatements in respect of irregularities, including fraud. The extent to which our procedures are capable of detecting irregularities, including fraud are set out below. 

## 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: 

- We enquired of management, finance committee, which included obtaining and reviewing supporting documentation, concerning the charity’s policies and procedures relating to: 

   - Identifying, evaluating, and complying with laws and regulations and whether they were 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 noncompliance 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 that the charity operates in, focusing on those laws and regulations that had a material effect on the financial statements or that had a fundamental effect on the operations of the charity from our professional and sector experience. 

- We communicated applicable laws and regulations throughout the audit team and remained alert to any indications of non-compliance throughout the audit. 

- We reviewed any reports made to regulators. 

- We reviewed the financial statement disclosures and tested these to supporting documentation to assess compliance with applicable laws and regulations. 

- We performed analytical procedures to identify any unusual or unexpected relationships that may indicate risks of material misstatement due to fraud. 

- In addressing the risk of fraud through management override of controls, we tested the appropriateness of journal entries and other adjustments, assessed whether the judgements made in making accounting estimates are indicative of a potential bias and tested significant transactions that are unusual 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 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 

21 



Independent auditor’s report 

To the members of 

## Action Against Medical Accidents 

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) 

## 12 December 2024 

for and on behalf of Sayer Vincent LLP, Statutory Auditor 110 Golden Lane, LONDON, EC1Y 0TG 

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

22 



## Action against Medical Accidents 

Statement of financial activities (incorporating an income and expenditure account) 

For the year ended 31 March 2024 

|Note<br>Income from:<br>2<br>3<br>3<br>3<br>4<br>5<br>6<br>6<br>6<br>6<br>6<br>Charitable trading activities<br>6<br>14<br>13b<br>13a<br>7<br>Reconciliation of funds:<br>20<br>20<br>Advice, information and support<br>Conferences and training<br>Medico-legal services<br>Donations and legacies<br>Charitable activities<br>Net income before net gains on investments<br>Other trading activities<br>Total expenditure<br>Charitable activities<br>Advice, information and support<br>Policy and external relations<br>Conferences and training<br>Medico-legal services<br>Investments<br>Other<br>Total income<br>Raising funds<br>Expenditure on:<br>Total funds carried forward<br>Total funds brought forward<br>Net gains/(losses) on investments<br>Net income/(expenditure) for the year<br>Net (losses) on investment property<br>(Impairment loss) on leasehold property|Restricted<br>£<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-|Unrestricted<br>£<br>278,241<br>521,664<br>407,641<br>9,981<br>168,531<br>105,722<br>1,185|2024<br>Total<br>£<br>278,241<br>521,664<br>407,641<br>9,981<br>168,531<br>105,722<br>1,185<br>1,492,965<br>57,386<br>462,766<br>356,977<br>389,557<br>73,477<br>38,615<br>1,378,778<br>114,187<br>15,672<br>(93,769)<br>(26,231)<br>9,859<br>3,853,152<br>3,863,011|Restricted<br>£<br>-<br>-<br>-<br>-<br>-<br>-<br>-|Unrestricted<br>£<br>183,456<br>413,712<br>405,962<br>20,882<br>167,658<br>81,669<br>14,169<br>1,287,508<br>30,684<br>409,419<br>305,678<br>377,137<br>64,254<br>36,905<br>1,224,077<br>63,431<br>(80,501)<br>(80,000)<br>(80,000)<br>(177,070)<br>4,030,223<br>3,853,152|2023<br>Total<br>£<br>183,456<br>413,712<br>405,962<br>20,882<br>167,658<br>81,669<br>14,169|
|---|---|---|---|---|---|---|
|||1,492,965||-||1,287,508|
|||57,386<br>462,766<br>356,977<br>389,557<br>73,477<br>38,615||-<br>-<br>-<br>-<br>-<br>-||30,684<br>409,419<br>305,678<br>377,137<br>64,254<br>36,905|
|||1,378,778||-||1,224,077|
|||114,187<br>15,672<br>(93,769)<br>(26,231)||-<br>-<br>-<br>-||63,431<br>(80,501)<br>(80,000)<br>(80,000)|
|||9,859<br>3,853,152||-<br>-||(177,070)<br>4,030,223|
|||3,863,011||-||3,853,152|



All funds are unrestricted. 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. 

23 



Action against Medical Accidents 

Company no. 02239250 

## Balance sheet 

## As at 31 March 2024 

|Note<br>£<br>Fixed assets:<br>Intangible assets<br>12<br>12<br>13a<br>13b<br>14<br>Current assets:<br>15<br>317,687<br>887,475<br>1,205,162<br>Liabilities:<br>16<br>185,942<br>20<br>2,822,098<br>1,040,913<br>Total unrestricted funds<br>Investments<br>Cash at bank and in hand<br>Tangible assets: other<br>Tangible assets: leasehold property<br>Investment property<br>The funds of the charity:<br>Net current assets<br>Total net assets<br>Debtors<br>Unrestricted income funds:<br>Designated funds<br>Creditors: amounts falling due within one year<br>General funds<br>Total charity funds|Note<br>£<br>Fixed assets:<br>Intangible assets<br>12<br>12<br>13a<br>13b<br>14<br>Current assets:<br>15<br>317,687<br>887,475<br>1,205,162<br>Liabilities:<br>16<br>185,942<br>20<br>2,822,098<br>1,040,913<br>Total unrestricted funds<br>Investments<br>Cash at bank and in hand<br>Tangible assets: other<br>Tangible assets: leasehold property<br>Investment property<br>The funds of the charity:<br>Net current assets<br>Total net assets<br>Debtors<br>Unrestricted income funds:<br>Designated funds<br>Creditors: amounts falling due within one year<br>General funds<br>Total charity funds|2024<br>£<br>189,884<br>5,911<br>327,884<br>1,172,116<br>1,147,996|£<br>122,840<br>1,120,102|2023<br>£<br>175,551<br>306<br>405,000<br>1,215,000<br>1,121,524|
|---|---|---|---|---|
|||2,843,791<br>1,019,220||2,917,381<br>935,771|
||1,205,162<br>185,942||1,242,942<br>307,171||
||2,822,098<br>1,040,913||2,986,185<br>866,967||
|||3,863,011||3,853,152|
|||3,863,011||3,853,152|
||||||
|||3,863,011||3,853,152|



Approved by the trustees on 12 December 2024 and signed on their behalf by 

Dr Jocelyn Cornwell Chair 

Michele Salter Treasurer 

24 



Action against Medical Accidents 

## Statement of cash flows 

## For the year ended 31 March 2024 

Reconciliation of net income/(expenditure) to net cash flow from operating activities 

|Net income/(expenditure) for the reporting period<br>(as per the statement of financial activities)<br>Depreciation and amortisation charges<br>(Gains)/losses on investments<br>Loss on property revaluation<br>Dividends, interest and rent from investments<br>(Increase)/decrease in debtors<br>(Decrease) in creditors<br>Net cash (used in) operating activities<br>Analysis of cash and cash equivalents and of net debt<br>Cash at bank and in hand<br>Notice deposits (less than three months)<br>Total cash and cash equivalents<br>Total<br>Cash and cash equivalents at the beginning of the<br>year<br>Cash and cash equivalents at the end of the year<br>Change in cash and cash equivalents in the year<br>Cash flows from operating activities<br>Net cash from investing activities<br>Cash flows from investing activities:<br>Dividends, interest and rents from investments<br>Purchase of fixed assets<br>Proceeds from sale of investments<br>Purchase of fixed asset investments and cash<br>invested into portfolio<br>Net cash (used in) operating activities|£<br>105,722<br>(44,297)<br>123,679<br>(134,479)|£<br>(283,252)<br>50,625<br>(232,627)<br>1,120,102<br>2024|2024<br>£<br>9,859<br>24,359<br>(15,672)<br>120,000<br>(105,722)<br>(194,847)<br>(121,229)|2023<br>£<br>(177,070)<br>1,072<br>80,501<br>160,000<br>(81,669)<br>24,403<br>(115,395)|
|---|---|---|---|---|
||||(283,252)|(108,158)|
||||£<br>81,669<br>(34,213)<br>-<br>(7,727)|£<br>(108,158)<br>39,729<br>(68,429)<br>1,188,531<br>2023|
||||Cash flows<br>£<br>85,285<br>(317,912)||
|||887,475||1,120,102|
|||At 1 April<br>2023<br>£<br>171,780<br>948,322||At 31 March<br>2024<br>£<br>257,065<br>630,410|
|||1,120,102|(232,627)|887,475|
|||1,120,102|(232,627)|887,475|



25 



Action against Medical Accidents 

Notes to the financial statements 

## For the year ended 31 March 2024 

## 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 on the charity within the year and going forward. 

## 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. 

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. 

26 



Action against Medical Accidents 

Notes to the financial statements 

## For the year ended 31 March 2024 

- 1 Accounting policies (continued) 

- 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. 

- h) Fund accounting 

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 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: 

- 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 activities 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 activity where the cost relates directly to that activity. 

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: 

||Raising funds|5%|
|---|---|---|
||Conferences and training|24%|
||Medico-legal services|30%|
||Advice, information and support|33%|
||Policy and external relations|5%|
||Charitable trading activities|3%|



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. 

27 



Action against Medical Accidents 

Notes to the financial statements 

## For the year ended 31 March 2024 

## 1 Accounting policies (continued) 

- k) Operating leases 

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

- l) Fixed assets 

   - Items of equipment are capitalised where the purchase price exceeds £500. 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: 

- Computer equipment and website development 3 years 

- Office equipment and furniture 5 years  Databases 10 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) 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. 

## 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. 

28 



Action against Medical Accidents 

Notes to the financial statements 

## For the year ended 31 March 2024 

## 1 Accounting policies (continued) 

## 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<br>Corporate donations<br>Unclaimed clients' money<br>Legacies<br>Other donations<br>Other fundraising|2024<br>Total<br>£<br>7,806<br>24,428<br>715<br>232,000<br>7,725<br>5,567|2023<br>Total<br>£<br>9,767<br>38,452<br>2,287<br>123,938<br>3,923<br>5,089|
||278,241|183,456|



All funds for 2024 and 2023 were unrestricted. 

29 



Action against Medical Accidents 

## Notes to the financial statements 

## For the year ended 31 March 2024 

- 3 Income from charitable activities 

|Income from charitable activities|||
|---|---|---|
|Sponsored leaflets<br>Corporate sponsorship<br>AvMA events<br>Fees earned<br>Referral panel fees<br>Income from other trading activities<br>Total: advice, information and support<br>Total: conferences and training<br>Subscription fees<br>Website subscriptions<br>Publications<br>Total: medico-legal services<br>Other<br>Lawyers' service directory<br>All funds for 2024 and 2023 were unrestricted.<br>All funds for 2024 and 2023 were unrestricted.<br>Rent<br>Delegate, sponsor and webinar income<br>Total income from charitable activities<br>Dividends and interest<br>Income from investments|2024<br>Total<br>£<br>521,664|2023<br>Total<br>£<br>413,712|
||521,664|413,712|
||392,553<br>15,088|392,745<br>13,217|
||407,641|405,962|
||9,981<br>-|20,120<br>762|
||9,981|20,882|
||939,286|840,556|
||2024<br>Total<br>£<br>5,569<br>131,958<br>5,927<br>13,006<br>1,169<br>10,902|2023<br>Total<br>£<br>4,655<br>115,881<br>14,152<br>12,455<br>10,871<br>9,644|
||168,531|167,658|
||2024<br>Total<br>£<br>56,781<br>48,941|2023<br>Total<br>£<br>21,823<br>59,846|
||105,722|81,669|



- 4 Income from other trading activities 

- 5 Income from investments 

All funds for 2024 and 2023 were unrestricted. 

30 



Action against Medical Accidents 

Notes to the financial statements 

## For the year ended 31 March 2024 

- 6a Analysis of expenditure (current year) 

## Charitable activities 

|Staff costs (Note 8)<br>Direct cost of events<br>Travel, subsistence and accommodation<br>Call handling<br>Investment management fees<br>Other professional fees<br>Office costs<br>Premises costs<br>Depreciation<br>Training and development<br>Major projects<br>Sundry<br>Direct expenditure<br>Support costs<br>Governance costs<br>Total expenditure 2024<br>Total expenditure 2023|Cost of<br>raising funds<br>£<br>30,886<br>-<br>-<br>-<br>-<br>-<br>290<br>-<br>-<br>-<br>-<br>-|Conferences<br>and training<br>£<br>140,913<br>196,041<br>5<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-|Medico-legal<br>services<br>£<br>196,751<br>270<br>108<br>-<br>-<br>-<br>2,589<br>-<br>-<br>-<br>-<br>-|Advice,<br>information<br>and support<br>£<br>205,098<br>-<br>200<br>6,447<br>-<br>-<br>349<br>4,479<br>-<br>-<br>-<br>-|Policy and<br>external<br>relations<br>£<br>46,864<br>-<br>403<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-|Charitable<br>trading<br>activities<br>£<br>21,943<br>578<br>-<br>-<br>-<br>-<br>368<br>-<br>-<br>-<br>-<br>-|Governance<br>costs<br>£<br>31,771<br>-<br>916<br>-<br>-<br>11,937<br>1,754<br>-<br>-<br>-<br>-<br>26|Support costs<br>£<br>233,425<br>-<br>1,496<br>-<br>11,516<br>31,878<br>65,383<br>95,647<br>24,359<br>2,977<br>5,098<br>6,013|2024<br>Total<br>£<br>907,651<br>196,889<br>3,128<br>6,447<br>11,516<br>43,815<br>70,733<br>100,126<br>24,359<br>2,977<br>5,098<br>6,039|2023<br>Total<br>£<br>895,141<br>176,540<br>1,304<br>4,147<br>9,377<br>25,882<br>68,050<br>37,262<br>1,072<br>568<br>4,180<br>555|
|---|---|---|---|---|---|---|---|---|---|---|
||31,176<br>23,890<br>2,320|336,959<br>114,670<br>11,137|199,718<br>143,338<br>13,921|216,573<br>157,671<br>15,313|47,267<br>23,890<br>2,320|22,889<br>14,334<br>1,392|46,404<br>-<br>(46,404)|477,791<br>(477,791)<br>-|1,378,778<br>-<br>-|1,224,077|
||57,386|462,766|356,977|389,557|73,477|38,615|-|-|1,378,778|1,224,077|
||30,684|409,419|305,678|377,137|64,254|36,905|-|-||1,224,076|



31 



Action against Medical Accidents 

Notes to the financial statements 

## For the year ended 31 March 2024 

- 6b Analysis of expenditure (previous year) 

|Staff costs (Note 8)<br>Direct cost of events<br>Travel, subsistence and accommodation<br>Call handling<br>Investment management fees<br>Other professional fees<br>Office costs<br>Premises costs<br>Depreciation<br>Training and development<br>Major projects<br>Sundry<br>Direct expenditure<br>Support costs<br>Governance costs<br>Total expenditure 2023|Cost of<br>raising funds<br>£<br>19,469<br>-<br>-<br>-<br>-<br>-<br>294<br>-<br>-<br>-<br>-<br>-||Charitable activities|Charitable activities|Charitable activities||Governance<br>costs<br>£<br>32,220<br>-<br>589<br>-<br>-<br>9,100<br>990<br>-<br>-<br>568<br>-<br>86|Support costs<br>£<br>233,252<br>-<br>586<br>-<br>9,377<br>16,765<br>58,949<br>37,262<br>1,072<br>-<br>4,180<br>(526)|2023<br>Total<br>£<br>895,141<br>176,540<br>1,304<br>4,147<br>9,377<br>25,882<br>68,050<br>37,262<br>1,072<br>568<br>4,180<br>555|
|---|---|---|---|---|---|---|---|---|---|
|||Conferences<br>and training<br>£<br>139,085<br>170,835<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-|Medico-legal<br>services<br>£<br>182,633<br>819<br>-<br>-<br>-<br>-<br>3,126<br>-<br>-<br>-<br>-<br>995|Advice,<br>information<br>and support<br>£<br>221,425<br>762<br>82<br>4,147<br>-<br>18<br>4,691<br>-<br>-<br>-<br>-<br>-|Policy and<br>external<br>relations<br>£<br>44,792<br>-<br>48<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-|Charitable<br>trading<br>activities<br>£<br>22,265<br>4,123<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-||||
||19,763<br>9,745<br>1,176|309,920<br>88,785<br>10,714|187,573<br>105,387<br>12,718|231,124<br>130,290<br>15,723|44,840<br>17,324<br>2,091|26,388<br>9,384<br>1,132|43,553<br>-<br>(43,553)|360,915<br>(360,915)<br>-|1,224,077<br>-|
||30,684|409,419|305,678|377,137|64,254|36,905|-|-|1,224,077|



32 



Action against Medical Accidents 

## Notes to the financial statements 

## For the year ended 31 March 2024 

- 7 Net incoming resources for the year 

This is stated after charging / (crediting): 

|This is stated after charging / (crediting):|||
|---|---|---|
||2024|2023|
||£|£|
|Depreciation|24,359|1,072|
|Auditor's remuneration (excluding VAT):|||
|Audit - current year|9,500|8,850|
|Foreign exchange (gains)|(33)|(71)|



8 Analysis of staff costs, trustee remuneration and expenses, and the cost of key management personnel Staff costs were as follows: 

|Staff costs were as follows:|||
|---|---|---|
|Employer’s contribution to defined contribution pension schemes<br>Salaries and wages<br>Social security costs|2024<br>£<br>814,201<br>74,806<br>18,644|2023<br>£<br>802,790<br>74,482<br>17,869|
||907,651|895,141|



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

|||2024|2023|
|---|---|---|---|
|||No.|No.|
|£80,000|- £89,999|2|-|
|£70,000|- £79,999|-|1|
|£60,000|- £69,999|-|1|



The total employee benefits including pension contributions and employer's national insurance of the key management personnel were £202,155 (2023: £200,731). 

The charity trustees were not paid or received any other benefits from employment with the charity in the year (2023: £nil). No charity trustee received payment for professional or other services supplied to the charity (2023: £nil). 

Trustees' expenses represents the payment or reimbursement of travel, subsistence and accommodation costs totalling £807 (2023: £216) incurred by 7 (2023: 2) members relating to attendance at trustee meetings and events and telephone costs. 

33 



## Action against Medical Accidents 

## Notes to the financial statements 

## For the year ended 31 March 2024 

## 9 Staff numbers 

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

|Raising funds<br>Medico-legal services<br>Conferences and training<br>Advice, information and support<br>Support<br>Governance<br>Policy and external relations<br>Charitable trading activities|2024<br>No.<br>0.6<br>3.7<br>4.5<br>4.8<br>0.7<br>0.4<br>5.6<br>0.5|2023<br>No.<br>0.4<br>3.6<br>4.3<br>5.3<br>0.7<br>0.4<br>5.4<br>0.5|
|---|---|---|
||20.8|20.6|



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

|Governance<br>Charitable trading activities<br>Advice, information and support<br>Policy and external relations<br>Support<br>Raising funds<br>Conferences and training<br>Medico-legal services|2024<br>No.<br>0.6<br>3.0<br>3.6<br>4.1<br>0.6<br>0.4<br>4.8<br>0.5|2023<br>No.<br>0.4<br>3.0<br>3.8<br>5.0<br>0.7<br>0.3<br>4.6<br>0.5|
|---|---|---|
||17.6|18.3|



## 10 Related party transactions 

There are no related party transactions to disclose for 2024 (2023: none). 

There are no donations from related parties which are outside the normal course of business and no restricted donations from related parties (2023: none). 

## 11 Taxation 

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

34 



## Action against Medical Accidents 

## Notes to the financial statements 

## For the year ended 31 March 2024 

## 12 Tangible and intangible fixed assets 

|At the end of the year<br>Depreciation<br>Net book value<br>Cost or valuation<br>At the end of the year<br> <br>Charge for the year<br>At the end of the year<br>At the start of the year<br>Eliminated on disposal<br>Written off in year<br>At the start of the year<br>Additions in year<br>At the start of the year|Computer<br>equipment<br>and website<br>(Tangible)<br>£<br>93,069<br>8,866<br>(55,323)<br>|Office<br>equipment<br>and<br>furniture<br>(Tangible)<br>£<br>61,372<br>-<br>(55,004)|EMIS<br>database<br>(Intangible)<br>£<br>20,000<br>-<br>(20,000)|MS Dynamics<br>CRM<br>database<br>(Intangible)<br>£<br>175,551<br>35,431<br>-|Total<br>£<br>349,992<br>44,297<br>(130,327)|
|---|---|---|---|---|---|
||46,612|6,368|-|210,982|263,962|
||93,069<br>2,955<br>(55,323)|61,066<br>306<br>(55,004)|20,000<br>-<br>(20,000)|-<br>21,098<br>-|174,135<br>24,359<br>(130,327)|
||40,701|6,368|-|21,098|68,167|
||5,911|-|-|189,884|195,795|
||-|306|-|175,551|175,857|



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; the majority of the work was complete and some modules were completed and in use and so a full year's depreciation has been charged on the costs to date. 

## 13 Property 

At the year end the charity owned the leasehold to Freedman House which comprises 4 floors. During the year the ground floor was occupied by the charity and disclosed as tangible fixed assets. The first, second and third floors were rental and disclosed as investment property. This allocation has been changed slightly to reflect exact floor areas of 21.9% fixed assets and 78.1% investment property. Per note 23, Freedman House was sold subsequent to the year end. 

The original total cost in 2013 was £1,206,659. The value for the total property at the year end was £1,500,000; this is the agreed sale price, which was confirmed in a S119 report by Savills (UK) Limited. This value is £120,000 lower than the value at 31 March 2023 and £293,341 higher than the original cost. 

35 



Action against Medical Accidents 

## Notes to the financial statements 

## For the year ended 31 March 2024 

## 13a Tangible fixed assets: Leasehold property 

(Ground floor only) 

|Tangible fixed assets: Leasehold property<br>(Ground floor only)|||
|---|---|---|
|Transfer to investment property<br>Transfer to investment property<br>Transfer from investment property (first floor)<br>At the start of the year<br>At the end of the year<br>Fair value at the start of the year<br>Fair value at the end of the year<br>At the end of the year<br>At the end of the year<br>At the start of the year<br>Net book value<br>Depreciation<br>(First, second and third floors)<br>Valuation<br>Investment property<br>Revaluation during the year<br>Impairment gains /(losses written back)|2024<br>£<br>512,500<br>(64,392)|2023<br>£<br>1,025,000<br>(512,500)|
||448,108|512,500|
||107,500<br>26,231<br>(13,507)|135,000<br>80,000<br>(107,500)|
||120,224|107,500|
||327,884|405,000|
||2024<br>£<br>1,215,000<br>(93,769)<br>50,885|2023<br>£<br>890,000<br>(80,000)<br>405,000|
||1,172,116|1,215,000|



## 13b Investment property 

36 



Action against Medical Accidents 

## Notes to the financial statements 

## For the year ended 31 March 2024 

## 14 Investments 

|Investments|||
|---|---|---|
|Fair value at the end of the year<br>Share in subsidiary undertaking (see below)<br>Investment Trusts/OEICs/REITs/SICAVs<br>Historic cost at the end of the year<br>Net gain/(loss) on change in fair value<br>Fair value at the start of the year<br>Additions at cost<br>Movements in cash element of portfolio<br>Cash<br>Disposal proceeds<br>Investments comprise:|2024<br>£<br>1,121,425<br>123,509<br>(123,679)<br>15,672<br>10,970|2023<br>£<br>1,194,199<br>-<br>-<br>(80,501)<br>7,727|
||1,147,897|1,121,425|
||1,163,911|1,160,336|
||1,120,511<br>27,386|1,105,008<br>16,417|
||1,147,897<br>99|1,121,425<br>99|
||1,147,996|1,121,524|



The value of the investments has recovered well and was £1,172,492 as at 24/10/24, which is greater than cost. 

## 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 (2023: £99). 

## 15 Debtors 

|Debtors|||
|---|---|---|
|Trade debtors<br>Other debtors<br>Prepayments<br>Accrued income|2024<br>£<br>59,820<br>34,413<br>27,052<br>196,402|2023<br>£<br>65,161<br>28,065<br>23,364<br>6,250|
||317,687|122,840|



16 Creditors: amounts falling due within one year 

|Creditors: amounts falling due within one year|||
|---|---|---|
|Taxation and social security<br>Other creditors<br>Accruals<br>Deferred income (note 17)|2024<br>£<br>23,609<br>10,033<br>44,610<br>107,690|2023<br>£<br>36,709<br>19,853<br>76,640<br>173,969|
||185,942|307,171|



37 



## Action against Medical Accidents 

## Notes to the financial statements 

## For the year ended 31 March 2024 

## 17 Deferred income 

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

|Balance at the beginning of the year<br>Amount released to income in the year<br>Amount deferred in the year<br>Balance at the end of the year|2024<br>£<br>173,969<br>(173,969)<br>107,690|2023<br>£<br>302,656<br>(302,656)<br>173,969|
|---|---|---|
||107,690|173,969|



## 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 2024 (2023: £nil). 

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

|Investment property<br>Net assets at 31 March 2024<br>Tangible fixed assets - other<br>Tangible fixed assets - leasehold<br>Fixed asset investments<br>Intangible fixed assets - database<br>Net current assets|Restricted<br>£<br>-<br>-<br>-<br>-<br>-<br>-|General<br>unrestricted<br>£<br>-<br>-<br>-<br>-<br>21,693<br>1,019,220|Fair value<br>reserve<br>£<br>-<br>-<br>-<br>-<br>-<br>-|Designated<br>£<br>189,884<br>5,911<br>327,884<br>1,172,116<br>1,126,303<br>-|Total<br>funds<br>£<br>189,884<br>5,911<br>327,884<br>1,172,116<br>1,147,996<br>1,019,220|
|---|---|---|---|---|---|
||-|1,040,913|-|2,822,098|3,863,011|



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

|Investment property<br>Net current assets<br>Fixed asset investments<br>Tangible fixed assets - other<br>Intangible fixed assets - database<br>Tangible fixed assets - leasehold<br>Net assets at 31 March 2023|Restricted<br>£<br>-<br>-<br>-<br>-<br>-<br>-|General<br>unrestricted<br>£<br>-<br>-<br>-<br>-<br>-<br>866,967|Fair value<br>reserve<br>£<br>-<br>-<br>-<br>-<br>-<br>-|Designated<br>£<br>175,551<br>306<br>810,000<br>810,000<br>1,121,524<br>68,804|Total<br>funds<br>£<br>175,551<br>306<br>810,000<br>810,000<br>1,121,524<br>935,771|
|---|---|---|---|---|---|
||-|866,967|-|2,986,185|3,853,152|



38 



Action against Medical Accidents 

## Notes to the financial statements 

## For the year ended 31 March 2024 

## 20a Movements in funds (current year) 

|Total designated funds<br>Fair value reserve<br>General funds<br>Business development projects<br>Unrestricted funds:<br>Fixed assets - property<br>Fixed assets - other<br>ICT replacement<br>Transitional fund<br>Designated funds:<br>Digital strategy<br>Patient safety campaign<br>Fundraising investment<br>Laptop replacement<br>CRM replacement<br>Major repairs and maintenance<br>New website and finance software<br>Property update and file clearing<br>Total unrestricted funds<br>Total funds<br>Fixed assets - CRM database|At 1 April<br>2023<br>£<br>1,620,000<br>175,551<br>306<br>200,000<br>75,000<br>10,328<br>25,000<br>600,000<br>110,000<br>120,000<br>10,000<br>10,000<br>30,000<br>-|Income &<br>gains<br>£<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-|Expenditure<br>& losses<br>£<br>-<br>-<br>-<br>-<br>(35,431)<br>-<br>(8,866)<br>-<br>-<br>(5,098)<br>-<br>-<br>(17,759)<br>-|Transfers<br>£<br>(120,000)<br>14,333<br>5,605<br>-<br>2,629<br>(10,328)<br>7,571<br>(100,000)<br>(100,000)<br>5,098<br>(5,100)<br>-<br>3,259<br>200,000|At 31 March<br>2024<br>£<br>1,500,000<br>189,884<br>5,911<br>200,000<br>42,198<br>-<br>23,705<br>500,000<br>10,000<br>120,000<br>4,900<br>10,000<br>15,500<br>200,000|
|---|---|---|---|---|---|
||2,986,185|-|(67,154)|(96,933)|2,822,098|
||-<br>866,966|-<br>1,492,965|-<br>(1,415,952)|-<br>96,933|-<br>1,040,913|
||3,853,152|1,492,965|(1,483,106)|-|3,863,011|
||3,853,152|1,492,965|(1,483,106)|-|3,863,011|



39 



Action against Medical Accidents 

## Notes to the financial statements 

## For the year ended 31 March 2024 

## 20b Movements in funds (prior year) 

|Movements in funds (prior year)||||||
|---|---|---|---|---|---|
|Total designated funds<br>Fair value reserve<br>General funds<br>Total funds<br>ICT replacement<br>Fixed assets - other<br>Major repairs and maintenance<br>Transitional fund<br>Fixed assets - CRM database<br>CRM replacement<br>Business development projects<br>New website and finance software<br>Laptop replacement<br>Total unrestricted funds<br>Digital strategy<br>Patient safety campaign<br>Property update and file clearing<br>Unrestricted funds:<br>Designated funds:<br>Fixed assets - property|At 1 April<br>2022<br>£<br>1,780,000<br>141,338<br>1,378<br>200,000<br>58,812<br>10,328<br>25,000<br>700,000<br>175,000<br>65,627<br>-<br>-<br>-|Income &<br>gains<br>£<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-<br>-|Expenditure<br>& losses<br>£<br>-<br>-<br>-<br>-<br>(34,213)<br>-<br>-<br>-<br>-<br>(4,180)<br>-<br>-<br>-|Transfers<br>£<br>(160,000)<br>34,213<br>(1,072)<br>-<br>50,401<br>-<br>-<br>(100,000)<br>(65,000)<br>58,553<br>10,000<br>10,000<br>30,000|At 1 April<br>2023<br>£<br>1,620,000<br>175,551<br>306<br>200,000<br>75,000<br>10,328<br>25,000<br>600,000<br>110,000<br>120,000<br>10,000<br>10,000<br>30,000|
||3,157,483|-|(38,393)|(132,905)|2,986,185|
||33,862<br>838,878|-<br>1,287,508|-<br>(1,426,186)|(33,862)<br>166,767|-<br>866,967|
||4,030,223|1,287,508|(1,464,579)|-|3,853,152|
||4,030,223|1,287,508|(1,464,579)|-|3,853,152|



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Action against Medical Accidents 

Notes to the financial statements 

## For the year ended 31 March 2024 

## Purposes of designated funds 

Fixed asset - property: 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 as at 31/3/23 is split 25:75 between functional fixed assets (ground floor) and investment property (1st, 2nd & 3rd floors). Per note 23, the property was sold on 30 August 2024 . 

Fixed asset - CRM database: reflects the development cost to date of the new CRM database, Microsoft Dynamics. This was still in development at the year end; the majority of the work was complete and some modules were completed and in use and so a full year's depreciation has been charged on the costs to date. 

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. 

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 2026/27 in accordance with our long range financial plan. The funds are released on a straight line basis over 10 years. This was rolled forward for a further 3 years to 2029/30. 

CRM replacement: to complete the CRM database project to replace our legacy 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 . 

Digital strategy : to commission consultancy for production of an overarching digital strategy for the charity . 

Patient safety campaign: costs associated with developing new patient safety campaign, such as the Harmed Patient Pathway. 

Property update and file clearing: to smarten up Freedman House and clear/digitise stored documents. 

Fundraising investment: to invest in further fundraising capability and support tools, in line with work with our income generation consultants. 

Fair value reserve : this represents any unrealised gains on fixed asset investments. 

## 21 Capital commitments 

At the balance sheet date, the charity had capital commitments of £6,734 for further work on development of the CRM (2023: £4,725). 

## 22 Contingent assets and liabilities 

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

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Action against Medical Accidents 

Notes to the financial statements 

## For the year ended 31 March 2024 

## 23. Post balance sheet events 

After the year end the charity was approached with a fair offer to sell Freedman House. After appropriate due diligence including a s119 valuation report, the offer was accepted. The sale completed on 30 August 2024. The value of the property has been written down to the sale price of £1.5m, see note 8. 

## 24 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. 

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